van Goudoever J B, Sulkers E J, Lafeber H N, Sauer P J
Department of Pediatrics, Academic Hospital Rotterdam/Sophia Children's Hospital, Rotterdam Netherlands.
Am J Clin Nutr. 2000 Mar;71(3):816-21. doi: 10.1093/ajcn/71.3.816.
Currently available preterm formulas with energy contents of 3350 kJ (800 kcal)/L promote weight and length gain at rates at or above intrauterine growth rates but disproportionately increase total body fat.
The objective of this study was to determine whether fat accretion in formula-fed, very-low-birth-weight (VLBW) infants could be decreased and net protein gain maintained by reducing energy intakes from 502 kJ (80 kcal)*kg(-)(1)*d(-)(1) [normal-energy (NE) formula] to 419 kJ (100 kcal)*kg(-)(1)d(-)(1) [low-energy (LE) formula] while providing similar protein intakes (3.3 gkg(-)(1)*d(-)(1)).
The study was a randomized, controlled trial enrolling 20 appropriate-for-gestational-age (AGA) and 16 small-for-gestational-age (SGA) VLBW infants (mean birth weight: 1.1 kg; mean gestational age: 31 wk); energy expenditure and nutrient balance were measured at 4 wk of age and anthropometric measurements were made when infants weighed 2 kg.
The percentage of fat in newly formed tissue was significantly lower in AGA infants fed the LE formula (n = 9) than in those fed the NE formula (n = 10) (9% compared with 23%; analysis of variance, P = 0.001). Energy expenditure was higher in AGA infants fed the NE formula than in those fed the LE formula. Skinfold thickness was markedly lower in AGA infants fed the LE formula than in those fed the NE formula, resulting in a lower estimated percentage body fat (8.0 +/- 1.9% and 10.8 +/- 3.5%, respectively; P < 0.05). Three of 6 SGA infants fed the LE formula were excluded during the study because of poor weight gain.
Body composition can easily be altered by changing the energy intakes of formula-fed VLBW infants. Energy intakes in these infants should be >419 kJ (100 kcal)*kg(-)(1)*d(-)(1).
目前能量含量为3350千焦（800千卡）/升的早产配方奶粉能使体重和身长的增长速度达到或超过子宫内生长速度，但会不成比例地增加全身脂肪。
本研究的目的是确定对于配方奶喂养的极低出生体重（VLBW）婴儿，将能量摄入量从502千焦（80千卡）·千克⁻¹·天⁻¹[正常能量（NE）配方奶粉]降至419千焦（100千卡）·千克⁻¹·天⁻¹[低能量（LE）配方奶粉]，同时提供相似的蛋白质摄入量（3.3克·千克⁻¹·天⁻¹），是否能减少脂肪堆积并维持净蛋白质增加量。
该研究为一项随机对照试验，纳入了20名适于胎龄（AGA）和16名小于胎龄（SGA）的极低出生体重婴儿（平均出生体重：1.1千克；平均胎龄：31周）；在4周龄时测量能量消耗和营养平衡，当婴儿体重达到2千克时进行人体测量。
喂养低能量配方奶粉的适于胎龄婴儿（n = 9）新形成组织中的脂肪百分比显著低于喂养正常能量配方奶粉的婴儿（n = 10）（分别为9%和23%；方差分析，P = 0.001）。喂养正常能量配方奶粉的适于胎龄婴儿的能量消耗高于喂养低能量配方奶粉的婴儿。喂养低能量配方奶粉的适于胎龄婴儿的皮褶厚度明显低于喂养正常能量配方奶粉的婴儿，导致估计的体脂百分比更低（分别为8.0±1.9%和10.8±3.5%；P < 0.05）。在研究期间，6名喂养低能量配方奶粉的小于胎龄婴儿中有3名因体重增加不佳被排除。
通过改变配方奶喂养的极低出生体重婴儿的能量摄入量，可以轻松改变身体成分。这些婴儿的能量摄入量应>419千焦（100千卡）·千克⁻¹·天⁻¹。
