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Bone mineralization status measured by dual energy radiographic densitometry in preterm infants fed commercial
E Narbona1, J Maldonado, E Ocete
1Department of Pediatrics, School of Medicine, University of Granada, Spain.
Insights
Higher calcium and phosphorus in preterm infant formula significantly improved mineral retention and bone mineralization. Formulas should contain at least 120 mg calcium/100 kcal with a 2:1 calcium/phosphorus ratio for optimal bone health.
Area of Science:
- Nutritional Science
- Pediatric Medicine
- Bone Metabolism
Background:
- Preterm infants are at risk for poor bone mineralization due to immature nutrient absorption.
- Standard preterm formulas may not provide adequate calcium and phosphorus for optimal bone development.
- Evaluating the impact of varying mineral content in infant formulas is crucial for preterm infant growth.
Purpose of the Study:
- To assess the effect of two preterm infant formulas with differing calcium and phosphorus levels on mineral balance and bone mineralization.
- To determine the optimal calcium and phosphorus content and ratio for preterm infant formula.
- To compare bone mineralization in preterm infants fed different formulas against a control group.
Main Methods:
- A study involving 30 preterm infants fed one of two commercial formulas for one month.
- Bone mineralization assessed using dual-energy X-ray densitometry.
- Mineral balance and retention measured, correlating intake with retention and bone parameters.
Main Results:
- The formula with higher calcium and phosphorus content resulted in significantly higher mineral retention (P<0.01).
- Higher mineral content formula led to increased bone mineral content (1.556 vs. 1.073 g) and bone mineral density (0.458 vs. 0.424 g/cm2).
- Calcium and phosphorus intake strongly correlated with their respective retention and positively with bone mineral content and density.
Conclusions:
- Preterm infant formulas require a minimum calcium content of 120 mg/100 kcal.
- A calcium/phosphorus ratio of approximately 2:1 is recommended for adequate bone mineralization in preterm infants.
- Optimizing mineral content in preterm formulas is essential for achieving bone health comparable to healthy controls.
Abstract:
We have studied the effect of two preterm commercial infant formulas with different calcium and phosphorus contents on the mineral balance and bone mineralization of 30 preterm infants at 1 month of age. Bone mineralization was measured by dual energy X-ray densitometry. The formula supplying a higher content of calcium and phosphorus promoted higher mineral retention (P<0.01) as well as higher bone mineral content (1.556 vs. 1.073 g, P<0.01) and bone mineral density (0.458 vs. 0.424 g/cm2, P<0.05), approaching values of the control group, which comprised a cohort of 15 preterm newborns whose gestational age was 4 weeks older than the subjects selected to be fed with the formulas. The intake of calcium correlated with retention (r=0.69); the phosphorus intake also correlated with phosphorus retention (r=0.95). Intakes of calcium and phosphorus correlated with the bone mineral content (r=0.65) and with bone mineral density (r=0.49). We conclude that formulas for preterm infants should not have a calcium content lower than 120 mg/100 kcal and should have a calcium/phosphorus ratio of about 2 to promote adequate bone mineralization.