# Early life protein-enriched human milk diets to increase lean body mass accretion and diversity of the gut microbiome in extremely preterm infants: a randomized trial

> **NIH NIH K23** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2022 · $162,150

## Abstract

SUMMARY
The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Ariel
A. Salas, MD, MSPH, with the mentorship, training, and research experience needed to become an
independent clinician scientist and leader in neonatal nutrition research. His long-term career goal is to reduce
the burden of postnatal growth failure through novel translational studies and large scale, multi-center clinical
trials of promising dietary interventions that optimize growth, reduce dysbiosis of the gut microbiome, and
ultimately improve neurodevelopment. His immediate goal is to acquire the skills needed to conduct a clinical
research program to study the effects of the protein intake and gut microbiome on growth and body
composition of extremely preterm infants (28 weeks of gestation or less). To achieve these goals and transition
to independence, Dr. Salas and his mentors have developed a comprehensive research and career
development plan that includes mentorship from an exceptional team of scientists with proven track records of
successful mentorship; intensive didactic training; and a research plan that is purposefully designed to provide
experiential learning in advanced research methods to study postnatal growth failure and the gut microbiome
of extremely preterm infants. Postnatal growth failure occurs in approximately 60% of the nearly 26,000
extremely preterm infants born every year in the United States. Postnatal growth failure is associated with a
higher risk of adverse health outcomes, particularly when fat mass (FM) gains are higher than fat-free mass
(FFM) gains. Recent work by Dr. Salas suggests that extremely preterm infants unable to tolerate early
progression of enteral feeding volumes during the first 2 weeks after birth have an increased risk of disrupted
maturation of the gut microbiome and an increased risk of postnatal growth failure. In the research plan
outlined in this K23 proposal, Dr. Salas will expand upon this work by 1) investigating the effects of early
postnatal life protein-enriched diets on FFM accretion in extremely preterm infants and 2) identifying maturation
patterns of the gut microbiome that differentiate preterm infants with postnatal growth failure and reduced FFM
accretion from preterm infants with appropriate postnatal growth and normal FFM accretion. This work will
produce novel insights into the pathogenesis of postnatal growth failure in preterm infants and will serve as the
foundation for Dr. Salas to inform his future R01 proposals and discover new, evidence-based approaches to
prevent postnatal growth failure. His career development plan outlines a clear path to gain the knowledge,
skills, and experience needed to become an independent clinician scientist, leader, and innovator in neonatal
nutrition research.

## Key facts

- **NIH application ID:** 10453715
- **Project number:** 5K23HD102554-03
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Ariel Salas
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $162,150
- **Award type:** 5
- **Project period:** 2020-08-10 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10453715

## Citation

> US National Institutes of Health, RePORTER application 10453715, Early life protein-enriched human milk diets to increase lean body mass accretion and diversity of the gut microbiome in extremely preterm infants: a randomized trial (5K23HD102554-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10453715. Licensed CC0.

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