title: Infant feeding and later obesity risk.
abstract: Some 30 years ago, Günter Dörner proposed that exposure to hormones, metabolites and neurotransmitters during limited, sensitive periods of early development exert programming effects on disease risk in human adults. Early programming of long term health has since received broad scientific support and attention. For example, evidence increases for programming effects of infant feeding choices on later obesity risk. Meta-analyses of observational studies indicate that breast feeding reduces the odds ratio for obesity at school age by about 20%, relative to formula feeding, even after adjustment for biological and sociodemographic confounding variables. We hypothesized that breast feeding protects against later obesity by reducing the likelihood of high weight gain in infancy, and that this protection is caused at least partly by the lower protein supply with breast milk relative to standard infant formulae (the "Early Protein Hypothesis"). These hypotheses are tested in the European Childhood Obesity Project, a randomized double blind intervention trial in more than 1,000 infants in five European countries (Belgium, Germany, Italy, Poland, Spain). Formula fed infants were randomized to receive during the first year of life infant formulae and follow-on-formulae with higher or lower protein contents. Follow-up at 2 years of age shows that lower protein supply with formula normalizes early growth relative to a breast fed reference group and to the WHO growth reference. These results demonstrate that modification of infant feeding practice has an important potential for long-term health promotion and should prompt a review of the recommendations and policies for infant formula composition.
authors.affiliation: Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Germany. office.koletzko@med.uni-muenchen.de
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Ricardo Closa
authors.initials: RC
authors.lastname: Monasterolo
authors.forename: Joaquín Escribano
authors.initials: JE
authors.lastname: Subías
authors.forename: Silvia
authors.initials: S
authors.lastname: Scaglioni
authors.forename: Marcello
authors.initials: M
authors.lastname: Giovannini
authors.forename: Jeannette
authors.initials: J
authors.lastname: Beyer
authors.forename: Hans
authors.initials: H
authors.lastname: Demmelmair
authors.forename: Brigitte
authors.initials: B
authors.lastname: Anton
authors.forename: Dariusz
authors.initials: D
authors.lastname: Gruszfeld
authors.forename: Anna
authors.initials: A
authors.lastname: Dobrzanska
authors.forename: Anne
authors.initials: A
authors.lastname: Sengier
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Langhendries
authors.forename: Marie-Françoise Rolland
authors.initials: MF
authors.lastname: Cachera
authors.forename: Viet
authors.initials: V
authors.lastname: Grote
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000453:epidemiology*; D015984:Causality; D002657:Child Development; D005247:Feeding Behavior / Q000502:physiology; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000502:physiology; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007231:Infant, Newborn; D008894:Milk Proteins; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D008894:Milk Proteins