Adu-Afarwuah Seth, Lartey Anna, Dewey Kathryn G
Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana.
Food and Agriculture Organization of the United Nations, Rome, Italy.
Ann N Y Acad Sci. 2017 Mar;1392(1):18-29. doi: 10.1111/nyas.13328.
The first 1000 days of life is marked by intense metabolic activity and tissue deposition. The increased nutritional needs during this period, and the challenges to meeting them, are often not understood or appreciated. Here, we describe the nutritional needs during the first 1000 days, highlight the challenges to meeting these needs in developing countries, outline intervention strategies, and examine the consumption of small-quantity lipid-based nutrient supplements (SQ-LNS) as a promising strategy. In low-income settings, the challenge to meeting nutritional needs during the first 1000 days is worsened by overreliance on cereal-based diets of low nutrient density and high prevalence of infections and infestations. Dietary diversification is the ideal long-term solution to nutritional deficiencies, but difficulties with obtaining adequate amounts of iron, zinc, and certain vitamins may still remain. Several other interventions are available, but applying them is often fraught with challenges, including cost and contextual factors limiting efficacy. Evidence suggests that SQ-LNS supplementation may help reduce inadequate gestational weight gain and promote fetal and child growth and development in some populations. More research is needed to evaluate the effectiveness of SQ-LNS and other fortified products in different contexts and within integrated programs that address other determinants of maternal and child undernutrition.
生命的最初1000天以强烈的代谢活动和组织沉积为特征。这一时期营养需求增加，而满足这些需求面临的挑战往往未得到理解或重视。在此，我们描述了最初1000天的营养需求，强调了发展中国家满足这些需求所面临的挑战，概述了干预策略，并探讨了食用小剂量脂质基营养补充剂（SQ-LNS）作为一种有前景的策略。在低收入环境中，由于过度依赖营养密度低的谷类饮食以及感染和寄生虫感染的高流行率，在最初1000天满足营养需求的挑战更加严峻。饮食多样化是解决营养缺乏问题的理想长期方案，但获取足够量的铁、锌和某些维生素可能仍存在困难。还有其他几种干预措施，但应用这些措施往往充满挑战，包括成本以及限制疗效的背景因素。有证据表明，补充SQ-LNS可能有助于减少孕期体重增加不足，并在某些人群中促进胎儿和儿童的生长发育。需要更多研究来评估SQ-LNS和其他强化产品在不同背景下以及在解决母婴营养不良其他决定因素的综合项目中的有效性。
