Lucas A
MRC Dunn Nutrition Unit, Cambridge, UK.
Ciba Found Symp. 1991;156:38-50; discussion 50-5.
Whether early diet influences long-term health or achievement is a key question in nutrition. Such long-term consequences would invoke the concept of 'programming'--a more general process whereby a stimulus or insult at a critical period of development has lasting or lifelong significance. Data from small mammals and primates show that early nutrition may have potentially important long-term effects, for example on blood lipids, plasma insulin, obesity, atherosclerosis, behaviour and learning. Corresponding studies in man have been largely retrospective and difficult to interpret. The preterm infant is however an important model for human research because formal random assignment to early diet is practical. A large prospective randomized multicentre study has been undertaken on 926 preterm infants to test the hypothesis that early diet influences long-term outcome. Diets included human milk, standard formula and nutrient-enriched preterm formula. The diet consumed for on average the first month post partum had a major impact on subsequent developmental attainment, growth and allergic status in early childhood. That such a brief period of dietary manipulation has lasting significance implies that the neonatal period is critical for nutrition after preterm birth. These data may have broader implications for human nutrition.
早期饮食是否会影响长期健康或成就，是营养学中的一个关键问题。这种长期后果会引出“编程”的概念——这是一个更普遍的过程，即发育关键期的刺激或损伤具有持久或终生的意义。来自小型哺乳动物和灵长类动物的数据表明，早期营养可能具有潜在的重要长期影响，例如对血脂、血浆胰岛素、肥胖、动脉粥样硬化、行为和学习的影响。在人类身上进行的相应研究大多是回顾性的，难以解释。然而，早产儿是人类研究的重要模型，因为对早期饮食进行正式随机分配是可行的。对926名早产儿进行了一项大型前瞻性随机多中心研究，以检验早期饮食影响长期结局这一假设。饮食包括母乳、标准配方奶和营养强化早产儿配方奶。产后平均第一个月所摄入的饮食对儿童早期随后的发育成就、生长和过敏状态有重大影响。如此短暂的饮食干预期具有持久意义，这意味着新生儿期对早产后的营养至关重要。这些数据可能对人类营养有更广泛的影响。
