英国伦敦大学学院大奥蒙德街儿童健康研究所Maximiliane L Verfürden团队研究了营养改良婴儿配方奶粉对学习成绩的影响。相关论文于2021年11月11日发表在《英国医学杂志》上。
为了比较在婴儿期随机分为改良配方奶粉组和标准配方奶粉组的青少年在学习成绩上的差异，研究组在1993年8月11日至2001年10月29日对英国五家医院，2002年9月至2016年8月对英国学校进行了七项休眠随机对照试验，并与国家教育数据关联。1763名青少年（425名早产出生，299名足月出生但小于胎龄，1039名足月出生）参加了7项婴儿配方奶粉随机对照试验中的一项。
七项随机对照试验分别为营养丰富的配方奶粉与标准配方奶粉（两个试验）、添加长链多不饱和脂肪酸（LCPUFA）的配方奶粉与未添加的配方奶粉（两个试验）、高铁与低铁的后续配方奶粉（一个试验）、高sn-2棕榈酸酯与低sn-2棕榈酸酯配方奶粉（一个试验）以及核苷酸添加的配方奶粉与未添加的配方奶粉（一个试验）。
主要结果由试验数据与学校数据关联确定，即16岁时数学统考标准偏差分数的平均差异。次要结果包括英语（16岁和11岁）和数学（11岁）标准差分数的差异。通过对缺少主要结果的参与者进行多重插补的意向性治疗进行分析。
1607名（91.2%）参与者与学校记录有关。未发现任何改良配方奶粉对16岁时的数学考试成绩有任何益处：出院后早产儿补充营养丰富配方奶粉的标准偏差为0.02分，小胎龄足月儿为−0.11 分；早产儿补充LCPUFA配方奶粉的标准偏差为−0.19分，足月婴儿为−0.14分；足月婴儿补充含铁后续配方奶粉的标准偏差为−0.12分； 足月儿补充sn-2棕榈酸酯配方奶粉的标准偏差分为−0.09分。
核苷酸试验的参与者年龄太小，在与学校数据挂钩时无法参加普通中等教育证书（GCSE）考试。营养丰富、高铁、sn-2棕榈酸酯或核苷酸补充配方奶粉的次要结果没有差异，但在11岁时，随机选择添加LCPUFA配方奶粉的早产儿和足月儿参与者在英语和数学方面得分较低。
研究结果表明，与标准婴儿配方奶粉相比，改良婴儿配方奶粉不会促进长期认知益处。
附：英文原文
Title: Effect of nutritionally modified infant formula on academic performance: linkage of seven dormant randomised controlled trials to national education data
Author: Maximiliane L Verfürden, Ruth Gilbert, Alan Lucas, John Jerrim, Mary Fewtrell
Issue&Volume: 2021/11/11
Abstract:
Objective To compare differences in academic performance between adolescents who were randomised in infancy to modified or standard infant formula.
Design Linkage of seven dormant randomised controlled trials to national education data.
Setting Five hospitals in England, 11 August 1993 to 29 October 2001, and schools in England, September 2002 to August 2016.
Participants 1763 adolescents (425 born preterm, 299 born at term and small for gestational age, 1039 born at term) who took part in one of seven randomised controlled trials of infant formula in infancy.
Interventions Nutrient enriched versus standard term formula (two trials), long chain polyunsaturated fatty acid (LCPUFA) supplemented versus unsupplemented formula (two trials), high versus low iron follow-on formula (one trial), high versus low sn-2 palmitate formula (one trial), and nucleotide supplemented versus unsupplemented formula (one trial).
Main outcome measures The primary outcome, determined by linkage of trial data to school data, was the mean difference in standard deviation scores for mandated examinations in mathematics at age 16 years. Secondary outcomes included differences in standard deviation scores in English (16 and 11 years) and mathematics (11 years). Analysis was by intention to treat with multiple imputation for participants missing the primary outcome.
Results 1607 (91.2%) participants were linked to school records. No benefit was found for performance in mathematics examinations at age 16 years for any modified formula: nutrient enriched in preterm infants after discharge from hospital, standard deviation score 0.02 (95% confidence interval 0.22 to 0.27), and nutrient enriched in small for gestational age term infants 0.11 (0.33 to 0.12); LCPUFA supplemented in preterm infants 0.19 (0.46 to 0.08) and in term infants 0.14 (0.36 to 0.08); iron follow-on formula in term infants 0.12 (0.31 to 0.07); and sn-2 palmitate supplemented formula in term infants 0.09 (0.37 to 0.19). Participants from the nucleotide trial were too young to have sat their General Certificate of Secondary Education (GCSE) examinations at the time of linkage to school data. Secondary outcomes did not differ for nutrient enriched, high iron, sn-2 palmitate, or nucleotide supplemented formulas, but at 11 years, preterm and term participants randomised to LCPUFA supplemented formula scored lower in English and mathematics.
Conclusions Evidence from these randomised controlled trials indicated that the infant formula modifications did not promote long term cognitive benefit compared with standard infant formulas.
DOI: 10.1136/bmj-2021-065805
Source: https://www.bmj.com/content/375/bmj-2021-065805
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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本期文章：《英国医学杂志》：Online/在线发表
