Preconception health

BELIZÁN, JOSÉ M; CORMICK, GABRIELA; BERGEL, EDUARDO; LOMBARTE, MERCEDES

LANCET

ELSEVIER SCIENCE INC

Año: 2018 vol. 392

0140-6736

We thank Lombarte and colleagues for their supportive comments and interesting data on calcium diet in rats, and look forward to the results of their randomised trial. A crucial theme of the second paper1 in our Series was that the origin of adverse offspring phenotype could be traced to periconceptional diet or environmental exposure, hence the need for preconception health. However, we note that in the calcium study2 by Bergel and Belizán in rats, experimental diets lasted for one month before mating to the end of pregnancy; therefore the effects on offspring blood pressure might derive from a broad period of exposure. It would be interesting to establish whether periconceptional maternal calcium levels alone mediate similar effects.We agree completely with Wilson and colleagues about the importance of parental mental health in relation to obstetric, neonatal, and child health outcomes. In relation to offspring outcomes, and since publication of the Series, our animal studies have shown that poor periconceptional nutrition compromises brain development and offspring mental health.3 The same inclusive view could be extended to other disorders of global importance, such as diabetes. The initial scope of the Series was broader and included mental health exposures. However, after peer review the scope focused more on nutrition and lifestyle to avoid superficial treatment of a potentially huge number of preconception health (physical and mental) and social conditions. Within these constraints, we believe that the Series succeeded in providing an evidence-based narrative about why preconception nutritional health matters, how it affects future health, and what we can do to improve it.KMG reports speakers´ fees from Nestle Nutrition Institute and grants from Abbott Nutrition and Nestec. All other authors declare no competing interests.