生命早期人乳宏量营养素、身体成分与婴儿食欲的纵向研究。

Longitudinal human milk macronutrients, body composition and infant appetite during early life.

机构信息

Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.

出版信息

Clin Nutr. 2021 May;40(5):3401-3408. doi: 10.1016/j.clnu.2020.11.024. Epub 2020 Nov 24.

DOI:10.1016/j.clnu.2020.11.024

PMID:33309161

Abstract

BACKGROUND & AIMS: Breastfeeding is the gold standard infant feeding. Data on macronutrients in relation to longitudinal body composition and appetite are very scarce. The aim of this study was to investigate longitudinal human milk macronutrients at 1 and 3 months in association with body composition and appetite during early life in healthy, term-born infants. We hypothesized that infants receiving higher caloric human milk would have more body fat mass and satiate earlier.

METHODS

In 133 exclusively breastfed infants (Sophia Pluto Cohort), human milk samples at 1 and 3 months were analyzed for macronutrients (fat, protein, carbohydrate) by MIRIS Human Milk Analyzer, with appetite assessment by Baby Eating Behavior Questionnaires. Fat mass (FM) and fat-free mass (FFM) were measured by PEA POD and DXA, and abdominal FM by ultrasound.

RESULTS

Milk samples showed large differences in macronutrients, particularly in fat content. Protein and energy content decreased significantly from 1 to 3 months. Fat and carbohydrate content tended to decrease (p = 0.066 and 0.081). Fat (g/100 ml) and energy (kcal/100 ml) content at 3 months were associated with FM% at 6 months (β 0.387 and 0.040, resp.) and gain in FM% from 1 to 6 months (β 0.088 and 0.009, resp.), but not with FM% at 2 years. Carbohydrate content at 3 months tended to associate with visceral FM at 2 years (β 0.290, p = 0.06). Infants receiving higher caloric milk were earlier satiated and finished feeding faster.

CONCLUSIONS

Our longitudinal data show decreasing milk protein and energy content from age 1 to 3 months, while fat and carbohydrate tended to decrease. Macronutrient composition, particularly fat content, differed considerably between mothers. Milk fat and energy content at 3 months associated with gain in FM% from age 1 to 6 months, indicating that higher fat and energy content associate with higher gain in FM% during the critical window for adiposity programming. As infants receiving higher caloric breastfeeding were earlier satiated, this self-regulatory mechanism might prevent intake of excessive macronutrients.

ONLINE TRIAL REGISTRY

NTR, NL7833.

摘要

背景与目的

母乳喂养是婴儿喂养的金标准。关于宏量营养素与婴儿早期身体成分和食欲的纵向关系的数据非常有限。本研究的目的是调查健康足月出生婴儿在生命早期，1 个月和 3 个月时人乳中的宏量营养素与身体成分和食欲的纵向关系。我们假设接受更高热量人乳的婴儿会有更多的体脂肪量，并更早感到饱足。

方法

在 133 名纯母乳喂养的婴儿（Sophia Pluto 队列）中，通过 MIRIS 人乳分析仪分析人乳样本中 1 个月和 3 个月的宏量营养素（脂肪、蛋白质、碳水化合物），并通过婴儿进食行为问卷评估食欲。使用 PEA POD 和 DXA 测量体脂肪量（FM）和去脂体重（FFM），使用超声测量腹部 FM。

结果

母乳样本中的宏量营养素差异很大，特别是脂肪含量。蛋白质和能量含量从 1 个月到 3 个月显著下降。脂肪和碳水化合物含量呈下降趋势（p=0.066 和 0.081）。3 个月时的脂肪（g/100ml）和能量（kcal/100ml）含量与 6 个月时的 FM%相关（β0.387 和 0.040），以及从 1 个月到 6 个月时的 FM%增长相关（β0.088 和 0.009），但与 2 岁时的 FM%无关。3 个月时的碳水化合物含量与 2 岁时的内脏 FM 呈正相关趋势（β0.290，p=0.06）。接受高热量母乳的婴儿更早感到饱足，进食速度也更快。

结论

我们的纵向数据显示，1 个月到 3 个月期间人乳中的蛋白质和能量含量逐渐下降，而脂肪和碳水化合物含量呈下降趋势。不同母亲的母乳宏量营养素组成，特别是脂肪含量，差异很大。3 个月时的母乳脂肪和能量含量与 1 个月到 6 个月时的 FM%增长相关，表明在脂肪生成编程的关键窗口期，较高的脂肪和能量含量与更高的 FM%增长相关。由于接受高热量母乳喂养的婴儿更早感到饱足，这种自我调节机制可能会防止摄入过多的宏量营养素。