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极低出生体重儿补充喂养期微量营养素摄入:比较固体食物早、晚引入的二次结局分析。

Micronutrient Intake during Complementary Feeding in Very Low Birth Weight Infants Comparing Early and Late Introduction of Solid Foods: A Secondary Outcome Analysis.

机构信息

Department of Neonatology, Kepler University Hospital, Johannes Kepler University, 4020 Linz, Austria.

Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

Nutrients. 2024 Sep 27;16(19):3279. doi: 10.3390/nu16193279.

Abstract

The complementary feeding period is crucial for addressing micronutrient imbalances, particularly in very low birth weight (VLBW) infants. However, the impact of the timing of solid food introduction on micronutrient intake in a representative VLBW population remains unclear. : This prospective, observational study investigated micronutrient intake during complementary feeding in VLBW infants categorized based on whether solids were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks CA). Nutritional intake was assessed using a 24 h recall at 6 weeks CA and with 3-day dietary records at 12 weeks and at 6, 9, and 12 months CA. : Among 218 infants, 115 were assigned to the early group and 82 to the late group. In total, 114-170 dietary records were valid for the final analysis at each timepoint. The timepoint of solid introduction did not affect micronutrient intake, except for a higher iron and phosphorus intake at 6 months CA in the early group (early vs. late: iron 0.71 vs. 0.58 mg/kg/d, adjusted -value (-adj.) = 0.04; phosphorus 341 vs. 286 mg/d, -adj. = 0.04). Total vitamin D, calcium, zinc, and phosphorus greatly met intake recommendations; however, dietary iron intake was insufficient to equalize the iron quantity from supplements during the second half year CA. While nutrient intakes were similar between infants with and without comorbidities, breastfed infants had lower micronutrient intakes compared with formula-fed infants. : This study suggests that micronutrient intakes were sufficient during complementary feeding in VLBW infants. However, prolonged iron supplementation may be necessary beyond the introduction of iron-rich solids. Further research is essential to determine micronutrient requirements for infants with comorbidities.

摘要

补充喂养期对于解决微量营养素失衡至关重要,特别是对于极低出生体重(VLBW)婴儿。然而,固体食物引入的时间对代表性 VLBW 人群中微量营养素摄入的影响仍不清楚。本前瞻性观察研究根据固体食物引入的时间(<17 周校正年龄(CA)或≥17 周 CA)将 VLBW 婴儿分为早期和晚期组,调查了补充喂养期间微量营养素的摄入情况。采用 6 周 CA 的 24 小时回忆和 12 周及 6、9 和 12 个月 CA 的 3 天饮食记录评估营养摄入量。在 218 名婴儿中,115 名被分配到早期组,82 名被分配到晚期组。每个时间点共有 114-170 份饮食记录有效用于最终分析。固体引入的时间点并未影响微量营养素的摄入,除了早期组在 6 个月 CA 时铁和磷的摄入量较高(早期 vs. 晚期:铁 0.71 与 0.58mg/kg/d,调整 -值(-adj.)=0.04;磷 341 与 286mg/d,-adj. = 0.04)。总维生素 D、钙、锌和磷的摄入量均大大满足了摄入建议;然而,膳食铁的摄入量不足以在 CA 的下半年平衡补充剂中的铁量。虽然有合并症的婴儿和无合并症的婴儿的营养素摄入量相似,但母乳喂养的婴儿的微量营养素摄入量低于配方奶喂养的婴儿。本研究表明,VLBW 婴儿在补充喂养期间微量营养素的摄入量充足。然而,可能需要在引入富含铁的固体食物后继续补充铁。需要进一步研究来确定有合并症的婴儿的微量营养素需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d8/11478718/86ae0ce1fd0a/nutrients-16-03279-g001.jpg

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