College of Health Solutions, Arizona State University, Phoenix, AZ, United States.
Department of Human Nutrition, The University of Alabama, Tuscaloosa, AL, United States.
Adv Nutr. 2023 Nov;14(6):1617-1632. doi: 10.1016/j.advnut.2023.09.007. Epub 2023 Sep 25.
Characterization of the nutrients in human milk is important to understand the dietary and developmental requirements of infants. The objective of this review was to summarize the state-of-the-science on the nutrient composition of human milk in the United States and Canada published from 2017 to 2022. Four databases were searched for randomized controlled studies and others given the scoping nature of this review. We limited type to mature milk collected 21 d postpartum and beyond from lactating individuals in the United States and Canada who gave birth at 37-wk gestation or later (full-term). Outcomes of interest included traditional macro- and micronutrients, including human milk oligosaccharides (HMOs), and milk volume. The publication date range was selected as January 1, 2017, to the day the literature search was performed. A total of 32 articles were included in the scoping review from primarily longitudinal cohort or cross-sectional designs. The most prevalent sample collection method was full-breast expression (n = 20) with most studies (n = 26) collecting samples from a single timepoint. Carbohydrates (HMOs [n = 12], glucose [n = 8], and lactose [n = 6]) and protein (n = 5) were the most frequently assessed nutrients in this body of work, with consensus among studies that glucose is present in limited concentrations compared to lactose (24-64 mg/dL compared with 6-7 g/dL) and that HMOs are influenced by temporality and secretor status. Included studies displayed an overall level of heterogeneity and sparsity paralleling previous reports and nutrient data in the USDA FoodData Central system. Much of the data extracted from retained articles generally provided analysis of a specific nutrient or group of nutrients. Moreover, many studies did not use the preferred analytical methods as outlined by the Human Milk Composition Initiative to increase measurement confidence. Up-to-date nutrient composition data of human milk is still greatly needed as it is paramount for the management of infant feeding, assessment of infant and maternal nutritional and health needs, and as a reference for infant formula development.
对人乳中的营养成分进行分析对于了解婴儿的饮食和发育需求非常重要。本综述的目的是总结 2017 年至 2022 年期间在美国和加拿大发表的关于人乳营养成分的最新科学研究。我们在四个数据库中搜索了随机对照研究和其他具有综述性质的研究。我们将类型限制为产后 21 天及以后从美国和加拿大的 37 周妊娠或足月分娩（足月）后哺乳个体中收集的成熟乳。感兴趣的结果包括传统的宏量和微量营养素，包括人乳寡糖（HMO）和奶量。选择出版日期范围为 2017 年 1 月 1 日至文献检索完成之日。该综述共纳入 32 篇文章，主要为纵向队列或横断面设计。最常见的样本采集方法是全乳表达（n = 20），大多数研究（n = 26）仅在一个时间点采集样本。碳水化合物（HMO [n = 12]、葡萄糖[n = 8]和乳糖[n = 6]）和蛋白质（n = 5）是该研究领域最常评估的营养素，研究一致认为葡萄糖的浓度有限，与乳糖相比（24-64mg/dL 与 6-7g/dL），并且 HMO 受到时间性和分泌状态的影响。纳入的研究显示出整体水平的异质性和稀疏性，与之前的报告和 USDA FoodData Central 系统中的营养数据相似。从保留的文章中提取的数据通常提供了对特定营养素或营养素组的分析。此外，许多研究并未使用人乳成分倡议概述的首选分析方法来提高测量可信度。仍然非常需要最新的人乳营养成分数据，因为它对于婴儿喂养管理、婴儿和母亲营养和健康需求的评估以及婴儿配方奶粉的开发都是至关重要的。
