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婴儿期后期大量喂食牛奶或配方奶与母乳喂养相比对儿童体型的影响。

Effects on childhood body habitus of feeding large volumes of cow or formula milk compared with breastfeeding in the latter part of infancy.

作者信息

Hopkins David, Steer Colin D, Northstone Kate, Emmett Pauline M

机构信息

Nutrition and Dietetic Department, Southampton General Hospital, Southampton, United Kingdom; and.

Centre for Child and Adolescent Health, School of Social and Community Medicine and.

出版信息

Am J Clin Nutr. 2015 Nov;102(5):1096-103. doi: 10.3945/ajcn.114.100529. Epub 2015 Sep 9.

Abstract

BACKGROUND

There is controversy over whether a lack of breastfeeding is related to obesity development.

OBJECTIVE

We examined the effects of feeding different types of milk in late infancy on childhood growth.

DESIGN

A cohort of 1112 term, singleton children (born in 1992) from the Avon Longitudinal Study of Parents and Children, United Kingdom, were studied prospectively. Food records collected at 8 mo of age were used to define the following 5 mutually exclusive feeding groups on the basis of the type and amount of milk consumed: breast milk (BM), <600 mL formula milk/d (FMlow), ≥600 mL formula milk/d (FMhigh), <600 mL cow milk/d (CMlow), and ≥600 mL cow milk/d (CMhigh). Weight, height, and BMI were measured at 14 time points from birth to 10 y of age, and SD scores (SDSs) were calculated. Dietary energy and macronutrient intakes were available at 7 time points.

RESULTS

CMhigh children were heavier than were BM children from 8 mo to 10 y of age with weight differences (after adjustment for maternal education, smoking, and parity) ≥0.27 SDSs and an average of 0.48 SDSs. The maximum weight difference was at 18 mo of age (0.70 SDS; 95% CI: 0.41, 1.00 SDS; P = <0.0001). CMhigh children were taller at some ages (25-43 mo; P < 0.01) and had greater BMI SDSs from ≥8 mo of age (at 9 y of age; P = 0.001). FMhigh children were heavier and taller than were BM children from 8 to 37 mo of age. There were marked dietary differences between milk groups at 8 mo of age, some of which persisted to 18 mo of age. Adjustments for current energy and protein intakes did not attenuate the growth differences observed.

CONCLUSIONS

The feeding of high volumes of cow milk in late infancy is associated with faster weight and height gain than is BM feeding. The feeding of bottle-fed infants with high volumes of cow milk in late infancy may have a persisting effect on body habitus through childhood.

摘要

背景

母乳喂养的缺乏是否与肥胖的发展相关存在争议。

目的

我们研究了婴儿晚期喂养不同类型的牛奶对儿童生长的影响。

设计

对来自英国埃文亲子纵向研究的1112名单胎足月儿(出生于1992年)进行前瞻性研究。根据8月龄时收集的食物记录,依据所摄入牛奶的类型和量定义以下5个相互排斥的喂养组:母乳(BM)、每日配方奶摄入量<600 mL(FMlow)、每日配方奶摄入量≥600 mL(FMhigh)、每日牛奶摄入量<600 mL(CMlow)以及每日牛奶摄入量≥600 mL(CMhigh)。从出生到10岁的14个时间点测量体重、身高和BMI,并计算标准差分数(SDS)。在7个时间点获取膳食能量和宏量营养素摄入量。

结果

从8月龄到10岁,CMhigh组儿童比BM组儿童更重,体重差异(在对母亲教育程度、吸烟情况和产次进行调整后)≥0.27 SDS,平均为0.48 SDS。最大体重差异出现在18月龄(0.70 SDS;95% CI:0.41,1.00 SDS;P = <0.0001)。CMhigh组儿童在某些年龄段更高(25 - 43月龄;P < 0.01),并且从8月龄起BMI SDS更高(9岁时;P = 0.001)。从8到37月龄,FMhigh组儿童比BM组儿童更重、更高。8月龄时各牛奶组之间存在明显的饮食差异,其中一些差异持续到18月龄。对当前能量和蛋白质摄入量进行调整并未减弱所观察到的生长差异。

结论

婴儿晚期大量喂养牛奶与比母乳喂养更快的体重和身高增长相关。婴儿晚期用大量牛奶奶瓶喂养婴儿可能会对儿童期的体型产生持续影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f759/4625583/28ba04c1e396/ajcn100529fig1.jpg

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