Programming of body composition by early growth and nutrition
Programming of body composition by early growth and nutrition
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DOI：
10.1017/s0029665107005691
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发表时间：
2007-08-01
影响因子：
7
通讯作者：
Fewtrell, Mary S.
中科院分区：
文献类型：
--
作者：
Wells, Jonathan C. K.;Chomtho, Sirinuch;Fewtrell, Mary S.
现在有令人信服的证据表明，早年的生长模式与成年后患代谢综合征的风险有关，尽管产前和产后生长对此类关联的相对重要性仍然存在争议。身体成分可能在这些疾病的“编程”中发挥关键作用，通过自身被早期生长编程，也许也是编程过程的中介。早期的研究报告出生体重和成人BMI之间的正相关表明，大婴儿有成为肥胖成年人的趋势。这些发现似乎与许多将低出生体重与代谢综合征风险增加联系起来的研究相矛盾。最近的研究表明，出生体重对以后的瘦体重有很强的预测作用，而与以后的肥胖的关联要弱得多。将低出生体重与以后生活中更集中的脂肪分布联系起来的研究仍然存在争议，需要使用更复杂的方法进行确认。婴儿生长率的研究结果似乎具有人口特异性，婴儿体重增加预测了发展中国家随后的瘦体重，但预测了工业化人口随后的脂肪量和肥胖。需要对这一问题进行进一步研究，以确保为各种经济发展水平的国家建议适当的公共卫生政策。尽管早期生长和后期疾病风险之间的联系涉及早期营养，无论是在子宫内还是在婴儿期，但很少有前瞻性研究探讨早期饮食对后期身体成分的影响。许多研究认为母乳喂养与BMI分类的肥胖患病率降低有关;然而，直接评估儿童肥胖的少数研究几乎没有支持这一假设。在婴儿时期测量身体组成的能力的最新进展提供了一个重要的机会，以提高对身体组成的营养规划及其贡献的理解，或缺乏其后续疾病的风险。
There is now compelling evidence that growth patterns in early life are associated with risk of the metabolic syndrome in adulthood, although the relative importance of prenatal v. postnatal growth for such associations remains controversial. Body composition may play a key role in the 'programming' of such diseases, through itself being programmed by early growth, and perhaps also by being a mediator of the programming process. Early studies reporting positive associations between birth weight and adult BMI suggested a tendency for large babies to become obese adults. Such findings appeared contradictory to the many studies linking low birth weight with increased risk of the metabolic syndrome. Recent studies now indicate that birth weight is strongly predictive of later lean mass, and has a much weaker association with later fatness. Studies that link low birth weight with a more central adipose distribution in later life remain controversial, and require confirmation using more sophisticated methodologies. Findings for infant growth rate appear population-specific, with infant weight gain predicting subsequent lean mass in developing countries, but predicting subsequent fat mass and obesity in industrialised populations. Further studies are required on this issue, to ensure that appropriate public health policies are recommended for countries across the range of economic development. Although the links between early growth and later disease risk implicate early-life nutrition, either in utero or during infancy, few prospective studies have explored the influence of early diet on later body composition. Many studies have associated breast-feeding with a reduced prevalence of obesity categorised by BMI; however, the few studies directly evaluating childhood fatness provide little support for this hypothesis. Recent advances in the ability to measure body composition during the infant period offer a major opportunity to improve the understanding of the nutritional programming of body composition and its contribution, or lack thereof, to subsequent disease risk.