Early nutrition has long-term metabolic impact

Issue: June 2011

Pediatric Academic Societies’ Annual Meeting 2011

Nutrition during the first days or weeks of life may have long-term consequences on health, potentially via the metabolic programming effect.

Metabolic programming is the concept that differences in nutritional experiences at critical periods early in life can program a person’s metabolism and health for the future.

Researchers conducted a clinical, controlled, double blind, randomized, single-center trial that compared growth, body composition and blood pressure in three groups of healthy, full-term newborns. All newborns were in the neonatal department at Hospices Civils de Lyon, Claude Bernard University, Lyon, France.

One group was randomly assigned to only breast milk for the first 4 months of life. Two other groups were assigned to a low-protein formula with 1.8 g of protein/100 kcal or a high-protein formula with 2.7 g/100 kcal. The protein content of both formulas was within the recommended levels of 1.8 g/100 kcal to 3 g/100 kcal. After 4 months, the formula-fed infants continued to receive the same formula, and the breast-fed infants were assigned to the low-protein formula, if needed.

The 234 children were followed for 3 years. During follow-up, researchers found that exclusive breast-feeding during the first weeks of life induced a specific pattern of growth and a specific metabolic profile, which appeared to differ in formula-fed infants. The protein content in infant formula may be a key factor in inducing these differences, according to study co-author Guy Putet, MD.

As early as 15 days of life, blood insulin levels were lower in breast-fed infants compared with formula-fed infants. These differences persisted at 4 months of age, but no differences were seen at 9 months.

Growth patterns also were different between groups during the first year of life, but by 3 years of age there no longer was any difference in length, weight or body composition, including fat mass, lean body mass, between groups. The exception was head circumference, which was slightly lower in the low-protein formula group but remained within the normal range.

At 3 years, diastolic and mean BP was higher in infants who had been fed the high-protein formula compared with breast-fed infants, Putet noted. However, these levels were still within the normal range.

“It appears that formula feeding induces differences in some hormonal profiles as well as in patterns of growth compared with breast-feeding,” Putet said. “The long-term consequences of such changes are not well-understood in humans and may play a role in later health. Well-designed studies with long-term follow-up are needed.”

If breastfeeding is not possible, Putet said, infants should be fed formulas that allow a growth pattern and a metabolic profile similar to that of breast-fed infants.

For more information:

Labaune JM. Poster 3670.3. Poster symposium session: Neonatal fetal nutrition & metabolism II. Presented at: Pediatric Academic Societies 2011; Apr. 30-May 3, 2011; Denver.

Follow EndocrineToday.com on Twitter.