title: Early Protein Intake Is Associated with Body Composition and Resting Energy Expenditure in Young Adults Born with Very Low Birth Weight.
abstract: BACKGROUND
  Suboptimal nutrition during fetal life and early childhood may be important in early programming of health and disease. Preterm infants born with very low birth weight (VLBW; <1500 g) frequently receive inadequate neonatal nutrition; the long-term consequences are poorly known.
  
  
  OBJECTIVE
  We evaluated the association between early macronutrient intake and body composition in young adults born with VLBW.
  
  
  METHODS
  We collected comprehensive information on daily nutritional intake during the initial hospital stay for 127 participants of the Helsinki Study of Very Low Birth Weight Adults. We calculated mean daily intakes of energy, protein, fat, and carbohydrate during the first 9 wk of life. At the mean age of 22.5 y, the subjects underwent measurements of weight, height, body composition by dual-energy X-ray absorptiometry, and resting energy expenditure. The associations were examined by linear regression.
  
  
  RESULTS
  We found that energy, protein, and fat intakes during the first 3 wk of life, all below current recommendations, predicted adult body composition. When adjusted for sex, age, birth weight SD score, and gestational age, a 1 g · kg(-1) · d(-1) higher protein intake predicted 11.1% higher lean body mass (LBM) (95% CI: 3.7%, 18.9%) and 8.5% higher resting energy expenditure (REE) (95% CI: 0.2%, 17.0%). Among those born before 28 wk of gestation, the numbers were 22.5% (95% CI: 1.9%, 47.4%) for LBM and 22.1% (95% CI: 3.6%, 44.0%) for REE. Similar associations were seen with energy (P = 0.01, P = 0.05) and fat (P < 0.01, P = 0.03) but not with carbohydrate. Energy intake was also associated with BMI (P = 0.01) and fat intake with BMI (P < 0.01) and percentage body fat (P = 0.05). The results were little changed when adjusted for prenatal and postnatal characteristics.
  
  
  CONCLUSIONS
  At relatively low neonatal protein intake levels, additional protein intake is reflected in a healthier body composition, accompanied by a higher metabolic rate, in young adults born with VLBW 20 y earlier.
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; hanna-maria.matinolli@thl.fi.
authors.forename: Hanna-Maria
authors.initials: HM
authors.lastname: Matinolli
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;
authors.forename: Petteri
authors.initials: P
authors.lastname: Hovi
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland;
authors.forename: Satu
authors.initials: S
authors.lastname: Männistö
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland;
authors.forename: Marika
authors.initials: M
authors.lastname: Sipola-Leppänen
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; Unit of General Practice, Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; and.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland; and.
authors.forename: Outi
authors.initials: O
authors.lastname: Mäkitie
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Järvenpää
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.affiliation: Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Obstetrics and Gynaecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Kajantie
mesh_terms: D015502:Absorptiometry, Photon; D001481:Basal Metabolism; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage*; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016014:Linear Models; D008297:Male; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins
keywords: body composition; early protein intake; nutrition; preterm birth; resting energy expenditure; very low birth weight