Nutrition of infants and young children (one to three years) and its effect on later health: A systematic review of current recommendations (EarlyNutrition project)

Background. EarlyNutrition (www.project-earlynutrition.eu) is an international research project investigating the effects of early nutrition on metabolic programming. Objective. To summarize, by performing a systematic review, current standards, recommendations, guidelines, and regulations (hereafter, referred to as documents) on the nutrition of children up to three years of age. Special emphasis was placed on long-term effects of early nutrition, such as the risk of cardiovascular disease, hypertension, overweight, obesity, metabolic syndrome, diabetes, or glucose intolerance. Methods. MEDLINE, selected databases, and websites were searched for documents published between 2008 and January 2013. Results. Forty two documents met the inclusion criteria. The strongest and most consistent evidence for a protective, long-term effect was documented for breastfeeding. Also, limiting the intake of sodium and rapidly absorbed carbohydrates, use of a specific meal pattern, reducing the consumption of saturated fatty acids by replacing them with polyunsaturated fatty acids, and lowering the intake of trans fatty acids, seems beneficial. Many documents did not evaluate long-term outcomes of interest to us, or reported insufficient or imprecise data. Inconsistency in recommendations for some outcomes and research gaps were identified. Conclusions. Our findings may serve as a helpful tool in planning further research, preventive actions against important diet-related diseases, and guidelines improvement.

背景。EarlyNutrition（www.project-earlynutrition.eu）是一项国际性研究项目，旨在探究早期营养对代谢编程的影响。目标。通过系统综述，总结目前针对三岁以下儿童营养的现行标准、建议、指南和法规（以下简称文件）。特别强调早期营养的长期影响，例如心血管疾病、高血压、超重、肥胖、代谢综合征、糖尿病或葡萄糖不耐性的风险。方法。对2008年至2013年1月间发表的文件进行了MEDLINE、选定数据库和网站的检索。结果。共检索到符合纳入标准的42篇文件。在具有保护性和长期效果的证据中，母乳喂养的证据最为强烈且一致。此外，限制钠和快速吸收碳水化合物的摄入、采用特定的饮食模式、通过以多不饱和脂肪酸替代饱和脂肪酸来降低饱和脂肪酸的摄入，以及降低反式脂肪酸的摄入似乎有益。许多文件未评估与我们感兴趣的长期结果相关的内容，或报告了数据不足或不精确。识别出某些结果的推荐不一致性和研究空白。结论。我们的研究结果可能有助于规划进一步研究、针对重要饮食相关疾病的预防措施以及指南的改进。