Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Am J Clin Nutr. 2013 Aug;98(2):549S-55S. doi: 10.3945/ajcn.112.040733.
Childhood obesity is increasing worldwide, and all previous attempts to stop this epidemic have shown little success. There is now growing evidence that the risk of childhood obesity is strongly influenced by perinatal determinants, including prepregnancy body mass index (BMI), gestational weight gain, and—at least in animal studies—dietary factors during pregnancy and lactation. This review addresses the issue of whether modulation of fat intake and its composition in this early-life period has a potential for primary prevention of childhood obesity. Of particular interest is the question of whether supplementation with n–3 long-chain PUFAs (LC-PUFAs) may exert an antiobesity effect. Retrospective analysis of human randomized controlled trials with fish-oil intervention during pregnancy and lactation gave inconsistent results concerning BMI and obesity development in offspring. A recent prospective human intervention study aimed at reducing the n–6:n–3 LC-PUFA ratio did not show an effect on adipose tissue growth in offspring up to the age of 1 y. Therefore, there is currently little evidence to support the hypothesis that dietary intervention to modify fat composition during pregnancy and lactation would be a promising strategy to prevent childhood obesity in humans, but more research is clearly needed to address the question if and how the risk of developing obesity can be modified by dietary intervention early in life.
儿童肥胖症在全球范围内呈上升趋势,所有以前试图阻止这一流行趋势的尝试都收效甚微。越来越多的证据表明,儿童肥胖的风险受到围产期决定因素的强烈影响,包括孕前体重指数(BMI)、孕期体重增加,以及——至少在动物研究中——孕期和哺乳期的饮食因素。这篇综述探讨了在生命早期阶段调节脂肪摄入及其组成是否具有预防儿童肥胖的潜力。特别感兴趣的问题是,在这个时期补充 n-3 长链多不饱和脂肪酸(LC-PUFAs)是否可能具有抗肥胖作用。对孕期和哺乳期进行鱼油干预的人类随机对照试验的回顾性分析结果显示,BMI 和后代肥胖的发展之间存在不一致。最近一项针对降低 n-6:n-3 LC-PUFA 比例的前瞻性人类干预研究表明,在 1 岁之前,这种干预对后代脂肪组织的生长没有影响。因此,目前几乎没有证据支持这样一种假设,即通过饮食干预来改变孕期和哺乳期的脂肪组成是预防人类儿童肥胖的一种有希望的策略,但显然需要更多的研究来解决这样一个问题,即饮食干预是否以及如何能在生命早期改变肥胖的风险。