Obesity has been the subject of research focused on preventive policies among the young population due to epidemiological studies which have shown devastating figures in recent years in terms of the incidence and prevalence of this condition. A number of previously known biomarkers have proven useful in the early diagnosis of complications associated with obesity, while others remain in the study stage. The intestinal microbiota are also relevant in the secondary prevention of obesity complications, another area that has turned into a hot topic of current research. The primary goal of this review is to highlight markers and mechanisms that can enhance specialists’ understanding of obesity assessment and its systemic complications. Salivary markers have been proven useful in the evaluation of obesity, with the advantage of being low-cost and easy to sample. Another interesting topic is the role of the renin–angiotensin and the kallikrein–kinin systems in obesity-related systemic complications. One well-known fact is the connection between obesity and high blood pressure, which is closely related to these systems. This paper also explores the link between gut microbiota and adiposity, particularly the potential of the Firmicutes/Bacteroidetes ratio as a useful biomarker.

The first 1000 days of life, starting from conception to a child’s second birthday, constitute a pivotal period for fetal lung and pulmonary vascular development. Maternal nutrition during this period plays an important role in fetal growth, immune programming and organ development, including that of the pulmonary system. This narrative review consolidates evidence linking maternal nutrition and early-life nutrient intake during this period with the development of pulmonary hypertension in the newborn. We examine the influence of both nutrient deficiencies and excesses on fetal lung and vascular development. We performed a structured search of PubMed and Embase (conducted from February 2025 to March 2025) and screened reference lists. Twenty-eight peer-reviewed studies were included, comprising human clinical and observational evidence and studies on animal models. The findings suggest that imbalances in maternal diet can disrupt placental function, induce inflammation, and trigger epigenetic alterations, all contributing to pulmonary vascular dysfunction and increased pulmonary hypertension susceptibility in neonates. Notably, maternal undernutrition and thiamine deficiency during lactation have been directly linked to pulmonary hypertension in infants. Conversely, high-fat diets and excessive polyphenol intake have been associated with adverse fetal cardiovascular remodeling. While current evidence is primarily derived from animal models and observational studies, it highlights the urgent need for targeted nutritional strategies and clinical trials during pregnancy. Although human causality is unproven for most exposures, studying maternal nutrition in the first 1000 days could offer a cost-effective method for reducing the burden of pediatric pulmonary hypertension and its long-term consequences and for prospective trials aimed at preventing early-life pulmonary vascular disease.

Congenital heart disease (CHD) is the most common congenital anomaly worldwide and is associated with substantial infant morbidity and mortality. This narrative review synthesizes evidence linking CHD to alterations in the gut microbiome across neonatal, perioperative, and chronic stages and highlights a gut–heart–immune framework in which microbial imbalance, intestinal barrier dysfunction, and systemic inflammation may interact to influence clinical outcomes. Early infancy represents a potential window for microbiome and immune development, shaped by delivery mode and feeding, with many breastfed infants developing a Bifidobacterium-dominant community supported by human milk oligosaccharides. In CHD, abnormal splanchnic perfusion and hypoxemia, together with intensive care and perioperative exposures (fasting, delayed enteral feeding, antibiotics, acid suppression), may predispose to dysbiosis and impaired barrier function. Cardiac surgery with cardiopulmonary bypass can act as a “second hit,” with evidence of increased gut permeability, endotoxemia, inflammatory activation, and biomarker signals of enterocyte injury and tight-junction disruption. Clinically, these mechanisms align with gut-sensitive outcomes including necrotizing enterocolitis (especially in ductal-dependent lesions), feeding intolerance, and postoperative infection-risk phenotypes. Interventions show mixed evidence: human milk exposure appears protective for NEC risk, synbiotics demonstrated outcome benefits in a randomized trial of cyanotic CHD infants, while probiotics may modify dysbiosis without consistently preventing intestinal injury and require careful safety frameworks. Key research gaps include the need for longitudinal stage-based cohorts, integration of microbiome profiling with barrier injury and perfusion markers, and standardized safety monitoring in intervention trials.

Background/Objectives: Maternal nutrition is an important exogenous factor which, together with other factors, may play a fundamental role in ensuring the well-being of the pregnant woman and in the development of the offspring, with long-term effects on health. Therefore, this narrative review aims to synthesize current evidence on how maternal dietary patterns and nutrient intake during pregnancy affect maternal well-being, pregnancy outcomes, fetal growth, and the short- and long-term health of the child, while addressing research gaps, and implications for antenatal nutrition guidance. Literature Search Strategy and Study Selection: A comprehensive literature search was performed using the electronic databases PubMed and Google Scholar. The selection and curation of articles were guided by the central research question: “How does maternal diet during pregnancy influence maternal health and offspring outcomes?” Results: The analysis of the literature reveals that the overall maternal dietary pattern is more important than the isolated intake of nutrients in determining the course of pregnancy and the long-term health of the offspring. Conclusions: The present review pointed out that maternal nutrition is not merely energy support for pregnancy, but a factor in fetal programming with a long-term impact on the child, in line with the Developmental Origins of Health and Disease (DOHaD) concept, and may act as an epigenetic and metabolic influence with potential transgenerational effects. Optimizing the diet in the periconceptional period and during pregnancy represents an accessible and effective form of preventive intervention, but it requires personalized recommendations and structured nutritional education begun as early as the preconception period.

Pulmonary hypertension is a complex condition that has distinct characteristics in pediatric populations. This review explores the important role of early childhood nutrition in the growth, progression, and management of pediatric pulmonary hypertension. Nutritional deficiencies, including those of vitamins C, D, and iron, are closely linked to worse outcomes in children with this disease, emphasizing the importance of early intervention to prevent malnutrition and promote growth. Emerging research revealed that promising nutrients like resveratrol, along with modulation of the gut and respiratory microbiomes, may offer therapeutic advances for managing pulmonary hypertension. However, the current literature is limited by a lack of pediatric-specific studies, with much of the data extrapolated from adult populations and animal models, especially rats. This review highlights the need for targeted research to develop effective nutritional interventions aimed at improving outcomes for pediatric patients.