School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Research Centre, Seattle, WA, USA.
Adv Nutr. 2020 Jul 1;11(4):928-950. doi: 10.1093/advances/nmaa011.
Dietary guidelines commonly recommend that children aged >2 y consume reduced-fat dairy products rather than regular- or whole-fat dairy. In adults, most studies have not found the consumption of whole-fat dairy products to be associated with increased cardiometabolic or adiposity risk. Associations in children could differ due to growth and development. We systematically reviewed the literature in indexed, peer-reviewed journals to summarize pediatric studies (children aged from 2 to 18 y) assessing associations between whole- and reduced-fat dairy intake and measures of adiposity as well as biomarkers of cardiometabolic disease risk, including the serum lipid profile, blood pressure, low-grade chronic inflammation, oxidative stress, and measures of glucose homeostasis. For the purposes of this review, a "whole-fat" dairy product was defined as a product with the natural fat content, whereas a "reduced-fat" dairy product was defined as a product with some or all of the fat removed (including "low-fat" and "skim" versions). A total of 29 journal articles met our criteria for inclusion. The majority were conducted in the United States and were prospective or cross-sectional observational studies, with only 1 randomized controlled trial. Studies were consistent in reporting that whole-fat dairy products were not associated with increased measures of weight gain or adiposity. Most evidence indicated that consumption of whole-fat dairy was not associated with increased cardiometabolic risk, although a change from whole-fat to reduced-fat dairy improved outcomes for some risk factors in 1 study. Taken as a whole, the limited literature in this field is not consistent with dietary guidelines recommending that children consume preferably reduced-fat dairy products. High-quality randomized controlled trials in children that directly compare the effects of whole-fat compared with reduced-fat dairy intake on measures of adiposity or biomarkers of cardiometabolic disease risk are needed to provide better quality evidence in this area.
饮食指南通常建议 2 岁以上的儿童食用低脂乳制品，而非全脂或高脂乳制品。在成年人中，大多数研究并未发现食用全脂乳制品与增加心血管代谢或肥胖风险相关。由于生长和发育的原因，儿童的关联可能会有所不同。我们系统地回顾了索引和同行评议期刊中的文献，以总结评估全脂和低脂乳制品摄入与肥胖指标以及心血管代谢疾病风险生物标志物（包括血清脂质谱、血压、低度慢性炎症、氧化应激和葡萄糖稳态指标）之间关联的儿科研究（年龄 2 至 18 岁的儿童）。为了本综述的目的，“全脂”乳制品被定义为具有天然脂肪含量的产品，而“低脂”乳制品被定义为去除部分或全部脂肪的产品（包括“低脂”和“脱脂”版本）。共有 29 篇期刊文章符合我们的纳入标准。这些研究主要在美国进行，是前瞻性或横断面观察性研究，仅有 1 项随机对照试验。这些研究一致报告称，全脂乳制品与体重增加或肥胖的增加无关。大多数证据表明，食用全脂乳制品与增加心血管代谢风险无关，尽管在 1 项研究中，从全脂乳制品改为低脂乳制品改善了一些风险因素的结果。总的来说，该领域的有限文献与建议儿童最好食用低脂乳制品的饮食指南不一致。需要在儿童中进行高质量的随机对照试验，直接比较全脂与低脂乳制品摄入对肥胖指标或心血管代谢疾病风险生物标志物的影响，以在该领域提供更好质量的证据。
