USDA, Food and Nutrition Service, Alexandria, VA.
Panum Group, Bethesda, MD.
Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):852S-871S. doi: 10.1093/ajcn/nqy266.
Proper nutrition during early life is critical for growth and development.
The aim was to describe systematic reviews conducted by the Nutrition Evidence Systematic Review team for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 Months Project to answer the following: What is the relation between 1) timing of introduction of complementary foods and beverages (CFBs) or 2) types and/or amounts of CFBs consumed and micronutrient status (iron, zinc, vitamin D, vitamin B-12, folate, and fatty acid status)?
A literature search identified articles from developed countries published from January 1980 to July 2016 that met the inclusion criteria. Data were extracted and risk of bias assessed. Evidence was qualitatively synthesized to develop a conclusion statement, and the strength of the evidence was graded.
Nine articles addressed the timing of CFB introduction and 31 addressed types or amounts or both of CFBs. Moderate evidence suggests that introducing CFBs at age 4 mo instead of 6 mo offers no advantages or disadvantages in iron status among healthy full-term infants. Evidence is insufficient on the timing of CFB introduction and other micronutrient status outcomes. Strong evidence suggests that CFBs containing iron (e.g., meat, fortified cereal) help maintain adequate iron status or prevent deficiency in the first year among infants at risk of insufficient iron stores or low intake. Benefits for infants with sufficient iron stores (e.g., infant formula consumers) are less clear. Moderate evidence suggests that CFBs containing zinc (e.g., meat, fortified cereal) support zinc status in the first year and CFB fatty acid composition influences fatty acid status. Evidence is insufficient with regard to types and amounts of CFBs and vitamin D, vitamin B-12, and folate status, or the relation between lower-iron-containing CFBs and micronutrient status.
Several conclusions on CFBs and micronutrient status were drawn from these systematic reviews, but more research that addresses specific gaps and limitations is needed.
生命早期的适当营养对生长和发育至关重要。
本研究旨在描述由美国农业部和卫生与公众服务部“怀孕和 24 个月以内婴儿养育”项目的营养证据系统评价小组进行的系统评价，以回答以下问题：1）补充食物和饮料（CFB）的引入时间，或 2）CFB 的类型和/或数量与微量营养素状况（铁、锌、维生素 D、维生素 B-12、叶酸和脂肪酸状况）之间有何关系？
文献检索确定了自 1980 年 1 月至 2016 年 7 月在发达国家发表的符合纳入标准的文章。提取数据并评估偏倚风险。对证据进行定性综合，以形成结论陈述，并对证据的强度进行分级。
9 篇文章探讨了 CFB 引入时间，31 篇文章探讨了 CFB 的类型或数量或两者兼而有之。有中等质量证据表明，健康足月婴儿在 4 个月而非 6 个月龄引入 CFB 不会对铁状况产生任何优势或劣势。关于 CFB 引入时间和其他微量营养素状况结果的证据不足。有强有力的证据表明，含有铁的 CFB（例如肉类、强化谷物）有助于在缺铁或低摄入量风险的婴儿中维持第一年的铁状况或预防缺铁。对于铁储存充足的婴儿（例如婴儿配方奶消费者），益处不太明确。有中等质量证据表明，含有锌的 CFB（例如肉类、强化谷物）支持第一年的锌状况，CFB 的脂肪酸组成影响脂肪酸状况。关于 CFB 的类型和数量以及维生素 D、维生素 B-12 和叶酸状况，或低铁 CFB 与微量营养素状况之间的关系，证据不足。
从这些系统评价中得出了关于 CFB 和微量营养素状况的几个结论，但需要更多针对具体差距和局限性的研究。
