Gruszfeld Dariusz, Socha Piotr
Children's Memorial Health Institute, Warsaw, Poland.
World Rev Nutr Diet. 2013;108:32-9. doi: 10.1159/000351482. Epub 2013 Sep 6.
Maternal diet, nutritional status during pregnancy, and the early diet of the offspring play an important role in later health. The short- and long-term outcomes of early nutrition have been extensively studied in recent decades. One of the most commonly investigated nutritional interventions is breastfeeding, which is associated with a number of positive short- and long-term outcomes. A short-term effect of breastfeeding is reduced morbidity and mortality in children from poor living conditions and in preterm infants. Breastfeeding is associated with better cognitive development and also has a long-term protective effect on obesity risk, prevalence of type 2 diabetes, and a lowering effect on blood pressure. Selected nutrients have undergone extensive investigation to show their role in disease prevention or improved development, e.g. protein intake in infancy seems to be associated with a later risk of obesity or docosahexaenoic acid supplementation has a positive impact on cognitive function. Another consideration is the fast catch-up growth in small for gestational age infants as an important factor associated with adult risk of cardiovascular problems. On the other hand, high protein and energy intake seems to be positively associated with some indicators of cognitive development. Most of the evidence comes from observational studies that cannot exclude potential confounders. Animal studies demonstrate causality but should not be directly extrapolated to humans. The number of randomized controlled studies is increasing but long-term follow-ups are necessary to obtain convincing results. The majority of these trials compare different infant formula compositions and macro- or micronutrient supplementation. One of the major questions is to define a critical (or opportunity) window and a mechanism of nutritional influence on several health outcomes.
孕期母亲的饮食、营养状况以及子代早期的饮食对其后期健康起着重要作用。近几十年来，人们广泛研究了早期营养的短期和长期影响。最常被研究的营养干预措施之一是母乳喂养，它与许多积极的短期和长期结果相关。母乳喂养的短期效果是降低生活条件差的儿童以及早产儿的发病率和死亡率。母乳喂养与更好的认知发展相关，并且对肥胖风险、2型糖尿病患病率具有长期保护作用，还能降低血压。某些营养素已被广泛研究以表明它们在疾病预防或促进发育方面的作用，例如婴儿期蛋白质摄入量似乎与后期肥胖风险相关，或者补充二十二碳六烯酸对认知功能有积极影响。另一个需要考虑的因素是小于胎龄儿的快速追赶生长，这是与成人心血管问题风险相关的一个重要因素。另一方面，高蛋白和高能量摄入似乎与认知发展的一些指标呈正相关。大多数证据来自观察性研究，这些研究无法排除潜在的混杂因素。动物研究证明了因果关系，但不应直接外推至人类。随机对照研究的数量在增加，但需要长期随访才能获得令人信服的结果。这些试验大多比较不同的婴儿配方奶粉成分以及宏量或微量营养素补充剂。一个主要问题是确定关键（或机会）窗口期以及营养对多种健康结果的影响机制。
