Impact of Early Nutrition on Body Composition in Children Aged 9.5 Years Born with Extremely Low Birth Weight.

Sonja Stutte,Joachim Woelfle,Bettina Gohlke,Annika Peiler,Peter Bartmann,Mark Born,Felix Schreiner

doi:10.3390/nu9020124

Sonja Stutte, Joachim Woelfle + Show 5 more

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https://doi.org/10.3390/nu9020124

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Abstract

To evaluate body composition, metabolism and growth as well as their interaction with early nutrition in former extremely low birth weight infants (ELBW), we assessed qualitative and quantitative nutritional intake during initial hospitalization and infantile growth parameters in 61 former ELBW infants with a birth weight <1000 g. In two follow-up exams, physical and biochemical development were measured at 5.7 and at 9.5 years. At the second follow-up, in addition to biochemical reassessment, body composition was analyzed by dual-energy x-ray absorptiometry (DEXA). Protein intake between birth and discharge was associated with weight gain in the first six months of life (r = 0.51; p < 0.01). Weight catch-up preceded height catch-up. Protein intake in early infancy correlated highly significantly with abdominal fat mass (r = 0.49; p < 0.05), but not with lean body mass at 9.5 years (r = 0.30; not significant (n.s.). In contrast to nutrient intake, birth weight was associated with lean body mass (r = 0.433; p < 0.001). Early protein and carbohydrate intake were associated with high-density lipoprotein (HDL)-cholesterol, and early catch-up growth correlated with fasting insulin at follow-up. Stepwise linear regression demonstrated that protein intake predicted fat mass (p < 0.05), whereas only gender and birth weight standard deviation score (SDS) contributed significantly to lean body mass variation (p < 0.05). Our results suggest an important impact of early nutrient intake on body composition and metabolism in later childhood in ELBW children.

Highlights

Decreased birth weight can have a persisting impact on metabolic health in later life [1]
Between 0.5 and 5.7 years, weight-standard deviation score (SDS) stabilized at around −1 SDS followed by a further improvement in weight gain until the second follow-up-examination
To the best of our knowledge, this is the first study which demonstrates that quantity and quality of macronutrient intake during the first weeks of life seem to exert a long-term effect on body composition and metabolic health in former very premature extremely low birth weight infants (ELBWs) children and that this is already measurable in childhood

Summary

Introduction

Decreased birth weight can have a persisting impact on metabolic health in later life [1]. In addition to metabolic dysfunction, subjects with low birth weight exhibit an increased risk of cardiovascular impairments in adulthood [2]. Catch-up growth in children with low birth weight has been associated with impaired metabolic parameters in later life [3]. Catch-up of head circumference is important for neurological development [4]. Preliminary animal data suggest that the macronutrient content of late fetal or early postnatal nutrition might influence later body composition [5]. Early life macronutrient composition and total caloric intake currently receive much attention in humans, with special regard to the feeding

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