1,000 first days of food

Issue 113 l Eka’s Weekly Roundup (11 March 2025)

Mar 11, 2025

The first 1,000 days of food plays a huge role in our life outcomes. This period starts at conception and ends around a child’s 2nd birthday. (Un)healthy nutrition has been linked to various health impacts later in life including obesity, cardiovascular disease, and mental health conditions.

There are some incredible policy interventions which have tried to target these first 1,000 days including banning new fast-food outlets to impact childhood obesity or maternal food programs helping subsidise healthy foods.

We are also excited about technology innovations which help ‘raise the bar’ for breastfeeding alternatives. While there is a lot of research & guidance on how breastfeeding is the gold standard for (at least) the first six months of feeding, there are many scenarios where this is not available to the child or parent.

We are exploring better ways to improve the food landscape in the first 1,000 days. Reach out if you would like to chat 👋

The impact of our diet in the first 1,000 days 🗞️

The first 1,000 days of life are a critical window for a child’s nutritional development. During this period, the brain grows more rapidly than at any other time in life, reaching 80% of its adult size by age three and 90% by age 5. What a child eats during this foundational period has lasting impacts on their physical growth, cognitive development, and lifelong health.

Studies conducted by organizations such as UNICEF, the World Health Organization (WHO), and the Food Foundation indicate that children who receive adequate nutrition during this phase exhibit higher cognitive function, improved academic performance, and stronger immunity.

In the ‘developing’ world (don’t love the term but for simplicity), this has very real effects including: malnourished children being 12x more likely to die than their well-nourished peers, and malnutrition remaining the underlying cause of 45% (!) of all deaths in children under 5. You should read that twice!
In the ‘developed’ world, this manifests differently including risks for type 2 diabetes and hypertension. An article published in October last year showed that restricting sugar intake in the first 1,000 days after conception reduced type 2 diabetes and hypertension risk by about 35-20% respectively. This becomes increasingly important in our ‘sugarised’ society, and we’ll look at a few initiatives later which reduce unhealthy food outlets in the hopes of reducing childhood obesity.

Investing in the first 1,000 days has large positive impacts on future earnings and output. The World Food Program estimates that every $1 invested in nutrition given the first 1000 days yields $16 in return. These are always hard numbers to verify & sense check but directionally it feels sensible given the importance of early years nutrition.

So, why do the first 1,000 days matter so much?

Why it matters: impacts on life outcomes

Malnourished children often face educational setbacks, as cognitive impairment caused by poor nutrition can lower IQ scores and hinder academic performance.

Physical health

Adult attained height: the paper linked above references two studies across the Dutch famine and Chinese famine in the 20th century. The Dutch famine of 1944/45 showed reduced adult heights when having been through undernutrition between gestation and ages 1/2. Similarly, the Chinese famine between 1959-61 showed a decreased height of 1.3-1.7cm by comparing malnourishment compared to non-malnourishment.
Obesity: epigenetic, metabolic, and metagenomic mechanisms have been shown to predict future risk of obesity within the first 1000 days of life.
Type 2 diabetes: The first study to establish a link between low birth weight and increased susceptibility to type 2 diabetes was published in the early 1990s, and revealed that adults with the lowest birth weight were six times more likely to develop type 2 diabetes or impaired glucose tolerance than those with the highest birth weight. More recently, a 2018 paper showed that low birth weight is linked to a higher likelihood of obesity in later life.
Cardiovascular disease: Breastfeeding is associated with lower blood pressure at 3 years of age, and likely sustains into later life. This is linked to the amount of sodium which exists in the diet of an infant in the first six months of life, where human milk may reduce this compared to alternatives.
Early years health: there is lots of research out there highlighting the benefits of breastfeeding versus formula milk in the first 0-6 months (and sometimes longer)! This reduces inflammation, risk of infections, and potential obesity. But, we know that this isn’t always possible for a host of reasons (parents’ health, children’s health…) and there should be healthy, safe, and efficacious alternatives where required.

Mental & cognitive health

Iron deficiency has been linked to neurodevelopmental alterations which may have a role to play in the development of ADHD.
Omega-3 supplementation has been linked in reducing behaviour problems for children aged 8-16 (again passed the 1,000 day mark but still interesting!).
Zinc deficiency has been linked with children’s neuropsychologic functioning, activity, and motor development which may in turn impact cognitive performance. However, the causal mechanisms are still unclear.

Plotting various health interventions in different countries

Indonesia's 2023 free early-years meals program set to improve nutrition outcomes

In 2023, Indonesia launched an ambitious program to provide free meals to nearly 90 million children and pregnant women. The initiative distributes meals such as rice, vegetables, chicken, and milk, with the goal of enhancing human resources. This is expected to cost $28b through to 2029. We’ve already spoken about this sort of ROI but it will be interesting to track this over time.

London's free school meals program reduces financial burden on families

This doesn’t relate to 0-2 year old children but is still important. In 2024, London extended a policy providing free meals to every state primary school pupil daily. This initiative aimed to alleviate hunger and reduce financial burdens on families, saving over £1,000 per child annually and benefiting up to 287,000 children. This has a few impacts including alleviating financial pressures on families but also impacts food security for children and improves educational attainment.

Gateshead Council policies which banned fast-food outlets shown to have positive impacts

In 2015, Gateshead Council banned further fast-food outlets to open up in order to tackle childhood obesity. More recently, a 2024 BBC article suggested the policy did have a positive impact with Gateshead seeing a 4.8% decrease in childhood obesity compared to control areas.

Reframing breast milk vs. formula milk

There is a lot of research talking about the benefits of breastfeeding, especially in the first 0-6 months of life. This is the common gold standard in many developed economies. However sometimes this is not possible for a variety of reasons (parents’ health, children’s health) and effective alternatives should be put in place.

There has been research showing that nutritional interventions in low and middle income countries can prevent growth stunting if they take the mothers & family’s nutritional profile into context.

More recently, we’ve met amazing companies which are creating novel ways to feed children in the early years using new technologies including personalised formula, cell-based milk alternatives, and companies conducting in-depth research into the breast milk microbiome.

We’re actively looking at the space and would be keen to speak with you if you’re building here 👋