Dietary protein requirements in children: Methods for consideration

Authors: HUDSON, JOSHUA - University Arkansas For Medical Sciences (UAMS); BAUM, JAMIE - University Of Arkansas; DIAZ, EVA - University Arkansas For Medical Sciences (UAMS); BORSHEIM, ELISABET - University Arkansas For Medical Sciences (UAMS)

Submitted to: Nutrients
Publication Type: Review Article
Publication Acceptance Date: 4/29/2021
Publication Date: 5/5/2021
Citation: Hudson, J.L., Baum, J.I., Diaz, E.C., Borsheim, E. 2021. Dietary protein requirements in children: Methods for consideration. Nutrients. 13:1554. https://doi.org/10.3390/nu13051554.
DOI: https://doi.org/10.3390/nu13051554

Interpretive Summary:

Technical Abstract: The current protein requirement estimates in children were largely determined from studies using the nitrogen balance technique, which has been criticized for potentially underestimating protein needs. Indeed, recent advances in stable isotope techniques suggests protein requirement as much as 60% higher than current recommendations. Furthermore, there is not a separate recommendation for children who engage in higher levels of physical activity. The current evidence suggests that physical activity increases protein requirements to support accretion of lean body masses from adaptations to exercise. The indicator amino acid oxidation and the 15N-end product methods represent alternatives to the nitrogen balance technique for estimating protein requirements. Several newer methods, such as the virtual biopsy approach and 2H3-creatine dilution method could also be deployed to inform about pediatric protein requirements, although their validity and reproducibility is still under investigation. Based on the current evidence, the Dietary Reference Intakes for protein indicate that children 4-13 y and 14-18 y require 0.95 and 0.85 g/kg-1/d-1, respectively, based on the classic nitrogen balance technique. There are not enough published data to overturn these estimates, however, this is a much-needed area of research.