Peer-reviewed article
FACTORS INHIBITING OPTIMAL PROTEIN UTILIZATION AMONG CHILDREN: A NARRATIVE REVIEW
Nurul Hasanah, Nurzanah Candraningrum Primadani, Refani Alycia Kusuma ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This narrative review looks at why children may not grow well even when they eat enough protein. It draws on studies published between 2020 and 2026 from four literature sources. The review reports that protein use in the body depends on protein quality, digestion, gut health, infection, inflammation, micronutrients, energy intake, and social and environmental conditions. It concludes that child nutrition programmes should combine good-quality protein with support for gut health, enough energy and micronutrients, infection prevention, and better living conditions.
Key points
- Child growth depends on how efficiently protein is used, not only on how much is eaten.
- Protein utilization is affected by protein quality, digestive function, intestinal absorption, environmental enteric dysfunction, gut microbiota, infection, inflammation, micronutrient status, energy adequacy, and socioeconomic and environmental conditions.
- These factors interact to reduce amino acid availability, suppress anabolic pathways, increase protein breakdown, and impair tissue protein synthesis, which limits linear growth.
- Growth faltering can occur even when protein intake is sufficient.
- Integrated strategies combining high-quality protein with gut health, energy and micronutrient adequacy, infection prevention, and better environments are recommended.
Limitations
The abstract does not name any country or study population. The country hint (ID) is not supported by the text, so no country is listed. It is a narrative review, so it gives no pooled effect sizes and cannot show how well any particular intervention works.
Abstract
Background: Adequate protein intake is essential for child growth, yet optimal growth depends not only on protein quantity but also on the efficiency of protein utilization. Multiple biological and environmental factors may impair the conversion of dietary protein into functional body proteins, contributing to growth faltering despite sufficient protein intake. Methods: This narrative review synthesized recent evidence published between 2020 and 2026 from PubMed, Scopus, ScienceDirect, and Google Scholar. Relevant peer-reviewed studies, systematic reviews, meta-analyses, and clinical guidelines were critically reviewed to identify determinants affecting protein digestion, absorption, metabolism, and tissue protein synthesis in children. Results: Protein utilization is influenced by dietary protein quality, digestive function, intestinal absorption, environmental enteric dysfunction, gut microbiota, infection, inflammation, micronutrient status, energy adequacy, and socioeconomic and environmental conditions. These factors interact to reduce amino acid bioavailability, suppress anabolic pathways, increase protein catabolism, and impair tissue protein synthesis, thereby limiting linear growth. Conclusions: Optimizing child growth requires integrated nutrition strategies that combine high-quality protein intake with interventions supporting intestinal health, adequate energy and micronutrient intake, infection prevention, and improved environmental conditions to maximize protein utilization.