Association of early protein intake and pre-peritoneal fat at five years of age: Follow-up of a randomized clinical trial

D. Gruszfeld, M. Weber, K. Gradowska, P. Socha, V. Grote, A. Xhonneux, E. Dain, E. Verduci, E. Riva, R. Closa-Monasterolo, J. Escribano, B. Koletzko, J. Beyer, M. Fritsch, G. Haile, U. Handel, I. Hannibal, S. Kreichauf, I. Pawellek, S. SchiessS. Verwied-Jorky, R. von Kries, N. Ferré, M. Gispert-Llaurado, V. Luque, M. C. Rubio-Torrents, M. Zaragoza-Jordana, R. Janas, A. Wierzbicka, A. Stolarczyk, J. Socha, E. Dain, J. N. Van Hees, J. Hoyos, F. Martin, P. Poncelet, E. Perrin, C. Agostoni, M. Giovannini, A. Re Dionigi, S. Scaglioni, F. Vecchi, C. Arriza

Research output: Contribution to journalArticlepeer-review


Background and aims The double-blind randomized European Childhood Obesity Project (CHOP) demonstrated that reduced protein content in infant formula leads to a lower body mass index (BMI) up to six years of age. Here we aimed at assessing pre-peritoneal fat, a marker of visceral fat, in children participating in the CHOP trial. Methods and results Healthy term formula-fed infants in five European countries were randomized either to higher (n = 550) or lower (n = 540) protein formulas in the first year of life. Infants who were exclusively breastfed for at least three months (n = 588) were enrolled as an observational (non randomized) group. At age 5 years, subcutaneous fat (SC) and pre-peritoneal fat (PP) were measured by ultrasound in a subgroup of 275 children. The PP fat layer was thicker in the higher compared to the lower protein group (adjusted estimated difference: 0.058 cm, 95%CI 0.002; 0.115; p = 0.043), while SC fat was not different. Girls showed a thicker SC fat layer than boys. Conclusions Higher protein intake in formula-fed infants appears to enhance pre-peritoneal fat tissue accumulation at the age of 5 years, but not of subcutaneous fat, which may trigger adverse metabolic and health consequences.

Original languageEnglish
Pages (from-to)824-832
Number of pages9
JournalNutrition, Metabolism and Cardiovascular Diseases
Issue number9
Publication statusPublished - Sep 1 2016


  • Child
  • Dietary proteins
  • Infant formula
  • Intra-abdominal fat
  • Protein
  • Subcutaneous fat

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine


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