The effects of varying protein and energy intakes on the growth and body composition of very low birth weight infants

Juan Antonio Costa-Orvay,Gerardo Romera,Xavier Carbonell-Estrany,Ricardo Closa-Monasterolo,Josep Figueras-Aloy

doi:10.1186/1475-2891-10-140

Abstract

ObjectiveTo determine the effects of high dietary protein and energy intake on the growth and body composition of very low birth weight (VLBW) infants.Study designThirty-eight VLBW infants whose weights were appropriate for their gestational ages were assessed for when they could tolerate oral intake for all their nutritional needs. Thirty-two infants were included in a longitudinal, randomized clinical trial over an approximate 28-day period. One control diet (standard preterm formula, group A, n = 8, 3.7 g/kg/d of protein and 129 kcal/kg/d) and two high-energy and high-protein diets (group B, n = 12, 4.2 g/kg/d and 150 kcal/kg/d; group C, n = 12, 4.7 g/kg/d and 150 kcal/kg/d) were compared. Differences among groups in anthropometry and body composition (measured with bioelectrical impedance analysis) were determined. An enriched breast milk group (n = 6) served as a descriptive reference group.ResultsGroups B and C displayed greater weight gains and higher increases in fat-free mass than group A.ConclusionAn intake of 150 kcal/kg/d of energy and 4.2 g/kg/d of protein increases fat-free mass accretion in VLBW infants.

Highlights

The Nutrition Committee of the American Academy of Pediatrics suggests that, with optimal care and nutritional support, the growth rates of very low birth weight (VLBW) infants should be similar to those of fetuses of the same gestational age [1]
Postnatal growth restriction is associated with an increased risk of poor neurodevelopmental outcomes [8,9,10,11], and inappropriate postnatal nutrition is an important contributor to growth failure [12,13]
If energy and protein intakes are inappropriate, weight gain and the rate of increase in length and head circumference are reduced [17]; if protein intake is appropriate, a relatively higher energy intake may enhance the rate of increase in skinfold thickness [17], which suggests that the excess energy is stored as fat [18]

Summary

Introduction

The Nutrition Committee of the American Academy of Pediatrics suggests that, with optimal care and nutritional support, the growth rates of very low birth weight (VLBW) infants should be similar to those of fetuses of the same gestational age [1]. The goal of obtaining appropriate intrauterine growth rates after birth has been successfully achieved with enriched diets, but these diets may. The ratio of lean body mass to fat mass in the weight gained depends on the protein and energy ratio in the diet. Fairey et al [19] did not show any difference in the proportion of fat to lean tissue gained in groups with a higher protein-to-energy ratio (3.2 g/100 kcal vs 2.6 g/100 kcal)

Methods

Results

Conclusion