LB003 - PROTEIN INTAKE IN TODDLER FORMULA SHAPES URINARY METABOLOMIC PROFILES: RESULTS FROM THE TOMI TRIAL

LB003

PROTEIN INTAKE IN TODDLER FORMULA SHAPES URINARY METABOLOMIC PROFILES: RESULTS FROM THE TOMI TRIAL

S. Rambousek^1,*, N. P. Hays², J.-P. Godin¹, J. M. Ramos-Nieves¹, H. Demmelmair^3,4, J. Escribano^5,6, V. Luque^5,6, V. Grote^3,4, B. Koletzko^3,4

¹Nestlé Research, ²Scientific Translation and Clinical Strategy Unit, Société de Produits Nestlé SA, Lausanne, Switzerland, ³Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU Hospital, ⁴German Center for Child and Adolescent Health, Munich, Germany, ⁵Paediatrics, Nutrition and Development Research Unit, Universitat Rovira i Virgili, URV, ⁶Paediatrics, Nutrition and Development Research Unit, Institut de Recerca Biomèdica Catalunya Sud, IRB CatSud, Reus, Spain

Rationale: The early protein hypothesis suggests that lower protein intake in early life promotes slower weight gain and reduces the risk of later obesity. Urinary metabolomics provides a noninvasive approach to capture metabolic responses to diet. This study aimed to characterize urinary metabolomic profiles associated with protein intake in the second year of life.

Methods: The metabolomics study was conducted within the Toddler Milk Intervention Trial (ToMI; NCT02907502), a multicenter randomized controlled trial in healthy toddlers from Germany and Spain comparing lower- and higher-protein toddler formulas (LP, proportions similar to human milk; HP, proportions similar to cow’s milk) during the second year of life. NMR-based metabolomics was performed on urine samples collected at 12 (baseline), 18, and 24 months from ~170 participants per group. Analyses of intervention impact included untargeted multivariate modeling (PLS-DA) and targeted analysis of 50 metabolites. Country-specific effects and associations with dietary intake (24-h recall) were also evaluated.

Results: Differences in the urine metabolome between LP and HP groups were most evident at 18 months, with moderate discrimination (PLS-DA classification error rate: 26%). Compared to LP, the HP group showed higher protein metabolism markers (urea, branched-chain amino acids, and related metabolites), while energy- and one-carbon–related metabolites were lower (FDR < 0.05). Clear country-specific separation was observed at all time points (~15% classification error rate). Discriminant metabolites were associated with dietary intake, reflecting distinct dietary patterns in toddlers from Spain and Germany.

Conclusion: Protein intake in the second year of life shapes urinary metabolomic profiles, highlighting NMR‑based urine metabolomics as a sensitive tool to capture dietary intake and biomarkers of protein‑related metabolic responses.

Disclosure of Interest: S. Rambousek Other: Employee of Societé de Produits Nestlé S.A., N. Hays Other: Employee of Societé de Produits Nestlé S.A., J.-P. Godin Other: Employee of Societé de Produits Nestlé S.A. , J. Ramos-Nieves Other: Employee of Societé de Produits Nestlé S.A., H. Demmelmair Other: Participates in industry funded research by Nestlé, Switzerland, J. Escribano Other: Participates in industry funded research by Beneo, Nestlé, and DGC, New Zealand, V. Luque Other: Participates in industry funded research by Beneo, Nestlé, and DGC, New Zealand, V. Grote Other: Received compensation from Nestlé for educational talks., B. Koletzko Other: Benefited from financial support for research and educational activities from Budenheim, Danone, DGC, Hipp, Nestlé, Pfizer, and Reckitt. BK is the Else Kröner Senior Professor of Paediatrics at LMU–University of Munich, supported by the Else Kröner-Fresenius Foundation, LMU Medical Faculty, and LMU University Hospital.