MS 20171505 / Frondas-Chauty et al - Does fat or fat-free body mass drive neurodevelopment?

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More than one-half of the growing brain is comprised of fat. The essential fatty acids, especially omega 3-fatty acids such as docosahexaenoic acid, have been linked to optimal brain development. These lipids provide critical microstructure to the nervous system, and even allow the absorption of fat soluble vitamins. But, is an understanding of the building blocks for an infant's brain development, particularly among premature babies, that simple? In this volume of The Journal Frondas-Chatuy et al report a secondary analysis of 172 preterm newborns followed in an observational study in order to determine whether their neurological outcome at age 24 months corrected was associated with a deficit in fat-free mass accretion by discharge during their initial hospitalization. The investigators found that both fat mass and fat-free mass predicted neurological outcome as determined by the Ages and Stages Questionnaire, but following adjustment and multivariable analysis, fat-free mass, and not fat mass, continued to be predictive, along with gestational age. Aspects of underlying illness were not considered. The authors' work is notable and foretells that the neurological outcome of very low birth weight preterm, and even term, babies during their early years is likely much more complex. No doubt, fat is crucial to brain growth, and thus we can deduce that lipids, proteins, calories, and multiple other components of overall nutrition are all vital. Further study and even prospective trials will help us understand what growing baby brains, including those preterm, require to develop optimally. Article page 301 ▶ Deficit of Fat Free Mass in Very Preterm Infants at Discharge is Associated with Neurological Impairment at Age 2 YearsThe Journal of PediatricsVol. 196PreviewPreterm infants have a deficit of fat-free mass accretion during hospitalization. This study suggests that z score of fat-free mass at discharge is associated with neurologic outcome (P = .003) at 2 years of age, independent of sex, gestational age, and birth weight z score. Interventions to promote quality of growth should be considered. Full-Text PDF