CONTEXT: Fetal growth restraint, if followed by rapid weight gain, confers risk for adult disease including diabetes. How breast-feeding may lower such risk is poorly understood. OBJECTIVE, STUDY PARTICIPANTS, INTERVENTION, OUTCOMES: In infants born small-for-gestational-age (SGA), we studied the effects of nutrition in early infancy (breast-feeding vs formula-feeding; BRF vs FOF) on weight partitioning and endocrine markers in late infancy. Body composition (by absorptiometry), fasting glycemia, insulin, IGF-I, and high-molecular-weight (HMW) adiponectin were assessed at 4 and 12 months in BRF controls born appropriate-for-GA (N = 31) and in SGA infants receiving BRF (N = 48) or FOF (N = 51), the latter being randomized to receive a standard formula (FOF1) or a protein-rich formula (FOF2). SETTING: The study was conducted in a University Hospital. RESULTS: SGA-BRF infants maintained a low fat mass and normal levels of IGF-I and HMW adiponectin. In contrast, SGA-FOF infants normalized their body composition by gaining more fat; this normalization was accompanied by a marked fall in HMW adiponectinemia and, in FOF2 infants, by elevated IGF-I levels. In late infancy, SGA-BRF infants were most sensitive to insulin, even more sensitive than appropriate-for-GA-BRF controls. CONCLUSIONS: Because the health perspectives are better for SGA-BRF than for SGA-FOF infants, the present results suggest that FOF for SGA infants should aim at maintaining normal IGF-I and HMW-adiponectin levels rather than at normalizing body composition. Nutriceutical research for SGA infants may thus have to be redirected.
RCT Entities:
CONTEXT: Fetal growth restraint, if followed by rapid weight gain, confers risk for adult disease including diabetes. How breast-feeding may lower such risk is poorly understood. OBJECTIVE, STUDY PARTICIPANTS, INTERVENTION, OUTCOMES: In infants born small-for-gestational-age (SGA), we studied the effects of nutrition in early infancy (breast-feeding vs formula-feeding; BRF vs FOF) on weight partitioning and endocrine markers in late infancy. Body composition (by absorptiometry), fasting glycemia, insulin, IGF-I, and high-molecular-weight (HMW) adiponectin were assessed at 4 and 12 months in BRF controls born appropriate-for-GA (N = 31) and in SGA infants receiving BRF (N = 48) or FOF (N = 51), the latter being randomized to receive a standard formula (FOF1) or a protein-rich formula (FOF2). SETTING: The study was conducted in a University Hospital. RESULTS: SGA-BRF infants maintained a low fat mass and normal levels of IGF-I and HMW adiponectin. In contrast, SGA-FOF infants normalized their body composition by gaining more fat; this normalization was accompanied by a marked fall in HMW adiponectinemia and, in FOF2 infants, by elevated IGF-I levels. In late infancy, SGA-BRF infants were most sensitive to insulin, even more sensitive than appropriate-for-GA-BRF controls. CONCLUSIONS: Because the health perspectives are better for SGA-BRF than for SGA-FOF infants, the present results suggest that FOF for SGA infants should aim at maintaining normal IGF-I and HMW-adiponectin levels rather than at normalizing body composition. Nutriceutical research for SGA infants may thus have to be redirected.
Authors: Fatma A Alzaree; Mones M AbuShady; Mohamed Abdel Atti; Gihan A Fathy; Essam M Galal; Alaa Ali; Tahany R Elias Journal: Open Access Maced J Med Sci Date: 2019-01-12
Authors: Camila E Orsso; Eloisa Colin-Ramirez; Catherine J Field; Karen L Madsen; Carla M Prado; Andrea M Haqq Journal: Nutrients Date: 2020-09-08 Impact factor: 5.717