Liv Hospital Pediatric Endocrinology and Metabolic Diseases, Prof. Dr. Cengiz Kara drew attention to the importance of the first thousand days in babies. prof. Dr. Cengiz Kara's first 1000 days is an increasingly common term that defines the period from the beginning of pregnancy to the second birth anniversary of the baby. It represents the sum of 270 days of pregnancy and the first 730 days after delivery. Today, a sensitive period to improve child and community health is considered as a “window of opportunity”.
What is the significance of the “first 1000 days”?
Kara emphasized that negative events in the womb and childhood paved the way for chronic diseases such as obesity, heart diseases and diabetes. prof. Dr. Cengiz Kara, "These diseases, the foundation of which was laid in the womb, are explained by "metabolic programming", the lifelong harmful effects of adverse events in the first 1000 days. Problems related to nutrition and growth-development in the prenatal and postnatal periods affect the development of cells and organs, change the body structure, disrupt the physiological system and create an imbalance in regulatory mechanisms. Changes in endocrine and metabolic responses are accompanied by 'epigenetic effects' that change the way genes work, resulting in deleterious effects that can last a lifetime and even be passed on to future generations.” made statements.
The foundation of diseases is laid in the first 1000 days
Emphasizing that metabolic programming caused by nutritional problems in the womb period and postpartum, emerges as obesity, type 2 diabetes and cardiovascular diseases in adulthood. Dr. Cengiz Kara “Obesity is the state of excessive and abnormal fat accumulation in the body, especially in the abdomen and around the internal organs. When this excessive fat accumulation is accompanied by insulin resistance, type 2 diabetes, hypertension and disorders in blood fat levels (dyslipidemia), it is called metabolic syndrome. Metabolic syndrome is also an important health problem, which is accompanied by diseases such as fatty liver, cirrhosis, coronary heart diseases and stroke, which seriously impairs the quality of life and can cause premature death. Today, obesity and metabolic syndrome component diseases are responsible for 60% of deaths all over the world, and the basis of these chronic diseases is laid in the first 1000 days. he said..
Kara explained 3 types of mechanisms that lead to early metabolic programming:
“Incompatibility with overnutrition in the postpartum period following malnutrition in the womb.
Overfeeding of the fetus in the womb.
Early rapid growth with postnatal overnutrition.”
Drawing attention to the nutritional process of the mother during pregnancy, Kara said, "Weakness of the mother, malnutrition during pregnancy, low weight gain and high blood pressure etc. Damage to the uterine vessels due to diseases disrupts the nutrition of the fetus and causes it to be born with low birth weight. This chronic hunger and malnutrition period in the mother's womb causes the baby to develop a 'frugal structure' that stores every energy it finds and tries to minimize its consumption. The effort of overfeeding with the haste to raise this small and weak baby, which is programmed to manage with less calories, backfires and causes excessive fat (energy) accumulation in the baby. On the other hand, the fact that the mother is obese, gaining excess weight during pregnancy and high sugar levels due to uncontrolled diabetes cause the baby to be overfed while still in the womb, to grow rapidly and eventually to be born with excess birth weight. Fat tissue and appetite are congenitally greater in large babies who encounter excess calories in the womb. The risk of lifelong obesity and diabetes increases in these children who are born obese and have an appetite, as babies of obese and/or diabetic mothers. In addition, even if the baby is born with a normal weight mother with a normal weight, excessive caloric intake after birth causes the baby to become fat. The effects of rapid postnatal weight gain and early rapid growth due to reasons such as not being able to breastfeed, over-feeding with formulas, and early initiation of high-calorie complementary foods are not limited to the early childhood period. he added.
prof. Dr. Cengiz Kara explained what needs to be done in the first 1000 days to prevent obesity and metabolic syndrome as follows:
“Before pregnancy, the body mass index of the mother should be normalized, pregnant women who are overweight should lose weight, and those who are weak should gain weight and reach their ideal body weight.
Smoking should be avoided during pregnancy and lactation.
Exercises should be continued to the extent that the body can be lifted during pregnancy, and excess weight gain should be avoided.
Strict sugar control should be ensured in those with gestational diabetes.
Rapid weight gain should be avoided in babies born with low birth weight, and catching growth should be achieved at a slow pace until the age of 1-2 years.
After birth, babies should be fed only with breast milk for 6 months and breastfeeding should be continued until the age of 2 years.
The initiation of solid foods and sugary drinks should be delayed. In particular, solid foods should not be started early in those who are fed with formula, since breast milk cannot be given.
After the baby is full, it should not be forced to finish the meal.
High protein intake should be restricted in infancy. Low-protein formulas should be preferred in infants who cannot take breast milk.
Cow's milk has a high protein density and should not be given to babies in the first year.
The growth of babies of obese mothers should be closely monitored. If there is rapid weight gain, breastfeeding should be controlled. In the transition period to supplementary food, foods with low energy density should be chosen.