TABLE 1.
Prospective cohort studies assessing the association between protein intakes from birth to 2 y and obesity outcomes in childhood or adolescence1
| First author, year (ref) | Sample characteristics, n, study country | Age at protein intake assessment, mo | Protein intake | Dietary assessment tool | Age at outcome assessment | Obesity outcomes | Adjusted confounders | Findings | Funding |
|---|---|---|---|---|---|---|---|---|---|
| Scaglioni, 2000 (33) | 147, Italy | 12 | Total protein (%E) | FFQ plus 24-h recall | 5 y | BMI | Child sex, weight, and length at birth and 12 mo; parental age | Children with BMI >90th percentile had higher total protein intake at 12 mo than those with BMI ≤90th percentile | N/D |
| Gunnarsdóttir, 2003 (25) | 90, Iceland | 2, 4, 6, 9, 12 | Total protein (%E) | 2-d WFR | 6 y | BMI | Total energy intake, intakes of fat and carbohydrate | Total protein at 2, 4, 9, 12 mo, but not 6 mo, and BMI in boys: + significantTotal protein and BMI in girls: NS | I |
| Hoppe, 2004 (28) | 100, Denmark | 9 | Total protein (g/d, g/kg BW) | 7-d FR | 10 y | BMI, weight, %BF | Child sex, parental height and weight, breastfeeding duration, BMI/weight/%BF at 9 mo | Total protein and weight: + significantTotal protein and BMI and %BF: NS | G |
| Günther, 2006 (26)2 | 313, Germany | 12, 18, 24 | Total protein (%E) | 3-d WFR | 5 y | BMI SDS | Total energy intake, maternal BMI, siblings, gestational age, breastfeeding status | Significant differences in BMI SDS by total protein intake tertiles from 12–24 mo were found in girls, not boys | G |
| Gunther, 2007 (27)2 | 203, Germany | 6, 12, 18–24 | Total protein groups (high-high, high-low, low-high, low-low) | 3-d WFR | 7 y | BMI SDS, %BF; overweight, overfatness | Child sex, total energy intake, maternal BMI, maternal education, gestational age, first birth, smoking, breastfeeding, siblings, and BMI SDS or %BF at 6 mo | All obesity outcomes were not statistically different by total protein intake groups at ages 6–12 moObesity measures by total protein intake groups at 12 and 18–24 mo | G |
| Günther, 2007 (14)2 | 203, Germany | 6, 12, 18–24 | Total protein and sources (%E and teriles) Animal: -Dairy -Meat Plant: -Cereal | 3-d WFR | 7 y | BMI SDS, %BF | Child sex, total energy intake, fat intake, siblings, firstborn status, maternal overweight, lnBF% BMI SDS at 6 mo | Total protein, animal, and dairy proteins at 12 mo and BMI SDS and %BF: + significantTotal protein, animal, and dairy proteins at 6, 18–24 mo and BMI SDS and %BF: NSLinear dose–response trend between total protein, animal, and dairy intake tertiles and BMI SDS and %BFPlant, meat, cereal proteins and BMI SDS and BF%: NS | G |
| Weijs, 2011 (38) | 120, Netherlands | 4–13 | Animal protein (total protein minus plant) tertiles (%E) | 2-d WFR | 8 y | BMI SDS, overweight (BMI SDS >1) | Child sex, age, body weight at 4–13 mo, breastfeeding status, maternal education, overweight, physical activity, and total energy intake | The highest animal protein tertile showed significant higher BMI SDS and risk of overweight compared with the lower 2 animal protein tertiles | G |
| Thorisdottir, 2013 (35)3 | 90 in 1995/1996; 170 in 2005; Iceland | 9, 12 | Total protein (%E) | 3-d WFR | 6 y | BMI | Child sex, total energy intake, birth weight, maternal education, breastfeeding duration | Total protein at 9 mo and BMI: NSTotal protein at 12 mo and BMI: + significant | N/D |
| Thorisdottir, 2014 (34)3 | 137, Iceland | 12 | Total protein and sources (%E) Animal: -Dairy -Meat/fish Plant | 2–3-d WFR | 6 y | BMI | Child sex, total energy intake, breastfeeding duration, maternal education and birth weight | Total protein and animal protein and BMI: + significantDairy and meat/fish protein, plant protein and BMI: NS | G |
| Braun, 2016 (24)4 | 3564, Netherlands | 13 | Total protein and sources (10 g/d) Animal: -Dairy -Nondairy animal Plant | FFQ | 14, 18, 24, 30, 36, 45 mo; 6, 9 y | BMI and weight SDS trajectories | Child sex, ethnicity, age, total energy intake, birth weight, breastfeeding, playing sports, household income, maternal BMI, education, folic acid use during pregnancy, smoking during pregnancy and diet score | Total protein, animal, dairy, nondairy animal protein and trajectories of weight SDS and BMI SDS: + significantPlant protein and trajectories of weight SDS and BMI SDS: NS | I |
| Pimpin, 2016 (31)5 | 2154, United Kingdom | 21 | Total protein (%E) | 3-d WFR | 36, 60 mo | BMI and weight trajectories, overweight (IOTF) | Child sex, age at diet entry, zygosity, ethnicity, feeding method, family SES, maternal BMI, rate of prior growth, birth weight, total energy intake | Total protein and trajectories of BMI and weight from 21–36 and 21–60 mo: + significantTotal protein and trajectories of BMI and weight from 21–36 and 21–60 mo: + significantTotal protein and overweight: NS | I |
| Voortman, 2016 (36)4 | 2911, Netherlands | 12 | Total protein and sources (10 g/d) Animal: -Dairy -Nondairy animal Plant | FFQ | 6 y | BMI SDS, FMI SDS, FFMI SDS | Child sex, total energy intake, maternal age, prepregnancy BMI, education level, smoking during pregnancy, household income, child ethnicity, birth weight, breastfeeding, total fat intake, diet quality score, screen time, pariticpation in sports, BMI at 13 mo | Total protein, animal protein and FMI SDS: + significant Total protein, animal protein and BMI SDS, FFMI SDS: NSPlant protein and BMI, FMI, FFMI SDS: NSDairy and nondairy animal and FMI SDS similar effect size | I, G |
| Voortman, 2016 (37)4 | 2965, Netherlands | 12 | Total protein and sources (10 g/d and tertile) Animal Plant | FFQ | 6 y | %BF, FMI | Maternal age, BMI, education, smoking during pregnancy, child ethnicity, birth weight z score, breastfeeding, total energy intake, fat intake, participation in sports, and screen time | Total protein and %BF: + significantLinear dose–response trend between total protein, animal, and dairy intake tertiles and %BF and FMISex-specific analyses revealed significant association in girls, but not in boys | I |
| Morgen, 2018 (30) | 7 y: 36,481; 11 y: 22,047; Denmark | 18 | Protein sourcesDairy (5 g/d)Meat/fish (2 g/d) | 4-d 24-h recall | 7, 11 y | BMI z score and overweight (IOTF) | Maternal pregnancy BMI, paternal BMI, maternal SES, maternal age at conception, parity, smoking during pregnancy, gestational weight gain | Dairy, meat/fish protein and BMI z score at 7 and 11 y: + significantDairy protein and overweight at 7 and 11 y: NSMeat/fish protein and overweight at 7 y: + significantMeat/fish protein and overweight at 11 y: NS | I |
| Pimpin, 2018 (32)5 | 1939, United Kingdom | 21 | Total protein and sourcesAnimal (meat, chicken fish, eggs) Dairy: -Milk Plant | 3-d 24-h recall | Quarterly 21–60 mo | Weight, BMI and overweight (IOTF) | Age at dietary assessment, child sex, birth weight, rate of prior weight gain, fat intake, total energy intake and height | Dairy and milk protein and weight, BMI, overweight: + significantAnimal, plant protein and weight, BMI, overweight: NS | I, G |
| Jen, 2019 (29)4 | 3573, Netherlands | 12 | Total protein and sources (5%E) Animal: -Dairy -Nondairy animal Plant | FFQ | Eight time points from 1 to 10 y and 6 to 10 y | BMI SDS, weight SDS trajectories from 1 to 10 y; FMI SDS, FFMI SDS trajectories from 6 to 10 y | Child sex, ethnicity, age at dietary measurement, total energy intake, birth weight, breastfeeding, diet quality, screen time, playing sports, household income, maternal BMI, maternal education, folic acid use during pregnancy, smoking during pregnancy | Total and animal protein and trajectories of weight SDS, BMI SDS and FMI SDS: + significantPlant protein and trajectories of BMI SDS and FMI SDS: NSNo association was found for any protein intake and FFMI SDS | I, G |
1
BW, body weight; FFMI, fat-free mass index; FMI, fat mass index; FR, food record; G, government; I, industry; IOTF, International Obesity Task Force; N/D, not described; ref, reference; SDS, SD score; SES, socioeconomic status; WFR, weighed food record; %BF, percentage of body fat; %E, percentage of energy; + significant, positive significant association (P < 0.05).
2
Second Longitudinal Icelandic Infant Study.
3
Dortmund Nutritional and Anthropometric Longitudinal Design study.
4
Generation R Study.
5
Gemini UK twin study.