Bernadeta Patro-Gołąb1, Bartłomiej M Zalewski2, Stefanie Mp Kouwenhoven3, Jacek Karaś2, Berthold Koletzko4, Johannes Bernard van Goudoever5, Hania Szajewska2. 1. Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland; abpatro@yahoo.com. 2. Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland; 3. Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands; 4. Ludwig Maximilians University, Dr. von Hauner Children's Hospital, Division of Metabolic and Nutritional Medicine, University of Munich Medical Centre, Munich, Germany; and. 5. Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands; Department of Pediatrics, Emma Children's Hospital, Amsterdam Medical Center, Amsterdam, Netherlands.
Abstract
BACKGROUND: Protein intake may influence important health outcomes in later life. OBJECTIVE: The objective of this study was to investigate current evidence on the effects of infant formulas and follow-on formulas with different protein concentrations on infants' and children's growth, body composition, and later risk of overweight and obesity. METHODS: In this systematic review, we searched electronic databases (including MEDLINE, Embase, and the Cochrane Library) up until November 2014 for randomized controlled trials (RCTs). Eligible studies had to include children aged 0-3 y who represented the general population and were fed cow milk-based infant formulas with variations in protein concentration. Control groups received lower-protein cow milk-based formulas (as defined by the authors). The primary outcomes were growth, overweight, obesity, and adiposity. Various time points for outcomes assessment were accepted for inclusion. If possible, a meta-analysis was performed. RESULTS: Twelve RCTs met our inclusion criteria. Different formula protein concentrations did not affect linear growth other than a transient effect on mean length at 3 mo observed in a meta-analysis of 4 studies (mean difference, - 0.27 cm; 95% CI: -0.52, -0.02). Lower mean weight and weight z scores obtained from the infants fed lower-protein formulas were observed only from 6 to 12 mo of age. Data from one large RCT showed that consumption of a lower-protein infant formula may reduce body mass index at 12 mo of age and later (12 mo, 24 mo, and 6y) and the risk of obesity at 6 y. Effects on body composition remained unclear. CONCLUSIONS: The current evidence is insufficient for assessing the effects of reducing the protein concentration in infant formulas on long-term outcomes, but, if confirmed, this could be a promising intervention for reducing the risk of overweight and obesity in children. In view of the limited available evidence, more studies replicating effects on long-term health outcomes are needed.
BACKGROUND: Protein intake may influence important health outcomes in later life. OBJECTIVE: The objective of this study was to investigate current evidence on the effects of infant formulas and follow-on formulas with different protein concentrations on infants' and children's growth, body composition, and later risk of overweight and obesity. METHODS: In this systematic review, we searched electronic databases (including MEDLINE, Embase, and the Cochrane Library) up until November 2014 for randomized controlled trials (RCTs). Eligible studies had to include children aged 0-3 y who represented the general population and were fed cowmilk-based infant formulas with variations in protein concentration. Control groups received lower-protein cowmilk-based formulas (as defined by the authors). The primary outcomes were growth, overweight, obesity, and adiposity. Various time points for outcomes assessment were accepted for inclusion. If possible, a meta-analysis was performed. RESULTS: Twelve RCTs met our inclusion criteria. Different formula protein concentrations did not affect linear growth other than a transient effect on mean length at 3 mo observed in a meta-analysis of 4 studies (mean difference, - 0.27 cm; 95% CI: -0.52, -0.02). Lower mean weight and weight z scores obtained from the infants fed lower-protein formulas were observed only from 6 to 12 mo of age. Data from one large RCT showed that consumption of a lower-protein infant formula may reduce body mass index at 12 mo of age and later (12 mo, 24 mo, and 6y) and the risk of obesity at 6 y. Effects on body composition remained unclear. CONCLUSIONS: The current evidence is insufficient for assessing the effects of reducing the protein concentration in infant formulas on long-term outcomes, but, if confirmed, this could be a promising intervention for reducing the risk of overweight and obesity in children. In view of the limited available evidence, more studies replicating effects on long-term health outcomes are needed.
Authors: Berthold Koletzko; K M Godfrey; Lucilla Poston; Hania Szajewska; Johannes B van Goudoever; Marita de Waard; Brigitte Brands; Rosalie M Grivell; Andrea R Deussen; Jodie M Dodd; Bernadeta Patro-Golab; Bartlomiej M Zalewski Journal: Ann Nutr Metab Date: 2019-01-23 Impact factor: 3.374
Authors: Bernadeta Patro-Gołąb; Bartłomiej M Zalewski; Maciej Kołodziej; Stefanie Kouwenhoven; Lucilla Poston; Keith M Godfrey; Berthold Koletzko; Johannes Bernard van Goudoever; Hania Szajewska Journal: Obes Rev Date: 2016-10-17 Impact factor: 9.213
Authors: Thomas A Brunner; Luca Casetti; Petra Haueter; Pascal Müller; Andreas Nydegger; Johannes Spalinger Journal: Eur J Nutr Date: 2017-08-10 Impact factor: 5.614