婴儿辅食添加研究新进展
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摘要
国内外关于辅食添加的循证证据有着差异。不仅是婴幼儿家长,各级医疗机构的医师对于辅食添加时间、成分、方式也观点不一。辅食添加对于营养和发育至关重要,而且是从母乳喂养过渡到家庭食品的重要阶段。辅食添加时期,是婴儿快速生长发育期,易受营养不足和营养过剩的影响,在此期间,随着接触新的食物、口味和喂养经历,饮食有明显变化。本文就近年来辅食添加时间、成分和方式进行综述,将婴幼儿辅食添加知识进行更新。
There exist differences on the evidence of complementary feeding recommendations and practices at home and abroad. Not only parents but also doctors are confused about the appropriate time,content and ways of complementary feeding. Complementary food is necessary for both nutritional and developmental reasons,and is an important stage in the transition from milk feeding to family foods. Complementary feeding period is one of rapid growth and development stages when infants are susceptible to nutrient deficiencies and excesses,and during which there are marked changes in the diet because of exposure to new foods,tastes,and feeding experiences. This review summarizes the time,content and ways of complementary feeding recently,so as to update the knowledge of complementary feeding in infants.
There exist differences on the evidence of complementary feeding recommendations and practices at home and abroad. Not only parents but also doctors are confused about the appropriate time,content and ways of complementary feeding. Complementary food is necessary for both nutritional and developmental reasons,and is an important stage in the transition from milk feeding to family foods. Complementary feeding period is one of rapid growth and development stages when infants are susceptible to nutrient deficiencies and excesses,and during which there are marked changes in the diet because of exposure to new foods,tastes,and feeding experiences. This review summarizes the time,content and ways of complementary feeding recently,so as to update the knowledge of complementary feeding in infants.
引文
[1] World Health Organization.Complementary feeding:report of the global consultation Summary of guidingprinciples[M].Geneva:Switzerland,2002.
[2] Fewtrell M,Bronsky J,Campoy C,et al.Complementary fee ding:a position paper by the European Society for Paediatric Gastroenterology,Hepatology,and Nutrition (ESPGHAN) Committee on Nutrition[J].J Pediatr Gastroenterol Nutr,2017,64(1):119-132.
[3] World Health Organization.Infant and young child nutrition[M].Geneva,Switzerland,2002.
[4] World Health Organization.Infant and Young Child Feeding:Model Chapter for Textbooks for Medical Students and Allied Health Professionals[M].Geneva:Switzerland,2009.
[5] Lanting CI,Heerdink N,Wouwe JPV.JGZ-richtlijn Voeding en eetgedrag[J].Jgz Tijdschrift Voor Jeugdgezondheidszorg,2013,45(5):106-106.
[6] 杨月欣,苏宜香,汪之顼,等.7～ 24 月龄婴幼儿喂养指南[J].临床儿科杂志,2016,34(5):381-387.
[7] Perkin MR,Logan K,Tseng A,et al.Randomized trial of introduction of allergenic foods in breast-fed infants[J].N Engl J Med,2016,374(18):1733-1743.
[8] Perkin MR,Logan K,Marrs T,et al.Enquiring early about tolerance (EAT) study:feasibility of an early allegenic food introduction regimen[J].J Allergy Clin Immunol,2016,137(5):1477-1486,e8.
[9] Muraro A,Halken S,Arshad SH,et al.EAACI food allergy and anaphylaxis guidelines.Primary prevention of food allergy[J].Allergy,2014,69(5):590-601.
[10] Ierodiakonou D,Garcia-Larsen V,Logan A,et al.Timing of allergenic food introduction to the infant diet and risk of allergenic or autoimmune disease:a systematic review and meta-analysis[J].JAMA,2016,316(11):1181-1192.
[11] DuToit G,Roberts G,Sayre PH,et al.LEAP Study Team.Randomised trial of peanut consumption in infants at risk for peanut allergy[J].N Engl J Med,2015,372(9):803-813.
[12] Szajewska H,Shamir R,Chmielewska A,et al.Systematic review with meta-analysis:early infant feeding and coeliac disease-update 2015[J].Aliment Pharmacol Ther,2015,41(11):1038-1054.
[13] Pies′cik-Lech M,Chmielewska A,Shamir R,et al.Systematic review:early infant feeding and the risk of type 1 diabetes[J].J Pediatr Gastroenterol Nutr,2017,64(3):454-459.
[14] Daniels L,Mallan KM,Fildes A,et al.The timing of solid introduction in an ‘obesogenic′ environment:a narrative review of the evidence and methodological issues[J].Aust NZ J Public Health,2015,39(4):366-373.
[15] Jonsdottir OH,Kleinman RE,Wells JC,et al.Exclusive breastfeeding for 4 versus 6 months and growth in early childhood[J].Acta Paediatr,2014,103(1):105-111.
[16] EFSA NDA Panel (EFSA Panel on Dietetic Products,Nutrition and Allergies).Scientific opinion on nutrient requirements and dietary intakes of infants and young children in the European Union[J].EFSA J,2013,11(10):3408.
[17] H?rnell A,Lagstr?m H,Lande B,et al.Protein intake from 0 to 18 years of age and its relation to health:a systematic literature review for the 5th Nordic Nutrition Recommendations[J].Food Nutr Res,2013,57(1):88-97.
[18] EFSA NDA Panel (EFSA Panel on Dietetic Products,Nutrition and Allergies).Scientific Opinion on the essential composition of infant and follow-on formulae[J].EFSA J,2014,12(7):3760.
[19] Harsl?f LB,Larsen LH,Ritz C,et al.FADS genotype and diet are important determinants of DHA status:a cross-sectional study in Danish infants[J].Am J Clin Nutr,2013,97(6):1403-1410.
[20] Libuda L,Mesch CM,Stimming M,et al.Fatty acid supply with complementary foods and LC-PUFA status in healthy infants:results of a randomised controlled trial[J].Eur J Nutr,2016,55(4):1633-1644.
[21] Mennella J A.Ontogeny of taste pbasic biology and implications for health[J].Am J Clin Nutr,2014,99(Suppl 3):704-711.
[22] Nehring I,Kostka T,Von Kries R,et al.Impacts of in utero and early infant taste experiences on later taste acceptance:a systematic review[J].J Nutr,2015,145(6):1271-1279.
[23] Remy E,Issanchou S,Chabanet C,et al.Repeated exposure of infants at complementary feeding to a vegetable puree increases acceptance as effectively as flavor-flavor learning and more effectively than flavor-nutrient learning[J].J Nutr,2013,143(7):1194-1200.
[24] Maier-N?th A,Schaal B,Leathwood P,et al.The lasting influences of early food-related variety experience:a longitudinal study of vegetable acceptance from 5 months to 6 years in two populations[J].PLoS One,2016,11(3):e0151356.
[25] Cameron SL,Heath A-LM,Taylor RW.How feasible is baby-led weaning as an approach to infant feeding?A review of the evidence[J].Nutrients,2012,4(11):1575-1609.
[26] Cameron S L,Taylor R W,Heath A L M.Development and pilot testing of Baby-Led Introduction to SolidS-a version of Baby-Led Weaning modified to address concerns about iron deficiency,growth faltering and choking[J].Bmc Pediatrics,2015,15(1):99.
[27] Redsell SA,Edmonds B,Swift JA,et al.Systematic review of randomised controlled trials of interventions that aim to reduce the risk,either directly or indirectly,of overweight and obesity in infancy and early childhood[J].Matern Child Nutr,2016,12(1):24-38.
[2] Fewtrell M,Bronsky J,Campoy C,et al.Complementary fee ding:a position paper by the European Society for Paediatric Gastroenterology,Hepatology,and Nutrition (ESPGHAN) Committee on Nutrition[J].J Pediatr Gastroenterol Nutr,2017,64(1):119-132.
[3] World Health Organization.Infant and young child nutrition[M].Geneva,Switzerland,2002.
[4] World Health Organization.Infant and Young Child Feeding:Model Chapter for Textbooks for Medical Students and Allied Health Professionals[M].Geneva:Switzerland,2009.
[5] Lanting CI,Heerdink N,Wouwe JPV.JGZ-richtlijn Voeding en eetgedrag[J].Jgz Tijdschrift Voor Jeugdgezondheidszorg,2013,45(5):106-106.
[6] 杨月欣,苏宜香,汪之顼,等.7～ 24 月龄婴幼儿喂养指南[J].临床儿科杂志,2016,34(5):381-387.
[7] Perkin MR,Logan K,Tseng A,et al.Randomized trial of introduction of allergenic foods in breast-fed infants[J].N Engl J Med,2016,374(18):1733-1743.
[8] Perkin MR,Logan K,Marrs T,et al.Enquiring early about tolerance (EAT) study:feasibility of an early allegenic food introduction regimen[J].J Allergy Clin Immunol,2016,137(5):1477-1486,e8.
[9] Muraro A,Halken S,Arshad SH,et al.EAACI food allergy and anaphylaxis guidelines.Primary prevention of food allergy[J].Allergy,2014,69(5):590-601.
[10] Ierodiakonou D,Garcia-Larsen V,Logan A,et al.Timing of allergenic food introduction to the infant diet and risk of allergenic or autoimmune disease:a systematic review and meta-analysis[J].JAMA,2016,316(11):1181-1192.
[11] DuToit G,Roberts G,Sayre PH,et al.LEAP Study Team.Randomised trial of peanut consumption in infants at risk for peanut allergy[J].N Engl J Med,2015,372(9):803-813.
[12] Szajewska H,Shamir R,Chmielewska A,et al.Systematic review with meta-analysis:early infant feeding and coeliac disease-update 2015[J].Aliment Pharmacol Ther,2015,41(11):1038-1054.
[13] Pies′cik-Lech M,Chmielewska A,Shamir R,et al.Systematic review:early infant feeding and the risk of type 1 diabetes[J].J Pediatr Gastroenterol Nutr,2017,64(3):454-459.
[14] Daniels L,Mallan KM,Fildes A,et al.The timing of solid introduction in an ‘obesogenic′ environment:a narrative review of the evidence and methodological issues[J].Aust NZ J Public Health,2015,39(4):366-373.
[15] Jonsdottir OH,Kleinman RE,Wells JC,et al.Exclusive breastfeeding for 4 versus 6 months and growth in early childhood[J].Acta Paediatr,2014,103(1):105-111.
[16] EFSA NDA Panel (EFSA Panel on Dietetic Products,Nutrition and Allergies).Scientific opinion on nutrient requirements and dietary intakes of infants and young children in the European Union[J].EFSA J,2013,11(10):3408.
[17] H?rnell A,Lagstr?m H,Lande B,et al.Protein intake from 0 to 18 years of age and its relation to health:a systematic literature review for the 5th Nordic Nutrition Recommendations[J].Food Nutr Res,2013,57(1):88-97.
[18] EFSA NDA Panel (EFSA Panel on Dietetic Products,Nutrition and Allergies).Scientific Opinion on the essential composition of infant and follow-on formulae[J].EFSA J,2014,12(7):3760.
[19] Harsl?f LB,Larsen LH,Ritz C,et al.FADS genotype and diet are important determinants of DHA status:a cross-sectional study in Danish infants[J].Am J Clin Nutr,2013,97(6):1403-1410.
[20] Libuda L,Mesch CM,Stimming M,et al.Fatty acid supply with complementary foods and LC-PUFA status in healthy infants:results of a randomised controlled trial[J].Eur J Nutr,2016,55(4):1633-1644.
[21] Mennella J A.Ontogeny of taste pbasic biology and implications for health[J].Am J Clin Nutr,2014,99(Suppl 3):704-711.
[22] Nehring I,Kostka T,Von Kries R,et al.Impacts of in utero and early infant taste experiences on later taste acceptance:a systematic review[J].J Nutr,2015,145(6):1271-1279.
[23] Remy E,Issanchou S,Chabanet C,et al.Repeated exposure of infants at complementary feeding to a vegetable puree increases acceptance as effectively as flavor-flavor learning and more effectively than flavor-nutrient learning[J].J Nutr,2013,143(7):1194-1200.
[24] Maier-N?th A,Schaal B,Leathwood P,et al.The lasting influences of early food-related variety experience:a longitudinal study of vegetable acceptance from 5 months to 6 years in two populations[J].PLoS One,2016,11(3):e0151356.
[25] Cameron SL,Heath A-LM,Taylor RW.How feasible is baby-led weaning as an approach to infant feeding?A review of the evidence[J].Nutrients,2012,4(11):1575-1609.
[26] Cameron S L,Taylor R W,Heath A L M.Development and pilot testing of Baby-Led Introduction to SolidS-a version of Baby-Led Weaning modified to address concerns about iron deficiency,growth faltering and choking[J].Bmc Pediatrics,2015,15(1):99.
[27] Redsell SA,Edmonds B,Swift JA,et al.Systematic review of randomised controlled trials of interventions that aim to reduce the risk,either directly or indirectly,of overweight and obesity in infancy and early childhood[J].Matern Child Nutr,2016,12(1):24-38.