Early Protein Intake Is Associated with Body Composition and Resting Energy Expenditure in Young Adults Born with Very Low Birth Weight

Matinolli, Hanna‐Maria; Hovi, Petteri; Männistö, Satu; Sipola-Leppänen, Marika; Eriksson, Johan G.; Mäkitie, Outi; Järvenpää, Anna‐Liisa; Andersson, Sture; Kajantie, Eero

doi:10.3945/jn.115.212415

Cited by 19 publications

(32 citation statements)

References 36 publications

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“…Finally, a small proportion of infants received nutritional products for which we were unable to trace the exact compositions: for those products, we used the composition data of a closely corresponding product (for example, the same label with composition information available for the previous year). [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…Nutritional data during the initial hospital stay came from hospital records and was available for the first 9 weeks of life (after which the number of participants with sufficient data was reduced because of hospital discharge). As previously described in more detail, [ 16 ] we divided the data into 3-week periods (birth to 3, 3–6, and 6–9 weeks of age), and calculated daily mean total energy intakes and energy intakes from protein , fat , and carbohydrates from all enteral and parenteral nutrition, and energy intake from human milk , including donated and mother's own milk, per kilogram bodyweight. The macronutrient content of the mother's own milk was estimated based on the nutritional composition data published by Anderson et al [ 17 ], who followed the milk content of mothers who delivered preterm.…”

Section: Methodsmentioning

confidence: 99%

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Nutrition after preterm birth and adult neurocognitive outcomes

et al. 2017

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BackgroundPreterm birth (<37 gestational weeks) poses a risk of poorer neurocognitive functioning. Faster growth after preterm birth predicts better cognitive abilities and can be promoted through adequate nutrition, but it remains unknown whether variations in nutrient intakes translate into long-term benefits for neurodevelopment.MethodsIn 86 participants of the Helsinki Study of Very Low Birth Weight Adults (birthweight <1500g), we examined if higher intakes of energy, macronutrients, and human milk during the first nine weeks after preterm birth predict performance in tests of cognitive ability at 25.1 years of age (SD = 2.1).Results10 kcal/kg/day higher total energy intake at 3 to 6 weeks of age was associated with 0.21 SD higher adult IQ (95% Confidence Interval [CI] 0.07–0.35). Higher carbohydrate and fat intake at 3–6 weeks, and higher energy intake from human milk at 3–6 and at 6–9 weeks were also associated with higher adult IQ: these effect sizes ranged from 0.09 SD (95% CI 0.01–0.18) to 0.34 SD (0.14–0.54) higher IQ, per one gram/kg/day more carbohydrate and fat, and per 10 kcal/kg/day more energy from human milk. Adjustment for neonatal complications attenuated the associations: intraventricular hemorrhage, in particular, was associated with both poorer nutrition and poorer IQ.ConclusionIn preterm neonates with very low birth weight, higher energy and human milk intake predict better neurocognitive abilities in adulthood. To understand the determinants of these infants' neurocognitive outcome, it seems important to take into account the role of postnatal nutrition, not just as an isolated exposure, but as a potential mediator between neonatal illness and long-term neurodevelopment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Nutrition after preterm birth and adult neurocognitive outcomes

et al. 2017

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“…On the macronutrient level, protein has been shown to positively affect preterm infant growth in some earlier studies [13,14,15] but not in others [16,17]. In addition, enhanced growth outcomes have been reported after the early administration of high doses of both protein and lipids [18].…”

Section: Discussionmentioning

confidence: 90%

Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants

et al. 2017

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Background: Extremely preterm birth is associated with a high risk of extrauterine growth retardation, which has been linked with adverse developmental outcomes. Objective: We investigated whether nutritional management during the first 7 days of life affects growth patterns until the corrected age of 2 years in extremely preterm infants. Study Design: A retrospective study of 78 extremely preterm (<28 weeks' gestation) neonates was conducted. Data regarding parenteral and enteral intake of energy, protein, lipids, and carbohydrates during the first 7 days of life were collected from patient records. The outcome measures included weight, height, and head circumference with Z scores at term-equivalent age and the corrected ages of 1 and 2 years. Analyses were performed with hierarchical-linear mixed models. Results: Nutritional intake during the first week of life did not reach the current recommendations. The total energy intake during the first 7 days of life was statistically significantly associated with weight, length, and head circumference until the corrected age of 2 years after adjusting for potential confounding factors. Individual macronutrient intake displayed no association with growth patterns. Conclusions: Energy intake during the first 7 days of life is associated with growth until the corrected age of 2 years. These results provide support for the aggressive early nutritional management of extremely preterm infants.

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“…Greater gains in fat-free mass in infancy and early childhood are associated with improved speed of processing and overall cognition, while greater gains in fat mass in childhood increase risk for hypertension and insulin resistance [23,24]. Predictors of adverse body composition status (low lean mass and/or high adiposity) are both nutritional and non-nutritional, with risk factors present both prenatally (such as maternal hypertension) and postnatally (such as nutrient intake, steroid exposure, or degree of illness) [25][26][27][28]. Therefore, monitoring quality of growth, including body composition, is important for multiple outcomes including retinopathy of prematurity.…”

Section: Discussionmentioning

confidence: 99%

Late Growth and Changes in Body Composition Influence Odds of Developing Retinopathy of Prematurity among Preterm Infants

et al. 2019

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Background: While postnatal growth in the first month of life is known to impact retinopathy of prematurity (ROP) risk, the impact of growth later in hospitalization, during critical times of retinal vascularization, remains unknown. The purpose of this study was to assess if postnatal growth and body composition during the second half of neonatal intensive care unit hospitalization were associated with severity of retinopathy of prematurity in very low birth weight preterm infants. Methods: Prospective observational pilot study of 83 infants born <32 weeks gestation and <1500 g, conducted at a Level IV neonatal intensive care unit. Body composition was measured during the second half of hospitalization. Infants were evaluated for retinopathy of prematurity. Logistic regression was performed. Results: Greater gains in fat mass, fat-free mass, and percent body fat from 32 to 37 weeks postmenstrual age and higher % body fat at term postmenstrual age were associated with decreased odds of ≥stage 2 retinopathy of prematurity (p < 0.05). Conclusions: Improved growth later in neonatal intensive care unit hospitalization and increased adiposity at term may reduce odds of severe retinopathy of prematurity.

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Early Protein Intake Is Associated with Body Composition and Resting Energy Expenditure in Young Adults Born with Very Low Birth Weight

Abstract: At relatively low neonatal protein intake levels, additional protein intake is reflected in a healthier body composition, accompanied by a higher metabolic rate, in young adults born with VLBW 20 y earlier.

Cited by 19 publications

References 36 publications

Nutrition after preterm birth and adult neurocognitive outcomes

Nutrition after preterm birth and adult neurocognitive outcomes

Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants

Late Growth and Changes in Body Composition Influence Odds of Developing Retinopathy of Prematurity among Preterm Infants

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