Protein Requirements of Term Infants: Quantity and Quality

Prof F. Haschke

Large nutrition surveysin the US (Butte et al, 2008, FITs) and China Ming Study indicate that children from infancy to preschool age consume morethan double the amount of protein which is recommended by WHO. One of the factors contributing to the high protein intake is theconsumption of infant formulas with higher protein concentration (> 2.3g/100kcal) and cow’s milk, in particular during later infancy and toddler age. Ithas been shown that in infants with higher protein consumption growth promotinghormones (IGF1, Insulin) are elevated and weight gain is faster than in infantswho continue to be breastfed into the 2nd year of life. Rapid weight gain ininfancy is associated with higher risk of childhood- and adulthood obesity.This is an example of unfavorable metabolic programming through early nutritionwith negative consequences (diseases associated with obesity such as diabetestype2, cardiovascular problems, and stroke) later in life.

Large nutrition surveysin the US (Butte et al, 2008, FITs) and China Ming Study indicate that childrenfrom infancy to preschool age consume more than double the amount of proteinwhich is recommended by WHO . One of the factors contributing to the highprotein intake is the consumption of infant formulas with higher proteinconcentration (> 2.3g/100 kcal) and cow’s milk, in particular during laterinfancy and toddler age. It has been shown that in infants with higher proteinconsumption growth promoting hormones (IGF1, Insulin) are elevated and weightgain is faster than in infants who continue to be breastfed into the 2nd yearof life. Rapid weight gain in infancy is associated with higher risk ofchildhood- and adulthood obesity. This is an example of unfavorable metabolicprogramming through early nutrition with negative consequences (diseasesassociated with obesity such as diabetes type2, cardiovascular problems, andstroke) later in life.

In conclusion promotionof breastfeeding beyond 6 months is the best way to ensure long-term health.When breastfeeding is not possible or the breastfeeding period is too shortfeeding low protein formulas to infants turns out to be a safe alternative. Lowprotein intake in infancy can prevent from excessive weight gain and maycontribute to decrease the risk of overweight and obesity later in life.Furthermore, the health economic effects for the population – lower childhoodand adulthood obesity rates - should be considered because they aresignificant. Lower obesity rates are cost saving for health insurances,governments, and the social security systems because of lower prevalence ofdiseases which are strongly linked to obesity.

References:

1. Inostroza J, Haschke F, Steenhout P, Grathwohl D,Nelson SE, Ziegler EE Low-protein formula slows weight gain in infants ofoverweight mothers. J Pediatr Gastroenterol Nutr. 2014; 59(1):70-7

2. Ziegler EE, Fields DA,. Chernausek SD, Steenhout P,Grathwohl D, Jeter JM, Nelson SE, Haschke F Adequacy of Infant Formula withProtein Content of 1.6 g/100 kcal for Infants between 3 and 12 Months: ARandomized Multicenter Trial. J Pediatr Gastroenterol Nutr (accepted forpublication) 

3. Weber M, Grote V, Closa-Monasterolo R, Escribano J,Langhendries JP, Dain E, Giovannini M, Verduci E, Gruszfeld D, Socha P,Koletzko B; European Childhood Obesity Trial Study Group.Lower protein contentin infant formula reduces BMI and obesity risk at school age: follow-up of arandomized trial. Am J Clin Nutr. 2014 May;99(5):1041-51. 

4. Lönnerdahl,B; Zhang,Z; Adelman,A; Rai,D; Boettcher,JAmino Acid Profiles in Term and Preterm Human Milk through Lactation: ASystematic Review; Nutrients 2013, 5, 4800-4821

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