Effect of Protein Intake on Preterm Infant Body Composition

NCT ID: NCT02353013

Last Updated: 2017-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-12-31

Study Completion Date

2017-10-01

Brief Summary

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The investigators will compare weight gain based on fat accretion and change in body composition in preterm infants receiving different amounts of enteral protein.

Detailed Description

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American Academy of Pediatrics guidelines define the growth rate of preterm, underweight babies as adequate if it matches the age-equivalent weight gains typical of term infants, approximately 10-15 grams per kg per day. Unfortunately, many pre-terms, especially very low birth weight ones, do not achieve this rate, resulting in neurodevelopmental deficits and low discharge weights. Typical feeding regimens, designed to increase weight gain, however, have been shown to increase the rate of fat accretion and increase the risk of obesity and metabolic disorders, such as insulin resistance and type 2 diabetes, later in life. Research has shown that higher protein diets can reduce the accretion of body fat in older, normal weight infants but this has not been systematically tested in low birth weight pre-terms. The current study will compare weight gain based on fat accretion and change in body composition in preterm infants receiving higher (4g/100 kcal) versus lower (3 g/100 kcal) protein-energy ratio diets. The hypothesis tested in this study is: Increased protein intake will reduce the percentage of weight gain due to fat accretion in pre-term infants. The identification of an effective feeding regimen that would both allow pre-term infants to acquire age-equivalent growth rates similar to those of term infants while avoiding the excess accretion of body fat could significantly improve the long term health outcomes of this high-risk population.

Conditions

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Premature; Infant, Light-for-dates

Keywords

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protein intake body composition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

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Standard Protein Group

For infants in this group, the target protein-energy ratio (PER) will be \~3 g/100 kcal. This will be achieved by providing standard fortification by adding a commercially available human milk fortifier to human milk or by providing a preterm formula.

Group Type ACTIVE_COMPARATOR

Standard fortification

Intervention Type DIETARY_SUPPLEMENT

Standard fortification of human milk involves adding a commercially available human milk fortifier to human milk in order to increase several nutrients.

Enhanced Protein Group

For infants in this group, the target protein-energy ratio (PER) will be \~4 g/100 kcal. This will be achieved by providing standard fortification by adding a commercially available human milk fortifier to human milk or by providing a preterm formula. In addition, liquid protein will be added to provide protein supplementation and increase the PER.

Group Type EXPERIMENTAL

Protein supplementation

Intervention Type DIETARY_SUPPLEMENT

Standard fortification of human milk may not have enough protein for optimal growth of premature infants. The investigators will add extra protein to this group to increase the protein consumed.

Standard fortification

Intervention Type DIETARY_SUPPLEMENT

Standard fortification of human milk involves adding a commercially available human milk fortifier to human milk in order to increase several nutrients.

Interventions

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Protein supplementation

Standard fortification of human milk may not have enough protein for optimal growth of premature infants. The investigators will add extra protein to this group to increase the protein consumed.

Intervention Type DIETARY_SUPPLEMENT

Standard fortification

Standard fortification of human milk involves adding a commercially available human milk fortifier to human milk in order to increase several nutrients.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Premature infants born less than 32 weeks EGA
* Growth that is appropriate for gestational age (AGA)
* Admitted to OU Children's NICU, inborn or outborn
* Receiving enteral feedings \<100 mL/kg/day
* Hemodynamically stable

Exclusion Criteria

* Severe congenital anomalies to include congenital heart disease, chromosomal anomalies, open neural tube defects, and/or intestinal anomalies precluding enteral feedings
* Growth restriction, growth that is small for gestational age (SGA) or large for gestational age (LGA)
* Inborn errors of metabolism
* History of necrotizing enterocolitis Bell stage III
* Cerebrospinal fluid indwelling shunt (affects body composition measurements)
* Expected death prior to 36 weeks EGA (the end of the study period)
* Inability to meet Pea Pod® requirements for the first measurement
* On vasopressor medications
Minimum Eligible Age

1 Minute

Maximum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oklahoma

OTHER

Sponsor Role lead

Responsible Party

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Courtney B. Atchley, DO

Assistant Professor of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Courtney B Atchley, DO

Role: PRINCIPAL_INVESTIGATOR

OUHSC

Locations

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OUHSC Children's Hospital

Oklahoma City, Oklahoma, United States

Site Status

Countries

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United States

References

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Atchley CB, Cloud A, Thompson D, Blunt MH, Satnes KJ, Szyld E, Ernst KD. Enhanced Protein Diet for Preterm Infants: A Prospective, Randomized, Double-blind, Controlled Trial. J Pediatr Gastroenterol Nutr. 2019 Aug;69(2):218-223. doi: 10.1097/MPG.0000000000002376.

Reference Type DERIVED
PMID: 31058772 (View on PubMed)

Other Identifiers

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4885

Identifier Type: -

Identifier Source: org_study_id