Energy Expenditure and Deposition of Breast-Fed and Formula-Fed Infants during Early Infancy

Abstract

ABSTRACT. The energy intake, expenditure, and deposition of 40 breast-fed and formula-fed infants were investigated at 1 and 4 mo of age to explore possible differences in energy utilization between feeding groups. Energy intake was calculated from 5-d test-weighing records or pre-and postweighing of formula bottles, in combination with bomb calorimetry of the milks. Total daily energy expenditure (TDEE) was determined by the doubly labeled water method. Sleeping metabolic rate (SMR) and minimal observable energy expenditure were measured by indirect calorimetry. Activity was estimated as the difference between TDEE and SMR. Energy deposition was estimated from dietary intake and TDEE. Energy intakes were significantly higher for the formula-fed than breast-fed infants at 1 mo (118 f 17 versus 101 f 16 kcal/kg/d) and 4 mo (87 f 11 versus 72 2 9 kcal/kg/d) (p < 0.001). TDEE averaged 67 f 8 and 64 k 7 kcal/kg/d at 1 mo and 73 f 9 and 64 f 8 kcal/kg/d at 4 mo for the formula-fed and breast-fed infants, respectively, and differed between feeding groups ( p < 0.04). SMR and minimal observable energy expenditure (kcallmin) were higher among the formula-fed infants at 1 and 4 mo ( p < 0.005). The energy available for activity and the thermic effect of feeding did not differ between feeding groups. Rates of weight gain (g/ d) and energy deposition (kcal/kg/d) tended to be greater among the formula-fed infants at 1 and 4 mo ( p < 0.06).Differences in weight gain, energy deposition, SMR, minimal observable energy expenditure, and TDEE partially accounted for the discrepancy in energy intake observed between breast-fed and formula-fed infants. The response to the varying levels of energy intake in infancy appear to be mediated through growth and basal-energy-requiring processes, but not through physical activity. ( CV, coefficient of variationAdaptations to varying levels of energy intake may affect an infant's body mass or composition, basal metabolism, activity, or thermogenesis. Although the response to severe energy restriction during infancy is well documented (I), the response to seemingly adequate but different levels of energy intake is not well understood. Energy intakes of breast-fed and formula-fed infants have been shown to differ after the first few months of life (2-4). Differing energy intakes between feeding groups imply that energy absorption, expenditure, and (or) deposition between groups also differ. In a previous study (3), we reported a 27% difference in energy intake between breast-fed and formula-fed infants at 4 mo of age, but did not observe statistically significant differences in length, body weight, or weight gain. Nor were anticipated differences in selected components of energy expenditure detected; SMR, TEF, and postprandial energy expenditure did not differ between feeding groups. Rates of MOEE were higher among the formula-fed infants, but the increment was insufficient to account for the differences in energy intake. Rates of weight gain tended to be greater among the 4-mo-old formulafed...

Breast milk and energy intake in exclusively, predominantly, and partially breast-fed infants

“…Butte et al (1990) compared sleeping metabolic rate in breast-and formula-fed babies and found higher values in the latter group. The same author also found differences in sleep organisation between formula or breast-fed infants (Butte et al, 1992).…”

“…In line with these differences in growth is the finding that energy requirements of breast-fed infants are different from those who are bottle-fed (Butte et al, 1990;Butte, 1996), and there is substantial evidence that recommendations of energy requirements (WHO, 1985) overestimate the needs by 9-39% (Butte, 1996). Energy requirements have originally been based on measurements of energy intake (WHO, 1985).…”

Energy intake and growth of infants in Iceland—a population with high frequency of breast-feeding and high birth weight

“…The growth discrepancy between different feeding groups of infants was discussed recently by Dewey (1998a). The breast-fed infants self-regulate their energy intake at a lower level than formula-fed infants, which has been related partly to lower metabolic rate and less weight gain (Butte et al, 1990;Davies, 1992). Other factors, such as varying digestibility and the composition of newly synthesized tissues, may differ between the feeding groups (Butte et al, 1990).…”

“…The breast-fed infants self-regulate their energy intake at a lower level than formula-fed infants, which has been related partly to lower metabolic rate and less weight gain (Butte et al, 1990;Davies, 1992). Other factors, such as varying digestibility and the composition of newly synthesized tissues, may differ between the feeding groups (Butte et al, 1990). It seems therefore that breast-feeding is an independent factor leading to lower energy expenditure and intake for a certain period in infancy.…”

Comparison of measured sleeping metabolic rate and predicted basal metabolic rate during the first year of life: evidence of a bias changing with increasing metabolic rate

“…In practice resting metabolic rate is usually measured under similar conditions except that the measurement is taken 4 h after a light meal. Due to practical and ethical considerations a resting fasting state cannot be attained in frequently fed infants and a SMR is measured instead (Azaz et al, 1992;Butte et al, 1990). As most of the subjects in the 0 -3-y-old age group in the studies Schofield used to predict BMR were either sleeping or sedated during testing it is expected that measured SMR in this study will equal predicted BMR.…”