Voortman T, Braun K V E, Kiefte-de Jong J C, Jaddoe V W V, Franco O H, van den Hooven E H
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Int J Obes (Lond). 2016 Jun;40(6):1018-25. doi: 10.1038/ijo.2016.29. Epub 2016 Feb 15.
Previous studies suggest that high protein intake in infancy leads to a higher body mass index (BMI) in later childhood. We examined the associations of total, animal and vegetable protein intake in early childhood with detailed measures of body composition at the age of 6 years.
This study was performed in 2911 children participating in a population-based cohort study. Protein intake at the age of 1 year was assessed with a validated food-frequency questionnaire and was adjusted for total energy intake. At the children's age of 6 years, we measured their anthropometrics and body fat (with dual-energy X-ray absorptiometry). We calculated age- and sex-specific s.d. scores for BMI, fat mass index (FMI) and fat-free mass index (FFMI).
After adjustment for confounders, a 10 g per day higher total protein intake at 1 year of age was associated with a 0.05 s.d. (95% confidence interval (CI) 0.00, 0.09) higher BMI at age 6. This association was fully driven by a higher FMI (0.06 s.d. (95%CI 0.01, 0.11)) and not FFMI (-0.01 s.d. (95%CI -0.06, 0.05)). The associations of protein intake with FMI at 6 years remained significant after adjustment for BMI at the age of 1 year. Additional analyses showed that the associations of protein intake with FMI were stronger in girls than in boys (P for interaction=0.03), stronger among children who had catch-up growth in the first year of life (P for interaction<0.01) and stronger for intake of animal protein (both dairy and non-dairy protein) than protein from vegetable sources.
Our results suggest that high protein intake in early childhood is associated with higher body fat mass, but not fat-free mass. Future studies are needed to investigate whether these changes persist into adulthood and to examine the optimal range of protein intake for infants and young children.
先前的研究表明，婴儿期高蛋白摄入会导致儿童后期更高的体重指数（BMI）。我们研究了幼儿期总蛋白、动物蛋白和植物蛋白摄入量与6岁时详细身体成分测量指标之间的关联。
本研究在2911名参与基于人群的队列研究的儿童中进行。使用经过验证的食物频率问卷评估1岁时的蛋白质摄入量，并对总能量摄入进行调整。在儿童6岁时，我们测量了他们的人体测量学指标和身体脂肪（采用双能X线吸收法）。我们计算了BMI、脂肪量指数（FMI）和去脂体重指数（FFMI）的年龄和性别特异性标准差分数。
在对混杂因素进行调整后，1岁时总蛋白摄入量每天每增加10克，与6岁时BMI升高0.05个标准差（95%置信区间（CI）0.00，0.09）相关。这种关联完全由较高的FMI（0.06个标准差（95%CI 0.01，0.11））驱动，而非FFMI（-0.01个标准差（95%CI -0.06，0.05））。在对1岁时的BMI进行调整后，蛋白质摄入量与6岁时FMI的关联仍然显著。进一步分析表明，蛋白质摄入量与FMI的关联在女孩中比男孩更强（交互作用P=0.03），在生命第一年有追赶生长的儿童中更强（交互作用P<0.01），并且动物蛋白（包括乳制品和非乳制品蛋白）摄入量的关联比植物来源蛋白更强。
我们的结果表明，幼儿期高蛋白摄入与更高的体脂肪量相关，但与去脂体重无关。未来需要研究这些变化是否持续到成年，并探讨婴幼儿蛋白质摄入的最佳范围。
