Protein Requirements of Term Infants: Quantity and Quality

Large nutrition surveys in the US (Butte et al, 2008, FITs) and China Ming Study indicate that children from infancy to preschool age consume more than double the amount of protein which is recommended by WHO. One of the factors contributing to the high protein intake is the consumption of infant formulas with higher protein concentration (> 2.3g/100 kcal) and cow’s milk, in particular during later infancy and toddler age. It has been shown that in infants with higher protein consumption growth promoting hormones (IGF1, Insulin) are elevated and weight gain is faster than in infants who continue to be breastfed into the 2nd year of life. Rapid weight gain in infancy is associated with higher risk of childhood- and adulthood obesity. This is an example of unfavorable metabolic programming through early nutrition with negative consequences (diseases associated with obesity such as diabetes type2, cardiovascular problems, and stroke) later in life.

Large nutrition surveys in the US (Butte et al, 2008, FITs) and China Ming Study indicate that children from infancy to preschool age consume more than double the amount of protein which is recommended by WHO . One of the factors contributing to the high protein intake is the consumption of infant formulas with higher protein concentration (> 2.3g/100 kcal) and cow’s milk, in particular during later infancy and toddler age. It has been shown that in infants with higher protein consumption growth promoting hormones (IGF1, Insulin) are elevated and weight gain is faster than in infants who continue to be breastfed into the 2nd year of life. Rapid weight gain in infancy is associated with higher risk of childhood- and adulthood obesity. This is an example of unfavorable metabolic programming through early nutrition with negative consequences (diseases associated with obesity such as diabetes type2, cardiovascular problems, and stroke) later in life.

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

References

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

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 content in infant formula reduces BMI and obesity risk at school age: follow-up of a randomized trial. Am J Clin Nutr. 2014 May;99(5):1041-51. 

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