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Quantitation of oxidation of medium-chain triglycerides in preterm infants
E J Sulkers1, H N Lafeber, P J Sauer
1Department of Paediatrics, Erasmus University, Rotterdam, The Netherlands.
Insights
Medium-chain triglycerides (MCT) are crucial in preterm infant formulas. This study found MCTs are highly oxidized by preterm infants, significantly contributing to their energy needs.
Area of Science:
- Nutritional Science
- Pediatric Metabolism
- Infant Nutrition
Background:
- Medium-chain triglycerides (MCTs) constitute up to 50% of fat in preterm infant formulas.
- Understanding MCT utilization is vital for optimizing infant nutrition.
Purpose of the Study:
- To quantify the oxidation of medium-chain triglycerides (MCTs) in preterm infants.
- To assess the contribution of MCTs to overall fat oxidation in this population.
Main Methods:
- A primed constant oral infusion study using 1-13C-potassium octanoate in 20 preterm infants.
- Measurement of 13C enrichment in breath CO2 to determine tracer oxidation.
- Indirect calorimetry to measure substrate and total fat oxidation.
Main Results:
- MCT oxidation was quantified, with an average recovery of 47.1% of the administered tracer.
- Preterm infants oxidized a significant portion of administered MCTs, averaging 1.26 g/kg/d.
- MCTs accounted for approximately 85% of total fat oxidation in appropriate for gestational age infants and 65% in small for gestational age infants.
Conclusions:
- Medium-chain triglycerides are readily oxidized by preterm infants, serving as a primary energy source.
- The study provides crucial data on MCT utilization, informing the composition of specialized infant formulas.
- Findings highlight the importance of MCTs in meeting the metabolic demands of preterm infants.
Abstract:
Medium-chain triglycerides, with a chain length of eight and 10 carbon atoms, form up to 50% of the total fat content in some preterm infant formulas. In 20 small preterm infants (birthwt: 1153 +/- 227 g; mean +/- SD) fed a special formula containing 40% MCT, a primed constant oral infusion study of 1-13C-potassium octanoate was conducted to quantify the oxidation of MCT. A plateau in 13C enrichment in breath CO2 was reached in all patients within 1-3 h. Simultaneously, substrate utilization was measured using a closed system indirect calorimeter. No significant difference was found between appropriate for gestational age (n = 8) and small for gestational age (n = 12) infants in the percentage of the administered tracer that was oxidized (44.9 +/- 9.1% versus 48.5 +/- 11.0%). In all patients, the recovery was calculated to be 47.1 +/- 10.2%, which is less than previously estimated and corresponds to a mean MCT oxidation of 1.26 +/- 0.27 g/kg/d. With indirect calorimetry, a total fat oxidation of 1.42 +/- 0.84 g/kg/d in appropriate for gestational age and 2.00 +/- 0.85 g/kg/d in small for gestational age infants was found, indicating that MCT accounted for around 85% of the total fat oxidation in appropriate for gestational age versus 65% in small for gestational age infants.