Institute for Market Research, Strategy and Planning, Munich, Germany.
Am J Clin Nutr. 2011 Dec;94(6 Suppl):2030S-2035S. doi: 10.3945/ajcn.110.001479. Epub 2011 Oct 5.
The reported effect sizes of early nutrition programming on long-term health outcomes are often small, and it has been questioned whether early interventions would be worthwhile in enhancing public health.
We explored the possible health economic consequences of early nutrition programming by performing a model calculation, based on the only published study currently available for analysis, to evaluate the effects of supplementing infant formula with long-chain polyunsaturated fatty acids (LC-PUFAs) on lowering blood pressure and lowering the risk of hypertension-related diseases in later life.
The costs and health effects of LC-PUFA-enriched and standard infant formulas were compared by using a Markov model, including all relevant direct and indirect costs based on German statistics. We assessed the effect size of blood pressure reduction from LC-PUFA-supplemented formula, the long-term persistence of the effect, and the effect of lowered blood pressure on hypertension-related morbidity.
The cost-effectiveness analysis showed an increased life expectancy of 1.2 quality-adjusted life-years and an incremental cost-effectiveness ratio of -630 Euros (discounted to present value) for the LC-PUFA formula in comparison with standard formula. LC-PUFA nutrition was the superior strategy even when the blood pressure-lowering effect was reduced to the lower 95% CI.
Breastfeeding is the recommended feeding practice, but infants who are not breastfed should receive an appropriate infant formula. Following this model calculation, LC-PUFA supplementation of infant formula represents an economically worthwhile prevention strategy, based on the costs derived from hypertension-linked diseases in later life. However, because our analysis was based on a single randomized controlled trial, further studies are required to verify the validity of this thesis.
早期营养编程对长期健康结果的报道效果通常较小，有人质疑早期干预是否值得提高公众健康水平。
我们通过进行模型计算，探索早期营养编程的可能健康经济后果，该计算基于目前可用于分析的唯一已发表研究，评估在婴儿配方奶粉中添加长链多不饱和脂肪酸 (LC-PUFA) 对降低血压和降低晚年高血压相关疾病风险的影响。
使用马尔可夫模型比较 LC-PUFA 强化和标准婴儿配方的成本和健康效果，该模型基于德国统计数据纳入了所有相关的直接和间接成本。我们评估了 LC-PUFA 配方降低血压的效果大小、效果的长期持久性以及降低血压对高血压相关发病率的影响。
成本效益分析显示，与标准配方相比，LC-PUFA 配方可使预期寿命延长 1.2 个质量调整生命年，增量成本效益比为-630 欧元（贴现至现值）。即使将降压效果降低到 95%CI 的下限，LC-PUFA 营养也是更优策略。
母乳喂养是推荐的喂养方式，但未母乳喂养的婴儿应接受适当的婴儿配方奶粉。根据该模型计算，基于晚年与高血压相关疾病相关成本，LC-PUFA 婴儿配方奶粉的补充代表了一种具有经济意义的预防策略。然而，由于我们的分析基于一项随机对照试验，因此需要进一步的研究来验证这一论点的有效性。
