Early Life Factors Influencing the Risk of Obesity

Area of Science:

• Pediatrics
• Nutrition Science
• Public Health

Background:

• The global obesity epidemic is a significant public health concern.
• Infant feeding practices, including formula composition, are potential modifiable factors influencing long-term weight trajectories.
• High protein (HP) content in infant formulas has been hypothesized to contribute to rapid infant weight gain and later obesity.

Purpose of the Study:

• To investigate the long-term effects of lower protein (LP) versus higher protein (HP) infant formula on growth and obesity risk.
• To compare the growth outcomes of infants fed LP or HP formula to a breastfed reference group.

Main Methods:

• A large, multicountry study comparing LP formula (1.77 and 2.2 g protein/100 kcal) with HP formula (2.9 and 4.4 g protein/100 kcal).
• Growth parameters, including weight-for-length z scores and body mass index (BMI), were assessed at 24 months and 6 years of age.
• Comparison with a reference group of breastfed infants.

Main Results:

• At 24 months, infants on LP formula had significantly lower weight-for-length z scores compared to the HP group, similar to breastfed infants.
• At 6 years, children previously fed HP formula exhibited a significantly higher BMI and a substantially increased risk of obesity compared to those fed LP formula.
• HP formula intake was associated with higher weight in the first two years but did not affect length.

Conclusions:

• Higher protein content in infant formula is linked to increased weight gain and a greater risk of obesity in early childhood.
• Lower protein intake during infancy may be a strategy to mitigate the risk of overweight and obesity.
• While breastfeeding is encouraged, reducing protein in formula for non-breastfed infants may be beneficial for obesity prevention.