Article

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 clinicaltrials.gov as NCT00338689.

0 Followers
 · 
189 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die stark gestiegene Rate an Übergewicht und Adipositas sowie die damit einhergehenden funktionellen Stoffwechselstörungen rücken immer mehr in den Fokus der Strategien zur Förderung der öffentlichen Gesundheit. Hinsichtlich der Langzeiteffekte der Ernährung in frühen Lebensabschnitten auf das spätere Adipositasrisiko und die damit assoziierten Erkrankungen nahm das Ausmaß an wissenschaftlicher Evidenz im vergangenen Jahrzehnt deutlich zu. Der Begriff der metabolischen Programmierung beschreibt die dauerhafte Manifestation von Veränderungen des kindlichen Stoffwechsels oder anderer Funktionen durch die frühe prä- und postnatale Ernährung sowie durch mütterliche Lebensstilfaktoren während der Schwangerschaft. Der vorliegende Beitrag führt in das Konzept der metabolischen Programmierung ein und stellt die zentralen Hypothesen dar, welche aktuell in der Forschung untersucht werden. International werden diese Fragestellungen im derzeit weltweit größten, von der Europäischen Union geförderten Forschungsprojekt EarlyNutrition (http://www.project-earlynutrition.eu) bearbeitet, mit dem Ziel, konkrete Empfehlungen und Strategien zur präventiven Intervention im frühen Lebensalter zu entwickeln. Abstract Scientific evidence for long-term effects of nutrition in early life on the later risk for adiposity and associated disorders has rapidly increased during the last decade. The phenomenon referred to as metabolic or developmental programming describes persisting changes in metabolic and other body functions caused by early nutrition and lifestyle factors and receives widespread attention due to its major public health importance. The present article offers an introduction into the concept of early nutrition programming and describes the key hypotheses which current research activities on the effects on later risk of adiposity and related disorders focus on. Combined international expertise in this area is brought together in the European Commission funded research project EarlyNutrition (http://www.project-earlynutrition.eu) which aims to refine recommendations and strategies for preventive intervention during early life.
    Monatsschrift Kinderheilkunde 11/2012; 160(11):1096-1102. DOI:10.1007/s00112-012-2639-z · 0.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Nutrition in childhood has an influence on the cardiovascular function later on in life. European Childhood Obesity Project is a multicenter, randomized clinical intervention trial examining the effect of early protein intake on later health outcomes, particularly adiposity and related disorders. The aim of the study was to examine the effect of nutritional intervention - different protein intake in infancy on carotid intima-media thickness (cIMT) at 5 years. The association of cardiovascular risk factors with cIMT was also assessed. Methods: Healthy term formula-fed infants in five European countries were enrolled either to the higher (HP) or to the lower (LP) protein group. Observational group consisted of breastfed infants. Plasma insulin, glucose, lipid profile, IGF-1, apolipoprotein A1 and B were measured as well as anthropometric parameters of parents and a child, blood pressure and physical activity. Results: No difference in cIMT between HP and LP group was observed. Insulin, HOMA-IR index and total IGF-1 were positively associated with cIMT but after adjustment for confounders only an inverse association between ApoA1 and positive between ApoB/ApoA1 and cIMT were significant. Conclusion: High versus low protein intake in infancy does not influence cIMT at 5 years. cIMT in healthy children at 5 years is associated with their apolipoprotein profile. © 2015 S. Karger AG, Basel.
    Annals of Nutrition and Metabolism 01/2015; 66(1):51-59. DOI:10.1159/000369980 · 2.75 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Infant formulas have historically been developed based on providing macronutrients at intake concentrations approximately matching the composition of human milk. In most countries, targets of 1.4-1.5 g of protein/dL and 20 kcal/oz (67-68 kcal/dL) have been set as the protein and energy concentrations for formulas during the first year of life, although this may be an overestimation of these contents. Recent introduction of lower-protein and -energy formulas in full-term infants led us to systematically review the literature for its effects on growth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, our inclusion criteria were studies that enrolled healthy full-term infants and evaluated lower-protein or lower-energy formula, reported anthropometric outcomes including weight and length, and followed infants for at least 6 mo. Six studies were eligible for inclusion. These studies varied in the content of nutrients provided in the intervention and control groups, by additional dietary components in the study groups, and the timing and length of the intervention, which limit their usefulness for interpreting newly introduced lower-protein and -energy formulas in the United States. These studies suggest adequate growth during infancy and early childhood with infant formulas with concentrations of protein and energy slightly below historical standards in the United States. Further long-term research is needed to assess the impact of the use of lower-protein and/or lower-energy products, especially for nutritionally at-risk populations such as preterm infants and infants who are born small for gestational age. © 2015 American Society for Nutrition.

Full-text (2 Sources)

Download
105 Downloads
Available from
Jun 3, 2014