Effets à long terme de la nutrition au début de la vie : les enseignements de l'étude ELANCE

There is increasing evidence that early life environment has an impact on adult health. The early adiposity rebound recorded in most obese subjects suggests that factors promoting body fat development have operated early in life. Some twenty years ago, the two-decade-long ELANCE prospective study showed that high intake of protein in early life was associated with an early adiposity rebound and later overweight. These results have been confirmed by various studies. Recently, the ELANCE study showed that early low fat intakes were associated with high adult body fat and high leptin concentration, suggesting a programming of leptin resistance by early dietary fat restriction. These results have also highlighted the inadequate nutrient balance of the infant diet in industrialized countries. Protein intake represents about 4 times the protein needs and fat intake is remarkably low, contrasting with the high fat-low protein content of human milk and with official recommendations that fat intake should not be restricted before the age of 3 years. An imbalanced diet in early life may program adaptive metabolism that can become detrimental when environmental conditions will change, particularly when low fat intakes will be followed by high fat intakes (mismatch). These observations stress the importance of providing nutritional intakes adapted to nutritional needs at the various stages of growth.