Maternal nutrition and developmental programming of lifelong health

Maternal nutrition plays a fundamental role in shaping fetal development and long-term health outcomes, forming the basis of the developmental origins of health and disease (DOHaD) paradigm. This perspective aims to examine how maternal nutritional status—before and during pregnancy, as well as in early postnatal life—acts as a key biological signal that programs gene expression, organ development, and metabolic function in the offspring. This paper highlights major mechanisms underlying developmental programming, including epigenetic modifications, hormonal influences, placental function, and the maternal microbiome. It also explores the consequences of both undernutrition and overnutrition, emphasizing the concept of environmental mismatch, whereby discordance between prenatal and postnatal environments increases susceptibility to obesity, type 2 diabetes, and cardiovascular disease. In addition, the role of essential micronutrients and the importance of early-life nutrition during the first 1000 days are discussed, alongside emerging evidence of transgenerational effects. In conclusion, optimizing maternal nutrition represents a critical and modifiable determinant of lifelong health, with significant clinical and public health implications, offering a powerful strategy for reducing the global burden of non-communicable diseases across generations.