Pediatric Clinic 2, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Italy.
Eur J Intern Med. 2013 Jan;24(1):5-10. doi: 10.1016/j.ejim.2012.08.011. Epub 2012 Sep 13.
In the last decades several studies tested the hypothesis that at early development stages certain foods or nutrients, in specific amounts, fed during limited sensitive periods, may determine an endocrine metabolic asset leading to clinical alterations that take place decades later (early nutritional programming of long term health). Evidence is mounting for programming effects of infant feeding. Observational studies indicate that breast feeding, relative to formula feeding, reduces the risk for obesity at school age by about 20% even after adjustment for biological and sociodemographic confounders. Moreover, breastfeeding is constantly associated with increased neurodevelopmental scores up to early adulthood, while its outcome in terms of delayed decay of brain function is still unknown. Besides the environment surrounding breastfeeding, specific nutrients within human milk may play a direct role. With the introduction of solids the major changes in diet are represented by the sudden decrease of fat intake from 50 to 30% of total energy. A protein excess, commonly found throughout all European Countries, has been associated to a higher risk of adiposity in early childhood, as confirmed by first reports from a large European trial. The amount of fat does not seem to be associated with later adiposity, while its quality may affect blood lipoproteins, blood pressure and neurodevelopmental performance. Early intake of dietary fibers might also have beneficial effects. Epidemiologic data show that episodes of rapid growth (growth acceleration hypothesis), whichever the dietary habits, are associated with later unfavorable health conditions and should be prevented.
在过去的几十年中，有几项研究检验了这样一种假设，即在早期发育阶段，某些食物或营养素以特定的量在特定的敏感时期内摄入，可能会决定一种内分泌代谢资产，导致几十年后出现临床改变（早期营养对长期健康的编程）。越来越多的证据表明婴儿喂养存在编程效应。观察性研究表明，与配方奶喂养相比，母乳喂养可使儿童期肥胖的风险降低约 20%，即使在调整了生物学和社会人口学混杂因素后也是如此。此外，母乳喂养与神经发育评分的增加有关，直至成年早期，而其在大脑功能衰退方面的效果仍未知。除了母乳喂养周围的环境外，人乳中的特定营养素也可能发挥直接作用。随着固体食物的引入，饮食的主要变化是脂肪摄入量从总能量的 50%突然减少到 30%。在所有欧洲国家都普遍存在的蛋白质过剩与儿童早期肥胖的风险增加有关，这一结论得到了一项大型欧洲试验的初步报告的证实。脂肪的摄入量似乎与以后的肥胖无关，而其质量可能会影响血液脂蛋白、血压和神经发育表现。早期摄入膳食纤维也可能有有益的影响。流行病学数据表明，无论饮食习惯如何，快速生长期（生长加速假说）与以后不利的健康状况有关，应予以预防。
