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Feasibility study: Assessing the influence of macronutrient intakes on preterm body composition, using air
Gemma McLeod1, Karen Simmer1, Jill Sherriff2
1Centre for Neonatal Research and Education, School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
Insights
Monitoring preterm infant body composition (BC) using the PEA POD reveals that fat and energy intake influence fat mass, while protein and carbohydrate intake affect fat-free mass. This method helps optimize preterm nutrition strategies.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Body Composition Analysis
Background:
- Current preterm nutrition guidelines aim for intrauterine growth rates, but preterm infants exhibit distinct phenotypes at term equivalent age.
- Understanding early body composition changes in response to macronutrient intake is crucial for optimizing preterm infant growth and development.
Purpose of the Study:
- To assess the feasibility of using the PEA POD for serial body composition measurements in preterm infants.
- To investigate the relationship between macronutrient intake and body composition changes in preterm infants.
Main Methods:
- Macronutrient intake was calculated from birth for infants born before 33 weeks gestation.
- Body composition was measured using the PEA POD once infants were stable and independent of respiratory support, with subsequent measurements every two weeks until term age.
- Regression analysis was employed to determine the impact of macronutrient intake on body composition alterations.
Main Results:
- The study included 27 preterm infants with a median gestation of 29 weeks.
- PEA POD measurements were feasible as early as 31.86 weeks corrected gestational age.
- Positive associations were observed between fat and energy intake and increased fat mass, while protein and carbohydrate intake correlated with increased fat-free mass.
Conclusions:
- The PEA POD is a sensitive tool for measuring body composition in preterm infants from 31 weeks corrected gestational age.
- Findings demonstrate that macronutrient intake significantly influences body composition changes in preterm infants, providing valuable data for refining nutritional support.
Aim:
Preterm nutrition guidelines target nutrient accretion and growth at intrauterine rates, yet at term equivalent age, the phenotype of the preterm infant differs from that of term infants. Monitoring early changes in preterm body composition (BC) in response to macronutrient intakes may facilitate our understanding of how best to meet preterm nutrition and growth targets.
Method:
Macronutrient intakes based on milk analysis were calculated from birth for infants born <33 weeks gestation. BC was measured in the PEA POD when infants were thermodynamically stable, free of intravenous lines and independent of respiratory support. Subsequent BC measurements were taken at least fortnightly until term age. Regression analysis was used to assess macronutrient influences on changes in BC.
Results:
Median (range) gestation and birthweight of preterm infants (n = 27) were 29 (25-32) weeks and 1395 (560-2148) g, respectively. The youngest corrected gestational and postnatal ages that infants qualified for a PEA POD measurement were 31.86 and 1.43 weeks, respectively. Fat and total energy intakes were positively associated with increasing fat mass. Protein (with carbohydrate) intake was positively associated with increasing fat-free mass.
Conclusion:
Preterm infants can be measured in the PEA POD as early as 31 weeks corrected gestational age and the method appears sufficiently sensitive to detect influences of macronutrient intake on changes in BC.
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