Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2024-01-01 DOI:10.1016/j.advnut.2023.100149

Meredith (Merilee) Brockway , Allison I. Daniel , Sarah M. Reyes , Matthew Granger , Joann M. McDermid , Deborah Chan , Rebecca Refvik , Karanbir K. Sidhu , Suad Musse , Pooja P. Patel , Caroline Monnin , Larisa Lotoski , Donna Geddes , Fyezah Jehan , Patrick Kolsteren , Lindsay H. Allen , Daniela Hampel , Kamilla G. Eriksen , Natalie Rodriguez , Meghan B. Azad

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引用次数: 0

Abstract

Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth.

There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.

查看原文本刊更多论文

人乳常量营养素与儿童头2年的生长和身体组成:系统综述。

在纯母乳喂养的婴儿中，母乳在生命的头几个月提供完整的营养，并且只要母乳喂养继续，母乳仍然是重要的能量来源。母乳中的常量营养素由可消化的碳水化合物、蛋白质和氨基酸，以及脂肪和脂肪酸组成，已经得到了很好的研究;然而，与它们与早期成长的关系有关的许多方面仍然没有得到很好的理解。我们系统地检索了Medline、EMBASE、Cochrane Library、Scopus和Web of Science，以综合1980-2022年间发表的关于足月健康婴儿2岁前HM成分和人体测量的证据。从筛选的9992篇摘要中，57篇报道了5979对夫妇的观察结果，并根据他们对HM宏量营养素和婴儿生长的报道进行了分类。在人体测量结果测量、牛奶收集时间表和HM抽样策略方面存在实质性的异质性，因此不可能进行meta分析。总的来说，可消化的碳水化合物与婴儿体重呈正相关。蛋白质与婴儿身高呈正相关，但与婴儿体重没有相关的报道。最后，尽管在单个研究中报告了各种关联，但HM脂肪与任何婴儿生长指标并不一致。除二十二碳六烯酸外，脂肪酸摄入量通常与头围呈正相关。我们对文献的综合受到牛奶收集策略的差异、人体测量结果和分析方法的异质性以及结果报告不足的限制。今后，母乳喂养研究人员应该准确地记录和解释母乳喂养的排他性，使用一致的采样方案来解释母乳大量营养素的时间变化，并使用可靠、敏感和准确的技术来分析母乳大量营养素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.