Energetic efficiency and nutrient accretion in preterm infants fed extremes of dietary intake

The role of diet-induced thermogenesis (DIT) in the regulation of energy utilization in preterm infants was investigated by measuring energy expenditure and nutrient deposition in groups of subjects fed either banked drip breast milk (BBM) or a preterm formula (PF). Nutrient deposition was determined by combining a 3-d nutrient balance study and measurement of energy expenditure. Infants fed PF consumed 57 per cent more metabolizable energy (ME) than those fed BBM. There were significant differences between groups in energy expenditure, energy deposition and protein deposition; 76 per cent of the additional ME intake consumed by the PF-fed group was deposited while the remaining 24 per cent was expended. Infants fed PF gained weight 39 per cent faster than those fed BBM (19, compared to 14 g/kg/d), and deposited 128 per cent more fat and 86 per cent more protein. These findings indicate that nutrient deposition, rather than DIT, was the primary use of the extra ME received by the infants fed PF. However, the effect of the high energy intake on weight gain in these subjects was reduced, compared to its effect on nutrient deposition, by increases in the concentrations of fat and protein in new tissue.