Nutrition Publication

NNIW33 - Protein and Energy Requirements in Infancy and Childhood

Editor(s): J. Rigo, E. Ziegler. vol. 58

The topic ‘Protein and Energy Requirements in Infancy and Childhood’ was chosen for the 58th Nestlé Nutrition Pediatric Workshop, which took place in November 2005 in Ho Chi Minh City, Viet Nam. In 1993 the 33rd Nestlé Nutrition Workshop on ‘Protein Metabolism during Infancy’, chaired by Prof. Niels Räihä, was held in South Africa. In this workshop, Prof. Räihä introduced a new concept in terms of protein requirements, proposing a reduction in the protein level of infant formulas in order to come closer to that of human milk.

Related Articles

Subject Index

Author(s): J. Rigo, E. Ziegler

The topic ‘Protein and Energy Requirements in Infancy and Childhood’ was chosen for the 58th Nestlé Nutrition Pediatric Workshop, which took place in November 2005 in Ho Chi Minh City, Viet Nam. In 1993 the 33rd Nestlé Nutrition Workshop on ‘Protein Metabolism during Infancy’, chaired by Prof. Niels Räihä, was held in South Africa. In this workshop, Prof. Räihä introduced a new concept in terms of protein requirements, proposing a reduction in the protein level of infant formulas in order to come closer to that of human milk.

Concluding Remarks

Author(s): E. Ziegler

The topic ‘Protein and Energy Requirements in Infancy and Childhood’ was chosen for the 58th Nestlé Nutrition Pediatric Workshop, which took place in November 2005 in Ho Chi Minh City, Viet Nam. In 1993 the 33rd Nestlé Nutrition Workshop on ‘Protein Metabolism during Infancy’, chaired by Prof. Niels Räihä, was held in South Africa. In this workshop, Prof. Räihä introduced a new concept in terms of protein requirements, proposing a reduction in the protein level of infant formulas in order to come closer to that of human milk.

Foreword

Author(s): D. Barclay, F. Haschke

The topic ‘Protein and Energy Requirements in Infancy and Childhood’ was chosen for the 58th Nestlé Nutrition Pediatric Workshop, which took place in November 2005 in Ho Chi Minh City, Viet Nam. In 1993 the 33rd Nestlé Nutrition Workshop on ‘Protein Metabolism during Infancy’, chaired by Prof. Niels Räihä, was held in South Africa. In this workshop, Prof. Räihä introduced a new concept in terms of protein requirements, proposing a reduction in the protein level of infant formulas in order to come closer to that of human milk.

Long-Term Consequences of Early Feeding on Later Obesity Risk

Author(s): B. Koletzko

Some 30 years ago, Günter Dörner stated that the concentrations of hormones,metabolites and neurotransmitters during critical periods of early development willprogram disease risk in human adulthood, a concept that since has received enormousscientific support and broad attention. Evidence has also accumulated showing thatearly nutrition programs later obesity risk.

Energy Requirements of Infants and Children

Author(s): Nancy F. Butte

The energy requirements of infants and children are defined as the amount offood energy needed to balance total energy expenditure (TEE) at a desirable level ofphysical activity, and to support optimal growth and development. New TEE datafrom doubly labeled water and heart rate monitoring are available to derive theenergy requirements. Compared with the 1985 FAO/WHO/UNU recommendations,the 2004 FAO/WHO/UNU and 2002 IOM recommendations are ~12–20% lower duringinfancy. The 2004 FAO/WHO/UNU recommendations are on average 18% lower forboys and 20% lower for girls 7 years of age, and 12% lower for boys and 5% lowerfor girls 7–11 years of age. From 12 to 18 years of age, the requirements are 12%higher for boys and girls. The 2002 IOM recommendations are 8% lower for children7 years of age, 2% lower for children 7–11 years of age, and 8% higher for children12–18 years of age.

Protein Requirements of Infants and Children

Author(s): P.J. Garlick

During the last 35 years there have been various published assessments of humanprotein needs, including those of infants and children. Most recently, the Institute ofMedicine of the US National Academies has published its report on Dietary ReferenceIntakes (DRI) for Macronutrients, and WHO/FAO/UNU have convened a new ExpertConsultation, which is due to be published soon.

Growth of Breast-Fed and Formula-Fed Infants

Author(s): E.E. Ziegler

Growth and nutrition during infancy are being viewed with renewed interestbecause of the possibility that they may be linked to cardiovascular and metabolichealth in later life. Of particular interest are differences between breast- and formulafedinfants with regard to nutrient intake and growth because breastfeeding has beenshown to be associated with a reduced risk of obesity in later life. During the first 6–8weeks of life there is little difference in growth (gain in weight and length) betweenbreast- and formula-fed infants. However, from about 2 months of age to the end of thefirst year of life formula-fed infants gain weight and length more rapidly than breast-fedinfants.

Body Composition during the First Year of Life

Author(s): J. Rigo

Knowledge of changes in body composition is of great potential benefit to the understandingof the nutritional needs and functional outcome of nutritional management forboth healthy and sick infants. This review evaluates the different methods presentlyavailable to evaluate whole-body composition analysis based on different models, i.e. 2,3, or more compartments.

Dietary Reference Intakes: Concepts and Approaches Underlying Protein and Energy Requirements

Author(s): A.A. Yates

Nutrient reference values provide guidance for maintaining and enhancing healthvia standard setting and development of nutritionally improved products to decreasethe risk of disease. Since 1941, the Food and Nutrition Board (FNB) of the NationalAcademy of Sciences in the United States has developed and periodically revised recommendationsfor nutrients; the last (10th) edition of the Recommended DietaryAllowances (RDA) was released in 1989.

Intestinal Amino Acid Metabolism in Neonates

Author(s): J.B. Van Goudoever, S.R.D. Van der Schoor, B. Stoll, D.G. Burrin, D. Wattimena, H. Schierbeek, M.W. Schaart, M.A. Riedijk, J. Van der Lugt

The portal-drained viscera (stomach, intestine, pancreas and spleen) have a muchhigher rate of both energy expenditure and protein synthesis than can be estimated onthe basis of their weight. A high utilization rate of dietary nutrients by the portal-drainedviscera might result in a low systemic availability which determines whole-body growth.From studies in our multiple catheterized piglet model, we conclude that more than halfof the dietary protein intake is utilized within the portal-drained viscera and that aminoacids are a major fuel source for the visceral organs.

Amino Acid Requirements of Infants and Children

Author(s): P.B. Pencharz, R.O. Ball

Nitrogen balances have been conducted in preterm infants, preschool children, and6- to 10-year-old children to determine dietary indispensable amino acid. A recentreview concluded that the data, being sufficiently uncertain, could not be used as thebasis for defining amino acid requirements in infants and children. Therefore, it wasdecided to use a factorial approach (basal plus growth).

Effects of High Protein Intakes

Author(s): I. Axelsson

Among other nutrients of breast milk, the amino acid pattern is considered normativethroughout infancy. Exclusive breastfeeding by a healthy mother should be thestandard from birth to 6 months. During the breastfeeding period the protein intake islow in the human being compared too many other animals.

Physiology of Food Intake Regulation: Interaction with Dietary Components

Author(s): G. Harvey Anderson, A. Aziz, R. Abou Samra

Food intake is regulated in both the short- and long-term by a complex physiologicalsystem that involves neuroendocrine pathways that are both distinct and overlapping.The underlying causes and mechanisms of the dysregulation of food intake inobesity is poorly understood; however, it is clear that dietary components interactwith the physiological determinants of food intake and can cause profound alterationsduring the development of control mechanisms.

Complementary Food: International Comparison on Protein and Energy Requirement/Intakes

Author(s): C. Agostoni, E. Riva, M. Giovannini

The possible role of early dietary habits as the origin of later consequences onhealth has raised questions on the optimal macronutrient intakes of the growinginfant. Infants and toddlers in developed countries usually show a high dietary protein:energy ratio during the complementary feeding period, averaging 2.5–3, becauseof the protein density of solid weaning foods and the low percentage of mothers stillbreastfeeding beyond the first 6 months of life.

What Is the Optimal Age for Introduction of Complementary Foods?

Author(s): K.G. Dewey

In 2001, a WHO Expert Consultation concluded that waiting until 6 months tointroduce complementary foods to breastfed infants confers several benefits for bothinfants and mothers. Nonetheless, there is still controversy about this issue. In developingcountries, the reduced risk of infant gastrointestinal illness and increased durationof maternal lactational amenorrhea associated with exclusive breastfeeding for 6months make the benefit-risk ratio of this recommendation highly favorable. In industrializedcountries, the case is less clear-cut, but the benefit-risk ratio is also likely tobe favorable with regard to infant infectious morbidity, motor development and maternalweight loss postpartum.

Recent Issues in Energy-Protein Malnutrition in Children

Author(s): J-F. Desjeux

Thirty years ago, protein deficiency was perceived to be the major nutritional problemof children in developing countries. Later on increasing the energy intake ofyoung children during the complementary feeding period became a priority. Earlystudies on the pathophysiology of malnutrition are now turned into strategic and practicalconsequences for the prevention and treatment of severe malnutrition, four ofwhich are presented. (1) Almost half of the deaths worldwide are due to being underweight.Nowadays, well-defined preventive and curative interventions have been identified.

Protein Quality and Quantity in Cow’s Milk-Based Formula for Healthy Term Infants: Past, Present and Future

Author(s): K. Macé, P. Steenhout, P. Klassen, A. Donnet

The development of infant formula with optimized protein quality and quantity hasbeen, and still is, the subject of intense investigation. A better understanding of theprotein composition of breast milk and infant needs in association with technologicalbreakthroughs in cow’s milk fractionation, has led to the development of infant formulaswith a protein content that is closer to that of human milk.

Recombinant Human Milk Proteins

Author(s): B. Lönnerdal

Human milk provides proteins that benefit newborn infants. They not only provideamino acids, but also facilitate the absorption of nutrients, stimulate growth anddevelopment of the intestine, modulate immune function, and aid in the digestion ofother nutrients. Breastfed infants have a lower prevalence of infections than formulafedinfants. Since many women in industrialized countries choose not to breastfeed,and an increasing proportion of women in developing countries are advised not tobreastfeed because of the risk of HIV transmission, incorporation of recombinanthuman milk proteins into infant foods is likely to be beneficial.