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Feeding preterm infants after hospital discharge: effect of diet on body composition
R J Cooke1, K McCormick, I J Griffin
1Department of Pediatrics, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Insights
Preterm infant formula improved body composition, including lean mass, in male infants compared to term formula. Dual energy x-ray absorptiometry (DEXA) precisely measured these dietary intervention effects.
Area of Science:
- Pediatrics
- Nutritional Science
- Body Composition Analysis
Background:
- Preterm infants (< 1750 g birthweight, < 34 wk gestation) require specialized nutrition for optimal growth.
- Assessing whole-body composition during nutritional interventions is crucial for preterm infant development.
Purpose of the Study:
- To evaluate the impact of different infant formulas on whole-body composition in preterm infants using dual energy x-ray absorptiometry (DEXA).
- To determine if specific formulas influence weight gain, lean mass, and fat mass over time.
Main Methods:
- Infants were randomized into three feeding groups: preterm formula, term formula, or a combination.
- Dual energy x-ray absorptiometry (DEXA) was used to measure body composition at multiple time points from discharge to 12 months corrected age.
- Nutrient intake was monitored, and data were analyzed using ANOVA.
Main Results:
- Protein and mineral intake varied significantly between groups.
- Infants fed preterm formula (Group A) showed greater weight and lean mass (LM) gain compared to those fed term formula (Group B).
- At 12 months, Group A had higher weight, LM, fat mass (FM), and bone mineral mass (BMM), but effects were significant only in males.
Conclusions:
- Dual energy x-ray absorptiometry (DEXA) is a precise tool for detecting body composition changes due to dietary interventions in preterm infants.
- Preterm formula supports enhanced growth, particularly lean mass, in rapidly growing preterm male infants, suggesting it better meets their protein and energy needs.
- Dietary effects on body composition were sex-specific, with no lasting impact observed in preterm girls.
Abstract:
Our purpose in this study was to examine whole body composition, using dual energy x-ray absorptiometry (DEXA) during dietary intervention in preterm infants (< or = 1750 g birthweight, < or = 34 wk gestation). At discharge, infants were randomized to be fed either a preterm infant formula (discharge-6 mo; group A) or a term formula (discharge-6 mo; group B), or the preterm formula (discharge-term) and the term formula (term-6 mo; group C). Nutrient intake was measured between each clinic visit. To measure body composition, DEXA was used at discharge, term, 12 wk, 6 mo, and 12 mo corrected age. The data were analyzed by ANOVA. At discharge, no differences were noted in patient characteristics between groups A, B, and C. Although energy intakes were similar, protein and mineral intakes differed between groups (A > C > B; p < 0.0001). During the study, weight gain and LM gain were greater in group A than B. At 12 mo, weight, LM, FM, and BMM but not % FM or BMD were greater in group A than B. However, the effects of diet were confined to boys, with no lasting effects seen in girls. In summary, therefore, DEXA was precise enough to detect differences in whole body composition during dietary intervention. Increased weight gain primarily reflected an increase in LM and is consistent with the idea that the preterm formula more closely met protein and/or protein-energy needs in rapidly growing preterm male infants.