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: 6.77). 05/2009; 89(6):1836-45. DOI: 10.3945/ajcn.2008.27091
Source: PubMed


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 clinicaltrials.gov as NCT00338689.

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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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    • "Notably, increased postnatal catch-up growth in small for gestational age infants is associated with increased postnatal mTORC1 signalling and increased childhood asthma risk [22]. Moreover, excessive postnatal protein intake by formula feeding increases weight gain, total body fat mass and increases the risk of childhood obesity [23-25], which has been linked to increased amino acid-mediated mTORC1-signalling [26]. "
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    • "and http://www.controlled-trials.com) 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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