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1 From Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany (BK, JB, HD and VG); the Institute of Social Paediatrics and Adolescent Medicine, University of Munich, Munich, Germany (RvK and VG); the Universitad Rovira i Virgili, Reus, Spain (RC and JE); the Department of Paediatrics, University of Milano, Milano, Italy (SS and MG); the Children's Memorial Health Institute, Warsaw, Poland (DG); the Department of Paediatrics, Université Libre de Bruxelles, Brussels, Belgium (AS); CHC St Vincent, Liège-Rocourt, Belgium (J-PL); and INSERM, U557, Bobigny, France (M-FRC).
2 This manuscript does not necessarily reflect the views of the Commission and in no way anticipates the future policy in this area.
3 Supported in part by the Commission of the European Communities, specific RTD Programme "Quality of Life and Management of Living Resources," within the 5th Framework Programme (research grant nos. QLRT–2001–00389 and QLK1-CT-2002-30582) and the 6th Framework Programme (contract no. 007036); the Child Health Foundation, Munich, Germany; LMU innovative research priority project MC-Health (sub-project I); the Kompetenznetzwerk Adipositas (Competence Network Obesity) funded by the German Federal Ministry of Education and Research (FKZ 01GI0828); and the International Danone Institutes. BK is the recipient of a Freedom to Discover Award of the Bristol-Myers-Squibb Foundation, New York, NY.
4 Address correspondence to B Koletzko, Dr von Hauner Children's Hospital, University of Munich, Lindwurmstraße 4, D-80337 München, Germany. E-mail: office.koletzko{at}med.uni-muenchen.de.
for the European Childhood Obesity Trial Study Group
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) or higher (2.9 and 4.4 g protein/100 kcal) 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 World Health Organization growth standards 2006.
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.
Received for publication October 13, 2008. Accepted for publication March 3, 2009.
This article has been cited by other articles:
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  S. C Kalhan Optimal protein intake in healthy infants Am. J. Clinical Nutrition, June 1, 2009; 89(6): 1719 - 1720. [Full Text] [PDF]
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