Department of Anthropology, University of Massachusetts Boston, Boston, Massachusetts.
Am J Hum Biol. 2019 Nov;31(6):e23318. doi: 10.1002/ajhb.23318. Epub 2019 Sep 3.
While prenatal supplementation with protein, lipids, carbohydrates, and micronutrients has been used to improve infant outcomes in undernourished populations since the 1960s with inconsistent results, a flourishing body of literature within biological anthropology has used life history theory to explain why supplemental resources are often allocated to maternal survival and future reproduction and not to the current offspring. To date, however, public health and nutrition researchers have not adopted evolutionary perspectives in designing or analyzing prenatal supplementation studies. The result is a long series of supplementation trials with unpredictable and often disappointing outcomes for women and children, as well as serious lacunae in the understanding of long-term consequences of supplementation for women. The goal of this article is to open a tactical conversation about how to build a bridge between the evolutionary logic of biological anthropology and the evidentiary standards and methods of public health and nutrition with the aim of advancing knowledge about reproductive and metabolic physiology and improving women's health over the life course. The article reviews recent prenatal supplementation studies and proposes programmatic strategies by which biological anthropologists and public health and nutrition workers may collaborate to define different conditions of prenatal supplement resource allocation and to target more effective interventions.
虽然自 20 世纪 60 年代以来，在营养不足的人群中，产前补充蛋白质、脂肪、碳水化合物和微量营养素已被用于改善婴儿的结局，但生物人类学领域涌现出大量文献，利用生活史理论来解释为什么补充资源通常被分配给母亲的生存和未来的繁殖，而不是当前的后代。然而，迄今为止，公共卫生和营养研究人员在设计或分析产前补充研究时并没有采用进化观点。其结果是一系列补充试验，对妇女和儿童的结果往往不可预测，而且常常令人失望，而且对补充对妇女的长期后果的理解也存在严重的空白。本文的目的是开启一场关于如何在生物人类学的进化逻辑与公共卫生和营养的证据标准和方法之间架起桥梁的战术对话，旨在推进对生殖和代谢生理学的认识，并改善妇女在整个生命过程中的健康。本文回顾了最近的产前补充研究，并提出了一些方案策略，生物人类学家和公共卫生与营养工作者可以通过这些策略进行合作，以确定不同的产前补充资源分配条件，并针对更有效的干预措施。
