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Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes.
Nutrients. 2020 Jan 04; 12(1)N

Abstract

Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants.

Authors+Show Affiliations

Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA.HealthPartners Institute, Minneapolis, MN 55425, USA.Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA.Department of Pediatrics, University of Minnesota, Minneapolis, MN 55454, USA.Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31947964

Citation

Ramel, Sara E., et al. "Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes." Nutrients, vol. 12, no. 1, 2020.
Ramel SE, Haapala J, Super J, et al. Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes. Nutrients. 2020;12(1).
Ramel, S. E., Haapala, J., Super, J., Boys, C., & Demerath, E. W. (2020). Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes. Nutrients, 12(1). https://doi.org/10.3390/nu12010145
Ramel SE, et al. Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes. Nutrients. 2020 Jan 4;12(1) PubMed PMID: 31947964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes. AU - Ramel,Sara E, AU - Haapala,Jacob, AU - Super,Jennifer, AU - Boys,Christopher, AU - Demerath,Ellen W, Y1 - 2020/01/04/ PY - 2019/12/11/received PY - 2019/12/29/revised PY - 2019/12/30/accepted PY - 2020/1/18/entrez PY - 2020/1/18/pubmed PY - 2020/1/18/medline KW - body composition KW - fat free mass KW - neurodevelopment KW - nutrition KW - preterm JF - Nutrients JO - Nutrients VL - 12 IS - 1 N2 - Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/31947964/Nutrition_Illness_and_Body_Composition_in_Very_Low_Birth_Weight_Preterm_Infants:_Implications_for_Nutritional_Management_and_Neurocognitive_Outcomes_ L2 - https://www.mdpi.com/resolver?pii=nu12010145 DB - PRIME DP - Unbound Medicine ER -
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