背景:人乳中的脂肪酸(FA)是婴儿的重要营养素。它们在能源供应中发挥着重要作用,神经系统发育,和代谢功能的维持。然而,主要牛奶FAs的组成如何随泌乳阶段而变化仍存在争议。
目的:系统评价不同泌乳阶段人乳中主要FAs的浓度范围。
方法:根据PRISMA清单和流程图对涉及3507名参与者的50组数据的总共12篇论文进行了审查。纳入标准为文献对健康泌乳母亲在三个泌乳阶段的母乳中FAs含量进行了计算,并可以计算出饮食模式。排除标准为:研究重复,与饮食模式或母乳成分无关,和/或研究人群不健康。我们搜索了PubMed,中国国家知识基础设施,万方,和Web的科学。医疗保健研究与质量机构(AHRQ)用于评估研究的偏倚。包括二十二碳六烯酸(DHA)在内的多不饱和脂肪酸(PUFA)的平均值,花生四烯酸(AA),二十碳五烯酸(EPA),α-亚麻酸(ALA),亚油酸(LA),单不饱和脂肪酸(MUFA),和饱和脂肪酸(SFAs,包括月桂酸和棕榈酸),在三个泌乳阶段的人乳中(初乳1-7天,过渡奶8-14天,根据高蛋白饮食模式对健康哺乳期妇女的成熟牛奶15d-3mo)进行了调查。通过Egger测试评估出版偏见。
结果:根据初乳中总脂肪的百分比,过渡牛奶,和成熟乳(%wt/wt),分别,结果表明,PUFA(25.72%,24.92%,和22.69%),AA(0.85%,0.76%,和0.59%),DHA(0.53%,0.47%,和0.39%),EPA(0.15%,0.10%,和0.10%),和MUFA(37.39%,37.21%,和36.14%)母乳中的含量随着泌乳而下降,而另外两个PUFA形式,洛杉矶(17.47%,17.82%,和17.48%),和ALA(1.09%,1.39%,和1.24%)在过渡乳中达到峰值,然后在成熟乳中下降,SFA(37.46%,38.64%,和40.52%),和月桂酸含量(2.78%,4.91%,和4.97%)随泌乳阶段增加。
结论:这些发现可以揭示主要FA代谢的动态变化过程,有可能增强泌乳生物学的知识,改善婴儿喂养方式以满足他们的需求。
BACKGROUND: Fatty acids (FAs) in human milk are important nutrients for infants. They play important roles in energy supply, nervous system development, and metabolic function maintenance. However, how the composition of major milk FAs change with lactation stages remains controversial.
OBJECTIVE: To systematically
review the concentration range of major FAs in human milk at various lactation stages.
METHODS: A total of 12 papers involving 50 sets of data with 3507 participants were reviewed according to the PRISMA checklist and flow diagram. The inclusion criteria was the literatures had the FAs contents in breast milk of healthy lactation mothers at three lactation stages and the dietary patterns could be calculated. The exclusion criteria were: the studies were duplicates, were unrelated to dietary patterns or breast milk composition, and/or the study populations were unhealthy. We searched PubMed, the China National Knowledge Infrastructure, WanFang, and Web of science. Agency for Health Care Research and Quality (AHRQ) was used to assess the bias of studies. The mean values of polyunsaturated fatty acids (PUFAs) including docosahexaenoic acid (DHA), arachidonic acid (AA), eicosapentaenoic acid (EPA), α-linolenic acid (ALA), linoleic acid (LA), monounsaturated fatty acids (MUFAs), and saturated fatty acids (SFAs, including lauric acid and palmitic acid), in human milk at three lactation stages (colostrum 1-7 d, transitional milk 8-14 d, mature milk 15 d-3 mo) of healthy lactating women were investigated in terms of the high protein dietary pattern. Publication biases were evaluated by Egger\'s test.
RESULTS: According to the percentage in total fat of colostrum, transitional milk, and mature milk (% wt/wt), respectively, the results showed that PUFA (25.72%, 24.92%, and 22.69%), AA (0.85%, 0.76%, and 0.59%), DHA (0.53%, 0.47%, and 0.39%), EPA (0.15%, 0.10%, and 0.10%), and MUFA (37.39%, 37.21%, and 36.14%) contents in breast milk decreased with lactation, while another two PUFA forms, LA (17.47%, 17.82%, and 17.48%), and ALA (1.09%, 1.39%, and 1.24%) arrived at a peak in the transitional milk and then decreased in the mature milk, SFA (37.46%, 38.64%, and 40.52%), and lauric acid contents (2.78%, 4.91%, and 4.97%) increased with the lactation stages.
CONCLUSIONS: These findings could shed light on the dynamic change progress of major FA metabolism, potentially enhancing the knowledge of lactation biology, and improving infant feeding practices to meet their needs.