Forsyth Stewart, Gautier Sheila, Salem Norman
School of Medicine, University of Dundee, West Ferry, Dundee, UK.
Ann Nutr Metab. 2017;70(3):217-227. doi: 10.1159/000463396. Epub 2017 Mar 17.
In developing countries, dietary intakes of arachidonic acid (ARA) and docosahexaenoic acid (DHA) in early life are lower than current recommended levels. This review specifically focusses on the contribution that complementary feeding makes to ARA and DHA intakes in medium- to low-income countries. The aims of the review are (1) to determine the availability of ARA and DHA food sources in developing countries, (2) to estimate the contribution of complementary feeding to dietary intakes of ARA and DHA in infants aged 6-36 months, and (3) to relate the dietary ARA and DHA intake data to key socioeconomic and health indicators.
The primary dietary data was collected by the Food and Agriculture Organisation (FAO) using Food Balance Sheets, and fatty acid composition was based on the Australian food composition tables. There is evidence of wide variation in per capita dietary intake for both DHA and ARA food sources, with low intakes of meat and seafood products being highly prevalent in most low-income countries. In children aged 6-36 months, the supply of ARA and DHA from the longer duration of breastfeeding in low-income countries is counterbalanced by the exceptionally low provision of ARA and DHA from complementary foods. The lowest tertile for ARA intake is associated with higher percentages of childhood stunting, birth rate, infant mortality, and longer duration of breast feeding. Key Message: In developing countries, intakes of DHA and ARA from complementary foods are low, and public health organisations need to adopt pragmatic strategies that will ensure that there is a nutritional safety net for the most vulnerable infants.
在发展中国家,生命早期的花生四烯酸(ARA)和二十二碳六烯酸(DHA)膳食摄入量低于当前推荐水平。本综述特别关注辅食对中低收入国家ARA和DHA摄入量的贡献。综述的目的是:(1)确定发展中国家ARA和DHA食物来源的可得性;(2)估计辅食对6至36个月婴儿ARA和DHA膳食摄入量的贡献;(3)将膳食ARA和DHA摄入数据与关键的社会经济和健康指标相关联。
主要膳食数据由联合国粮食及农业组织(粮农组织)使用食物平衡表收集,脂肪酸组成基于澳大利亚食物成分表。有证据表明,DHA和ARA食物来源的人均膳食摄入量差异很大,大多数低收入国家肉类和海产品摄入量低的情况非常普遍。在6至36个月的儿童中,低收入国家较长时间母乳喂养提供的ARA和DHA,被辅食中ARA和DHA的极低供应量所抵消。ARA摄入量最低的三分位数与儿童发育迟缓、出生率、婴儿死亡率的较高百分比以及较长的母乳喂养时间相关。关键信息:在发展中国家,辅食中DHA和ARA的摄入量较低,公共卫生组织需要采取务实策略,确保为最脆弱的婴儿提供营养安全网。