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Body composition in preterm infants who are fed long-chain polyunsaturated fatty acids: a prospective, randomized,
Sharon Groh-Wargo1, Joan Jacobs, Nancy Auestad
1Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109, USA. sgrohwargo@metrohealth.org
Insights
Supplementing preterm infant formula with arachidonic acid (ARA) and docosahexaenoic acid (DHA) to 1 year corrected age improved body composition. Infants showed increased lean body mass and reduced fat mass, supporting normal growth.
Area of Science:
- * Nutritional Science
- * Pediatric Nutrition
- * Human Physiology
Background:
- * Premature infants (<33 wk gestation) require specialized nutrition for optimal growth and development.
- * Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are crucial fatty acids for infant neurodevelopment and overall growth.
- * Optimal levels and sources of DHA and ARA in preterm formulas are still under investigation.
Purpose of the Study:
- * To assess the impact of DHA and ARA supplementation in preterm formulas on growth and body composition up to 1 year of corrected age.
- * To compare the effects of different DHA+ARA sources (fish/fungal oil vs. egg/fish oil) on preterm infant development.
- * To evaluate the long-term effects of DHA and ARA on body composition, including lean body mass and fat mass.
Main Methods:
- * A randomized controlled trial involving preterm infants (750-1800 g birth weight, <33 wk gestation).
- * Infants were fed one of three formulas: control, DHA+ARA from fish/fungal oil, or DHA+ARA from egg/fish oil.
- * Body composition was assessed using dual-energy x-ray absorptiometry at various time points up to 12 months corrected age.
Main Results:
- * No significant differences in weight, length, or head circumference were observed among the groups.
- * Bone mineral content and density were comparable across all study groups.
- * Infants fed DHA+ARA-supplemented formulas exhibited significantly greater lean body mass and lower fat mass at 12 months corrected age compared to controls.
Conclusions:
- * DHA and ARA supplementation in preterm formulas supports normal growth and bone mineralization in preterm infants.
- * Supplementation with DHA and ARA to 1 year corrected age positively influences body composition, increasing lean mass and decreasing fat mass.
- * Preterm formulas with specific levels and ratios of DHA and ARA can be effectively used to optimize body composition in premature infants.
Abstract:
The objective of this study was to evaluate growth and body composition of premature infants who were fed formulas with arachidonic acid (ARA; 20:4n6) and docosahexaenoic acid (DHA; 22:6n3) to 1 y of gestation-corrected age (CA). Preterm infants (750-1800 g birth weight and <33 wk gestational age) were assigned within 72 h of first enteral feeding to one of three formulas: control (n = 22), DHA+ARA from fish/fungal oil [DHA+ARA(FF); n = 20], or DHA+ARA from egg/fish oil [DHA+ARA(EF); n = 18]. Human milk feeding was allowed on the basis of the mother's choice. Infants were fed breast milk and/or preterm formulas with or without 0.26% DHA and 0.42% ARA to term CA followed by breast milk or postdischarge preterm formulas with or without 0.16% DHA and 0.42% ARA to 12 mo CA. Body composition was measured by dual-energy x-ray absorptiometry. There were no significant differences among the three study groups at any time point in weight, length, or head circumference. Bone mineral content and bone mineral density did not differ among groups. At 12 mo CA, infants who were fed DHA+ARA-supplemented formulas had significantly greater lean body mass (p < 0.05) and significantly less fat mass (p < 0.05) than infants who were fed the unsupplemented control formula. The DHA+ARA-supplemented formulas supported normal growth and bone mineralization in premature infants who were born at <33 wk gestation. Preterm formulas that had DHA+ARA at the levels and ratios in this study and were fed to 1 y CA led to increased lean body mass and reduced fat mass by 1 y of age.
