Early nutrition and growth
A healthy start to life
Customised diets for premature babies. Healthier relief food that improves the chances of survival for mothers and children. Advanced operations on animal foetuses that tell us more about how chemical substances affect the unborn child. Nutritious breast milk substitutes which more closely resemble natural breast milk. Groundbreaking knowledge about the health potential of colostrum, or first milk, and how it can benefit children suffering from cancer and intestinal disease.
The above examples illustrate the focus of LIFE’s emerging elite research area within early nutrition and growth.
Text: Katherina Killander
We have asked anchorman Professor Per Sangild eight questions about LIFE’s emerging elite research area in Early Nutrition and Growth:
• Where is research within early nutrition and growth currently heading as a field?
• How does LIFE contribute worldwide to the research within early nutrition and growth?
• Which other promising research projects would you like to mention?
• If the elite research area becomes the success you are hoping for in the coming years, what do you hope to achieve?
• How will LIFE students benefit from the elite research area?
• What are your considerations in relation to collaborating with companies, authorities or others that may have a particular interest in this elite research area?
• Where can you follow the elite research area’s results?
• Who is behind the elite research area?
Professor Per Sangild:
“The first main trend I would like to mention in relation to the research being conducted into early nutrition and growth is the growing focus on the fact that nutrition plays an important role for newborn infants.
It means that newborn infants who, due to incorrect conditions during the foetal stage, a difficult birth or illness following birth, have very specific nutritional needs.
Programming hypotheses for health
Another important trend is the so-called programming hypotheses. They assume that poor nutrition early in life has a bearing on a person’s health for the rest of his or her life. This is particularly valid during the so-called ‘critical phases of life’.
Particularly vulnerable during the critical phases of life
The critical phases of life are periods when it is particularly dangerous to be undernourished or malnourished. 
One example of a well-known critical phase of life is the foetal stage and immediately following birth. Here, nutrition is crucial. If the mother is starving or malnourished, it has a negative programming effect on the foetus.
It has already been documented that malnutrition in the foetal stage can provoke different types of metabolic disorders later in life, for example diabetes and cardiovascular disease.
Thus, there are several groups in our elite research area who, after studying lamb foetuses, are looking at the development of metabolic disorders resulting from early malnutrition.
However, you can generally say that critical life phases are difficult to establish because they vary according to which disease is at issue.
Breast milk and the body’s amazing ability to adapt
Breast milk is very important for all children, especially for those born with various developmental problems.
When breast milk is not available, it is imperative to be able to produce breast milk substitutes, or formulas, which have the same beneficial properties as breast milk.
At the same time, we are deeply intrigued by the organism’s incredible ability to adapt itself to imperfect developmental conditions.
Even with a relatively poor diet, low birth weight and undernutrition following birth, most people manage surprisingly well throughout life.
We would like to know more about how the body is able to perform so well.
Lack of knowledge about alternatives to breast milk
It is well documented that breast milk provides the best nutrition for newborn infants, but there are obviously cases where alternatives are the only solution.
Worldwide, studies are therefore being conducted to determine how we can develop healthy and nutritious infant formulas. However, we still don’t know what the best alternative is to breast milk.
Milk is designed to protect the newborn infant 
When a mother gives birth prematurely and does not have sufficient milk for her child, it leads to serious gastrointestinal problems in 10% of cases.
Research shows that breast milk consists of much more than just nutrients.
The milk is composed to protect the infant against a number of threatening influences from the environment, for example bacteria.
It is all these other properties of breast milk which are still barely researched and which are still not included in infant formulas.
Thus, it is unclear how to make artificial milk. Therefore, we are initially trying out different types of breast milk substitutes on newborn piglets.
Colostrum is super milk for newborn infants
Moreover, there are different types of milk. Colostrum, or first milk, is the very first milk that the child receives from its mother during the first 24 hours after birth, and it has a different composition to the breast milk it gets later.
For example, first milk has an over-representation of protective, active substances. This is also true in the case of animals.
Colostrum from animals can possibly help humans
It is still not known to what extent first milk for animals, for example calves, is particularly adapted to the cow’s own offspring or whether it can also be used for children.
We are researching this very issue at the moment together with Copenhagen University Hospital (Rigshospitalet) and Odense University Hospital where, using colostrum, we are treating intestinal disease in adults and sick children.
We are focusing in particular on patients who have intestinal problems due to chemotherapy or who have to live with a shortened intestine after intestinal surgery.”
How does LIFE contribute worldwide to the research within early nutrition and growth?
Professor Per Sangild:
“Many children in developing countries die because of undernourishment. Consequently, we are endeavouring to develop a dietary system targeted at children in these parts of the world.
The dietary system will prevent the development of disease while also improving survival chances once illnesses have broken out. Globally, undernourishment continues to pose a bigger problem than over-nourishment.
Better relief food on its way in collaboration with Médecins Sans Frontières
We are working with international companies and organisations such as Médecins Sans Frontières, which distributes food to relief programmes.
Our ambition is to optimise relief food so we can improve the chances of survival for those in need.
In this way we can help to prevent malnutrition and re-establish child health in the developing countries.
Newborn piglets resemble babies
At LIFE, we use preterm piglets as models for premature babies and normal babies.
However, newborn piglets are also good models for themselves as 10-20% of all neonatal piglets die within the first 24 hours of being born, which amounts to 5 million pigs in Denmark alone.
Thus, there is also a desire to improve mortality among pigs in the interests of production. These problems have become exacerbated in the past 20 years as the number of pigs per litter has been significantly increased through breeding.
Pig research offers huge potential because pigs resemble us nutritionally – they are also omnivores.
World first 
We at LIFE are actually the first in the world to be studying large domestic animals such as pigs to learn more about the best nutrition for preterm individuals – both preterm humans and animals.
10% of all pregnancies in Denmark end with premature birth (less than 37 weeks gestational age).
Thus, knowing about the best nutrition for premature babies can also tell us what normal infants require.
LIFE leading the way within foetus operations
Operations on animal foetuses are extremely complicated, but here LIFE has distinguished itself over the past 20 years as one of the leading research environments worldwide.
For example, we implant catheters in pig and calf foetuses to take blood samples and study how different substances affect the foetus in the last stage of pregnancy – the last critical phase for the foetus.”
Professor Per Sangild:
“There was a research project where we looked at the effect, or the possible damage, of adding supposedly beneficial probiotics to infant breast milk substitutes.
Probiotics is the collective name for hundreds of types of bacteria, many of them still unknown.
In the Journal of Nutrition, we have recently documented both the positive and negative effects of adding probiotics to milk substitute for preterm piglets.
This can have the same effects on children. The Department of Neonatology at Copenhagen University Hospital, which treats two thirds of the most immature children in Denmark, is one of our key partners in this project.
The animal models provide far greater insight into understanding the relationship between nutrition, bacteria and the gastrointestinal system than is possible through only studying premature infants.
Among other things, this is because pigs give us a much better chance of conducting many tests and closely examining the microbiological interaction.
Caesareans thwart the development of key organs 
We have conducted many studies on calves and pigs where we have taken a closer look at the supposed benefits of a natural birth.
We have documented a number of negative consequences of being born by Caesarean section.
Here, the development of key organs such as the lungs, intestines and liver is curtailed, and the bacterial flora, to which the child’s intestines are exposed to at birth, are more random.
Vaginally born babies are always exposed to bacteria from the mother’s vaginal and rectal flora.
However, we have not yet established the impact of the consequences of being born by Caesarean section.”
If the elite research area becomes the success you are hoping for in the coming years, what do you hope to achieve?
Professor Per Sangild:
“To have fully developed various ways of looking after and feeding premature babies. And to have developed a diet which increases the possibilities for preventing and treating malnutrition and underdevelopment among children in developing countries.
We also want to map the protective properties of breast milk in order to develop new infant formulas and treat certain patient groups, for example cancer patients.
Here, we would also like to know more about how to treat milk to avoid losing the protective elements.
These measures can be very significant during the baby’s transition from breast milk to formula and later to solids (transitional diet phase), a phase which therefore commands our considerable focus.
More knowledge about the health potential of colostrum
We also want to find out more about the benefits which can be derived from colostrum, for example in relation to strengthening immune responses among patients with gastrointestinal injuries.
Another success criterion is that we want to intensify internationalisation through partnerships with selected companies and hospitals.
Our clear ambition is to strengthen the research constellation that spans practical issues with hospital patients to experiments with and intensive studies on animals to groundbreaking cellular research.
In so doing, we can shed light on the full breadth of the research area – from cells to human health.”
How will LIFE students benefit from this emerging elite research area?
Professor Per Sangild:
“The elite research area includes a number of projects for BSc and MSc students. Many of the academics working within the research area teach various courses at the Department of Human Nutrition.
The majority of the activities relating to animal experiments take place in the CAMPUS barn, Frederiksberg and Tåstrup, where students often participate in conducting the tests.”
What are your considerations in relation to collaborating with companies, authorities or others that may have a particular interest in this specific elite research area?
Professor Per Sangild:
“The elite research area’s partners regularly participate in the ongoing debate about diets for infants and babies as well as in working groups engaged in producing nutritional recommendations.
The elite research area works extensively with industrial partners, who help make the research results relevant for the general public.”
Where can you follow the elite research area’s results?
Professor Per Sangild:
“You can also developments on the LIFE website, in the media and in a large number of scientific journals.”
Professor Per Sangild
Professor Kim Fleischer Michaelsen
Professor Henrik Friis
Associate Professor Mette Olaf Nielsen
Kirsten Jenlev, - last update:29 September 2011