Abstract
Epidemiological studies and animal models suggest that early postnatal nutrition and growth can influence adult health. However, few human studies have objective recordings of early nutrient intake. We studied whether nutrient intake and growth during the first 9 weeks after preterm birth with very low birth weight (VLBW, <1500 g) predict total energy intake, resting energy expenditure (REE), physical activity and food preferences in young adulthood. We collected daily nutritional intakes and weights during the initial hospital stay from hospital records for 127 unimpaired VLBW participants. At an average age 22.5 years, they completed a three-day food record and a physical activity questionnaire and underwent measurements of body composition (dual X-ray absorptiometry; n = 115 with adequate data) and REE (n = 92 with adequate data). We used linear regression and path analysis to investigate associations between neonatal nutrient intake and adult outcomes. Higher energy, protein and fat intakes during the first three weeks of life predicted lower relative (=per unit lean body mass) energy intake and relative REE in adulthood, independent of other pre- and neonatal factors. In path analysis, total effects of early nutrition and growth on relative energy intake were mostly explained by direct effects of early life nutrition. A path mediated by early growth reached statistical significance only for protein intake. There were no associations of neonatal intakes with physical activity or food preferences in adulthood. As a conclusion, higher intake of energy and nutrients during first three weeks of life of VLBW infants predicts energy balance after 20 years. This association is partly mediated through postnatal growth.
Highlights
Obesity is a consequence of a chronic imbalance between energy intake and energy m but in humans there is considerable individual variation in energy balance, preference to energy-rich, Nutrients 2017, 9, 1282; doi:10.3390/nu9121282 www.mdpi.com/journal/nutrientsNutrients 2017, 9, 1282 palatable foods and susceptibility to weight gain as a result of overeating [3,4]
Epidemiological data mostly on subjects who were born small for gestational age (SGA) have shown that metabolic abnormalities in adulthood are associated with catch up growth during early life, which preterm born subjects often experience [13,14,15,16]
While the cohort includes controls born at term [8], they are not included in the current study, which focuses on early nutrition after preterm birth
Summary
Obesity is a consequence of a chronic imbalance between energy intake and energy m but in humans there is considerable individual variation in energy balance, preference to energy-rich, Nutrients 2017, 9, 1282; doi:10.3390/nu9121282 www.mdpi.com/journal/nutrients. The few exceptions include trials assessing the long term effects of protein content in infant formula [25] or observational studies in those born preterm at VLBW whose daily nutrient intake during the weeks to months long neonatal hospital stay is recorded in detail [26,27]. Most of these studies have not yet extended to adult age. We hypothesize that lower early intakes of energy and protein are associated with higher intake of energy and nutrients, lower resting energy expenditure and energy expenditure from physical activity and preference for palatable foods in young adult age and that these associations are mediated through growth during the same period
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