Associations of Measured Protein and Energy Intakes with Growth and Adiposity in Human Milk-Fed Preterm Infants at Term Postmenstrual Age: A Cohort Study

Israel Macedo; Luis Pereira-da-Silva; Manuela Cardoso

doi:10.1055/s-0038-1626717

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(09): 882-891
DOI: 10.1055/s-0038-1626717

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Associations of Measured Protein and Energy Intakes with Growth and Adiposity in Human Milk-Fed Preterm Infants at Term Postmenstrual Age: A Cohort Study

Israel Macedo

¹NICU, Maternidade Dr. Alfredo da Costa, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

,

Luis Pereira-da-Silva

²Medicine of Women, Children and Adolescents, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal

³NICU, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

,

Manuela Cardoso

⁴Nutrition Unit, Maternidade Dr. Alfredo da Costa, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

› Author Affiliations

Abstract

Objective To determine the associations of measured protein, energy, and protein-to-energy (PER) intakes with body composition in human milk (HM)-fed preterm infants.

Study Design Neonates born at < 33 gestational weeks were eligible. Standard fortification method with modular supplements was used and the HM composition was measured. The weight gain velocity was calculated, and body composition was assessed by air displacement plethysmography at 40 weeks' postmenstrual age (PMA). The fat mass percentage and fat mass index were used as indicators of adiposity, with convenience cut-offs ≤ –1 and ≥ + 1 z-scores for low and high adiposity, respectively.

Results Thirty-three infants were included (median [interquartile range] gestational age: 30 [28–31] weeks; birth weight: 1.175 [1.010–1.408] g); 36.4 and 84.8% did not receive the minimum recommended protein and energy intakes, respectively. Weight gain velocity showed positive weak-to-moderate correlations with nutrient intakes. Overall, no correlations between nutrient intakes and body composition were found. Infants with lower adiposity received lower energy, protein, and PER intakes, while those with higher adiposity received lower energy intake but higher PER intake.

Conclusion Overall, no correlations of nutrient intakes with body composition were found; however, differences in nutrient intakes were found between infants with lower and higher adiposity at term PMA.

Keywords

body composition - energy intake - growth velocity - human milk composition - protein intake - very preterm infant

Full Text

References

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