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Enhanced Protein Diet for Preterm Infants: A Prospective, Randomized, Double-blind, Controlled Trial

Courtney B Atchley1, Ann Cloud2, David Thompson3

  • 1Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center.

Journal of Pediatric Gastroenterology and Nutrition
|May 7, 2019
PubMed

Insights

Enhanced protein diets (EPD) may improve fat accretion in hospitalized preterm infants. Infants receiving EPD showed a trend toward greater weight gain and fat mass increase compared to standard protein diets (SPD).

Area of Science:

  • Neonatal nutrition
  • Pediatric gastroenterology
  • Infant metabolism

Background:

  • Preterm infants often experience suboptimal growth and body composition.
  • Optimizing nutrient intake, particularly protein, is crucial for development in extremely premature infants.
  • Understanding the impact of dietary protein on fat accretion is essential for nutritional strategies.

Purpose of the Study:

  • To investigate the effect of an enhanced protein diet (EPD) versus a standard protein diet (SPD) on fat accretion and weight gain in hospitalized preterm infants.
  • To compare body composition changes between preterm infants receiving EPD and SPD.
  • To determine if increased protein intake influences the rate of fat accumulation in this vulnerable population.

Main Methods:

  • A prospective, randomized, double-blind, controlled trial was conducted with 36 preterm infants (<32 weeks gestation).
  • Infants were assigned to either an EPD (protein-energy ratio [PER] 4 g/100 kcal) or SPD (PER 3 g/100 kcal) after achieving full enteral feeding.
  • Body composition, including fat mass, was assessed weekly using air displacement plethysmography over a maximum of 4 weeks.

Main Results:

  • While not statistically significant, the EPD group showed a trend towards higher relative weight gain (21.6 g/kg/day) compared to the SPD group (19.1 g/kg/day).
  • Baseline percent fat mass was lower in the EPD group (5.15%) versus the SPD group (7.29%), with a trend towards significance (P=0.0517).
  • The rate of increase in percent fat mass was higher in the EPD group (0.398%/day) compared to the SPD group (0.284%/day), approaching statistical significance (P=0.0878).

Conclusions:

  • Preterm infants receiving an enhanced protein diet demonstrated a trend towards improved fat accretion, particularly those with lower initial fat mass.
  • The findings suggest that higher protein intake may support better body composition development in hospitalized preterm infants.
  • Further research with larger sample sizes may be needed to confirm the statistical significance of these observed trends.
Abstract

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