Prentice A M, Paul A A
MRC International Nutrition Group, London, and MRC Human Nutrition Research, Cambridge, United Kingdom.
Am J Clin Nutr. 2000 Nov;72(5 Suppl):1253S-1265S. doi: 10.1093/ajcn/72.5.1253s.
The fat requirements of children can be judged according to 4 criteria: 1) the possible obligate needs of fat as a metabolic fuel, 2) the provision of a sufficiently energy-dense diet to meet energy needs, 3) the adequate supply of essential fatty acids, and 4) the supply of sufficient fat to allow adequate absorption of fat-soluble vitamins. In these respects the fat requirements of children in developing countries are probably similar to those of children in affluent nations except for the additional needs imposed by environmental stresses, particularly recurrent infections. In many developing countries, the low energy density of weaning foods appears to be a major contributor to growth faltering and ultimate malnutrition. Evidence from doubly labeled water studies suggests that these diets are adequate when children are healthy but fail to support rapid catch-up growth after diarrhea and other infections. The issues in determining and meeting the fat needs of children in developing countries are illustrated with use of detailed comparative dietary data from a rural community in The Gambia and from Cambridge, United Kingdom. The outstanding feature of the Gambian data is the great importance of breast milk as a source of fat and essential fatty acids up until the end of the second year of life. Weaning foods and adult foods contain low amounts of fat, which causes a sharp transition from adequate fat intakes to probable inadequate fat intakes when children are weaned from the breast. The effects of such low fat intakes, particularly in terms of immune function, require investigation.
儿童的脂肪需求可根据4条标准来判断:1)脂肪作为代谢燃料可能的必需需求;2)提供能量密度足够高的饮食以满足能量需求;3)充足供应必需脂肪酸;4)供应足够的脂肪以保证脂溶性维生素的充分吸收。在这些方面,发展中国家儿童的脂肪需求可能与富裕国家儿童的需求相似,只是环境压力(尤其是反复感染)会带来额外需求。在许多发展中国家,断奶食品的低能量密度似乎是导致生长发育迟缓及最终营养不良的一个主要因素。双标水研究的证据表明,这些饮食在儿童健康时是足够的,但在腹泻及其他感染后无法支持快速的追赶生长。通过使用来自冈比亚一个农村社区以及英国剑桥的详细比较饮食数据,来说明确定和满足发展中国家儿童脂肪需求方面的问题。冈比亚数据的突出特点是,直到儿童两岁末,母乳作为脂肪和必需脂肪酸来源的重要性极高。断奶食品和成人食品中的脂肪含量低,这使得儿童断奶后脂肪摄入量从充足急剧转变为可能不足。这种低脂肪摄入的影响,尤其是在免疫功能方面,需要进行研究。