ENERGY EXPENDITURE, DIETARY INTAKE AND FEEDING PRACTICES FOR PRETERM INFANTS

早产儿的能量消耗、膳食摄入和喂养方法

• 批准号: 6282035
• 负责人: Karen Amelia Pridham
• 金额: $ 2.43万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-12-01 至 1998-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6282035
• 关键词: bioenergetics; child physical development; clinical research; developmental nutrition; diet route /schedule; human subject; infant nutrition disorder; inflammation; low birth weight infant human; lung disorder; nutrient intake activity; nutrition related tag; pediatric nursing; premature infant human

The question the proposed study addresses is: How is energy expenditure related to dietary intake and somatic growth, considering infant characteristics, infant activity, and food intolerance, and controlling feeding practice (caloric density of the diet and ad libitum or prescribed feeding regimen)? The specific aims of the study are as follows: (1) To determine the energy expenditure in the three groups of preterm infants during levels of activity, ranging from quiet sleep to vigorous activity with crying and including feeding; and (2) To determine the contribution energy expenditure makes to the dietary intake and somatic growth of these infants, taking infant characteristics (birthweight, gender, ethnicity, severity of lung disease, and postconceptional age at the time of energy expenditure assessment), infant activity, and food intolerance into account and controlling the caloric density of the diet and the feeding regimen. A 2 x 2 experimental design with random assignment of infants to either ad libitum or prescribed feeding, and, within the feeding practice, to 20- or 24-calorie/ounce feeding substance will be used. Twelve infants will be randomly assigned to each of the four feeding practices. All Infants admitted to the Neonatal Intensive Care Unit (NICU) born at less than 35 weeks gestation with weight that is appropriate for gestational age and who are exclusively formula fed or fed at least 80 percent breast milk will be eligible for this study. Study infants must not have congenital or medical problems interfering with nutritional status. Infants may have recovered from Respiratory Distress Syndrome (RDS) or have mild Bronchopulmonary Dysplasia (BPD). The four study arms will be balanced with respect to the following possible covariates: (a) birthweight, (b) gender, (c) ethnicity, (d) respiratory status (RDS, BPD, or none), and (e) post-conceptional age at the time of energy expenditure assessment. Energy expenditure will be observed with indirect respiratory calorimetry on the first and second day the infant is completely nipple fed at ninety minutes post-prandial for a ninety-minute period each day and with mean heart rate during feeding. The infant's six-hourly dietary intake and daily weight will be the basis for the following measures over the 72-hour study period: (1) mean volume in cc/kg/day of intake; (2) mean kcalories/kg/six-hours of intake; and (3) mean g protein/kg/six-hours of intake. Mean grams weight gain/six-hour period (rate of weight gain) divided by the weight that day will be the measure of somatic growth. Dietary intake outcomes will be analyzed using iterative generalized least-squares regression against the following covariates: (a) NICU location, (b) food intolerance, (c) energy expenditure, (d) severity of lung disease, and (e) feeding practice. The weighted rate of weight gain will be regressed against dietary intake and the other previously listed covariates. The interaction of the two feeding practice factors (feeding regimen and caloric density) will be examined.

拟议研究要解决的问题是：能量消耗如何 与饮食摄入和躯体生长有关，考虑到婴儿 特征、婴儿活动和食物不耐受以及控制 喂养方式（饮食的热量密度和随意或 规定的喂养方案）？ 研究的具体目的如下 如下： (1) 确定三组的能量消耗 早产儿在活动水平（从安静睡眠）期间 进行剧烈活动，包括哭闹和喂食； (2) 至 确定能量消耗对饮食的贡献 这些婴儿的摄入量和躯体生长，服用婴儿 特征（出生体重、性别、种族、肺部疾病严重程度 疾病和能量消耗时的受孕年龄 评估）、婴儿活动和食物不耐受考虑在内 控制饮食的热量密度和喂养方案。 2 x 2 实验设计，将婴儿随机分配到任一组 随意或按规定喂养，并且在喂养实践中， 将使用 20 或 24 卡路里/盎司的喂养物质。 十二个婴儿 将被随机分配到四种喂养方式中的每一种。 全部 出生时入住新生儿重症监护病房 (NICU) 的婴儿 妊娠超过 35 周且体重适合妊娠 年龄和纯配方奶喂养或至少 80% 喂养的人 母乳将有资格参加这项研究。 研究婴儿不得 有先天性或健康问题影响营养状况。 婴儿可能已从呼吸窘迫综合征 (RDS) 中恢复或 患有轻度支气管肺发育不良（BPD）。 四个研究组将 就以下可能的协变量进行平衡：(a) 出生体重，(b) 性别，(c) 种族，(d) 呼吸状况（RDS， BPD，或无），以及（e）精力充沛时的受孕后年龄 支出评估。 通过间接呼吸观察能量消耗 婴儿完全乳头第一天和第二天的热量测量 餐后九十分钟进食，每天九十分钟 以及喂食期间的平均心率。 婴儿每六小时 膳食摄入量和每日体重将作为以下的基础 72 小时研究期间的测量：(1) 平均体积（cc/kg/天） 摄入量； (2) 平均千卡/公斤/六小时摄入量； (3) 平均 g 蛋白质/公斤/六小时摄入量。 平均体重增加克数/六小时 （体重增加率）除以当天的体重就是测量值 体细胞生长。 将使用以下方法分析膳食摄入结果 针对以下各项的迭代广义最小二乘回归 协变量：(a) NICU 位置，(b) 食物不耐受，(c) 能量 支出，(d) 肺部疾病的严重程度，以及 (e) 喂养方式。 体重增加的加权率将根据饮食进行回归 摄入量和其他先前列出的协变量。 的相互作用 两个喂养实践因素（喂养方案和热量密度） 将接受检查。