The interaction between diet and neurobehavior in very low birth weight infants.


Journal

Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714

Informations de publication

Date de publication:
02 2022
Historique:
received: 20 07 2020
accepted: 22 02 2021
revised: 17 02 2021
pubmed: 27 3 2021
medline: 12 4 2022
entrez: 26 3 2021
Statut: ppublish

Résumé

Modulation of behavior and physiology by dietary perturbations early in life can provide clues to the pathogenesis of adult diseases. We tested the hypothesis that a period of early protein supplementation modulates sympathetic nervous system activity demonstrated indirectly by an increase in active sleep state distribution in very low birth weight (VLBW) infants. VLBW infants (n = 71) were randomized to a total parenteral nutritional regimen providing 18% of the energy intake as amino acids (AA) or a conventional regimen providing 12.5% to achieve targeted AA intakes of 4 g/kg/day (0.004 kcal/kg/day) and 3 g/kg/day (0.003 kcal/kg/day), respectively. Both groups were weaned to enteral feeding and advanced to provide similar AA intake of 4 g/kg/day (0.004 kcal/kg/day). Six-hour daytime, behavioral sleep studies were performed when the infants reached full enteral intake (165 ml/kg/day). Infants in the high protein group spent more time in active sleep (77.2 ± 10.5% vs. 70.7 ± 11.8%), p < 0.01 and less time in quiet sleep (12.9 ± 3.4% vs. 17.7 ± 7.0%, p < 0.01) as compared to the conventional group. No group differences were observed for indeterminate sleep, awake, or crying states. These results suggest that dietary intake may indirectly influence sympathetic nervous system activity. Infants randomized to an early, high protein nutritional regimen spent an increased percentage of time in active sleep, supporting the hypothesis that nutrition and behavior are interactive. Furthermore, sleep states are an indirect measure of sympathetic nervous system activity, suggesting that dietary intake may influence sympathetic nervous system activity. This study highlights the importance of considering the impact of nutrition during critical periods of development in order to further understand and improve the long-term outcomes of very low birth weight infants.

Sections du résumé

BACKGROUND
Modulation of behavior and physiology by dietary perturbations early in life can provide clues to the pathogenesis of adult diseases. We tested the hypothesis that a period of early protein supplementation modulates sympathetic nervous system activity demonstrated indirectly by an increase in active sleep state distribution in very low birth weight (VLBW) infants.
METHODS
VLBW infants (n = 71) were randomized to a total parenteral nutritional regimen providing 18% of the energy intake as amino acids (AA) or a conventional regimen providing 12.5% to achieve targeted AA intakes of 4 g/kg/day (0.004 kcal/kg/day) and 3 g/kg/day (0.003 kcal/kg/day), respectively. Both groups were weaned to enteral feeding and advanced to provide similar AA intake of 4 g/kg/day (0.004 kcal/kg/day). Six-hour daytime, behavioral sleep studies were performed when the infants reached full enteral intake (165 ml/kg/day).
RESULTS
Infants in the high protein group spent more time in active sleep (77.2 ± 10.5% vs. 70.7 ± 11.8%), p < 0.01 and less time in quiet sleep (12.9 ± 3.4% vs. 17.7 ± 7.0%, p < 0.01) as compared to the conventional group. No group differences were observed for indeterminate sleep, awake, or crying states.
CONCLUSIONS
These results suggest that dietary intake may indirectly influence sympathetic nervous system activity.
IMPACT
Infants randomized to an early, high protein nutritional regimen spent an increased percentage of time in active sleep, supporting the hypothesis that nutrition and behavior are interactive. Furthermore, sleep states are an indirect measure of sympathetic nervous system activity, suggesting that dietary intake may influence sympathetic nervous system activity. This study highlights the importance of considering the impact of nutrition during critical periods of development in order to further understand and improve the long-term outcomes of very low birth weight infants.

Identifiants

pubmed: 33767376
doi: 10.1038/s41390-021-01464-z
pii: 10.1038/s41390-021-01464-z
pmc: PMC8463624
mid: NIHMS1679517
doi:

Substances chimiques

Amino Acids 0
Dietary Proteins 0

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

646-651

Subventions

Organisme : NICHD NIH HHS
ID : R01 HD027564
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001873
Pays : United States

Informations de copyright

© 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

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Auteurs

Jennifer Hammond (J)

Division of Neonatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.

Rajit Kamboj (R)

Division of Neonatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.

Sudha Kashyap (S)

Division of Neonatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.

Rakesh Sahni (R)

Division of Neonatology, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA. rs62@columbia.edu.

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