# Infant diet and cardiometabolic risk among children born preterm

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $746,826

## Abstract

Project Summary / Abstract
 Each year, over 63,000 U.S. infants are born very preterm, prior to 32 weeks of gestation. With >90% now
surviving to discharge due to better obstetrical and neonatal intensive care unit (NICU) management, the
present challenge is to reduce short- and long-term morbidities experienced by survivors, including the two- to
four-fold increased risk of obesity, diabetes, hypertension, and metabolic syndrome that manifest by young
adulthood. The Developmental Origins of Health and Disease (DOHaD) framework posits that chronic
conditions result from adverse exposures during vulnerable developmental stages known as “critical” or
“sensitive” periods. Of particular importance is the first 1000 days of life, when key developmental processes
set the stage for lifelong health. Very preterm infants are an especially vulnerable population, as they require
NICU support for 2-4 months after birth, coinciding with the 3rd trimester – an established sensitive period for
programming of obesity and cardiometabolic risk. In this context, the most highly modifiable and relevant
exposure is diet during the NICU hospitalization, which may contribute to the accelerated accretion of fat mass
relative to fat-free mass. Hospitalized very preterm infants typically experience impaired weight gain, stunted
linear growth, and excess fat accretion relative to the typical fetus. To offset these issues and support brain
development, dietary fortification of human milk is provided as standard of care. However, the consequences
of dietary fortification for cardiometabolic health in this population are poorly understood. This proposal seeks
to uncover the extent to which diet-based interventions that promote physical growth and brain development
during a sensitive period may also contribute to cardiometabolic risk. We will study 130 infants born 24-31
weeks of gestation who are participating in the Nourish Study (R01HD097327l; PI: Belfort), an ongoing
randomized controlled trial testing the effect of individually targeted human milk fortification vs. standard of
care during the NICU hospitalization. By extending follow-up of this cohort and adding cardiometabolic
biomarkers at 2 and 5 years of age, we have a unique opportunity to investigate how macronutrient and energy
delivery during a sensitive period contributes to, or protects from, cardiometabolic risk during childhood. We
are further poised to address key questions about NICU growth patterns in relation to cardiometabolic health in
this population. Findings from this work have strong potential to impact clinical care by informing dietary
strategies during a sensitive window in development to optimize lifelong health for a vulnerable population.

## Key facts

- **NIH application ID:** 10912782
- **Project number:** 5R01HD112751-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Mandy Brown Belfort
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $746,826
- **Award type:** 5
- **Project period:** 2023-08-23 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10912782

## Citation

> US National Institutes of Health, RePORTER application 10912782, Infant diet and cardiometabolic risk among children born preterm (5R01HD112751-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10912782. Licensed CC0.

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