Abstract
Aim: Carotenoids are important as pro-vitamin A, for retinal development and as antioxidants. In adults carotenoids protect against reactive oxygen species (ROS) diseases i.e. cancer and cardiovascular diseases. Preterm infants are also at risk for ROS related diseases such as bronchopulmonary dysplasia (BPD). Just as for vitamins E and A adequate supplementation of carotenoids may reduce the incidence of BPD in preterm infants. Carotenoids are present in human milk, but not in parenteral nutrients and most preterm formulas.
Methods: The levels of the most occurring carotenoids were measured in 29 preterm infants ( mean [SD]: g.a. 29.4[1.6] wks, birth weight 1205[322]g) at postnatal days 1,3,7 and 21. All infants received parenterale nutrition supplemented with vitamin E 1.4 IU/d and A 460 IU/d without carotenoids. Introduction of enterale feeds with human milk or a preterm formula (FrisopreR, containing 65 μg/dl â-carotene) was started as soon as possible.
Results: In the total group of infants the levels of all vitamins were low at birth: mean (SD): vitamin A 0.48(0.22) μmol/l, vitamin E 9.1(4.0) μmol/l, lycopene 36.1(21.0) nmol/l, â-carotene 35.7(16.9) nmol/l, á-carotene 10.1(5.5) nmol/l. Postnatally the levels of lycopene declined [day 21 mean(SD) 21.3(9.5) nmol/l, MANOVA p<0.01], á-carotene remained stable [day 21 8.3(7.2) nmol/l], and the levels of â-carotene, vitamin A and E rose [day 21: 72.1(76.5) nmol/l p <0.05, 0.70(0.34) μmol/l, P<0.01 and 33.6(19.6) μmol/l, p<0.001 respectively]. No significant differences were found between the infants fed predominant human milk (n=18) or preterm formula (n=10). No correlation was found between levels of the vitamins E, A, lycopene, â- and á carotene on day 21 and the duration of parenteral nutrition.
Discussion: The low carotenoid levels at birth and the postnatal decline of lycopene and á-carotene may reduce the antioxidant capacity of the preterm infant. More infants need to be studied to confirm these results. Although human milk contains carotenoids, human milk fed infants did not have higher levels. This can be due to the short period these infants received enteral feeds. Financial support Friesland Nutrition, The Netherlands.
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van Zoeren-Grobben, D., Dikkeschei, L., van Lingen, R. et al. 261 Effect of Nutrition on Carotenoid Levels in Preterm Infants. Pediatr Res 56, 508 (2004). https://doi.org/10.1203/00006450-200409000-00284
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DOI: https://doi.org/10.1203/00006450-200409000-00284