title: Association of early protein intake and pre-peritoneal fat at five years of age: Follow-up of a randomized clinical trial.
abstract: The double-blind randomized European Childhood Obesity Project (CHOP) demonstrated that reduced protein content in infant formula leads to a lower body mass index (BMI) up to six years of age. Here we aimed at assessing pre-peritoneal fat, a marker of visceral fat, in children participating in the CHOP trial.
  
  
  
  Healthy term formula-fed infants in five European countries were randomized either to higher (n = 550) or lower (n = 540) protein formulas in the first year of life. Infants who were exclusively breastfed for at least three months (n = 588) were enrolled as an observational (non randomized) group. At age 5 years, subcutaneous fat (SC) and pre-peritoneal fat (PP) were measured by ultrasound in a subgroup of 275 children. The PP fat layer was thicker in the higher compared to the lower protein group (adjusted estimated difference: 0.058 cm, 95%CI 0.002; 0.115; p = 0.043), while SC fat was not different. Girls showed a thicker SC fat layer than boys.
  
  
  
  Higher protein intake in formula-fed infants appears to enhance pre-peritoneal fat tissue accumulation at the age of 5 years, but not of subcutaneous fat, which may trigger adverse metabolic and health consequences.
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland. Electronic address: d.gruszfeld@czd.pl.
authors.forename: D
authors.initials: D
authors.lastname: Gruszfeld
authors.affiliation: Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Gradowska
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Socha
authors.affiliation: Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Grote
authors.affiliation: CHC Saint Vincent, Liège-Rocourt, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Xhonneux
authors.affiliation: University Children's Hospital Queen Fabiola, ULB, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Dain
authors.affiliation: San Paolo Hospital, University of Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Verduci
authors.affiliation: San Paolo Hospital, University of Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Riva
authors.affiliation: Universitat Rovira i Virgili, IISPV, Reus, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Closa-Monasterolo
authors.affiliation: Universitat Rovira i Virgili, IISPV, Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Escribano
authors.affiliation: Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Koletzko
mesh_terms: D050154:Adiposity; D000367:Age Factors; D002657:Child Development; D002675:Child, Preschool; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000009:adverse effects*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D009752:Nutritional Status; D063766:Pediatric Obesity / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010537:Peritoneum; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D004044:Dietary Proteins
keywords: Child; Dietary proteins; Infant formula; Intra-abdominal fat; Protein; Subcutaneous fat