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Free amino acid content in standard infant formulas: comparison with human milk.

OBJECTIVE: To compare the concentration of non-protein nitrogen (NPN) and free amino acids (FAA) in powdered and liquid commercial formulas with that in human milk. METHODS: The non-protein nitrogen and FAAs in pooled breast milk was compared with that in 11 protein-modified starting infant formulas (seven powdered, four liquid whey-predominant formulas) and one powdered soy-formula. Human milk was collected at the end of each feeding (hindmilk) over 24 hours in a group of 40 healthy lactating women after delivery of full-term infants at age one month. RESULTS: In human milk glutamic acid plus glutamine and taurine were the prevalent amino acids, accounting for around 50% total FAA. In the analysed formulas the total FAA fraction was 10% or even less than in human milk, mostly represented by taurine, while methionine was high in soy formula. The sum of glutamic acid and glutamine in all the formulas was much lower than in human milk. CONCLUSIONS: Breastfed infants are supplied with FAA, mainly glutamic acid and glutamine, compared to formula-fed counterparts. The different FAA intake might be the origin of some functional differences at the enteral level between breast- and formula-fed infants.

Amino Acids↗

Prevention of cyclophosphamide-induced accelerated diabetes in the NOD mouse by nicotinamide or a soy protein-based infant formula.

Spontaneous diabetes in the NOD mouse can be prevented by nicotinamide or by an infant formula diet in which the protein source is replaced with casein hydrolysate (Pregestimil) or soy protein (Prosobee). NOD mice maintained on the standard diet (chow and water) and given cyclophosphamide (Cy) at day 95 develop accelerated and synchronised diabetes within 14 days. Here, we compared the ability of oral nicotinamide or Prosobee, either given alone or concurrently, from weaning, in preventing diabetes in the Cy model. The resulting insulitis and the expression of intra-islet inducible nitric oxide synthase (iNOS) were examined at days 0, 4, 7, 11 and 14 following Cy administration. Intra-islet CD4 and CD8 cells and macrophages were also enumerated at day 11. In mice given the standard diet and injected with Cy at day 95 (group 5), diabetes developed in 7/11 mice, 14 days later. Mice exposed to oral nicotinamide (group 2), Prosobee (group 3) or both (group 4), did not develop the disease during this period and until a further 30 days (p = 0.03). In mice exposed to the standard diet and without Cy treatment (group 1) the insulitis scores increased slowly until day 11 and then declined slightly at day 14 whereas mice exposed to the same diet but given Cy at day 95, showed a sharp decline at day 4 followed by a rapid increase between day 7-14. However, in mice given either nicotinamide, Prosobee or both, the insulitis scores at most time-points were generally lower than in Cy-treated animals on the standard diet. In the latter group, CD4 and CD8 cells and macrophages were also higher at day 11 than all other 4 groups (CD4: p < 0.05; CD8: p< 0.05; macrophages: p<0.0001). The number of iNOS labelled cells increased progressively in mice on the standard diet and given Cy and were significantly higher at days 4, 7 and 11 than in the 3 dietary groups. Thus, oral nicotinamide or Prosobee, either alone or together, prevents Cy induced diabetes in the NOD mouse. The protective diets suppress Cy-induced intra-islet immune cell influx and iNOS expression.

Animals↗

Whey predominant, whey modified infant formula with protein/energy ratio of 1.8 g/100 kcal: adequate and safe for term infants from birth to four months.

BACKGROUND: Protein quality of breast milk is superior to that of formula proteins. To ensure that the protein intake is sufficient, starter formulas with conventional protein composition provide a protein/energy ratio of 2.2-2.5 g per 100 kcal to infants, which is much higher than that supplied with breast milk. Several studies have shown that formula-fed infants have higher plasma or serum urea concentrations than breast-fed infants do. We tested if feeding formulas with improved protein quality and a protein content corresponding to the minimum level that is consistent with international recommendations (1.8 g/100 kcal) allows patients to achieve normal growth and plasma urea concentrations. METHODS: Healthy term infants were enrolled into the study and were either breast-fed or randomly assigned to three formula-fed groups. Formula-fed infants received either a standard formula with a protein/energy ratio of 2.2 g/100 kcal, whereas the two other groups received formulas with a protein/energy ratio of 1.8g/100 kcal differing mainly by their source of protein. Subjects received breast milk or these formulas ad libitum as the sole source of energy from birth to four months of age in a controlled blind design (except for the breast-fed group). Anthropometric measurements (body weight and length) were obtained at birth, at 30, 60, 90, and 120 days. Energy and protein intakes were calculated from three-day dietary records. Blood was collected for biochemical measurements at 30, 60, and 120 days. RESULTS: No differences were found between the four feeding groups for weight- and length-gains or for body mass indices (BMI). No differences in energy intakes between the formula-fed groups could be found, whereas protein intakes were less in infants fed the 1.8 g/100 kcal formulas. Plasma urea levels of the infants fed the 1.8 g/100 kcal formulas were closer to those found in the breast-fed infants. CONCLUSION: Improvement of the amino acid profile permits a whey predominant starter formula with 1.8 g protein per 100 kcal to meet the needs of normal term infants during the first four months of life.

Amino Acids↗

Thickening infant formula with digestible and indigestible carbohydrate: availability of calcium, iron, and zinc in vitro.

BACKGROUND: Regurgitation is common in infants and is usually due to gastroesophageal reflux. Often parental reassurance and dietary management by feeding thickened formulas are the only therapeutic steps necessary. Adding fibers may interfere with the absorption of micronutrients. METHODS: A continuous-flow dialysis in vitro method with a preliminary intraluminal digestive phase, modified to simulate the conditions of infants less than 6 months of age and children from 6 months of age on, was used to study the availability of calcium, iron, and zinc from thickened and nonthickened first-and second-age infant formulas. Pooled mature human milk was used as the reference standard. The elemental content of the samples and dialysate fractions of calcium, iron, and zinc after digestion was determined by atomic absorption spectrometry. RESULTS: In human milk, calcium, iron, and zinc were highly available for absorptive processes. Availability of calcium, iron, and zinc from nonthickened first- and second-age infant formulas tends to be significantly better than in the corresponding products thickened with locust bean gum. Thickening infant formulas with pregelatinized rice starch, however, does not affect the availability of calcium, iron, and zinc. CONCLUSIONS: It appears that human milk provides optimal conditions for the availability of calcium, iron, and zinc. Availability of calcium, iron, and zinc seems to lower when infant formulas are thickened with indigestible carbohydrates, whereas it does not by adding digestible carbohydrates.

Biological Availability↗

Immunogenicity and antigenicity of a partially hydrolyzed cow's milk infant formula.

We evaluated the immunogenicity and antigenicity of a formula based on partially hydrolyzed cow's milk whey protein in infants at risk of atopy and in controls. Total IgE and specific IgE, IgG, and IgG4 subclass antibodies against egg albumin and cow's milk alpha-lactalbumin, casein, and beta-lactoglobulin were measured by radioimmunoassay of cord blood and of peripheral blood at 5 days and 6 months of life in five groups of infants: 16 breast-fed infants at risk of atopy (group 1), 21 partially hydrolyzed whey formula-fed infants at risk of atopy (group 2), 14 formula-fed infants at risk of atopy (group 3), 10 breast-fed control infants (group 4), and 13 formula-fed control infants (group 5). Total IgE concentration was significantly lower in group 2 at 6 months than in groups 3 and 5 infants and similar to that observed in groups 1 and 4 infants. The concentration of specific antiegg and anti-cow's milk protein IgG and of specific anti-cow's milk alpha-lactalbumin and beta-lactoglobulin IgG4 subclass antibodies was significantly reduced in group 2 as compared to group 3 infants and similar to that found in breast-fed infants. In conclusion, the partially hydrolyzed formula was less immunogenic and antigenic than a traditional formula and was as immunogenic and antigenic as breast milk.

Allergens↗

Chromium content in human milk, cow's milk, and infant formulas.

Chromium was measured by Electrothermal Atomic Absorption Spectrometry in human milk, cow's milk, and infant formulas. The mean levels found were 1.56, 0.83, and 4.84 (13%) micrograms/L, respectively. According to our data, the daily intake for the Spanish neonates is lower than the Recommended Dietary Allowances (RDAs) (10-40 micrograms/d) for this element.

Animals↗

Calcium, phosphorus, and magnesium: how much is too much for infant formulas?

Despite the use of metabolic balance studies and measurements of bone mineral content, it is difficult to assess the requirements of Ca and P in growing infants. From observations made forty years ago with cow's milk formulas it is obvious what is too much calcium and phosphorus in infant formulas. These observations were utilized in the development of "humanized cow's milk formulas" in the 1950s. Though the total concentrations of Ca and P have been greatly reduced in these formulas, the Ca/P ratio imbalance, compared to human milk, persists. Infants fed these formulas still receive a relative phosphorus load, and cases of neonatal tetany are still occasionally reported. Thus, formula-fed infants have higher serum P and lower serum Ca concentrations than do human milk-fed infants. Unlike Ca and P, the magnesium concentration of infant formulas is similar to that of human milk, and Mg toxicity from formulas has not been reported. Like Ca and P, however, it is difficult to determine the growing infant's requirement for magnesium. The available information does not favor either increasing or decreasing the present concentrations of Ca, P or Mg in infant formulas. The upper limit for these minerals should remain at the present concentrations: 45-50 mg/dl (65-75 mg/100 kcal) for Ca, 30-40 mg/dl (48-58 mg/100 kcal) for P and 12 mg/dl (18 mg/100 kcal) for Mg.

Calcium↗

Human milk and infant formula can induce in vitro adipocyte differentiation in murine 3T3-L1 preadipocytes.

The potential of infant diet to influence fat cell development has largely been examined in clinical studies with conflicting results. In this study, the direct effects of two standard infant formulas, Enfamil and Similac, as well as human milk were examined using a well characterized model of adipocyte differentiation, the 3T3-L1 murine preadipocyte cell line. After exposure to a hormonal regimen of insulin, dexamethasone, and 1-methyl-3-isobutylmethylxanthine, these cells undergo a mitotic expansion phase followed by terminal differentiation. On d 4 of hormonal exposure, greater than 95% of 3T3-L1 cells exhibit the morphologic and biochemical characteristics of mature adipocytes. In this study, cells were exposed to control medium, or control medium supplemented with either 10% Enfamil, 10% Similac, 10% human milk (skim or whole), or the standard hormonal regimen. Oil Red O-detectable lipid accumulation, immunocytochemical cell proliferation assays, and activated expression of adipocyte differentiation-specific mRNAs by Northern blot analysis were used to assess the effects of treatment on adipocyte differentiation. Results from each level of assessment revealed that both Enfamil and human milk were as effective as the standard hormonal regimen at stimulating adipocyte differentiation. In contrast, results from treatment with Similac or human skim milk were indistinguishable from control unstimulated cells. This study, demonstrating that Enfamil and human milk are capable of independently inducing in vitro adipocyte differentiation, suggests that diet during infancy could influence body fat development.

3T3 Cells↗

The effect of age on manganese uptake and retention from milk and infant formulas in rats.

Manganese nutrition of the neonate is poorly understood, due in part to a paucity of information on the amount and availability of manganese in infant foods. We have developed a suckling pup model to assess the uptake of manganese from fluid diets by using extrinsic labeling. Human milk, cow milk and infant formulas were fed by intubation to fasted rat pups and adults. Rats were killed after varying time periods, and tissues were removed and counted. A period of 6 h was found to be adequate to allow for stomach emptying while limiting tissue redistribution; 24 h was found to reflect pup manganese retention. From human milk, manganese retention was highest (greater than or equal to 80%) in pups less than or equal to 15 days of age; in older pups average retention decreased to 40%. Using d 14 pups to assess relative Mn uptake from diets, wholebody Mn uptake was highest from cow milk (approximately 89%); uptake from human and cow milk formula was similar (approximately 80%) whereas it was lower from soy formula (approximately 60%). These findings suggest that bioavailability of Mn from infant diets is very high during the suckling period. Since most formulas contain considerably more manganese than is found in human milk, Mn deficiency may be less of a concern than possible toxicity from formulas.

Absorption↗

Evaluation in guinea pigs of the allergenic capacity of two infant formulae based on hydrolyzed milk proteins.

The purpose of the present study was to evaluate the potential capacity of infant formulae based, respectively, on hydrolyzed casein and on hydrolyzed whey proteins to induce sensitization in guinea pigs. This potential capacity was tested by intravenous challenges with centrifuged formulae and by passive cutaneous anaphylaxis. The results showed that neither formula was sensitizing, therefore suggesting that protein hydrolyzates can be considered a suitable cow's milk substitute for infants with cow's milk protein intolerance. However, further studies are necessary in order to investigate whether these hydrolyzates are not allergenic in infants as well.

Animals↗

Assessing the cariogenic potential of some infant formulas, milk and sugar solutions.

Using a desalivated rat model, the authors found that several commonly used infant formulas had significant cariogenic potential. Sucrose was by far the most cariogenic and cows' milk the least cariogenic of all the products examined. The data show that dental practitioners and other health care professionals should discourage the use of sugar in baby bottles and provide information on which formulas are least likely to induce caries when continuous bottle feeding is unavoidable.

Animals↗

Recent developments in infant formulae: 1--The addition of LCPs.

Long chain polyunsaturated fats (LCPs) are important components of membranes in the human brain and retina. Preterm babies require a dietary source of LCPs, and all preterm formulae in the UK are currently supplemented with LCPs. Supplementation of term infant formulae with AA and DHA has resulted in apparent improvements to visual and cognitive functioning in bottle-fed babies. These improvements may be temporary and more research is needed to determine whether these differences remain in the longer term.

Bottle Feeding↗

Rapid determination of thiamine, riboflavin, pyridoxine, and niacinamide in infant formulas by liquid chromatography.

A simplified, simultaneous determination of vitamins B1, B2, B3, and B6 in supplemented infant formulas was developed from a single deproteinized sample extract, with analysis by reversed-phase, ion-pair chromatography with an acidified methanol-water mobile phase. The dioctylsulfosuccinate counter-ion facilitates unique retention of the pyridine-based vitamins (niacinamide and pyridoxine) and allows for concurrent measurement of both the pyridoxal and riboflavin 5'-phosphate endogenous components of milk. Other naturally occurring undetected vitamin congeners have minimal analytical significance. UV detection is used for niacinamide, and programmed fluorescence detection is used for riboflavin and the B6 vitamins. Thiamine is routinely determined sequentially under modified elution conditions.

Chromatography, Liquid↗

Quantitative determination of linoleic acid in infant formulas by gas chromatography.

A method has been developed for the quantitative determination of linoleic acid in infant formulas by gas chromatography (GC). A known amount of triheptadecanoin was spiked into the sample. Total lipid was extracted from the product by an ethyl ether-petroleum ether-ethanol system in a Mojonnier flask. The sample was saponified by methanolic KOH after the solvents were evaporated. Methyl esters of the fatty acids were prepared by boron trifluoride (BF3) in methanol and analyzed by gas chromatography. A glass column packed with 10% SP-2340 (75% cyanopropyl silicone) was used to separate and identify the methyl linoleate and the methyl heptadecanoate. The quantity of methyl linoleate was calculated by comparing the integrated peak areas of these 2 fatty acid methyl esters. This method was satisfactory for both milk protein-based and soy protein-based matrixes. The results obtained by this method are comparable to those obtained by the AOAC spectrophotometric method 28.082-28.085.

Chromatography, Gas↗

Whey deionization method of infant formula affects plasma lipids.

BACKGROUND: Casein has proved to be hypercholesterolemic. According to results of previous studies, the casein-to-whey ratio in infant formula influences plasma lipid profile. This study explored whether different methods of whey deionization also affect levels of plasma lipids. METHODS: Two types of a whey-predominant (whey 60%:casein 40%) formula which differed only in the methods used for whey deionization (ultrafiltration or electrodialysis), were fed to healthy newborn infants for 60 days, using a prospective, double-blind, randomized design. Formulas were otherwise identical in composition. RESULTS: Groups were similar in gestational age, gender, birth weight, and growth parameters. Evaluation of fasting plasma levels after 60 days revealed significantly higher values of total cholesterol (p < 0.001) and low-density lipoprotein cholesterol (p < 0.001) in infants fed ultrafiltrated whey compared with the same values in infants fed electrodialyzed whey. Plasma levels in the two groups of very low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides revealed no statistically significant differences. CONCLUSIONS: Plasma lipid profile in infancy is influenced by dietary protein, not only by the casein-to-whey ratio, but also by the method of whey deionization.

Cholesterol↗