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

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


Background: 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.

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity
  • Adolescent
  • Body Composition*
  • Body Mass Index
  • Child
  • Child Development*
  • Child, Preschool
  • Dietary Proteins / analysis
  • Dietary Proteins / metabolism*
  • Female
  • Humans
  • Insulin-Like Growth Factor I / genetics
  • Insulin-Like Growth Factor I / metabolism*
  • Male
  • Prospective Studies


  • Dietary Proteins
  • Insulin-Like Growth Factor I

Associated data