Early Nutrition and Long-Term Health, Second Edition – Chapter 1. Nutrition in the first 1000 days of life: Society’s greatest opportunity

The nutrition of infants in the first 1000 days of life, from conception through 2 years of age, has both immediate and long-term health consequences. Most of the global burden of disease, the increase in chronic non-communicable conditions, and its associated costs to individuals, communities, and society are related to poor nutrition and exacerbated by the coexistence of under- and overnutrition. New threats such as the COVID-19 pandemic are adversely affecting the energy intake and diet quality of infants and young children worldwide. The mechanisms explaining the relationships between early life nutrition and long-term health are increasingly better understood. These include nutrition-related metabolic, immune, neurocognitive, and epigenetic changes which program long-term health. We review the state of global infant and young child nutrition, its long-term health consequences, the mechanisms involved, and potential approaches to addressing these challenges. A holistic, whole of society approach, engaging stakeholders from all key disciplines and public and private sectors, and importantly, children’s families and community, will be needed. Prioritizing investment in improving diets and lifestyles in the first 1000 days of life is society’s greatest opportunity for progress.