Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
19 - Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
Published online by Cambridge University Press: 10 December 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- List of abbreviations
- 1 Fetal nutrition
- 2 Determinants of intrauterine growth
- 3 Aspects of fetoplacental nutrition in intrauterine growth restriction and macrosomia
- 4 Postnatal growth in preterm infants
- 5 Thermal regulation and effects on nutrient substrate metabolism
- 6 Development and physiology of the gastrointestinal tract
- 7 Metabolic programming as a consequence of the nutritional environment during fetal and the immediate postnatal periods
- 8 Nutrient regulation in brain development: glucose and alternate fuels
- 9 Water and electrolyte balance in newborn infants
- 10 Amino acid metabolism and protein accretion
- 11 Carbohydrate metabolism and glycogen accretion
- 12 Energy requirements and protein-energy metabolism and balance in preterm and term infants
- 13 The role of essential fatty acids in development
- 14 Vitamins
- 15 Normal bone and mineral physiology and metabolism
- 16 Disorders of mineral, vitamin D and bone homeostasis
- 17 Trace minerals
- 18 Iron
- 19 Conditionally essential nutrients: choline, inositol, taurine, arginine, glutamine and nucleotides
- 20 Intravenous feeding
- 21 Enteral amino acid and protein digestion, absorption, and metabolism
- 22 Enteral carbohydrate assimilation
- 23 Enteral lipid digestion and absorption
- 24 Minimal enteral nutrition
- 25 Milk secretion and composition
- 26 Rationale for breastfeeding
- 27 Fortified human milk for premature infants
- 28 Formulas for preterm and term infants
- 29 Differences between metabolism and feeding of preterm and term infants
- 30 Gastrointestinal reflux
- 31 Hypo- and hyperglycemia and other carbohydrate metabolism disorders
- 32 The infant of the diabetic mother
- 33 Neonatal necrotizing enterocolitis: clinical observations and pathophysiology
- 34 Neonatal short bowel syndrome
- 35 Acute respiratory failure
- 36 Nutrition for premature infants with bronchopulmonary dysplasia
- 37 Nutrition in infants with congenital heart disease
- 38 Nutrition therapies for inborn errors of metabolism
- 39 Nutrition in the neonatal surgical patient
- 40 Nutritional assessment of the neonate
- 41 Methods of measuring body composition
- 42 Methods of measuring energy balance: calorimetry and doubly labelled water
- 43 Methods of measuring nutrient substrate utilization using stable isotopes
- 44 Postnatal nutritional influences on subsequent health
- 45 Growth outcomes of preterm and very low birth weight infants
- 46 Post-hospital nutrition of the preterm infant
- Index
- References
Summary
Introduction
The term “conditionally essential” has been used to describe the role of choline, inositol, taurine, arginine, glutamine, and nucleotides in human nutrition. The biochemical pathways to synthesize these nutrients are present, and their absence from the diet does not lead to a classical clinical deficiency syndrome. However, under certain conditions, the biosynthetic capacity may be below functional metabolic demands. The conditions under which these nutrients may become essential include prematurity, certain disease states, periods of limited nutrient intake or rapid growth, and the presence of regulatory or developmental factors that interfere with full expression of the endogenous synthetic capacity. Under these conditions, dietary intake of the nutrient may optimize tissue function.
Several of the conditionally essential nutrients are present in significantly higher quantities in human milk versus infant formulas, and several are added to term and/or preterm formulas. On-going research will help to clarify their roles in neonatal nutrition and metabolism.
Choline
Choline was classified in 1998 as an essential nutrient for humans by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. The Board recognized that fetal development and infancy constitute periods of increased demand for choline. The classification of choline as an essential nutrient will likely stimulate renewed interest and research in its role in the developing infant.
Choline has a variety of biological functions. It is a precursor for the neurotransmitter acetylcholine, and for two signaling lipids, platelet-activating factor and sphingosylphosphorylcholine.
- Type
- Chapter
- Information
- Neonatal Nutrition and Metabolism , pp. 299 - 311Publisher: Cambridge University PressPrint publication year: 2006
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