Nutrient balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formula

Putet, G; Senterre, J; Rigo, Jacques; Salle, B

doi:10.1016/s0022-3476(84)80368-6

Cited by 106 publications

(71 citation statements)

References 28 publications

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“…The comparison between the studied premature babies and fetuses of the same age is interesting, even if there is little rationale to do so. Their growth, in terms of weight gain and protein gain is comparable, whereas their fat gain differs (23,29,30). The premature infants' fat accumulation is higher than intrauterine values at the comparable postconceptional age and lower than that of term babies at a comparable postnatal age.…”

Section: Nutrient Balance and Composition Of Weight Gainmentioning

confidence: 90%

“…A number of practical considerations preclude the utilization of methods like body density or K-40 measurements to get this information. Therefore bedside, noninvasive methods have to be used and a limited number of investigations have been performed ENERGY METABOLISM IN PREMATURE INFANTS (6,21,23,29,30). The measured protein gain as well as the rate of weight gain are comparable to the studies using different milk formulas and different levels of energy intakes (6,23,29,30).…”

Section: Nutrient Balance and Composition Of Weight Gainmentioning

confidence: 94%

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Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

et al. 1986

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ABSTRACT. In order to assess the contribution of the thermogenic effect of feeding and muscular activity to total energy expenditure, nine premature infants were studied for 2 consecutive days during which time repeated measurements of energy expenditure by indirect calorimetry were performed throughout the day, combined with a visual activity score based on body movement. The infants were growing at 16.6 f 4.0 g/kg/day (mean f SD) and received 110 + 8 kcal/kg/day metabolizable energy (milk formula) and 522 + 40 mg N/kg/day. Their total energy expenditure was 68 f 4 kcal/kg/day indicating that 41 2 7 kcal/kg/day was retained for growth. Based on the combination of energy + N balances it was estimated that 80% of the weight gain was fat-free tissue and 20% was fat tissue. The rate of energy expenditure measured minute-by-minute was significantly and linearly correlated with the activity score in both the premeal ( r = 0.75; p < 0.001) and the postmeal periods ( r = 0.74; p < 0.001) with no difference in the regression slope, but with a significant difference in intercept. In preset feeding schedules the latter allowed an estimation of the thermogenic effect without the confounding effect of activity. This was found to be 3.1 + 1.8% when expressed as a percentage of metabolizable energy intake. However when the "classical" approach was used as a comparison (integretation of extra energy expenditure induced by the meal), the thermogenic effect was found to be greater, i.e. 9.5 + 3.8% of the meal's metabolizable energy, due to the superimposed effect of physical activity in the postprandial state. The study suggests that the intradaily variation in energy expenditure in premature infants nursed according to present day techniques is almost equally due to the thermogenic effect of feeding (3.2 kcal/kg/day), and to variations in muscular activity (3.6 kcal/kg/day) both representing a small fraction of the total energy expenditure in premature infants (i.e. 4.7 and 5.3%, respectively). This work was supported by a research grant from NestlC, Vevey Switzerland. 6ing and feeding, the study of energy metabolism in preterm infants has progressed at a rapid pace. However, measurements of energy expenditure in premature babies have been generally of short duration (5, 7-9), i.e. approximately 1-3 h. Therefore the extent to which these limited periods of measurement can be extrapolated to 24 h is still uncertain. When energy expenditure of preterm infants is continuously monitored over 24 h (6), the variability of measurements generally observed is mainly due to two factors: variations in physical activity (i.e. whole body movements, crying), and the thermogenic response to feeding. Although several methods have been developed to score changes in spontaneous physical activity of infants (7, 9-16), it is not known to what extent these scores are related to the rate of energy expenditure. Because the thermogenic response itself can be influenced by several factors such as duration of measurement, feeding frequency, size and typ...

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Section: Nutrient Balance and Composition Of Weight Gainmentioning

confidence: 90%

Section: Nutrient Balance and Composition Of Weight Gainmentioning

confidence: 94%

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

et al. 1986

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“…(Pediatr Res 35: [704][705][706][707][708][709][710][711][712]1994) Abbreviations LBW, low birth weight Current guidelines for feeding LBW infants stress the importance of achieving as soon after birth as possible a rate of weight gain that is at least equal to or, preferably, greater than the intrauterine rate (1, 2). A number of studies have demonstrated that even the higher rates of weight gain can easily be achieved but that the accompanying rates of fat accretion are as much as 3-fold greater than the intrauterine rate (3)(4)(5)(6)(7)(8). The desirability of such high rates of fat accretion are unknown.…”

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confidence: 99%

Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

et al. 1994

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ABSTRACT'. A model for predicting the relationship between protein and energy intakes of low-birth-weight (LBW) infants and the rate and composition of weight gain is described. It is based on linear multiple regression equations summarizing the rates of weight gain, nitrogen retention, and energy retention of 101 previously studied LBW infants fed protein intakes ranging from 2.25 to 3.9 g. kg-' .d-' and concomitant energy intakes ranging from 115 to 147 kcal. kg-'.d-' plus current theory concerning nutrient retention and body composition. To test the validity of the model, three combinations of protein and energy intake predicted by the model to result in specific rates and compositions of weight gain were fed to 44 LBW infants, and the observed rates of weight gain, protein accretion, and fat accretion were compared with the rates predicted by the model. Differences in these and other outcome variables between two of the groups, the intakes of which differed only in energy, also were compared to provide additional insight into the effect of concomitant energy intake on protein utilization. Across groups, actual outcomes correlated closely with predicted outcomes, supporting the validity of the model for the total population. However, outcomes of individual infants deviated as much as 30% from predicted outcomes; the magnitude of the deviation was independent of birth weight, gestational age, or size for gestational age. In addition, the mean rate of protein accretion of the group fed the highest protein/ energy ratio was significantly less than predicted. The higher mean urinary nitrogen excretion as well as blood urea nitrogen and plasma amino acid concentrations of this group versus the group that received a similar protein intake with a higher energy intake suggest that the higher energy intake improved nitrogen utilization. In toto, the data support the concept that the rate and composition of weight gain of LBW infants can be manipulated by intake; however, for individual infants, the extent of manipulation seems to be dependent on as-yet-unidentified inherent biologic variables. (Pediatr Res 35: [704][705][706][707][708][709][710][711][712] 1994) Abbreviations LBW, low birth weight Current guidelines for feeding LBW infants stress the importance of achieving as soon after birth as possible a rate of weight gain that is at least equal to or, preferably, greater than the intrauterine rate (1, 2). A number of studies have demonstrated that even the higher rates of weight gain can easily be achieved but that the accompanying rates of fat accretion are as much as 3-fold greater than the intrauterine rate (3-8). The desirability of such high rates of fat accretion are unknown. For most populations, they are considered undesirable, but this may not be true for the LBW infant who is born with limited fat stores. Moreover. approximately 40% of the weight gained by term infants over the first 4 mo of life appears to be fat (9), raising the possibility that high rates of fat accretion are unavoidable during ear...

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“…Já Putet et al 14 A influência no gasto energético de fatores como condição clínica do RN, tipo de leite, uso de drogas com xantinas, diuréticos, entre outros, ainda precisa ser avaliada através de estudos específicos para estes objetivos, já que o desenho …”

Section: Avaliação Metabólicaunclassified

Indirect calorimetry: a tool to adjust energy expenditure in very low birth weight infants

Soares¹,

Moreira²,

Abranches³

et al. 2007

J Pediatr (Rio J)

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ResumoObjetivo: Verificar o gasto energético de repouso dos recém-nascidos de muito baixo peso ao nascer através da calorimetria indireta. Métodos:Estudo transversal com 29 recém-nascidos de muito baixo peso ao nascer, clinicamente estáveis, recebendo dieta > 100 kcal/kg/dia. A desnutrição foi determinada como todo escore z do peso para idade ≤ -2 DP. A aferição do gasto energético de repouso foi realizada através da calorimetria indireta com o sistema aberto. Resultados:No momento do exame, o peso médio foi de 1.564±393 g, idade corrigida de 35±3 semanas, e a desnutrição estava presente em 62,1%. O valor médio da taxa metabólica basal foi de 57,01±7,76 kcal/kg/dia, maior do que o usado como referência. Conclusão:O elevado gasto energético de repouso pode estar exercendo um forte impacto no desenvolvimento da desnutrição no período de hospitalização, pois o gasto energético de repouso é o principal componente calórico do gasto energético total.J Pediatr (Rio J). 2007;83(6):567-570: Nutrição, calorimetria indireta, pré-termos. AbstractObjective: To determine the resting metabolic rate in very low birth weight infants through indirect calorimetry. Methods:Cross-sectional study including 29 clinically stable very low birth weight infants receiving an enteral diet > 100 kcal/kg/day. Malnutrition was defined as weight-for-age z score ≤ - IntroduçãoNutrir adequadamente o recém-nascido (RN) prematuro com o objetivo de proporcionar-lhe um crescimento extraútero semelhante ao crescimento fetal é um dos grandes desafios da neonatologia. Apesar da importância do manuseio nutricional dos RN prematuros estar claramente reconhecida, as quantidades necessárias da maioria dos nutrientes não estão bem estabelecidas. Estas incertezas podem contribuir para ingestão limitada de nutrientes, e sabe-se que uma nutrição inadequada em períodos precoces da vida pode apresentar um impacto no desenvolvimento a longo prazo 1 .

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Nutrient balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formula

Cited by 106 publications

References 28 publications

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

Evaluation of a Mathematical Model for Predicting the Relationship between Protein and Energy Intakes of Low-Birth-Weight Infants and the Rate and Composition of Weight Gain

Indirect calorimetry: a tool to adjust energy expenditure in very low birth weight infants

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