Xu Anna, Guerlich Kathrin, Koletzko Berthold, Grote Veit
Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU University Hospital, Munich, Germany.
German Center for Child and Adolescent Health, site, Munich, Germany.
Pediatr Res. 2025 Jul 18. doi: 10.1038/s41390-025-04215-6.
Nutrition in early life can influence health in later life. This systematic review evaluated the impact of nutrition intervention programs in the first 1000 days of life on long-term cardio-metabolic, respiratory, and mental health and dietary behaviour in children.
Randomized controlled trials (RCTs) from high-income countries were searched in four databases and two trial registries in March 2020, and updated in November 2022. Risk of bias was evaluated using the Cochrane Risk of Bias tool and certainty of results using the GRADE considerations. Results were synthesized narratively.
Sixty-three articles covering 20 interventions were included. Most interventions began in early infancy (<6 months of age), lasted 12-36 months and had follow-ups under five years. Initial results showed some positive impact of interventions on cardio-metabolic health (three RCTs). No effect was found on mental health (four RCTs), while no RCT reported on respiratory health. Interventions showed some improvements on dietary behaviour, with mixed results across studies.
Trials on early nutritional interventions seldom report health outcomes with long-term follow-ups. There is some evidence of a positive impact on cardio-metabolic health and dietary behaviour.
In the assessed studies, nutritional interventions in the first 1000 days of life mainly had short follow-ups and reported heterogeneous outcomes. There was some evidence that nutritional interventions can improve children's dietary behaviour and cardio-metabolic health, while there was no effect on mental health. We provide a systematic review on the impact of early nutrition intervention programs on long-term health outcomes in children showing research gaps for intervention studies with long-term and clinically relevant outcomes. Understanding the effectiveness and implementation of early nutritional interventions provides insights for preventative population health and affects future intervention planning.
生命早期的营养状况会影响后期的健康。本系统评价评估了生命最初1000天内营养干预项目对儿童长期心肺代谢、呼吸及心理健康和饮食行为的影响。
于2020年3月在四个数据库和两个试验注册库中检索来自高收入国家的随机对照试验（RCT），并于2022年11月进行更新。使用Cochrane偏倚风险工具评估偏倚风险，使用GRADE考量评估结果的确定性。结果采用叙述性综合分析。
纳入了63篇涵盖20项干预措施的文章。大多数干预措施始于婴儿早期（<6个月龄），持续12 - 36个月，随访时间在5年以下。初步结果显示干预措施对心肺代谢健康有一些积极影响（三项RCT）。未发现对心理健康有影响（四项RCT），而没有RCT报告对呼吸健康的影响。干预措施在饮食行为方面有一些改善，各研究结果不一。
早期营养干预试验很少报告长期随访的健康结果。有一些证据表明对心肺代谢健康和饮食行为有积极影响。
在所评估的研究中，生命最初1000天的营养干预主要随访时间较短，报告的结果各异。有一些证据表明营养干预可以改善儿童的饮食行为和心肺代谢健康，而对心理健康没有影响。我们对早期营养干预项目对儿童长期健康结果的影响进行了系统评价，显示了具有长期和临床相关结果的干预研究存在研究空白。了解早期营养干预的有效性和实施情况可为预防性人群健康提供见解，并影响未来的干预计划。
