Lower protein in infant formula is associated with lower weight up to age 2 y: A randomized clinical trial

Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
American Journal of Clinical Nutrition (Impact Factor: 6.92). 05/2009; 89(6):1836-45. DOI: 10.3945/ajcn.2008.27091
Source: PubMed

ABSTRACT Protein intake during infancy was associated with rapid early weight gain and later obesity in observational studies.
The objective was to test the hypothesis that higher protein intake in infancy leads to more rapid length and weight gain in the first 2 y of life.
In a multicenter European study, 1138 healthy, formula-fed infants were randomly assigned to receive cow milk-based infant and follow-on formula with lower (1.77 and 2.2 g protein/100 kcal, respectively) or higher (2.9 and 4.4 g protein/100 kcal, respectively) protein contents for the first year. For comparison, 619 exclusively breastfed children were also followed. Weight, length, weight-for-length, and BMI were determined at inclusion and at 3, 6, 12, and 24 mo of age. The primary endpoints were length and weight at 24 mo of age, expressed as length and weight-for-length z scores based on the 2006 World Health Organization growth standards.
Six hundred thirty-six children in the lower (n = 313) and higher (n = 323) protein formula groups and 298 children in the breastfed group were followed until 24 mo. Length was not different between randomized groups at any time. At 24 mo, the weight-for-length z score of infants in the lower protein formula group was 0.20 (0.06, 0.34) lower than that of the higher protein group and did not differ from that of the breastfed reference group.
A higher protein content of infant formula is associated with higher weight in the first 2 y of life but has no effect on length. Lower protein intake in infancy might diminish the later risk of overweight and obesity. This trial was registered at as NCT00338689.

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Available from: Jean-Paul Langhendries, Aug 13, 2015
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    • "Previous studies have evidenced perinatal nutrition environment as the risk factor for the development of metabolic disease in the adulthood of the offspring (Armitage et al., 2008). An epidemiological study revealed that children fed on milk formulas gained more weight, when compared with those fed on breast milk, with greater body mass index (BMI) at 24 months of age and increased risk of childhood overweight and obesity (Koletzko et al., 2009). Nutritional insults suffered in the early childhood periods may be related to the morphological and physiological changes in the adulthood, resulting in the phenomenon of phenotypic plasticity (Wells, 2007). "
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    ABSTRACT: This study evaluated the long-term effects of a westernized diet during pregnancy and lactation. Female Wistar rats (n = 12) were divided into two groups according to their food intake, namely, control (C) or westernized (W) diet, throughout pregnancy/lactation. On the 21st day, the male pups were weaned on a standard diet as follows: Control diet (CC) (n = 8) and westernized diet in perinatal life followed by control diet post weaning (WC) (n = 8). The levels of fasting (12 h) serum glucose, triglycerides (TG), and total cholesterol and fraction in the pups were determined. During weaning, the WC group showed 14% greater body weight (p < 0.001). In the adulthood, the offspring from dams fed on westernized diet showed hyperphagia, hyperinsulinism, hypertriglyceridemia, higher fat visceral weight, higher very-low-density-lipoprotein cholesterol level, decreased high-density-lipoprotein cholesterol level, and altered glucose tolerance test. In conclusion, maternal western-style diet in early life altered long-term food intake, visceral fat pad, insulin, glucose and lipid serum, and increased risk of metabolic disorders.
    International Journal of Food Sciences and Nutrition 09/2014; 65(8). DOI:10.3109/09637486.2014.950208 · 1.20 Impact Factor
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    • "and was conducted and nine trials in this age group were identified [27] [28] [29] [30] [31] [32] [33] [34] [35]. However none of them targeted energy intake from formula-milk, the focus of the baby milk intervention. "
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    ABSTRACT: Introduction. We describe our experience of using the Medical Research Council framework on complex interventions to guide the development and evaluation of an intervention to prevent obesity by modifying infant feeding behaviours. Methods. We reviewed the epidemiological evidence on early life risk factors for obesity and interventions to prevent obesity in this age group. The review suggested prevention of excess weight gain in bottle-fed babies and appropriate weaning as intervention targets; hence we undertook systematic reviews to further our understanding of these behaviours. We chose theory and behaviour change techniques that demonstrated evidence of effectiveness in altering dietary behaviours. We subsequently developed intervention materials and evaluation tools and conducted qualitative studies with mothers (intervention recipients) and healthcare professionals (intervention deliverers) to refine them. We developed a questionnaire to assess maternal attitudes and feeding practices to understand the mechanism of any intervention effects. Conclusions. In addition to informing development of our specific intervention and evaluation materials, use of the Medical Research Council framework has helped to build a generalisable evidence base for early life nutritional interventions. However, the process is resource intensive and prolonged, and this should be taken into account by public health research funders. This trial is registered with ISRTCN: 20814693 Baby Milk Trial.
    Journal of obesity 07/2014; 2014:646504. DOI:10.1155/2014/646504
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    • "Study population, randomization, allocation and follow-up of the study participants for the first two years in the intervention and observational group have been reported in previous publications [24] [25]. "
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    ABSTRACT: Objective The interplay of genetic and nutritional regulation of the insulin-like growth factor-I axis in children is unclear. Therefore, potential gene–nutrient effects on serum levels of the IGF-I axis in a formula feeding trial were studied. Design European multicenter randomized clinical trial of 1090 term, formula-fed infants assigned to receive cow's milk-based infant and follow-on formulae with lower (LP: 1.25 and 1.6 g/100 mL) or higher (HP: 2.05 and 3.2 g/100 mL) protein contents for the first 12 months of life; a comparison group of 588 breastfed infants (BF) was included. Eight single nucleotide polymorphisms (SNPs) of the IGF-1-(rs6214, rs1520220, rs978458, rs7136446, rs10735380, rs2195239, rs35767, and rs35766) and two of the IGFBP-3-(rs1496495, rs6670) gene were analyzed. Serum levels of total and free IGF-I, IGFBP-3 and the molar ratio IGF-1/IGFBP-3 at age 6 months were regressed on determined SNPs and feeding groups in 501 infants. Results IGF-1-SNPs rs1520220, rs978458, and rs2195239 significantly increased total-IGF-I and molar-ratio IGF-I/IGFBP-3 by ~ 1.3 ng/mL and ~ 1.3 per allele, respectively; compared to LP infants concentration and molar-ratio were increased in HP by ~ 1.3 ng/mL and ~ 1.3 and decreased in BF infants by ~ 0.6 ng/mL and ~ 0.6, respectively. IGFBP-3 was only affected by the BF group with ~ 450 ng/mL lower levels than the LP group. No gene-feeding-group interaction was detected for any SNP, even without correction for multiple testing. Conclusions Variants of the IGF-1-gene play an important role in regulating serum levels of the IGF-I axis but there is no gene-protein-interaction. The predominant nutritional regulation of IGF-I and IGFBP-3 gives further evidence that higher protein intake contributes to metabolic programming of growth.
    Growth Hormone & IGF Research 10/2013; 23(5):149–158. DOI:10.1016/j.ghir.2013.05.002 · 1.33 Impact Factor
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