Lean Gain Is Enhanced by Leucine Pulses during Continuous Feeding in Neonates (original) (raw)
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American journal of physiology. Endocrinology and metabolism, 2016
Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in skeletal muscle compared to continuous feeding alone. To determine the long-term effects of leucine pulses, neonatal piglets (n=11-12/group) were continuously fed formula via orogastric tube for 21 d with an additional parenteral infusion of either leucine (800 μmol·kg(-1)·h(-1), CON+LEU) or alanine (CON+ALA) for 1 h every 4 h. The results show that body and muscle weights and lean gain were ~25% greater and fat gain was 48% lower in CON+LEU than CON+ALA; weights of other tissues were unaffected by treatment. Fractional protein synthesis rates in longissimus dorsi, gastrocnemius, and soleus muscles were ~30% higher in CON+LEU compared to CON+ALA and were associated with decreased Deptor ...
Leucine pulses enhance skeletal muscle protein synthesis during continuous feeding in neonatal pigs
AJP: Endocrinology and Metabolism, 2013
Infants unable to maintain oral feeding can be nourished by orogastric tube. We have shown that orogastric continuous feeding restricts muscle protein synthesis compared with intermittent bolus feeding in neonatal pigs. To determine whether leucine infusion can be used to enhance protein synthesis during continuous feeding, neonatal piglets received the same amount of formula enterally by orogastric tube for 25.25 h continuously (CON) with or without LEU or intermittently by bolus every 4 h (BOL). For the CON+LEU group, leucine pulses were administered parenterally (800 μmol·kg−1·h−1) every 4 h. Insulin and glucose concentrations increased after the BOL meal and were unchanged in groups fed continuously. LEU infusion during CON feeding increased plasma leucine after the leucine pulse and decreased essential amino acids compared with CON feeding. Protein synthesis in longissimus dorsi (LD), gastrocnemius, and soleus muscles, but not liver or heart, were greater in CON+LEU and BOL tha...
The Journal of Pediatrics, 1987
The effect of energy and protein intakes on energy expenditure, energy balance, and amount and relative rate of both protein and fat deposition in new tissue was investigated in 19 low birth weight infants whose mean protein and energy intakes, respectively, were/2.24 g/kg/d and 113 kcal/kg/d (formula A, n = 8), 3.6 g/kg/d and 115 kcal/kg/d (formula B, n = 5), and 3.5 g/kg/d and 149 kcal/kg/d (formula C, n = 6). The higher energy intake (formula C) but not the higher protein intake (formula B) resulted in greater energy expenditure. Both the higher protein (formula B vs formula A) and higher energy intakes (formula C vs formula B) resulted in greater weight gain secondary, in group B, to a greater absolute rate of protein deposition and, in group C, to a greater absolute rate of fat deposition. The relative composition of the new tissue deposited reflected the proportional intakes of protein and energy. The numerical value of the protein/fat ratio (g/g) of the new tissue deposited by infants fed formulas A and C, the protein contents of which were low relative to energy contents, were similar and significantly lower than the numerical value of the protein/fat ratio of the new tissue deposited by infants fed formula B, which had a higher protein content relative to energy content. These findings suggest that the composition of weight gain is related to both the absolute amounts and the proportions of dietary protein and energy; thus, both must be considered in formulation of nutritional regimens for LBW infants. (J PEDIATR
American Journal of Clinical Nutrition
Currently available preterm formulas with energy contents of 3350 kJ (800 kcal)/L promote weight and length gain at rates at or above intrauterine growth rates but disproportionately increase total body fat. The objective of this study was to determine whether fat accretion in formula-fed, very-low-birth-weight (VLBW) infants could be decreased and net protein gain maintained by reducing energy intakes from 502 kJ (80 kcal)*kg(-)(1)*d(-)(1) [normal-energy (NE) formula] to 419 kJ (100 kcal)*kg(-)(1)*d(-)(1) [low-energy (LE) formula] while providing similar protein intakes (3.3 g*kg(-)(1)*d(-)(1)). The study was a randomized, controlled trial enrolling 20 appropriate-for-gestational-age (AGA) and 16 small-for-gestational-age (SGA) VLBW infants (mean birth weight: 1.1 kg; mean gestational age: 31 wk); energy expenditure and nutrient balance were measured at 4 wk of age and anthropometric measurements were made when infants weighed 2 kg. The percentage of fat in newly formed tissue was ...
Intensive Care Medicine, 1996
Total parenteral nutrition (TPN) is a well known cause of cholelithiasis in adult and pediatric age. Aim of this prospective study was to evaluate the incidence of cholelithiasis in the neonates submitted to TPN in the neonatal intensive care unit (NTCU). During 1 year, 46 neonates (28M-1 8F) were supported by TPN in the NICU of our hospital; mean gestational age was 31,7 weeks (range 26-39); mean birth weight was 1625g (range 610-3400); mean onset of TPN was on 5th day of life (range 1-25) with a mean duration of 16 days (range 3-60). The administration of hyperalimentation was always by central venous line: in 7 patients PN was associated with minimal oral food. The study stated the first ultrasound and serum examination at the onset of TPN, a control every 10 days till the end of TPN and a successive, check after I and 12 months. We used, as control group, 35 infants affected by pyloric stenosis (mean age 45.6 days) in ;;'hom, during US cxaminati.,.r to tors..,-, the diagn: sic, the gallbladder was also studied. Twenty two patients conclude the study, 15 did the examinations till one month after the discharge and 9 patients died. GGT was increased in 26 patients, in 5 of them direct bilirubin was also raised. Thre out of 26 patients with increased GGT had cholelithiasis; one, with both indices raised, had stones. Three with stones were affected by necrotizing enterocolitis (NEC). One patient had cholecistectomy during other surgery, 3 are asymptomatic and followed. The control group didn't present any sign of cholelithiasis. The incidence of cholelithiasis in this study is 8.7%. In our experience the association between TPN and NEC is at high risk to develop cholelithiasis. A follow-up US study in all the neonates submitted to TPN is suggested.
Amino Acids, 2020
When neonatal pigs continuously fed formula are supplemented with leucine pulses, muscle protein synthesis and body weight gain are enhanced. To identify the responsible mechanisms, we combined plasma metabolomic analysis with transcriptome expression of the transcriptome and protein catabolic pathways in skeletal muscle. Piglets (n = 23, 7-day-old) were fed continuously a milk replacement formula via orogastric tube for 21 days with an additional parenteral infusion (800 μmol kg −1 h −1) of either leucine (LEU) or alanine (CON) for 1 h every 4 h. Plasma metabolites were measured by liquid chromatography-mass spectrometry. Gene and protein expression analyses of longissimus dorsi muscle were performed by RNA-seq and Western blot, ✉
The American journal of clinical nutrition, 2018
Orogastric tube feeding is indicated in neonates with an impaired ability to ingest food normally and can be administered with an intermittent bolus or continuous feeding schedule. The objectives were to 1) compare the long-term effect of continuous with intermittent feeding on growth using the newborn pig as a model, 2) determine whether feeding frequency alters lean tissue and fat mass gain, and 3) identify the signaling mechanisms by which protein deposition is controlled in skeletal muscle in response to feeding frequency. Neonatal pigs were fed the same amount of a balanced formula by orogastric tube either as an intermittent bolus meal every 4 h (INT) or as a continuous infusion (CON). Body composition was assessed at the start and end of the study by dual-energy X-ray absorptiometry, and hormone and substrate profiles, muscle mass, protein synthesis, and indexes of nutrient and insulin signaling were measured after 21 d. Body weight, lean mass, spine length, and skeletal musc...
Higher protein and energy intake is associated with increased weight gain in pre-term infants
Journal of Paediatrics and Child Health, 2010
To characterise and compare the nutritional management and growth in infants <33 weeks' gestation in two tertiary centres. An audit of daily intake and growth from birth to discharge home was undertaken in two neonatal units: The KK Women's and Children's Hospital Singapore and the Adelaide Women's and Children's Hospital, South Australia. Mixed models were used to model intake and daily weight (g/day) accounting for repeated day per subject. The clinical characteristics of the two cohorts were similar. The Adelaide cohort had a higher initial energy intake in the first 5 days compared with the Singapore cohort, and a significantly greater weekly increase of 21.0 kcal/week (95% CI 7.7-34.3; P = 0.002). The Adelaide cohort also had a higher initial protein intake and a significantly greater weekly increase of 0.88 g/week (95% CI 0.5, 1.3), P < 0.001) compared with the Singapore cohort. The weight gain of the Adelaide cohort was 9 g/day more than the Singapore cohort (95% CI 7.3, 10.7; P < 0.001). Post-natal growth failure was evident in 32% (n = 64) of the Adelaide cohort and 64% (n = 94) of the Singapore cohort. The two centres showed distinct differences in nutritional management. A higher energy and protein intake was associated with improved growth yet growth in both cohorts was still below current recommendations.
Metabolic Programming: Effects of Early Nutrition on Growth, Metabolism and Body Composition
Nestle Nutrition Institute workshop series, 2016
High protein requirements of premature infants during the first weeks of postnatal life are a well-established fact. Those infants gain fat-free mass and protein rapidly during the first weeks of postnatal growth and require a much higher protein/energy ratio than term infants. Recommended protein intakes are 3.5-4.0 g/kg per day. For term infants, on the other hand, FAO and WHO have recently lowered recommended protein intakes to better reflect our current knowledge about the protein concentration in breast milk during the first 12 months of lactation. Longitudinal randomized clinical trials now confirm that term infants who are fed infant and follow-up formulas with protein concentrations >2.25 g/100 kcal (high protein formulas) during the first year of life grow faster than indicated by the WHO growth standards. Rapid weight gain during infancy is a predictor of childhood and adult obesity. Infants fed high protein quality formulas with protein concentrations of 1.6-2.2 g/100 ...
How to use: nutritional assessment in neonates
Archives of disease in childhood. Education and practice edition, 2014
Adequate nutrition and growth during the neonatal period are important, especially for preterm infants, for whom there is evidence of poor nutrient intakes and growth, and this has important implications for their health in later life. Increased nutritional support while on the neonatal intensive care unit has been shown to improve growth, but such support is not universally available. Being able to carry out and interpret a nutritional assessment is therefore an important skill for paediatricians caring for neonates. This article aims to explain how to use nutritional assessment in neonates and provides some tools to make this process as straightforward as possible.