Soy protein-based infant formula feeding association with adolescent growth, body composition, cardiometabolic health, and pubertal development in comparison with cow's milk-based infant formula and human milk feeding

Authors: DA CRUZ, LARISSA - University Arkansas For Medical Sciences (UAMS); FIECKE, CHELSEY - University Arkansas For Medical Sciences (UAMS); REED, BRITTANY - Arkansas Children'S Nutrition Research Center (ACNC); MARTINEZ, AUDREY - Arkansas Children'S Nutrition Research Center (ACNC); KECK, ADRIENNE - Arkansas Children'S Nutrition Research Center (ACNC); FUENMAYOR, ANNI - Arkansas Children'S Nutrition Research Center (ACNC); SOBIK, SARAH - University Arkansas For Medical Sciences (UAMS); ROWELL, AMY - Louisiana State University; MOORE, MARY - University Arkansas For Medical Sciences (UAMS); BIMALI, MILAN - University Arkansas For Medical Sciences (UAMS); WILLIAMS, KEITH - Arkansas Children'S Nutrition Research Center (ACNC); ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/16/2026
Publication Date: 2/16/2026
Citation: Da Cruz, L.L., Fiecke, C., Reed, B., Martinez, A., Keck, A., Fuenmayor, A., Sobik, S., Rowell, A.C., Moore, M.B., Bimali, M., Williams, K.D., Andres, A. 2026. Soy protein-based infant formula feeding association with adolescent growth, body composition, cardiometabolic health, and pubertal development in comparison with cow's milk-based infant formula and human milk feeding. Journal of Nutrition. 156(3):1-13. https://doi.org/10.1016/j.tjnut.2026.101376888.
DOI: https://doi.org/10.1016/j.tjnut.2026.101376888

Interpretive Summary: More than 50% of infants in the United States are fed infant formula at one point in their life, yet many parents wonder whether this choice affects their child’s long-term health. To better understand this, researchers followed nearly 200 children from infancy to age 14 and compared those who were fed soy-based infant formula, cow’s milk based infant formula, or breast milk. At age 14, the teens were carefully evaluated for growth, body fat, diet quality, blood pressure, cholesterol, blood sugar, puberty development, and reproductive health. The reassuring finding was that adolescents who had been fed soy formula as infants were just as healthy as those who had received cow’s milk based infant formula or breast milk in terms of body weight, body fat, heart and metabolic health, and pubertal development. Diet quality in adolescence was also similar across groups. Breastfeeding was associated with slightly lower body fat in adolescence compared to cow’s milk based infant formula feeding. Overall, the results suggest that soy infant formula feeding in infancy does not negatively impact growth, metabolism, or puberty by early adolescence.

Technical Abstract: Background:Although ~12% of infants in the United States are fed soy protein-based infant formulas (SF), data on the long-term health effects compared with cow's milk-based infant formulas (MF) and human milk (HM) remain limited. Objectives:This study aims to assess whether SF feeding during infancy influences adolescent growth, adiposity, dietary intake, metabolic health, or pubertal development compared with MF or HM feeding during infancy. Methods:In the Beginnings follow-up study, 190 participants (SF = 52, HM = 76, MF = 62) were assessed at age 14 y for anthropometry, body composition, dietary intake, cardiometabolic biomarkers, pubertal stage, and reproductive organ volumes and characteristics. Statistical analyses were performed using R (version 4.4.2), and included generalized linear regression models adjusted for age, sex, race/ethnicity, mother’s education, and birth characteristics. Results:At 14.10 ± 0.26 (13.47–14.96) y, adjusted models showed that adolescents who were fed SF as infants had similar body weight, BMI-for-age z-score, fat mass index, abdominal adiposity (visceral and subcutaneous adipose tissue areas), and waist circumference compared with participants fed MF and HM as infants. Energy intake, macronutrient intakes, and diet quality (Healthy Eating Index-2020) were comparable across groups, except for a lower fat intake (%kcal) for participants fed SF and HM as infants compared with MF. There were no significant differences between the groups in blood pressure, glucose metabolism, lipid profile, inflammatory biomarkers, pubertal stage, age of menarche and reproductive organ sizes and characteristics at age 14 y. The prevalence of cardiometabolic risk factors was significantly higher in participants who were fed MF (8.1%) compared with SF (3.8%) and HM (0.0%) as infants. Conclusions:SF feeding during infancy was associated with similar growth, body composition, cardiometabolic health and puberty outcomes at age 14 y as MF and HM feeding. In adjusted models, HM feeding was protective against adolescent adiposity compared with MF feeding.