Can we do something in early life to reduce the risk of obesity?

Obesity usually results from a combination of several modifiable and non-modifiable contributing factors, such as genetics, race, and socioeconomic status. Other factors, including birth by cesarean section, perinatal antibiotics usage, and promotion of exclusive breastfeeding for six months, could be potentially prevented or modulated. However, one of the factors can be easily implemented through reduction of protein content in infant formulas for non-breastfed infants. High protein (HP) in infant formula is one of the causes of rapid weight gain, predisposing the neonates to later obesity. This study was performed to evaluate the effect of HP formula on weight gain and resulting risks of later obesity. The samples (i.e., non-breastfed infants) were randomly divided into two groups of HP formula (2.9 and 4.4 g protein/100 kcal before and after five months of age, respectively) and LP formula (1.77 and 2.2 g protein/100 kcal before and after five months of age, respectively) in this study. At the age of two, weight-for-length z-score of the infants in the HP formula group was calculated at 0.20 (95%CI: 0.06, 0.34), which was higher compared to the LP group. Meanwhile, the latter group had results similar to the findings of the control group (breastfed). Body length of the infants was not affected by the extent of protein intake. A six-year follow-up of the subjects indicated a significantly lower body mass index (BMI) (0.51) in the LP formula group (95% CI: 0.13, 0.90; P=0.009). In addition, a 2.43 fold risk of later obesity (95% CI: 1.12, 5.27; P=0.024) was reported in the LP group, which was lower compared to the HP formula group. Given the role of HP formula as one of the contributing factors in the development of metabolic syndrome and obesity risks in infants, it is recommended that lower protein content formulas be used in non-breastfed neonates to prevent later obesity and other complications.