背景:人乳包含被天然磷脂膜包裹的大脂肪球,而婴儿配方奶粉含有少量,蛋白质涂层的脂滴。先前的实验研究表明,在婴儿配方奶粉(IMF)中模仿人乳脂滴的结构会改变脂质代谢,并对以后的代谢健康产生持久的有益影响。
目的:为了评估一项随机随访(FU)研究,对照试验是否具有大的概念IMF,富含乳制品脂质的乳磷脂涂层脂滴有益地影响长期体重指数(BMI,以kg/m2为单位)的轨迹和学龄期的血压。
方法:完全配方喂养的婴儿被随机分配到概念IMF(n=115)或对照IMF,前4个月含有植物油的小脂滴(n=108)。一组88名母乳喂养的婴儿作为参考。FU期间,人体测量在1、3、4和5岁时收集,和血压只有在最后一次访问。
结果:与对照组相比,概念组儿童在FU期间的平均BMI值一直较低,在1岁时差异最大(平均值差异-0.71kg/m2,95%置信区间(CI):-1.13,-0.29;P=0.001);平均值接近母乳喂养组(P>0.05)。相反,在FU1~5岁期间,对照组的平均BMI值高于母乳喂养组(平均值差异分别为0.59~0.96kg/m2;P<0.02).五岁时,与对照组相比,概念组的平均舒张压和动脉压降低;-4.3mmHg(95%CI:-7.3,-1.3;P=0.005)和-3.7mmHg(95%CI:-6.5,-0.9;P=0.01),分别。
结论:创新的IMF的早期喂养,富含乳制品脂质的乳磷脂涂层脂滴导致BMI轨迹更接近母乳喂养的婴儿,并在学龄期降低血压。该试验在荷兰试验登记处注册为NTR3683和NTR5538。
BACKGROUND: Human milk comprises large fat globules enveloped by a native phospholipid membrane, whereas infant formulas contain small, protein-coated lipid droplets. Previous experimental studies indicated that mimicking the architecture of human milk lipid droplets in infant milk formula (IMF) alters lipid metabolism with lasting beneficial impact on later metabolic health.
OBJECTIVE: To evaluate in a follow-up (FU)
study of a randomized, controlled
trial whether a Concept IMF with large, milk phospholipid-coated lipid droplets enriched with dairy lipids beneficially impacts long-term body mass index (BMI in kg/m2) trajectories and blood pressure at school age.
METHODS: Fully formula-fed infants were randomly assigned to Concept IMF (n = 115) or Control IMF with conventional, small lipid droplets containing vegetable oils (n = 108) for the first 4 mo of age. A group of 88 breastfed infants served as a reference. During FU, anthropometrics were collected at 1, 3, 4, and 5 y of age, and blood pressure only at the last visit.
RESULTS: Compared to Control, Concept group children had consistently lower mean BMI values during FU, with the most marked difference at 1 y of age (difference in means -0.71 kg/m2, 95% confidence interval (CI): -1.13, -0.29; P = 0.001); mean values were close to the breastfed group (P > 0.05). Contrary, the mean BMI values of the Control group were higher compared with the breastfed group during FU from 1 to 5 y of age (differences in means from 0.59 to 0.96 kg/m2, respectively; P < 0.02). At 5 y of age, the Concept group had a lower mean diastolic and arterial blood pressure compared with the Control group; -4.3mm Hg (95% CI: -7.3, -1.3; P = 0.005) and -3.7 mm Hg (95% CI: -6.5, -0.9; P = 0.01), respectively.
CONCLUSIONS: Early life feeding of an innovative IMF with large, milk phospholipid-coated lipid droplets enriched with dairy lipids results in a BMI trajectory closer to breastfed infants and a lower blood pressure at school age. This
trial was registered at the Dutch
Trial Register as NTR3683 and NTR5538.