Protein intake in early childhood and cardiometabolic health at school age: the Generation R Study.
OBJECTIVE
High protein intake in infancy has been linked to obesity. We aimed to examine the associations of protein intake in early childhood with cardiovascular and metabolic outcomes at school age.


METHODS
This study was performed in 2965 children participating in a population-based prospective cohort study. Protein intake at 1 year was assessed with a food frequency questionnaire and was adjusted for energy intake. At the children's age of 6 years, we measured their body fat percentage (BF%), blood pressure (BP), and insulin, HDL cholesterol, and triglyceride serum levels. These measures were incorporated into a cardiometabolic risk factor score, using age- and sex-specific SD scores.


RESULTS
In covariate-adjusted models, higher protein intake was associated with a higher BF%, lower diastolic BP, and lower triglyceride levels. We observed a significant interaction of protein intake with child sex on metabolic outcomes. Stratified analyses showed that protein intake was positively associated with BF% [0.07 SD (95 % CI 0.02; 0.13) per 10 g/day] and insulin levels in girls, but not in boys. In boys, but not in girls, higher protein intake was associated with lower triglyceride levels [-0.12 SD (95 % CI -0.20; -0.04) per 10 g/day] and a lower cardiometabolic risk factor score. Protein intake was not consistently associated with systolic BP or HDL cholesterol levels.


CONCLUSIONS
Protein intake in early childhood was associated with a higher BF% and higher insulin levels at 6 years in girls and with lower triglyceride levels in boys. Further studies are needed to explore these sex differences and to investigate whether the observed changes persist into adulthood.
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. trudy.voortman@erasmusmc.nl.|The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. trudy.voortman@erasmusmc.nl.
Trudy
T
Voortman
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Edith H
EH
van den Hooven
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Myrte J
MJ
Tielemans
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Albert
A
Hofman
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Jessica C
JC
Kiefte-de Jong
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.|Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Vincent W V
VW
Jaddoe
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Oscar H
OH
Franco
D050154:Adiposity; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis*; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology; D015596:Nutrition Assessment; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004044:Dietary Proteins; D007328:Insulin; D014280:Triglycerides
Blood pressure; Body fat; Children; Dietary protein; Epidemiology; Insulin