Undernutrition in early life: using windows of opportunity to break the vicious cycle

The Sustainable Development Goal (SDG 2) targets the intergenerational cycle of chronic undernutrition and its consequences by their focus on optimizing maternal and child nutrition. The preconception period and the first 1,000 days of life, i.e., from conception to 2 years of age, are critical intervention windows to optimize maternal and child nutrition. However, less is known on the first 1,000 days including pregnancy, as well as what are important determinants of a healthy first 1,000 days when looking at the pre-pregnancy conditions. Therefore, the current thesis aims to shed light on the window of opportunity in the pre-pregnancy period and during the first 1,000 days to improve maternal and child outcomes to contribute to breaking the vicious circle of chronic undernutrition and its consequences. Based on the evidence in the current thesis, we believe that the pre-pregnancy, pregnancy, and postpartum period are clearly still missed opportunities to optimize maternal nutrition status, birth outcomes, and child growth. Multifaceted factors were found to affect maternal and child nutrition. Therefore, nutrition should be part of a life-course approach that regards maternal and child nutrition within women’s and their children’s overall health. To this end, selected nutrition-sensitive and-specific interventions may play a role in breaking the intergenerational cycle of undernutrition and its consequences. The nutrition-sensitive interventions may include strengthening the health extension package, women empowerment, and screening and managing perinatal distress. Similarly, preconception nutritional supplements, promoting maternal dietary quality, and optimizing sociocultural factors such as religious fasting may be some of the nutrition-specific interventions