Department of Pediatrics, University of Milan, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy.
J Pediatr Gastroenterol Nutr. 2011 Dec;53(6):594-600. doi: 10.1097/MPG.0b013e318235b23e.
Discussions and debates have recently emerged on the potential positive and negative effects of cow's milk in the paediatric community, also under the pressure of public opinion. The negative effects of cow's-milk consumption seem to be limited to iron status up to 9 to 12 months; then no negative effects are observed, provided that cow's milk, up to a maximum daily intake of 500 mL, is adequately complemented with iron-enriched foods. Lactose intolerance can be easily managed and up to 250 mL/day of milk can be consumed. Allergy to cow's-milk proteins is usually transient. Atopic children may independently be at risk for poor growth, and the contribution of dairy nutrients to their diet should be considered. The connection of cow's milk to autistic spectrum disorders is lacking, and even a cause-effect relation with type 1 diabetes mellitus has not been established because many factors may concur. Although it is true that cow's milk stimulates insulin-like growth factor-1 and may affect linear growth, association with chronic degenerative, noncommunicable diseases has not been established. Finally, fat-reduced milk, if needed, should be considered after 24 to 36 months. Cow's milk represents a major source of high nutritional quality protein as well as of calcium. Moreover, it has growth-promoting effects independent of specific compounds. Its protein and fat composition, together with the micronutrient content, is suggestive of a functional food, whose positive effects are emphasised by regular consumption, particularly under conditions of diets poor in some limiting nutrients, although in industrialised countries cow's milk's optimal daily intake should be around 500 mL, adequately complemented with other relevant nutrients.
最近,在儿科领域,人们对牛奶的潜在积极和消极影响展开了讨论和辩论,这也是公众舆论的压力所致。牛奶消费的负面影响似乎仅限于 9 至 12 个月的铁状态;在这种情况下,如果牛奶的摄入量不超过 500 毫升/天,并适当补充富含铁的食物,就不会有负面影响。乳糖不耐受很容易处理,每天可以摄入多达 250 毫升的牛奶。对牛奶蛋白的过敏通常是短暂的。特应性儿童可能本身存在生长不良的风险,应考虑将乳制品营养素纳入其饮食中。牛奶与自闭症谱系障碍之间没有联系,甚至与 1 型糖尿病之间也没有建立因果关系,因为许多因素可能同时存在。虽然牛奶确实会刺激胰岛素样生长因子-1,并可能影响线性生长,但与慢性退行性非传染性疾病之间的关联尚未建立。最后,如果需要,可以在 24 至 36 个月后考虑饮用低脂牛奶。牛奶是高营养质量蛋白质以及钙的主要来源。此外,它还具有独立于特定化合物的促进生长作用。其蛋白质和脂肪组成以及微量营养素含量表明它是一种功能性食品,其积极作用因定期食用而得到强调,特别是在某些限制营养素的饮食条件下,尽管在工业化国家,牛奶的最佳每日摄入量应为 500 毫升左右,同时要适当补充其他相关营养素。