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Protein Intake, IGF-1 Concentrations, and Growth in the Second Year of Life in Children Receiving Growing Up Milk – Lite (GUMLi) or Cow's Milk (CM) Intervention

  • Lovell, Amy L.1
  • Milne, Tania2
  • Matsuyama, Misa3
  • Hill, Rebecca J.3
  • Davies, Peter S. W.3
  • Grant, Cameron C.4, 5, 6
  • Wall, Clare R.1
  • 1 Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland , (New Zealand)
  • 2 Faculty of Medical and Health Sciences, University of Auckland, Auckland , (New Zealand)
  • 3 Child Health Research Centre, University of Queensland, Brisbane, QLD , (Australia)
  • 4 Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland , (New Zealand)
  • 5 Centre for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland , (New Zealand)
  • 6 General Paediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland , (New Zealand)
Published Article
Frontiers in Nutrition
Frontiers Media SA
Publication Date
Jun 10, 2021
DOI: 10.3389/fnut.2021.666228
  • Nutrition
  • Clinical Trial


The relationship of protein intake with insulin-like growth factor 1 (IGF-1) concentrations in well-nourished children during the second year of life is poorly understood. The aim of this study was to explore the effect of a reduced-protein Growing Up Milk Lite (GUMLi) or unfortified cow's milk (CM) on protein intake, growth, and plasma IGF-1 at 2 y. An exploratory analysis of a sub-sample of Auckland-based children (n = 79) in the GUMLi trial (a double-blind, randomised control trial, N = 160) completed in Auckland and Brisbane (2015–2017) was conducted. One-year old children were randomised to receive a reduced-protein GUMLi (1.7 g protein/100 mL) or a non-fortified CM (3.1 g protein/100 mL) for 12 months. Blood sampling and anthropometric measurements were made at 1 and 2 y. Diet was assessed using a validated food frequency questionnaire. Total protein intake (g/d) from all cow's milk sources was 4.6 g (95% CI: −6.7, −2.4; p < 0.005) lower in the GUMLi group after 12 months of the intervention, with a significant group-by-time interaction (p = 0.005). Length-for-age (LAZ) and weight-for-length (WLZ) z-scores did not differ between groups, however, mean body fat % (BF%) was 3.2% (95%CI: −6.2, −0.3; p = 0.032) lower in the GUMLi group at 2 y. There was no difference between the intervention groups in relation to IGF-1 and IGF-BP3 (p = 0.894 and 0.698, respectively), with no group-by-sex interaction. After combining the groups, IGF-1 concentration at 2 y was positively correlated with parameters of growth (all p < 0.05), total cow's milk intake (p = 0.032) after adjusting for sex, breastfeeding status, and gestation. Randomisation to a reduced protein GUMLi resulted in small reduction in %BF and lower total protein intakes but had no effect on growth. Plasma IGF-1 concentrations were independently associated with total protein intake from cow's milk at 2 y, highlighting a potential area of the diet to target when designing future protein-related nutrition interventions. Clinical Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12614000918628. Date registered: 27/08/2014.

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