Growth, nutrient retention, and metabolic response of low-birth-weight infants fed supplemented and unsupplemented preterm human milk

Kashyap, Sudha; Schulze, Karl; Forsyth, Mary; Dell, Ralph B.; Ramakrishnan, Rajasekhar; Heird, William C.

doi:10.1093/ajcn/52.2.254

Cited by 126 publications

(61 citation statements)

References 33 publications

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“…As summarized in Table 2, the clinical characteristics of the 44 infants who completed the study differed minimally among groups. The clinical characteristics of these infants also differed minimally from infants studied previously (3,(10)(11)(12)(13), although the lower birth weight limit for inclusion in previous studies was 900 g rather than 750 g. Nutrient intakes. The mean volume of intake of all infants was very close to that intended.…”

Section: Discussionmentioning

confidence: 59%

“…Our previous studies of growth and nutrient retention of LBW infants fed varying intakes of protein and energy (3,(10)(11)(12)(13) suggest that postnatal rates of weight gain as well as protein and fat accretion are closely related to dietary protein and energy intakes. The data from these studies are summarized quite well by linear multiple regression equations relating the rate of weight gain primarily to the intakes of protein and energy and the rates of protein and fat accretion to dietary protein and energy intakes, respectively (14).…”

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confidence: 99%

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Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

et al. 1994

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ABSTRACT'. A model for predicting the relationship between protein and energy intakes of low-birth-weight (LBW) infants and the rate and composition of weight gain is described. It is based on linear multiple regression equations summarizing the rates of weight gain, nitrogen retention, and energy retention of 101 previously studied LBW infants fed protein intakes ranging from 2.25 to 3.9 g. kg-' .d-' and concomitant energy intakes ranging from 115 to 147 kcal. kg-'.d-' plus current theory concerning nutrient retention and body composition. To test the validity of the model, three combinations of protein and energy intake predicted by the model to result in specific rates and compositions of weight gain were fed to 44 LBW infants, and the observed rates of weight gain, protein accretion, and fat accretion were compared with the rates predicted by the model. Differences in these and other outcome variables between two of the groups, the intakes of which differed only in energy, also were compared to provide additional insight into the effect of concomitant energy intake on protein utilization. Across groups, actual outcomes correlated closely with predicted outcomes, supporting the validity of the model for the total population. However, outcomes of individual infants deviated as much as 30% from predicted outcomes; the magnitude of the deviation was independent of birth weight, gestational age, or size for gestational age. In addition, the mean rate of protein accretion of the group fed the highest protein/ energy ratio was significantly less than predicted. The higher mean urinary nitrogen excretion as well as blood urea nitrogen and plasma amino acid concentrations of this group versus the group that received a similar protein intake with a higher energy intake suggest that the higher energy intake improved nitrogen utilization. In toto, the data support the concept that the rate and composition of weight gain of LBW infants can be manipulated by intake; however, for individual infants, the extent of manipulation seems to be dependent on as-yet-unidentified inherent biologic variables. (Pediatr Res 35: [704][705][706][707][708][709][710][711][712] 1994) Abbreviations LBW, low birth weight Current guidelines for feeding LBW infants stress the importance of achieving as soon after birth as possible a rate of weight gain that is at least equal to or, preferably, greater than the intrauterine rate (1, 2). A number of studies have demonstrated that even the higher rates of weight gain can easily be achieved but that the accompanying rates of fat accretion are as much as 3-fold greater than the intrauterine rate (3-8). The desirability of such high rates of fat accretion are unknown. For most populations, they are considered undesirable, but this may not be true for the LBW infant who is born with limited fat stores. Moreover. approximately 40% of the weight gained by term infants over the first 4 mo of life appears to be fat (9), raising the possibility that high rates of fat accretion are unavoidable during ear...

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Section: Discussionmentioning

confidence: 59%

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confidence: 99%

Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

et al. 1994

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“…Çok DDA bebeklerde büyüme için gerekli en düflük miktar olarak kabul edilen aminoasit dozlar› tercih edildi (9)(10)(11)(12)(13). Parenteral uygulama düzene¤inde 2006 y›l› öncesi dönemde protein ikinci gün 0,5 gr/kg/gün ile bafllan›p befl günden daha uzun sürede 3,5 gr/kg/gün'e kadar günde 0,5 gr/kg artt›r›l›rken (geç grup) 2006 y›l›nda ilk gün 1 gr/kg/gün bafllan›p ilk befl günde 3,5-4 gr/kg/gün'e 1 gr/kg/gün artt›r›larak ulafl›ld› (erken grup).…”

Section: çAl›flma Plan›unclassified

Erken aminoasit desteğinin çok düşük doğum ağırlıklı bebeklerin büyüme ve nörolojik gelişimi üzerine etkisi

Karakus¹,

Turker²,

Gökalp³

2011

tpa

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E Er rk ke en n a am mi in no oa as si it t d de es st te e¤ ¤i in ni in n ç ço ok k d dü üfl flü ük k d do o¤ ¤u um m a a¤ ¤› ›r rl l› ›k kl l› › b be eb be ek kl le er ri in n b bü üy yü üm me e v ve e n nö ör ro ol lo oj ji ik k g ge el li ifl fli im mi i ü üz ze er ri in ne e e et tk ki is si i T Th he e e ef ff fe ec ct t o of f e ea ar rl ly y p pa ar re en nt te er ra al l a am mi in no o a ac ci id ds s, , o on n g gr ro ow wt th h a an nd d n ne eu ur ro od de ev ve el lo op pm me en nt t o of f v ve er ry y l lo ow w b bi ir rt th h w we ei ig gh ht t i in nf fa an nt ts s F Fa at tm ma a K Ka ar ra ak ku ufl fl, , G Gü ül lc ca an n T Tü ür rk ke er r* *, , A Ay yfl fle e S Se ev vi im m G Gö ök ka al lp p* * S Su um mm ma ar ry yAim: To assess the effect of early parenteral amino acids, on growth and neurodevelopment of very low birth weight infants at 36 weeks' postmenstrual age and 18 months' corrected age. Material and Method:Infants who received ≥3 gr/kg per day of parenteral amino acids within the first 5 days of life were considered early group; infants who receive <3 gr/kg per day of parenteral amino acids within the first 5 days of life were considered late group. Infants' weight, length and head circumference were measured et 36 weeks' of postmenstrual age and 18 months' of corrected age. Nerodevelopmental index was evaluated by "Bayley Scales of Infant Development". Results: There were no statistically differences between the early and late amino acid groups in baseline characteristics; except birth weight. At 36 weeks' postmenstrual age and 18 months' corrected age, there were no statistically differences in weight, length and head circumference between the two groups. In the early group, female babies had bigger head circumference than male babies at 36 weeks' postmenstrual age and 18 months' corrected age. There were no other observed differences between boys or girls. There were no differences between two groups for neurodevelopmental impairment by Bayley mental and psychomotor developmental index. Conclusions: On evaluation of head circumferences at 36 weeks' postmenstrual age and 18 months' corrected age, it is shown that the low birth weight early group catch-up with the late group and girls in the early group have bigger head circumference therefore it is suggested that early aminoacid supplementation may have positive effect on growth and neurodevelopmental impact. Girifl ‹nfertilite tedavisindeki geliflmeler ile artan erken do¤umlar, yenido¤an hastal›klar›n›n da %75'ini oluflturmaktad›r (1). Yenido¤an ölümlerinin %65'den fazlas› düflük do¤um a¤›rl›kl› (DDA) bebeklerden, %51'den fazlas› çok dü-flük do¤um a¤›rl›kl› (ÇDDA) bebeklerden kaynaklanmakta olup hayatta kalma oran›, do¤um a¤›rl›¤› ile do¤rudan ilifl-

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“…25 g/kg per d to approximately 4 . 5 g/kg per d, all with a concomitant energy intake of approximately 504 kJ (120 kcal)/kg per d (Kashyap et al 1986(Kashyap et al , 1990. The clinical characteristics of the >200 infants enrolled in these studies are summarized in Table 1.…”

Section: Contributions Of Studies Of Growth In Defining Protein Needsmentioning

confidence: 99%

Biochemical homeostasis and body growth are reliable end points in clinical nutrition trials

Heird

2005

Proc. Nutr. Soc.

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Studies of biochemical homeostasis and/or body growth have been included as outcome variables in most nutrition trials in paediatric patients. Moreover, these outcome variables have provided important insights into the nutrient requirements of infants and children, and continue to do so. Examples of the value of such studies in improving parenteral nutrition, in defining essential fatty acid metabolism and requirements of infants and in defining the protein and energy needs of low-birth-weight infants are discussed. Data from such studies have helped to define the mechanism of metabolic acidosis and hyperammonaemia associated with the use of early crystalline amino acid mixture and, hence, how to prevent these disorders. Such studies have allowed the development of parenteral amino acid mixtures that circumvent grossly abnormal plasma concentrations of most amino acids and appear to be utilized more efficiently. These studies have also helped define micronutrient requirements, including requirements for several such nutrients that had not been previously recognized as essential (e.g. Cr, Se, Mo, α-linolenic acid). Studies of body growth have been particularly valuable in defining the nutritional requirements of low-birth-weight infants. Finally, studies of metabolic homeostasis coupled with more sophisticated metabolic studies have provided considerable insight into the metabolism of the essential fatty acids, linoleic acid (18:2n-6) and α-linolenic acid (18:3n-3). Although such studies have not defined the amount of the longer-chain PUFA synthesized from each of these essential fatty acids, i.e. arachidonic acid (20:4n-6) and DHA (22:6n-3), they have shown that the rates of conversion are extremely variable from infant to infant, suggesting a possible explanation of why some studies show developmental advantages from intake of these fatty acids while others do not.

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Growth, nutrient retention, and metabolic response of low-birth-weight infants fed supplemented and unsupplemented preterm human milk

Cited by 126 publications

References 33 publications

Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

Erken aminoasit desteğinin çok düşük doğum ağırlıklı bebeklerin büyüme ve nörolojik gelişimi üzerine etkisi

Biochemical homeostasis and body growth are reliable end points in clinical nutrition trials

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