Achieving appropriate growth and nutrient accretion of preterm and low birth weight (LBW) infants is often difficult during hospitalization because of metabolic and gastrointestinal immaturity and other complicating medical conditions. Advances in the care of preterm-LBW infants, including improved nutrition, have reduced mortality rates for these infants from 9.6 to 6.2% from 1983 to 1997. The Food and Drug Administration (FDA) has responsibility for ensuring the safety and nutritional quality of infant formulas based on current scientific knowledge. Consequently, under FDA contract, an ad hoc Expert Panel was convened by the Life Sciences Research Office of the American Society for Nutritional Sciences to make recommendations for the nutrient content of formulas for preterm-LBW infants based on current scientific knowledge and expert opinion. Recommendations were developed from different criteria than that used for recommendations for term infant formula. To ensure nutrient adequacy, the Panel considered intrauterine accretion rate, organ development, factorial estimates of requirements, nutrient interactions and supplemental feeding studies. Consideration was also given to long-term developmental outcome. Some recommendations were based on current use in domestic preterm formula. Included were recommendations for nutrients not required in formula for term infants such as lactose and arginine. Recommendations, examples, and sample calculations were based on a 1000 g preterm infant consuming 120 kcal/kg and 150 mL/d of an 810 kcal/L formula. A summary of recommendations for energy and 45 nutrient components of enteral formulas for preterm-LBW infants are presented. Recommendations for five nutrient:nutrient ratios are also presented. In addition, critical areas for future research on the nutritional requirements specific for preterm-LBW infants are identified.

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Objective Low vitamin D levels have been implicated in the development of and increased morbidity from asthma. The prevalence of asthma among urban African American (AA) youth is high. The goal of this study was to examine the prevalence of vitamin D insufficiency and deficiency among urban AA youth with asthma compared with non-asthmatic controls. Study Design A cross-sectional case-control study was conducted at an urban pediatric medical center. Total 25-hydroxyvitamin D insufficiency (< 30 ng/mL) and deficiency (< 20 ng/mL) were assessed in urban self-reported AA patients, aged 6 to 20 years, with (n = 92) and without (n = 21) physician-diagnosed asthma. Results Blood samples were available for 85 (92%) cases. After adjusting for age, gender, body mass index percentile, and season of sampling, the median vitamin D level of cases [18.5 (interquartile range (IQR): 11.3, 25.1)] was significantly lower than that of controls [40.4 (IQR: 34.6, 49.5), P = 0.002]. The prevalences of vitamin D insufficiency and deficiency were significantly greater among cases than controls [73/85 (86%) vs. 4/21 (19%), adjusted odds ratio (OR) = 41.7 (95% confidence interval (95%CI): 4.4 to 398.5) for insufficiency and 46/85 (54%) vs. 1/21 (5%), adjusted OR = 19.5 (95%CI: 1.4 to 272.0) for deficiency]. Conclusions A majority of this sample of urban AA youth with persistent asthma were vitamin D deficient and/or insufficient. Given the emerging associations between low vitamin D levels and asthma, strong consideration should be given to routine vitamin D testing in urban AA youth, particularly those with asthma. Clinical trials of vitamin D supplementation among urban AA youth with asthma are warranted.

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