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
(Our Organization
is not responsible for the content of Internet sites.)
American
College of Physicians
American
Diabetes Association
American
Heart Association
Diabetes
Care
National
Institutes of Health
|
May 2003
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
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.
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