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THE BIOLOGY
OF THE FIRST
1,000 DAYS
 OXIDATIVE STRESS AND DISEASE

Series Editors

Lester Packer, PhD

Enrique Cadenas, MD, PhD
University of Southern California School of Pharmacy
Los Angeles, California

1. Oxidative Stress in Cancer, AIDS, and Neurodegenerative Diseases,

edited by Luc Montagnier, René Olivier, and Catherine Pasquier
2. Understanding the Process of Aging: The Roles of Mitochondria, Free
Radicals, and Antioxidants, edited by Enrique Cadenas and Lester Packer
3. Redox Regulation of Cell Signaling and Its Clinical Application, edited by
Lester Packer and Junji Yodoi
4. Antioxidants in Diabetes Management, edited by Lester Packer, Peter Rösen,
Hans J. Tritschler, George L. King, and Angelo Azzi
5. Free Radicals in Brain Pathophysiology, edited by Giuseppe Poli, Enrique
Cadenas, and Lester Packer
6. Nutraceuticals in Health and Disease Prevention, edited by Klaus Krämer,
Peter-Paul Hoppe, and Lester Packer
7. Environmental Stressors in Health and Disease, edited by Jürgen Fuchs and
Lester Packer
8. Handbook of Antioxidants: Second Edition, Revised and Expanded,
edited by Enrique Cadenas and Lester Packer
9. Flavonoids in Health and Disease: Second Edition, Revised and Expanded,
edited by Catherine A. Rice-Evans and Lester Packer
10. Redox–Genome Interactions in Health and Disease, edited by Jürgen Fuchs,
Maurizio Podda, and Lester Packer
11. Thiamine: Catalytic Mechanisms in Normal and Disease States,
edited by Frank Jordan and Mulchand S. Patel
12. Phytochemicals in Health and Disease, edited by Yongping Bao and
Roger Fenwick
13. Carotenoids in Health and Disease, edited by Norman I. Krinsky,
Susan T. Mayne, and Helmut Sies
14. Herbal and Traditional Medicine: Molecular Aspects of Health, edited by
Lester Packer, Choon Nam Ong, and Barry Halliwell
15. Nutrients and Cell Signaling, edited by Janos Zempleni and
Krishnamurti Dakshinamurti
16. Mitochondria in Health and Disease, edited by Carolyn D. Berdanier
17. Nutrigenomics, edited by Gerald Rimbach, Jürgen Fuchs, and Lester Packer
18. Oxidative Stress, Inflammation, and Health, edited by Young-Joon Surh and
Lester Packer
19. Nitric Oxide, Cell Signaling, and Gene Expression, edited by Santiago Lamas
and Enrique Cadenas
20. Resveratrol in Health and Disease, edited by Bharat B. Aggarwal and
Shishir Shishodia
21. Oxidative Stress and Age-Related Neurodegeneration, edited by Yuan Luo
and Lester Packer
22. Molecular Interventions in Lifestyle-Related Diseases, edited by
Midori Hiramatsu, Toshikazu Yoshikawa, and Lester Packer
23. Oxidative Stress and Inflammatory Mechanisms in Obesity, Diabetes, and the
Metabolic Syndrome, edited by Lester Packer and Helmut Sies
24. Lipoic Acid: Energy Production, Antioxidant Activity and Health Effects,
edited by Mulchand S. Patel and Lester Packer
25. Dietary Modulation of Cell Signaling Pathways, edited by Young-Joon Surh,
Zigang Dong, Enrique Cadenas, and Lester Packer
26. Micronutrients and Brain Health, edited by Lester Packer, Helmut Sies,
Manfred Eggersdorfer, and Enrique Cadenas
27. Adipose Tissue and Inflammation, edited by Atif B. Awad and
Peter G. Bradford
28. Herbal Medicine: Biomolecular and Clinical Aspects, Second Edition,
edited by Iris F. F. Benzie and Sissi Wachtel-Galor
29. Inflammation, Lifestyle and Chronic Diseases: The Silent Link,
edited by Bharat B. Aggarwal, Sunil Krishnan, and Sushovan Guha
30. Flavonoids and Related Compounds: Bioavailability and Function,
edited by Jeremy P. E. Spencer and Alan Crozier
31. Mitochondrial Signaling in Health and Disease, edited by Sten Orrenius,
Lester Packer, and Enrique Cadenas
32. Vitamin D: Oxidative Stress, Immunity, and Aging, edited by
Adrian F. Gombart
33. Carotenoids and Vitamin A in Translational Medicine, edited by
Olaf Sommerburg, Werner Siems, and Klaus Kraemer
34. Hormesis in Health and Disease, edited by Suresh I. S. Rattan and
Éric Le Bourg
35. Liver Metabolism and Fatty Liver Disease, edited by Oren Tirosh
36. Nutrition and Epigenetics, edited by Emily Ho and Frederick Domann
37. Lipid Oxidation in Health and Disease, edited by Corinne M. Spickett and
Henry Jay Forman
38. Diversity of Selenium Functions in Health and Disease, edited by
Regina Brigelius-Flohé and Helmut Sies
39. Mitochondria in Liver Disease, edited by Derick Han and Neil Kaplowitz
40. Fetal and Early Postnatal Programming and its Influence on Adult Health,
edited by Mulchand S. Patel and Jens H. Nielsen
41. Biomedical Application of Nanoparticles, edited by Bertrand Rihn
42. The Biology of the First 1,000 Days, edited by Crystal D. Karakochuk,
Kyly C. Whitfield, Tim J. Green, and Klaus Kraemer
http://taylorandfrancis.com
 THE BIOLOGY
OF THE FIRST
1,000 DAYS

EDITED BY
CRYSTAL D. KARAKOCHUK, KYLY C. WHITFIELD,
TIM J. GREEN, AND KLAUS KRAEMER
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742

© 2018 by Taylor & Francis Group, LLC

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Printed on acid-free paper

International Standard Book Number-13: 978-1-4987-5679-2 (Hardback)

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Library of Congress Cataloging‑in‑Publication Data

Names: Karakochuk, Crystal D., editor. | Whitfield, Kyly C., editor. | Green, Tim J.,
1967- editor. | Kraemer, Klaus, 1960- editor.
Title: The biology of the first 1,000 days / [edited by] Crystal D. Karakochuk, Kyly C.
Whitfield, Tim J. Green, and Klaus Kraemer.Other titles: Biology of the first thousand
days | Oxidative stress and disease ; 42.
Description: Boca Raton : Taylor & Francis, 2018. | Series: Oxidative stress and disease;
42 | Includes bibliographical references.
Identifiers: LCCN 2017013475 | ISBN 9781498756792 (hardback : alk. paper)
Subjects: | MESH: Pregnancy--physiology | Pregnancy Trimester, First--physiology |
Maternal Nutritional Physiological Phenomena | Fetal Development | Nutritional
Requirements | Pregnancy Complications--etiology | Pregnancy Complications--
prevention & control
Classification: LCC RG525 | NLM WQ 200.1 | DDC 618.2--dc23
LC record available at https://lccn.loc.gov/2017013475

Visit the Taylor & Francis Web site at

http://www.taylorandfrancis.com

and the CRC Press Web site at

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Contents
Series Preface.......................................................................................................... xiii
Preface...................................................................................................................... xv
Acknowledgments...................................................................................................xvii
Editors......................................................................................................................xix
Contributors.............................................................................................................xxi

Section I  Introduction

Chapter 1 The Importance of the First 1,000 Days: An Epidemiological

Perspective.............................................................................................3
Christine M. McDonald and Andrew L. Thorne-Lyman

Section II  What Is Normal Growth?

Chapter 2 World Health Organization Child Growth Standards......................... 17

Mercedes de Onis

Section III  Nutritional Requirements

in the Life Stages
Chapter 3 Nutrient Requirements and Recommendations during Pregnancy..... 35
Magali Leyvraz and Lynnette M. Neufeld

Chapter 4 Nutrient Requirements during Lactation............................................ 53

Victoria Hall Moran

Chapter 5 Nutrient Requirements of Infants and Young Children...................... 75

Minghua Tang, Kathryn G. Dewey, and Nancy F. Krebs

vii
viii Contents

Section IV Endocrinology in the

Regulation of Growth
Chapter 6 Hormonal Regulation during Lactation and Human Milk
Production........................................................................................... 89
William R. Crowley

Chapter 7 Thyroid Function and Growth: The Mechanisms of Iodine............. 105

Jessica Farebrother and Fabian Rohner

Section V A
 dverse Pregnancy and Birth
Outcomes (Pathophysiology
and Consequences)
Chapter 8 Neural Tube Defects: Mechanisms of Folate.................................... 123
Anne M. Molloy

Chapter 9 Cleft Lip and Palate........................................................................... 137

Eman Allam, Ahmed Ghoneima, and Katherine Kula

Chapter 10 Obesity and Gestational Diabetes..................................................... 145

Maria Farren and Michael J. Turner

Chapter 11 Nutrition and Hypertensive Disorders of Pregnancy........................ 155

Antonia W. Shand and Tim J. Green

Chapter 12 Low Birth Weight and Small for Gestational Age in the Context
of 1,000 Days..................................................................................... 171
Amira M. Khan, Bianca Carducci, and Zulfiqar A. Bhutta

Section VI  P
 athophysiology and Nutrition
Requirements in Child Malnutrition

Chapter 13 Acute Malnutrition............................................................................ 191

André Briend
Contents ix

Chapter 14 Management of Acute Malnutrition in Infants under 6 Months

of Age................................................................................................207
Marko Kerac and Marie McGrath

Chapter 15 Chronic Malnutrition........................................................................ 221

Saskia de Pee

Chapter 16 Nutritional Regulation of the Growth Plate...................................... 237

Julian C. Lui

Section VII  Body Composition

Chapter 17 Gestational Weight Gain and Body Composition in Pregnant

and Postpartum Women.................................................................... 255
Elisabet Forsum

Chapter 18 Body Composition Changes from Infancy to Young Childhood...... 269

Daniel J. Hoffman and Pamela L. Barrios

Section VIII  The Gut Microbiome

Chapter 19 Early Life Gut Microbiome............................................................... 289

Christopher J. Stewart and Stephen P. Cummings

Chapter 20 Impact of Different Exposures, Including Environmental

Enteropathies, on Gut Flora and Integrity......................................... 303
Fayrouz A. Sakr Ashour

Section IX Effects of Early Life

Exposures and Nutrition

Chapter 21 Effects of Early Diet on Childhood Allergy..................................... 323

Merryn Netting and Maria Makrides
x Contents

Chapter 22 Epigenetics, Nutrition, and Infant Health......................................... 335

Philip T. James, Matt J. Silver, and Andrew M. Prentice

Chapter 23 Fetal Origins of Obesity, Cardiovascular Disease, and Type 2

Diabetes............................................................................................. 355
Herculina Salome Kruger and Naomi S. Levitt

Section X Effective Interventions

during the First 1,000 Days

Chapter 24 Effectiveness of Nutrition-Specific Interventions in Pregnancy

and Early Childhood......................................................................... 371
Rebecca Heidkamp, Adrienne Clermont, and Robert E. Black

Chapter 25 Nutrition-Sensitive Interventions for the First 1,000 Days............... 389

Jessica Fanzo and Haley Swartz

Chapter 26 Global Progress in the Scaling Up Nutrition (SUN) Movement.......409

Tom Arnold

Section XI  Before and Beyond the First 1,000 Days

Chapter 27 A Role for Preconception Nutrition.................................................. 423

Taylor Marie Snyder, Homero Martinez, Sara Wuehler,
and Luz Maria De-Regil

Chapter 28 Interpregnancy Intervals and Birth Spacing..................................... 439

Amanda Wendt and Usha Ramakrishnan

Chapter 29 Adolescent Nutrition: A Critical Opportunity for Intervention........ 457

Emily Mates and Anne Bush
Contents xi

Section XII  Discovery Research

Chapter 30 Metabolomics and Proteomics: Methodological Advances to

Increase Our Knowledge of Biology during the First 1,000 Days.... 473
Richard D. Semba and Marta Gonzalez-Freire

Index....................................................................................................................... 485
http://taylorandfrancis.com
Series Preface
OXIDATIVE STRESS IN HEALTH AND DISEASE
Oxidative stress is an underlying factor in health and disease. In this series of books
the importance of oxidative stress and disease associated with cell and organ sys-
tems of the body is highlighted by exploring the scientific evidence and the clinical
applications of this knowledge. This series is intended for researchers in the bio-
medical sciences and clinicians and all persons with interest in the health sciences.
The potential of such knowledge for healthy development, healthy aging, and disease
prevention warrants further knowledge about how oxidants and antioxidants modu-
late cell and tissue function.
Crystal D. Karakochuk, Kyly C. Whitfield, Tim J. Green, and Klaus Kraemer are
to be congratulated for producing this very excellent and timely book, The Biology
of the First 1,000 Days, in the ever-growing field of importance of early nutrition to
human health.

Lester Packer
Enrique Cadenas

xiii
http://taylorandfrancis.com
Preface
The first 1,000 days, from conception to 2 years of age, is a critical window of growth
and development. Exposures to dietary, environmental, hormonal, and other stress-
ors during this period have been associated with an increased risk of adverse health
outcomes. Researchers using cell culture, animal models, and humans have identi-
fied this time as a period of rapid physiological change and plasticity with significant
potential for lasting effects. As such, interventions during the first 1,000 days will
have the greatest impact on outcomes, particularly in low- and middle-income coun-
tries where the need is greatest.
To date, there is no single resource that compiles our knowledge of the biology
of the first 1,000 days. Our knowledge and understanding of the biology behind
the first 1,000 days is still limited. This greater understanding is helping us inform
effective nutrition policy and programming. The strength of this book lies in its
cross-​disciplinary nature that encompasses the full range of human biology, provid-
ing a more holistic perspective during this critical time frame. Moreover, we have
broadened the scope and included important periods before and after the 1,000 days.
We have designed this book as a comprehensive resource for those involved in
global health and nutrition policy, strategy, programming, or research. This book
will also be a resource for students learning about nutrition and health across the
1,000 days. The book includes an exceptional group of contributors who are experts
in their given fields. As biology underlies the core of each discussion, it allows
the readers to answer the what and why, and, we hope, the how for new discovery
research and more effective interventions.
Each chapter in this volume provides insight into a specific life stage, disease
state, nutrient, and stressor in the first 1,000 days. As such, each chapter can be read
independently, providing a comprehensive overview of that subject. However, there
is continuity between chapters allowing this collection of chapters to be read cover
to cover. The first chapters set the stage, providing a succinct resource to understand
the well-established biological mechanisms that underlie growth regulation and
nutrient recommendations throughout the first 1,000 days. The next chapters move
on to the evidence behind nutrition-specific and nutrition-sensitive interventions
to combat adverse outcomes and disease states in the first 1,000 days. This book
also features emerging research areas, such as the gut microbiome, environmental
enteric dysfunction, and the role of epigenetics in health and development. The final
chapter pushes the boundaries of discovery research, exploring novel areas such as
proteomics and metabolomics, and how insults such as environmental enteric dys-
function affect metabolism in the first 1,000 days.

xv
xvi Preface

We approached this book with the ambition to shed more light on the biology dur-
ing 1,000 days, but there was also a need to put the biology into a broader context of
nutrition and health. There are still many gaps in our understanding of the biology
of the first 1,000 days. It is only by bridging this knowledge gap through research
that we can inform effective interventions to improve outcomes during the first 1,000
days.

Crystal D. Karakochuk
Kyly C. Whitfield
Tim J. Green
Klaus Kraemer
Acknowledgments
We extend our sincere thanks to the contributing authors. We are grateful for your
dedication to this project and it was an honor to work with each of you. We owe
special thanks to Susie Lunt and Sandra Elias for their editorial assistance. Last,
we thank Chuck Crumly and Jennifer Blaise for their support and leadership in the
creation of this landmark publication.

xvii
http://taylorandfrancis.com
Editors
Crystal D. Karakochuk, PhD, RD, is an assistant professor in the Department of
Food, Nutrition, and Health at the University of British Columbia, and an investigator
in Healthy Starts at BC Children’s Hospital, Vancouver, British Columbia, Canada.
She has worked internationally as a nutritionist for the United Nations World Food
Programme (Rwanda, Malawi, Ethiopia, and Rome) and UNICEF (New York and
Timor-Leste). Her research focuses on anemia, nutritional biomarkers (namely, iron
and zinc), the effect of inflammation on nutritional biomarkers, and genetic hemo-
globinopathies and blood disorders (e.g., sickle cell).

Kyly C. Whitfield, PhD, is an assistant professor in the Department of Applied

Human Nutrition at Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
Her research focuses on identifying culturally appropriate public health interven-
tions to combat micronutrient deficiencies in low-resource settings, particularly
among lactating mothers and their infants. Her current work explores fortification
to address thiamin deficiency among breastfed infants in Southeast Asia. She is also
interested in exploring the long-term effects of infant feeding behaviors on disease
risk later in life.

Tim J. Green, PhD, is a principal nutritionist in the Healthy Mothers, Babies, and
Children Theme at the South Australian Health and Medical Research Institute, and
an affiliate professor in the Discipline of Paediatrics at the University of Adelaide,
Adelaide, Australia. His research focuses on micronutrients in prepregnancy, preg-
nancy, lactation, and early life with studies conducted in Canada, Oceania, Asia,
and Africa. His group seeks to identify micronutrient deficiencies through nutrition
surveys, better define micronutrient requirements and pregnancy outcomes in these
groups through randomized control studies, and develop sustainable strategies to
improve micronutrient status.

Klaus Kraemer, PhD, is the managing director of the Sight and Life Foundation,
a nutrition think tank working toward a world free from malnutrition, headquar-
tered in Basel, Switzerland; and an adjunct associate professor in the Department
of International Health of Johns Hopkins Bloomberg School of Public Health,
Baltimore, Maryland. With over 30 years of experience in research and advocacy
in the field of nutrition and health, he has developed an expertise in nutrition and
safety of micronutrients, and translating discovery research into effective and tai-
lored nutrition solutions at scale. He is a member of the Steering Committee of the
Micronutrient Forum, Executive Committee of the Home Fortification Technical
Advisory Group, Executive Board of the Mongolian Health Initiative, and a found-
ing member of the Society for Implementation Science in Nutrition, among others.

xix
http://taylorandfrancis.com
Contributors
Eman Allam Anne Bush
School of Dentistry Independent Consultant
Indiana University Surrey, United Kingdom
Indianapolis, Indiana
Bianca Carducci
Tom Arnold The Hospital for Sick Children
Institute of International and European The Centre for Global Child Health
Affairs Toronto, Ontario, Canada
Dublin, Ireland
Adrienne Clermont
Fayrouz A. Sakr Ashour Global Disease and Epidemiology
Department of Nutrition and Food Program
Science Bloomberg School of Public Health
University of Maryland Johns Hopkins University
College Park, Maryland Baltimore, Maryland

Pamela L. Barrios William R. Crowley

Department of Nutritional Sciences Department of Pharmacology
New Jersey Institute for Food, and Toxicology
Nutrition, and Health University of Utah
Rutgers University Salt Lake City, Utah
New Brunswick, New Jersey
Stephen P. Cummings
Zulfiqar A. Bhutta School of Science and Engineering
The Hospital for Sick Children Teesside University
The Centre for Global Child Health Middlesbrough, United Kingdom
Toronto, Ontario, Canada
Mercedes de Onis
Robert E. Black Growth Assessment and Surveillance
Department of International Health Unit
Bloomberg School of Public Health Department of Nutrition for Health
Johns Hopkins University and Development
Baltimore, Maryland World Health Organization
Geneva, Switzerland
André Briend
Department of Nutrition, Exercise Saskia de Pee
and Sports Nutrition Division
University of Copenhagen World Food Programme
Frederiksberg, Denmark Rome, Italy

xxi
xxii Contributors

Luz Maria De-Regil Tim J. Green

Micronutrient Initiative Healthy Mothers, Babies, and Children
Ottawa, Ontario, Canada South Australian Health and Medical
Research Institute
Kathryn G. Dewey Adelaide, South Australia, Australia
Department of Nutrition
University of California, Davis Rebecca Heidkamp
Davis, California Department of International Health
Bloomberg School of Public Health
Jessica Fanzo Johns Hopkins University
School of Advanced International Baltimore, Maryland
Studies
Johns Hopkins University Daniel J. Hoffman
Baltimore, Maryland Department of Nutritional Sciences
New Jersey Institute for Food,
Jessica Farebrother Nutrition, and Health
Laboratory for Human Nutrition Rutgers University
Institute of Food, Nutrition and Health New Brunswick, New Jersey
ETH Zürich
Zürich, Switzerland Philip T. James
MRC Unit The Gambia and MRC
Maria Farren International Nutrition Group
University College Dublin Centre for London School of Hygiene and Tropical
Human Reproduction Medicine
Coombe Women and Infants University London, United Kingdom
Hospital
Dublin, Ireland Marko Kerac
Department of Population Health
Elisabet Forsum London School of Hygiene & Tropical
Department of Clinical and Medicine
Experimental Medicine London, United Kingdom
Linköping University
Linköping, Sweden Amira M. Khan
The Hospital for Sick Children
Ahmed Ghoneima The Centre for Global Child Health
School of Dentistry Toronto, Ontario, Canada
Indiana University
Indianapolis, Indiana Nancy F. Krebs
Section of Nutrition
Marta Gonzalez-Freire Department of Pediatrics
National Institute on Aging University of Colorado
National Institutes of Health Aurora, Colorado
Baltimore, Maryland
Contributors xxiii

Herculina Salome Kruger Christine M. McDonald

Centre of Excellence for Nutrition Children’s Hospital Oakland Research
North-West University Institute
Potchefstroom, South Africa Oakland, California

Katherine Kula Marie McGrath

School of Dentistry Emergency Nutrition Network
Indiana University Oxford, United Kingdom
Indianapolis, Indiana
Anne M. Molloy
Naomi S. Levitt School of Medicine and School of
Chronic Disease Initiative for Africa Biochemistry and Immunology
Division of Diabetic Medicine Trinity College Dublin
and Endocrinology Dublin, Ireland
University of Cape Town
Cape Town, South Africa Victoria Hall Moran
Maternal and Infant Nutrition
Magali Leyvraz and Nurture Unit
Global Alliance for Improved Nutrition University of Central Lancashire
Geneva, Switzerland Preston, United Kingdom

Julian C. Lui Merryn Netting

Section on Growth and Development Healthy Mothers, Babies, and Children
Eunice Kennedy Shriver National South Australian Health and Medical
Institute of Child Health and Human Research Institute
Development Adelaide, South Australia, Australia
National Institutes of Health
Bethesda, Maryland Lynnette M. Neufeld
Global Alliance for Improved Nutrition
Maria Makrides Geneva, Switzerland
Healthy Mothers, Babies, and Children
South Australian Health and Medical Andrew M. Prentice
Research Institute MRC Unit The Gambia and MRC
Adelaide, South Australia, Australia International Nutrition Group
London School of Hygiene and Tropical
Homero Martinez Medicine
Hospital Infantil de Mexico Federico London, United Kingdom
Gómez
Mexico City, Mexico Usha Ramakrishnan
Rollins School of Public Health
Emily Mates Emory University
Emergency Nutrition Network Atlanta, Georgia
Oxford, United Kingdom
xxiv Contributors

Fabian Rohner Haley Swartz

GroundWork Berman Institute of Bioethics
Fläsch, Switzerland Johns Hopkins University
Baltimore, Maryland
Richard D. Semba
Wilmer Eye Institute Minghua Tang
Johns Hopkins University University of Colorado, Denver
Baltimore, Maryland School of Medicine
Aurora, Colorado
Antonia W. Shand
Menzies Centre for Health Policy Andrew L. Thorne-Lyman
University of Sydney Center for Human Nutrition
Sydney, New South Wales, Australia Department of International Health
Bloomberg School of Public Health
John Hopkins University
Matt J. Silver Baltimore, Maryland
MRC Unit The Gambia and MRC
International Nutrition Group Michael J. Turner
London School of Hygiene and Tropical University College Dublin Centre for
Medicine Human Reproduction
London, United Kingdom Coombe Women and Infants University
Hospital
Taylor Marie Snyder Dublin, Ireland
Maternal and Infant Health Consulting
Salt Lake City, Utah Amanda Wendt
Unit of Epidemiology and Biostatistics
Christopher J. Stewart Institute of Public Health
Alkek Center for Metagenomics and University of Heidelberg
Microbiome Research Heidelberg, Germany
Department of Molecular Virology and
Microbiology Sara Wuehler
Baylor College of Medicine Micronutrient Initiative
Houston, Texas Ottawa, Ontario, Canada
Section I
Introduction
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