1. The Relationship of Early Body Composition Changes and 1 year Neurodevelopment in VLBW Preterm Infants SARA RAMEL, MD 1, HEATHER GRAY, MPH 2, ELLEN W DEMERATH, PhD 3 1 Department of Pediatrics, University of Minnesota, Minneapolis, MN, 2 Department of Maternal Fetal Medicine, University of Minnesota, Minneapolis, MN and 3 Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN Disclosure: I presented a 2015 Educational Webinar for Mead Johnson Nutrition Results  SAMPLE: 34 appropriate for gestational age very low birth weight (VLBW )(<1500g) preterm infants  MEASURES: Body composition (fat mass, fat free mass and percent body fat) using air-displacement plethysmography (Pea Pod, COSMED USA) were measured weekly from birth to discharge (once stable enough to tolerate RA for 5 minutes). Data were also gathered on several clinical markers of illness. Total hospital caloric and protein deficits were calculated by taking the total amounts received throughout hospitalization and subtracting it from a calculated goal of 120 kcal/kg/day and 3.5 g of protein/kg/day, respectively. Neurodevelopment was tested using the Bayley Scales of Infant Development-III at 12 months CA.  STATISTICAL ANALYSIS: Linear mixed effects models were used to test subject-specific changes in FFM from birth to discharge as predictors of Bayley scores (SAS v9.3). Potential confounders were included if they improved the models (higher R 2 and lower AIC). Background Methods Objective Table 1. Descriptive characteristics To investigate the relationship between early body composition changes and neurodevelopment at 1 year CA. Summary & Conclusions  Fat-free mass is an important biomarker of brain development and should be monitored closely throughout early life in very low birth weight preterm infants  Increased fat mass gains during hospitalization do not improve neurodevelopmental scores and may increase later metabolic risk  Additional research into strategies which increase fat-free mass gains without further increasing fat mass are needed to inform the nutritional and clinical management of VLBW preterm infants.  Increased fat-free mass gains prior to hospital discharge are associated with improved neurodevelopment at 12 months CA  Even after controlling for important confounders, an additional gain of 10 grams/per week of fat-free mass is associated with increased motor and cognitive scores by 2-3 points when measured at 12 months CA  Fat-free mass may be an important biomarker of brain development  More research into nutritional and non-nutritional interventions aimed at specifically increasing early fat-free mass gains is needed to improve long-term outcomes for VLBW preterm infants  Increased fat mass gains prior to hospital discharge are not associated with neurodevelopment at 12 months CA  Early and rapid fat mass gains may be associated with increased risk for later obesity and metabolic syndrome without additional neurodevelopmental benefit  Long-term studies investigating the associations between early body composition on both metabolic and neurodevelopmental outcomes are needed Discussion Table 3. Association of fat mass (g/wk) from birth to discharge and Bayley Scales of Infant Development-III scores at 12moCA Table 2. Association of fat-free mass (g/wk) from birth to discharge and Bayley Scales of Infant Development-III scores at 12moCA  Preterm infants have less fat free mass and increased relative adiposity at term corrected gestational age (CA).  Early alterations in body composition may increase later risk for obesity and components of metabolic syndrome.  Increased weight gain during hospitalization and increased linear growth throughout the first year are associated with improved neurodevelopmental outcomes.