title: Protein intakes and their nutritional sources during the first 2 years of life: secondary data evaluation from the European Childhood Obesity Project.
abstract: High protein intake in infancy affects future obesity risk and other health outcomes. We aim to describe total protein intake and its sources in a birth cohort in five European countries over the first 2 years of life.
  
  
  
  A total of 746 formula-fed infants were included. Three-day weighed dietary records at 6, 7, 8, 9, 12, 18 and 24 months of age were used. Kruskal-Wallis, ANOVA and Friedman's tests were used to assess possible differences in nutritional intake among countries and over time.
  
  
  
  Dairy products were the main components of the infants' diets. Cow's milk was rarely introduced before 12 months of age, whereas infants' formula was the main contributor of protein intake. Food choices and protein intake differed among countries (P<0.001). Protein intake often exceeded European recommendations from 9 months onwards, partly because of the substitution of dairy protein (mainly infant formula) by meat protein. Two nutritional patterns were identified that were characterised by differences in energy, fat, protein and animal protein intake. Finally, food consumption was not always in line with protein intakes, and thus infants from some countries showed high consumption of specific food groups but relatively low protein intakes.
  
  
  
  During weaning, over-limited substitution of dairy products with other sources (especially meat) resulted in relatively high protein intakes in formula-fed infants. Differences in preferences of specific protein sources from complementary foods existed among European countries. Great opportunities in improving early nutrition were revealed, although cultural and geographical differences should always be considered.
authors.affiliation: Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Damianidi
authors.affiliation: Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Gruszfeld
authors.affiliation: Department of Pediatrics, San Paolo Hospital, Milan, Italy.|Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Verduci
authors.affiliation: Department of Pediatrics, San Paolo Hospital, Milan, Italy.|Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Vecchi
authors.affiliation: CHC St Vincent, Liège-Rocourt, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Xhonneux
authors.affiliation: CHC St Vincent, Liège-Rocourt, Belgium.
authors.forename: J-P
authors.initials: JP
authors.lastname: Langhendries
authors.affiliation: Paediatrics Research Unit, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Luque
authors.affiliation: Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Theurich
authors.affiliation: Paediatrics Research Unit, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Zaragoza-Jordana
authors.affiliation: Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Koletzko
authors.affiliation: Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Grote
mesh_terms: D004044:Dietary Proteins / Q000032:analysis*; D002149:Energy Intake; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009753:Nutritive Value; D063766:Pediatric Obesity / Q000517:prevention & control*
chemical_list: D004044:Dietary Proteins