Abstract
ABSTRACTBackgroundProtein intake from cow milk–based infant formula has been associated with rapid weight gain and increased adiposity, but the effect of protein from complementary foods has not been prospectively evaluated, and the effect of protein from sources other than formula during complementary feeding is not clear.ObjectiveThe aim of this study was to directly compare the effect of protein from 2 common complementary food sources, meat and dairy, on infant growth and weight trajectory.DesignHealthy term, formula-fed infants were recruited from the metro Denver area, matched by sex and race/ethnicity and randomly assigned to a meat or a dairy complementary food group from 5 to 12 mo of age. Total protein intake during this 7-mo intervention was ∼3 g ⋅ kg−1 ⋅ d−1 for both groups. Intakes of infant formula, cereal, fruit, and vegetables were ad libitum. Caregivers also completed 3-d diet records at 5, 10, and 12 mo of age. Anthropometric measures were obtained during monthly home visits, and blood samples were collected at 5 and 12 mo of age.ResultsSixty-four infants completed the intervention (meat: n = 32; dairy: n = 32). The average total protein intake (mean ± SD) increased from 2.01 ± 0.06 g ⋅ kg−1 ⋅ d−1 at 5 mo to 3.35 ±0.12 g ⋅ kg−1 ⋅ d−1 at 12 mo and did not differ between groups. Over time, weight and weight-for-age z score increased by 0.48 ± 0.07. However, there was a significant group-by-time interaction for both length-for-age z score (LAZ) and weight-for-length z score (WLZ). Post hoc analysis showed that LAZ increased in the meat group (+0.33 ± 0.09; P = 0.001 over time) and decreased in the dairy group (−0.30 ± 0.10; P = 0.0002 over time); WLZ significantly increased in the dairy group (0.76 ± 0.21; P = 0.000002 over time) compared with the meat group (0.30 ± 0.17; P = 0.55 over time). Insulin-like growth factor I and insulin-like growth factor-binding protein 3 both increased over time without group differences.ConclusionsProtein source may have an important role in regulating growth. In these formula-fed older infants, meat- and dairy-based complementary foods led to distinct growth patterns, especially for length. This trial was registered at www.clinicaltrials.gov as NCT02142647.
Highlights
Evidence-based feeding guidance could yield long-term benefits for optimal growth and obesity prevention, especially early in life, when the rate of growth is high and may hold greater plasticity
Results showed that weight gain was more rapid in the high-protein formula group, leading to a 0.20-SD higher weight-for-length z score (WLZ), a crude parameter of overweight status, but linear growth or length-for-age z score (LAZ) did not differ between groups
The increase in blood urea nitrogen (BUN) over time is consistent with the increase in protein intake (Figure 2). This is the first randomized controlled trial in formula-fed infants that directly compared the effects of dietary protein from 2 common complementary foods on infant growth trajectory and relevant serum biomarkers
Summary
Evidence-based feeding guidance could yield long-term benefits for optimal growth and obesity prevention, especially early in life, when the rate of growth is high and may hold greater plasticity. Results showed that weight gain was more rapid in the high-protein formula group, leading to a 0.20-SD higher weight-for-length z score (WLZ), a crude parameter of overweight status, but linear growth or length-for-age z score (LAZ) did not differ between groups. Another smaller study [6] found that infants fed a high-protein formula. Conclusions: Protein source may have an important role in regulating growth In these formula-fed older infants, meat- and dairybased complementary foods led to distinct growth patterns, especially for length.
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