Vanderhout Shelley M, Birken Catherine S, Parkin Patricia C, Lebovic Gerald, Chen Yang, O'Connor Deborah L, Maguire Jonathon L
a Department of Nutritional Sciences, University of Toronto, Room 316, 150 College Street, Toronto, ON M5S 3E2, Canada.
b Department of Pediatrics, St. Michael's Hospital, 2nd Floor, 61 Queen Street East, Toronto, ON M5C 2T2, Canada.
Appl Physiol Nutr Metab. 2016 May;41(5):516-21. doi: 10.1139/apnm-2015-0671. Epub 2016 Jan 13.
Current guidelines for cow's milk consumption in children older than age 2 years suggest 1% or 2% milk to reduce the risk of obesity. Given that milk is the main dietary source of vitamin D for North American children and that vitamin D is fat soluble, we hypothesized 25-hydroxyvitamin D (25(OH)D) concentration to be positively associated with the fat content of milk. The objective was to determine the relationship between the fat content of milk consumed and the serum 25(OH)D concentration; our secondary objective was to explore the role that the volume of milk consumed played in this relationship. We completed a cross-sectional study of children aged 12-72 months in the TARGetKids! research network. Multivariable linear regression was used to test the association between milk fat content and child 25(OH)D, adjusted for clinically relevant covariates. The interaction between volume of milk and fat content was examined. Two thousand eight hundred fifty-seven children were included in the analysis. The fat content of milk was positively associated with 25(OH)D (p = 0.03), and the interaction between the volume of milk consumed and the milk fat content was statistically significant (p = 0.005). Children who drank 1% milk needed 2.46 cups (95% confidence interval (CI) 2.38-2.54) of milk to have a 25(OH)D concentration similar to that of children who drank 1 cup of homogenized milk (3.25% fat). Children who consumed 1% milk had 2.05 (95% CI 1.73-2.42) times higher odds of having a 25(OH)D concentration <50 nmol/L compared with children who consumed homogenized milk. In conclusion, recommendations for children to drink lower-fat milk (1% or 2%) may compromise serum 25(OH)D levels and may require study to ensure optimal childhood health.
目前针对2岁以上儿童饮用牛奶的指南建议饮用1%或2%脂肪含量的牛奶，以降低肥胖风险。鉴于牛奶是北美儿童维生素D的主要膳食来源，且维生素D是脂溶性的，我们推测25-羟基维生素D（25(OH)D）浓度与牛奶的脂肪含量呈正相关。目的是确定所饮用牛奶的脂肪含量与血清25(OH)D浓度之间的关系；我们的次要目的是探讨饮用牛奶的量在这种关系中所起的作用。我们在TARGetKids!研究网络中对12至72个月大的儿童进行了一项横断面研究。使用多变量线性回归来测试牛奶脂肪含量与儿童25(OH)D之间的关联，并对临床相关协变量进行了调整。研究了牛奶饮用量与脂肪含量之间的相互作用。共有2857名儿童纳入分析。牛奶的脂肪含量与25(OH)D呈正相关（p = 0.03），饮用牛奶的量与牛奶脂肪含量之间的相互作用具有统计学意义（p = 0.005）。饮用1%脂肪含量牛奶的儿童需要2.46杯（95%置信区间（CI）2.38 - 2.54）牛奶才能使25(OH)D浓度与饮用1杯全脂牛奶（3.25%脂肪）的儿童相似。与饮用全脂牛奶的儿童相比，饮用1%脂肪含量牛奶的儿童25(OH)D浓度<50 nmol/L的几率高2.05倍（95% CI 1.73 - 2.42）。总之，建议儿童饮用低脂牛奶（1%或2%）可能会影响血清25(OH)D水平，可能需要进行研究以确保儿童的最佳健康状态。
