Protein Metabolism During Infancy

Other chapters focus on the nutritional importance of nonprotein nitrogen; the role of essential and nonessential amino acids in neonatal nutrition; the significance of nucleic acids, nucleotides, and related compounds in infants; and the role of tumor necrosis factor in protein metabolism.

The Institute of Medicine's (IOM's) Roundtable on Research and Development of Drugs, Biologics, and Medical Devices evolved from the Forum on Drug Development, which was established in 1986. Sponsor representatives and IOM determined the importance of maintaining a neutral setting for discussions regarding long-term and politically sensitive issues justified the need to revise and enhance past efforts. The new Roundtable is intended to be a mechanism by which a broad group of experts from the public* and private sectors can be convened to conduct a dialogue and exchange information related to the development of drugs, biologics, and medical devices. Members have expertise in clinical medicine, pediatrics, clinical pharmacology, health policy, health insurance, industrial management, and product development; and they represent interests that address all facets of public policy issues. From time to time, the Roundtable requests that a workshop be conducted for the purpose of exploring a specific topic in detail and obtaining the views of additional experts. The first workshop for the Roundtable was held on April 14 and 15, 1998, and was entitled Assuring Data Quality and Validity in Clinical Trials for Regulatory Decision Making. The summary on that workshop is available from IOM. This workshop summary covers the second workshop, which was held on May 24 and 25, 1999, and which was aimed at facilitating the development and proper use of drugs, biologics, and medical devices for infants and children. It explores the scientific underpinnings and clinical needs, as well as the regulatory, legal, and ethical issues, raised by this area of research and development.

Abstract: A reference text for clinicians and nutrition researchers presents the proceedings of a recent symposium that focused on energy and protein requirements during infant development. The text includes 11 authoritative, critical reviews and 4 technic al discussions, prepared by experts in the respective fields of study, that have been grouped among 4 principal themes: (1) energy needs during infancy (including a model to explain metabolic rate variability); (2) protein requirements during infancy (covering the needs of both term and preterm infants, and the types of proteins and growth modulators in human milk); (3) protein-energy interactions, including their assessments and mechanisms; and (4) problems in meeting the energy and protein requirements of infants (including amino acid needs and glucose and lipid metabolism in parenteral feeding of infants). A discussion paper is appended to each of these 4 sections. Tabular data and illustrations are provided throughout the text, and literature citations are appended to each of the reviews.

In this volume, world-renowned specialists review the latest scientific information and recommendations for protein and energy requirements of infants and children. New data obtained with the latest techniques show significantly lower requirements for both energy and protein than previously thought. This will have far-reaching implications for nutrition and health, not only during infancy and childhood, but also for long-term health outcomes, such as obesity and related disorders. Indeed for the latest generation of some infant formulas, many of the new nutrition concepts presented in this volume (especially those concerning protein level and quality) have already been translated into clinically tested products that are coming ever closer to the "gold standard" human milk, not only in terms of composition, but also of outcome. The important public health implications of the information reviewed in this volume provide essential reading for pediatricians, clinical investigators and health workers engaged in the prevention of nutrition-related disorders.

Lipids have been in clinical use as components of intravenous nutrition for over 50 years. Over the last 15 years, new and improved lipids that include olive oil and/or fish oil have replaced the more traditional ones. These new lipids offer the opportunity to deliver high amounts of fatty acids and possess different functional properties: in particular, they can influence inflammatory processes, immune responses and hepatic metabolism. This book brings together articles written by leading international authorities in the area of intravenous lipids. Contributions discuss the latest findings in the field, ranging from pre-clinical research to the most recent clinical trials. Lipid functionality and utility in pediatric, adult surgical and critically ill patients are covered, as is the use of lipids in long-term home parenteral nutrition. Addressing a broad spectrum of topics, this publication provides a wealth of information for basic scientists, clinical researchers and clinical practitioners alike.

We present to our readers the proceedings of the Second International Workshop on Phosphate. A short account of the history of the effort led to the Phosphate Workshops is appro priate and can be of interest to the reader. The idea for Phosphate Workshops was born in the early days of November, 1974. One of us (S. G. M. ) suggested the thought to a group of scientists gathered for a luncheon in one of the attrac tive small restaurants in Weisbaden, Germany. The purpose of the workshop was to bring together interested scientists to discuss the newer developments and the recent advances in the field of phosphate metabolism and the other related minerals. An Organizing Committee made of Shaul G. Massry (USA), Louis V. Avioli (USA), Philippe Bordier (France), Herbert Fleisch (Switzerland), and Eduardo Slatopolsky (USA) was formed. The First Workshop was held in Paris during June 5-6, 1975 and was hosted by Dr. Philippe Bordier. Its proceeding was already published. The Second Workshop took place in Heidelberg during June 28-30, 1976 and was hosted by Dr. Eberhard Ritz. Both of these workshops were extremely successful scientific endeavors, and the need for them was demonstrated by the great interest they generated among the scientific community. The Or ganizing Committee, therefore, decided to continue with the tradi tion to hold additional Workshops annually or every other year.