,
Asma Ferdousi,
Susmita Biswas,
Ayesha Begum,
Mitra Datta,
Sunanda Shil,
Fahim Hasan Reza,
Mishu Talukdar
Protein is a vital macronutrient, essential for growth, tissue repair, and immune function. However, the impact of elevated protein intake during childhood and adolescence remains controversial. While high protein intake in older adults is often recommended for maintaining muscle mass and preventing frailty, excessive intake in younger populations has raised concerns about potential health risks, particularly related to obesity. This review aims to update current literature on the long-term effects of protein consumption in children and adolescents (ages 4-18) and to explore emerging methods for evaluating protein metabolism in this age group. The RDA for protein varies based on age, sex, and activity level. Generally, it is suggested that children consume about 0.95-1.3 grams of protein per kilogram of body weight per day, depending on age and specific requirements. In many developed countries, children and adolescents often consume protein at levels 2-3 times higher than the RDA, potentially leading to both positive and negative health outcomes. Protein is critical for normal growth and development during childhood and adolescence. Adequate intake supports muscle development, immune function, and the production of hormones. Studies suggest that elevated protein intake may be linked to increased Fat-Free Mass Index (FFMI), which is beneficial for muscle development and overall body composition. High protein diets have been associated with increased satiety, which can help in managing appetite and potentially reducing overall caloric intake, thus contributing to healthier weight maintenance. Some evidence suggests a correlation between high protein intake in infancy and childhood and increased risk of obesity later in life. This association may be due to the overactivation of growth pathways and increased insulin-like growth factor-1 (IGF-1) levels. Excessive protein intake has been hypothesized to strain kidney function, especially in individuals with pre-existing kidney conditions. However, current evidence in healthy children and adolescents is inconclusive. This narrative review emphasizes the need for a nuanced understanding of protein intake in children and adolescents, considering both the benefits and potential risks associated with high protein consumption. As research evolves, dietary guidelines may need to be adjusted to reflect the latest findings.
| Published in | American Journal of Pediatrics (Volume 11, Issue 1) |
| DOI | 10.11648/j.ajp.20251101.13 |
| Page(s) | 14-25 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2025. Published by Science Publishing Group |
Protein Intake, Children, Adolescent, Body Composition, BMI, FMI, FFMI, Right Amount and Quality of Protein, Protein for Bone and Muscle
| [1] | Das, J. K.; Lassi, Z. S.; Hoodbhoy, Z.; Salam, R. A. Nutrition for the Next Generation: Older Children and Adolescents. Ann. Nutr. Metab. 2018, 72 (Suppl. 3), 56-64. |
| [2] | Scaglioni, S.; Agostoni, C.; Notaris, R. D.; Radaelli, G.; Radice, N.; Valenti, M.; Giovannini, M.; Riva, E. Early macronutrient intake and overweight at five years of age. Int. J. Obes. Relat. Metab. Disord. 2000, 24, 777-781. |
| [3] | Luque, V.; Closa-Monasterolo, R.; Escribano, J.; Ferre, N. Early Programming by Protein Intake: The Effect of Protein on Adiposity Development and the Growth and Functionality of Vital Organs. Nutr. Metab. Insights 2015, 8, 49-56. |
| [4] | Rolland-Cachera, M. F.; Deheeger, M.; Akrout, M.; Bellisle, F. Influence of macronutrients on adiposity development: A follow up study of nutrition and growth from 10 months to 8 years of age. Int. J. Obes. Relat. Metab. Disord. 1995, 19, 573-578. |
| [5] | Zheng, M.; Lamb, K. E.; Grimes, C.; Laws, R.; Bolton, K.; Ong, K. K.; Campbell, K. Rapid weight gain during infancy and subsequent adiposity: A systematic review and meta-analysis of evidence. Obes. Rev. Off. J. Int. Assoc. Study Obes. 2018, 19, 321-332. |
| [6] | Camier, A.; Davisse-Paturet, C.; Scherdel, P.; Lioret, S.; Heude, B.; Charles, M. A.; de Lauzon-Guillain, B. Early growth according to protein content of infant formula: Results from the EDEN and ELFE birth cohorts. Pediatr. Obes. 2021, 16, e12803. |
| [7] | EFSA NDA Panel. Scientific Opinion on the essential composition of infant and follow-on formulae. EFSA J. 2014, 12, 3760. |
| [8] | Kouwenhoven, S. M. P.; Muts, J.; Finken, M. J. J.; Goudoever, J. B. V. Low-Protein Infant Formula and Obesity Risk. Nutrients 2022, 14, 2728. |
| [9] | Wargo, W. F. The History of Infant Formula: Quality, Safety, and Standard Methods. J. AOAC Int. 2016, 99, 7-11. |
| [10] | Commission, E. Commission Delegated Regulation (EU) 2016/127 of 25 September 2015 supplementing Regulation (EU) No 609/2013 of the European Parliament and of the Council as regards the specific compositional and information requirements for infant formula and follow-on formula and as regards requirements on information relating to infant and young child feeding. Off. J. Eur. Union (OJL) 2016, 25, 1-29. |
| [11] | Baum, J. I.; Kim, I. Y.; Wolfe, R. R. Protein Consumption and the Elderly: What Is the Optimal Level of Intake? Nutrients 2016, 8, 359. |
| [12] | Lonnie, M.; Hooker, E.; Brunstrom, J. M.; Corfe, B. M.; Green, M. A.; Watson, A. W.; Williams, E. A.; Stevenson, E. J.; Penson, S.; Johnstone, A. M. Protein for Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients 2018, 10, 360. |
| [13] | Volpi, E.; Campbell, W. W.; Dwyer, J. T.; Johnson, M. A.; Jensen, G. L.; Morley, J. E.; Wolfe, R. R. Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J. Gerontol. A Biol. Sci. Med. Sci. 2013, 68, 677-681. |
| [14] | Thomas, D. T.; Erdman, K. A.; Burke, L. M. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J. Acad. Nutr. Diet. 2016, 116, 501-528. |
| [15] | Trumbo, P.; Schlicker, S.; Yates, A. A.; Poos, M. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. J. Am. Diet. Assoc. 2002, 102, 1621-1630. |
| [16] | Morais, J. A.; Chevalier, S.; Gougeon, R. Protein turnover and requirements in the healthy and frail elderly. J. Nutr. Health Aging 2006, 10, 272-283. |
| [17] | Authority, E. F. S. General principles for the collection of national food consumption data in the view of a pan-European dietary survey. EFSA J. 2009, 7, 1435. |
| [18] | Hornell, A.; Lagstrom, H.; Lande, B.; Thorsdottir, I. Protein intake from 0 to 18 years of age and its relation to health: A systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr. Res. 2013, 57, 21083. |
| [19] | Hoppe, C.; Molgaard, C.; Dalum, C.; Vaag, A.; Michaelsen, K. F. Differential effects of casein versus whey on fasting plasma levels of insulin, IGF-1 and IGF-1/IGFBP-3: Results from a randomized 7-day supplementation study in prepubertal boys. Eur. J. Clin. Nutr. 2009, 63, 1076-1083. |
| [20] | Hoppe, C.; Mølgaard, C.; Juul, A.; Michaelsen, K. F. High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys. Eur. J. Clin. Nutr. 2004, 58, 1211-1216. |
| [21] | Günther, A. L.; Remer, T.; Kroke, A.; Buyken, A. E. Early protein intake and later obesity risk: Which protein sources at which time points throughout infancy and childhood are important for body mass index and body fat percentage at 7 y of age? Am. J. Clin. Nutr. 2007, 86, 1765-1772. |
| [22] | Singhal, S.; Baker, R. D.; Baker, S. S. A Comparison of the Nutritional Value of Cow’s Milk and Nondairy Beverages. J. Pediatr. Gastroenterol. Nutr. 2017, 64, 799-805. |
| [23] | Berryman, C. E.; Lieberman, H. R.; Fulgoni, V. L., III; Pasiakos, S. M. Protein intake trends and conformity with the Dietary Reference Intakes in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001-2014. Am. J. Clin. Nutr. 2018, 108, 405-413. |
| [24] | Lopez-Sobaler, A. M.; Aparicio, A.; Rubio, J.; Marcos, V.; Sanchidrian, R.; Santos, S.; Perez-Farinos, N.; Dal-Re, M. A.; Villar-Villalba, C.; Yusta-Boyo, M. J.; et al. Adequacy of usual macronutrient intake and macronutrient distribution in children and adolescents in Spain: A National Dietary Survey on the Child and Adolescent Population, ENALIA 2013-2014. Eur. J. Nutr. 2019, 58, 705-719. |
| [25] | National Institute of Health Research Cambridge Biomedical Research Centre (NIHR BRC). National Diet and Nutrition Survey Rolling Programme Years 9 to 11 (2016/2017 to 2018/2019); National Institute of Health Research Cambridge Biomedical Research Centre (NIHR BRC): Cambridge, UK, 2020. |
| [26] | EFSA NDA Panel. Scientific Opinion on Dietary Reference Values for protein. EFSA J. 2012, 10, 2557. |
| [27] | Joint World Health Organisation; Food and Agriculture Organization; UNU Expert Consultation. Protein and amino acid requirements in human nutrition. World Health Organ. Tech. Rep. Ser. 2007, 935, 1-265. |
| [28] | Elango, R.; Humayun, M. A.; Ball, R. O.; Pencharz, P. B. Evidence that protein requirements have been significantly underestimated. Curr. Opin. Clin. Nutr. Metab. Care 2010, 13, 52-57. |
| [29] | Hudson, J. L.; Baum, J. I.; Diaz, E. C.; Borsheim, E. Dietary Protein Requirements in Children: Methods for Consideration. Nutrients 2021, 13, 1554. |
| [30] | Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids; The National Academies Press: Washington, DC, USA, 2005; p. 1358. |
| [31] | EFSA Panel on Dietetic Products, Nutrition, and Allergies. Scientific Opinion on principles for deriving and applying Dietary Reference Values. EFSA J. 2010, 8, 1458. |
| [32] | Mittendorfer, B.; Klein, S.; Fontana, L. A word of caution against excessive protein intake. Nat. Rev. Endocrinol. 2020, 16, 59-66. |
| [33] | Jen, V.; Karagounis, L. G.; Jaddoe, V. W. V.; Franco, O. H.; Voortman, T. Dietary protein intake in school-age children and detailed measures of body composition: The Generation R Study. Int. J. Obes. 2018, 42, 1715-1723. |
| [34] | Moore, D. R. Protein Metabolism in Active Youth: Not Just Little Adults. Exerc. Sport Sci. Rev. 2019, 47, 29-36. |
| [35] | Weiler, M.; Hertzler, S. R.; Dvoretskiy, S. Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake? Nutrients 2023, 15, 838. |
| [36] | Elango, R.; Humayun, M. A.; Ball, R. O.; Pencharz, P. B. Protein requirement of healthy school-age children determined by the indicator amino acid oxidation method. Am. J. Clin. Nutr. 2011, 94, 1545-1552. |
| [37] | Pencharz, P. B.; Elango, R.; Wolfe, R. R. Recent developments in understanding protein needs-How much and what kind should we eat? Appl. Physiol. Nutr. Metab. 2016, 41, 577-580. |
| [38] | Gattas, V.; Barrera, G. A.; Riumallo, J. S.; Uauy, R. Protein-energy requirements of prepubertal school-age boys determined by using the nitrogen-balance response to a mixed-protein diet. Am. J. Clin. Nutr. 1990, 52, 1037-1042. |
| [39] | Baxter-Jones, A. D.; Eisenmann, J. C.; Mirwald, R. L.; Faulkner, R. A.; Bailey, D. A. The influence of physical activity on lean mass accrual during adolescence: A longitudinal analysis. J. Appl. Physiol. 2008, 105, 734-741. |
| [40] | Tobias, J. H.; Steer, C. D.; Mattocks, C. G.; Riddoch, C.; Ness, A. R. Habitual levels of physical activity influence bone mass in 11-year-old children from the United Kingdom: Findings from a large population-based cohort. J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res. 2007, 22, 101-109. |
| [41] | Boisseau, N.; Le Creff, C.; Loyens, M.; Poortmans, J. Protein intake and nitrogen balance in male non-active adolescents and soccer players. Eur. J. Appl. Physiol. 2002, 88, 288-293. |
| [42] | Boisseau, N.; Persaud, C.; Jackson, A. A.; Poortmans, J. R. Training does not affect protein turnover in pre- and early pubertal female gymnasts. Eur. J. Appl. Physiol. 2005, 94, 262-267. |
| [43] | Burd, N. A.; McKenna, C. F.; Salvador, A. F.; Paulussen, K. J. M.; Moore, D. R. Dietary Protein Quantity, Quality, and Exercise Are Key to Healthy Living: A Muscle-Centric Perspective Across the Lifespan. Front. Nutr. 2019, 6, 83. |
| [44] | Moore, D. R.; Volterman, K. A.; Obeid, J.; Offord, E. A.; Timmons, B. W. Postexercise protein ingestion increases whole body net protein balance in healthy children. J. Appl. Physiol. 2014, 117, 1493-1501. |
| [45] | Pikosky, M.; Faigenbaum, A.; Westcott, W.; Rodriguez, N. Effects of resistance training on protein utilization in healthy children. Med. Sci. Sports Exerc. 2002, 34, 820-827. |
| [46] | Volterman, K. A.; Moore, D. R.; Breithaupt, P.; Godin, J. P.; Karagounis, L. G.; Offord, E. A.; Timmons, B. W. Postexercise Dietary Protein Ingestion Increases Whole-Body Leucine Balance in a Dose-Dependent Manner in Healthy Children. J. Nutr. 2017, 147, 807-815. |
| [47] | Volterman, K. A.; Obeid, J.; Wilk, B.; Timmons, B. W. Effects of postexercise milk consumption on whole body protein balance in youth. J. Appl. Physiol. (1985) 2014, 117, 1165-1169. |
| [48] | Thams, L.; Stounbjerg, N. G.; Hvid, L. G.; Molgaard, C.; Hansen, M.; Damsgaard, C. T. Effects of high dairy protein intake and vitamin D supplementation on body composition and cardiometabolic markers in 6-8-y-old children-the D-pro trial. Am. J. Clin. Nutr. 2022, 115, 1080-1091. |
| [49] | Hermanussen, M. Nutritional protein intake is associated with body mass index in young adolescents. Georgian Med. News 2008, 156, 84-88. |
| [50] | Assmann, K. E.; Joslowski, G.; Buyken, A. E.; Cheng, G.; Remer, T.; Kroke, A.; Günther, A. L. B. Prospective association of protein intake during puberty with body composition in young adulthood. Obesity 2013, 21, E782-E789. |
| [51] | Joslowski, G.; Remer, T.; Assmann, K. E.; Krupp, D.; Cheng, G.; Garnett, S. P.; Kroke, A.; Wudy, S. A.; Gunther, A. L.; Buyken, A. E. Animal protein intakes during early life and adolescence differ in their relation to the growth hormone-insulin-like-growth-factor axis in young adulthood. J. Nutr. 2013, 143, 1147-1154. |
| [52] | Magarey, A. M.; Daniels, L. A.; Boulton, T. J.; Cockington, R. A. Does fat intake predict adiposity in healthy children and adolescents aged 2-15 y? A longitudinal analysis. Eur. J. Clin. Nutr. 2001, 55, 471-481. |
| [53] | Switkowski, K. M.; Jacques, P. F.; Must, A.; Fleisch, A.; Oken, E. 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, 109, 1154-1163. |
| [54] | van Vught, A. J.; Heitmann, B. L.; Nieuwenhuizen, A. G.; Veldhorst, M. A.; Brummer, R. J.; Westerterp-Plantenga, M. S. Association between dietary protein and change in body composition among children (EYHS). Clin. Nutr. 2009, 28, 684-688. |
| [55] | van Vught, A. J.; Heitmann, B. L.; Nieuwenhuizen, A. G.; Veldhorst, M. A.; Andersen, L. B.; Hasselstrom, H.; Brummer, R. J.; Westerterp-Plantenga, M. S. Association between intake of dietary protein and 3-year-change in body growth among normal and overweight 6-year-old boys and girls (CoSCIS). Public Health Nutr. 2010, 13, 647-653. |
| [56] | Maffeis, C.; Talamini, G.; Tatò, L. Influence of diet, physical activity and parents’ obesity on children’s adiposity: A four-year longitudinal study. Int. J. Obes. Relat. Metab. Disord. 1998, 22, 758-764. |
| [57] | Skinner, J. D.; Bounds, W.; Carruth, B. R.; Morris, M.; Ziegler, P. Predictors of children’s body mass index: A longitudinal study of diet and growth in children aged 2-8 y. Int. J. Obes. Relat. Metab. Disord. 2004, 28, 476-482. |
| [58] | Durao, C.; Oliveira, A.; Santos, A. C.; Severo, M.; Guerra, A.; Barros, H.; Lopes, C. Protein intake and dietary glycemic load of 4-year-olds and association with adiposity and serum insulin at 7 years of age: Sex-nutrient and nutrient-nutrient interactions. Int. J. Obes. 2017, 41, 533-541. |
| [59] | Wright, M.; Sotres-Alvarez, D.; Mendez, M. A.; Adair, L. The association of trajectories of protein intake and age-specific protein intakes from 2 to 22 years with BMI in early adulthood. Br. J. Nutr. 2017, 117, 750-758. |
| [60] | Romero-Corral, A.; Somers, V. K.; Sierra-Johnson, J.; Thomas, R. J.; Collazo-Clavell, M. L.; Korinek, J.; Allison, T. G.; Batsis, J. A.; Sert-Kuniyoshi, F. H.; Lopez-Jimenez, F. Accuracy of body mass index in diagnosing obesity in the adult general population. Int. J. Obes. 2008, 32, 959-966. |
| [61] | Nuttall, F. Q. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutr. Today 2015, 50, 117-128. |
| [62] | Cossio Bolaños, M. A.; Andruske, C. L.; de Arruda, M.; Sulla-Torres, J.; Urra-Albornoz, C.; Rivera-Portugal, M.; Luarte-Rocha, C.; Pacheco-Carrillo, J.; Gómez-Campos, R. Muscle Mass in Children and Adolescents: Proposed Equations and Reference Values for Assessment. Front. Endocrinol. 2019, 10, 583. |
| [63] | Koppes, L. L. J.; Boon, N.; Nooyens, A. C. J.; van Mechelen, W.; Saris, W. H. M. Macronutrient distribution over a period of 23 years in relation to energy intake and body fatness. Br. J. Nutr. 2008, 101, 108-115. |
| [64] | van Vught, A. J.; Nieuwenhuizen, A. G.; Brummer, R. J.; Westerterp-Plantenga, M. S. Effects of oral ingestion of amino acids and proteins on the somatotropic axis. J. Clin. Endocrinol. Metab. 2008, 93, 584-590. |
| [65] | Isidori, A.; Lo Monaco, A.; Cappa, M. A study of growth hormone release in man after oral administration of amino acids. Curr. Med. Res. Opin. 1981, 7, 475-481. |
| [66] | Grenov, B.; Larnkjaer, A.; Ritz, C.; Michaelsen, K. F.; Damsgaard, C. T.; Molgaard, C. The effect of milk and rapeseed protein on growth factors in 7-8 year-old healthy children—A randomized controlled trial. Growth Horm. IGF Res. 2021, 60-61, 101418. |
| [67] | Rachdaoui, N. Insulin: The Friend and the Foe in the Development of Type 2 Diabetes Mellitus. Int. J. Mol. Sci. 2020, 21, 1770. |
| [68] | Juul, A. Determination of insulin-like growth factor I in children: Normal values and clinical use. Horm. Res. 2001, 55 (Suppl. 2), 94-99. |
| [69] | Koletzko, B.; Demmelmair, H.; Grote, V.; Totzauer, M. Optimized protein intakes in term infants support physiological growth and promote long-term health. Semin. Perinatol. 2019, 43, 151153. |
| [70] | Bidlingmaier, M.; Friedrich, N.; Emeny, R. T.; Spranger, J.; Wolthers, O. D.; Roswall, J.; Korner, A.; Obermayer-Pietsch, B.; Hubener, C.; Dahlgren, J.; et al. Reference intervals for insulin-like growth factor-1 (igf-i) from birth to senescence: Results from a multicenter study using a new automated chemiluminescence IGF-I immunoassay conforming to recent international recommendations. J. Clin. Endocrinol. Metab. 2014, 99, 1712-1721. |
| [71] | Smith, C. P.; Dunger, D. B.; Williams, A. J.; Taylor, A. M.; Perry, L. A.; Gale, E. A.; Preece, M. A.; Savage, M. O. Relationship between insulin, insulin-like growth factor I, and dehydroepiandrosterone sulfate concentrations during childhood, puberty, and adult life. J. Clin. Endocrinol. Metab. 1989, 68, 932-937. |
| [72] | Caprio, S.; Plewe, G.; Diamond, M. P.; Simonson, D. C.; Boulware, S. D.; Sherwin, R. S.; Tamborlane, W. V. Increased insulin secretion in puberty: A compensatory response to reductions in insulin sensitivity. J. Pediatr. 1989, 114, 963-967. |
| [73] | Breen, M. E.; Laing, E. M.; Hall, D. B.; Hausman, D. B.; Taylor, R. G.; Isales, C. M.; Ding, K. H.; Pollock, N. K.; Hamrick, M. W.; Baile, C. A.; et al. 25-hydroxyvitamin D, insulin-like growth factor-I, and bone mineral accrual during growth. J. Clin. Endocrinol. Metab. 2011, 96, E89-E98. |
| [74] | Xu, L.; Wang, Q.; Wang, Q.; Lyytikäinen, A.; Mikkola, T.; Völgyi, E.; Cheng, S.; Wiklund, P.; Munukka, E.; Nicholson, P.; et al. Concerted actions of insulin-like growth factor 1, testosterone, and estradiol on peripubertal bone growth: A 7-year longitudinal study. J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res. 2011, 26, 2204-2211. |
| [75] | Matar, M.; Al-Shaar, L.; Maalouf, J.; Nabulsi, M.; Arabi, A.; Choucair, M.; Tamim, H.; El-Hajj Fuleihan, G. The Relationship Between Calciotropic Hormones, IGF-1, and Bone Mass Across Pubertal Stages. J. Clin. Endocrinol. Metab. 2016, 101, 4860-4870. |
| [76] | Levine, M. A. Assessing bone health in children and adolescents. Indian J. Endocrinol. Metab. 2012, 16, S205-S212. |
| [77] | Moran, A.; Jacobs, D. R., Jr.; Steinberger, J.; Cohen, P.; Hong, C. P.; Prineas, R.; Sinaiko, A. R. Association between the insulin resistance of puberty and the insulin-like growth factor-I/growth hormone axis. J. Clin. Endocrinol. Metab. 2002, 87, 4817-4820. |
| [78] | Renehan, A. G.; Zwahlen, M.; Minder, C.; O’Dwyer, S. T.; Shalet, S. M.; Egger, M. Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: Systematic review and meta-regression analysis. Lancet 2004, 363, 1346-1353. |
| [79] | Conti, E.; Carrozza, C.; Capoluongo, E.; Volpe, M.; Crea, F.; Zuppi, C.; Andreotti, F. Insulin-like growth factor-1 as a vascular protective factor. Circulation 2004, 110, 2260-2265. |
| [80] | Yamaguchi, T.; Kanatani, M.; Yamauchi, M.; Kaji, H.; Sugishita, T.; Baylink, D. J.; Mohan, S.; Chihara, K.; Sugimoto, T. Serum levels of insulin-like growth factor (IGF); IGF-binding proteins-3, -4, and -5; and their relationships to bone mineral density and the risk of vertebral fractures in postmenopausal women. Calcif. Tissue Int. 2006, 78, 18-24. |
| [81] | Sandhu, M. S.; Heald, A. H.; Gibson, J. M.; Cruickshank, J. K.; Dunger, D. B.; Wareham, N. J. Circulating concentrations of insulinlike growth factor-I and development of glucose intolerance: A prospective observational study. Lancet 2002, 359, 1740-1745. |
| [82] | Hua, Y.; Remer, T. Adult Stature and Protein Intake during Childhood and Adolescence from 3 Years Onward. J. Clin. Endocrinol. Metab. 2022, 107, e2833-e2842. |
| [83] | Wolstenholme, H.; Kelly, C.; Hennessy, M.; Heary, C. Childhood fussy/picky eating behaviours: A systematic review and synthesis of qualitative studies. Int. J. Behav. Nutr. Phys. Act. 2020, 17, 2. |
| [84] | Samuel, T. M.; Musa-Veloso, K.; Ho, M.; Venditti, C.; Shahkhalili-Dulloo, Y. A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth. Nutrients 2018, 10, 1992. |
| [85] | Taylor, C. M.; Hays, N. P.; Emmett, P. M. Diet at Age 10 and 13 Years in Children Identified as Picky Eaters at Age 3 Years and in Children Who Are Persistent Picky Eaters in a Longitudinal Birth Cohort Study. Nutrients 2019, 11, 807. |
| [86] | Haszard, J. J.; Skidmore, P. M.; Williams, S. M.; Taylor, R. W. Associations between parental feeding practices, problem food behaviours and dietary intake in New Zealand overweight children aged 4-8 years. Public Health Nutr. 2015, 18, 1036-1043. |
| [87] | Taylor, C. M.; Northstone, K.; Wernimont, S. M.; Emmett, P. M. Macro- and micronutrient intakes in picky eaters: A cause for concern? Am. J. Clin. Nutr. 2016, 104, 1647-1656. |
| [88] | Xue, Y.; Zhao, A.; Cai, L.; Yang, B.; Szeto, I. M.; Ma, D.; Zhang, Y.; Wang, P. Growth and development in Chinese pre-schoolers with picky eating behaviour: A cross-sectional study. PLoS ONE 2015, 10, e0123664. |
| [89] | Dubois, L.; Farmer, A.; Girard, M.; Peterson, K.; Tatone-Tokuda, F. Problem eating behaviors related to social factors and body weight in preschool children: A longitudinal study. Int. J. Behav. Nutr. Phys. Act. 2007, 4, 9. |
| [90] | Dubois, L.; Farmer, A. P.; Girard, M.; Peterson, K. Preschool children’s eating behaviours are related to dietary adequacy and body weight. Eur. J. Clin. Nutr. 2007, 61, 846-855. |
| [91] | Berger, P. K.; Hohman, E. E.; Marini, M. E.; Savage, J. S.; Birch, L. L. Girls’ picky eating in childhood is associated with normal weight status from ages 5 to 15 y. Am. J. Clin. Nutr. 2016, 104, 1577-1582. |
| [92] | Grulichova, M.; Kuruczova, D.; Svancara, J.; Pikhart, H.; Bienertova-Vasku, J. Association of Picky Eating with Weight and Height—The European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ). Nutrients 2022, 14, 444. |
| [93] | Taylor, C. M.; Steer, C. D.; Hays, N. P.; Emmett, P. M. Growth and body composition in children who are picky eaters: A longitudinal view. Eur. J. Clin. Nutr. 2019, 73, 869-878. |
| [94] | de Barse, L. M.; Tiemeier, H.; Leermakers, E. T.; Voortman, T.; Jaddoe, V. W.; Edelson, L. R.; Franco, O. H.; Jansen, P. W. Longitudinal association between preschool fussy eating and body composition at 6 years of age: The Generation R Study. Int. J. Behav. Nutr. Phys. Act. 2015, 12, 153. |
| [95] | Sheng, X.; Tong, M.; Zhao, D.; Leung, T. F.; Zhang, F.; Hays, N. P.; Ge, J.; Ho, W. M.; Northington, R.; Terry, D. L.; et al. Randomized controlled trial to compare growth parameters and nutrient adequacy in children with picky eating behaviors who received nutritional counseling with or without an oral nutritional supplement. Nutr. Metab. Insights 2014, 7, 85-94. |
| [96] | Ghosh, A. K.; Kishore, B.; Shaikh, I.; Satyavrat, V.; Kumar, A.; Shah, T.; Pote, P.; Shinde, S.; Berde, Y.; Low, Y. L.; et al. Effect of oral nutritional supplementation on growth and recurrent upper respiratory tract infections in picky eating children at nutritional risk: A randomized, controlled trial. J. Int. Med. Res. 2018, 46, 2186-2201. |
| [97] | Alarcon, P. A.; Lin, L. H.; Noche, M., Jr.; Hernandez, V. C.; Cimafranca, L.; Lam, W.; Comer, G. M. Effect of oral supplementation on catch-up growth in picky eaters. Clin. Pediatr. 2003, 42, 209-217. |
| [98] | Khanna, D.; Yalawar, M.; Saibaba, P. V.; Bhatnagar, S.; Ghosh, A.; Jog, P.; Khadilkar, A. V.; Kishore, B.; Paruchuri, A. K.; Pote, P. D.; et al. Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors. Nutrients 2021, 13, 3590. |
| [99] | Zhang, Z.; Li, F.; Hannon, B. A.; Hustead, D. S.; Aw, M. M.; Liu, Z.; Chuah, K. A.; Low, Y. L.; Huynh, D. T. T. Effect of Oral Nutritional Supplementation on Growth in Children with Undernutrition: A Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3036. |
| [100] | Lebenthal, Y.; Yackobovitch-Gavan, M.; Lazar, L.; Shalitin, S.; Tenenbaum, A.; Shamir, R.; Phillip, M. Effect of a nutritional supplement on growth in short and lean prepubertal children: A prospective, randomized, double-blind, placebo-controlled study. J. Pediatr. 2014, 165, 1190-1193. e1191. |
| [101] | Yackobovitch-Gavan, M.; Lebenthal, Y.; Lazar, L.; Shalitin, S.; Demol, S.; Tenenbaum, A.; Shamir, R.; Phillip, M. Effect of Nutritional Supplementation on Growth in Short and Lean Prepubertal Children after 1 Year of Intervention. J. Pediatr. 2016, 179, 154-159. e151. |
| [102] | Fisch Shvalb, N.; Lazar, L.; Demol, S.; Mouler, M.; Rachmiel, M.; Hershkovitz, E.; Shamir, R.; Phillip, M.; Yackobovitch-Gavan, M. Effect of a nutritional supplementation on growth and body composition in short and lean preadolescent boys: A randomised, double-blind, placebo-controlled study. Acta Paediatr. 2022, 111, 141-150. |
| [103] | Kim OY, Kim EM, Chung S. Impacts of Dietary Macronutrient Pattern on Adolescent Body Composition and Metabolic Risk: Current and Future Health Status—A Narrative Review. Nutrients. 2020; 12(12): 3722. |
| [104] | Carbone JW, Pasiakos SM. Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients. 2019 May 22; 11(5): 1136. |
APA Style
Alam, S., Ferdousi, A., Biswas, S., Begum, A., Datta, M., et al. (2025). The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass. American Journal of Pediatrics, 11(1), 14-25. https://doi.org/10.11648/j.ajp.20251101.13
ACS Style
Alam, S.; Ferdousi, A.; Biswas, S.; Begum, A.; Datta, M., et al. The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass. Am. J. Pediatr. 2025, 11(1), 14-25. doi: 10.11648/j.ajp.20251101.13
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Download@article{10.11648/j.ajp.20251101.13,
author = {Shah Alam and Asma Ferdousi and Susmita Biswas and Ayesha Begum and Mitra Datta and Sunanda Shil and Fahim Hasan Reza and Mishu Talukdar},
title = {The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass
},
journal = {American Journal of Pediatrics},
volume = {11},
number = {1},
pages = {14-25},
doi = {10.11648/j.ajp.20251101.13},
url = {https://doi.org/10.11648/j.ajp.20251101.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251101.13},
abstract = {Protein is a vital macronutrient, essential for growth, tissue repair, and immune function. However, the impact of elevated protein intake during childhood and adolescence remains controversial. While high protein intake in older adults is often recommended for maintaining muscle mass and preventing frailty, excessive intake in younger populations has raised concerns about potential health risks, particularly related to obesity. This review aims to update current literature on the long-term effects of protein consumption in children and adolescents (ages 4-18) and to explore emerging methods for evaluating protein metabolism in this age group. The RDA for protein varies based on age, sex, and activity level. Generally, it is suggested that children consume about 0.95-1.3 grams of protein per kilogram of body weight per day, depending on age and specific requirements. In many developed countries, children and adolescents often consume protein at levels 2-3 times higher than the RDA, potentially leading to both positive and negative health outcomes. Protein is critical for normal growth and development during childhood and adolescence. Adequate intake supports muscle development, immune function, and the production of hormones. Studies suggest that elevated protein intake may be linked to increased Fat-Free Mass Index (FFMI), which is beneficial for muscle development and overall body composition. High protein diets have been associated with increased satiety, which can help in managing appetite and potentially reducing overall caloric intake, thus contributing to healthier weight maintenance. Some evidence suggests a correlation between high protein intake in infancy and childhood and increased risk of obesity later in life. This association may be due to the overactivation of growth pathways and increased insulin-like growth factor-1 (IGF-1) levels. Excessive protein intake has been hypothesized to strain kidney function, especially in individuals with pre-existing kidney conditions. However, current evidence in healthy children and adolescents is inconclusive. This narrative review emphasizes the need for a nuanced understanding of protein intake in children and adolescents, considering both the benefits and potential risks associated with high protein consumption. As research evolves, dietary guidelines may need to be adjusted to reflect the latest findings.
},
year = {2025}
}
TY - JOUR T1 - The Essential Role of Right Amount and Quality of Protein for Ensuring Child Growth and Maintenance of Bone and Muscle Mass AU - Shah Alam AU - Asma Ferdousi AU - Susmita Biswas AU - Ayesha Begum AU - Mitra Datta AU - Sunanda Shil AU - Fahim Hasan Reza AU - Mishu Talukdar Y1 - 2025/01/24 PY - 2025 N1 - https://doi.org/10.11648/j.ajp.20251101.13 DO - 10.11648/j.ajp.20251101.13 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 14 EP - 25 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20251101.13 AB - Protein is a vital macronutrient, essential for growth, tissue repair, and immune function. However, the impact of elevated protein intake during childhood and adolescence remains controversial. While high protein intake in older adults is often recommended for maintaining muscle mass and preventing frailty, excessive intake in younger populations has raised concerns about potential health risks, particularly related to obesity. This review aims to update current literature on the long-term effects of protein consumption in children and adolescents (ages 4-18) and to explore emerging methods for evaluating protein metabolism in this age group. The RDA for protein varies based on age, sex, and activity level. Generally, it is suggested that children consume about 0.95-1.3 grams of protein per kilogram of body weight per day, depending on age and specific requirements. In many developed countries, children and adolescents often consume protein at levels 2-3 times higher than the RDA, potentially leading to both positive and negative health outcomes. Protein is critical for normal growth and development during childhood and adolescence. Adequate intake supports muscle development, immune function, and the production of hormones. Studies suggest that elevated protein intake may be linked to increased Fat-Free Mass Index (FFMI), which is beneficial for muscle development and overall body composition. High protein diets have been associated with increased satiety, which can help in managing appetite and potentially reducing overall caloric intake, thus contributing to healthier weight maintenance. Some evidence suggests a correlation between high protein intake in infancy and childhood and increased risk of obesity later in life. This association may be due to the overactivation of growth pathways and increased insulin-like growth factor-1 (IGF-1) levels. Excessive protein intake has been hypothesized to strain kidney function, especially in individuals with pre-existing kidney conditions. However, current evidence in healthy children and adolescents is inconclusive. This narrative review emphasizes the need for a nuanced understanding of protein intake in children and adolescents, considering both the benefits and potential risks associated with high protein consumption. As research evolves, dietary guidelines may need to be adjusted to reflect the latest findings. VL - 11 IS - 1 ER -
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Medical College, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Maa Shishu O General Hospital, Chattogram, Bangladesh
Department of Paediatrics, Chattogram Maa Shishu O General Hospital, Chattogram, Bangladesh
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