Author(s): B erthold Koletzko
Effective strate g ies for primar y pre v ention are ur g entl y needed to combat t he rapidly increasing prevalence of childhood obesity. Evidence accumulates that early nutrition programmes later obesity risk. Breast feeding reduces the odds ratio for obesity at school age, adjusted fo r biological and sociodemographic c o nfounding variables, by some 20-25 %. We propose that the protective effect o f breast feeding is related in part by the induction of a lower weight gain in infancy, which is related to d iff e r e n ces in subs trat e intak e. Pr o t e in intake per k g bod y wei g ht is some 5 5-80 % hi g her in formula fed than i n breast fed infants. We h y pothesize t hat hi g h earl y protein intakes i n excess of metabolic re q uirements enhance weight gain in infancy and i n c rease later obesity risk (the “early protein hypothesis”). The Euro p ean Childhood Obesity Programme tests t his hypothesis in a randomized double blind intervention trial in 1150 i nfants in five European centres. Infants that are not breast fed are r andomized to formulae with higher o r lower protein content and followed u p to school age. If an effect of infant feeding habits on later obesity ris k s hould be established, there is g reat p otential for effective p reventive i ntervention with a significant potentia l h e alth be n e fit f o r th ec hil d an d adult population.