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Am J Clin Nutr. 2019 Apr 1;109(4):1154-1163. doi: 10.1093/ajcn/nqy354.

Associations of protein intake in early childhood with body composition, height, and insulin-like growth factor I in mid-childhood and early adolescence.

Author information

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
Friedman School of Nutrition Science and Policy.
Jean Mayer USDA Human Nutrition Research Center on Aging.
Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA.
Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME.
Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME.
Department of Nutrition, Harvard School of Public Health, Boston, MA.



Early protein intake may program later body composition and height growth, perhaps mediated by insulin-like growth factor I (IGF-I). In infancy, higher protein intake is consistently associated with higher IGF-I concentrations and more rapid growth, but associations of protein intake after infancy with later growth and IGF-I are less clear.


Our objective was to examine associations of protein intake in early childhood (median 3.2 y) with height, IGF-I, and measures of adiposity and lean mass in mid-childhood (median 7.7 y) and early adolescence (median 13.0 y), and with changes in these outcomes over time. We hypothesized that early childhood protein intake programs later growth.


We studied 1165 children in the Boston-area Project Viva cohort. Mothers reported children's diet using food-frequency questionnaires. We stratified by child sex and examined associations of early childhood protein intake with mid-childhood and early adolescent BMI z score, skinfold thicknesses, dual-energy X-ray absorptiometry (DXA) fat mass, DXA lean mass, height z score, and IGF-I concentration. We adjusted linear regression models for race/ethnicity, family sociodemographics, parental and birth anthropometrics, breastfeeding status, physical activity, and fast food intake.


Mean protein intake in early childhood was 58.3 g/d. There were no associations of protein intake in early childhood with any of the mid-childhood outcomes. Among boys, however, each 10-g increase in early childhood total protein intake was associated with several markers of early adolescent size, namely BMI z score (0.12 higher; 95% CI: 0.01, 0.23), DXA lean mass index (1.34% higher; 95% CI: -0.07%, 2.78%), and circulating IGF-I (5.67% higher; 95% CI: 0.30%, 11.3%). There were no associations with fat mass and no associations with any adolescent outcomes among girls.


Early childhood protein intake may contribute to programming lean mass and IGF-I around the time of puberty in boys, but not to adiposity development. This study was registered at as NCT02820402.


IGF-I; Project Viva; body composition; cohort; early childhood protein intake; height growth

[Available on 2020-04-01]

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