Benefits of Supplemented Preterm Formulas on Insulin Sensitivity and Body Composition after Discharge from the Neonatal Intensive Care Unit

Objective To evaluate body composition and fasting insulin level in preterm infants receiving preterm formulas (higher protein plus docosahexaenoic acid) for longer periods compared with a recent historical cohort receiving these formulas for shorter periods. Study design A total of 95 infants fed preterm formula for 6 months or longer (postdischarge formula group) and 87 infants fed preterm formula only during their hospital stay (hospital formula group) were included in this arm of the study. Results Bone mineral density, content, and lean mass were not different at 1 year and 2 years. However, in the postdischarge formula group, total fat mass (%) was lower by the second year (19.3% +/- 5.3% vs 21.7% +/- 4.2%; P < .01), trunk fat was lower by the first year (14.7% +/- 5.0% vs 16.9% +/- 4.9%; P < .005) and at the second year (14.1% +/- 5.7% vs 17.2% +/- 4.7%; P < .001), and fasting insulin was lower by the first year (13.2% +/- 7.1% vs 17.2% +/- 13.6% mIU/L; P = .06) and at the second year (13.6% +/- 6.1% vs 26.4% +/- 14.2%; P < .001). Conclusion Preterm infants fed formulas enriched with docosahexaenoic acid may have a better subsequent metabolic profile. (J Pediatr 2011;159:926-32).