婴幼儿喂养方式与后代心血管疾病结局的系统评价。

Infant milk-feeding practices and cardiovascular disease outcomes in offspring: a systematic review.

机构信息

Panum Group, Bethesda, MD.

USDA, Food and Nutrition Service, Alexandria, VA.

出版信息

Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):800S-816S. doi: 10.1093/ajcn/nqy332.

DOI:10.1093/ajcn/nqy332

PMID:30982872

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6500930/

Abstract

BACKGROUND

During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations.

OBJECTIVES

The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) lower versus higher intensities of human milk fed to mixed-fed infants with intermediate and endpoint cardiovascular disease (CVD) outcomes in offspring.

METHODS

The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.

RESULTS

The 4 systematic reviews included 13, 24, 6, and 0 articles, respectively. The evidence was insufficient to draw conclusions about endpoint CVD outcomes across all 4 systematic reviews. Limited evidence suggests that never versus ever being fed human milk is associated with higher blood pressure within a normal range at 6-7 y of age. Moderate evidence suggests there is no association between the duration of any human milk feeding and childhood blood pressure. Limited evidence suggests there is no association between the duration of exclusive human milk feeding and blood pressure or metabolic syndrome in childhood. Additional evidence about intermediate outcomes for the 4 systematic reviews was scant or inconclusive.

CONCLUSIONS

There is insufficient evidence to draw conclusions about the relationships between infant milk-feeding practices and endpoint CVD outcomes; however, some evidence suggests that feeding less or no human milk is not associated with childhood hypertension.

摘要

背景

在美国农业部和卫生与公众服务部的“怀孕与生育至 24 个月项目”中，启动了一项针对这些人群饮食与健康相关证据的审查。

目的

这些系统综述的目的是检验以下几个方面的关系：1）从未还是曾经喂哺过母乳；2）任何母乳喂养时长更短还是更长；3）纯母乳喂养时长更短还是更长；4）混合喂养婴儿的母乳喂养频率更低还是更高，与子代中间和终点心血管疾病（CVD）结局的关系。

方法

营养证据系统评价小组与外部专家合作进行了系统综述。我们检索了 CINAHL、Cochrane、Embase 和 PubMed 数据库，以获取发表于 1980 年 1 月至 2016 年 3 月的文章，使用预定标准双屏幕筛选结果，从纳入的每项研究中提取数据并评估偏倚风险，对证据进行定性综合，形成结论陈述，并对证据的强度进行分级。

结果

4 项系统综述分别纳入了 13、24、6 和 0 篇文章。由于证据不足，4 项系统综述均无法得出关于终点 CVD 结局的结论。有限的证据表明，从未喂哺过母乳的儿童在 6-7 岁时血压处于正常范围内更高。中等质量证据表明，任何母乳喂养时长与儿童期血压之间无关联。有限的证据表明，纯母乳喂养时长与儿童期血压或代谢综合征之间无关联。关于 4 项系统综述的中间结局，额外证据很少或无结论。