Study:
Preemies' Early Nutrition May Affect Health Status Later
Researchers
Debate Pros and Cons of Nutrient Levels
The
levels of nutrients a baby receives during the first few weeks of life
may affect the risk of diabetes and cardiovascular problems later in
life, a new study suggests.
Premature
infants who were given a diet rich in nutrients had significantly higher
levels of fasting proinsulin than infants who ate a less-nutritious
diet, British researchers report in the medical journal The
Lancet.
Proinsulin
is a substance believed to be a marker for insulin resistance and the
possible development of type 2 diabetes, the researchers say.
"We
have found that infants born prematurely who grew fastest in the first
two weeks of life had higher proinsulin levels in adolescence than those
who had the slowest growth," says the study's lead author, Dr. Atul
Singhal. He is deputy director of the MRC Childhood Nutrition Research
Center at the Institute of Child Health in London.
"Faster
growth during a crucial window after birth may increase later risk factors
for diabetes and cardiovascular disease," Singhal says.
"So,
our study suggests that overfeeding after birth that promotes too rapid
growth should be avoided," says Singhal.
"Because
it is difficult to overfeed breastfed babies in the first few weeks,
our study is another piece of evidence that breastfeeding is the best
way to feed young babies," he adds.
However,
the study results definitely do not mean that parents should restrict
what their baby eats, cautions Singhal.
Expert:
Stay With Current Thinking, More Research Needed
Dr.
Denise Blumberg, director of pediatric endocrinology at Nassau University
Medical Center in East Meadow, N.Y., says, "This study raises the question
of what effect nutrition levels in early infancy have on long-term health.
It's interesting, but needs further study."
"No
one should change what they're doing for premature infants at this point,"
she says.
Blumberg
adds that "undernutrition" can cause problems in early growth and development
in infants. And, she points out, formula and medical interventions for
premature infants have changed significantly since the 1980s when the
children in the study were born. So, tests done on children born today
might have different results.
Additionally,
Blumberg says high levels of split 32-33 proinsulin are not a routine
measure of who will develop diabetes or insulin resistance. She also
notes that many factors throughout life affect the development of diabetes,
including diet, exercise, stress levels, and exposure to infection.
Researches
Study Teens Who Were Preemies
The
researchers took blood samples from 216 teens between the ages of 13
and 16 years who had been born prematurely and had participated in infant
nutrition studies. They also took blood samples from 61 healthy teens
who had been born at full-term for comparison.
The
premature infants had been fed either a low-nutrient diet (breast milk
or standard infant formula) or an enriched diet (a special formula for
pre-term infants) when they were born in the 1980s. Pre-term formula
is fortified with protein, fat, vitamins, and minerals. At that time,
the effects of diet on premature infant growth had not been well studied.
In
the study, the teens' blood samples were tested for levels of blood
sugar, insulin, and several types of proinsulin.
The
only significant difference between the groups was in a test of a type
of proinsulin known as 32-33 split proinsulin, which Singhal says can
be a marker for the development of non-insulin dependent - or type 2
- diabetes. Levels of this type of proinsulin were 20 percent lower
in the youngsters who had been fed a lower nutrient diet in the first
few weeks of life.
Singhal recommends
parents talk with their healthcare provider "to ensure that your child
grows at a steady but not excessive rate, particularly if bottle-feeding."
Always
consult your physician for more information.
Online
Resources
American
College of Physicians
American
Diabetes Association
American
Heart Association
Diabetes
Care
National
Institutes of Health
|
May 2003
In
This Issue:
Researchers
Debate Pros and Cons of Nutrient Levels
Expert:
Stay With Current Thinking, More Research Needed
Researches
Study Teens Who Were Preemies
Blood
Pressure Control Is Important
Online
Resources
Other
Resources:
Find
a St. John's Mercy Physician
Diabetes
Services at St. John's Mercy
Diabetes
Health Information
St.
John's Mercy Classes and Programs
In
Other Diabetes Health News:
Blood
Pressure Control Is Important
Because
high blood sugar levels can lead to complications that include heart
disease, the American College of Physicians (ACP)
recently issued new guidelines on this topic in the Annals
of Internal Medicine.
The
authors of the ACP guidelines reviewed studies
about blood pressure and cardiovascular complications and death
in people with type 2 diabetes. They used these studies to identify
the benefits of blood pressure control, the ideal blood pressure
levels, and the most effective blood pressure drugs in people with
this disease.
Three
studies about the benefits of blood pressure control in type 2 diabetes
showed that controlling blood pressure decreases heart disease,
stroke, and early death.
Another
two studies showed that people with type 2 diabetes do best if their
diastolic blood pressure (the second number in blood pressure readings)
is less than 80 mm Hg. Systolic blood pressure (the first number
in blood pressure readings) was less well studied.
However,
the studies suggested that physicians should aim for systolic
blood pressure less than 135 mm Hg. The studies that evaluated the
various blood pressure drugs showed that people with type 2 diabetes
and high blood pressure do best when they take angiotensin-converting
enzyme (ACE) inhibitors and thiazide diuretics.
And,
the ACP says studies suggested, angiotensin-receptor
blockers may be a good option in patients who do not tolerate ACE
inhibitors.
Other
types of blood pressure drugs include calcium-channel blockers and
beta-blockers. The studies underscored the fact that most patients
with type 2 diabetes need more than one drug to control blood pressure,
according to the ACP.
ACP
concludes that treating high blood pressure in patients with type
2 diabetes dramatically decreases patients' risk for heart disease,
stroke, and early death. Patients with type 2 diabetes should aim
for blood pressure levels less than 135/80 mm Hg, according to the
ACP.
The
ACP reports that even in the best-designed studies, most patients
did not reach target blood pressure levels with just one drug. ACP suggests
that it is important for patients to understand that they will probably
need to take more than one medication to adequately control their
blood pressure.
Always
consult your physician for more information.
What
Is Blood Pressure?
Blood
pressure, measured with a blood pressure cuff and stethoscope by
a nurse or other healthcare provider, is the force of the blood
pushing against the artery walls.
Each
time the heart beats, it pumps blood into the arteries, resulting
in the highest blood pressure as the heart contracts.
One
cannot take his own blood pressure unless an electronic blood pressure
monitoring device is used. Electronic blood pressure monitors may
also measure the heart rate, or pulse.
Two
numbers are recorded when measuring blood pressure.
The
second number in blood pressure readings, or systolic pressure,
refers to the pressure inside the artery when the heart contracts
and pumps blood through the body.
The first
number, or diastolic pressure, refers to the pressure inside the
artery when the heart is at rest and is filling with blood.
Both
the systolic and diastolic pressures are recorded as "mm Hg" (millimeters
of mercury). This recording represents how high the mercury column
is raised by the pressure of the blood.
Always
consult your physician for more information.
|
