The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Horm Res Paediatr. 2023;96(3):278-288. doi: 10.1159/000526671. Epub 2022 Sep 5.
Adequate nutrition plays an important role in linear growth throughout childhood, including puberty. However, not all children are willing or able to consume an adequate and balanced diet daily. We aimed to evaluate the 1-year effectiveness and safety of nutritional supplementation on linear growth, weight gain, and changes in body composition in short and lean peripubertal boys.
A 1-year, 2-phase multicenter interventional study comprising 1-6 months of a double-blinded intervention with nutritional formula or placebo, followed by 6-12 months of an open-label extension with the nutritional formula for all participants.
The outcomes of the double-blinded intervention were reported previously. A total of 79/98 (81%) boys, aged ≥10 years, Tanner stages 1-3, completed the open-labeled extension phase. For this phase, a significant dose-response correlation (p < 0.05) was found of the consumption of the formula with Δ height-SDS, Δ weight-SDS, and Δ muscle mass (crude correlations and after adjustment for baseline age and end-of-study Tanner stage). In the extension phase and in the 12-month analysis, participants who were good formula consumers (intake ≥50% of the recommended dose) maintained their height-SDS, while poor consumers had a significant decline in their height-SDS (p = 0.028 and p = 0.009, between group difference in the extension phase and 12-month analysis, respectively). Between-group differences were not observed in the Tanner stage at any point of the study. No serious adverse events were reported.
An intervention in healthy peripubertal boys suggests that 1-year consumption of a multi-nutrient, protein-rich nutritional supplement is efficacious and safe. The induced changes in growth and body composition, although modest, may be clinically significant. The effect of the formula on growth parameters was not mediated by enhancement of the pubertal tempo.
充足的营养在儿童期(包括青春期)的线性生长中起着重要作用。然而,并非所有儿童都愿意或能够每天摄入充足和均衡的饮食。我们旨在评估营养补充对短期和瘦型青春期前男孩线性生长、体重增加和身体成分变化的 1 年有效性和安全性。
这是一项为期 1 年、2 期的多中心干预性研究,包括 1-6 个月的双盲干预期,使用营养配方或安慰剂,随后所有参与者进行 6-12 个月的开放标签扩展期,使用营养配方。
双盲干预的结果之前已经报道过。共有 79/98(81%)名年龄≥10 岁、Tanner 分期 1-3 期、完成了开放标签扩展阶段的男孩。对于这一阶段,发现配方消耗量与Δ身高-SDS、Δ体重-SDS 和Δ肌肉量之间存在显著的剂量反应相关性(未经调整的和经过基线年龄和研究结束时 Tanner 分期调整后的)(p<0.05)。在扩展阶段和 12 个月分析中,良好配方消费者(摄入量≥推荐剂量的 50%)维持身高-SDS,而不良消费者的身高-SDS 显著下降(p=0.028 和 p=0.009,分别为扩展阶段和 12 个月分析的组间差异)。在研究的任何时候,都没有观察到组间 Tanner 分期的差异。未报告严重不良事件。
对健康青春期前男孩的干预表明,1 年多营养素、高蛋白营养补充剂的摄入是有效和安全的。生长和身体成分的变化虽然适度,但可能具有临床意义。配方对生长参数的影响不是通过增强青春期速度来介导的。