Ricardo Uauy

London School of Hygiene and Tropical Medicine | LSHTM · Department of Nutrition and Public Health Interventions Research

Background Copper (Cu), an essential trace mineral regulating multiple actions of inflammation and oxidative stress, has been implicated in risk for preterm birth (PTB). Objectives This study aimed to determine the association of maternal Cu concentration during pregnancy with PTB risk and gestational duration in a large multicohort study includin...

Background: Anaemia in pregnancy is a global health problem with associated maternal and neonatal morbidity and mortality. We aimed to investigate the association between maternal haemoglobin concentrations during pregnancy and the risk of adverse maternal and neonatal outcomes. Methods: In this prospective, observational, multinational, INTERBI...

Background: Bovine milk fat globule membrane (MFGM) added in infant formula supports typical growth and safety through 24 mo of age in term infants. Objectives: To assess micronutrient (zinc, iron, ferritin, transferrin receptor), metabolic [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), insulin-like growth factor-1...

Background Bovine milk fat globule membrane (MFGM) added in infant formula supports typical growth and safety through 24 months of age in term infants. Objective To assess micronutrient (zinc, iron, ferritin, transferrin receptor), metabolic (glucose, insulin, HOMA-IR, IGF-1, triglycerides, total, HDL, LDL-cholesterol), and inflammatory (leptin, a...

Background: Obesity predominantly affects populations in high-income countries and those countries facing epidemiological transition. The risk of childhood obesity is increased among infants who had overweight or obesity at birth, but in low-resource settings one in five infants are born small for gestational age. We aimed to study the relationshi...

Objective To assess the impact of an experimental formula (EF) with added whey protein-lipid concentrate (5 g/L; source of bovine milk fat globule membrane [bMFGM]) on growth, body composition (BC), and safety through 24 mo of age in term infants. Methods Double-blinded randomized controlled trial conducted in Santiago, Chile. Infants were enrolle...

Objectives: To evaluate growth (weight, length, head circumference, and knee-heel length [KHL]) in very low birth weight (VLBW) infants (500-1,500 g) who received human milk with a liquid fortifier (LHMF) with high protein and fatty acid content versus a traditional powder fortifier (PHMF) for 45 days or until discharge. Methods: This was a mult...

Objectives Bovine milk fat globule membrane (bMFGM) added in routine infant formula supports normal growth and safety through 24 mo of age in term infants. The impact on micronutrients and glucose-related biomarkers is assessed here. Methods In this double-blind, randomized, controlled trial, formula-fed infants were enrolled (<120 days of age) an...

Background: Deleterious long-term effects in the offspring from women with pregravid obesity have been described. However, the evidence supporting early metabolic and inflammatory markers in the offspring at birth and gender differences are conflicting. Objective: This study aimed to compare cord blood adipokines and cytokines concentrations and...

Many observational studies and some randomized trials demonstrate how fetal growth can be influenced by environmental insults (for example, maternal infections)¹ and preventive interventions (for example, multiple-micronutrient supplementation)² that can have a long-lasting effect on health, growth, neurodevelopment and even educational attainment...

Importance: The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures. Objective: To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term...

Objective: To determine if time to initial enteral feeding (EF) and rate of advancement are associated with necrotizing enterocolitis (NEC) or death. Methods: Secondary analysis of prospectively collected data of very low birth weight infants (VLBWI: 400- 1,500 g) born in 26 NEOCOSUR centers between 2000-2014. Results: Among 12,387 VLBWI, 83.7...

Aim: To determine changes in global DNA methylation in monocytes from neonates of women with obesity, as markers of an immune programming resulting from maternal obesity. Materials & methods: Cord blood monocytes were obtained from neonates born to women with obesity and normal weight, genome-wide differentially methylated CpGs were determined usin...

Background Lifestyle interventions have shown limited effectiveness in the prevention of gestational diabetes mellitus. The combination of lifestyle interventions with omega-3 polyunsaturated fatty acid supplementation could have a synergetic effect on maternal and offspring outcomes. Objective We evaluated the effects of docosahexaenoic acid supp...

Unhealthy diets contribute to an increased risk of non-communicable diseases, which are the leading causes of deaths worldwide. Nutrition policies such as front-of-pack labeling have been developed and implemented globally in different countries to stimulate healthier diets. The Choices Programme, including the International Choices criteria, is an...

Rationale: Maternal obesity is associated with asthma in the offspring. Whether maternal leptin is associated with risk of asthma in offspring is unclear. Objective: To assess whether leptin levels in maternal obesity predict preschool asthma. Methods: In this birth cohort study, we divided pregnant women into three weight categories during th...

Background: Some nutritional interventions have shown their efficacy in reducing gestational weight gain (GWG); however, their applicability in routine care is limited. Objective: We assessed the effectiveness of a low-intensity and high-coverage nutritional intervention on maternal and offspring outcomes; the intervention enhanced existing nutr...

Background Preterm birth is a major global health challenge, the leading cause of death in children under 5 years of age, and a key measure of a population's general health and nutritional status. Current clinical methods of estimating fetal gestational age are often inaccurate. For example, between 20 and 30 weeks of gestation, the width of the 95...

Objectives To evaluate growth through 24 months of age in infants receiving added bovine milk fat globule membrane (MFGM) in infant formula through 12 months of age. Concentration of MFGM from bovine milk fractions and incorporation in infant formula may better approximate the composition of complex milk lipids in human milk. Methods In the double...

Background: A central aim for pediatric nutrition is to develop infant formula compositionally closer to human milk. Milk fat globule membranes (MFGM) have shown to have functional components that are found in human milk, suggesting that addition of bovine sources of MFGM (bMFGM) to infant formula may promote beneficial outcomes potentially helpin...

Objectives To assess the consumption of ultra-processed foods and its association with the overall dietary content of nutrients related to non-communicable diseases (NCD) in the Chilean diet and to estimate the population attributable fraction of ultra-processed food consumption on the unhealthy nutrient content. Design Cross-sectional analysis of...

Background: Growing evidence shows that atopic dermatitis (AD), food allergy (FA), allergic rhinitis, and asthma are largely determined during the first 1000 days (time elapsed from conception to the 2nd birthday). The ARIES birth cohort aims to determine prenatal and perinatal conditions, as well as genetic and epigenetic factors, that participat...

Objective To develop predictive anthropometric models for total and truncal body fat in Chilean children, using the following anthropometric measurements: weight, height, skinfold thicknesses and circumferences. Methods Cross-sectional study including 669 Chilean children (12.0 y ± 1.3) in Tanner stage IV from the Growth and Obesity Chilean Cohort...

Background: Reference values for umbilical artery Doppler indices are used clinically to assess fetal wellbeing. However, many studies that have produced reference charts have important methodological limitations, and these result in significant heterogeneity of reported reference ranges. Objectives: To produce international gestational age-spec...

Background: Hunger, food insecurity, stunting, anemia, overweight, and noncommunicable diseases (NCDs) may coexist in the same person, household, and community in Latin America and the Caribbean (LAC). The double burden of malnutrition (DBM) is an important cause of disability and premature death, which could be addressed with comprehensive polici...

Background Intimate partner violence (IPV) against women is a major global health issue, particularly in low- and middle-income countries (LMICs), that is associated with poor physical and mental health, but its association with breastfeeding practices is understudied. Both the World Health Organization (WHO) and the United Nations Children’s Fund...

Nonalcoholic fatty liver disease (NAFLD), defined as fat accumulation greater than 5% in hepatocytes, may progress to fibrosis or cirrhosis later in life. NAFLD prevalence in adolescents has increased significantly in direct relation with obesity prevalence. Fatty liver has become the most frequent indication for liver transplantation in adults. O...

Inadequate protein quality may be a risk factor for poor growth. To examine the effect of a macronutrient–micronutrient supplement KOKO Plus (KP), provided to infants from 6 to 18 months of age, on linear growth, a single-blind cluster-randomised study was implemented in Ghana. A total of thirty-eight communities were randomly allocated to receive...

Background: Lecithin-cholesterol acyltransferase (LCAT) is a plasma enzyme that esterifies cholesterol in high- and low-density lipoproteins (HDL and LDL). Mutations in LCAT gene causes familial LCAT deficiency, which is characterized by very low plasma HDL-cholesterol levels (Hypoalphalipoproteinemia), corneal opacity and anemia, among other lipi...

Objective: Evaluate if an intervention based on nutritional counseling decreases total sugars and energy consumption in overweight and obese pregnant women, compared to their previous consumption and compared to women who only received routine counseling. Methods: Randomized study of two groups: dietary counseling (Intervention Group: IG) and routi...

Background: INTERBIO-21 st is Phase II of the INTERGROWTH-21 st Project, the population-based, research initiative involving nearly 70,000 mothers and babies worldwide coordinated by Oxford University and performed by a multidisciplinary network of more than 400 healthcare professionals and scientists from 35 institutions in 21 countries worldwide....

Chile approved the law of food labelling and advertising in 2012; this law aims to address the obesity epidemic, particularly in children. The implementation details were published in 2015, and the law was implemented finally in 2016, as described in the current article. Regulated foods were defined based on a specially developed nutrient profiling...

Background: INTERBIO-21 st is Phase II of the INTERGROWTH-21 st Project, the population-based, research initiative involving nearly 70,000 mothers and babies worldwide coordinated by Oxford University and performed by a multidisciplinary network of more than 400 healthcare professionals and scientists from 35 institutions in 21 countries worldwide....

Background Only 13% of Ghanaian infants 6–23 months have a minimum acceptable diet. The study examined the effect of a macro‐ and micro‐nutrient fortified complementary food supplement (KokoPlus™) on growth and nutritional status of Ghanaian infants. Methods In a cluster randomized study, 38 communities were randomly assigned to three arms: KokoPl...

Childhood obesity in Chile is one of the highest in the world. The objective of this study was to assess the impact of excessive weight gained or maintained over a 3-year period, on markers of metabolic homeostasis in young children. This is a longitudinal study which includes 243 children followed from 4 to 7 years. We assessed BMI, body fat perce...

Existe evidencia sólida de la existencia de relaciones entre la industria de alimentos y bebidas y la academia. Ésta sugiere que la investigación patrocinada por la industria es susceptible de conferir sesgos a su favor en los resultados. En América Latina, se han documentado ejemplos de estas situaciones en México, Brasil, Chile, Perú, Colombia y...

In Nepal, more than one‐third of children are stunted. Prior studies have shown that women's empowerment in agriculture is associated with child (<2 years) length‐for‐age z‐scores (LAZ) in Nepal. This study tests whether child dietary diversity (DD) and household water, sanitation, and hygiene (WASH) facilities and practices mediate the association...

Background: Adults and young children in countries experiencing the nutrition transition are known to be affected simultaneously by undernutrition and overnutrition. Adolescence is a critical period for growth and development. Yet, it is unknown to what extent this double burden of malnutrition affects adolescents in low- and middle-income countri...

Dariush Mozaffarian and colleagues describe how the history of modern nutrition science has shaped current thinking

Infant malnutrition remains an important cause of death and disability, and Haiti has the highest prevalence in the Americas. Therefore, preventive strategies are needed. Our aims were (1) To assess the prevalence of malnutrition among young children seen at a health center in Haiti; (2) Examine adherence to infant feeding practices recommended by...

Purpose: Evidence supporting the use of dietary supplements, in particular, multivitamin/multimineral supplements (MVMS), has been mixed, complicating the ability of health care professionals to recommend their use. To clarify the role that MVMS can play in supporting human health, a series of consensus statements was developed based on expert opi...

Aims: We aimed to assess whether female offspring birth weight (BW) is associated with anthropometric and metabolic outcomes in Chilean mothers at 10-years postpartum. Methods: We assessed data from 396 Chilean mother-daughter pairs participating in the longitudinal Chilean Growth and Obesity Cohort (GOCS) and Determinants of Breast Cancer Risk...

Maternal obesity is associated with large-for-gestational-age (LGA) neonates and programming of obesity-related cardiovascular disease in the offspring, however, the mechanisms that lead to the later are unclear. Presently, interpretations of NO-dependent changes in vascular function in LGA newborn from obese mothers are conflicting. Adiponectin im...

Infant malnutrition remains as an important cause of death and disability, Haiti has the highest prevalence in America, so preventive strategies are needed. Our objective was to assess infant and young children malnutrition in Haiti and to study an association to World Health Organization (WHO) recommended feeding practices adherence. Cross-section...

Copper deficiency and excess have been recognized as potential health problems for infants and children worldwide. Clinical manifestations of copper deficiency and excess are well characterized but the precise sequence by which high copper intake interacts with genetic control systems, leading to liver damage in infants, is unknown. The possibility...

Background and Objective: A rapid simultaneous increase in sales of ultra-processed foods and prevalence of obesity and other diet-related non-communicable chronic diseases (NCDs) has been observed in Latin America over the past decades. Our study describes the consumption of ultra-processed foods and its association with the nutrient profile of di...

Background: The specific metabolomic perturbations that occur in vitamin B-12 deficiency, and their associations with neurological function, are not well characterized. Objective: We sought to characterize the human serum metabolome in subclinical vitamin B-12 deficiency and repletion. Methods: A before-and-after treatment study provided 1 inj...

Background Changes in DNA methylation, one of the most studied epigenetic mechanisms, are considered an initial marker for early cancer detection. We evaluated how availability of dietary factors (folates and vitamin B12) involved in one-carbon metabolism may contribute to DNA methylation changes of cancer-related genes in human subjects. Methods...

Objective To assess the consumption of ultra-processed foods and analyse its association with the content of added sugars in the Chilean diet. Design Cross-sectional study of national dietary data obtained through 24 h recalls and classified into food groups according to the extent and purpose of food processing (NOVA classification). Setting Chi...

We identified factors associated with gestational weight gain (GWG) in 1,654 Chilean pregnant women with full-term pregnancies. At baseline, we collected information about sociodemographic, gyneco-obstetric, anthropometric, and health care-related factors. We found that pre-pregnancy nutritional body mass index (BMI) was the most important factor r...

Background: Frequent dairy consumption in childhood has been related to higher growth-hormone concentrations that may affect mammary gland and pubertal development. Objective: We evaluated the relation of dairy intake to breast composition at Tanner stage 4 and age at menarche. Design: A total of 515 Chilean girls are included in the Growth and Obe...

Background: We aimed to describe newborn body composition and identify which anthropometric ratio (weight/length; BMI; or ponderal index, PI) best predicts fat mass (FM) and fat-free mass (FFM). Methods: Air-displacement plethysmography (PEA POD) was used to estimate FM, FFM and body fat percentage (BF%). Associations between FFM, FM and BF% and...

Background: Frequent dairy consumption in childhood has been related to higher growth-hormone concentrations that may affect mammary gland and pubertal development. Objective: We evaluated the relation of dairy intake to breast composition at Tanner stage 4 and age at menarche. Design: A total of 515 Chilean girls are included in the Growth and Obe...

PurposeHigh mammographic breast density (BD) is a strong risk factor of breast cancer; however, little is known in women under 40 years of age. Recently, dual-energy X-ray Absorptiometry (DXA) has been developed as a low-dose method to measure BD in young populations. Thus, our aims were to describe BD in relation to risk factors in Chilean women u...

Appendix S1 Members of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH‐21st and INTERBIO‐21st) and its Committees

Figure S1 Relationship between fetal weight and abdominal circumference in the final model, plotted for a fixed head circumference of 26 cm.

Figure S2 Relationship between fetal weight and head circumference in the final model, plotted for a fixed abdominal circumference of 23 cm.