Higher urinary excretion of essential amino acids in preterm infants fed protein hydrolysates

Maggio, Luca; Zuppa, Antonio Alberto; Sawatzki, G.; Valsasina, R.; Schubert, Werner; Tortorolo, Giuseppe Gio Batta

doi:10.1080/08035250410023188

Cited by 43 publications

(24 citation statements)

References 27 publications

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“…Maggio et al 7 fed preterm infants either a standard nHWC or a HW preterm infant formula for B4 weeks. No significant differences were detected in blood urea nitrogen (BUN) but urinary excretion of essential amino acids was less and weight gain was greater (20.5 ± 3.3 >17.4 ± 3.4 g kg -1 per day; P<0.05) in infants fed the nHWC formula.…”

Section: Introductionmentioning

confidence: 99%

“…No significant differences were detected in blood urea nitrogen (BUN) but urinary excretion of essential amino acids was less and weight gain was greater (20.5 ± 3.3 >17.4 ± 3.4 g kg -1 per day; P<0.05) in infants fed the nHWC formula. 7 More recently, our group examined nutrient balance in preterm infants fed two pHW formulas containing different levels of protein, 3.0 and 3.6 g per 100 kcal. 8 Irrespective of level, protein utilization was at least as good as that previously noted by us in preterm infants 9 and better than that previously noted by other investigators 4,5 or the data recently summarized by Rigo and Senterre.…”

Section: Introductionmentioning

confidence: 99%

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Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

et al. 2008

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Objective: To compare feeding tolerance, nutrient intake and growth in preterm infants (p32 weeks, p1750 g) fed either a standard nonhydrolyzed whey-casein (nHWC) or a partially hydrolyzed whey (pHW) preterm infant formula.Study Design: In this double-blind randomized controlled trial infants were fed either formula for at least 3 weeks. Intake was monitored daily, serum chemistries and growth weekly. Data were analyzed using analysis of covariance.Result: A total of 80 infants were enrolled, 72 completed the study. No differences were noted in demographic characteristics. No differences were detected in feeding tolerance, intakes (118 ± 21 vs 119 ± 14; nHWC vs pHW) or growth weight, 28 ± 1.5 vs 28 ± 1.6 g per day; length, 1.0 ± 0.7 vs 1.0±0.6 cm per week; head circumference, 0.9±0.4 vs 1.0±0.44 cm per week). At the end of study, blood urea nitrogen (5.2 ± 3.1 <6.7±2.3 mg per 100 ml, nHWC4.4 ± 0.5 g per 100 ml) and albumin (2.7 ± 0.3 >2.6 ± 0.4 g per 100 ml) differed. Conclusion:A pHW preterm infant formula was not associated with improved feeding tolerance, enteral intake or growth but differences in serum chemistries. These are unlikely to be clinically relevant because values were well within normal limits for preterm infants, whereas growth was identical in both groups and paralleled that 'in utero'.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

et al. 2008

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“…From the nutritional point of view, although most human infants fed on protein hydrolysate formula show good body weight gain (36), the large protein in milk formula may enhance the availability of some coexisting nutrients in human infants (25,32,33). On the other hand, the physiological significance of the form of dietary protein for infants has received little attention.…”

Section: Discussionmentioning

confidence: 99%

Large molecule protein feeding during the suckling period is required for the development of pancreatic digestive functions in rats

Kinouchi

Koyama

Harada

et al. 2012

American Journal of Physiology-Regulatory, Integrative and Comp

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Kinouchi T, Koyama S, Harada E, Yajima T. Large molecule protein feeding during the suckling period is required for the development of pancreatic digestive functions in rats. Am J Physiol Regul Integr Comp Physiol 303: R1268 -R1276, 2012. First published October 24, 2012 doi:10.1152/ajpregu.00064.2012.-We examined if large molecule protein feeding during the suckling period is prerequisite for the proper development of pancreatic digestive functions. Most amino acids in breast milk exist as the constituent of large proteins and not as oligopeptides or free amino acids. Accumulating evidence indicates the nutritional importance of large protein feeding for suckling infants; however, evidence on the physiological significance remains small. We thus artificially reared rat pups on a standard rat formula with milk protein or a formula with milk protein hydrolysate from 7 to 21 days of age, and thereafter, fed a standard solid diet until 42 days of age. Pancreas weight and the stock of pancreatic digestive enzymes in the hydrolysate-fed rats were significantly lower than those in the protein-fed rats during and also after the suckling period. Plasma insulin, a stimulator of amylase synthesis, was also significantly low in the hydrolysate-fed rats compared with the protein-fed rats. At 28 days of age, we evaluated the pancreatic secretory ability in response to dietary protein and cholecystokinin (CCK) by means of pancreatic duct cannulation. Pancreatic secretion stimulated by dietary protein in the hydrolysate-fed rats was significantly weaker than that in the protein-fed rats. No significant difference was observed in the increasing rate of pancreatic enzyme secretion in response to CCK between the two groups. These results suggest that the presence of large proteins in breast milk is significant for the development of pancreatic digestive functions and the outcomes could remain even later on in life. cholecystokinin; breast milk; protein hydrolysate formula; insulin MOST AMINO ACIDS in breast milk exist as the constituent of large molecule proteins. In human milk, for instance, about 95% of all amino acids constitute ␣-lactalbumin

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“…It is unclear if this strategy and the use of hydrolysed protein in place of intact protein have an impact on growth. Carbohydrate is thought to be the main determinant of growth when protein intake is adequate [31] and use of hydrolysed protein in formula-fed preterm infants to reduce risk of feeding intolerance, has been associated with slower growth [32].…”

Section: Proprietary Fortifiersmentioning

confidence: 99%

Breast Milk Additives and Infant Formula

Sherriff

McLeod

2013

Nutrition for the Preterm Neonate

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Breast milk is recommended for very preterm infants but fortification is required to increase its nutrient density in order to promote growth and development. Even with fortification, those born extremely preterm and those who are fluid restricted may not achieve intrauterine growth targets. Thus, fortification beyond routine amounts may be necessary for some infants. Further study is necessary to determine optimal methods, types and amounts of fortification, as well as upper limits of osmolality, so as to ensure avoidance of feeding intolerance and necrotizing enterocolitis whilst achieving appropriate rate of weight gain and accretion of nutrients. The efficacy of new formulations of fortifiers and infant formulae needs further study. Key points• Breast milk requires fortification to meet the nutrient needs of preterm infants; monitoring protein intake via blood urea nitrogen to guide fortification looks promising.• Breast milk fortifiers have variable effects on osmolality of fortified expressed breast milk.• Randomised controlled trials are required to assess the efficacy of recently revised formulations of breast milk fortifier and preterm formulae in the context of their ability to meet nutritional requirements for growth and effect on osmolality and feeding intolerance.• Use of gum-based thickening agents for treatment of regurgitation is associated with increased risk of necrotising enterocolitis in preterm and term infants.

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Higher urinary excretion of essential amino acids in preterm infants fed protein hydrolysates

Cited by 43 publications

References 27 publications

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

Growth in preterm infants fed either a partially hydrolyzed whey or an intact casein/whey preterm infant formula

Large molecule protein feeding during the suckling period is required for the development of pancreatic digestive functions in rats

Breast Milk Additives and Infant Formula

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