小柯机器人

美国塔夫茨大学Susan B Roberts团队研究了膳食补充剂对营养不良幼儿认知功能、脑血流和营养状况的影响。2020年7月22日，该研究发表在《英国医学杂志》上。

为了评估膳食补充剂对改善工作记忆，以及包括营养不良儿童脑血流在内的其他指标的影响，研究组在几内亚比绍的10个村庄进行了一项随机对照试验。他们招募了1059名儿童，年龄为15个月至7岁。将其随机分组，接受监督等热量服务（约1300 kJ，每周5次早膳，为期23周）的新膳食补充剂（NEWSUP，高植物多酚和欧米茄3脂肪酸，多种高强度微量营养素和高蛋白质含量），或营养计划中使用的强化混合食品（FBF），或对照餐（传统米饭早餐）。主要观察指标是工作记忆，其他指标为血红蛋白浓度、生长发育、身体组成和脑血流量指数（CBFi）。

在4岁以下的儿童中，与对照餐相比，NEWSUP显著增加了工作记忆，比率为1.20，对每个治疗方案群体的影响更大。与对照餐相比，NEWSUP还显著提高了贫血儿童的血红蛋白浓度，降低了体重指数z得分，增加了瘦肉组织积累，且脂肪含量降低。此外，在两个年龄组中，NEWSUP与对照餐和FBF相比，CBFi显著增加。在4岁及以上的儿童中，NEWSUP对工作记忆或贫血无明显影响，但与FBF相比，瘦肉组织增加。

儿童营养不良与长期认知障碍有关。研究结果与当前理解相反，23周的补充喂养可改善生活在低收入国家的弱势幼儿的执行功能、大脑健康和营养状况。

附：英文原文

Title: Effects of food supplementation on cognitive function, cerebral blood flow, and nutritional status in young children at risk of undernutrition: randomized controlled trial

Author: Susan B Roberts, Maria A Franceschini, Rachel E Silver, Salima F Taylor, Augusto Braima de Sa, Raimundo Có, Aliu Sonco, Amy Krauss, Amy Taetzsch, Patrick Webb, Sai Krupa Das, C-Y Chen, Beatrice L Rogers, Edward Saltzman, Pei-Yi Lin, Nina Schlossman, William Pruzensky, Carlito Balé, Kenneth Kwan Ho Chui, Paul Muentener

Issue&Volume: 2020/07/22

Abstract: Objective To assess the effects of food supplementation on improving working memory and additional measures including cerebral blood flow in children at risk of undernutrition.

Design Randomized controlled trial.

Setting 10 villages in Guinea-Bissau.

Participants 1059 children aged 15 months to 7 years; children younger than 4 were the primary population.

Interventions Supervised isocaloric servings (≈1300 kJ, five mornings each week, 23 weeks) of a new food supplement (NEWSUP, high in plant polyphenols and omega 3 fatty acids, within a wide variety and high fortification of micronutrients, and a high protein content), or a fortified blended food (FBF) used in nutrition programs, or a control meal (traditional rice breakfast).

Main outcome measurements The primary outcome was working memory, a core executive function predicting long term academic achievement. Additional outcomes were hemoglobin concentration, growth, body composition, and index of cerebral blood flow (CBFi). In addition to an intention-to-treat analysis, a predefined per protocol analysis was conducted in children who consumed at least 75% of the supplement (820/925, 89%). The primary outcome was assessed by a multivariable Poisson model; other outcomes were assessed by multivariable linear mixed models.

Results Among children younger than 4, randomization to NEWSUP increased working memory compared with the control meal (rate ratio 1.20, 95% confidence interval 1.02 to 1.41, P=0.03), with a larger effect in the per protocol population (1.25, 1.06 to 1.47, P=0.009). NEWSUP also increased hemoglobin concentration among children with anemia (adjusted mean difference 0.65 g/dL, 95% confidence interval 0.23 to 1.07, P=0.003) compared with the control meal, decreased body mass index z score gain (0.23, 0.43 to 0.02, P=0.03), and increased lean tissue accretion (2.98 cm2, 0.04 to 5.92, P=0.046) with less fat (5.82 cm2, 11.28 to 0.36, P=0.04) compared with FBF. Additionally, NEWSUP increased CBFi compared with the control meal and FBF in both age groups combined (1.14 mm2/s×108, 0.10 to 2.23, P=0.04 for both comparisons). Among children aged 4 and older, NEWSUP had no significant effect on working memory or anemia, but increased lean tissue compared with FBF (4.31 cm2, 0.34 to 8.28, P=0.03).

Conclusions Childhood undernutrition is associated with long term impairment in cognition. Contrary to current understanding, supplementary feeding for 23 weeks could improve executive function, brain health, and nutritional status in vulnerable young children living in low income countries. Further research is needed to optimize nutritional prescriptions for regenerative improvements in cognitive function, and to test effectiveness in other vulnerable groups.

DOI: 10.1136/bmj.m2397

Source: https://www.bmj.com/content/370/bmj.m2397

BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
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