High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial

Background: High intake of cow-milk protein in formula-fed infants is associated with higher weight gain and increased adiposity, which have led to recommendations to limit protein intake in later infancy. The impact of protein from meats for breastfed infants during complementary feeding may be different. Objective: We examined the effect of protein from meat as complementary foods on growth and metabolic profiles of breastfed infants. Design: This was a secondary analysis from a trial in which exclusively breastfed infants (5-6 mo old from the Denver, CO, metro area) were randomly assigned to receive commercially available pureed meats (Meat group; n = 14) or infant cereal (Cereal group; n = 28) as their primary complementary feedings for similar to 5 mo. Anthropometric measures and diet records were collected monthly from 5 to 9 mo of age; intakes from complementary feeding and breast milk were assessed at 9 mo of age. Results: The Meat group had significantly higher protein intake, whereas energy, carbohydrate, and fat intakes from complementary feeding did not differ by group over time. At 9 mo of age, mean (+/- SEM) intakes of total (complementary feeding plus breast milk) protein were 2.9 +/- 0.6 and 1.4 +/- 0.4 g center dot kg(-1) center dot d(-1), I, similar to 17% and similar to 9% of daily energy intake, for Meat and Cereal groups, respectively (P < 0.001). From 5 to 9 mo of age, the weight-for-age z score (WAZ) and length-for-age z score (LAZ) increased in the Meat group (triangle WAZ: 0.24 +/- 0.19; triangle LAZ: 0.14 +/- 0.12) and decreased in the Cereal group (triangle WAZ: -0.07 +/- 0.17; triangle LAZ: -0.27 +/- 0.24) (P-group by time < 0.05). The change in weight-for-length z score did not differ between groups. Total protein intake at 9 mo of age and baseline WAZ were important predictors of changes in the WAZ (R-2 = 0.23, P = 0.01). Conclusion: In breastfed infants, higher protein intake from meats was associated with greater linear growth and weight gain but without excessive gain in adiposity, suggesting that potential risks of high protein intake may differ between breastfed and formula-fed infants and by the source of protein.