Publication Date
1-1-2026
Journal
Current Opinion in Clinical Nutrition & Metabolic Care
DOI
10.1097/MCO.0000000000001178
PMID
41057241
PMCID
PMC12700696
PubMedCentral® Posted Date
11-7-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Purpose of review: This review evaluates recent evidence on how total protein and energy intake, amino acid composition, and nutrient delivery modality influence protein synthesis in preterm neonates, with the goal of informing nutritional strategies to support optimal lean mass accretion and growth.
Recent findings: Preterm neonates exhibit anabolic resistance to feeding due to impaired insulin and amino acid signaling in skeletal muscle. Enteral nutrition, especially fortified human milk, supports better lean mass accretion and neurodevelopment than parenteral nutrition. Intermittent bolus feeding and pulsatile leucine supplementation during continuous feeding further enhance mTORC1-dependent translation initiation signaling and protein synthesis efficiency in skeletal muscle, offering promising strategies to optimize lean tissue growth.
Summary: Strategies that prioritize early enteral feeding, appropriate milk fortification, and nutrient delivery patterns that mimic feeding pulsatility may overcome anabolic resistance and enhance lean mass accretion, supporting healthy growth trajectories in preterm infants.
Keywords
Humans, Infant, Newborn, Infant, Premature, Amino Acids, Infant Nutritional Physiological Phenomena, Enteral Nutrition, Energy Intake, Parenteral Nutrition, Muscle, Skeletal, Milk, Human, Dietary Proteins, growth, infant, lean mass, milk, muscle, nutritional care
Published Open-Access
yes
Recommended Citation
Antonio C Ramos Dos Santos, Marta L Fiorotto, and Teresa A Davis, "Amino Acids and Lean Mass Accretion in Preterm Neonates" (2026). Faculty, Staff and Students Publications. 6446.
https://digitalcommons.library.tmc.edu/baylor_docs/6446