Department of Neonatology, VU University Medical Center, 1117 De Boelelaan, 1081 HV, Amsterdam, Netherlands.
Am J Clin Nutr. 2013 Aug;98(2):556S-60S. doi: 10.3945/ajcn.112.045039.
Recent nutritional research in very-low-birth-weight (VLBW) infants is focused on the prevention of protein malnutrition during the first postnatal weeks. At this early age, nutritional protein fortification depends on amino acid infusion via a central vein because of the immature gastrointestinal tract. In 2010 new guidelines on nutrition were proposed by the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition nutrition committee. In particular, the relative increase in the protein fraction in the nutrition of these infants aims to prevent early postnatal weight loss, to prevent morbidity, and to stimulate neurodevelopment. On the other hand, an increasing number of follow-up studies in VLBW infants indicate that, in particular, those infants who show rapid growth after preterm birth are at risk of metabolic consequences and cardiovascular disease later in life. In this review, we describe the quest to develop a customized diet that offers optimal nutrition at several time points of growth and development during the first year of life. This diet should prevent early malnutrition, enhance neurodevelopment, and limit the increase in total body fat during the first 6 mo. We question whether one type of early diet suffices for normal neurodevelopment with a normal body composition in later life or whether we need several types of diet at various stages of development.
最近极低出生体重（VLBW）婴儿的营养研究重点是预防出生后最初几周的蛋白质营养不良。由于胃肠道不成熟，此时营养蛋白质强化依赖于通过中心静脉输注氨基酸。2010 年，欧洲儿科胃肠病学、肝病学和营养学会营养委员会提出了新的营养指南。特别是，这些婴儿营养中蛋白质部分的相对增加旨在预防早期的体重减轻，预防发病，并刺激神经发育。另一方面，越来越多的 VLBW 婴儿的随访研究表明，特别是那些在早产出生后快速生长的婴儿，他们以后有患代谢并发症和心血管疾病的风险。在这篇综述中，我们描述了寻求开发一种定制饮食的过程，该饮食在生命的第一年的几个生长和发育时间点提供最佳营养。这种饮食应预防早期营养不良，促进神经发育，并在最初 6 个月限制总体脂肪增加。我们质疑一种早期饮食是否足以满足正常的神经发育和以后生活中正常的身体成分，或者我们是否需要在不同的发育阶段使用几种类型的饮食。
