Effects of higher protein formula with improved fat blend on growth, feeding tolerance and nutritional biomarkers in preterm infants: A double-blind, randomized, controlled clinical trial

Thanh, Lê Quang; Chen, Yipu; Hartweg, Mickaël; Nguyen, Tu Anh

doi:10.1016/j.pedneo.2021.09.007

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…In addition, an enhanced protein diet demonstrated a more pronounced catch-up percentage of fat accretion in preterm infants of <32 GA with a lower baseline fat mass percentage [ 63 ]. The available data, however, are inadequate to draw conclusions on the effect of high protein feeds on safety and clinical outcomes [ 64 ]. Feeding preterms with formula, compared with donor breast milk, resulted in higher rates of weight gain but a higher risk of developing necrotising enterocolitis [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Estimated Energy and Protein Balances on Extrauterine Growth in Preterm Infants

Lygerou,

Ilia,

Briassoulis

et al. 2023

Nutrients

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Background: Nutritional support of preterm infants remains a field of debate in the literature and clinical practice varies significantly. Adequate nutrition should promote growth and aim for optimal later neurodevelopment. However, it is often impaired by prematurity-associated morbidity and the physiologic immaturity of preterm infants. This study assessed the impact of energy and macronutrient provision on growth velocity and outcome and explored differences attributed to the heterogeneity of the preterm population. Methods: We retrospectively collected clinical and nutritional data from neonates hospitalized in two separate Neonatal Intensive Care Units (NICUs). Estimated energy and protein balance were calculated based on the ESPGHAN guidelines and their association with the growth outcome was explored. Growth assessment was based on somatometry Delta (Δ) z-scores at discharge. Results: In total, 174 neonates were included in the study. By day 14, most preterm infants were exclusively enterally fed, whereas there were infants in the <28 and 28–31+6 subgroups fed exclusively parenterally. Energy balance was positive for all gestational age (GA) subgroups except for those born <28 weeks. Protein balance was consistently positive for extremely premature but negative for late preterms. Cumulative substrates provisions were strong predictors of a positive energy or protein balance in the <34 weeks GA preterms on days 14 (ROC analyses, p < 0.001) and 7 (p < 0.05). A higher GA (p = 0.013) and enteral nutrition (p = 0.005) were additional predictors of a positive energy balance. All GA subgroups had a negative Δ z-score of weight at discharge. In the <34 GA subcohorts, a positive protein balance on day 14 (p = 0.009) and a short time to regain birth weight (exp(B) 3.1 (p = 0.004) were independently associated with a positive Δ z-score of weight at discharge. Conclusions: Early achievement of a positive energy and protein balance, based on the ESPGHAN guidelines, is crucial to ensure optimal postnatal growth and prevent extrauterine growth restriction, a relatively common occurrence in preterm infants.

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Section: Discussionmentioning

confidence: 99%

The Impact of Estimated Energy and Protein Balances on Extrauterine Growth in Preterm Infants

Lygerou,

Ilia,

Briassoulis

et al. 2023

Nutrients

View full text Add to dashboard Cite

show abstract

“…However, children in the HP group might have gained slightly greater head circumference from birth until discharge or 36 weeks (12 studies. 34,39,47,48,[60][61][62][63][64][65][66][67] ; 1,191 children; MD 0.05 cm, 95% CI 0.01, 0.09 cm; P = 0.01; I 2 90%; Supplementary Fig. 6e).…”

Section: I)mentioning

confidence: 99%

High protein intake on later outcomes in preterm children: a systematic review and meta-analysis

Das,

McClintock,

Cormack

et al. 2024

Pediatr Res

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Background Appropriate protein intake is crucial for growth and development in children born preterm. We assessed the effects of high (HP) versus low protein (LP) intake on neurodevelopment, growth, and biochemical anomalies in these children. Methods Randomised and quasi-randomised trials providing protein to children born preterm (<37 completed weeks of gestation) were searched following PRISMA guideline in three databases and four registers (PROSPERO registration CRD42022325659). Random-effects model was used for assessing the effects of HP (≥3.5 g/kg/d) vs. LP (<3.5 g/kg/d). Results Data from forty-four studies (n = 5338) showed HP might slightly reduce the chance of survival without neurodisability at ≥12 months (four studies, 1109 children, relative risk [RR] 0.95 [95% CI 0.90, 1.01]; P = 0.13; low certainty evidence) and might increase risk of cognitive impairment at toddler age (two studies; 436 children; RR 1.36 [0.89, 2.09]; P = 0.16; low certainty evidence). At discharge or 36 weeks, HP intake might result in higher weight and greater head circumference z-scores. HP intake probably increased the risk of hypophosphatemia, hypercalcemia, refeeding syndrome and high blood urea, but reduced risk of hyperglycaemia. Conclusions HP intake for children born preterm may be harmful for neonatal metabolism and later neurodisability and has few short-term benefits for growth. Impact statement Planned high protein intake after birth for infants born preterm might be harmful for survival, neurodisability and metabolism during infancy and did not improve growth after the neonatal period. Protein intake ≥3.5 g/kg/d should not be recommended for children born preterm.

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1,3-Dioleoyl-2-palmitoyl-glycerol and 1-oleoyl-2-palmitoyl-3-linoleoyl-glycerol: Structure-function relationship, triacylglycerols preparation, nutrition value

Wei,

Mueed,

Luo

et al. 2024

Food Chemistry

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Effects of higher protein formula with improved fat blend on growth, feeding tolerance and nutritional biomarkers in preterm infants: A double-blind, randomized, controlled clinical trial

Cited by 5 publications

References 35 publications

The Impact of Estimated Energy and Protein Balances on Extrauterine Growth in Preterm Infants

The Impact of Estimated Energy and Protein Balances on Extrauterine Growth in Preterm Infants

High protein intake on later outcomes in preterm children: a systematic review and meta-analysis

1,3-Dioleoyl-2-palmitoyl-glycerol and 1-oleoyl-2-palmitoyl-3-linoleoyl-glycerol: Structure-function relationship, triacylglycerols preparation, nutrition value

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