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极低出生体重儿补充喂养期的宏量营养素摄入:比较固体食物的早期和晚期引入:二次结局分析。

Macronutrient 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 Oct 9;16(19):3422. doi: 10.3390/nu16193422.

DOI:10.3390/nu16193422
PMID:39408387
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11478545/
Abstract

Very low birth weight (VLBW) infants may require enhanced nutrition, even during complementary feeding. However, there are limited data on macronutrient intake during this period, particularly concerning the individual timing of the introduction of solid foods in a representative VLBW infant population. This prospective observational study analyzed macronutrient intake in VLBW infants with a gestational age < 32 weeks based on whether solid foods were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks corrected age) Nutritional intake was analyzed using a 24 h recall at 6 weeks CA and 3-day dietary records at 12 weeks, 6, 9, and 12 months CA. In total, 115 infants were assigned to the early and 82 to the late group. The timing of solid food introduction did not affect macronutrient intake, except for a lower fat and higher carbohydrate intake (% of energy) in the early group at 12 weeks and 6 months CA: early vs. late, fat-12 weeks: 47.0% vs. 49.0%, 6 months: 39.2% vs. 43.3%; carbohydrates-12 weeks: 44.9% vs. 43.2%, 6 months: 51.3% vs. 48.0%. Apart from docosahexaenoic acid (DHA) and arachidonic acid (AA), dietary intake recommendations were met in both groups. While nutrient intakes varied significantly between breastfed and formula-fed infants, those with comorbidities exhibited similar nutrient intake levels compared to those without. Our findings suggest adequate macronutrient intakes in VLBW infants irrespective of the timing of solid introduction. However, there is a notable need to enhance dietary intakes of DHA and AA. Future research is crucial to assess whether current nutrient intakes are sufficient for VLBW infants with comorbidities.

摘要

极低出生体重(VLBW)婴儿可能需要强化营养,即使在补充喂养期间也是如此。然而,关于这一时期宏量营养素摄入量的数据有限,特别是在代表性的 VLBW 婴儿人群中固体食物引入的个体时间方面。这项前瞻性观察研究根据固体食物是早期(<17 周校正年龄(CA))还是晚期(≥17 周校正年龄)引入,分析了胎龄<32 周的 VLBW 婴儿的宏量营养素摄入量。在 6 周 CA 和 12 周、6、9 和 12 个月 CA 时使用 24 小时回忆和 3 天饮食记录来分析营养摄入。共有 115 名婴儿被分配到早期组,82 名婴儿被分配到晚期组。固体食物引入的时间并未影响宏量营养素的摄入,除了在 12 周和 6 个月 CA 时早期组的脂肪和碳水化合物(占能量的百分比)摄入较低:早期 vs. 晚期,脂肪-12 周:47.0% vs. 49.0%,6 个月:39.2% vs. 43.3%;碳水化合物-12 周:44.9% vs. 43.2%,6 个月:51.3% vs. 48.0%。除了二十二碳六烯酸(DHA)和花生四烯酸(AA)外,两组均满足膳食摄入建议。虽然母乳喂养和配方奶喂养的婴儿之间的营养素摄入量存在显著差异,但合并症婴儿的营养素摄入量与无合并症婴儿相似。我们的研究结果表明,VLBW 婴儿的宏量营养素摄入量充足,与固体引入的时间无关。然而,需要显著增加 DHA 和 AA 的饮食摄入量。未来的研究对于评估合并症 VLBW 婴儿的当前营养素摄入量是否充足至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/f5771ce8b0e1/nutrients-16-03422-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/e4716bc4e8c2/nutrients-16-03422-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/1499a0583fa4/nutrients-16-03422-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/d5f05c3dc035/nutrients-16-03422-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/c98b66d6c062/nutrients-16-03422-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/3f2624b73385/nutrients-16-03422-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/f5771ce8b0e1/nutrients-16-03422-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/e4716bc4e8c2/nutrients-16-03422-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/1499a0583fa4/nutrients-16-03422-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/d5f05c3dc035/nutrients-16-03422-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/c98b66d6c062/nutrients-16-03422-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/3f2624b73385/nutrients-16-03422-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4b3/11478545/f5771ce8b0e1/nutrients-16-03422-g006.jpg

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本文引用的文献

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Nutrients. 2024 Jun 28;16(13):2077. doi: 10.3390/nu16132077.
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Neurodevelopmental outcomes of preterm with necrotizing enterocolitis: a systematic review and meta-analysis.早产儿坏死性小肠结肠炎的神经发育结局:系统评价和荟萃分析。
Eur J Pediatr. 2024 Aug;183(8):3147-3158. doi: 10.1007/s00431-024-05569-5. Epub 2024 Apr 30.
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Arachidonic and docosahexaenoic acid supplementation and brain maturation in preterm infants; a double blind RCT.
花生四烯酸和二十二碳六烯酸补充与早产儿脑成熟;一项双盲 RCT 研究。
Clin Nutr. 2024 Jan;43(1):176-186. doi: 10.1016/j.clnu.2023.11.037. Epub 2023 Nov 29.
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Neurodevelopmental outcomes in preterm or low birth weight infants with germinal matrix-intraventricular hemorrhage: a meta-analysis.伴有脑室内出血的早产儿或低出生体重儿的神经发育结局:一项荟萃分析。
Pediatr Res. 2024 Feb;95(3):625-633. doi: 10.1038/s41390-023-02877-8. Epub 2023 Nov 7.
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Polyunsaturated Fatty Acid Intake during Complementary Feeding and Neurodevelopmental Outcome in Very Low Birth Weight Infants.补充喂养期间多不饱和脂肪酸的摄入与极低出生体重儿的神经发育结局。
Nutrients. 2023 Jul 14;15(14):3141. doi: 10.3390/nu15143141.
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Effects of early introduction of solid foods on nutrient intake in preterm infants during their 1st year of life: a secondary outcome analysis of a prospective, randomized intervention study.早期引入固体食物对早产儿出生后第一年营养摄入的影响:一项前瞻性随机干预研究的次要结局分析
Front Nutr. 2023 May 18;10:1124544. doi: 10.3389/fnut.2023.1124544. eCollection 2023.
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