Does early nutrition program later bone health in preterm infants?

Area of Science:

• Neonatal nutrition
• Pediatric bone health
• Metabolic bone disease

Background:

• Preterm infants face metabolic bone disease (MBD) risk due to insufficient mineral intake.
• MBD in infancy can predict reduced linear growth, despite potential catch-up mineralization.
• Early nutrition's long-term effects on bone health in preterm infants require further investigation.

Purpose of the Study:

• To investigate if neonatal nutrition programs influence later bone health and peak bone mass in preterm infants.
• To assess the impact of varied nutrient and mineral content in neonatal diets on bone development.
• To explore the association between human milk intake and long-term bone outcomes.

Main Methods:

• Longitudinal study of 20-year-old subjects born preterm.
• Random assignment to neonatal diets with varying nutrient/mineral content (no phosphate supplements).
• Assessment of peak bone mass, bone turnover, and anthropometric data, comparing with population references.

Main Results:

• Randomized diets did not affect peak bone mass or turnover, despite variations in nutrient intake and MBD occurrence.
• Increased proportion of human milk in the neonatal diet correlated positively with later whole-body bone size and mineral content.
• Preterm subjects were shorter and had lower lumbar spine bone mineral density than population references, especially those born small for gestational age.

Conclusions:

• Neonatal diet composition, as randomized, did not influence peak bone mass in preterm infants.
• Observed deficits in height and bone mass may not stem from suboptimal early nutrient/mineral intake.
• Non-nutritive factors in human milk might contribute to enhanced bone mass in preterm infants.