Infant Feeding and Later Obesity Risk
Infant Feeding and Later Obesity Risk
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DOI：
10.1007/978-1-4020-9173-5_2
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发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Grote, Veit
中科院分区：
文献类型：
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作者：
Koletzko, Berthold;von Kries, Ruediger;Grote, Veit
大约30年前，Gunter Dorner提出，在有限的、敏感的早期发育时期，暴露于激素、代谢物和神经递质中，会对成人的疾病风险产生编程效应。此后，长期健康的早期规划得到了广泛的科学支持和关注。例如，越来越多的证据表明，婴儿喂养选择对日后肥胖风险的规划影响。观察性研究的荟萃分析表明，即使在对生物学和社会人口学混杂变量进行调整后，母乳喂养也能使学龄儿童肥胖的比值比相对于配方奶喂养降低约20%。我们假设母乳喂养通过减少婴儿时期体重增加的可能性来防止日后肥胖，而这种保护至少部分是由于母乳中蛋白质的供应低于标准婴儿配方奶粉（“早期蛋白质假说”）。这些假设在欧洲儿童肥胖项目中得到了验证，这是一项随机双盲干预试验，在五个欧洲国家（比利时、德国、意大利、波兰、西班牙）对1000多名婴儿进行了试验。配方奶粉喂养的婴儿在出生后一年内随机接受婴儿配方奶粉和随后的蛋白质含量较高或较低的配方奶粉。两岁时的随访显示，与母乳喂养参照组和世卫组织生长参照组相比，配方奶蛋白质供应较低使早期生长正常。这些结果表明，改变婴儿喂养方式具有促进长期健康的重要潜力，并应促使对婴儿配方奶粉成分的建议和政策进行审查。
Some 30 years ago, Gunter Dorner proposed that exposure to hormones, metabolites and neurotransmitters during limited, sensitive periods of early development exert programming effects on disease risk in human adults. Early programming of long terin health has since received broad scientific support and attention. For example, evidence increases for programming effects of infant feeding choices on later obesity risk. Meta-analyses of observational studies indicate that breast feeding reduces the odds ratio for obesity at school age by about 20%, relative to formula feeding, even after adjustment for biological and sociodemographic confounding variables. We hypothesized that breast feeding protects against later obesity by reducing the likelihood of high weight gain in infancy, and that this protection is caused at least partly by the lower protein supply with breast milk relative to standard infant formulae (the "Early Protein Hypothesis"). These hypotheses are tested in the European Childhood Obesity Project, a randomized double blind intervention trial in more than 1,000 infants in five European countries (Belgium, Germany, Italy, Poland, Spain). Formula fed infants were randomized to receive during the first year of life infant formulae and follow-on-formulae with higher or lower protein contents. Follow-up at 2 years of age shows that lower protein supply with formula normalizes early growth relative to a breast fed reference group and to the WHO growth reference. These results demonstrate that modification of infant feeding practice has an important potential for long-term health promotion and should prompt a review of the recommendations and policies for infant formula composition.