全脂牛奶或与儿童较低的超重风险相关
  • 纳入28项观察性研究(20项横断面,8项前瞻性队列研究),未发现符合要求的干预试验;
  • 其中18项研究显示较高的牛奶脂肪摄入与较低的儿童肥胖风险相关,剩余10项没有发现相关性;
  • 对其中14项研究进行荟萃分析,发现摄入全脂牛奶(3.25%脂肪)儿童的超重或肥胖患病风险比摄入低脂牛奶(0.1-2%脂肪)儿童低,OR值为0.61;
  • 纳入荟萃分析的研究存在较大异质性,还需干预试验来确定哪种脂肪含量的牛奶可以降低肥胖风险。
主编推荐语
flying dutchman
许多机构建议儿童在2岁后,应将饮食中的全脂牛奶转换为低脂牛奶来降低肥胖风险。近期American Journal of Clinical Nutrition上发表的一项荟萃分析展示了不一样的结果。该研究纳入28项报道了健康儿童(1-18岁)牛奶脂肪摄入与肥胖关系的观察性研究,并对其中14项报道了全脂牛奶或低脂牛奶摄入比例及测量了超重或肥胖的研究进行荟萃分析。该研究发现,摄入全脂牛奶(3.25%脂肪)儿童的超重或肥胖风险比摄入低脂牛奶(0.1-2%脂肪)儿童低。但需注意,纳入研究间的异质性较大,多为横断面研究,且大部分研究偏倚风险高,仍需高质量的前瞻性研究或干预试验来评价哪种脂肪含量的牛奶可以降低肥胖风险。
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Whole milk compared with reduced-fat milk and childhood overweight: a systematic review and meta-analysis

全脂牛奶,低脂牛奶与儿童超重:一项系统综述和荟萃分析

10.1093/ajcn/nqz276

2019-12-18, Article

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Background The majority of children in North America consume cow-milk daily. Children aged >2 y are recommended to consume reduced-fat (0.1–2%) cow-milk to lower the risk of obesity. Objectives To evaluate the relation between cow-milk fat consumption and adiposity in children aged 1–18 y. Methods Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Scopus, and Cochrane Library databases from inception to August 2019 were used. The search included observational and interventional studies of healthy children aged 1–18 y that described the association between cow-milk fat consumption and adiposity. Two reviewers extracted data, using the Newcastle–Ottawa Scale to assess risk of bias. Meta-analysis was conducted using random effects to evaluate the relation between cow-milk fat and risk of overweight or obesity. Adiposity was assessed using BMI z-score (zBMI). Results Of 5862 reports identified by the search, 28 met the inclusion criteria: 20 were cross-sectional and 8 were prospective cohort. No clinical trials were identified. In 18 studies, higher cow-milk fat consumption was associated with lower child adiposity, and 10 studies did not identify an association. Meta-analysis included 14 of the 28 studies (n = 20,897) that measured the proportion of children who consumed whole milk compared with reduced-fat milk and direct measures of overweight or obesity. Among children who consumed whole (3.25% fat) compared with reduced-fat (0.1–2%) milk, the OR of overweight or obesity was 0.61 (95% CI: 0.52, 0.72; P < 0.0001), but heterogeneity between studies was high (I2 = 73.8%). Conclusions Observational research suggests that higher cow-milk fat intake is associated with lower childhood adiposity. International guidelines that recommend reduced-fat milk for children might not lower the risk of childhood obesity. Randomized trials are needed to determine which cow-milk fat minimizes risk of excess adiposity.

First Authors:
Shelley M Vanderhout

Correspondence Authors:
Jonathon L Maguire

All Authors:
Shelley M Vanderhout,Mary Aglipay,Nazi Torabi,Peter Jüni,Bruno R da Costa,Catherine S Birken,Deborah L O'Connor,Kevin E Thorpe,Jonathon L Maguire

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