UMR 7206 Eco-anthropologie et Ethnobiologie, Centre National de la Recherche Scientifique, Muséum national d'Histoire naturelle, Paris Diderot University, Paris, France.
PLoS One. 2012;7(6):e39007. doi: 10.1371/journal.pone.0039007. Epub 2012 Jun 11.
Recent studies suggest that early modifications in metabolic pathways and behaviour, leading to energy conservation and reduced linear growth, could represent adaptations to nutritional constraints during foetal life and infancy. Impaired fat oxidation, low resting energy expenditure and reduced physical activity, resulting from these adaptations, could facilitate fat storage and development of overweight in growth-retarded children that consume more energy-dense food. This study aims at assessing whether: (1) dual-burden preschool children (simultaneously stunted and overweight) of Yaounde (Cameroon) have low birth-weight (indicator of foetal undernutrition) and reductions in fat oxidation, resting energy expenditure (REE) and physical activity, (2) fat oxidation, REE and physical activity are associated with foetal growth.
METHODOLOGY/PRINCIPAL FINDINGS: 162 children (24-72 months) were considered: 22 stunted-overweight (SO), 40 stunted (S), 41 overweight (O), and 59 non stunted-non overweight (NSNO). Nutritional status and body composition were assessed using anthropometry and multifrequency bioimpedance analysis. Fasting respiratory quotient (RQ) and REE were measured by indirect calorimetry. Physical activity was determined using accelerometers, food questionnaires were used for diet assessment and birth-weight was noted. Mean RQs and REE (weight adjusted) did not differ between stunted children (SO and S) and non-stunted children (O and NSNO). SO and S children spent more time in sedentary activities than O children (p = 0.01 and p = 0.02, respectively) and less time in moderate-to-vigorous activities than NSNO children (p = 0.05 and p = 0.04, respectively). SO children's diet was less diverse (p = 0.01) with less animal products (p = 0.006). Multiple linear regressions model revealed that birth-weight is predictive of RQ (β = 0.237, p<0.01, R(2) = 0.08).
CONCLUSIONS/SIGNIFICANCE: This study showed that growth retardation in stunted-overweight children could be associated with postnatal nutritional deficiencies. Overweight in stunted children could be associated with reduced physical activity in the context of nutrition transition. High birth-weight was a predictor of reduced lipid oxidation, a risk factor of fat deposition.
最近的研究表明，代谢途径和行为的早期改变，导致能量节约和线性生长减少，可能代表了胎儿期和婴儿期营养限制的适应。这些适应导致脂肪氧化受损、静息能量消耗降低和体力活动减少，可能促进生长迟缓儿童的脂肪储存和超重发展，而这些儿童摄入更多能量密集型食物。本研究旨在评估以下内容：（1）雅温得（喀麦隆）的双重负担学龄前儿童（同时生长迟缓且超重）是否具有低出生体重（胎儿营养不良的指标）和脂肪氧化、静息能量消耗（REE）和体力活动减少，（2）脂肪氧化、REE 和体力活动是否与胎儿生长有关。
方法/主要发现：共考虑了 162 名儿童（24-72 个月）：22 名生长迟缓超重（SO）、40 名生长迟缓（S）、41 名超重（O）和 59 名非生长迟缓非超重（NSNO）。使用人体测量法和多频生物电阻抗分析评估营养状况和身体成分。通过间接热量法测量空腹呼吸商（RQ）和 REE。使用加速度计确定体力活动，使用饮食问卷评估饮食，记录出生体重。生长迟缓儿童（SO 和 S）与非生长迟缓儿童（O 和 NSNO）之间的平均 RQ 和 REE（体重调整）没有差异。SO 和 S 儿童比 O 儿童更多地处于久坐活动（p=0.01 和 p=0.02），比 NSNO 儿童更少地进行中等到剧烈活动（p=0.05 和 p=0.04）。SO 儿童的饮食种类较少（p=0.01），动物产品较少（p=0.006）。多元线性回归模型显示，出生体重可预测 RQ（β=0.237，p<0.01，R²=0.08）。
结论/意义：本研究表明，生长迟缓超重儿童的生长迟缓可能与出生后营养不足有关。生长迟缓儿童的超重可能与营养转型背景下体力活动减少有关。高出生体重是脂肪氧化减少的预测因子，脂肪氧化减少是脂肪沉积的一个危险因素。
