Abstract
Background
Modulation of behavior and physiology by dietary perturbations early in life can provide clues to the pathogenesis of adult diseases. We tested the hypothesis that a period of early protein supplementation modulates sympathetic nervous system activity demonstrated indirectly by an increase in active sleep state distribution in very low birth weight (VLBW) infants.
Methods
VLBW infants (n = 71) were randomized to a total parenteral nutritional regimen providing 18% of the energy intake as amino acids (AA) or a conventional regimen providing 12.5% to achieve targeted AA intakes of 4 g/kg/day (0.004 kcal/kg/day) and 3 g/kg/day (0.003 kcal/kg/day), respectively. Both groups were weaned to enteral feeding and advanced to provide similar AA intake of 4 g/kg/day (0.004 kcal/kg/day). Six-hour daytime, behavioral sleep studies were performed when the infants reached full enteral intake (165 ml/kg/day).
Results
Infants in the high protein group spent more time in active sleep (77.2 ± 10.5% vs. 70.7 ± 11.8%), p < 0.01 and less time in quiet sleep (12.9 ± 3.4% vs. 17.7 ± 7.0%, p < 0.01) as compared to the conventional group. No group differences were observed for indeterminate sleep, awake, or crying states.
Conclusions
These results suggest that dietary intake may indirectly influence sympathetic nervous system activity.
Impact
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Infants randomized to an early, high protein nutritional regimen spent an increased percentage of time in active sleep, supporting the hypothesis that nutrition and behavior are interactive.
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Furthermore, sleep states are an indirect measure of sympathetic nervous system activity, suggesting that dietary intake may influence sympathetic nervous system activity.
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This study highlights the importance of considering the impact of nutrition during critical periods of development in order to further understand and improve the long-term outcomes of very low birth weight infants.
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Acknowledgements
This study was supported by the NIH R01 HD27564 and National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Number 1UL1TR001873-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Hammond, J., Kamboj, R., Kashyap, S. et al. The interaction between diet and neurobehavior in very low birth weight infants. Pediatr Res 91, 646–651 (2022). https://doi.org/10.1038/s41390-021-01464-z
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DOI: https://doi.org/10.1038/s41390-021-01464-z
