Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, UK.
J Dairy Sci. 2020 Nov;103(11):9681-9699. doi: 10.3168/jds.2020-18296.
The ongoing increase in life expectancy is not always accompanied by an increase in healthy life span. There is increasing evidence that dietary exposure in early life can substantially affect chronic disease risk in later life. Milk and dairy foods are important suppliers of a range of key nutrients, with some being particularly important at certain life stages. It is now recognized that milk protein can stimulate insulin-like growth factor-1 (IGF-1), essential for longitudinal bone growth and bone mass acquisition in young children, thus reducing the risk of stunting. Low milk consumption during adolescence, particularly by girls, may contribute to suboptimal intake of calcium, magnesium, iodine, and other important nutrients. Given the generally low vitamin D status of European populations, this may have already affected bone development, and any resulting reduced bone strength may become a big issue when the populations are much older. Suboptimal iodine status of many young women has already been reported together with several observational studies showing an association between suboptimal iodine status during pregnancy and reduced cognitive development in the offspring. There is now good evidence that consumption of milk and dairy foods does not lead to an increased risk of cardiovascular diseases and type 2 diabetes. Indeed, some negative associations are seen, notably between yogurt consumption and type 2 diabetes, which should be researched with urgency. Greater emphasis should be placed on reducing malnutrition in the elderly and on dietary approaches to reduce their loss of muscle mass, muscle functionality, and bone strength. Whey protein has been shown to be particularly effective for reducing muscle loss; this needs to be developed to provide simple dietary regimens for the elderly to follow. There is an ongoing, often too simplistic debate about the relative value of animal versus plant food sources for protein in particular. It is important that judgments on the replacement of dairy products with those from plants also include the evidence on relative functionality, which is not expressed in simple nutrient content (e.g., hypotensive and muscle synthesis stimulation effects). Only by considering such functionality will a true comparison be achieved.
预期寿命的持续增长并不总是伴随着健康寿命的延长。越来越多的证据表明，生命早期的饮食暴露会对以后的生活中的慢性疾病风险产生实质性影响。牛奶和乳制品是一系列关键营养素的重要来源，其中一些在某些生命阶段尤为重要。现在人们认识到，牛奶蛋白可以刺激胰岛素样生长因子-1（IGF-1），这对于幼儿的纵向骨骼生长和骨量积累至关重要，从而降低发育迟缓的风险。青少年时期，特别是女孩，牛奶摄入量低，可能导致钙、镁、碘和其他重要营养素摄入不足。考虑到欧洲人口普遍维生素 D 状况较低，这可能已经影响了骨骼发育，而当人口年龄更大时，任何由此导致的骨强度降低都将成为一个大问题。许多年轻女性的碘状况不佳已经被报道，并且一些观察性研究表明，怀孕期间碘状况不佳与后代认知发育降低之间存在关联。现在有充分的证据表明，食用牛奶和乳制品不会增加心血管疾病和 2 型糖尿病的风险。事实上，一些负面关联已经被发现，特别是酸奶的摄入与 2 型糖尿病之间的关联，应该紧急进行研究。应更加重视减少老年人的营养不良，并采取饮食措施减少他们的肌肉质量、肌肉功能和骨强度的损失。乳清蛋白已被证明对减少肌肉损失特别有效；这需要进一步开发，为老年人提供简单的饮食方案。关于动物和植物食物来源的蛋白质的相对价值，目前正在进行一场持续的、往往过于简单的辩论。重要的是，在用植物制品替代乳制品的判断中，还应包括关于相对功能的证据，而这在简单的营养成分中无法体现（例如，降压和肌肉合成刺激作用）。只有考虑到这些功能，才能进行真正的比较。
