Influence of Feeding Types during the First Months of Life on Calciuria Levels in Healthy Infants: A Secondary Analysis from a Randomized Clinical Trial

Abstract

Background/Aims: Dietary factors can modify calciuria. We aim to investigate urinary calcium excretion in healthy infants according to their protein. Methods: Secondary data analysis from a randomized clinical trial where healthy term infants were randomized after birth to a higher (HP) or lower (LP) protein content formula that was consumed until age 1 year. A non-randomized group of breastfed (BF) infants was used for reference. Anthropometry, dietary intakes and calciuria (calcium/creatinine ratios) from spot urine samples were assessed at ages 3 and 6 months. At 6 months, the kidney volumes were assessed using ultrasonography, and the serum urea and creatinine levels were determined. Results: BF infants showed the highest calciuria levels, followed by the HP and the LP groups (p < 0.001 for all comparisons). Either protein intakes or formula types modulated the calciuria in linear regression models adjusted for other influencing dietary factors. The usual cut-off values classified 37.8% (BF), 16.8% (HP) and 4.9% (LP) of the infants as hypercalciuric. Conclusions: Feeding types during the first months of life affect calciuria, with BF infants presenting the highest levels. We propose new cut-off values, based on feeding types, to prevent the overestimation in hypercalciuria diagnoses among BF infants.

Urinary calcium creatinine ratio in breast fed and artificial fed healthy infants

“…This agree with the prospective randomized clinical trial performed by Ferré et al, [17] which showed that the high protein formulation significantly increased the urinary Ca/Cr ratio, according to this study [17] . Consistent with our research, Cillo et al, [18] who performed a study on 104 healthy newborns had found that neonates that were exclusively fed artificial milk exhibited a significantly higher urinary excretion of Ca (mean 0.10±0.06) compared to those that were exclusively fed breast milk [18] . Our results comes in harmony with the study obtained by Erol et al [19] Using 425 healthy children aged 0-5 years, this study aimed to establish age-specific reference values for UCa/Cr in healthy Turkish children and examine the effect of nutrition on UCa excretion in infants younger than six months.…”

“…This agree with the study obtained by Gül et al [26] to determine the prevalence of hypercalciuria and percentiles of urinary calcium excretion among school-aged children in Tokat [23] . However, the study obtained by Cillo et al [18] showed higher Ca excretion in newborns with a body weight less than 3 kg than those with body weight more than 3 Kg [18] .…”

Protein quality and safety evaluation of sarcoplasmic protein derived from silver carp (Hypophthalmichthys molitrix) using a rat model

“…Diet is a major factor influencing urinary Ca excretion which promotes hypercalciuria and can lead to nephrocalcinosis (Khan, 2010). A randomized study including 1,090 healthy term infants from five different countries reported hypercalciuria prevalence in 16.8% of infants fed a high protein formula (2.05 to 3.20 g/100 mL) compared to 4.9% of infants fed a low protein formula (1.25 to 1.60 g/100 mL) for 3 months (Ferré et al., 2017).…”