Grote Veit, Theurich Melissa, Luque Veronica, Gruszfeld Darek, Verduci Elvira, Xhonneux Annick, Koletzko Berthold
Nestle Nutr Inst Workshop Ser. 2018;89:93-103. doi: 10.1159/000486495. Epub 2018 Jul 10.
The complementary feeding period is a short transitional period from breastfeeding and formula feeding to family foods. Timing, quantity, and quality are implied to impact growth and obesity risk. We summarized the literature and analyzed data of monthly 3-day food diaries of >1,000 children from 5 European countries in the first 2 years of life, which were collected as part of the prospective European Childhood Obesity Project (CHOP Study). Formula-fed children started complementary food approximately 2 weeks earlier than breastfed children, and almost 40% of them at or before 4 months of age. While introduction of solids between 4 and 6 months or after 6 months does not seem to impact growth and later obesity risk, solids before 4 months of age increased the risk. There are indications that this is especially problematic for formula-fed children. During the complementary feeding period, fat intake decreases, and protein and carbohydrate intakes increase. Protein intake often exceeds European recommendations from 9 months onwards. However, the role of macronutrients during complementary feeding in growth and metabolism needs further clarification. Findings on the role of responsive feeding or baby-led feeding during complementary feeding in growth are not conclusive. In summary, while introduction of complementary foods before 4 months of age should be avoided, the impact of the quality of complementary food on short-term growth and later obesity risk has to be elucidated further.
辅食添加期是从母乳喂养和配方奶喂养过渡到家庭食物的短暂时期。辅食添加的时间、数量和质量被认为会影响生长发育和肥胖风险。我们总结了相关文献，并分析了来自5个欧洲国家的1000多名儿童在生命最初两年每月3天的食物日记数据，这些数据是作为前瞻性欧洲儿童肥胖项目（CHOP研究）的一部分收集的。配方奶喂养的儿童开始添加辅食的时间比母乳喂养的儿童大约早2周，其中近40%在4个月及以前就开始添加。虽然在4至6个月之间或6个月之后引入固体食物似乎不会影响生长发育和日后的肥胖风险，但在4个月之前引入固体食物会增加风险。有迹象表明，这对配方奶喂养的儿童尤其成问题。在辅食添加期，脂肪摄入量减少，蛋白质和碳水化合物摄入量增加。从9个月起，蛋白质摄入量常常超过欧洲的建议量。然而，在辅食添加期，宏量营养素在生长和新陈代谢中的作用需要进一步阐明。关于辅食添加期顺应性喂养或自主进食在生长中的作用的研究结果尚无定论。总之，虽然应避免在4个月之前添加辅食，但辅食质量对短期生长发育和日后肥胖风险的影响仍需进一步阐明。
