Barbosa L, Butte N F, Villalpando S, Wong W W, Smith E O
Unidad de Investigacion en Nutricion, Instituto Mexicano del Seguro Social, Mexico City.
Am J Clin Nutr. 1997 Sep;66(3):575-83. doi: 10.1093/ajcn/66.3.575.
The effect of maternal energy balance in conjunction with body energy reserves on lactation performance has not been fully elucidated in humans. Energy balance was computed from changes in weight and body composition over 6 mo postpartum in 21 Otomi Indian women with relatively low postpartum body mass indexes (BMIs; in kg/m2, 21.4 +/- 0.9) and 19 with relatively high BMIs (25.7 +/- 1.9). Body fat was determined by deuterium dilution. Milk production was estimated by 24-h test weighing. Macronutrient content of human milk was measured by standard techniques. In both groups weight declined over the 6 mo postpartum (P = 0.04). In the lower BMI group only, body fat (kg, % of wt) decreased significantly (P = 0.04). Milk fat concentration was positively correlated with body fat at 3 and 6 mo (r = 0.32 and 0.40; P = 0.04 and 0.01, respectively). Energy balance was not associated with milk production or composition, nutrient secretion into milk, or infant growth velocity, except at 6 mo, when energy balance was positively correlated with milk energy and fat concentration in the lower BMI group (r = 0.55; P = 0.01). Fat concentration was lower in the lower BMI group (P = 0.04). Because of the inverse correlation between milk production and milk fat at 3 and 6 mo (r = -0.47 and -0.43, respectively; P = 0.01), fat secretion into milk did not differ between groups. Infant growth velocities did not differ significantly between groups. In conclusion, negative energy balance in conjunction with lower energy reserves did not adversely affect lactation performance or infant growth in this population of Otomi Indians.
母亲能量平衡与身体能量储备对泌乳性能的影响在人类中尚未完全阐明。对21名产后体重指数（BMI；单位为kg/m²，21.4±0.9）相对较低的奥托米印第安妇女和19名BMI相对较高（25.7±1.9）的妇女，根据产后6个月内体重和身体成分的变化计算能量平衡。通过氘稀释法测定体脂。通过24小时称重试验估算产奶量。采用标准技术测量母乳中的宏量营养素含量。两组在产后6个月内体重均下降（P = 0.04）。仅在BMI较低的组中，体脂（kg，占体重的百分比）显著下降（P = 0.04）。产后3个月和6个月时，乳脂肪浓度与体脂呈正相关（r分别为0.32和0.40；P分别为0.04和0.01）。能量平衡与产奶量或成分、营养素分泌到乳汁中的情况或婴儿生长速度无关，不过在产后6个月时，能量平衡与BMI较低组的乳能量和脂肪浓度呈正相关（r = 0.55；P = 0.01）。BMI较低组的脂肪浓度较低（P = 0.04）。由于产后3个月和6个月时产奶量与乳脂肪呈负相关（r分别为 -0.47和 -0.43；P = 0.01），两组间乳汁中的脂肪分泌无差异。两组间婴儿生长速度无显著差异。总之，能量负平衡与较低的能量储备并未对这群奥托米印第安人的泌乳性能或婴儿生长产生不利影响。
