Lipid metabolism in pediatric nutrition.

The abrupt transition from carbohydrate to fat as the main energy source that occurs at birth is not matched by commensurate endogenous fat-digesting capacity in the newborn. Newborn infants are, however, able to digest fat efficiently through the activities of gastric lipase and the exogenous digestive lipase of human milk, which compensate for the low activity of pancreatic lipase. Fat absorption is well-developed at birth and is commensurate with the high fat intake of the infant. Tissue uptake of dietary fat is also adequate, based on sufficient lipoprotein lipase (above 26 to 27 weeks' gestation) and rapid postnatal increase of lecithin:cholesterol acyl transferase, the enzymes that regulate tissue uptake of circulatory lipoprotein triglyceride and cholesterol.