1. Long-term effects of a modified, low-protein infant formula on growth and body composition
- Author
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Martijn J J Finken, Eline M. van der Beek, Stefanie M.P. Kouwenhoven, Bert J. M. van de Heijning, Berthold Koletzko, Jos W. R. Twisk, Marieke Abrahamse-Berkeveld, Nadja Antl, Johannes B. van Goudoever, Center for Liver, Digestive and Metabolic Diseases (CLDM), Reproductive Origins of Adult Health and Disease (ROAHD), Internal medicine, Pediatric surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), Epidemiology and Data Science, APH - Health Behaviors & Chronic Diseases, APH - Methodology, AGEM - Endocrinology, metabolism and nutrition, and ACS - Diabetes & metabolism
- Subjects
0301 basic medicine ,Male ,Pediatrics ,medicine.medical_specialty ,Low protein ,Waist ,Infancy ,REQUIREMENT ,030209 endocrinology & metabolism ,Standard score ,OBESITY RISK ,MASS ,Critical Care and Intensive Care Medicine ,Childhood obesity ,law.invention ,Infant nutrition ,03 medical and health sciences ,0302 clinical medicine ,AGE ,Randomized controlled trial ,Double-Blind Method ,law ,medicine ,Humans ,Infant Nutritional Physiological Phenomena ,EARLY-CHILDHOOD ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Infant, Newborn ,Infant ,ENTERALLY FED TERM ,Anthropometry ,medicine.disease ,Infant Formula ,LIFE ,Infant formula ,Equivalence Trial ,Protein intake ,FAT ,Body Composition ,Amino acids ,Female ,Early childhood ,Dietary Proteins ,WEIGHT ,business ,1ST MONTH - Abstract
Background & aim: High protein intake in early life is associated with an increased risk of childhood obesity. Feeding a modified lower-protein (mLP) infant formula (1.7 g protein/100 kcal) until the age of 6 months is safe and supports adequate growth. The aim of the present study is to assess longer-term anthropometry with BMI at 1 and 2 years as primary outcome parameter and body composition in children fed mLP formula. Methods: Healthy term-born infants received mLP or control formula (CTRL) (2.1 g protein/100 kcal) until 6 months of age in a double-blinded RCT. A breast-fed (BF) group served as a reference. Anthropometry data were obtained at 1 and 2 years of age. At the age of 2 years, body composition was measured with air-displacement plethysmography. Groups were compared using linear mixed model analysis. Results: At 1 and 2 years of age, anthropometry, including BMI, and body composition did not differ between the formula groups (n = 74 mLP; n = 69 CTRL). Compared to the BF group (n = 51), both formula-fed groups had higher z scores for weight for age, length for age, waist circumference for age, and mid-upper arm circumference for age at 1 year of age, but not at 2 years of age (except for z score of weight for age in the mLP group). In comparison to the BF group, only the mLP group had higher fat mass, fat-free mass, and fat mass index. However, % body fat did not differ between feeding groups. Conclusions: In this follow-up study, no significant differences in anthropometry or body composition were observed until 2 years of age between infants fed mLP and CTRL formula, despite the significantly lower protein intake in the mLP group during the intervention period. The observed differences in growth and body composition between the mLP group and the BF reference group makes it necessary to execute new trials evaluating infant formulas with improved protein quality together with further re-ductions in protein content. Clinical Trial Registry: This trial was registered in the Dutch Trial Register (Study ID number NTR4829, trial number NL4677). https://www.trialregister.nl/trial/4677. (c) 2021 Published by Elsevier Ltd.
- Published
- 2021
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