The Committee on Nutrition of the American Academy of Pediatrics suggests that a logical goal for nutritional support of the LBW infant is to achieve postnatal growth approximating that of a normal fetus of the same post-conceptional age. To date, attempts to achieve sufficient catch-up growth in the LBW infant to result, at discharge, in the infant's weighing the same and having the same body composition as a fetus of comparable post-conceptional age have failed. Our previous studies suggest that this is because the relatively high protein intake required is not utilized completely unless accompanied by an energy intake that results in excessive fat deposition. We, therefore, propose to evaluate a strategy for enhancing accretion of lean body mass without excessive fat accretion. Specifically, we will test the hypothesis that a high- carbohydrate diet relative to an isocaloric high-fat diet will enhance protein utilization but may exert undesirable effects on cardiorespiratory function. To test this general hypothesis, we will examine systematically the differential effects of high- carbohydrate and high-fat energy intakes on weight gain, nitrogen retention, ratio of tryptophan to concentrations of large neutral amino acids, sleep state, substrate utilization, energy expenditure and cardiorespiratory functions of enterally fed, growing LBW infants (Birth weight, 750-1600 g). All infants will receive a protein intake of 4.0 g/kg.d; concomitant energy intake will be either 120 kcal/kg.d (non-protein energy 65% carbohydrate and 35% fat, 35% carbohydrate and 65% fat or 50% carbohydrate and 50% fat) or 150 kcal/kg.d (non-protein energy 65% carbohydrate and 35% fat or 35% carbohydrate and 65% fat). The question whether fat and carbohydrate are equivalent sources of energy is not only important for the nutritional management of LBW infants but may also be relevant to their neurobehavioral development.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD027564-02
Application #
2200505
Study Section
Nutrition Study Section (NTN)
Project Start
1993-07-01
Project End
1997-06-30
Budget Start
1994-07-01
Budget End
1995-06-30
Support Year
2
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Columbia University (N.Y.)
Department
Pediatrics
Type
Schools of Medicine
DUNS #
064931884
City
New York
State
NY
Country
United States
Zip Code
10027
Sahni, R; Schulze, K F; Ohira-Kist, K et al. (2010) Interactions among peripheral perfusion, cardiac activity, oxygen saturation, thermal profile and body position in growing low birth weight infants. Acta Paediatr 99:135-9
Ammari, Amer; Schulze, Karl F; Ohira-Kist, Kiyoko et al. (2009) Effects of body position on thermal, cardiorespiratory and metabolic activity in low birth weight infants. Early Hum Dev 85:497-501
Kashyap, Sudha (2008) Is the early and aggressive administration of protein to very low birth weight infants safe and efficacious? Curr Opin Pediatr 20:132-6
Kashyap, Sudha (2007) Enteral intake for very low birth weight infants: what should the composition be? Semin Perinatol 31:74-82
Fifer, William P; Myers, Michael M; Sahni, Rakesh et al. (2005) Interactions between sleeping position and feeding on cardiorespiratory activity in preterm infants. Dev Psychobiol 47:288-96
Sahni, R; Schulze, K F; Kashyap, S et al. (2005) Sleeping position and electrocortical activity in low birthweight infants. Arch Dis Child Fetal Neonatal Ed 90:F311-5
Sahni, Rakesh; Saluja, Deepak; Schulze, Karl F et al. (2002) Quality of diet, body position, and time after feeding influence behavioral states in low birth weight infants. Pediatr Res 52:399-404
Kashyap, S; Ohira-Kist, K; Abildskov, K et al. (2001) Effects of quality of energy intake on growth and metabolic response of enterally fed low-birth-weight infants. Pediatr Res 50:390-7
Sahni, R; Schulze, K F; Kashyap, S et al. (2000) Maturational changes in heart rate and heart rate variability in low birth weight infants. Dev Psychobiol 37:73-81
Sahni, R; Schulze, K F; Kashyap, S et al. (1999) Body position, sleep states, and cardiorespiratory activity in developing low birth weight infants. Early Hum Dev 54:197-206

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