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Brinkis R, Albertsson-Wikland K, Šmigelskas K, Vanckavičienė A, Aldakauskienė I, Tamelienė R, Verkauskienė R. Impact of Nutrient Intake on Body Composition in Very Low-Birth Weight Infants Following Early Progressive Enteral Feeding. Nutrients 2024; 16:1462. [PMID: 38794701 PMCID: PMC11124094 DOI: 10.3390/nu16101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Preterm infants have increased body adiposity at term-equivalent age and risk of adverse metabolic outcomes. The aim of the study was to define how nutrient intake may impact body composition (BC) of very low-birth weight infants fed with early progressive enteral feeding and standard fortification. Eighty-six infants with <1500 g birth weight were included in the BC study and stratified into extremely preterm (EP) and very preterm (VP) groups. Nutrient intake was calculated during the first 28 days and BC assessed by dual X-ray absorptiometry at discharge and by skinfold thickness at 12 months of corrected age (CA). Total nutrient intake did not differ between the groups. EP infants had a higher fat mass percentage at discharge than VP infants (24.8% vs. 19.4%, p < 0.001); lean mass did not differ. None of the nutrients had any impact on BC of EP infants. Protein intake did not result in a higher lean mass in either group; fat intake was a significant predictor of increased fat mass percentage in VP infants at discharge (p = 0.007) and body adiposity at 12 months of CA (p = 0.021). Nutritional needs may depend on gestational age and routine fortification should be used with caution in more mature infants.
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Affiliation(s)
- Rasa Brinkis
- Department of Neonatology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (I.A.); (R.T.)
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden;
| | - Kastytis Šmigelskas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Aurika Vanckavičienė
- Department of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Ilona Aldakauskienė
- Department of Neonatology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (I.A.); (R.T.)
| | - Rasa Tamelienė
- Department of Neonatology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (I.A.); (R.T.)
| | - Rasa Verkauskienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
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Pan S, Yu W, Zhang J, Guo Y, Qiao X, Xu P, Zhai Y. Environmental chemical TCPOBOP exposure alters milk liposomes and offspring growth trajectories in mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116061. [PMID: 38340598 DOI: 10.1016/j.ecoenv.2024.116061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
Exposure to environmental endocrine disruptors (EEDs) has become a global health concern, and EEDs are known to be potent inducers of constitutive androstane receptor (CAR). 1,4-bis [2-(3,5-dichloropyridyloxy)] benzene (TCPOBOP, hereafter abbreviated as TC), a specific ligand for CAR, has been considered as a potential EED. Here, we analyzed the effect of TC exposure to female mice on the histological morphology of their alveoli in the basic unit of lactation. We quantified differences in the milk metabolome of the control and TC-exposed group while assessing the correlations between metabolites and neonatal growth. Mammary histological results showed that TC exposure inhibited alveolar development. Based on the milk metabolomic data, we identified a total of 1505 differential metabolites in both the positive and negative ion mode, which indicated that TC exposure affected milk composition. As expected, the differential metabolites were significantly enriched in the drug metabolism pathway. Further analyses revealed that differential metabolites were significantly enriched in multiple lipid metabolic pathways, such as fatty acid biosynthesis, suggesting that most differential metabolites were concentrated in lipids. Simultaneously, a quantitative analysis showed that TC exposure led to a decrease in the relative abundance of total milk lipids, affecting the proportion of some lipid subclasses. Notably, a portion of lipid metabolites were associated with neonatal growth. Taken together, these findings suggest that TC exposure may affect milk lipidomes, resulting in the inability of mothers to provide adequate nutrients, ultimately affecting the growth and health of their offspring.
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Affiliation(s)
- Shijia Pan
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
| | - Wen Yu
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
| | - Jia Zhang
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
| | - Yuan Guo
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
| | - Xiaoxiao Qiao
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
| | - Pengfei Xu
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan 430071, China; Center for Pharmacogenetics and Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | - Yonggong Zhai
- Beijing Key Laboratory of Gene Resource and Molecular Development, College of Life Sciences, Beijing Normal University, Beijing 100875, China; Key Laboratory for Cell Proliferation and Regulation Biology of State Education Ministry, College of Life Sciences, Beijing Normal University, Beijing 100875, China.
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Zhou F, Cheng T, Xing Y, Ma H, Yang L. Network exploration of gene signatures underlying low birth weight induced metabolic alterations. Medicine (Baltimore) 2022; 101:e31489. [PMID: 36316897 PMCID: PMC9622720 DOI: 10.1097/md.0000000000031489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study explored underlying gene signatures of low birth weight (LBW) by analyzing differentially expressed genes (DEGs) between LBW and normal birth weight (NBW) subjects. METHODS Subjects with different birth weight was collected from GEO database. P < .05 and | logFC | ≥ 1.0 were used for screening DEGs. David (2021 Update) was used to perform GO annotation and KEGG signaling pathway enrichment analysis. The protein-protein interaction network of DEGs was constructed using the STRING database, in which hub genes were mined through Cytoscape software. RESULTS A total of 326 DEGs were identified, including 287 up-regulated genes and 39 down-regulated genes. The GO biological processes enriched by DEGs mainly involved epidermal growth, keratinization and intermediate fibrous tissue. The DEGs were significantly enriched in intracellular insoluble membranes, desmosomes and extracellular space. Their molecular functions mainly focused on structural molecular activity, structural components of epidermis and structural components of cytoskeleton. PI3K/AKT signaling pathway and tight junction were highlighted as critical pathways enriched by DEGs. Ten hub genes which included KRT14, EGF, DSP, DSG1, KRT16, KRT6A, EPCAM, SPRR1B, PKP1, and PPL were identified from the constructed protein-protein interaction network. CONCLUSION A total of 326 DEGs and 10 hub genes were identified as candidates for metabolic disorders in LBW individuals. Our results indicated PI3K/AKT signaling pathway as an intrauterine adaptive mechanism for LBW individuals. We observed activated PI3K/AKT pathway in LBW individuals, which would promote growth and development at the early stage of life, but adversely introduce extra metabolic stress and thereby potentially induce metabolic disorders in adulthood.
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Affiliation(s)
- Fei Zhou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Tiantian Cheng
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yuling Xing
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Huijuan Ma
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
- *Correspondence: Huijuan Ma, Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, (e-mail: )
| | - Linlin Yang
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China
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Casirati A, Somaschini A, Perrone M, Vandoni G, Sebastiani F, Montagna E, Somaschini M, Caccialanza R. Preterm birth and metabolic implications on later life: A narrative review focused on body composition. Front Nutr 2022; 9:978271. [PMID: 36185669 PMCID: PMC9521164 DOI: 10.3389/fnut.2022.978271] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Preterm newborn infants are characterized by low body weight and lower fat mass at birth compared with full-term newborn neonates. Conversely, at term corrected age, body fat mass is more represented in preterm newborn infants, causing a predisposition to developing metabolic syndrome and cardiovascular diseases in later life with a different risk profile in men as compared with women. Postnatal growth is a complex change in anthropometric parameters and body composition. Both quantity and quality of growth are regulated by several factors such as fetal programming, early nutrition, and gut microbiota. Weight gain alone is not an optimal indicator of nutritional status as it does not accurately describe weight quality. The analysis of body composition represents a potentially useful tool to predict later metabolic and cardiovascular risk as it detects the quality of growth by differentiating between fat and lean mass. Longitudinal follow-up of preterm newborn infants could take advantage of body composition analysis in order to identify high-risk patients who apply early preventive strategies. This narrative review aimed to examine the state-of-the-art body composition among born preterm children, with a focus on those in the pre-school age group.
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Affiliation(s)
- Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- *Correspondence: Amanda Casirati,
| | - Alberto Somaschini
- Division of Cardiology and Cardiac Intensive Care Unit, San Paolo Hospital, Savona, Italy
| | - Michela Perrone
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Vandoni
- Clinical Nutrition, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Federica Sebastiani
- Endocrinology and Metabolic Diseases, Azienda USL IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Montagna
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Córdoba-Rodríguez DP, Iglesia I, Gómez-Bruton A, Álvarez Sauras ML, Miguel-Berges ML, Flores-Barrantes P, Casajús JA, Moreno LA, Rodríguez G. Early Life Factors Associated with Lean Body Mass in Spanish Children: CALINA Study. CHILDREN 2022; 9:children9050585. [PMID: 35626762 PMCID: PMC9139173 DOI: 10.3390/children9050585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022]
Abstract
Early life is critical for the programming of body composition. The literature links perinatal factors with fat mass development and its future effects (e.g., obesity); however, little evidence exists between early life factors and lean body mass (LBM). This study follows up on a cohort of 416 Spanish children at ages six to eight, previously evaluated at birth in the CALINA study. Here, we studied the association between early life factors, LBM, and limb strength. Parental origin/nutritional status, maternal smoking during pregnancy, gestational diabetes/weight gain/age, birth weight (BW), early feeding, and rapid weight gain (RWG) were collected from primary care records. Bioimpedance analysis, dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and a handgrip/standing long jump test were used to assess fat-free mass index (FFMI), total lean soft tissue mass index (TLSTMI), muscle cross-sectional area index (MCSAI), and limb strength, respectively. In girls, maternal smoking, gestational age, and BW were positively associated with FFM/LSTM. In boys, the parents’ BMI, BW, and RWG were positively associated with FFM/LSTM. BW was associated with handgrip strength in both. Maternal BMI in girls and RWG in boys were negatively associated with the standing long jump. Early life programming plays a key role in determining LBM in children.
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Affiliation(s)
- Diana Paola Córdoba-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain;
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0012, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-876843756
| | - Alejandro Gómez-Bruton
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y del Deporte (FCSD), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, 28029 Madrid, Spain
| | | | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
| | - José Antonio Casajús
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain;
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud y del Deporte (FCSD), Universidad de Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, 28029 Madrid, Spain
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain;
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, 28029 Madrid, Spain
| | - Gerardo Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, 50009 Zaragoza, Spain; (A.G.-B.); (M.L.M.-B.); (P.F.-B.); (J.A.C.); (L.A.M.); (G.R.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain;
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Área de Pediatría, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Murano Y, Shoji H, Ikeda N, Okawa N, Hayashi K, Kantake M, Morisaki N, Shimizu T, Gilmour S. Analysis of Factors Associated With Body Mass Index at Ages 18 and 36 Months Among Infants Born Extremely Preterm. JAMA Netw Open 2021; 4:e2128555. [PMID: 34648012 PMCID: PMC8517745 DOI: 10.1001/jamanetworkopen.2021.28555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE The development of neonatology has been associated with improved survival among infants born extremely preterm, and understanding their long-term outcomes is becoming increasingly important. However, there is little information on body mass index (BMI) among these children. OBJECTIVE To determine factors associated with BMI at ages 18 months and 36 months among infants born extremely preterm. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study was conducted using data from the Neonatal Research Network Japan database for 8838 infants born at gestational ages 23 to 28 weeks with data on BMI at 18 months and 36 months. Data were analyzed from April 2018 through June 2021. EXPOSURES BMI and BMI z score at ages 18 months and 36 months were regressed with gestational age, intrauterine growth restriction (IUGR) status, and complications during pregnancy and the neonatal period separately by presence of multiple pregnancy and sex. MAIN OUTCOMES AND MEASURES BMI and BMI z score at ages 18 months and 36 months. RESULTS Among 16 791 eligible infants born extremely preterm, 8838 infants were included in the analysis. There were 7089 infants born from single pregnancies (mean [SD] gestational age, 26.0 [1.6] weeks; 3769 [53.2%] boys; mean [SD] birth weight, 847 [228] g) and 1749 infants born from multiple pregnancies (mean [SD] gestational age, 26.3 [1.5] weeks; 903 [51.6%] boys; mean [SD] birth weight, 860 [217] g). In single pregnancies, every week of increased gestational age was associated with an increase in BMI of 0.21 (95% CI, 0.17-0.25) among boys and 0.20 (95% CI, 0.15-0.25) among girls at age 18 months and 0.21 (95% CI, 0.18-0.24) among boys and 0.21 (95% CI, 0.18-0.24) among girls at age 36 months. There was an interaction association between gestational age and IUGR among boys at age 36 months, with a decrease in the change associated with gestational age of 0.12 (95% CI, 0.05-0.19). Every week of increased gestational age in single pregnancies was associated with an increase in BMI z score of 0.14 (95% CI, 0.17-0.21) among boys and 0.17 (95% CI, 0.13-0.21) among girls at age 18 months and 0.19 (95% CI, 0.16-0.22) among boys and 0.17 (95% CI, 0.15-0.20) among girls at age 36 months. Among single pregnancies, IUGR was associated with a decrease in BMI among boys (0.59 [95% CI, 0.23-0.95]) and girls (0.75 [95% CI, 0.39-1.11]) and BMI z score among boys 0.85 [95% CI, 0.25-0.95)] and girls (0.67 [95% CI, 0.36-0.97] at age 18 months and BMI among boys (0.44 [95% CI, 0.17-0.18]) and girls (0.84 [95% CI, 0.55-1.12]) and BMI z score among boys (0.46 [95% CI, 0.21-0.71]) and girls (0.77 [95% CI, 0.53-1.01]) at age 36 months. In multiple pregnancies, IUGR was associated with a decrease in BMI z score at age 36 months among boys (0.26 [95% CI, 0.42-0.89]) and girls (0.29 [95% CI, 0.22-0.79]). In single pregnancies intraventricular hemorrhage (IVH) was associated with a decrease in BMI of 0.47 (95% CI, 0.21-0.73) among boys and 0.42 (95% CI, 0.13-0.71) among girls at age 18 months and 0.53 (95% CI, 0.32-0.74) among boys and 0.31 (95% CI, 0.07-0.54) among girls at age 36 months. IVH was associated with a decrease in BMI z score in single pregnancies of 0.63 (95% CI, 0.20-0.41) among boys and 0.35 (95% CI, 0.12-0.60) among girls at age 18 months and 0.53 (95% CI, 0.34-0.71) among boys and 0.30 (95% CI, 0.11-0.50) among girls at age 36 months. Similar associations were seen in multiple pregnancies. CONCLUSIONS AND RELEVANCE This study found that gestational age, the presence of IUGR and multiple pregnancy, and IVH complications were associated with infant BMI at ages 18 months and 36 months. These findings suggest that these complicating factors should be considered when setting growth targets and nutrition strategies for infants born extremely preterm.
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Affiliation(s)
- Yayoi Murano
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
| | - Hiromichi Shoji
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Naho Ikeda
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Natsuki Okawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kuniyoshi Hayashi
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
| | - Masato Kantake
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Akashi-cho, Chuo-ku, Tokyo, Japan
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Wiechers C, Doll JN, Maas C, Gründler K, Büchner K, Poets CF, Franz AR. Enteral feeding advancement and growth until 5 years in extremely preterm infants. BMC Pediatr 2021; 21:420. [PMID: 34556084 PMCID: PMC8459503 DOI: 10.1186/s12887-021-02878-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background In-utero weight gain can be achieved in very preterm infants through rapid advancement of enteral feeds without increasing risk of necrotizing enterocolitis. There are concerns, however, that such rapid weight gain may lead to an increased childhood adiposity risk, although long-term data are sparse. Design This retrospective observational study included two well-characterized cohorts comprising 145 infants born at < 28 weeks or with < 1000 g birth weight. We investigated associations between advancing enteral feeding volumes in daily increments of 15–20 ml/kg (Cohort 1, n = 84, born in 2006/2007) vs. 25–30 ml/kg (Cohort 2, n = 61, born in 2010) and growth up to 5 years of age. Results There was no significant difference in anthropometric parameters post discharge to 5 years between both cohorts. Standard deviation score (SDS) weight and SDS BMI at the age of 5 years remained lower than in the reference population. SDS weight decreased from discharge to about 10–12 months postnatal age and returned to birth values by age 5 years. There was a catch-up for SDS length/height from discharge to 5 years; SDS head circumference decreased from birth to 5 years. Multiple regression analyses revealed that for all anthropometric parameters SDS at birth was the most important predictor for SDS at 5 years. Early parenteral protein intake may be another important factor, at least for head growth. Conclusions Growth was similar in both cohorts without benefit from more accelerated feeding advancement in cohort 2. In both cohorts, early enteral nutrition was associated with in-hospital weight gain as in utero, a drop in weight SDS post discharge and catch-up to birth SDS until age 5 years, remaining below the reference population. Length showed catch-up form discharge to 5 years, whereas head circumference progressively deviated from the reference population. Increased parenteral protein supplementation may be needed to accompany early enteral feeding advancements.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Jan-Niklas Doll
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Christoph Maas
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Kerstin Gründler
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Katja Büchner
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Christian F Poets
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany.
| | - Axel R Franz
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076, Tuebingen, Germany.,Center for Pediatric Clinical Studies, University Children's Hospital, Eberhard Karls University, Tuebingen, Germany
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8
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Nsamba J, Lule SA, Namara B, Zziwa C, Akurut H, Lubyayi L, Akello F, Tumusiime J, Elliott AM, Webb EL. Effect of birth weight, exclusive breastfeeding and growth in infancy on fat mass and fat free mass indices in early adolescence: an analysis of the Entebbe Mother and Baby Study (EMaBs) cohort. AAS Open Res 2020; 2:11. [PMID: 32259024 PMCID: PMC7118828 DOI: 10.12688/aasopenres.12947.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2019] [Indexed: 12/02/2022] Open
Abstract
Background: There is limited data from Africa on the effect of pre- and post-natal growth and infant feeding on later body composition. This study's aim was to investigate the effect of birth weight, exclusive breastfeeding and infant growth on adolescent body composition, using data from a Ugandan birth cohort. Methods: Data was collected prenatally from pregnant women and prospectively from their resulting live offspring. Data on body composition (fat mass index [FMI] and fat free mass index [FFMI]) was collected from 10- and 11-year olds. Linear regression was used to assess the effect of birth weight, exclusive breastfeeding and infant growth on FMI and FFMI, adjusting for confounders. Results: 177 adolescents with a median age of 10.1 years were included in analysis, with mean FMI 2.9 kg/m
2 (standard deviation (SD) 1.2), mean FFMI 12.8 kg/m
2 (SD 1.4) and mean birth weight 3.2 kg (SD 0.5). 90 (50.9%) were male and 110 (63.2%) were exclusively breastfeeding at six weeks of age. Birth weight was associated with FMI in adolescence (regression coefficient β= 0.66 per kg increase in birth weight, 95% confidence interval (CI) (0.04, 1.29), P=0.02), while exclusive breastfeeding (β= -0.43, 95% CI (-1.06, 0.19), P=0.12), growth 0-6 months (β= 0.24 95% CI (-0.43, 0.92), P=0.48) and growth 6-12 months (β= 0.61, 95% CI (-0.23, 1.46), P=0.11) were not associated with FMI among adolescents. Birth weight (β= 0.91, 95% CI (0.17, 1.65), P=0.01) was associated with FFMI in adolescence. Exclusive breastfeeding (β= 0.17, 95% CI (-0.60, 0.94), P=0.62), growth 0-6 months (β= 0.56, 95% CI (-0.20, 1.33), P= 0.10), and growth 6-12 months (β= -0.02, 95% CI (-1.02, 0.99), P=0.97) were not associated with FFMI. Conclusions: Birth weight predicted body composition parameters in Ugandan early adolescents, however, exclusive breastfeeding at six weeks of age and growth in infancy did not.
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Affiliation(s)
- Jonathan Nsamba
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, Keppel Street, WC1E 7HT, UK.,Department of Clinical Research, Jeuticals Research and Consulting (U) Ltd, Kampala, Uganda
| | - Swaib A Lule
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.,Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Benigna Namara
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Christopher Zziwa
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Hellen Akurut
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Lawrence Lubyayi
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Florence Akello
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Josephine Tumusiime
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda
| | - Alison M Elliott
- Immunomodulation and Vaccines Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, P.O. Box 49, Entebbe, Uganda, Uganda.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.,Medical Research Council Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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9
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Lin L, Amissah E, Gamble GD, Crowther CA, Harding JE. Impact of macronutrient supplements on later growth of children born preterm or small for gestational age: A systematic review and meta-analysis of randomised and quasirandomised controlled trials. PLoS Med 2020; 17:e1003122. [PMID: 32453739 PMCID: PMC7250404 DOI: 10.1371/journal.pmed.1003122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nutritional supplements may improve short-term growth of infants born small (preterm or small for gestational age), but there are few data on long-term effects and concerns that body composition may be adversely affected. Effects also may differ between girls and boys. Our systematic review and meta-analysis assessed the effects of macronutrient supplements for infants born small on later growth. METHODS AND FINDINGS We searched OvidMedline, Embase, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from inception to January 30, 2020, and controlled-trials.com, clinicaltrials.gov, and anzctr.org.au on January 30, 2020. Randomised or quasirandomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born small and growth was assessed after discharge. Primary outcome was body mass index (BMI) in childhood. Data were pooled using random-effect models. Outcomes were evaluated in toddlers (< 3 years), childhood (3 to 8 years), adolescence (9 to 18 years), and adulthood (>18 years). Forty randomised and 2 quasirandomised trials of variable methodological quality with 4,352 infants were included. Supplementation did not alter BMI in childhood (7 trials, 1,136 children; mean difference [MD] -0.10 kg/m2, [95% confidence interval (CI) -0.37 to 0.16], p = 0.45). In toddlers, supplementation increased weight (31 trials, 2,924 toddlers; MD 0.16 kg, [0.01 to 0.30], p = 0.03) and length/height (30 trials, 2,889 toddlers; MD 0.44 cm, [0.10 to 0.77], p = 0.01), but not head circumference (29 trials, 2,797 toddlers; MD 0.15 cm, [-0.03 to 0.33], p = 0.10). In childhood, there were no significant differences between groups in height (7 trials, 1,136 children; MD 0.22 cm, [-0.48 to 0.92], p = 0.54) or lean mass (3 trials, 354 children; MD -0.07 kg, [-0.98 to 0.85], p = 0.88), although supplemented children appeared to have higher fat mass (2 trials, 201 children; MD 0.79 kg, [0.19 to 1.38], p = 0.01). In adolescence, there were no significant differences between groups in BMI (2 trials, 216 adolescents; MD -0.48 kg/m2, [-2.05 to 1.08], p = 0.60), height (2 trials, 216 adolescents; MD -0.55 cm, [-2.95 to 1.86], p = 0.65), or fat mass (2 trials, 216 adolescents; MD -1.3 5 kg, [-5.76 to 3.06], p = 0.55). In adulthood, there also were no significant differences between groups in weight z-score (2 trials, 199 adults; MD -0.11, [-0.72 to 0.50], p = 0.73) and height z-score (2 trials, 199 adults; MD -0.07, [-0.36 to 0.22], p = 0.62). In subgroup analysis, supplementation was associated with increased length/height in toddler boys (2 trials, 173 boys; MD 1.66 cm, [0.75 to 2.58], p = 0.0003), but not girls (2 trials, 159 girls; MD 0.15 cm, [-0.71 to 1.01], p = 0.74). Limitations include considerable unexplained heterogeneity, low to very low quality of evidence, and possible bias due to low or unbalanced followup. CONCLUSIONS In this systematic review and meta-analysis, we found no evidence that early macronutrient supplementation for infants born small altered BMI in childhood. Although supplements appeared to increase weight and length in toddlers, effects were inconsistent and unlikely to be clinically significant. Limited data suggested that supplementation increased fat mass in childhood, but these effects did not persist in later life. PROSPERO registration: CRD42019126918.
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Affiliation(s)
- Luling Lin
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Emma Amissah
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Jane E. Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
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10
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Chen Y, Wang Y, Chen Z, Xin Q, Yu X, Ma D. The effects of rapid growth on body mass index and percent body fat: A meta-analysis. Clin Nutr 2020; 39:3262-3272. [PMID: 32151438 DOI: 10.1016/j.clnu.2020.02.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/12/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND & AIMS Rapid growth in childhood and obesity are highly prevalent in congenital deficiency infants, but the associations between them remain controversial. This meta-analysis was performed to explore the effects of rapid growth on body mass index (BMI) and percent body fat (PBF), and to clarify potential confounders. METHODS A systematic search was performed using electronic databases including EMBASE (1985 to July 2019) and Medline (1966 to July 2019) for English articles. China National Knowledge Infrastructure Chinese citation database (CNKI) and WANFANG database were used to search articles in Chinese. Reference lists were also screened as supplement. All relevant studies that compare BMI or PBF between rapid group and control group were identified. The definition of rapid growth should be clearly specified. Means and standard deviations/95% confidence intervals (CIs) of BMI and PBF should be available. Relevant information was extracted independently by two reviewers. Study quality was reassessed using the Newcastle-Ottawa Scale. Publication bias and heterogeneity were detected. The random effect model was adopted for combined and stratified analysis. RESULTS About the effect of rapid growth on BMI, seventeen researches (4473 participants) involving 49 comparisons were included. Pooled analysis showed rapid group had higher BMI of 0.573 (95% CI, 0.355 to 0.791; P < 0.001). Stratified analyses revealed that catch-up weight gain, follow-up age >6 years old, rapid growth duration >2 years, full-term, comparing rapid growth SGA infants with control SGA infants, and from developed and developing countries, would all lead to higher BMI in rapid groups. About the effect of rapid growth on PBF, eleven researches (4594 participants) involving 37 comparisons were included. Pooled analysis showed rapid group had higher PBF of 2.005 (95% CI, 1.581 to 2.429; P < 0.001). Subgroup analyses suggested that catch-up weight gain, follow-up age ≤6 years old, rapid growth duration >2 years, full-term, comparing rapid growth SGA infants with control AGA infants, and participants from developing countries, would lead to increased PBF in rapid groups. CONCLUSION Rapid growth has a positive correlation with BMI and PBF. However, stratified analyses show that it is catch-up weight gain that lead to higher BMI and PBF, but not catch-up growth. In addition, rapid growth have long-term effect on BMI and short-term effect on PBF. Rapid growth duration longer than 2 years may increase the risk effect of rapid growth on BMI and PBF. But given that rapid growth would induce multiple health outcomes apart from BMI and PBF, the benefits and risks of rapid growth must be carefully considered and weighted.
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Affiliation(s)
- Yunli Chen
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ying Wang
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zekun Chen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Qinghua Xin
- Academy of Occupational Health and Occupational Medicine, Shandong, China
| | - Xue Yu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Defu Ma
- School of Public Health, Peking University Health Science Center, Beijing, China.
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11
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Nakano Y. Adult-Onset Diseases in Low Birth Weight Infants: Association with Adipose Tissue Maldevelopment. J Atheroscler Thromb 2019; 27:397-405. [PMID: 31866623 PMCID: PMC7242223 DOI: 10.5551/jat.rv17039] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Low birth weight (LBW) infants have higher risk of developing insulin resistance and its comorbidities later in life. The concept of “developmental origins of health and disease” suggests that intrauterine and postnatal environments have an important role in increasing these risks. The risk of such adult-onset diseases in LBW infants might be associated with adipose tissue maldevelopment including altered body composition and increased amount of visceral fat, which is the same mechanism as that in children and adults with metabolic syndrome. However, LBW infants often have different characteristics: they are not always overweight or obese over their life course. The inconsistency might be associated with the thrifty phenotype, which is produced in response to impaired growth potential and decreased lean body mass. LBW infants tend to be obese within the limits of impaired growth potential. Through our previous investigations evaluating longitudinal changes in adiponectin levels at an early stage of life, we speculated that probably, the intrauterine life of term infants or the period up to term-equivalent age in preterm infants might be the key age for the development of adipose tissues including fat cells. Because of that, we hypothesized that the smaller number of adipocytes in LBW infants might be associated with overloading of single adipocytes and impaired adipose tissue expandability. The possible mechanisms are discussed from the perspective of adipose tissue maldevelopment in LBW infants.
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Affiliation(s)
- Yuya Nakano
- Department of Pediatrics, Showa University School of Medicine
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12
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Abstract
PURPOSE OF REVIEW A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental programming." A common phenotype in humans and animal models is altered body composition, with reduced muscle and bone mass, and increased fat mass. In this review, we summarize the recent literature linking prenatal factors to future body composition and explore contributing mechanisms. RECENT FINDINGS Many prenatal exposures, including intrauterine growth restriction, extremes of birth weight, maternal obesity, and maternal diabetes, are associated with increased fat mass, reduced muscle mass, and decreased bone density, with effects reported throughout infancy and childhood, and persisting into middle age. Mechanisms and mediators include maternal diet, breastmilk composition, metabolites, appetite regulation, genetic and epigenetic influences, stem cell commitment and function, and mitochondrial metabolism. Differences in body composition are a common phenotype following disruptions to the prenatal environment, and may contribute to developmental programming of obesity and diabetes risk.
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Affiliation(s)
- Elvira Isganaitis
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Research Division, Joslin Diabetes Center, 1 Joslin Place, Room 655A, Boston, 02215, MA, USA.
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13
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Nsamba J, Lule SA, Namara B, Zziwa C, Akurut H, Lubyayi L, Akello F, Tumusiime J, Elliott AM, Webb EL. Effect of birth weight, exclusive breastfeeding and growth in infancy on fat mass and fat free mass indices in early adolescence: an analysis of the Entebbe Mother and Baby Study (EMaBs) cohort. AAS Open Res 2019; 2:11. [DOI: 10.12688/aasopenres.12947.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data from Africa on the effect of pre- and post-natal growth and infant feeding on later body composition. This study's aim was to investigate the effect of birth weight, exclusive breastfeeding and infant growth on adolescent body composition, using data from a Ugandan birth cohort. Methods: Data was collected prenatally from pregnant women and prospectively from their resulting live offspring. Data on body composition (fat mass index [FMI] and fat free mass index [FFMI]) was collected from 10- and 11-year olds. Linear regression was used to assess the effect of birth weight, exclusive breastfeeding and infant growth on FMI and FFMI, adjusting for confounders. Results: 177 adolescents with a median age of 10.1 years were included in analysis, with mean FMI 2.9 kg/m2 (standard deviation (SD) 1.2), mean FFMI 12.8 kg/m2 (SD 1.4) and mean birth weight 3.2 kg (SD 0.5). 90 (50.9%) were male and 110 (63.2%) were exclusively breastfeeding at six weeks of age. Birth weight was associated with FMI in adolescence (regression coefficient β= 0.66 per kg increase in birth weight, 95% confidence interval (CI) (0.04, 1.29), P=0.02), while exclusive breastfeeding (β= -0.43, 95% CI (-1.06, 0.19), P=0.12), growth 0-6 months (β= 0.24 95% CI (-0.43, 0.92), P=0.48) and growth 6-12 months (β= 0.61, 95% CI (-0.23, 1.46), P=0.11) were not associated with FMI among adolescents. Birth weight (β= 0.91, 95% CI (0.17, 1.65), P=0.01) was associated with FFMI in adolescence. Exclusive breastfeeding (β= 0.17, 95% CI (-0.60, 0.94), P=0.62), growth 0-6 months (β= 0.56, 95% CI (-0.20, 1.33), P= 0.10), and growth 6-12 months (β= -0.02, 95% CI (-1.02, 0.99), P=0.97) were not associated with FFMI. Conclusions: Birth weight predicted body composition parameters in Ugandan early adolescents, however, exclusive breastfeeding at six weeks of age and growth in infancy did not.
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14
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Yang HB, Han JW, Youn JK, Oh C, Kim HY, Jung SE. The Optimal Timing of Enterostomy Closure in Extremely Low Birth Weight Patients for Acute Abdomen. Sci Rep 2018; 8:15681. [PMID: 30356166 PMCID: PMC6200749 DOI: 10.1038/s41598-018-33351-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/24/2018] [Indexed: 11/25/2022] Open
Abstract
There are few reports on enterostomy closure (EC) timing for acute abdomen in extremely low birth weight (ELBW) patients. We retrospectively reviewed ELBW patients who underwent enterostomy formation (EF) and subsequent EC. We investigated baseline characteristics, surgical outcomes, and follow-up data of 55 patients and analyzed optimal timing by age at EC, enterostomy duration, and body weight (Bwt) at EC. The minimum p-value approach (MPA) using the Chi-squared test was used to determine each cut-off value. Mean gestational age was 25+3 weeks, while mean age and Bwt at EF were 10 days and 660 g. Enterostomy duration and Bwt at EC were 102 days and 2400 g. Fourteen surgical complications were related to EC. The MPA identified a cut-off of 2100 g (p = 0.039) at EC but no significant cut-off age or enterostomy duration. The 18 patients <2100 g had more enterostomy-related problems at EC than the >2100 g group (66.7% vs 10.8%, p < 0.001). No other characteristics were significantly different. Operation time, ventilator period, hospital stay, parenteral nutrition duration, and full feeding day were significantly longer in <2100 g patients. Follow-up Bwt did not differ (11.55 kg vs 13.95 kg, p = 0.324). Our findings suggest EC can be safely performed when Bwt is over 2100 g.
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Affiliation(s)
- Hee-Beom Yang
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Ji-Won Han
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Joong Kee Youn
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Chaeyoun Oh
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University, College of Medicine, Seoul, Korea.
| | - Sung Eun Jung
- Department of Pediatric Surgery, Seoul National University, College of Medicine, Seoul, Korea
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15
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Earlier achievement of full enteral feeding in extremely low birth weight neonates is not associated with growth improvement in the first 2 years of life. Eur J Pediatr 2018; 177:1247-1254. [PMID: 29850934 DOI: 10.1007/s00431-018-3178-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022]
Abstract
UNLABELLED Limiting the number of days until achievement of full enteral feeding in extremely low birth weight neonates (ELBW; < 1000 g) might affect growth in the first years of life. This study compared the Z scores in growth over time of two cohorts of ELBW neonates that were comparable on maternal and neonatal characteristics and characteristics of hospitalization, but differed in enteral feeding strategy during neonatal admission. In the 2010-2014 cohort, full enteral feeding was achieved on average 16 days earlier than in the 2000-2005 cohort. In both cohorts, weight, height, and head circumference were recorded at birth and at the corrected ages of 9 and 24 months. A linear mixed model with repeated measures controlling for neonates small for gestational age showed no significant effect of different strategies in achievement of full enteral feeding on any anthropometric Z scores over time. Although full enteral feeding was achieved earlier in the 2010-2014 cohort, this was not associated with growth patterns during the first two years of life. CONCLUSION The effect of a change in strategy to achieve full enteral feeding at an earlier stage in ELBW neonates was assessed. Early enteral feeding strategies do not necessarily improve growth during the first two years of life. What is Known: • Feeding strategies during neonatal stay may affect growth in the first years of life. • Strategies to achieve full enteral feeding earlier were implemented, but data on the impact on subsequent growth after discharge are limited. What is New: • Full enteral feeding was achieved earlier, but this was not associated with improved growth during the first 2 years of life after discharge. • Early enteral feeding strategies do not necessarily improve growth during the first 2 years of life.
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Parlapani E, Agakidis C, Karagiozoglou-Lampoudi T. Anthropometry and Body Composition of Preterm Neonates in the Light of Metabolic Programming. J Am Coll Nutr 2018; 37:350-359. [PMID: 29425475 DOI: 10.1080/07315724.2017.1400479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The improved survival of preterm infants has led to increased interest regarding their health as adults. In the context of metabolic programming, the connection between perinatal and early postnatal nutrition and growth with health in later life has brought to the fore the role of catch-up growth during the first months of preterm infants' lives and its association with body fat and obesity in childhood or puberty. A state-of-the art review was conducted in order to assess the way catch-up is evaluated, in terms of timing and rate. Adequate growth is of major importance for neurodevelopment; however, it may compete with adiposity or metabolic health. Studies based on body composition assessment have given conflicting results as regards the effect of early versus late and rapid versus slow catch-up growth on later health, mainly attributed to the lack of established criteria and definitions. Given that adequate early nutrition is crucial for the neurodevelopment of preterm infants, further studies are needed on the role of catch-up growth in long-term outcome, using generally accepted qualitative and quantitative criteria.
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Affiliation(s)
- Elisavet Parlapani
- a Clinical Nutrition Lab, Nutrition/Dietetics Department , Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , Greece.,b 1st Department of Neonatology and NICU , Faculty of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki , Greece
| | - Charalampos Agakidis
- c 1st Department of Pediatrics , Faculty of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital , Thessaloniki , Greece
| | - Thomais Karagiozoglou-Lampoudi
- a Clinical Nutrition Lab, Nutrition/Dietetics Department , Alexander Technological Educational Institute of Thessaloniki , Thessaloniki , Greece
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