Related Experiment Video
Updated: Mar 19, 2026
In Ovo Feeding of Commercial Broiler Eggs: An Accurate and Reproducible Method to Affect Muscle Development and Growth
Published on: September 20, 2021
Optimizing Early Protein Intake for Long-Term Health of Preterm Infants
1The Childhood Nutrition Research Centre, Institute of Child Health, University College London, London, UK.
Insights
Early high protein intake in preterm infants supports brain development but may increase later cardiovascular risks. Current policy prioritizes neurodevelopment, accepting potential metabolic trade-offs.
Area of Science:
- Neonatal Nutrition
- Developmental Pediatrics
- Metabolic Health
Background:
- Decades of research since the 1980s suggest early protein intake programs long-term health in preterm infants.
- Preterm infants require high protein for growth approximating intrauterine rates, considered optimal for health.
- Early growth acceleration in preterm infants is linked to neurodevelopmental benefits and cardiovascular risks.
Purpose of the Study:
- To review evidence on the impact of early protein intake on preterm infant health.
- To examine the 'growth acceleration' hypothesis concerning metabolic disease risk.
- To evaluate current nutrition policies prioritizing neurodevelopment in preterm infants.
Main Methods:
- Review of randomized and observational studies on neonatal diets and infant outcomes.
- Analysis of long-term follow-up data on neurodevelopment and cardiovascular risk factors.
- Examination of the evidence base for current preterm infant nutrition guidelines.
Main Results:
- Higher protein intake promoted growth in preterm infants, showing long-term brain structure and function benefits up to 16 years.
- Detrimental effects observed include increased insulin resistance and adiposity, associated with metabolic disease risk.
- Current policy prioritizes neurodevelopment, advocating high early protein intake despite potential cardiovascular risks.
Conclusions:
- The consensus supports high early protein intake for optimal neurodevelopment in preterm infants.
- This policy acknowledges and accepts potential increased cardiovascular risk factors.
- Evidence review informs understanding of the balance between neurodevelopmental benefits and metabolic risks.
Abstract:
The idea that early protein intake may influence, or program, long-term health in preterm infants is strongly supported by decades of research starting from the early 1980s. At this time, it was recognized that preterm infants required a high protein intake to achieve postnatal growth closer to the intrauterine growth rate of a normal fetus of the same postconceptional age, a goal regarded optimal for short- and long-term health. Subsequently, follow-up of preterm infants randomized to different neonatal diets demonstrated that those receiving higher protein intakes that promoted growth had benefits for brain structure and function up to 16 years later, but also detrimental effects on cardiovascular risk factors such as insulin resistance and adiposity. These effects of early growth on risk of metabolic disease, termed the 'growth acceleration' hypothesis, have been demonstrated in randomized and observational studies in infants born preterm and at term. Nevertheless, on balance, current nutrition policy for preterm infants is based on the consensus that supporting optimal neurodevelopment is the neonatologist's highest priority. Therefore, this policy appropriately favors early administration of a high protein intake to benefit neurodevelopment, irrespective of any increase in cardiovascular risk. The current review will consider the evidence underlying this policy.
Related Concept Videos
01:28Proteins: Dietary Sources and Requirements
01:21Overview of Protein Metabolism
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
00:48Optimal Foraging
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion