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Pediatrics

Dietary protein intake in school-age children and detailed measures of body composition: the Generation R Study

International Journal of Obesity volume 42, pages 1715–1723 (2018)Cite this article

Subjects

Abstract

Background

A high-protein diet in infancy increases the risk of obesity, but the effects of dietary protein intake in mid-childhood on body composition are unclear. Therefore, we studied associations of protein intake (total, animal and plant-sourced) at 8 years of age with anthropometric measures and body composition up to age 10 years.

Methods

We included 3991 children of the Generation R Study, a prospective cohort in the Netherlands. Dietary protein intake was assessed at 8 years of age using a food-frequency questionnaire and is expressed in energy percentage (E%). Anthropometric measures and body composition (using dual-energy X-ray absorptiometry (DXA)) were assessed at 6 years and during follow-up at 10 years. We calculated body mass index (BMI), fat mass index (FMI), and fat-free mass index (FFMI). All outcomes were sex- and age-standardized and overweight (yes/no) was derived from BMI-SDS. We examined associations of protein intake at 8 years with the combined risk of overweight and obesity, and body composition at 10 years using multivariable logistic and linear regression models. These analyses were adjusted for outcomes at 6 years and protein intake in early life.

Results

In multivariable-adjusted models, a 5E% higher protein intake at 8 years was associated with a higher combined risk of overweight and obesity up to 10 years (odds ratio (OR) 1.51, 95% confidence interval (CI): 1.22,1.86), independent of whether it replaced carbohydrates or fat. However, this was mainly explained by an association of protein intake with a higher FFMI (0.07 standard deviation scores (SDS) per 5E%, 95% CI: 0.02,0.11), not FMI. Both plant and animal were associated with a higher FFMI, but the association was stronger for protein from plant sources. For FMI, our findings also suggest trends of higher plant protein intake with lower FMI, and higher animal protein intake with higher FMI. Following this, a higher plant protein intake at the expense of animal protein was associated with a lower FMI (−0.08 SDS per 5E%, 95% CI: −0.15,−0.01).

Conclusions

We observed that a higher protein intake in mid-childhood is associated with a higher fat-free mass. Our findings also suggest that protein from plant sources seems to be beneficial for body composition in school-age children.

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Acknowledgements

The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam; the Municipal Health Service, Rotterdam area; and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. We gratefully acknowledge the contribution of participating mothers, general practitioners, hospitals, midwives, and pharmacies in Rotterdam, the Netherlands. This work was supported by the Erasmus Medical Center, Rotterdam; the Erasmus University, Rotterdam; the Dutch Ministry of Health, Welfare and Sport; and the Netherlands Organization for Health Research and Development (ZonMw). V.W.V.J. was supported by a grant from the Netherlands Organization for Health Research and Development (VIDI 016.136.361), a European Research Council Consolidator Grant (ERC-2014-CoG-648916), and funding from the European Union’s Horizon 2020 research and innovation program under grant agreements no. 733206 (LifeCycle) and no. 633595 (DynaHEALTH). T.V. received additional support from the Thrasher Research Fund. L.G.K. works at the Nestlé Research Center. V.J., O.H.F., and T.V. work in ErasmusAGE, a center for aging research across the life course. The current work was financially supported by Nestlé Research Center (Nestec).

Author contributions

The authors’ responsibilities were as follows: V.J., L.G.K., and T.V. designed the research project; V.W.V.J. and O.H.F. were involved in the study design and data collection; V.J. and T.V. analyzed the data; L.G.K., V.W.V.J., and O.H.F. provided consultation regarding the analyses and interpretation of the results; V.J. and T.V. wrote the manuscript; V.J., L.G.K., and T.V. had primary responsibility for the final content. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Vincent Jen, Vincent W. V. Jaddoe, Oscar H. Franco & Trudy Voortman

  2. Nestlé Research Center, Lausanne, Switzerland

    Leonidas G. Karagounis

  3. Experimental Myology and Integrative Biology Research Cluster, Faculty of Sport and Health Sciences, University of St Mark and St John, Plymouth, UK

    Leonidas G. Karagounis

  4. Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands

    Vincent W. V. Jaddoe

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  1. Vincent Jen
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Correspondence to Trudy Voortman.

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Jen, V., Karagounis, L.G., Jaddoe, V.W.V. et al. Dietary protein intake in school-age children and detailed measures of body composition: the Generation R Study. Int J Obes 42, 1715–1723 (2018). https://doi.org/10.1038/s41366-018-0098-x

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