Driving research in infant and children’s nutrition: a perspective on
Deshanie Rai and Brian Larson
As part of theworkshop entitled ‘‘Early Risk Determinants and Later
Health Outcomes: Implications for Research Prioritization and the
Food Supply’’ (8–9 July 2008, Washington, DC), which was cospon-
sored by the International Life Sciences Institute of North America
and the International Life Sciences Institute Research Foundation,
representatives of the food industry discussed the practical applica-
tion of nutrition science. Nutrition plays a key role in guiding health
outcomes throughout the life cycle. In particular, the prenatal, post-
natal,and earlychildhoodperiods are extremely sensitivetothepres-
ence ofappropriatenutrition. Agrowingbody ofevidenceshowsthat
early nutrition may program the unborn and the infant’s key phys-
iologic systems, including the endocrine, cardiovascular, and central
nervous systems, to influence later life outcomes. While scientists in
academia continue to explore the multifactorial nature of early risk
determinants and later life outcomes at a mechanistic and basic sci-
ence level, itis important tounderstand the potential ofthe infant and
child food industries to address questions such as, what factors have
been noted to drive research in these sectors of the food industry?
How can scientists in these industries work alongside the scientists
in academia and in government to set priorities, make decisions
around these health issues, and translate academic insights into in-
novative nutritional solutions for the benefit of public health? Given
the commitment of the infant and child food industries to deliver sci-
entifically supported early life nutrition, it is easy to understand why
this industry would work in partnership with both the scientists in
academia and the government to identify a means of addressing
the fundamental questions of this workshop.
Am J Clin Nutr
the life cycle, including body weight gain, cardiovascular health,
neural and mental capabilities, and the development and function
of immunity. In particular, the prenatal, postnatal, and early
childhood periods are extremely sensitive to the presence of
appropriate nutrition. There is a growing body of evidence
showing that early nutrition may program the unborn and infant’s
and central nervous systems, to influence later life outcomes. The
workshop cosponsored by the International Life Sciences In-
stitute of North America and the International Life Sciences
Institute Research Foundation entitled ‘‘Early Risk Determinants
of Later Health Outcomes: Implications for Research Prioriti-
zation and the Food Supply’’ focused primarily on the relative
influence of genetics and environmental factors on determinants
of risk within the developmental stages of pregnancy, infancy (0–
12 mo), and early childhood ?5 y of age, particularly in relation
to specific nutrients and food components. In addition, repre-
science in this area may be practically translated to benefit the
Many questions remain unanswered, such as when during each
period early nutrition most critically affects the mechanisms
that influence later life outcomes. While scientists in academia
continue to explore and dissect the multifactorial nature of early
risk determinants and later life outcomes at a mechanistic and
basic science level, it is important to understand the potential of
the infant and child food industries to address such questions.
More specifically, what factors drive research in these industries?
How can scientists in these sectors work with scientists in ac-
ademia and in government to set priorities, make decisions
around these health issues, and translate academic insights into
innovative nutritional solutions for the benefit of public health?
Fetal development is a dynamic process from conception to
birth. Nutrient adequacy is crucial to the growth of physiologic
role of B vitamins in fetal development. Folate and choline are
methyl donors and have been shown to reduce single nucleotide
polymorphisms that may lead to system deformities (1, 2).
Children of women consuming folate-adequate diets have re-
duced the incidence of neural tube defects in North America (3).
In addition, women consuming diets low in choline have a
4-times-greater risk of having a baby with neural tube defects
(4) and 1.75-times-greater risk of bearing a child with a cleft lip
and palate (5).
The fetal nutrition interrelations of folate, choline, vitamin
B-12, vitamin B-6, and the amino acid methionine are being
studied to better recommend daily intakes for women. As the
methods of determining fetal nutrient needs and understanding
the epigenetic effects of nutrients accelerate, the list of critical
nutrients and their optimal intakes will increase. On the basis of
1From Mead Johnson Nutritionals, Evansville, IN (DR), and the Kellogg
Company, Battle Creek, MI (BL).
2Presented at the workshop ‘‘Early Risk Determinants and Later Health
Outcomes: Implications for Research Prioritization and the Food Supply,’’
held in Washington, DC, July 8–9, 2008.
3Reprints not available. Address correspondence to D Rai, Mead Johnson
Nutritionals, 2400 West Lloyd Expressway, Evansville, IN 47721. E-mail:
Am J Clin Nutr 2009;89(suppl):1S–3S. Printed in USA. ? 2009 American Society for Nutrition
AJCN. First published ahead of print March 11, 2009 as doi: 10.3945/ajcn.2009.27113I.
Copyright (C) 2009 by the American Society for Nutrition
the correlation of folate fortification with reduced neural tube
defects, the infant and child food industries can be expected to
embrace research to incorporate optimal concentrations of nu-
trients needed to better ensure the growth and development of
the unborn, infants, and growing children.
Moreover, going back .100 y, it is evident that the foundation
of the infant food industry has been built on a strong scientific
heritage in which the central themes driving advances in infant
nutrition research have been the following: 1) addressing unmet
physiologic needs, 2) providing nutritional interventions, and 3)
expanding the nutritional knowledge base among the scientific
and health care communities as well as the public at large.
Because the primary objective of the infant food industry is to
help provide infants with a foundation of nutrition support that
also accommodates the development and function of key rapidly
developing organ systems, including the brain, the immune, and
the gastrointestinal systems, it behooves the infant food industry
to invest in research at almost every level, including the use of
appropriate cell culture and animal models, well-designed clinical
studies, as well as research at the analytic science, product de-
velopment, and sensory science levels. To do this, scientists in the
infant food industry have notably shown what may be called an
open innovation model approach. This describes an approach that
maximizes collaborations with external capabilities, eg, with
universities and other institutions, through the presence of strong
internal scientific talent to drive scientific advances in infant and
A key driver dictating research within the infant food industry
has been the need to better understand the compositional and
gold standard of infant feeding. As industry invests in research
that helps to answer these questions, we also need to ask the
duringthecourseof lactation?Second, howdoesthecomposition
of human milk vary regionally and globally? An example of this
would be the wide variations in docosahexaenoic acid (DHA;
22:6n23) concentrations observed in breast milk from women
worldwide (6). Third, what are the species-to-species variations
in breast milk? For example, protein in cow milk, a common
milk protein source for infant formula, is present at a higher
concentration than in human milk but also is predominantly
present as casein; the protein in human milk is predominantly
present as whey for the first 6 mo of lactation (7). Therefore,
significant research has been conducted by scientists in industry
and academia, frequently in collaboration, to identify how infant
formula, on the basis of an understanding of human milk, can be
adapted to more closely follow the composition and function-
ality of human milk.
of infant feeding, the scientific community can also identify and
explore ways to narrow the gaps between breastfeeding and for-
mula feeding. For example, the quantification of worldwide
help support brain and eye development. Similarly, the choline
concentrations in infant formula have been revised in alignment
with recommendations by the Institute of Medicine (8).
Research into the compositional and functional qualities of
human milk also promotes an understanding of how industry may
continue to support women breastfeeding their infants. Recent
studies indicate that dietary intake of DHA during pregnancy and
lactation, in the United States, for example, is low in comparison
to that recommended by expert panels, including PeriLip and the
International Society for the Study of Fatty Acids and Lipids (54
compared with 200 mg/d) (9–11). Additionally, it is apparent
that concentrations of DHA in breast milk are declining among
North Americans (12). Research in these areas has provided
pregnant and lactating mothers with the information and prod-
ucts that encourage consumption of incremental dietary DHA
during pregnancy and lactation. Indeed, Jensen et al (13) showed
that DHA supplementation during the first 4 mo postpartum not
only increased breast milk DHA concentrations to worldwide
mean human milk concentrations but also was associated with
improved neural outcomes at 2.5 and 5 y of age. Another ex-
ample is the availability of human milk fortifiers, which have
been designed to support the nutritional needs of preterm and
low-birth-weight infants who are fed human milk.
Given the infant food industry’s stated commitment to help
deliver scientifically supported prenatal and pediatric nutrition, it
is easyto understandwhythis industry wouldwork in partnership
with the scientists in both academia and the government to
identify and explore ways in which to address the fundamental
concerns of this workshop: the periods during which early nu-
trition may be most effective in influencing later life outcomes
and, equally importantly, how early nutrition may influence these
Furthermore, scientists in the infant nutrition and food in-
dustries should recognize that the science must be compelling
and that there should be strong research results before academic
insights can be translated into product ideas and educational
messaging innovations. This can be achieved by engaging in
research that increases the public’s confidence in nutrition re-
search and that is also meaningful to both the scientific and the
health care communities. To do this, scientists in industry need
to support research that results in the identification and execu-
tion of valid, reliable, and relevant biomarkers and clinical
outcomes that fulfills a physiologic need in infants and/or nu-
tritional needs for consumers.
Other factors need to be accounted for when aligning research
priorities within the food industry. Key among these is an un-
derstanding of the regulatory environment. The infant food in-
dustry is regulated tightly by international and federal agencies
and industry guidelines. Global infant nutrition companies must
comply with regulatory guidelines worldwide. More specifically,
infant formula, on the safety and efficacy of the ingredients, and
on the completed product as well as the accuracy of messages
made for that product. Other factors that affect nutrition research
priorities could include the availability of project resources,
including skills and talents, technology, time, and the ability to
have proprietary rights in product developments.
In summary, as the scientific community moves forward in
resolving the role of early nutrition on later life outcomes, it is
heartening and motivating to recognize that scientists in the infant
and child food industries, government, and academia have
demonstrated a common objective in supporting the health and
Nutrition scientists in industry have frequently partnered with the
through, for example, research grants and investigator-initiated
RAI AND LARSON
clinical trials, to translate academic insights into nutritional so-
lutions and nutrition education in alignment with expert scientific
and efficacy studies. Nutrition scientists need to continue to
embrace these efforts and partnerships to identify how industry
can help to prioritize a research agenda on the role of early nu-
trition and laterlife outcomes.(Otherarticlesinthissupplementto
the Journal include references 14–21.)
Each author contributed equally to the writing of the manuscript. The
authors had no conflicts of interest and no disclosures to declare.
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KEY FACTORS DRIVING NUTRITION RESEARCH IN INDUSTRY