Increased protein intake augments kidney volume and function in healthy infants

Escribano, Joaquín; Luque, Verónica; Ferré, Natàlia; Zaragoza‐Jordana, Marta; Grote, Veit; Koletzko, Berthold; Gruszfeld, Dariusz; Socha, Piotr; Dain, Elena; Hees, Jean‐Noel Van; Verduci, Elvira; Closa‐Monasterolo, Ricardo

doi:10.1038/ki.2010.499

Cited by 61 publications

(64 citation statements)

References 52 publications

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“…Considering such caution in transposing findings to humans, our findings highlight the long-term renal consequences of neonatal HP diet in LBW infants. While no study has clearly explored the renal effects of a neonatal HP diet in these infants, two recent studies reported renal hypertrophy (+10% to +25% increase in kidney volume) in 3-and 6-mo-old NBW infants exposed from birth to HP formulas (39,40). The long-term consequences are unknown.…”

Section: Discussionmentioning

confidence: 99%

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

et al. 2015

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Background: Intrauterine growth restriction (IUGR) and postnatal nutrition are risk factors for cardiovascular and renal diseases in both humans and animals. The long-term renal effects of protein intake early in life remain unknown. The objective was to evaluate the effects of a neonatal feeding with high protein (HP) milk on renal functions and structure in IUGR male rats. Methods: Maternal gestational low protein diet was used to produce IUGR. At day 5, IUGR pups were gastrostomized in the "pup-in-the cup" model and received either normal protein (NP) milk or HP (+50% protein content) milk until day 21. After weaning, the animals were fed the same standard diet. Renal functions and structure were assessed at postnatal day 18 (D18) and in adult offspring. results: During the preweaning period, the postnatal weight gain between the two groups was unaffected. On D18, kidneys from HP offspring were heavier with significant glomerular hypertrophy (+40%, P < 0.05). HP diet was associated with significant proteinuria and glomerulosclerosis (+49%, P < 0.05). Glomerular number was unaltered. conclusion: Neonatal HP feeding following IUGR affects renal functions and structure at adulthood. These alterations may result from a single nephron glomerular hyperfiltration.

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Section: Discussionmentioning

confidence: 99%

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

et al. 2015

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“…The effect of the intervention was not different among the countries for any of the analyzed anthropometric measures. In addition to total body growth, also a significant effect on kidney growth was found [69]. We estimated the potential impact of the reduced protein intake in infancy on obesity in adolescence based on the observed effects of change in weight-forlength gain during the first 2 years of life on later obesity in large prospective cohort studies, and we calculated an expected reduction of obesity prevalence at 14-16 years by 13% [24].…”

Section: Mechanisms Of Protective Effects Of Breastfeeding: the 'Earlmentioning

confidence: 99%

Early Influences of Nutrition on Postnatal Growth

Koletzko¹,

Beyer²,

Brands³

et al. 2013

Nestlé Nutrition Institute Workshop Series

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Health and nutrition modulate postnatal growth. The availability of amino acids and energy, and insulin and insulin-like growth factor-I (IGF-I) regulates early growth through the mTOR pathway. Amino acids and glucose also stimulate the secretion of IGF-I and insulin. Postnatal growth induces lasting, programming effects on later body size and adiposity in animals and in human observational studies. Rapid weight gain in infancy and the first 2 years was shown to predict increased obesity risk in childhood and adulthood. Breastfeeding leads to lesser high weight gain in infancy and reduces obesity risk in later life by about 20%, presumably partly due to the lower protein supply with human milk than conventional infant formula. In a large randomized clinical trial, we tested the hypothesis that reduced infant formula protein contents lower insulin-releasing amino acid concentrations and thereby decrease circulating insulin and IGF-I levels, resulting in lesser early weight gain and reduced later obesity risk (the 'Early Protein Hypothesis'). The results demonstrate that lowered protein in infant formula induces similar -but not equal -metabolic and endocrine responses and normalizes weight and BMI relative to breastfed controls at the age of 2 years. The results available should lead to enhanced efforts to actively promote, protect and support breastfeeding. For infants that are not breastfed or not fully breastfed, the use of infant formulas with lower protein contents but high protein quality appears preferable. Cows' milk as a drink provides high protein intake and should be avoided in infancy.

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“…For instance, it has been proposed that poor nutritional status during gestation may affect nephrogenesis in the offspring, which could lead to impaired kidney development that could induce hypertension risk as well as poor kidney function in adulthood (3,4). Conversely, increased protein supply has been reported to stimulate kidney growth not only prenatally but also in postnatal life, both in animal models (5) and in humans (6). One of the mechanisms that may induce compensatory kidney growth in response to an increase in protein supply is the increased renal workload in response to urea and other compounds derived from protein metabolism (7,8).…”

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confidence: 99%

Does insulin-like growth factor-1 mediate protein-induced kidney growth in infants?: A secondary analysis from a randomized controlled trial

Luque

Escribano

Grote³

et al. 2013

Pediatr Res

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Background: Animal models have shown that insulin-like growth factor I (IGF-I) may mediate protein-induced kidney growth. Our aim was to analyze the effect of IGF-I on proteininduced kidney growth in healthy infants. Methods: This is a secondary analysis of a randomized trial that compared growth of infants fed with a higher-protein (HP) (n = 169) vs. lower-protein (LP) (n = 182) formula (in the first year of life). Outcome measures were anthropometric parameters, kidney volume (cm 3 ), and total and free IGF-I (ng/ml). results: The highest levels of total and free IGF-I were found in the HP group. Both parameters correlated significantly with BMI z-score (r = 0.229, P < 0.001 and r = 0.223, P < 0.001, respectively), kidney volume (r = 0.115, P = 0.006 and r = 0.208, P < 0.001, respectively), and kidney volume/body length (r = 0.109, P = 0.010 and r = 0.194, P < 0.001, respectively) at 6 mo. Linear regression analyses showed a significant effect of free IGF-I on kidney volume in models, including significant effects of HP formula and anthropometry. The structural equation model revealed a significant direct effect of the HP formula on kidney volume and an indirect effect mediated by free IGF-I. conclusion: This study suggests that IGF-I partly mediates protein-induced kidney growth in healthy infants. IGF-I could be involved in a pathway for the programming of the renal system. r ecent research on the early origins of adult diseases has highlighted the importance of nutrition early in life. Early nutrition could affect body structures and tissue development, which could be expressed as a permanent effect on a function that could affect health in adulthood (1). This is what is known as nutritional programming. Nutritional factors could act in different tissues and systems during a critical period of development affecting growth (2). Programming through early growth mechanisms may affect different body tissues and organs, such as bone, muscle, adipose tissue, the heart, and the kidney. Different nutritional interventions early in life have been shown to produce permanent effects on kidney function and structure. For instance, it has been proposed that poor nutritional status during gestation may affect nephrogenesis in the offspring, which could lead to impaired kidney development that could induce hypertension risk as well as poor kidney function in adulthood (3,4). Conversely, increased protein supply has been reported to stimulate kidney growth not only prenatally but also in postnatal life, both in animal models (5) and in humans (6). One of the mechanisms that may induce compensatory kidney growth in response to an increase in protein supply is the increased renal workload in response to urea and other compounds derived from protein metabolism (7,8). Furthermore, animal models have shown that insulin-like growth factor I (IGF-I) may also mediate proteininduced kidney growth. However, there is little evidence suggesting a direct effect of IGF-I on kidney size or function in humans. The relationship between IGF...

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Increased protein intake augments kidney volume and function in healthy infants

Cited by 61 publications

References 52 publications

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

High protein intake in neonatal period induces glomerular hypertrophy and sclerosis in adulthood in rats born with IUGR

Early Influences of Nutrition on Postnatal Growth

Does insulin-like growth factor-1 mediate protein-induced kidney growth in infants?: A secondary analysis from a randomized controlled trial

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