Early feeding of low-protein formula and mental performance at 8 years of age

Thursday, Feb 01, 2018

Latest: Early feeding of low-protein formula and mental performance at 8 years of age


Escribano J, Luque V, Canals-Sans J, Ferré N, Koletzko B, Grote V, Weber M, Gruszfeld D, Szott K, Verduci E, Riva E, Brasselle G, Poncelet P, Closa-Monasterolo R. Mental performance in 8-year-old children fed reduced protein content formula during the 1st year of life: safety analysis of a randomised clinical trial. Br J Nutr. 2016 Jan 22:1-9. [Epub ahead of print]. Link to PubMed


  • The period between the 3rd trimester of gestation and 2 years of age is a critical window where maximum brain development occurs
  • The recommended intake of protein during early childhood has tended to be lower since recent years, as a role to help reduce obesity risk, with safety shown in terms of mental performance


  • A follow-up analysis of a randomized clinical trial – The Childhood Obesity Project
  • Healthy term infants recruited during the 1st 8 weeks of life from 5 European countries – Germany, Belgium, Italy, Poland and Spain
  • Subjects were randomized to be fed a higher-protein (HP) or a lower-protein (LP) formula during the 1st year of life:

      Higher-protein (HP) group (n = 550) Lower-protein (LP) group (n = 540)
    Infant formula 2.9 g protein/100 kcal 1.77 g protein/100 kcal
    Follow-on formula 4.4 g protein/100 ml 2.2 g protein/100 ml

  • Neuropsychological assessment was carried out at 8 years of age

Key Findings:

  • 537 subjects were available for neuropsychological assessment at 8 years of age
  • No statistically significant difference between HP and LP groups in terms of the following domains for neuropsychological battery of tests, where influencing factors are being adjusted, e.g. parental education level, mother’s age, child’s gestational age at birth, head circumference, etc.:
    Domain Function
    Memory o Visual episodic memory
    o Verbal memory
    Attention o Sustained and focused attention
    o Spatial attention
    Perception o Visual-perceptual integration
    Language o Semantic fluency
    o Verbal comprehension
    Processing speed o Processing speed
    Motor o Visual-motor coordination
    Executive functions o Verbal comprehension
    o Impulsivity / inhibition, selective attention
    o Flexibility / shifting
    o Working memory
    o Reasoning
    o Selective and focused attention
    o Visual-spatial skills
    o Decision making


  • Early feeding with a lower protein formula (with protein levels closer to that of human milk) showed appropriate outcomes on mental performance at 8 years of age.



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