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Koletzko, B.; Demmelmair, H.; Grote, V.; Hellmuth, C.; Kirchberg, F.; Uhl, O.; Weber, M. and Prell, C. (2016): Langfristige Prägung der Gesundheit durch die Säuglingsernährung. In: Monatsschrift Kinderheilkunde, Vol. 164, No. 2: pp. 114-121

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The early nutrition from conception to early childhood has imprinting or programming effects on later health and disease risks. Rapid weight gain in fetal life and early childhood increases the risk of later obesity, diabetes and other non-communicable diseases (NCD). In observational cohort studies rapid weight gain from birth to 2 years old was associated with an increased risk of obesity up to adulthood. Breastfeeding is associated with less rapid weight gain in infancy than conventional infant formula nutrition. Several meta-analyses of observational studies found that breastfeeding was associated with an approximately 12-24% reduction in the risk of obesity in later life. We investigated the early protein hypothesis, which proposes that a high protein intake in infancy leads to increased concentrations of insulinogenic amino acids, the growth factors insulin and insulin-like growth factor-1 (IGF-1) as well as greater weight gain and later obesity. The hypothesis was tested in a double blind randomized clinical trial involving 1678 term infants who received conventional infant and follow-on formulae with higher protein content or with reduced protein content during the first year of life. The reduced protein diet led to significantly reduced body weight, weight-for-length and body mass index (BMI) up to the age of 2 years and to a 2.4-2.9-fold reduction of obesity at 6 years old compared to conventional bottle feeding formulae. We concluded that infant feeding has powerful long-term programming effects, with very large effect sizes on obesity in early school age. Breastfeeding should be actively promoted, protected and supported. Infants not exclusively breastfed should receive infant formulae with reduced protein content. Unmodified cows' milk contains three times as much protein as human milk and should be avoided as a drink in infancy.

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