Document Detail


Protein requirements of infants and children: growth during recovery from malnutrition.
MedLine Citation:
PMID:  8632935     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the adequacy of protein intakes now recommended as safe for infants and toddlers. METHODS: Subjects were recovering malnourished infants, age 5.3 to 17.9 months, length age (LA) 2.5 to 6.4 months, weight age (WA) 1.5 to 5.2 months, weight/length (W/L) 78% to 100% of National Center for Health Statistics data; and toddlers age 11.4 to 31.6 months, LA 6.1 to 17.9 months, WA 3.9 to 12.0 months, W/L 79% to 99%. Infants were assigned at random to formulas with 5.5%, 6.7%, or 8.0% energy as 60:40 whey:casein protein. The 5.5% was based on FAO-WHO-UNU safe protein and average energy for ages 2.5 to 6.0 months. Toddlers received 4.7% (recommended for 6 to 18 months), 6.4%, or 8.0%. Identical concentrations (weight/kcal) of other nutrients were maintained; intakes were adjusted weekly to reach, in 90 days, the 50th percentile of weight for a LA 3 months greater than the initial one. RESULTS: Infants consumed 125 +/- 11 (SD), 116 +/- 10, and 126 +/- kcal and 1.7 +/- 0.1, 1.9 +/- 0.2, and 2.5 +/- 0.3 g protein kg-1 . d-1; gained 2.4 +/- 0.7, 2.9 +/- 0.7, and 2.6 +/- 0.5 months in LA, and reached a W/L of 105 +/- 5, 103 +/- 6, and 105 +/- 5% of reference. Sum of four fat-folds (sigma FF) grew 13.1 +/- 6.9, 10.4 +/- 4.8, and 11.7 +/- 5.3 mm to 32.5 +/- 5.2, 31.7 +/- 4.7, and 30.5 +/- 5.5 mm; arm muscle areas (AMA) 57%, 51%, 70% to 1004 +/- 109, 1017 +/- 110, and 1004 +/- 116 mm2, still low; arm fat areas (AFA) 93%, 66%, and 93% to higher-than-normal 598 +/- 105, 610 +/- 101, and 541 +/- 116 mm2. Regression of intake on weight gain estimated energy for maintenance + activity to be 81.0 +/- 7.5 (SEM) kcal . kg-1 . d-1, and cost of gain (storage + metabolic cost) as 7.6 +/- 1.7 kcal/g, with no significant effect of % protein. Toddlers consumed 107 +/- 9, 103 +/- 12, and 105 +/- 10 kcal and 1.3 +/- 0.1, 1.6 +/- 0.2, and 2.1 +/- 0.2 g protein . kg-1 . d-1, gained 3.3 +/- 0.7, 2.9 +/- 0.6, and 3.3 +/- 0.7 months in LA; to a W/L of 102 +/- 1, 102 +/- 3, and 101 +/- 4%. Sigma FF grew 9.2 +/- 4.0, 7.4 +/- 4.3, and 6.0 +/- 3.8 to 28.9 +/- 5.2, 30.5 +/- 3.7, and 27.0 +/- 2.7 mm; AMA 31%, 33%, and 34% to 1121 +/- 115, 1124 +/- 110, and 1117 +/- 120 mm2; AFA 53%, 44%, and 45% to higher-than normal 578 +/- 106, 636 +/- 99, and 569 +/- 68 mm2. Cost of maintenance + activity was 70.8 +/- 3.8 (SEM) kcal . kg-1 . d-1, that of weight gain 9.7 +/- 1.35 kcal/g, with no effect of % protein. CONCLUSIONS: Within age groups, there were no significant protein-related differences in growth. In both infants and toddlers, high-energy intakes resulted in mild obesity, with lean body mass still deficient. Protein intakes two SD below the means in the lowest protein/energy cells, 1.5 g . kg-1 . d-1 for infants and 1.1 g times kg-1 . d-1 for toddlers, should still be safe for nearly all children of comparable biological ages.
Authors:
G G Graham; W C MacLean; K H Brown; E Morales; J Lembcke; A Gastañaduy
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  97     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-07-01     Completed Date:  1996-07-01     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  499-505     Citation Subset:  AIM; IM    
Affiliation:
Instituto de Investigación Nutrucional (IIN), Lima, Perú.
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue / anatomy & histology
Arm / anatomy & histology
Body Height
Body Mass Index
Body Weight
Caseins / therapeutic use
Child Nutritional Physiological Phenomena*
Child, Preschool
Dietary Proteins / therapeutic use*
Energy Intake
Energy Metabolism
Female
Growth*
Humans
Infant
Infant Food
Infant Nutritional Physiological Phenomena*
Male
Milk Proteins / therapeutic use
Muscle, Skeletal / anatomy & histology
Nutrition Disorders / drug therapy*,  physiopathology
Nutritional Requirements*
Obesity / pathology
Regression Analysis
Skinfold Thickness
Weight Gain
Grant Support
ID/Acronym/Agency:
HD-10111/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Caseins; 0/Dietary Proteins; 0/Milk Proteins; 0/whey protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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