Efficient Assimilation of Lactose Carbon in Premature Infants

Kien, C. Lawrence; Kepner, J.; Grotjohn, Karen; Gilbert, M.; McClead, Richard E.

doi:10.1097/00005176-199210000-00005

Cited by 10 publications

(5 citation statements)

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“…As noted above, a fraction of ingested lactose (and possibly other dietary carbohydrates) is fermented in the colon of preterm infants, where much of the constituent energy can be absorbed as short-chain fatty acids and lactate (Kien et al, 1987;Kien et al, 1989;Kien et al, 1990b;Kien, 1990;Kien et al, 1992a;Kien, 1996). This process of colonic salvage or retrieval of carbohydrate energy compensates, at least in part, for the inefficiency of dietary energy utilization resulting from inefficient small intestinal digestion of lactose by preterm infants (Kien et al, 1992b;Kien et al, 1996). However, there is controversy concerning whether the production of shortchain fatty acids such as butyric acid is advantageous to the preterm infant or is toxic to the colon or the small intestine if excessive fermentation occurs at that site (Argenzio & Meuten, 1991;Butel et al, 1998;Kien, 1990;Roediger, 1982;Szylit et al, 1998).…”

Section: Fate Of Lactose or Other Dietary Carbohydrates Reaching The Colon: Possible Clinical Significancementioning

confidence: 97%

Nutrient Requirements For Preterm Infant Formulas

Klein

2002

The Journal of Nutrition

327

231

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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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Section: Fate Of Lactose or Other Dietary Carbohydrates Reaching The Colon: Possible Clinical Significancementioning

confidence: 97%

Nutrient Requirements For Preterm Infant Formulas

Klein

2002

The Journal of Nutrition

327

231

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“…An increase in transit time will result in increased delivery of carbohydrates to the large bowel and consequently greater bacterial fermentation (Kien et al, 1987(Kien et al, , 1989(Kien et al, , 1992(Kien et al, , 1996. The quantitative contribution of the bacterial fermentation products, that is short chain fatty acids, to whole body energy metabolism, remains inconclusive (Kien et al, 1989).…”

Section: Type Of Carbohydratementioning

confidence: 99%

Carbohydrate as nutrient in the infant and child: range of acceptable intake

Kalhan

Kılıç

1999

Eur J Clin Nutr

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Carbohydrates are the major source of energy for humans. Following their digestion, almost all ingested carbohydrates are converted to glucose. Glucose is the primary oxidative fuel for the brain. Although few studies have been done in infants and children to de®ne the upper and lower limits of carbohydrate intake, such information may be derived from the published data on glucose metabolism in vivo. The upper and lower limits are determined by the need to provide for total energy expenditure, need for other essential nutrients such as protein and fats, requirements of the glucose dependent tissues such as the brain, and the need to minimize the protein cost of gluconeogenesis and thus irreversible loss of nitrogen. With these considerations, the upper and lower boundaries of carbohydrate intake in relation to age are described.

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“…Po stcon ceptional age ranged from 33 to 37 week s. Thus, o n the basis of fetal lact ase activity data, lactose digestion might have be en predicted to approach normal term levels. However, although the data will be reported separately (21), breath Hz concentration was highl y elevated in the majority of subj ects . All infants wer e gaining weight at the time of study .…”

Section: Resultsmentioning

confidence: 86%

“…10072), CE a bsorptio n was 95%, but tracer absorption was 82% . Both of these subjects particip at ed in a larg er , longitudinal study of lact ose tracer abs orption a nd breath H z co nce ntratio n (21). Subj ect 10023 was normal clinic ally du ring the study a nd did not ha ve diarrhea.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Methods for Estimating Fecal Carbohydrate Excretion in Premature Infants

Kien,

McClead,

Kepner

et al. 1993

J. pediatr. gastroenterol. nutr.

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SummaryOur previous studies have suggested that there is minimal fecal excretion of carbohydrate‐derived energy in premature infants fed lactose or glucose‐polymer as the source of carbohydrate. In these studies, carbohydrate energy excretion was equated with the non‐nitrogenous, nonfat energy. Although these studies provided consistent results, this methodological approach cannot distinguish actual excretion of dietary carbohydrate from carbohydrate in the form of large molecular compounds derived from infant or bacterial cells (which in fact comprise 90% of the measured value). Therefore, in this study we compared the absorption of carbohydrate energy to the fractional absorption of 13C derived from [D‐l‐13C]‐lactose in 10 premature infants 30–32 weeks gestational age fed either a commercial premature infant formula containing a mixture of carbohydrates (50% lactose: 50% glucose polymer) or the same formula in which lactose was the sole carbohydrate. The two methods provided comparable estimates of carbohydrate absorption (96 and 94%, respectively), although there were significant discrepancies in two infants. These studies provide evidence of external validity for the two methods

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Efficient Assimilation of Lactose Carbon in Premature Infants

Cited by 10 publications

References 0 publications

Nutrient Requirements For Preterm Infant Formulas

Nutrient Requirements For Preterm Infant Formulas

Carbohydrate as nutrient in the infant and child: range of acceptable intake

Comparison of Methods for Estimating Fecal Carbohydrate Excretion in Premature Infants

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