Prevention

1.2.1 Considerations by generational group

Prenatal Nutrition

Maternal nutrition during pregnancy is critical for both immediate birth outcomes and the long-term health trajectory of the child. Balanced maternal diets including essential micronutrients such as iron, iodine and folic acid can reduce the risks of neural tube defects, low birth weight and developmental delays (Black et al., 2013; NICE, 2021). Routine folic acid supplementation (400 mcg daily) is recommended, as is iron and vitamin D supplementation, alongside the avoidance of harmful substances such as alcohol, tobacco and excessive caffeine (WHO, 2016; NHS, 2023). Comprehensive antenatal education and support programmes, including nutritional counselling and screening for micronutrient deficiencies, are recommended to optimise maternal and infant health (Cetin et al., 2019).

Early Childhood (0–4 years)

Optimal nutrition in the first four years is foundational for growth and cognitive development. Exclusive breastfeeding is recommended for the first six months, followed by continued breastfeeding alongside appropriate complementary feeding up to two years and beyond (Victora et al., 2016; WHO, 2023). Interventions to promote breastfeeding include Baby-Friendly Hospital Initiatives, community lactation support, and workplace accommodations for breastfeeding mothers (Rollins et al., 2016). Introduction of diverse, nutrient-rich complementary foods should begin at six months, focusing on fruits, vegetables, whole grains, and limiting added sugars and salt (Fewtrell et al., 2017). Early childhood settings should implement nutrition standards and provide education to caregivers to reinforce healthy habits (Neelon & Briley, 2011).

Children (5–14 years)

School-aged children benefit from interventions that foster lifelong healthy eating behaviours. School meal nutritional guidelines, restrictions on the marketing of unhealthy foods and nutrition education integrated into curricula are proven strategies (Waters et al., 2011; Office for Health Improvement and Disparities, 2016). The provision of free fruit and vegetable schemes, such as the School Fruit and Vegetable Scheme in England, increases access to healthy options (Evans et al., 2012). Family engagement through cooking classes and shared meal times further supports positive dietary patterns (Scaglioni et al., 2018).

Adolescents and Young Adults (15–21 years)

Adolescents and young adults face unique nutritional challenges, including increased autonomy, peer and media influences and a tendency towards convenience foods. Interventions targeting this group include digital health campaigns to counteract misinformation and peer-led education (Story et al., 2002; Viner et al., 2019). Behavioural design strategies—such as default healthy options in cafeterias and digital nudges—have shown effectiveness in improving dietary choices (Hollands et al., 2017). Schools, colleges, and workplaces should provide nutritious food options and integrate nutrition literacy into health and wellbeing programmes (WHO, 2022).

Young Adults (22–36 years)

During early adulthood, nutrition should align with lifestyle such as physical activity level, pregnancy etc, as well as focussing on the prevention of early onset of chronic diseases by limiting foods high in fat, salt and sugar. Workplace wellness programmes that offer healthy meal options, nutrition workshops and incentives for physical activity have demonstrated positive impacts on dietary quality (Afshin et al., 2019; NICE, 2020). Community-based interventions, including cooking skills classes and access to affordable fresh produce, further support healthy eating (Mozaffarian et al., 2018).

Adults (37–54 years)

Individuals in this age group face an increasing risk of obesity, diabetes, cardiovascular disease and other chronic diseases. Gender-specific needs, such as bone health in women and cardiovascular health in men, should be addressed through targeted interventions (British Dietetic Association, 2019). Programmes promoting the Mediterranean or DASH diets, which emphasise fruits, vegetables, whole grains, lean proteins and healthy fats, are recommended for chronic disease prevention (Estruch et al., 2018). Regular health screenings and personalised nutrition counselling can support behaviour change, while workplace initiatives and community support groups provide additional reinforcement (NICE, 2022).

Older Adults (55–70 years)

For adults aged 55 to 70, dietary interventions focus on the prevention of chronic diseases, maintenance of cognitive and physical function and the prevention of frailty. Adequate protein intake, vitamin D and calcium supplementation (particularly for post-menopausal women), and the consumption of antioxidant-rich foods are recommended (EFSA, 2016). Strategies include group nutrition education, meal delivery services and social eating programmes to combat isolation and support adherence (Milte & McNaughton, 2016).

Later Years (70+ years)

Nutrition in adults over 70 must account for physiological changes, such as reduced appetite, altered taste perception and decreased nutrient absorption. Interventions include the provision of nutrient-dense, palatable meals, routine screening for malnutrition (e.g., MUST tool), and oral nutrition supplements where needed (Volkert et al., 2019). Programmes such as Meals on Wheels, dietary advice tailored to swallowing difficulties and fortified foods are effective in maintaining nutritional status and supporting independence (Morley et al., 2010).