Abstract
In humans, maximum brain development occurs between the third trimester of gestation and 2 years of life. Nutrition during these critical windows of rapid brain development might be essential for later cognitive functioning and behaviour. In the last few years, trends on protein recommendations during infancy and childhood have tended to be lower than that in the past. It remains to be demonstrated that lower protein intakes among healthy infants, a part of being able to reduce obesity risk, is safe in terms of mental performance achievement. Secondary analyses of the EU CHOP, a clinical trial in which infants from five European countries were randomised to be fed a higher or a lower protein content formula during the 1st year of life. Children were assessed at the age of 8 years with a neuropsychological battery of tests that included assessments of memory (visual and verbal), attention (visual, selective, focused and sustained), visual-perceptual integration, processing speed, visual-motor coordination, verbal fluency and comprehension, impulsivity/inhibition, flexibility/shifting, working memory, reasoning, visual-spatial skills and decision making. Internalising, externalising and total behaviour problems were assessed using the Child Behaviour Checklist 4-18. Adjusted analyses considering factors that could influence neurodevelopment, such as parental education level, maternal smoking, child's gestational age at birth and head circumference, showed no differences between feeding groups in any of the assessed neuropsychological domains and behaviour. In summary, herewith we report on the safety of lower protein content in infant formulae (closer to the content of human milk) according to long-term mental performance.
Highlights
In humans, the critical window of brain development is between the third trimester of gestation and 2 years of age[1]
Our aim was to demonstrate that lower protein (LP) content in infant formulae during the 1st year of life does not affect cognition and behaviour later in childhood compared with higher protein (HP) formulae intake
A total of 1678 infants were recruited in the five European countries (550 HP, 540 LP and 588 BF) (Fig. 1)
Summary
The critical window of brain development is between the third trimester of gestation and 2 years of age[1]. A study conducted in Guatemala demonstrated that infants exposed to a protein–energy supplementation (during gestation and the first 2 years of life) scored significantly better in knowledge, numeracy, reading, vocabulary, time-reaction in information-processing tasks during adolescence than those who were not supplemented[11]. When these children were followed-up 20 years later, the authors found a better educational achievement among those who received protein supplementation in infancy compared with those who received energy supplementation[12]. In the last few years, trends on protein recommendations during infancy and childhood have tended to be lower than that in the past, as shown by a significant reduction recommended by the last WHO and the FAO Joint Report[13]
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