Association of early protein intake and pre-peritoneal fat at five years of age: Follow-up of a randomized clinical trial

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2016-09, Vol.26 (9), p.824-832
• Main Authors: Gruszfeld, D, Weber, M, Gradowska, K, Socha, P, Grote, V, Xhonneux, A, Dain, E, Verduci, E, Riva, E, Closa-Monasterolo, R, Escribano, J, Koletzko, B
• Format: Article
• Language: English
• Subjects: Adiposity; Age Factors; Cardiovascular; Child; Child Development; Child, Preschool; Diet, Protein-Restricted; Dietary proteins; Dietary Proteins - administration & dosage; Dietary Proteins - adverse effects; Double-Blind Method; Europe; Female; Humans; Infant; Infant formula; Infant Formula - adverse effects; Infant Nutritional Physiological Phenomena; Infant, Newborn; Intra-abdominal fat; Intra-Abdominal Fat - diagnostic imaging; Intra-Abdominal Fat - physiopathology; Male; Nutritional Status; Pediatric Obesity - diagnosis; Pediatric Obesity - etiology; Pediatric Obesity - physiopathology; Pediatric Obesity - prevention & control; Peritoneum; Protein; Subcutaneous fat; Subcutaneous Fat - diagnostic imaging; Subcutaneous Fat - physiopathology; Time Factors; Ultrasonography
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2016.04.005

Abstract Background and aims The double-blind randomized European Childhood Obesity Project (CHOP) demonstrated that reduced protein content in infant formula leads to a lower body mass index (BMI) up to six years of age. Here we aimed at assessing pre-peritoneal fat, a marker of visceral fat, in children participating in the CHOP trial. Methods and results Healthy term formula-fed infants in five European countries were randomized either to higher (n = 550) or lower (n = 540) protein formulas in the first year of life. Infants who were exclusively breastfed for at least three months (n = 588) were enrolled as an observational (non randomized) group. At age 5 years, subcutaneous fat (SC) and pre-peritoneal fat (PP) were measured by ultrasound in a subgroup of 275 children. The PP fat layer was thicker in the higher compared to the lower protein group (adjusted estimated difference: 0.058 cm, 95%CI 0.002; 0.115; p = 0.043), while SC fat was not different. Girls showed a thicker SC fat layer than boys. Conclusions Higher protein intake in formula-fed infants appears to enhance pre-peritoneal fat tissue accumulation at the age of 5 years, but not of subcutaneous fat, which may trigger adverse metabolic and health consequences.