title: Branched-chain amino acid requirements for enterally fed term neonates in the first month of life.
abstract: BACKGROUND
  Knowledge of essential amino acid requirements in infants is important because excessive intake of protein can lead to increased long-term morbidity such as obesity. A deficient intake may lead to suboptimal growth and impaired neurodevelopment. The current recommended branched-chain amino acid requirements in infants aged 0-1 mo are based on the amino acid content of human milk.
  
  
  OBJECTIVE
  We quantified the requirements for isoleucine, leucine, and valine for term neonates by using the indicator amino acid oxidation method with [1-(13)C]phenylalanine as the indicator.
  
  
  METHODS
  Fully enterally fed term infants received randomly graded amounts of isoleucine (5-216 mg · kg(-1) · d(-1)), leucine (5-370 mg · kg(-1) · d(-1)), or valine (5-236 mg · kg(-1) · d(-1)) as part of an elemental formula. Data are expressed as means ± SDs.
  
  
  RESULTS
  Eighty-three Asian, term neonates (mean ± SD birth weight: 3.3 ± 0.4 kg; gestational age: 39.4 ± 1.3 wk) were studied at a postnatal age of 13 ± 5 d. Mean requirements for isoleucine, leucine, and valine (measured in boys only) were 105 mg · kg(-1) · d(-1) (r(2) = 0.61, P < 0.001), 140 mg · kg(-1) · d(-1) (r(2) = 0.26, P < 0.01), and 110 mg · kg(-1) · d(-1) (r(2) = 0.35, P = 0.001), respectively.
  
  
  CONCLUSIONS
  Current human milk-based recommendations for isoleucine and valine in term infants aged 0-1 mo are correct. However, the current recommendation for leucine (166 mg · kg(-1) · d(-1)) is higher than the mean requirement of 140 mg · kg(-1) · d(-1) that we determined in this study. This trial was registered at www.trialregister.nl as NTR1610.
authors.affiliation: Department of Pediatrics, Emma's Children's Hospital, Academic Medical Center, Amsterdam, Netherlands (FdG, JBvG, and HS); the Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands (JBvG, LH, and IvV); the Division of Neonatology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, Netherlands (GJV and LCWR); the Hospital Pharmacy, Erasmus Medical Center, Rotterdam, Netherlands (AV); and the Division of Neonatology (CC) and the Department of Gastro-Enterology (YH), Fudan Children's Hospital, Shanghai, China.
authors.forename: Femke
authors.initials: F
authors.lastname: de Groof
authors.forename: Lisha
authors.initials: L
authors.lastname: Huang
authors.forename: Ineke
authors.initials: I
authors.lastname: van Vliet
authors.forename: Gardi J
authors.initials: GJ
authors.lastname: Voortman
authors.forename: Henk
authors.initials: H
authors.lastname: Schierbeek
authors.forename: Lodi C W
authors.initials: LC
authors.lastname: Roksnoer
authors.forename: Andras
authors.initials: A
authors.lastname: Vermes
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
mesh_terms: D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage*; D018592:Cross-Over Studies; D002149:Energy Intake; D005260:Female; D005865:Gestational Age; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007532:Isoleucine / Q000378:metabolism; D007930:Leucine / Q000378:metabolism; D016014:Linear Models; D008297:Male; D009751:Nutritional Requirements; D010084:Oxidation-Reduction; D064167:Recommended Dietary Allowances; D014633:Valine / Q000378:metabolism
chemical_list: D000597:Amino Acids, Branched-Chain; D007532:Isoleucine; D007930:Leucine; D014633:Valine