Lawson Yolanda, Mpasi Priscilla, Young Michal, Comerford Kevin, Mitchell Edith
Associate Attending, Baylor University Medical Center, Dallas, TX, United States.
ChristianaCare Health System, Assistant Clinical Director Complex Care and Community Medicine, Wilmington, DE, United States.
J Natl Med Assoc. 2024 Apr;116(2 Pt 2):228-240. doi: 10.1016/j.jnma.2024.01.014. Epub 2024 Feb 15.
Adequate nutrition is paramount for proper growth and musculoskeletal, neurocognitive, and immunological development in infants, toddlers, and young children. Among breastfeeding mother-child dyads, this critical window of development, is impacted by both maternal and offspring dietary patterns. For mothers, their dietary patterns impact not only their own health and well-being, but also the nutrition of their breast milk - which is recommended as the sole source of food for the first 6 months of their infant's life, and as a complementary source of nutrition until at least 2 years of age. For infants and toddlers, the breast milk, formulas, and first foods they consume can have both short-term and long-term effects on their health and well-being - with important impacts on their taste perception, microbiome composition, and immune function. According to dietary intake data in the US, infants and young children meet a greater number of nutrient requirements than older children and adults, yet numerous disparities among socially disadvantaged racial/ethnic groups still provide significant challenges to achieving adequate nutrition during these early life stages. For example, Black children are at greater risk for disparities in breastfeeding, age-inappropriate complementary feeding patterns, nutrient inadequacies, food insecurity, and obesity relative to most other racial/ethnic groups in the US. For infants who do not receive adequate breast milk, which includes a disproportionate number of Black infants, dairy-based infant formulas are considered the next best option for meeting nutritional needs. Fermented dairy foods (e.g., yogurt, cheese) can serve as ideal first foods for complementary feeding, and cow's milk is recommended for introduction during the transitional feeding period to help meet the nutrient demands during this phase of rapid growth and development. Low dairy intake may put children at risk for multiple nutrient inadequacies and health disparities - some of which may have lifelong consequences on physical and mental health. A burgeoning body of research shows that in addition to breast milk, cow's milk and other dairy foods may play critical roles in supporting physical growth, neurodevelopment, immune function, and a healthy gut microbiome in early life. However, most of this research so far has been conducted in White populations and can only be extrapolated to Black infants, toddlers, and young children. Therefore, to better understand and support the health and development of this population, greater research and education efforts on the role of milk and dairy products are urgently needed. This review presents the current evidence on health disparities faced by Black children in the US from birth to four years of age, and the role that dairy foods can play in supporting the normal growth and development of this vulnerable population.
充足的营养对于婴儿、幼儿和儿童的正常生长以及肌肉骨骼、神经认知和免疫发育至关重要。在母乳喂养的母婴二元组中,这个关键的发育窗口期受到母亲和后代饮食模式的影响。对于母亲来说,她们的饮食模式不仅会影响自身的健康和幸福,还会影响母乳的营养——母乳被推荐为婴儿出生后前6个月的唯一食物来源,并作为至少到2岁的补充营养来源。对于婴幼儿来说,他们食用的母乳、配方奶和第一种食物会对其健康和幸福产生短期和长期影响——对他们的味觉感知、微生物群组成和免疫功能有重要影响。根据美国的饮食摄入数据,婴幼儿比大龄儿童和成年人满足更多的营养需求,但社会弱势种族/族裔群体之间的众多差异仍然给在这些生命早期阶段实现充足营养带来重大挑战。例如,与美国大多数其他种族/族裔群体相比,黑人儿童在母乳喂养、不适当的辅食喂养模式、营养不足、粮食不安全和肥胖方面存在差异的风险更大。对于没有获得足够母乳的婴儿(其中黑人婴儿占比过高),以乳制品为基础的婴儿配方奶被认为是满足营养需求的次优选择。发酵乳制品(如酸奶、奶酪)可以作为辅食喂养的理想第一种食物,建议在过渡喂养期引入牛奶,以帮助满足这个快速生长和发育阶段的营养需求。低乳制品摄入量可能使儿童面临多种营养不足和健康差异的风险——其中一些可能对身心健康产生终身影响。大量新兴研究表明,除了母乳之外,牛奶和其他乳制品可能在支持生命早期的身体生长、神经发育、免疫功能和健康的肠道微生物群方面发挥关键作用。然而,迄今为止,这项研究大多是在白人人群中进行的,只能推断到黑人婴幼儿和儿童。因此,为了更好地了解和支持这一人群的健康和发育,迫切需要对牛奶和乳制品的作用进行更多的研究和教育工作。本综述介绍了美国黑人儿童从出生到四岁所面临的健康差异的现有证据,以及乳制品在支持这一弱势群体正常生长和发育中可以发挥的作用。