Abstract
Background/Objective
To investigate impacts of early postnatal macronutrient intakes on growth and body composition of preterm infants within the first 6 months.
Subjects/Methods
One hundred and thirty-three very preterm (VPT) and/or very low birth weight (VLBW) infants were consecutively included. Enteral and parenteral macronutrient intakes during the first 28 days were recorded and average daily intakes were calculated. Growth was measured at birth, term age, and 6 months of corrected age (CA). Body composition was examined by air displacement plethysmograph at term age and 6 months of CA. Associations of nutrient intakes with growth and body composition over time were analyzed using generalized estimating equation.
Results
After adjusting for covariates, higher daily protein, lipid, and energy intake during the first 28 days was associated with higher weight at term age for every 1 g/kg/day increment of protein and lipid intake, and every 10 kcal/kg/day increment of energy intake was associated with 0.50 (95% CI 0.04, 0.96), 0.29 (95% CI 0.07, 0.51), and 0.27 (95% CI 0.10, 0.44) higher weight z-score, respectively. Higher protein intake was associated with lower z-score of fat mass (FM, β = −1.88, 95% CI −3.53, −0.23) and percentage of body fat (PBF, β = −2.18, 95% CI −3.98, −0.39) at 6 months of CA, but higher lipid and carbohydrate intake was associated with higher FM and PBF z-scores at 6 months of CA.
Conclusions
Macronutrient intakes during the first month of life have impacts on growth and body composition before 6 months of age. Higher daily protein intake is associated with a better growth and healthier body composition for VPT/VLBW infants.
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Acknowledgements
The authors would like to thank the other staff of Neonatal Department and Child Healthcare Department of Children’s Hospital of Fudan University who are not included in the authors’ list. The authors are also grateful for the time of families who participated.
Funding
This study is supported by CAMS Innovation Fund for Medical Sciences (2019-I2M-5-002).
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WY and YC conceived and designed the study and guided the manuscript writing as corresponding authors. JH participated in the study design, data collection, and drafted the manuscript mainly. LZ and SL took part in the data collection at follow-up visits. YZ and YJ contributed in analyzing data and making charts. XC, YW, and YD merged the databases and participated in data analyses. PD and YL contributed in the body composition test. All authors were involved in results interpretation and final approval before the submission.
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This study was approved by the institution ethics committee. Oral informed consents were obtained from the guardians of eligible infants.
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Han, J., Zhang, L., Li, S. et al. Associations of early nutrition with growth and body composition in very preterm infants: a prospective cohort study. Eur J Clin Nutr 76, 103–110 (2022). https://doi.org/10.1038/s41430-021-00901-w
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DOI: https://doi.org/10.1038/s41430-021-00901-w