FECAL CHOLESTEROL EXCRETION IN PRETERM INFANTS FED BREAST-MILK OR FORMULA WITH DIFFERENT CHOLESTEROL CONTENTS

In 44 very low-birth-weight infants, fecal cholesterol excretion was m easured and in 29 other infants serum total cholesterol concentrations in response to different cholesterol intakes were studied. The infant s received fortified breast milk (mean cholesterol content 15.3 mg/dl) or were fed either a standard preterm formula (cholesterol content 5. 5 mg/dl) or the same formula but with a modified lipid composition (lo ng chain polyunsaturated fatty acid concentration closely related to b reast milk fat) and 30 mg of cholesterol/dl. In the group fed the high cholesterol formula, fecal cholesterol excretion was significantly hi gher (35.5 mmol/kg/day) than in the groups fed breast milk or the stan dard formula (20.1 and 18.2 mmol/kg/day). Cholesterol balance in the g roup fed the high cholesterol formula (21.8 mmol/kg/day) was significa ntly higher than in the group fed breast milk (+8.6 mg/kg/day). In the infants fed the low cholesterol formula the balance was negative (-7. 7 mg/kg/day). Serum concentrations of total cholesterol were similar i n the groups fed breast milk or the high cholesterol formula (3.47 and 3.51 mmol/l), but significantly higher than in the group fed the low cholesterol formula (3.15 mmol/l). The data suggest that preterm infan ts are able to regulate a higher cholesterol intake than during breast feeding by increasing fecal cholesterol excretion as well as decreasi ng endogenous synthesis.