Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Gastroenterol Nutr. 2024 Jul;79(1):140-147. doi: 10.1002/jpn3.12232. Epub 2024 May 2.
Processing speed is suboptimal among preterm-born children which is of concern as it is a foundational skill supporting higher-level cognitive functions. The study objective was to evaluate associations between early-life nutrition and processing speed in childhood.
Macronutrient and human milk (mother's own, donor) intakes from 137 children born preterm with very low birth weight enrolled in a nutrition feeding trial were included. Processing speed was evaluated at age 5 using the Wechsler Preschool and Primary Scale of Intelligence-fourth edition Processing Speed Index. Associations between early-life nutrition and processing speed were explored through linear regression.
Children had a mean (standard deviation [SD]) birth gestational age of 28.1 (2.5) weeks, weight of 1036 (260) g and 52% were male. The mean (SD) assessment age was 5.7 (0.2) years. Sex-dependent relationships were identified between first postnatal month protein, lipid and energy intakes and processing speed at 5 years. For females, lower protein (per 0.1 g/kg/d: -0.88, 95% confidence interval [CI]: -1.53, -0.23; p = 0.01) and energy (per 10 kcal/kg/d: -2.38, 95% CI: -4.70, -0.05; p = 0.03) intakes were related to higher processing speed scores. Mother's milk provision was positively associated (per 10% increase: 0.80, 95% CI: 0.22, 1.37; p = 0.01) and donor milk was negatively associated (per 10% increase: -1.15, 95% CI: -2.22, -0.08; p = 0.04) with processing speed scores; no sex differences were observed.
First postnatal month nutrition was related to processing speed at age 5 in children born preterm with very low birth weight. Early-life nutrition that supports processing speed may be leveraged to improve later cognitive outcomes for this vulnerable population.
早产儿的处理速度不理想，这令人担忧，因为处理速度是支持更高层次认知功能的基础技能。本研究旨在评估儿童期早期生活营养与处理速度之间的关系。
本研究纳入了 137 名极低出生体重早产儿，他们参与了一项营养喂养试验，研究人员分析了他们在出生后第一个月的宏量营养素和人乳（母亲的、捐赠者的）摄入量。在 5 岁时使用韦氏学前和小学智力量表第四版处理速度指数评估处理速度。通过线性回归探讨早期生活营养与处理速度之间的关系。
儿童的平均（标准差[SD]）出生胎龄为 28.1（2.5）周，体重为 1036（260）g，其中 52%为男性。平均（SD）评估年龄为 5.7（0.2）岁。研究人员发现，在第一个月，蛋白质、脂肪和能量摄入量与 5 岁时的处理速度之间存在性别依赖性关系。对于女性，蛋白质摄入量每增加 0.1 g/kg/d（-0.88，95%置信区间[CI]：-1.53，-0.23；p = 0.01）和能量摄入量每增加 10 kcal/kg/d（-2.38，95% CI：-4.70，-0.05；p = 0.03）与处理速度得分较高相关。人乳供应与处理速度得分呈正相关（每增加 10%：0.80，95% CI：0.22，1.37；p = 0.01），捐赠人乳与处理速度得分呈负相关（每增加 10%：-1.15，95% CI：-2.22，-0.08；p = 0.04）；未观察到性别差异。
极低出生体重早产儿出生后第一个月的营养状况与 5 岁时的处理速度有关。支持处理速度的早期生活营养可以被利用来改善这一脆弱人群的后期认知结果。
