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DHA藻油、相当于DHA 柠檬酸钙 葡萄糖酸锌 甘氨酸镁 胆钙化醇油、 维生素K2油（MK-7） 帮我查一下这些成分对儿童相关的前沿研究，另外，这些成分有什么优势。
这些成分对儿童的生长发育至关重要，涵盖了大脑神经发育、骨骼健康、免疫调节和情绪稳定等多个核心领域。它们的优势在于：相比传统基础营养素，这些成分在吸收率、生物利用度、作用靶向性和安全性上具有明显的前沿优势，能更精准、高效地满足儿童快速生长的特殊需求。
下面为您详细拆解每种成分在儿童相关领域的前沿研究发现及其独特优势。
1. DHA藻油 / 相当于DHA
前沿研究发现： DHA（Docosahexaenoic acid，二十二碳六烯酸，一种对人体非常重要的Omega-3脂肪酸）是儿童大脑和视网膜发育的绝对核心物质。大脑灰质中约有15%的脂肪酸是DHA。前沿研究主要集中在以下几个阶段：
- 孕期与婴儿期： 胎儿大脑对DHA的积累主要发生在怀孕的最后三个月，并在出生后头两年持续高速进行。母体通过胎盘和母乳提供的DHA，直接影响婴儿的神经发育（如神经生长、信号传递）和视力发育。如果DHA水平低，会导致儿童学习困难和行为改变。
- 儿童与青少年期： 过去认为DHA只对婴儿重要，但最新研究表明，DHA对儿童期的脑功能维持、预防认知下降，甚至与多动症（ADHD）、抑郁症等主要精神类问题都存在关联。
- 特殊儿童群体（自闭症）： 一项为期12个月的随机对照试验发现，为自闭症谱系障碍（ASD）儿童补充包含DHA在内的综合营养干预，能显著提高他们的非言语智商（平均增加约6.7分），并显著改善自闭症症状和发育年龄。
成分优势：
- 来源更安全（藻油优势）： 传统的DHA主要来自深海鱼油，但海洋存在重金属污染风险。藻油是从海洋微藻中直接提取的，处于食物链底端，没有鱼类富集的重金属和污染物，且不含致敏的鱼蛋白，对儿童极其友好。
- 转化率问题： 人体吃核桃、亚麻籽里的Alpha-亚麻酸（ALA），理论上能转化成DHA，但这个转化过程在大多数人身上效率极低。尤其是男性和小婴儿，转化能力更弱。因此，直接补充现成的DHA（藻油）是最高效的途径，不需要身体费力气去转化。
2. 柠檬酸钙
前沿研究发现： 钙是儿童骨骼发育的基石。前沿研究越来越强调，单补钙不够，必须联合维生素D、维生素K2以及运动，才能有效预防儿童和年轻人的低能量骨折（指没有受到剧烈撞击就发生的骨折，说明骨头太脆）。 关于钙的吸收，研究也发现了有趣的细节：
- 乳糖的帮忙： 含有乳糖的配方奶能让钙的吸收率显著提高（总吸收量差异约为10.3%，60毫克/天）。但很多儿童乳糖不耐受，这就对钙源本身提出了要求。
- 高钙会不会影响锌吸收？ 这是家长常担心的。针对青春期女孩的研究证实，每天摄入高达1500毫克的钙，并不会妨碍锌的吸收和利用。
成分优势：
- 吸收依赖胃酸少，对肠胃友好： 传统的碳酸钙（最便宜的钙）需要大量胃酸才能溶解，小孩子的胃酸分泌不如成人，空腹吃碳酸钙基本不吸收，还容易引起便秘和肚子胀。柠檬酸钙不需要很多胃酸就能溶解，空腹或随餐吃都能很好吸收，非常适合胃部娇嫩的儿童。
- 水溶性好： 冲泡时不会产生沉淀物或沙粒感，孩子接受度高。
3. 葡萄糖酸锌
前沿研究发现： 锌是儿童免疫力和食欲的关键，也直接参与骨骼发育。前沿研究对锌的吸收机制有了更精细的发现：
- 植酸的阻碍： 在以玉米、谷物为主食的地区（植酸高），儿童的锌吸收率极低，吃一顿高植酸的饭，锌吸收率会从63.4%暴跌到16.2%。使用酶制剂去植酸，能让锌吸收翻倍。
- 钙锌同补的真相： 过去担心钙和锌在肠道里会“抢通道”，但研究证实，在婴儿配方奶中，乳糖能促进钙吸收，但完全不影响锌的吸收；青少年高钙补钙也不影响锌的平衡。所以科学配比下，钙锌可以同补。
成分优势：
- 口味极佳，孩子不抗拒： 锌补充剂最怕“难吃”。传统的硫酸锌有金属涩味，俗称“锌子味”，孩子一喝就吐。葡萄糖酸锌味道微甜，口感好，非常适合做成儿童口服液或软糖。
- 胃肠道刺激小： 空腹服用硫酸锌容易恶心伤胃，葡萄糖酸锌对胃黏膜几乎没有刺激，耐受性更好。
4. 甘氨酸镁
前沿研究发现： 镁在儿童大脑发育中扮演着“刹车片”的角色。大脑中有一个叫NMDA受体的东西（负责传递兴奋信号），如果过度兴奋，就会导致抽搐、癫痫等问题。研究发现，新生儿的NMDA受体非常活跃，而镁离子能够抑制这种过度兴奋，保护大脑。
- 新生儿的特殊需求： 新生儿大脑中的NMDA受体对镁的敏感度较低（需要更高浓度的镁才能起效）。在对患有非酮性高甘氨酸血症（一种严重的惊厥疾病）的婴儿治疗中发现，补充镁能有效帮助控制抽搐，改善神经状态。
- 情绪与睡眠： 充足的镁有助于安抚儿童神经系统，缓解焦虑、多动，改善睡眠质量。
成分优势：
- 超高吸收率和生物利用度： 传统的氧化镁或氢氧化镁吸收率极低，容易导致腹泻（俗称“蹿稀”）。甘氨酸镁是将镁和甘氨酸（一种最简单的氨基酸）结合，通过氨基酸通道被肠道完整吸收，吸收率远高于无机镁，且极少引起肠胃不适和腹泻。
- 双重营养： 甘氨酸本身有镇静安神、改善睡眠的作用，与镁协同，对夜间易醒、多动、情绪易激惹的儿童有更好的安抚效果。
5. 胆钙化醇油
前沿研究发现： 胆钙化醇就是维生素D3。近年来对维生素D的认知发生了根本性的转变——它不仅是“长骨头用的”，更是免疫调节剂。
- 骨骼需要D3启动： 钙吃进去后，必须有维生素D3的帮忙才能进入血液到达骨骼。没有D3，钙就是“过客”。
- 孕期与儿童免疫： 针对中低收入国家的大规模荟萃分析（涉及超45万名女性）发现，孕妇补充维生素D能显著减少早产风险。孩子出生后，充足的维生素D与更少的呼吸道感染、自身免疫性疾病相关。
成分优势：
- 天然活性形式： 维生素D分为D2（麦角钙化醇，植物来源）和D3（胆钙化醇，动物来源）。人体皮肤经太阳照射合成的就是D3。D3在血液中的半衰期更长，提升和维持血清维生素D水平的能力远强于D2，是人体的“原装配置”。
- 油剂形态吸收更好： 维生素D是脂溶性的，溶于油中（如MCT油、橄榄油）的形态更符合其理化性质，随餐服用时能借助食物中的脂肪被胆汁乳化，吸收率远高于干燥的粉剂压片。
6. 维生素K2油（MK-7）
前沿研究发现： 如果说钙是修骨头的砖，维生素D3是运砖的车，那么维生素K2就是指挥砖头“去该去的地方”的交通警察。这是目前儿童骨骼健康最前沿的发现：
- 领钙入骨，防止钙乱跑： 骨钙素（Osteocalcin，一种依赖维生素K的蛋白质）需要K2激活后，才能把血液中的钙“粘”到骨头上。如果缺乏K2，钙可能会沉积在血管壁上，导致血管硬化。
- 儿童骨折预防的盲点： 现在发现很多看似健康的儿童，体内其实存在亚临床的维生素D和K缺乏，这是他们容易发生低能量骨折的重要原因。同时补充钙、D3和K2，才是完整的骨骼健康闭环。
成分优势：
- MK-7形式半衰期极长： 维生素K分为K1和K2。K2中又有MK-4、MK-7等。常见的MK-4半衰期很短，几小时就代谢没了，需要一天吃好几次。而MK-7（来自纳豆发酵）在血液中的半衰期长达数天，能在体内持续发挥“领钙入骨”的作用，一天只需服用一次，依从性对孩子来说非常重要。
- 靶向性更强： K1主要参与肝脏凝血，而MK-7更容易被骨骼和血管组织吸收利用，对骨骼健康的针对性更强。
- 油剂形态： 与D3同理，K2也是脂溶性的，油剂形态确保了其高吸收率。
总结： 您列出的这份成分清单，是一个非常专业且搭配精妙的组合：藻油DHA直接为大脑和视力供能；柠檬酸钙提供好吸收的建骨原料；葡萄糖酸锌温和地保障食欲和免疫；甘氨酸镁安抚神经、协同大脑信号传递；胆钙化醇油负责把钙推进血液；而维生素K2油（MK-7）则确保钙精准沉淀到骨骼而不伤血管。这套组合避开了传统补充剂吸收差、口感差、易伤胃的缺点，采用了目前生物利用度和安全性最优的有机/活性形态，非常契合儿童高速发育且身体机能尚未成熟的生理特点。
References
1DHA Effects in Brain Development and Function.PubMed
Lotte Lauritzen, Paolo Brambilla, Alessandra Mazzocchi, et al.
Docosahexaenoic acid (DHA) is a structural constituent of membranes specifically in the central nervous system. Its accumulation in the fetal brain takes place mainly during the last trimester of pregnancy and continues at very high rates up to the end of the second year of life. Since the endogenous formation of DHA seems to be relatively low, DHA intake may contribute to optimal conditions for brain development. We performed a narrative review on research on the associations between DHA levels and brain development and function throughout the lifespan. Data from cell and animal studies justify the indication of DHA in relation to brain function for neuronal cell growth and differentiation as well as in relation to neuronal signaling. Most data from human studies concern the contribution of DHA to optimal visual acuity development. Accumulating data indicate that DHA may have effects on the brain in infancy, and recent studies indicate that the effect of DHA may depend on gender and genotype of genes involved in the endogenous synthesis of DHA. While DHA levels may affect early development, potential effects are also increasingly recognized during childhood and adult life, suggesting a role of DHA in cognitive decline and in relation to major psychiatric disorders.
2Calcium and zinc absorption from lactose-containing and lactose-free infant formulas.PubMed
Steven A Abrams, Ian J Griffin, Penni M Davila
BACKGROUND: Calcium absorption is enhanced by the presence of lactose, but the quantitative significance of this effect in infant formulas is uncertain. It is also not known whether lactose affects zinc absorption. OBJECTIVE: We measured the absorption of calcium and zinc from infant formulas by using a multitracer, stable-isotope technique. DESIGN: Eighteen full-term infants (aged 8-12 wk at enrollment) were fed 2 partially hydrolyzed whey-protein-based formulas ad libitum for 2 wk per formula. The carbohydrate source was lactose in one formula and glucose polymers in the other (lactose-free). Infants were studied in a blinded crossover fashion after 2 wk of adaptation to each formula. Isotope absorption studies were conducted with a 4-tracer method in which (70)Zn and (44)Ca were provided orally and (67)Zn and (46)Ca intravenously. Zinc and calcium absorption was measured from the fractional excretion of the oral and intravenous isotopes in urine. RESULTS: Fractional and total calcium absorption was significantly greater from the lactose-containing formula than from the lactose-free formula. For total calcium absorption, the mean difference between formulas was 10.3% (P = 0.002) and 60 mg/d (P = 0.006). For zinc, fractional absorption (32 +/- 11%), total absorption, and intake did not differ significantly between the 2 formulas. CONCLUSIONS: The presence of lactose in a formula based on cow-milk protein increases absorption of calcium but not of zinc. Absorption of calcium from a lactose-free infant formula is, however, adequate to meet the calcium needs of full-term infants when the formula's calcium content is similar to that of lactose-containing, cow-milk-based infant formulas.
3Modulation by magnesium of N-methyl-D-aspartate receptors in developing human brain.PubMed
H Chahal, S W D'Souza, A J Barson, et al.
AIM: To investigate age related alterations in glutamate N-methyl-D-aspartate (NMDA) receptor binding produced by the modulatory compounds glutamate, glycine, and magnesium (Mg2+) sulphate. METHODS: The effects produced by glutamate plus glycine, and Mg2+ on the binding of [3H]MK-801, a ligand for the N-methyl-D-aspartate ion channel phencyclidine site, were measured in membrane preparations made from prefrontal cortex from human neonate (n = 5), infant (n = 6), and adult (n = 6) necropsy brains. RESULTS: Neonatal brains had the least [3H]MK-801 binding, suggesting either a low density of NMDA receptors or a more restricted access of [3H]MK-801 to cation channel sites. Infant brains had the most [3H]MK-801 binding which was stimulated to a greater extent by L-glutamate (100 microM) and glycine (10 microM) than in neonatal and adult brains. MG2+ invariably inhibited [3H]MK-801 binding. However, the Mg2+ IC50 value was higher in neonatal brain (3.6 mM) than infant (1.4 mM) and adult (0.87 mM) brains. CONCLUSION: Infant brain may have excess NMDA receptors which are hyper responsive to glutamate and glycine. The lower potency of Mg2+ to inhibit [3H]MK-801 binding in neonatal cortex may be because newborn babies have NMDA receptors without the normal complement of Mg2+ sites. The findings suggest that therapeutic NMDA receptor block in neonates requires higher concentrations of magnesium sulphate in brain tissue.
4Roles of Vitamins D and K, Nutrition, and Lifestyle in Low-Energy Bone Fractures in Children and Young Adults.PubMed
Michał Karpiński, Janusz Popko, Katarzyna Maresz, et al.
The research on skeletal system health in children and young adults, while recognizing the important role of calcium and vitamin D, goes beyond these nutritional standards. This review focuses on the role of vitamin K in combination with vitamin D and other factors in bone health. The current understanding is that maintaining bone health and prevention of low-energy fractures in any pediatric population includes nutritional factors combined with an active lifestyle. Calcium, vitamin D, and vitamin K supplementation contribute independently and collectively to bone health. The beneficial role of vitamin K, particularly vitamin K2 as menaquinone-7 (MK-7), in bone and cardiovascular health is reasonably well supported scientifically, with several preclinical, epidemiological, and clinical studies published over the last decade. Osteocalcin and matrix-Gla (glutamate-containing) protein (MGP) exemplify vitamin K-dependent proteins involved in building bone matrix and keeping calcium from accumulating in the arterial walls, respectively. An important part of the mechanism of vitamin K involves carboxylation and posttranslational activation of the family of vitamin K-dependent proteins, which prevent expression of pro-inflammatory factors and support improvement in bone mineral concentration, bone mineral density, and the quality of bone matrix. Understanding the combined approach to a healthy skeletal system in children and young adults, including the roles of vitamins D and K, calcium, healthy diet, and exercise, is particularly important in view of reports of subclinical insufficiency of vitamins D and K in otherwise healthy pediatric populations with low-energy bone fractures.
5Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder-A Randomized, Controlled 12-Month Trial.PubMed
James B Adams, Tapan Audhya, Elizabeth Geis, et al.
This study involved a randomized, controlled, single-blind 12-month treatment study of a comprehensive nutritional and dietary intervention. Participants were 67 children and adults with autism spectrum disorder (ASD) ages 3-58 years from Arizona and 50 non-sibling neurotypical controls of similar age and gender. Treatment began with a special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF) diet. There was a significant improvement in nonverbal intellectual ability in the treatment group compared to the non-treatment group (+6.7 ± 11 IQ points vs. -0.6 ± 11 IQ points, = 0.009) based on a blinded clinical assessment. Based on semi-blinded assessment, the treatment group, compared to the non-treatment group, had significantly greater improvement in autism symptoms and developmental age. The treatment group had significantly greater increases in EPA, DHA, carnitine, and vitamins A, B2, B5, B6, B12, folic acid, and Coenzyme Q10. The positive results of this study suggest that a comprehensive nutritional and dietary intervention is effective at improving nutritional status, non-verbal IQ, autism symptoms, and other symptoms in most individuals with ASD. Parents reported that the vitamin/mineral supplements, essential fatty acids, and HGCSF diet were the most beneficial.
6Maternal Docosahexaenoic Acid Status during Pregnancy and Its Impact on Infant Neurodevelopment.PubMed
Sanjay Basak, Rahul Mallick, Asim K Duttaroy
Dietary components are essential for the structural and functional development of the brain. Among these, docosahexaenoic acid, 22:6n-3 (DHA), is critically necessary for the structure and development of the growing fetal brain . DHA is the major n-3 long-chain polyunsaturated fatty acid in brain gray matter representing about 15% of all fatty acids in the human frontal cortex. DHA affects neurogenesis, neurotransmitter, synaptic plasticity and transmission, and signal transduction in the brain. Data from human and animal studies suggest that adequate levels of DHA in neural membranes are required for maturation of cortical astrocyte, neurovascular coupling, and glucose uptake and metabolism. Besides, some metabolites of DHA protect from oxidative tissue injury and stress in the brain. A low DHA level in the brain results in behavioral changes and is associated with learning difficulties and dementia. In humans, the third trimester-placental supply of maternal DHA to the growing fetus is critically important as the growing brain obligatory requires DHA during this window period. Besides, DHA is also involved in the early placentation process, essential for placental development. This underscores the importance of maternal intake of DHA for the structural and functional development of the brain. This review describes DHA's multiple roles during gestation, lactation, and the consequences of its lower intake during pregnancy and postnatally on the 2019 brain development and function.
7Zinc balance in adolescent females consuming a low- or high-calcium diet.PubMed
A A McKenna, J Z Ilich, M B Andon, et al.
There is increasing evidence that calcium intake up to the threshold amount (1480 mg/d) increases bone mass during growth. However, there is concern that such a high calcium intake may interfere with the utilization of other nutrients such as zinc, which is also important for skeletal development. The purpose of our study was to investigate the effect of long-term calcium supplementation on zinc utilization in 26 adolescent females (mean +/- SD age 11.3 +/- 0.5 y) during a 14-d period. Each day subjects consumed a metabolic diet containing 722 mg Ca and 6.3 mg Zn. Participants were randomly assigned to receive either a placebo or a calcium supplement containing 1000 mg supplemental Ca/d as calcium citrate malate. Supplementation began 15 wk before the balance period to allow for adaptation to the greater calcium intake. Mean (+/-SD) zinc balance (0.8 +/- 0.8 compared with 0.3 +/- 1.1 mg/d, P = 0.23), fecal zinc (4.3 +/- 0.6 compared with 4.7 +/- 1.4 mg/d, P = 0.27), urinary zinc (0.4 +/- 0.2 compared with 0.5 +/- 0.1 mg/d, P = 0.55), and net zinc absorption (21% compared with 15%, P = 0.33) were not significantly different between the high- and low-calcium groups. Our results suggest that increasing the recommended dietary allowance of calcium to 1500 mg/d as recommended by the National Institutes of Health consensus panel will not have adverse effects on zinc utilization in adolescent females.
8Ketamine and strychnine treatment of an infant with nonketotic hyperglycinaemia.PubMed
H Tegtmeyer-Metzdorf, B Roth, M Günther, et al.
UNLABELLED: Non-ketotic hyperglycinaemia (NKH) is a severe seizure disorder associated with high glycine levels. Glycine is a major inhibitory neurotransmitter in the CNS, but has also modulating effects at one of the glutamate receptors, the N-methyl-D-aspartate-(NMDA) receptor. Based on this knowledge we treated a female newborn suffering from severe NKH with the NMDA receptor blocker ketamine in association with strychnine and magnesium supplementation. This treatment led to cessation of seizures, reappearance of swallowing and sucking and improved the neurological status. Some pharmacokinetic data of strychnine and ketamine in the infant are given. CONCLUSION: Ketamine in combination with strychnine may be beneficial in non-ketotic hyperglycinaemia.
9Bioactive Components of Human Milk and Their Impact on Child's Health and Development, Literature Review.PubMed
Hubert Szyller, Katarzyna Antosz, Joanna Batko, et al.
The composition of human breast milk is an ideal combination of substances necessary for the healthy development of an infant's body while protecting from pathogens and the balanced development of the microbiota. Its composition is dynamic and changes with the age of the child, meeting their current needs. The study provides a thorough overview of human milk components, such as immunological components, growth factors, hormones, carbohydrates, lipids, minerals, and vitamins. Authors focus on capturing the most important aspects of the effects of these substances on a newborn's body, while also looking for specific connections and describing the effects on given systems. Supplementation and the use of ingredients are also discussed. The purpose of this paper is to present the current state of knowledge about the bioactive components of human milk and their impact on the growth, development, and health of the young child.
10Health benefits of docosahexaenoic acid (DHA).PubMed
L A Horrocks, Y K Yeo
Docosahexaenoic acid (DHA) is essential for the growth and functional development of the brain in infants. DHA is also required for maintenance of normal brain function in adults. The inclusion of plentiful DHA in the diet improves learning ability, whereas deficiencies of DHA are associated with deficits in learning. DHA is taken up by the brain in preference to other fatty acids. The turnover of DHA in the brain is very fast, more so than is generally realized. The visual acuity of healthy, full-term, formula-fed infants is increased when their formula includes DHA. During the last 50 years, many infants have been fed formula diets lacking DHA and other omega-3 fatty acids. DHA deficiencies are associated with foetal alcohol syndrome, attention deficit hyperactivity disorder, cystic fibrosis, phenylketonuria, unipolar depression, aggressive hostility, and adrenoleukodystrophy. Decreases in DHA in the brain are associated with cognitive decline during aging and with onset of sporadic Alzheimer disease. The leading cause of death in western nations is cardiovascular disease. Epidemiological studies have shown a strong correlation between fish consumption and reduction in sudden death from myocardial infarction. The reduction is approximately 50% with 200 mg day(-1)of DHA from fish. DHA is the active component in fish. Not only does fish oil reduce triglycerides in the blood and decrease thrombosis, but it also prevents cardiac arrhythmias. The association of DHA deficiency with depression is the reason for the robust positive correlation between depression and myocardial infarction. Patients with cardiovascular disease or Type II diabetes are often advised to adopt a low-fat diet with a high proportion of carbohydrate. A study with women shows that this type of diet increases plasma triglycerides and the severity of Type II diabetes and coronary heart disease. DHA is present in fatty fish (salmon, tuna, mackerel) and mother's milk. DHA is present at low levels in meat and eggs, but is not usually present in infant formulas. EPA, another long-chain n-3 fatty acid, is also present in fatty fish. The shorter chain n-3 fatty acid, alpha-linolenic acid, is not converted very well to DHA in man. These longchain n-3 fatty acids (also known as omega-3 fatty acids) are now becoming available in some foods, especially infant formula and eggs in Europe and Japan. Fish oil decreases the proliferation of tumour cells, whereas arachidonic acid, a longchain n-6 fatty acid, increases their proliferation. These opposite effects are also seen with inflammation, particularly with rheumatoid arthritis, and with asthma. DHA has a positive effect on diseases such as hypertension, arthritis, atherosclerosis, depression, adult-onset diabetes mellitus, myocardial infarction, thrombosis, and some cancers.
11Meals and dephytinization affect calcium and zinc absorption in Nigerian children with rickets.PubMed
Tom D Thacher, Oluseyi Aliu, Ian J Griffin, et al.
Nutritional rickets resulting from calcium insufficiency is common in Nigeria and high dietary phytate is thought to inhibit calcium and zinc absorption. We compared the effects of a high-phytate meal and enzymatic dephytinization on calcium and zinc absorption in Nigerian children with and without rickets. Nineteen children with rickets and 15 age-matched control children, aged 2-10 y, were given calcium (600 mg/d) and ergocalciferol (1250 microg/wk). After 6 wk, calcium and zinc absorption were measured in both groups with and without maize porridge using stable isotopes. One week later, absorption measurements were repeated to assess the effects of enzymatic dephytinization and fermentation of the maize porridge. The phytate concentration of maize porridge (3.87 +/- 0.38 g/kg wet weight) was reduced by enzymatic dephytinization (2.83 +/- 0.41 g/kg; P < 0.001) but not by fermentation (3.35 +/- 0.27 g/kg; P = 0.08). Calcium and zinc absorption were unaffected by the presence of rickets or by fermentation of maize porridge. Calcium absorption was greater with a meal (61.3 +/- 25.1%) than without (27.8 +/- 14.6%; P < 0.001). Zinc absorption was lower with a meal (16.2 +/- 8.0%) than without (63.4 +/- 23.9%; P < 0.001). Enzymatic dephytinization increased relative zinc absorption from a meal by 101 +/- 81% (P < 0.001) but did not affect calcium absorption. Rickets was not associated with impaired calcium or zinc absorption. Calcium absorption was enhanced by maize porridge, but zinc absorption was reduced. Enzymatic dephytinization increased zinc absorption. Multiple strategies may be required to optimize calcium and zinc absorption in deficient populations.
12Vitamin and Mineral Supplementation During Pregnancy on Maternal, Birth, Child Health and Development Outcomes in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.PubMed
Christina Oh, Emily C Keats, Zulfiqar A Bhutta
Almost two billion people are deficient in key vitamins and minerals, mostly women and children in low- and middle-income countries (LMICs). Deficiencies worsen during pregnancy due to increased energy and nutritional demands, causing adverse outcomes in mother and child, but could be mitigated by interventions like micronutrient supplementation. To our knowledge, this is the first systematic review that aimed to compile evidence from both efficacy and effectiveness trials, evaluating different supplementation interventions on maternal, birth, child health, and developmental outcomes. We evaluated randomized controlled trials and quasi-experimental studies published since 1995 in peer-reviewed and grey literature that assessed the effects of calcium, vitamin A, iron, vitamin D, and zinc supplementation compared to placebo/no treatment; iron-folic (IFA) supplementation compared to folic acid only; multiple micronutrient (MMN) supplementation compared to IFA; and lipid-based nutrient supplementation (LNS) compared to MMN supplementation. Seventy-two studies, which collectively involved 314 papers (451,723 women), were included. Meta-analyses showed improvement in several key birth outcomes, such as preterm birth, small-for-gestational age (SGA) and low birthweight with MMN supplementation, compared to IFA. MMN also improved child outcomes, including diarrhea incidence and retinol concentration, which are findings not previously reported. Across all comparisons, micronutrient supplementation had little to no effect on mortality (maternal, neonatal, perinatal, and infant) outcomes, which is consistent with other systematic reviews. IFA supplementation showed notable improvement in maternal anemia and the reduction in low birthweight, whereas LNS supplementation had no apparent effect on outcomes; further research that compares LNS and MMN supplementation could help understand differences with these commodities. For single micronutrient supplementation, improvements were noted in only a few outcomes, mainly pre-eclampsia/eclampsia (calcium), maternal anemia (iron), preterm births (vitamin D), and maternal serum zinc concentration (zinc). These findings highlight that micronutrient-specific supplementation should be tailored to specific groups or needs for maximum benefit. In addition, they further contribute to the ongoing discourse of choosing antenatal MMN over IFA as the standard of care in LMICs.
13Docosahexaenoic Acid.PubMed
Philip C Calder
Docosahexaenoic acid (DHA) is a long-chain, highly unsaturated omega-3 (n-3) fatty acid. It has a structure that gives it unique physical and functional properties. DHA is metabolically related to other n-3 fatty acids: it can be synthesised from the plant essential fatty acid α-linolenic acid (ALA). However, this pathway does not appear to be very efficient in many individuals, although the conversion of ALA to DHA is much better in young women than in young men. Furthermore, young infants may be more efficient converters of ALA to DHA than many adults, although the conversion rate is variable among infants. Many factors have been identified that affect the rate of conversion. The implication of poor conversion is that preformed DHA needs to be consumed. DHA is found in fairly high amounts in seafood, especially fatty fish, and in various forms of n-3 supplements. The amount of DHA in seafood and in supplements varies. Breast milk contains DHA. DHA is found esterified into complex lipids within the bloodstream, in adipose stores and in cell membranes. Its concentration in different compartments varies greatly. The brain and eye have high DHA contents compared to other organs. DHA is especially concentrated in the grey matter of the brain and in the rod outer segments of the retina. In the brain DHA is involved in neuronal signalling, while in the eye it is involved in the quality of vision. DHA is accumulated in the brain and eye late in pregnancy and in early infancy. A lower DHA content is linked to poorer cognitive development and visual function. DHA affects cell and tissue physiology and function through numerous mechanisms, including alterations in membrane structure and function, in membrane protein function, in cellular signalling and in lipid mediator production.
14Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors.PubMed
Deepti Khanna, Menaka Yalawar, Pinupa Venkata Saibaba, et al.
The problem of poor nutrition with impaired growth persists in young children worldwide, including in India, where wasting occurs in 20% of urban children (<5 years). Exacerbating this problem, some children are described by their parent as a picky eater with behaviors such as eating limited food and unwillingness to try new foods. Timely intervention can help prevent nutritional decline and promote growth recovery; oral nutritional supplements (ONS) and dietary counseling (DC) are commonly used. The present study aimed to determine the effects of ONS along with DC on growth in comparison with the effects of DC only. Enrolled children (N = 321) were >24 to ≤48 months old, at malnutrition risk (weight-for-height percentile 3rd to 15th), and described as a picky eater by their parent. Enrollees were randomized to one of the three groups (N = 107 per group): ONS1 + DC; ONS2 + DC; and DC only. From day 1 to day 90, study findings showed significant increases in weight-for-height percentile for ONS1 + DC and for ONS2 + DC interventions, as compared to DC only ( = 0.0086 for both). There was no significant difference between the two ONS groups. Anthropometric measurements (weight and body mass index) also increased significantly over time for the two ONS groups (versus DC only, < 0.05), while ONS1 + DC significantly improved mid-upper-arm circumference ( < 0.05 versus DC only), as well. ONS groups showed a trend toward greater height gain when compared to DC only group, but the differences were not significant within the study interval. For young Indian children with nutritional risk and picky eating behaviors, our findings showed that a 90-day nutritional intervention with either ONS1 or ONS2, along with DC, promoted catch-up growth more effectively than did DC alone.
15Maternal nutrition and its effects on fetal neurodevelopment.PubMed
Álvaro Eustáquio de Matos Reis, Ingrid Silva Teixeira, Juliana Marino Maia, et al.
Herein, we present a thorough examination of the impact of maternal nutrition on fetal and infant neurodevelopment, focusing on specific nutrients and their critical roles in perinatal and pediatric health. Through a comprehensive narrative review of the literature, this study highlights the importance of a balanced maternal diet rich in nutrients like eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), folic acid, iron, and iodine in shaping children's neurological functions. Key findings underscore the influence of maternal nutrition during pregnancy and the peri-gestational period on children's cognitive, motor, speech, and socio-emotional development. Deficiencies in essential nutrients, such as DHA, are linked to adverse long-lasting outcomes such as premature birth and intrauterine growth restriction, where a suitable intake of iron and folic acid is vital to prevent neural tube defects and promote healthy brain development. We highlight areas requiring further investigation, particularly regarding iodine's impact and the risks associated with alcohol consumption during pregnancy. In conclusion, this research sheds light on our current understanding of maternal nutrition and child neurodevelopment, offering valuable insights for health professionals and researchers.