Search Results (266)

Maternal undernutrition in late gestation can compromise fetal development and postnatal productivity in beef cattle. This study evaluated whether maternal supplementation with hydroxytyrosol (HT)—a potent antioxidant from olive by-products—during late gestation could alleviate the effects of undernutrition on growth, concentrate conversion ratio, and metabolic and endocrine adaptation of male offspring during the fattening phase. Forty-six multiparous pregnant cows were assigned to four dietary treatments combining nutritional level (T100% vs. T60% of nutritional requirements) and HT supplementation (CONTROL vs. HT at 180 mg/kg of diet) exclusively during the last third of pregnancy. Maternal undernutrition reduced calf morphometric development at the beginning of fattening (4 months), although compensatory growth enabled recovery by slaughter (12 months). For live weight (LW), the feeding level and HT interaction showed a tendency (p = 0.084), but pairwise comparisons within the restricted groups suggested that calves from HT-supplemented dams were 31 kg heavier at slaughter than calves from non-supplemented dams (p = 0.023). HT supplementation was also associated with higher plasma urea concentrations at 12 months in restricted calves, suggesting potential adaptations in nitrogen metabolism without changes in glucose or IGF-1 profiles. In summary, these findings might support our hypothesis suggesting potential benefits in the development of male offspring from HT-supplemented cows during the last third of gestation. However, further studies will be needed to demonstrate definitive overall evidence of HT benefits. Full article

Background: Type 2 inflammatory diseases are among the most common chronic inflammatory conditions in childhood and represent a growing global health burden. Increasing evidence suggests that early-life nutritional exposures may influence immune programming and allergic disease development. This Position Paper aims to summarize the current evidence regarding the immunomodulatory role of polyunsaturated fatty acids (PUFAs), particularly omega-3 long-chain fatty acids, in the prevention of allergic diseases during early life. Methods: A scoping literature review and consensus process were conducted to map biological mechanisms and clinical evidence linking omega-3 PUFAs with allergic disease prevention. This document analyzed experimental, observational, and randomized controlled studies evaluating maternal prenatal/lactational omega-3 exposure. The clinical evidence was qualitatively appraised using study-design-specific Joanna Briggs Institute (JBI) Critical Appraisal Tools. Particular attention was given to immune modulation, inflammatory pathways, epithelial barrier function, gut microbiota interactions, and the ferroptosis–immune–metabolic axis. Results: Omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert immunomodulatory and anti-inflammatory effects through multiple mechanisms, including specialized pro-resolving mediator production, regulation of T-helper cell responses, cytokine modulation, maintenance of epithelial barrier integrity, and microbiota interaction. Emerging evidence also supports their involvement in oxidative stress and ferroptosis regulation. Current clinical evidence, particularly from higher-quality prenatal randomized trials and evidence syntheses, suggests that adequate maternal omega-3 intake during pregnancy and lactation may reduce the risk of respiratory allergic outcomes, especially wheezing and asthma, in selected offspring. Conclusions: Adequate omega-3 PUFA intake, such as 2 g/die, during critical windows of immune maturation may represent a valuable strategy for the primary prevention of allergic diseases. Current evidence most strongly supports supplementation during pregnancy and lactation, particularly in populations with low dietary omega-3 intake or increased allergic risk. Omega-3 supplementation should be considered within a broader multifactorial preventive approach aimed at promoting immune tolerance and reducing the future burden of allergic diseases. Full article

The incidence of cancer in young adults has risen worldwide. Women comprise a disproportionate share of young-onset cases, among whom breast cancer predominates. This shift parallels globalization and urbanization, including the wider adoption of Western-pattern diets. Although hereditary syndromes explain a minority of cases, the secular rise underscores the impact of modifiable exposures, particularly diet. Prenatal life, neonatal life, childhood, adolescence, and early adulthood are critical periods during which dietary exposures may shape long-term mammary development. Mammary tissue undergoes rapid proliferation and differentiation during development, creating windows of heightened susceptibility to carcinogenic insults. However, most existing studies emphasize dietary exposures during a single developmental period; the entire span of critical developmental windows plays a formative role in shaping young-onset breast cancer (YoBC) risk, and the mechanisms underlying this life-course shaping remain insufficiently characterized. This review comprehensively synthesizes evidence on how nutrition across sensitive developmental windows shapes the risk of YoBC. We evaluate protective and adverse dietary factors within these stages and examine mechanistic pathways linking early-life nutrition to carcinogenesis, focusing on hormonal regulation, epigenetic programming, chronic inflammation, and the gut microbiome. A structured literature search was conducted in PubMed, Embase, and Web of Science for English-language articles published from 1990 through May 2026, supplemented by hand-searching of relevant reviews and key primary studies. By framing nutrition and breast cancer through a life-course lens, this review provides an integrated foundation for stage-specific prevention strategies and identifies priority directions for future research on early-life dietary determinants of YoBC. Full article

Background/Objectives: Adequate micronutrient intake during pregnancy is critical for fetal development, yet whether pregnant women and healthcare professionals share consistent knowledge, beliefs, and supplementation practices remains poorly characterized. Methods: Two parallel cross-sectional surveys using identical core items were conducted at a German tertiary care center between April and November 2024. Pregnant women (n = 132) and healthcare professionals who initiated the survey (n = 105) completed anonymous QR-code-based questionnaires assessing micronutrient-related knowledge, perceived dietary adequacy, and supplementation practices or recommendation patterns. Comparative analyses were restricted to fully completed healthcare professional questionnaires (n = 80). Group differences were analyzed using chi-square or Fisher’s exact tests. Results: Healthcare professionals demonstrated higher knowledge levels across most micronutrients. Knowledge gaps were most pronounced for vitamin B12, with 53.0% of pregnant women unable to identify any fetal effect compared with 20.0% of providers (p < 0.001). Beliefs about dietary sufficiency were broadly aligned for folic acid (p = 0.452) and vitamin D (p > 0.999), but diverged markedly for vitamin B12, where 79.2% of providers considered dietary intake alone adequate compared with 47.3% of pregnant women (p < 0.001). Substantial differences were observed between patient-reported supplementation practices and provider-reported recommendation patterns: Vitamin B12 (70.0% vs. 3.8%), vitamin D (76.2% vs. 41.3%), omega-3 fatty acids (76.2% vs. 47.5%), and folic acid (98.5% vs. 81.3%; all p < 0.001). The internet was the most frequently cited information source among pregnant women (89.4%), while healthcare professionals reported using both scientific literature (75.0%) and internet-based resources (76.3%), the latter primarily for accessing professional and scientific information. Conclusions: Substantial patient–provider differences in micronutrient knowledge, beliefs, and supplementation practices persist even within a highly educated population at a tertiary care center. These findings suggest potential differences between patient-reported supplementation behavior and provider-reported recommendation practices, particularly for vitamin B12 and vitamin D. These findings suggest that more structured communication regarding micronutrient supplementation during pregnancy is needed. Full article

Background/Objectives: Vitamin D is a nutrient-related secosteroid system with endocrine, paracrine, immunological, and neurodevelopmental actions relevant to nutritional psychiatry. Psychiatric research has often treated vitamin D either as a cross-sectional correlate of depression or as a non-specific supplement expected to act across heterogeneous diagnostic categories. This narrative review aimed to develop a more discriminating framework in which vitamin D is considered a lifespan neuroimmune and immunometabolic signal whose psychiatric relevance depends on developmental timing, biological context, and phenotype. Methods: Evidence was integrated from developmental epidemiology, neonatal dried-blood-spot studies, randomized trials, meta-analyses, Mendelian randomization studies, clinical guidelines, and mechanistic neuroscience. The review focuses on prenatal and neonatal 25-hydroxyvitamin D, vitamin D-binding protein, free and bioavailable vitamin D, vitamin D receptor signaling, immune and microglial pathways, neurotransmitter systems, neurotrophic signaling, mitochondrial function, oxidative stress, hypothalamic–pituitary–adrenal-axis regulation, and the gut–microbiota–immune–brain axis. Results: The available evidence does not support vitamin D as a universal treatment for psychiatric disorders. Instead, vitamin D deficiency and altered vitamin D biology appear most relevant in biologically and clinically defined risk states, including neurodevelopmental vulnerability, inflammatory depression, psychosis liability, severe mental illness with nutritional deprivation, metabolic comorbidity, and cognitive frailty. Mechanistic data support plausible links with cytokine biology, the tryptophan–kynurenine pathway, dopaminergic and serotonergic systems, stress regulation, and neuroimmune homeostasis. Conclusions: Vitamin D should be conceptualized in psychiatry as a context-dependent neuroimmune and immunometabolic signal rather than a generic psychotropic intervention. Future studies should prioritize biomarker-enriched, developmentally timed, nutrition-centered models of precision prevention and adjunctive care. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized as a neurodevelopmental condition shaped by early-life biological and environmental factors. Emerging evidence highlights the role of nutrition in modulating key brain processes involved in ADHD, from gestational development through childhood. This review aims to examine how dietary interventions influence neuroimaging outcomes in individuals with ADHD, assessing whether nutritional approaches can modulate brain structure, function, or connectivity. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted to identify studies examining the effects of dietary interventions on neuroimaging outcomes in individuals with ADHD. Study quality was assessed using Cochrane RoB 2.0, ROBINS-I, the Newcastle–Ottawa Scale, and the JBI Critical Appraisal Checklist, according to study design. Results: A total of 1059 records were identified, and 4 studies met the final inclusion criteria. The included studies suggest that prenatal vitamin D exposure, omega-3 fatty acids, and micronutrients such as zinc may be associated with structural, functional, and neurometabolic brain characteristics relevant to ADHD. Reported findings included associations with brain volume, glutamatergic regulation, white matter organization, resting-state network integrity, and inattentive symptom. Conclusions: Current evidence supports the hypothesis that nutrition may influence neurodevelopmental processes involved in ADHD, including brain maturation and neural network organization. Although findings remain heterogeneous and limited in number, nutrition appears to represent a biologically plausible and potentially modifiable factor within the developmental framework of ADHD. Further longitudinal and multimodal neuroimaging studies are needed to clarify the mechanisms linking nutrition, brain development, and ADHD. Full article

Background/Objectives: Accurate identification of neonatal malnutrition is essential for optimizing perinatal care and reducing adverse outcomes. Traditional birthweight-based methods fail to account for body proportionality, limiting their ability to distinguish constitutionally small or large neonates from those with true nutritional abnormalities. We previously developed a customized fetal body mass index (cFBMI) percentile model that incorporates both weight and length, adjusted for maternal and fetal characteristics. This study aims to perform a temporal external validation of the cFBMI model following the Riley et al. framework, comparing its performance against the GROW customized birthweight model and the INTERGROWTH-21st population-based standard. Methods: A temporal validation study was conducted using singleton deliveries from Hospital Universitario de Puerto Real, Cádiz, Spain. The development cohort comprised 7864 deliveries (2002–2021); the validation cohort comprised 4441 deliveries (2022–2025). Inclusion criteria: singleton pregnancy, gestational age of 33–42 + 6 weeks, birthweight of 500–6000 g, known neonatal sex and length, and complete maternal data. The Ponderal Index (PI = weight/length³ × 100) stratified by sex and gestational age served as the gold standard (undernutrition: PI < p10; overnutrition: PI > p90). Discrimination was assessed using the area under the receiver operating characteristic curve (AUC) with bootstrap 95% confidence intervals (2000 iterations) and DeLong tests. Calibration was evaluated by comparing observed versus expected proportions across percentile categories. Clinical utility was assessed using decision curve analysis (DCA). Temporal stability was quantified by comparing AUCs and Brier scores between the development and validation cohorts. Results: In the validation cohort (n = 4441), cFBMI demonstrated superior discrimination for both undernutrition (AUC: 0.962) and overnutrition (AUC: 0.961) compared with GROW (AUC: 0.751 and 0.676, respectively) and INTERGROWTH-21st (AUC: 0.756 and 0.682, respectively); all DeLong comparisons p < 0.0001. The cFBMI exhibited excellent temporal stability (ΔAUC = −0.004 for undernutrition, +0.002 for overnutrition) and superior calibration (observed proportions: 9.6%/81.7%/8.8% vs. expected 10%/80%/10%; χ² = 9.22, p = 0.010). The decision curve analysis confirmed the superior net benefit of cFBMI across all threshold probabilities. Conclusions: The customized fetal BMI percentile model demonstrates excellent and temporally stable discriminative performance in this single-institution temporal validation study, with superior calibration and apparent advantages in clinical utility as determined by decision curve analysis compared with existing methods. Its integration of body proportionality provides conceptual alignment with the Ponderal Index gold standard. These findings are promising but require confirmation through external multicenter validation before clinical implementation can be recommended. Although the mathematical relationship between the index test (weight/length²) and the reference standard (weight/length³) should be considered when interpreting the magnitude of discrimination metrics, validation against independent clinical outcomes is an essential next step. The cFBMI thus provides a proportionality-aware nutritional metric whose primary discriminative advantage over weight-based methods is realized at and beyond the moment of birth, and which is forward-compatible with emerging modalities for independent prenatal fetal length estimation. Full article

Plastic-derived chemical additives, including bisphenols, phthalates, perfluoroalkyl substances (PFAS) and microplastic-associated contaminants, are now recognised as widespread environmental toxins that measurably affect endocrine signalling, oxidative balance, inflammation and metabolic homeostasis. Continuous exposure through food contact materials, consumer products, and environmental media raises concerns about long-term health effects. An increasing number of epidemiological and experimental studies are linking these exposures to metabolic disorders, reproductive dysfunction, neurodevelopmental alterations, and increased disease susceptibility throughout the lifespan. This narrative review summarises the latest evidence on the toxicological mechanisms of these compounds, with a focus on endocrine disruption, redox imbalance, reproductive impairment, thyroid hormone dysregulation and epigenetic modifications induced by plastic-derived chemicals. Literature was identified through searches of major scientific databases, including PubMed, Scopus, and Web of Science. Reference screening was also employed to complement these searches and ensure comprehensive coverage of vertebrate and invertebrate models. The inclusion criteria encompassed studies published within the last 10 years, focusing on experimental, experimental, and translational research. The review evaluates phytochemicals such as polyphenols, flavonoids, isoflavones, catechins, sulforaphane, and chlorogenic acid as natural agents that can mitigate the biological effects of plastic-derived toxicants. These compounds exhibit antioxidant, anti-inflammatory, and receptor-modulating properties that counteract pathways disrupted by BPA, phthalates, and PFAS. Experimental studies have demonstrated that phytochemicals can modulate oestrogen receptor activity, enhance detoxification systems, reduce oxidative biomarkers and mitigate epigenetic and metabolic alterations induced by micro- and nanoplastics. Emerging nutritional evidence suggests that diets high in polyphenols may reduce the biological impact of plastic-derived contaminants within the body, rather than reducing exposure itself. This effect appears to be especially relevant during sensitive developmental periods, such as the prenatal, early postnatal and adolescent stages. Full article

Over recent decades, a substantial body of research has expanded our understanding of how early-life conditions influence long-term health. These observations led to the formulation of the Barker Hypothesis, which postulates that adverse nutritional exposures during fetal life can induce persistent physiological and metabolic adaptations, thereby increasing susceptibility to chronic diseases later in life. This narrative review aims to provide a comprehensive overview of current recommendations for adequate maternal nutrition during pregnancy, with particular emphasis on key nutrients and specific dietary patterns. In addition, the effects of maternal diet on placental function and fetal growth are examined. A literature search was conducted in the following electronic databases: MEDLINE (via PubMed), Scopus, Web of Science, Embase, and the Cochrane Library. Manuscripts published between 2005 and 2025 were considered. The impact of prenatal nutritional exposures on immune development, neurodevelopment, metabolic regulation, and gut microbiota is also discussed, highlighting how these mechanisms may contribute to an increased long-term risk of non-communicable diseases, including obesity, metabolic syndrome, and neuropsychiatric disorders. Maternal nutrition during pregnancy plays a crucial role in shaping infants’ and children’s health, particularly regarding the development of non-communicable diseases. Therefore, ensuring adequate nutritional intake during this critical period—both quantitatively and qualitatively—is essential to optimize health outcomes for the newborn and to promote long-term well-being throughout childhood and beyond. Full article

Objectives: The objectives of this review are to explore the effects of various nutrition and exercise lifestyle interventions on pregnancy outcomes in individuals with, or at risk of, gestational diabetes mellitus (GDM), as well as to examine whether interventions that are culturally and/or religiously sensitive influence clinical and behavioural outcomes. Methods: This study was conducted as a narrative review. PRISMA was used solely as a reporting guide to enhance transparency in the search and study selection process. PubMed/MEDLINE, CINAHL, and Scopus were searched for studies published up to November 2025. Intervention-based studies evaluating nutrition, physical activity, or combined lifestyle interventions targeting either GDM incidence, insulin use, or glycemic outcomes were included. Forty-three studies met eligibility criteria. Study designs consisted primarily of randomized controlled trials (RCTs) with one case–control and one quasi-experimental design trial. Results: Combined lifestyle interventions generally showed the most consistent improvements in glycemic control; however, findings were not uniform across all studies, and reporting on insulin outcomes was limited. The Mediterranean, low-glycemic index (LGI) and DASH diets, along with supervised, prenatal exercise programs with low–moderate intensity, delivered at least three times per week, were effective in managing GDM. Regarding culturally or religiously sensitive interventions, only one study was identified. Conclusions: Lifestyle interventions may improve glycemic outcomes in GDM; however, further high-quality research is needed, particularly studies incorporating culturally and religiously sensitive approaches and improved reporting of insulin-related outcomes. Full article

Background and Objectives: The double burden of malnutrition (DBM), characterized by the coexistence of malnutrition and overweight within the same household, has become a significant public health concern in low- and middle-income countries. Tanzania is undergoing a nutritional transition marked by persistent child malnutrition alongside increasing maternal overweight. This study examined socio-demographic, maternal, and child-level factors associated with DBM among children under five years in Tanzania. Methods: This cross-sectional study used data from the 2022 Tanzania Demographic and Health Survey, including a weighted sample of 5744 children under five and their mothers aged 15–49 years. DBM was defined as the presence of child malnutrition, measured using the Composite Index of Anthropometric Failure (CIAF), in households where the mother was overweight or obese. Bivariate chi-square tests and binary logistic regression analyses were conducted in STATA 17. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated to identify predictors of DBM. Results: DBM was more prevalent in rural areas. Significant predictors included birth order (AOR = 0.611, p = 0.030), child sex (AOR = 0.708, p = 0.011), perceived birth size (AOR = 0.270, p = 0.004), child age (AOR = 0.474, p < 0.001), maternal age (AOR = 0.599, p = 0.045), and maternal education (AOR = 0.604, p = 0.035). Higher maternal education reduced the likelihood of DBM, while firstborn male and small-sized children were at greater risk. Conclusions: DBM in Tanzania is influenced by both biological and socio-demographic factors. Integrated, multi-sectoral interventions targeting maternal education, prenatal care, and optimal maternal nutrition are essential to reduce DBM and achieve global malnutrition reduction targets. Full article

Maternal nutrition during late gestation is critical for fetal development, neonatal resilience, and postnatal adaptation in beef cattle. This study aimed to evaluate the effects of nutritional restriction and supplementation of hydroxytyrosol (HT) in late pregnancy on behavioural, circadian, stress-related, and inflammatory responses in cows and their restricted nursed offspring. Pregnant cows were allocated to a 2 × 2 factorial experimental design (feeding level: T100% vs. T60% of nutrient requirements; HT: 0 vs. 180 mg/kg of diet). Cow behaviours were recorded during meals (from week −12 prepartum to term), and calf activities, body temperature, and mother–offspring interactions were assessed at 5 weeks postpartum. Nutritional restriction accelerated feed intake in cows and increased stress-related behaviours, while HT partially mitigated these effects. Molecular analyses in blood samples revealed dynamic prepartum upregulation of glucocorticoid-receptor NR3C1 in week −6, and downregulation of circadian (BMAL1, PER1, CRY1) gene expression in week 5 after parturition, both in T60%-HT cows. In calves, maternal HT supplementation promoted active exploratory behaviour, and counteracted behavioural and circadian (CRY1 and PER1) and inflammatory markers (IL8) gene expression resulting from prenatal nutrient restriction, leading to behavioural profiles and blood gene expression comparable to those observed in calves born to adequately fed dams. Full article

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder characterized by progressive synaptic dysfunction, axonal pathology, and cognitive decline, with the hippocampal circuits showing particular vulnerability during disease progression. However, early-life nutritional interventions may influence long-term synaptic resilience. In this study, we investigated the long-term effects of prenatal and lactational supplementation with choline, UMP, and fish oil in the 5XFAD mouse model. To this end, hippocampal synaptic and axonal pathology was assessed at 3, 6, and 9 months using Western blotting and immunofluorescence to measure synaptophysin, PSD-95, and neurofilament medium chain (NF-M), alongside a multidimensional behavioral battery that evaluated cognitive, affective, motor, and sensory outcomes. Results showed that early-life supplementation did not significantly improve the learning performance decline, increase nociception, or reverse changes in anxiety behavior in transgenic mice. However, it attenuated synaptic decline in transgenic animals by partially preserving synaptophysin and PSD-95 levels and reducing NF-M elevations. These molecular effects were accompanied by selective behavioral modulation, including preserved learning dynamics, altered anxiety-like behavior, and delayed nociceptive hypersensitivity, while late-stage motor impairments remained largely unaffected. Overall, prenatal and lactational supplementation produced modest, age-dependent effects on synaptic markers and partially prevented neurodegenerative progression in the 5XFAD model. Full article

Background: Although there is substantial research into individual nutrients during pregnancy, such as folate, iron, and vitamin D, little is known about the impact of mixtures of essential nutrients. We investigated the associations between mixtures of maternal essential minerals and vitamin concentrations and child cognition and executive functions at age 7. Methods: Data from 348 mother–child pairs in the Growing up in Singapore Towards Healthy Outcomes birth cohort with both plasma nutrient and neurodevelopmental outcome data were used. Gestational fasting plasma samples between 26 and 28 weeks of gestation were analyzed for 10 essential minerals and 12 B and D vitamers. Child cognition and executive functions at 7 years were assessed using the Wechsler Abbreviated Scale of Intelligence 2nd Edition (WASI-II) [n = 331] and the Behavior Rating Inventory of Executive Function 2nd Edition (BRIEF-2) [n = 348], respectively. Generalized weighted quantile sum regression (gWQS) was used to investigate the associations between nutrient mixtures and child cognitive executive function scores. Single-nutrient analysis using covariate-adjusted multivariable regressions was performed as a sensitivity analysis. Results: A one-quartile increase in the positively weighted nutrient mixture index was associated with higher block design T-scores (β = 2.17, 95% CI: 0.03, 4.31). Additionally, the negatively weighted mixture was associated with lower block design (β = −2.25, 95% CI: −4.92, 0.41, p = 0.02) and perceptual reasoning (β = −1.94, 95% CI: −5.17, 1.29, p = 0.04) scores in boys only. We found no association between the nutrient mixture and BRIEF-2 subscale T-scores. Conclusions: In this study, we found that a positively weighted nutrient mixture index of maternal gestational minerals and vitamins was associated with a greater ability in children to analyze and understand abstract visual items. Full article

Chronic kidney disease (CKD) represents a major global health burden, with growing evidence indicating that its origins extend back to early developmental stages. This narrative review integrates epidemiological, clinical, and mechanistic experimental evidence to position inflammation as a life-course driver of kidney vulnerability rather than a late-stage consequence. Inflammation has emerged as a central mechanistic link connecting adverse prenatal and postnatal exposures to lifelong kidney vulnerability. We highlight the translational potential by identifying pathways amenable to early-life interventions that could modify disease trajectory. During fetal development, maternal nutritional status, metabolic stress, and inflammatory exposures influence nephron endowment, immune maturation, and epigenetic regulation, thereby shaping long-term CKD risk. In childhood, early immune dysregulation and low-grade inflammation contribute to disease initiation, defining critical windows for preventive and renoprotective interventions that can be implemented in at-risk populations. In adulthood and aging, persistent activation of cytokine signaling, inflammasomes, oxidative stress pathways, autophagy–mitophagy imbalance, and cellular senescence drives progressive kidney injury, further amplified by gut microbiota dysbiosis and renin–angiotensin system interactions. Emerging life-course strategies include maternal nutrition optimization, early-life risk stratification, targeted anti-inflammatory and immunomodulatory therapies, and microbiota-directed interventions tailored to developmental stage and individual risk profile. By emphasizing inflammation as a developmentally programmed and preventable process, this review underscores opportunities for early-life and transgenerational CKD prevention, translating mechanistic insights into actionable strategies for preventive medicine and public health. Full article