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It has been known that protein as one of the macronutrients, known by the layman as a builder substance, especially for infants and children who are in the flower-growing period. It is related to the role of proteins to replace and/or repair all damaged and/or aging cells and tissues. However, in fact, until now there has been no research evidence that can provide recommendations on the number of protein requirements for all age groups. What has been used is based on research results using the accumulation of potassium-40 minerals in infants and children, which is then calculated as an average protein requirement with a range of 2 standard intersections.
In his presentation, Professor Ziegler said that all this time we are all more worried about the problem of protein intake because of the high prevalence of protein-energy (PEM), especially in infants and children and pregnant women, especially in babies born prematurely. In premature infants, the lack of protein intake can affect the occurrence of lung disease, increased the retinopathic severity and impaired cognitive and motor development. [Ii] It is well known along with the very high importance of the need for protein in premature infants, whose needs will adjust to the infant's growth. However, with concerns about the negative impact of excess protein intake causes protein intake to be pursued as needed and impacts on always lack protein intake. Moreover, attempts to adjust the intake according to protein requirements are constrained by the fact that the milk protein content of dairy is much lower to meet the needs of premature and highly variable infants so it is difficult to know for sure. One of the efforts to increase the protein content of dairy milk is to enrich it with additional protein or fortifier.
In infants born fairly monthly, after six months of age, when infants begin to get the complementary feeding of milk, with reduced protein intake from breast milk, infants and children in developing countries, such as Indonesia, usually only consume low-fiber cereals and vegetable protein. Lack of protein intake will cause the problem of failure to grow (short child/stunting) with various long-term impact. Conversely, the provision of high-protein MPASI in infants and pre-school children was also worried about the impact of increased fat in childhood. Thus, we are faced with the problem of determining the right amount of protein intake to prevent stunting at the same time by minimizing the risk of obesity in later childhood.
The controversy about the protein intake is corroborated by Professor Prescott who says that the better we begin this life the better we will be to solve it, long-lived and healthy for life. [Iii] The occurrence of a global chronic disease epidemic (PTM) today clearly begins with complex modern environmental changes that affect immunity and metabolic responses, thereby increasing the predisposition of inflammation and metabolic regulatory disorders resulting in many aspects of health throughout life. Nutrition since the beginning of life, one of them, has the strongest influence on the development of immunity and metabolic programming. Even nutrients can affect biological clocks, also known as telomeres (repetition of DNA segments at the ends of chromosomes), which will shorten due to cell division.
Although further research is needed, the short telomere is often associated with an increased risk of heart disease, chronic lung disease, cognitive decline, and death. Shortening of these telomeres can be accelerated by the presence of obesity, caloric load, lack of physical activity, stress and inflammation. Meanwhile, the telomere length at every age depends on the initial length at birth and the shortening rate throughout that age. The environment in the womb and during influential childhood include poor nutrition, pre-eclampsia, infection, smoking and various inflammatory causes and poverty and psychological stress. Thus, stress during pregnancy and growth disorders can accelerate cell aging and age biologically. Research on experimental animals has proven that poor nutrition and low birth weight babies (BBLR) are associated with oxidative stress, DNA damage and telomere shortening of the infant's blood vessels. There is an acceleration of the biological aging of the kidneys and heart, especially after rapid improvement at birth, and telomere shortening of pancreatic cells predisposing to diabetes.
The right time becomes very important, it is evident from animal experiments that show that limiting the protein before birth will shorten the telomere and its restriction after birth will precisely lengthen the telomere. Fetal growth is lacking and followed by rapid improvement after birth, precisely related to shortening of telomere and shorter lifespan. Although the association with telomeres is unclear when applied to humans, human studies show that fetal growth retardation in the womb is a risk factor for obesity, inflammation and chronic disease not infectious in adult life. Or, starting an unhealthy life will lower biological reserves, which will be exacerbated by maladaptive responses and unhealthy behavior. This condition cannot be improved if the baby is born with fewer kidney nephrons, pancreatic cells, and nerve synapses in the brain, and shorter peak repetition. As a result, the child is difficult to face the challenges of life, thus anticipating it with a maladaptive metabolic response leading to the occurrence of obesity and metabolic syndrome. And, this condition will be exacerbated by the unhealthy living behavior of course.
In addition to growth, protein is also important to get attention because it is associated with allergic reactions. [Iv] In theory, allergies can occur in various foods, except staples and fruits with little protein content. In infants, cow's milk allergy is the most common food allergy. Even mothers who breastfed babies with cow's milk allergy were asked to keep their food intake in order to reduce allergy symptoms in their infants. Meanwhile, in infants who are allergic to cow's milk and formula feeding, it is necessary to provide a special hypo-allergic breast milk substitute formula (which has been hydrolyzed extensively or amino-based). The use of other mammalian milk is also discouraged due to homologous similarity to cow's milk protein and the high risk of cross-reactivity in cow's milk allergy. While soy milk is not recommended also to be given to infants due to concerns about phytoestrogens, phytate content and protein quality. But soy milk can be given to older infants to overcome the problem of cow milk allergy.
What about babies born prematurely? The general goal of nutrition in premature infants is the achievement of growth that should occur in the womb, the development of optimal neurons and long-term health. [V] Unfortunately, however, it is not yet known exactly the exact formulation of nutrients, especially proteins needed by premature infants the. It is proven that premature babies have different nutritional patterns than those occurring naturally during the last trimester of pregnancy, so that general goals are difficult to manifest and fail to grow after birth are often found. When compared to the size of a baby who is born enough months, then premature infants at the age of enough monthly corrected usually will be lighter, shorter and smaller the size of the circumference of the head. Several studies have also shown that premature infants have different body compositions in their corrected lunar age, ie less in fat-free mass than in term infants. Differences in growth patterns and body composition have an important impact on the development of neurons, metabolic and heart health and blood vessels at a later age.
Also read : 5 Menu Complementary Foods For Baby Allergy
It is further known that proteins are the structural and functional components of each cell, and the growth of fat-free mass depends on the nutrients that provide adequate amounts of protein. Meanwhile, to form a network-building protein structure, the amino acid has an important effect in regulating muscle protein synthesis and growth factor secretion. Therefore, a number of balanced proteins and amino acids are needed to improve growth, body composition, neuronal development and other health effects. Several studies have shown that intake of more protein intake, especially in the first month after the baby is born shows a decrease in growth failure and increased fat-free mass, but does not improve the performance of neuron development.
In connection with that need to be done the determination of protein requirement in a baby born enough month. Based on the factorial method, the baby's protein needs are born high enough month in the first 1-2 months of life, then the need will decrease sharply until reaching the age of about six months and settle to about 1 g / kgBB / day or 1.0 g / 100 kcal. [viii] Similarly, the protein content of breast milk also decreases according to the infant's need for protein. Meanwhile, infants fed formula will receive protein intake that exceeds their needs because the quality of protein formula is lower than the quality of milk proteins. In addition, also because the protein content of formula milk has been settled and can not follow the decreased needs of baby protein.
After six months of age, both in breastfed and formula-fed infants, there is an additional intake of supplementary foods. Although some additives such as cereals and vegetables are low in protein, cow's milk and meat have a high protein content. Even in some Western countries babies and preschoolers are fed with very high protein content. As a result, some epidemiological studies have found that high intake of protein during the first two years of life increases the risk of obesity in childhood.
In light of this fact, recent attention has been given to the potential relationship between protein intake in early life and its later effects, the occurrence of excess BB and/or obesity. [Ix] There have been many studies that have proven such relationships, such as sedentary effects of high protein intake in the first year of life early on body mass index (BMI) at 6.5 years of age. Thus it is necessary vigilance related to optimal protein intake in early childhood compared with the intake in early infancy. Attention should also be given to formula by adjusting the reduction of protein content to 2.5 g / 100 kcal. In addition, for further research it is advisable to use body size and fat mass compositions as the best markers of body size, in addition to using the under-age of two years and the measurement of protein intake from milk against total protein intake, as well as the effects of free amino acids from breast milk and formula to control and appetite management.
What about the developing countries in Southeast Asia, as in Indonesia? Currently, Indonesia has multiple nutritional problems, namely the high rate of malnutrition in children under five (in 2013: underweight 19.6% and stunting 37.2%), along with increasing the rate of excess BB (overweight 11.9%). In addition, the number of women of productive age with less nutrition and LBW rate is still around 11%, and the success rate of exclusive breastfeeding is still far below the target (only about 30%), while the quality of complementary feeding food (MPASI) is still low in quality. Do you also have to think about reducing protein intake in infants after six months of age? In contrast, there is now a new scientific view of cellular mechanisms explaining the relationship between protein content in infant formula and atopy and obesity, [x] and that growth patterns early in life correlate with the risk of diseases such as type 2 diabetes mellitus, heart disease and blood vessels and metabolic syndrome
Source : ina-nutri.org
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