Abstract • Questions regarding fat deposition and hormonal control of lipogenesis in infants fed formulas containing medium-chain triglycerides have been raised by studies in animals. To compare growth, clinical observations, and laboratory measures of infants fed the same basic isocaloric formulas with 10%, 30%, or 50% of the total fat as medium-chain triglycerides, we studied longitudinally for the first four weeks of life 22 infants who weighed 1000 to 1750g. We found no differences in weight or skin-fold thickness between the groups. There were no clinical characteristics to distinguish one group from another. Two-hour postprandial levels of insulin and glucagon showed no differences one week to ten days after the start of the formula diet. The skin-fold thickness of all infants studied continued to increase after birth, regardless of weight loss. The increase in skin-fold thickness was comparable with the increase expected in the fetus in utero, but not significantly greater. The weight curve was parallel to the fetal weight curve but was lower, due to the first-week loss that possibly reflected a loss of body water, as suggested by the dynamic skin-fold thickness curve. (AJDC 1987;141:516-519) References 1. American Academy of Pediatrics, Committee on Nutrition: Nutritional needs of low-birth-weight infants . Pediatrics 1985;75:976-986. 2. Wu PYK, Edmond J, Auestad N, et al: Medium-chain triglycerides in infant formulas and their relation to plasma ketone body concentrations . Pediatr Res 1986;20:338-341.Crossref 3. Whyte RK, Campbell D, Stanhope R, et al: Energy balance in low birth weight infants fed formula of high or low medium-chain triglyceride content . J Pediatr 1986;108:964-971.Crossref 4. Bach AC, Babyan VK: Medium chain triglycerides: An update . Am J Clin Nutr 1982;36: 950-962. 5. Isselbacher KJ: Mechanisms of absorption of long and medium chain triglycerides , in Senior JR (ed): Medium Chain Triglycerides . Philadelphia, University of Pennsylvania, 1968, pp 21-34. 6. Kuo PT, Huang NN: The effect of medium chain triglyceride upon fat absorption plasma lipid and depot fat of children with cystic fibrosis of the pancreas . J Clin Invest 1965;44:1924-1933.Crossref 7. Okamoto E, Muttart CR, Sucker CL, et al: Use of medium chain triglycerides in feeding the low-birth-weight infant . AJDC 1982;136:428-431. 8. Bustamante SA, Jacobs P, Gaines JA: Body weight, static and dynamic skinfold thickness in small premature infants during the first month of life . Early Hum Dev 1983;8:217-224.Crossref 9. Boehm G, Melichar V, Lorenz I, et al: Nutrition of newborns small for gestational age with human milk lyophilisate enriched human milk during the first week of life . Ada Paediatr Hung 1985;26:261-269. 10. Thornton CJ, Shannon DL, Hunter MA, et al: Dynamic skinfold thickness measurements: A non-invasive estimate of neonatal extracellular water content . Pediatr Res 1982;16:989-994.Crossref 11. Vaucher YE, Harrison GG, Udall JN, et al: Skinfold thickness in North American infants 24-41 weeks gestation . Hum Biol 1984;56: 713-731. 12. Bustamante SA: The nutritional approach to intrauterine growth retardation: Fetal malnutrition . Ariz Med 1980;37:481-483. 13. Richman B, Cheesex P, Putet G, et al: Diet, fat accretion, and growth in premature infants . N Engl J Med 1981;305:1495-1500.Crossref 14. Putet G, Santerre J, Rigo J, et al: Nutrient balance, energy utilization, and composition of weight in very-low-birth-weight infants fed pooled human milk or a preterm formula . J Pediatr 1984;105:79-85.Crossref 15. Lavau MM, Hashim S: Effect of medium chain triglyceride on lipogenesis and body fat in the rat . J Nutr 1978;108:613-620.
American Journal of Diseases of Children – American Medical Association
Published: May 1, 1987
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