Berkey Catherine S, Rockett Helaine R H, Willett Walter C, Colditz Graham A
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston, MA 02115, USA.
Arch Pediatr Adolesc Med. 2005 Jun;159(6):543-50. doi: 10.1001/archpedi.159.6.543.
Milk is promoted as a healthy beverage for children, but some researchers believe that estrone and whey protein in dairy products may cause weight gain. Others claim that dairy calcium promotes weight loss.
To assess the associations between milk, calcium from foods and beverages, dairy fat, and weight change over time.Design, Subjects, and Outcome Measure We followed a cohort of 12 829 US children, aged 9 to 14 years in 1996, who returned questionnaires by mail through 1999. Children annually reported their height and weight and completed food frequency questionnaires regarding typical past-year intakes. We estimated associations between annual change in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and our dietary factors, adjusted for adolescent growth and development, race, physical activity, inactivity, and (in some models) total energy intake.
Children who drank more than 3 servings a day of milk gained more in BMI than those who drank smaller amounts (boys: beta +/- SE, 0.076 +/- 0.038 [P = .04] more than those who drank 1 to 2 glasses a day; girls: beta +/- SE, 0.093 +/- 0.034 [P = .007] more than those who drank 0 to 0.5 glass a day). For boys, milk intake was associated with small BMI increases during the year (beta +/- SE, 0.019 +/- 0.009 per serving a day; P = .03); results were similar for girls (beta +/- SE, 0.015 +/- 0.007 per serving a day; P = .04). Quantities of 1% milk (boys) and skim milk (girls) were significantly associated with BMI gain, as was total dietary calcium intake. Multivariate analyses of milk, dairy fat, calcium, and total energy intake suggested that energy was the most important predictor of weight gain. Analyses of year-to-year changes in milk, calcium, dairy fat, and total energy intakes provided generally similar conclusions; an increase in energy intake from the prior year predicted BMI gain in boys (P = .003) and girls (P = .03).
Children who drank the most milk gained more weight, but the added calories appeared responsible. Contrary to our hypotheses, dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not. Drinking large amounts of milk may provide excess energy to some children.
牛奶被宣传为儿童的健康饮品，但一些研究人员认为，乳制品中的雌酮和乳清蛋白可能会导致体重增加。另一些人则声称，乳制品中的钙有助于减肥。
评估牛奶、食物和饮料中的钙、乳制品脂肪与体重随时间变化之间的关联。
设计、研究对象与结果测量：我们对1996年年龄在9至14岁的12829名美国儿童进行了队列研究，这些儿童在1999年之前通过邮寄问卷的方式参与调查。孩子们每年报告自己的身高和体重，并完成关于过去一年典型饮食摄入量的食物频率问卷。我们估计了体重指数（BMI，计算方法为体重（千克）除以身高（米）的平方）的年度变化与我们的饮食因素之间的关联，并对青少年的生长发育、种族、身体活动、不活动情况以及（在某些模型中）总能量摄入进行了调整。
每天饮用超过3份牛奶的儿童，其BMI的增加幅度高于饮用较少牛奶的儿童（男孩：β±标准误，比每天饮用1至2杯牛奶的儿童高0.076±0.038[P = 0.04]；女孩：β±标准误，比每天饮用0至0.5杯牛奶的儿童高0.093±0.034[P = 0.007]）。对于男孩，牛奶摄入量与一年内BMI的小幅增加有关（β±标准误，每天每份增加0.019±0.009；P = 0.03）；女孩的结果类似（β±标准误，每天每份增加0.015±0.007；P = 0.04）。1%牛奶（男孩）和脱脂牛奶（女孩）的摄入量与BMI增加显著相关，膳食总钙摄入量也是如此。对牛奶、乳制品脂肪、钙和总能量摄入的多变量分析表明，能量是体重增加的最重要预测因素。对牛奶、钙、乳制品脂肪和总能量摄入逐年变化的分析得出了大致相似的结论；与上一年相比能量摄入增加可预测男孩（P = 0.003）和女孩（P = 0.03）的BMI增加。
喝牛奶最多的儿童体重增加更多，但增加的热量似乎是原因所在。与我们的假设相反，膳食钙以及脱脂和1%牛奶与体重增加有关，但乳制品脂肪则不然。大量饮用牛奶可能会给一些儿童提供过多能量。
