Association of infant formula composition and anthropometry at 4 years: Follow-up of a randomized controlled trial (BeMIM study)

Abstract

The relationships between nutrition, metabolic response, early growth and later body weight have been investigated in human studies. The aim of this follow-up study was to assess the long-term effect of infant feeding on growth and to study whether the infant metabolome at the age of 4 months might predict anthropometry at 4 years of age. The Belgrade-Munich infant milk trial (BeMIM) was a randomized controlled trial in which healthy term infants received either a protein-reduced infant formula (1.89 g protein/100 kcal) containing alpha-lactalbumin enriched whey and long-chain polyunsaturated fatty acids (LC-PUFA), or a standard formula (2.2 g protein/100 kcal) without LC-PUFA, focusing on safety and suitability. Non-randomized breastfed infants were used as a reference group. Of the 259 infants that completed the BeMIM study at the age of 4 months (anthropometry assessment and blood sampling), 187 children participated in a follow-up visit at 4 years of age. Anthropometry including weight, standing height, head circumference, and percent body fat was determined using skinfolds (triceps, subscapular) and bioelectrical impedance analysis. Plasma metabolite concentration, collected in samples at the age of 4 months, was measured using flow-injection tandem mass spectrometry. A linear regression model was applied to estimate the associations between each metabolite and growth with metabolites as an independent variable. At 4 years of age, there were no significant group differences in anthropometry and body composition between formula groups. Six metabolites (Asn, Lys, Met, Phe, Trp, Tyr) measured at 4 months of age were significantly associated with changes in weight-for-age z-score between 1 to 4 months of age and BMI-for-age z-score (Tyr only), after adjustment for feeding group. No correlation was found between measured metabolites and long-term growth (up to 4 years of age). No long-term effects of early growth patterns were shown on anthropometry at 4 years of age. The composition of infant formula influences the metabolic profile and early growth, while long-term programming effects were not observed in this study.

Early growth according to protein content of infant formula: Results from the EDEN and ELFE birth cohorts

“…In contrast to the CHOP trial, the BeMIM trial found higher weight-for-length z-scores in infants fed a formula with low protein content (1.89 g/100 kcal) as compared with infants fed 2.2 g/100 kcal protein during the intervention time (up to 120 days), 33 but no difference was observed at age 4 years. 37 However, the range of protein content considered in this trial was lower than in the CHOP trial or in our study. Moreover, the formula with reduced protein content was also enriched in long-chain polyunsaturated fatty acids, so a formal comparison between the two IFs is impossible.…”

Comportamiento alimentario, suficiencia dietaria y estado nutricional en niños entre 6 a 18 meses

“…Cabe destacar lo observado con proteínas y carbohidratos, los cuales tuvieron una adecuación sobre lo esperado, siendo en las proteínas similar a lo observado en un estudio italiano en niños de 6, 9 y 12 meses 35 , existen diversos estudios que asocian el exceso en la ingesta de estos macronutrientes y obesidad infantil. Esta relación se ha observado en lactantes que consumen fórmulas lácteas (FL) infantiles con alta concentración de proteínas 36,37 y en conjunto con su alimentación complementaria 38,39 , donde se ha visto aumento del peso y grasa corporal. Los resultados concuerdan con un estudio nacional el cual mostró los problemas que existen en la dilución de las FL, siendo más habituales en el NSE bajo, en el que cerca de un 40% de los padres la concentraba por sobre lo recomendado en niños entre 6 a 11 meses 40 .…”

A Scoping Review of the Application of Metabolomics in Nutrition Research: The Literature Survey 2000–2019

“…Nutrimetabolomics studies using human milk samples have been focused on because, in addition to being non-invasive and easy to collect, fetal and infancy nutritional statuses may affect their subsequent growth, health risk, or genetic modification. In fact, reports included not only studies on changes in perinatal milk composition, but also studies investigating links between maternal obesity and human milk metabolites [40] as well as risks of postnatal weight gain [41].…”