Complementary feeding and non communicable diseases: current knowledge and future research needs

Early diet and nutrition may set in place growth patterns and/or metabolic pathways that promote risk factors for later NCDs. Most relevant studies so far available have a cross-sectional or retrospective design and are thus of limited validity for evaluating the impact of early feeding on later disease. Standardised protocols for prospective research should be developed. The contribution of protein intake in early life to later NCD development has been the object of several studies; however future research should specifically target the effects of early protein intake on (a) how protein intake influences body composition, (b) how different body composition in infancy contributes to later NCDs, (c) whether there is an age 'window' when high protein intake is particularly associated with later overweight and obesity, (d) what levels of protein intake may protect against later overweight/obesity, (e) what level of cow milk intake in the first years of life minimises risk-inducing growth whilst meeting recommended calcium intakes. The role of the quality of fat and carbohydrate intakes at early ages should be better investigated. There is a dearth of data from many communities about the foods introduced as complementary feeds, the ages at which they are introduced and why mothers use these foods. Definitely more information is needed on how and to what extent mothers' behaviour is influenced by media, advertising and other commercial pressures and why formula fed infants are started on other foods much earlier than breast fed infants. Standardized protocols are needed to develop more data on complementary feeding in different regions, different countries and different socio-economic environments.