human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: abstract Objectives : To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm . Design : R and omised , blinded nutritional intervention trial . Blinded follow up at 7 1/2 - 8 years . Setting : Intervention phase in two neonatal units ; follow up in a clinic or school setting . Subjects : 424 preterm infants who weighed under 1850 g at birth ; 360 of those who survived were tested at 7 1/2 - 8 years . Interventions : St and ard infant formula versus nutrient enriched preterm formula r and omly assigned as sole diet ( trial A ) or supplements to maternal milk ( trial B ) fed for a mean of 1 month . Main outcome measures : Intelligence quotient ( IQ ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children ( revised ) . Results : There was a major sex difference in the impact of diet . At 7 1/2 - 8 years boys previously fed st and ard versus preterm formula as sole diet had a 12.2 point disadvantage ( 95 % confidence interval 3.7 to 20.6 ; P<0.01 ) in verbal IQ . In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ ( 1.2 to 17.7 ; P<0.05 ) and verbal IQ ( 5.7 to 23.2 ; P<0.01 ) . Consequently , more infants fed term formula had low verbal IQ ( < 85 ) : 31 % versus 14 % for both sexes ( P=0.02 ) and 47 % versus 13 % in boys P=0.009 ) . There was a higher incidence of cerebral palsy in those fed term formula ; exclusion of such children did not alter the findings . Conclusions : Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance — notably , language based skills — at 7 1/2 - 8 years , when cognitive scores are highly predictive of adult ones . Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult . Cognitive function , notably in males , may be permanently impaired by suboptimal neonatal nutrition Summary : Very low birthweight ( VLBW ) infants weighing < 1,600 g at birth were fed their own mother 's milk ( OMM ) or r and omly assigned to receive one of three formulas : a “ humanized ” formula ( SF ) , a partially modified casein-predominant cow 's milk formula ( CF ) , or a premature formula ( PF ) . All infants were fed at 120 kcal/kg/day where possible , PF infants had significantly greater weight increments ( 28.0 g/day ) than those on OMM ( 19.4 g/day ) , SF ( 18.9 g/day ) , and CF ( 18.2 g/day ) . Those on PF also had greater increments of length , head circumference , and skinfold thickness than those on the other two formulas and greater length increments than those on OMM . Dynamic skinfold measurements suggested that no infants accumulated excessive amounts of interstitial fluid . Infants on the two st and ard formulas had significantly greater base deficits , whereas those on CF also had higher urea values . Those on OMM had lower phosphate and higher alkaline phosphatase values than the other groups . Thus VLBW infants fed a premature formula had better growth and fewer biochemical problems than those on st and ard formulas , whereas supplementation of OMM may be necessary to ensure optimal growth and bone mineralization BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ard term formula or preterm formula . Within each trial , the allocated milk was the sole diet for some infants ( study A ) , whereas for others it was a supplement to maternal breast milk , given when not enough expressed breast milk was available ( study B ) . We followed up 781 of 833 survivors ( 94 % ) to age 7.5 - 8 y. Trained assessors obtained anthropometric measurements according to a st and ard protocol . RESULTS Despite significantly better neonatal growth performance in infants fed preterm formula ( compared with either banked donor breast milk or st and ard formula ) , early diet had no influence on weight , height , head circumference , or skinfold thicknesses at 9 or 18 mo postterm or at age 7.5 - 8 y. CONCLUSIONS These findings suggest that the preterm period is not a critical window for nutritional programming of growth , which contrasts with evidence from these trials showing that early diet influences later neurodevelopment Background : Infants born very preterm are at an increased risk of poor growth in the post-natal period . Poor brain growth in this critical period may result from inadequate nutrition , and has long-term effects on neurodevelopmental outcome . Aims : To examine the feasibility of providing macronutrients at amounts above current recommendations ( hyperalimentation ) to improve nutrition and head growth in preterm infants . Methods : 142 infants < 29 weeks ' gestation were r and omised to hyperalimented or st and ard parenteral and enteral nutrition .  Growth was monitored from birth to 36 weeks ' postmenstrual age ( PMA ) . The primary outcome measure was occipitofrontal circumference ( OFC ) at 36 weeks ' PMA . Results : 55 infants in the intervention group and 59 infants in the control group survived to 36 weeks ' PMA . 11 ( 16 % ) infants in the intervention group and 13 ( 18 % ) infants in the control group were small for gestational age ( SGA ) . There was no statistically significant difference between the two groups in the primary outcome measure or other growth variables . Babies in the intervention group received significantly more energy and protein , but 80 % were still in a cumulative protein/energy deficit at the end of 4 weeks . 20 ( 24 % , p = 0.008 ) of those in deficit at 4 weeks had an OFC of more than 2 SD below the mean at 36 weeks ' PMA , as opposed to none of those not in deficit . Conclusion : Cumulative energy/protein deficit is predictive of poor head growth , but the delivery of adequate intakes remains a challenge in the preterm OBJECTIVE : To examine the influence of the macronutrient intake in early life on the development of  overweight in children . DESIGN AND SUBJECTS : An ongoing longitudinal study including 147 r and omized healthy children followed up from birth . MEASUREMENTS : Anthropometric parameters were measured at birth , 1 and 5 y of age . Dietary habits at the age of 1 and 5 were assessed by age-adjusted food-frequency question naires and 24 h recalls .  Parents ’ body mass index ( BMI ) was also recorded . RESULTS :  Parental overweight was observed for 51 % children . The prevalence of overweight at the age of 5 y was higher in children with than without parental overweight ( 37.3 % vs 8.3 % , P<0.0001 ) . Five-year old overweight children had a higher percentage intake of proteins at the age of 1 y than non overweight children ( 22 % vs 20 % , P=0.024 ) and lower intake of carbohydrates ( 44 % vs 47 % , P=0.031 ) . Multiple logistic analysis confirmed that protein intake at 1 y of age was associated with overweight at 5 y ( P=0.05 ) . In children born from overweight mothers , prevalence of overweight at the age of 5 y tended to be higher in bottle-fed than in breast-fed ones ( 62.5 % vs 23.3 % , P=0.08 ) . CONCLUSION : Parental overweight is a major risk factor for childhood overweight in the first years of life , but an early high protein intake may also influence the development of adiposity Objective : To determine if enteral protein and energy supplementation would significantly improve weight gain as compared with energy supplementation alone in ⩽1250 g infants . Study Design : Inclusion criteria were birth weight ( BW ) ⩽1250 g , postnatal age ⩾14 days , diet of ⩾75 % enteral nutrition ( fortified human milk or formula ) and either failure to regain BW or weight gain<15 g kg−1 per days . Infants were r and omized to a multinutrient supplement that provided increased protein and energy ( P/E ) intake or energy alone ( medium chain triglyceride oil , MCT ) . Growth rates were compared at the end of the 4-week study period . Result : Of 30 eligible infants , 23 were enrolled , 12 received MCT ( BW=862±252 g , mean±s.d . ) and 11 received P/E ( BW=879±241 g ) . Significantly higher protein intake  ( P/E=3.5±0.3 g kg−1 per day , MCT=3.0±0.5 g kg−1 per day ) and better growth  ( P/E=17.0±2.4 g kg−1 per day , MCT=11.5±4.8 g kg−1 per day ) were observed in the P/E group . Conclusion : These data are consistent with the importance of providing additional daily protein intake to achieve increased postnatal growth in very low birth weight infants experiencing slow growth To test the hypothesis that the nutrient intake and growth of infants with chronic lung disease would be improved by providing nutrients in more concentrated form , and that the lower volume would improve respiratory status , 60 preterm infants requiring supplemental oxygen at 28 days of age were r and omly assigned a low‐density ( 24 kcal/oz ) formula fed at 180 ml/kg/day , or a high‐density ( 30 kcal/oz ) formula at 145 ml/kg/day . There was no difference in growth , respiratory outcome , oedema or diuretic requirement between dietary groups . Infants fed the high nutrient density formula had significantly greater total energy ( 143 vs 134 kcal/kg/day ) and protein ( 3.9 vs 3.6g/kg/day ) intakes , largely because the low‐density formula group did not achieve the design ated 180 ml/kg/day . In conclusion , use of a high‐density formula in infants with chronic lung disease did not improve growth or respiratory outcome , despite a small increase in total energy and protein intake In a prospect i ve longitudinal study of 48 very low birth weight and preterm infants with mean birth weight 1385 + /- 343 g and gestational age 30.8 + /- 2.9 weeks an assessment was made of the impact of varying the protein intake in the postnatal period from the 3rd to 7th week of life . The infants were r and omly allocated to one of three dietary groups with isocaloric energy supply but different protein content , i.e. human milk ( 1.6 g/100 kcal ) , formula 1 ( 2.3 g/100 kcal ) and formula 2 ( 3.0 g/100 kcal ) . In the human milk group 12 of 18 infants were fed their own mother 's breastmilk . During the study period the mean weight gain was slight higher in the infants fed formula . There were no group differences in S-albumin but B-urea-N and B-base deficit were significantly higher in formula-fed infants compared to infants fed human milk . After the study period that lasted to about 20 weeks of age the slope in weight gain remained slightly higher for formula fed infants , whereas the gain in body length and hear circumference was equal in all three groups . After around 8 months of age there was no difference in any growth parameter . Neurodevelopmental examinations showed no group differences during the follow-up period to 2 years of age . With few exceptions breastmilk-preferably from their own mothers-was adequate for both early and longterm growth and development of the very low birth weight infants in this population 424 preterm infants were r and omly assigned a st and ard " term " formula or a nutrient-enriched " preterm " formula as sole diets ( trial A ) or as supplements to mother 's own expressed milk ( trial B ) for a median of 4 weeks postnatally . 18 months post term , blind evaluation of 377 survivors showed that those previously fed preterm rather than term formula had major developmental advantages , more so in motor than mental function ; the advantages , in both mental and motor scores , were especially striking in small-for-gestational-age infants and in males . For motor development index in trial A , this advantage was 15 points ; in infants born small for gestation , it was 23 points ( nearly 1.5 SD ) . Moderate developmental impairment ( developmental index less than 85 ) , notably motor impairment , was considerably more common in the group fed term formula . Infants fed preterm formula also had a small benefit in social maturity quotient . Thus , a short period of early dietary manip 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: abstract Objectives : To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm . Design : R and omised , blinded nutritional intervention trial . Blinded follow up at 7 1/2 - 8 years . Setting : Intervention phase in two neonatal units ; follow up in a clinic or school setting . Subjects : 424 preterm infants who weighed under 1850 g at birth ; 360 of those who survived were tested at 7 1/2 - 8 years . Interventions : St and ard infant formula versus nutrient enriched preterm formula r and omly assigned as sole diet ( trial A ) or supplements to maternal milk ( trial B ) fed for a mean of 1 month . Main outcome measures : Intelligence quotient ( IQ ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children ( revised ) . Results : There was a major sex difference in the impact of diet . At 7 1/2 - 8 years boys previously fed st and ard versus preterm formula as sole diet had a 12.2 point disadvantage ( 95 % confidence interval 3.7 to 20.6 ; P<0.01 ) in verbal IQ . In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ ( 1.2 to 17.7 ; P<0.05 ) and verbal IQ ( 5.7 to 23.2 ; P<0.01 ) . Consequently , more infants fed term formula had low verbal IQ ( < 85 ) : 31 % versus 14 % for both sexes ( P=0.02 ) and 47 % versus 13 % in boys P=0.009 ) . There was a higher incidence of cerebral palsy in those fed term formula ; exclusion of such children did not alter the findings . Conclusions : Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance — notably , language based skills — at 7 1/2 - 8 years , when cognitive scores are highly predictive of adult ones . Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult . Cognitive function , notably in males , may be permanently impaired by suboptimal neonatal nutrition Summary : Very low birthweight ( VLBW ) infants weighing < 1,600 g at birth were fed their own mother 's milk ( OMM ) or r and omly assigned to receive one of three formulas : a “ humanized ” formula ( SF ) , a partially modified casein-predominant cow 's milk formula ( CF ) , or a premature formula ( PF ) . All infants were fed at 120 kcal/kg/day where possible , PF infants had significantly greater weight increments ( 28.0 g/day ) than those on OMM ( 19.4 g/day ) , SF ( 18.9 g/day ) , and CF ( 18.2 g/day ) . Those on PF also had greater increments of length , head circumference , and skinfold thickness than those on the other two formulas and greater length increments than those on OMM . Dynamic skinfold measurements suggested that no infants accumulated excessive amounts of interstitial fluid . Infants on the two st and ard formulas had significantly greater base deficits , whereas those on CF also had higher urea values . Those on OMM had lower phosphate and higher alkaline phosphatase values than the other groups . Thus VLBW infants fed a premature formula had better growth and fewer biochemical problems than those on st and ard formulas , whereas supplementation of OMM may be necessary to ensure optimal growth and bone mineralization BACKGROUND Preterm children are at high risk of poor growth performance . In 2 r and omized trials , preterm infants fed preterm formula grew better in the neonatal period than those fed banked donor breast milk or st and ard term formula . OBJECTIVE Our objective was to test the hypothesis that for preterm infants , the neonatal period is a critical one for programming growth performance and that early diet influences long-term growth . DESIGN A total of 926 preterm infants were recruited into 2 parallel , r and omized trials of neonatal diet . In trial 1 , infants were fed either banked donor breast milk or preterm formula whereas in trial 2 , infants were fed either st and ard term formula or preterm formula . Within each trial , the allocated milk was the sole diet for some infants ( study A ) , whereas for others it was a supplement to maternal breast milk , given when not enough expressed breast milk was available ( study B ) . We followed up 781 of 833 survivors ( 94 % ) to age 7.5 - 8 y. Trained assessors obtained anthropometric measurements according to a st and ard protocol . RESULTS Despite significantly better neonatal growth performance in infants fed preterm formula ( compared with either banked donor breast milk or st and ard formula ) , early diet had no influence on weight , height , head circumference , or skinfold thicknesses at 9 or 18 mo postterm or at age 7.5 - 8 y. CONCLUSIONS These findings suggest that the preterm period is not a critical window for nutritional programming of growth , which contrasts with evidence from these trials showing that early diet influences later neurodevelopment Background : Infants born very preterm are at an increased risk of poor growth in the post-natal period . Poor brain growth in this critical period may result from inadequate nutrition , and has long-term effects on neurodevelopmental outcome . Aims : To examine the feasibility of providing macronutrients at amounts above current recommendations ( hyperalimentation ) to improve nutrition and head growth in preterm infants . Methods : 142 infants < 29 weeks ' gestation were r and omised to hyperalimented or st and ard parenteral and enteral nutrition .  Growth was monitored from birth to 36 weeks ' postmenstrual age ( PMA ) . The primary outcome measure was occipitofrontal circumference ( OFC ) at 36 weeks ' PMA . Results : 55 infants in the intervention group and 59 infants in the control group survived to 36 weeks ' PMA . 11 ( 16 % ) infants in the intervention group and 13 ( 18 % ) infants in the control group were small for gestational age ( SGA ) . There was no statistically significant difference between the two groups in the primary outcome measure or other growth variables . Babies in the intervention group received significantly more energy and protein , but 80 % were still in a cumulative protein/energy deficit at the end of 4 weeks . 20 ( 24 % , p = 0.008 ) of those in deficit at 4 weeks had an OFC of more than 2 SD below the mean at 36 weeks ' PMA , as opposed to none of those not in deficit . Conclusion : Cumulative energy/protein deficit is predictive of poor head growth , but the delivery of adequate intakes remains a challenge in the preterm OBJECTIVE : To examine the influence of the macronutrient intake in early life on the development of  overweight in children . DESIGN AND SUBJECTS : An ongoing longitudinal study including 147 r and omized healthy children followed up from birth . MEASUREMENTS : Anthropometric parameters were measured at birth , 1 and 5 y of age . Dietary habits at the age of 1 and 5 were assessed by age-adjusted food-frequency question naires and 24 h recalls .  Parents ’ body mass index ( BMI ) was also recorded . RESULTS :  Parental overweight was observed for 51 % children . The prevalence of overweight at the age of 5 y was higher in children with than without parental overweight ( 37.3 % vs 8.3 % , P<0.0001 ) . Five-year old overweight children had a higher percentage intake of proteins at the age of 1 y than non overweight children ( 22 % vs 20 % , P=0.024 ) and lower intake of carbohydrates ( 44 % vs 47 % , P=0.031 ) . Multiple logistic analysis confirmed that protein intake at 1 y of age was associated with overweight at 5 y ( P=0.05 ) . In children born from overweight mothers , prevalence of overweight at the age of 5 y tended to be higher in bottle-fed than in breast-fed ones ( 62.5 % vs 23.3 % , P=0.08 ) . CONCLUSION : Parental overweight is a major risk factor for childhood overweight in the first years of life , but an early high protein intake may also influence the development of adiposity Objective : To determine if enteral protein and energy supplementation would significantly improve weight gain as compared with energy supplementation alone in ⩽1250 g infants . Study Design : Inclusion criteria were birth weight ( BW ) ⩽1250 g , postnatal age ⩾14 days , diet of ⩾75 % enteral nutrition ( fortified human milk or formula ) and either failure to regain BW or weight gain<15 g kg−1 per days . Infants were r and omized to a multinutrient supplement that provided increased protein and energy ( P/E ) intake or energy alone ( medium chain triglyceride oil , MCT ) . Growth rates were compared at the end of the 4-week study period . Result : Of 30 eligible infants , 23 were enrolled , 12 received MCT ( BW=862±252 g , mean±s.d . ) and 11 received P/E ( BW=879±241 g ) . Significantly higher protein intake  ( P/E=3.5±0.3 g kg−1 per day , MCT=3.0±0.5 g kg−1 per day ) and better growth  ( P/E=17.0±2.4 g kg−1 per day , MCT=11.5±4.8 g kg−1 per day ) were observed in the P/E group . Conclusion : These data are consistent with the importance of providing additional daily protein intake to achieve increased postnatal growth in very low birth weight infants experiencing slow growth To test the hypothesis that the nutrient intake and growth of infants with chronic lung disease would be improved by providing nutrients in more concentrated form , and that the lower volume would improve respiratory status , 60 preterm infants requiring supplemental oxygen at 28 days of age were r and omly assigned a low‐density ( 24 kcal/oz ) formula fed at 180 ml/kg/day , or a high‐density ( 30 kcal/oz ) formula at 145 ml/kg/day . There was no difference in growth , respiratory outcome , oedema or diuretic requirement between dietary groups . Infants fed the high nutrient density formula had significantly greater total energy ( 143 vs 134 kcal/kg/day ) and protein ( 3.9 vs 3.6g/kg/day ) intakes , largely because the low‐density formula group did not achieve the design ated 180 ml/kg/day . In conclusion , use of a high‐density formula in infants with chronic lung disease did not improve growth or respiratory outcome , despite a small increase in total energy and protein intake In a prospect i ve longitudinal study of 48 very low birth weight and preterm infants with mean birth weight 1385 + /- 343 g and gestational age 30.8 + /- 2.9 weeks an assessment was made of the impact of varying the protein intake in the postnatal period from the 3rd to 7th week of life . The infants were r and omly allocated to one of three dietary groups with isocaloric energy supply but different protein content , i.e. human milk ( 1.6 g/100 kcal ) , formula 1 ( 2.3 g/100 kcal ) and formula 2 ( 3.0 g/100 kcal ) . In the human milk group 12 of 18 infants were fed their own mother 's breastmilk . During the study period the mean weight gain was slight higher in the infants fed formula . There were no group differences in S-albumin but B-urea-N and B-base deficit were significantly higher in formula-fed infants compared to infants fed human milk . After the study period that lasted to about 20 weeks of age the slope in weight gain remained slightly higher for formula fed infants , whereas the gain in body length and hear circumference was equal in all three groups . After around 8 months of age there was no difference in any growth parameter . Neurodevelopmental examinations showed no group differences during the follow-up period to 2 years of age . With few exceptions breastmilk-preferably from their own mothers-was adequate for both early and longterm growth and development of the very low birth weight infants in this population 424 preterm infants were r and omly assigned a st and ard " term " formula or a nutrient-enriched " preterm " formula as sole diets ( trial A ) or as supplements to mother 's own expressed milk ( trial B ) for a median of 4 weeks postnatally . 18 months post term , blind evaluation of 377 survivors showed that those previously fed preterm rather than term formula had major developmental advantages , more so in motor than mental function ; the advantages , in both mental and motor scores , were especially striking in small-for-gestational-age infants and in males . For motor development index in trial A , this advantage was 15 points ; in infants born small for gestation , it was 23 points ( nearly 1.5 SD ) . Moderate developmental impairment ( developmental index less than 85 ) , notably motor impairment , was considerably more common in the group fed term formula . Infants fed preterm formula also had a small benefit in social maturity quotient . Thus , a short period of early dietary manip 
    Output:
    