Koletzko, Berthold; Beyer, Jeanette; Brands, Brigitte; Demmelmair, Hans; Grote, Veit; Haile, Gudrun; Gruszfeld, Dariusz; Rzehak, Peter; Socha, Piotr; Weber, Martina
Early Influences of Nutrition on Postnatal Growth.
In: Gillman, M. W.; Gluckman, P. D.; Rosenfeld, R. G. (eds.) :
Recent Advances in Growth Research: Nutritional, Molecular and Endocrine Perspectives. Vol. 71. Karger pp. 11-27
Health and nutrition modulate postnatal growth. The availability ofamino acids and energy, and insulin and insulin-like growth factor-I(IGF-I) regulates early growth through the mTOR pathway. Amino acids andglucose also stimulate the secretion of IGF-I and insulin. Postnatalgrowth induces lasting, programming effects on later body size andadiposity in animals and in human observational studies. Rapid weightgain in infancy and the first 2 years was shown to predict increasedobesity risk in childhood and adulthood. Breastfeeding leads to lesserhigh weight gain in infancy and reduces obesity risk in later life byabout 20%, presumably partly due to the lower protein supply with humanmilk than conventional infant formula. In a large randomized clinicaltrial, we tested the hypothesis that reduced infant formula proteincontents lower insulin-releasing amino acid concentrations and therebydecrease circulating insulin and IGF-I levels, resulting in lesser earlyweight gain and reduced later obesity risk (the ‘Early ProteinHypothesis’). The results demonstrate that lowered protein in infantformula induces similar - but not equal - metabolic and endocrineresponses and normalizes weight and BMI relative to breastfed controlsat the age of 2 years. The results available should lead to enhancedefforts to actively promote, protect and support breastfeeding. Forinfants that are not breastfed or not fully breastfed, the use of infantformulas with lower protein contents but high protein quality appearspreferable. Cows’ milk as a drink provides high protein intake andshould be avoided in infancy.