Nutrient Accretion in Preterm Infants Fed Formula with Different Protein:Energy Ratios

Fairey, Ann K.; Butte, Nancy F.; Mehta, Nitesh R; Thotathuchery, Mary; Schanler, Richard J.; Heird, William C.

doi:10.1097/00005176-199707000-00006

Cited by 27 publications

(16 citation statements)

References 31 publications

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“…Based upon a series of elegant studies in which protein:energy ratios were systematically varied, Kashyap, Heird et al suggested an upper limit of 4.5 g/kg/d or 3.75 g/100 kcal (38). More recently, the same group were unable to demonstrate any advantage in lean mass accretion in infants 2.6 or 3.2 g/100 (39). In this parallel study, the sample size was small (n ϭ 8, n ϭ 7/gp) and negative findings are somewhat difficult to interpret.…”

Section: Protein-energy Needs Of Pre-term Infantsmentioning

confidence: 66%

High Protein Pre-Term Infant Formula: Effect on Nutrient Balance, Metabolic Status and Growth

et al. 2006

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Several lines of evidence suggest that formula with protein content of 3.0 g/100 kcal does not fully meet the protein needs of very-low-birth weight infants. Our purpose was to compare nitrogen balance, metabolic status and growth in infants fed a standard (3.0 g/100 kcal; RegPro) and high (3.6 g/100 kcal; HiPro) protein infant formula. Infants were fed both formulas, each formula for one week in balanced cross-over design. Metabolic status was monitored throughout. Nutrient balance and plasma amino acids were determined at the end of each week. Data were analysed using a linear mixed model. Eighteen infants were studied. Nine infants received the RegPro and nine received HiPro formula first. Nitrogen intake, absorption and retention were greater with the HiPro formula. None of the infants developed uremia or metabolic acidosis but retinol-binding-protein and weight gain were greater with the HiPro formula. Increased protein accretion paralleled by better weight gain without evidence of metabolic stress indicates that a formula with a protein content of 3.6 g/100 kcal better meets protein needs in these rapidly-growing infants. Further studies are needed to determine whether these short-term outcomes will be translated into long-term benefits. T here is compelling evidence that premature infants frequently do not receive protein intakes that meet their needs (1,2). In the case of formula-fed infants, one critical reason is that pre-term formulas contain too little protein. The protein needs of premature infants are reasonably well established based on the factorial method and experimental data. By one estimate, protein requirements are 4.0 g/kg/d for infants weighing less than 1200 g, decreasing to 3.9 g/kg/d for infants weighing 1200 -1500 g (3). Expressed per unit of energy, the requirements for protein are 3.8 g/100 kcal for infants weighing 500 -700 g, decreasing gradually to 3.1 g/100 kcal for infants weighing 1200 -1500 g (3).A formula that provides 3.0 g/100 kcal, therefore, cannot provide an adequate intake of protein. If needs of these infants are to be met, a formula must provide more than 3.0 g/100 kcal. We, therefore, hypothesized that a formula with a protein concentration of 3.6 g/100 kcal would lead to greater nitrogen retention and greater short term weight gain than a formula with a protein concentration of 3.0 g/100 kcal. The present study was designed to test this hypothesis. METHODS AND PROCEDURESStudy design. The study design was based on a previous study in pre-term infants and is outlined in Table 1 (4). It comprised of 2 one-week comparison periods during which each formula was fed. It was conducted in a double blind fashion, with the sequence of formula feeding randomly determined and balanced. Immediately before the first study formula was fed, baseline (anthropometric, metabolic) determinations were made. After a minimum equilibration period of 72 h, anthropometric and metabolic determinations were repeated and the first metabolic balance study was begun. At the end of the fi...

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Section: Protein-energy Needs Of Pre-term Infantsmentioning

confidence: 66%

High Protein Pre-Term Infant Formula: Effect on Nutrient Balance, Metabolic Status and Growth

et al. 2006

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“…It is possible that higher energy intakes would have been required to adequately assimilate the additional protein provided in the current study as suggested by others (14). Previous studies suggested that energy intakes of ‫051ف‬ kcal/kg/d in association with higher protein intakes promoted improved weight gain compared with intakes of 120 kcal/kg/d (16,17,21).…”

Section: Protein Intakes In Preterm Infantsmentioning

confidence: 67%

“…Previous controlled studies assessing protein requirements in preterm infants have examined growth during initial hospital stay (12)(13)(14)(15)(16)(17). However, infants born preterm are usually discharged home before they have reached a corrected age of term.…”

Section: Discussionmentioning

confidence: 99%

“…Bhatia et al (12) were unable to demonstrate differences in growth between formula with 2.2 g, 2.7 g, or 3.2 g/100 kcal, but did show improvements in behavioral score, which might suggest later cognitive advantage. Fairey et al (14) compared a protein density of 2.6 g/100 kcal (n ϭ 7) to 3.2 g/100 kcal (n ϭ 8) and were unable to show any differences in growth or body composition despite differences in nitrogen retention.…”

Section: Protein Intakes In Preterm Infantsmentioning

confidence: 98%

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Protein Requirements in Preterm Infants: Effect of Different Levels of Protein Intake on Growth and Body Composition

Embleton

Cooke

2005

Pediatr Res

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“…A total of fourteen studies on zinc retention were identified [11,[17][18][19][21][22][23][24][25][26][27][28][29][30] with data on forty-five distinctly identifiable groups (Tables 1 and 2). All studies were identified in the primary PubMed search.…”

Section: Zincmentioning

confidence: 99%

Zinc and copper requirements in preterm infants: An examination of the current literature

Griffin

Domellöf

Bhatia

et al. 2013

Early Human Development

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a b s t r a c t a r t i c l e i n f oBackground: Zinc and copper are essential for preterm infants, but recommended requirements from different groups vary widely. Recommended zinc intakes have steadily increased over the years. Although this would be expected to impair copper absorption, recommended copper intakes have not risen in parallel. Objectives: To systematically review the literature on zinc and copper retention in preterm infants; to examine the effect on zinc intake on copper retention; and to estimate the zinc and copper intakes required to meet the levels of zinc and copper retention required for normal growth. Design: Studies reporting zinc and/or copper retention in preterm infants (b36 weeks of gestation) during the first 120 days of life were identified using PubMed. Only studies reporting net retention were included. Results: Fourteen studies on zinc retention reporting data on 45 different groups were identified. Eleven studies (32 groups) were identified reporting copper retention. Zinc retention was significantly higher at higher zinc intakes, and higher in formula-based diets than in human milk based diets. Zinc intakes of between 1.8-2.4 mg/kg/d (from formula based diets) and 2.3-2.4 mg/kg/d (from human-milk based diets) were required to achieve adequate zinc retention. Copper retention was significantly positively correlated with copper intake and significantly negatively correlated with zinc intake. At the zinc intakes suggested previously (1.8-2.4, 2.3-2.4 mg/kg/d), copper intakes of between 200 and 250 mcg/kg/d are required to ensure adequate copper retention. Conclusions: Our results support the higher zinc intakes recommended in recent guidelines. However, they suggest that recommended copper intakes have not kept pace with increasing zinc intakes, and that preterm infants may need higher copper intakes than currently recommended.

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Nutrient Accretion in Preterm Infants Fed Formula with Different Protein:Energy Ratios

Abstract: In this study, formula for preterm infants with a P:E ratio of 3.2 g/100 kcal vs. 2.6 g/100 kcal provided no apparent benefit in terms of the proportion of fat to lean tissue accretion as determined from nutrient balance data.

Cited by 27 publications

References 31 publications

High Protein Pre-Term Infant Formula: Effect on Nutrient Balance, Metabolic Status and Growth

High Protein Pre-Term Infant Formula: Effect on Nutrient Balance, Metabolic Status and Growth

Protein Requirements in Preterm Infants: Effect of Different Levels of Protein Intake on Growth and Body Composition

Zinc and copper requirements in preterm infants: An examination of the current literature

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