Lower protein in infant formula is associated with lower weight up to age 2 y: a randomized clinical trial
Berthold Koletzko, Rüdiger von Kries, Ricardo Closa, Joaquín Escribano, Silvia Scaglioni, Marcello Giovannini, Jeannette Beyer, Hans Demmelmair, Dariusz Gruszfeld, Anna Dobrzanska, Anne Sengier, Jean-Paul Langhendries, Marie-Francoise Rolland Cachera, Veit Grote, European Childhood Obesity Trial Study Group, Annick Xhonneux, Jean-Noel Van Hees, Françoise Martin, Anna Stolarczyk, Jerzy Socha, Piotr Socha, Roman Janas, Ewa Pietraszek, Sabine Verwied-Jorky, Sonia Schiess, Ingrid Pawellek, Uschi Handel, Iris Hannibal, Michaela Fritsch, Helfried Groebe, Anna Reith, Renate Hofmann, Joana Hoyos, Philippe Goyens, Clotilde Carlier, Elena Dain, Verónica Luque Moreno, Georgina Méndez Riera, Sabrina Tedeschi, Carlo Agostoni, Fiammetta Vecchi, Elvira Verduci, Berthold Koletzko, Rüdiger von Kries, Ricardo Closa, Joaquín Escribano, Silvia Scaglioni, Marcello Giovannini, Jeannette Beyer, Hans Demmelmair, Dariusz Gruszfeld, Anna Dobrzanska, Anne Sengier, Jean-Paul Langhendries, Marie-Francoise Rolland Cachera, Veit Grote, European Childhood Obesity Trial Study Group, Annick Xhonneux, Jean-Noel Van Hees, Françoise Martin, Anna Stolarczyk, Jerzy Socha, Piotr Socha, Roman Janas, Ewa Pietraszek, Sabine Verwied-Jorky, Sonia Schiess, Ingrid Pawellek, Uschi Handel, Iris Hannibal, Michaela Fritsch, Helfried Groebe, Anna Reith, Renate Hofmann, Joana Hoyos, Philippe Goyens, Clotilde Carlier, Elena Dain, Verónica Luque Moreno, Georgina Méndez Riera, Sabrina Tedeschi, Carlo Agostoni, Fiammetta Vecchi, Elvira Verduci
Abstract
Background: Protein intake during infancy was associated with rapid early weight gain and later obesity in observational studies.
Objective: 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.
Design: 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.
Results: 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.
Conclusions: 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.
Source: PubMed