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PubMed1991

[Supply, metabolism and biological effects of trans-isomeric fatty acids in infants].

Consumption of trans-fatty acids increased markedly during this century due to the widespread use of partially hydrogenated fats. A sensitive analytical method was developed which enables the precise determination of 7 trans-isomers in small sample volumes. With this method we documented the materno-fetal transfer of trans-fatty acids across the human placenta. The content in human milk depends on maternal diet and is lower in Germany than in the Sudan. The distribution in fore- and hind-milk, in milk fat fractions and within the triglyceride molecule was determined. The content of trans-fatty acids is lower in commercial and home-made infant formulae than in human milk, although there is a certain batch to batch variation in formulae. Infants absorb dietary trans-isomers and incorporate them into endogenous lipids, subcutaneous tissue and cell membranes. Trans-fatty acids in plasma lipids are significantly higher in infants fed human milk than in those fed formulae. African children have a lower exposure than Germans. The relative contribution of trans-octadecenoic acid is lower in plasma sterol esters than in triglycerides and phospholipids, pointing to a negative selectivity of plasmatic cholesterol esterification with this fatty acid. Thus, a high supply of trans-octadecenoic acid might have negative effects on the cholesterol levels. In premature infants we found an inverse correlation between trans-fatty acid exposure and birthweight, thus interference with intrauterine growth appears possible. A possible causative factor could be impaired biosynthesis of long-chain polyunsaturated fatty acids by trans-isomers, for which we found strong indications. The results of our investigations the question whether the consumption of trans-fatty acids in pregnant and lactating women and in infants is nutritionally safe.

Birth Weight↗

PubMed1999

Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization.

BACKGROUND: The low sn-2 palmitate content of infant formulas results in formation of fatty acid calcium soaps in the stools and reduced calcium absorption. OBJECTIVE: Our objective was to test the hypotheses that increasing the proportion of sn-2 palmitate in formula for term infants would result in greater skeletal mineral deposition and reduced stool hardness. DESIGN: Healthy term neonates were randomly assigned to receive standard formula (n = 103) or formula containing 50% sn-2 palmitate (high-sn-2 formula; n = 100) for 12 wk. One hundred twenty breast-fed infants were also studied. The main outcome measures were 1) radial (single-photon absorptiometry) and whole-body (dual-energy X-ray absorptiometry) bone mineral content (WBBMC) at 12 wk and 2) stool frequency, volume, and consistency at 6 and 12 wk. Secondary outcome measures included stool fatty acid content. RESULTS: Infants receiving high-sn-2 formula had higher WBBMC (128.1 +/- 9.7 compared with 122.7 +/- 10.1 g, adjusted for size and sex), softer stools at 6 and 12 wk, and a lower proportion of stool soap fatty acids than did infants receiving the control formula. Breast-fed infants had adjusted WBBMC values (128.3 +/- 9.1 g) similar to those of infants fed high-sn-2 formula and significantly higher than those of infants fed the control formula. CONCLUSIONS: Changing the stereoisomeric structure of palmitate in infant formula resulted in higher WBBMC, reduced stool soap fatty acids, and softer stools more like those of breast-fed infants. The greater bone mass measured could be important if it persists beyond the trial period; this merits further investigation.

Absorptiometry, Photon↗

PubMed1984

Clinical trial of a milk formula for infants of low birth weight.

An infant milk formula specially designed to meet the specific needs of the small premature infant was compared with a modified infant milk formula in common use. Healthy infants of very low birth weight were fed with either the specially designed infant milk formula or the standard modified infant milk formula. No statistically significant differences between the two groups of infants were found, although the weight gain, skinfold thickness, serum total protein, albumin and calcium values were marginally better at 28 days in the group fed with the specially designed formula.

Animals↗

PubMed1996

A lamb-meat-based formula for infants allergic to casein hydrolysate formulas.

Ten infants with colitis due to milk protein allergy, presenting as hematochezia, whose symptoms did not resolve with the use of hydrolyzed cow-milk-based formulas, were treated with a modular lamb-meat-based formula (LOP). The patients were followed up for 3 months to 5 years. Prompt resolution of symptoms was achieved. In three patients, increased levels of creatinine and blood urea nitrogen and mild metabolic acidosis were noted, all returning to normal after the protein intake was lowered. All patients had normal growth. Seven patients were able to tolerate cow milk protein or soy at age 9-15 months. The LOP formula is well tolerated and is a safe alternative formula for infants allergic to cow milk hydrolysate formula.

Animals↗

PubMed1993

Infant nutrition, physical growth, breastfeeding, and general nutrition.

It is becoming increasingly apparent that infants who receive human milk develop differently from infants who receive infant formulas. Infants who receive human milk appear to have higher scores on tests of intelligence even after controlling for confounding variables. These differences have been demonstrated to persist in children for as long as 15 years of age. Infants who are fed human milk also grow at a different rate after 4 months of age. New growth charts should be employed that are specific for the breastfed infants so that these infants will not be characterized as "failing to thrive." Breastfed infants appear to be capable of adapting to the nutrient composition of their mother's milk by altering their own intake and although many mothers discontinue nursing because they perceive they have developed breast milk insufficiency, careful studies document that they are still producing adequate quantities of milk and that their infants are growing satisfactorily.

Breast Feeding↗

PubMed1994

Polymerase chain reaction for detection of Clostridium botulinum types A, B and E in food, soil and infant faeces.

The application of the polymerase chain reaction (PCR) for detection of Clostridium botulinum types A, B and E in foods, environmental and clinical samples was evaluated and compared to the mouse bioassay. Samples inoculated with 10, 100 and 1000 spores of Cl. botulinum types A and B included pasteurized milk, UHT milk, infant formula, infant faeces, meat juice, canned tuna, mushrooms, blood sausage and soil. Clostridium botulinum type E spores were inoculated into fish eggs, canned tuna, picked herring, raw fish and soil at similar levels. Spores were added to 2.5 g of each sample with the exception of soil which was inoculated in 10 g samples. The presence of Cl. botulinum in sample enrichments was determined by both PCR and the bioassay. An overall correlation of 95.6% was observed between PCR results and the mouse bioassay. Of the total of 114 samples tested there was disparity between the mouse bioassay and the PCR in three samples of soil inoculated with 100 type A or E spores and 10 type B spores per 10 g, respectively, and two samples of infant faeces inoculated with 10 type A or B spores per 2.5 g. All of these samples gave negative animal results and positive PCR results.

Animals↗

PubMed1992

Serum bone gamma-carboxyglutamic acid protein in a longitudinal study of infants: lower values in formula-fed infants.

Bone gamma-carboxyglutamic acid protein [BGP (osteocalcin)] is a protein synthesized by osteoblasts and incorporated in the bone matrix. Serum BGP is a sensitive marker of bone formation, and it parallels the growth velocity curve during childhood and adolescence. Serum BGP was measured at the age of 2, 6, and 9 mo in a cohort study of nutrition and growth in 91 healthy infants. At 2 mo, the mean BGP value (+/- SD) was 275 +/- 87 ng/mL in infants exclusively breast-fed, and 80 +/- 44 ng/mL in formula-fed infants. At 6 mo, the values were 142 +/- 58 ng/mL and 55 +/- 30 ng/mL, and at 9 mo 75 +/- 39 ng/mL and 45 +/- 19 ng/mL in partially breast-fed and formula-fed infants, respectively. The differences were significant (p less than 0.001) at all three ages. At 2 and 9 mo, breast-milk intake was measured by test-weighing. Serum BGP was positively correlated to breast milk intake (mL/kg body wt) at 2 mo (r = 0.59, p less than 0.001) and 9 mo (r = 0.41, p = 0.06). When breast-feeding was stopped, the high BGP concentrations were not sustained. There were no significant differences in linear growth velocity between breast-fed and formula-fed infants and no correlation between BGP values and linear growth velocity. We speculate that either a factor in human milk or the level of minerals in human milk causes the high BGP values. Moreover, if the higher values are associated with increased osteoblast activity, then the remodeling or the mineralization of bone might be different in infants not being breast-fed.

Age Factors↗

PubMed1990

Formulas for older infants.

We explored the possibility that standard infant formulas designed as the sole source of nutrients for small, rapidly growing infants may not be equally suitable for older, larger, and less rapidly growing infants who obtain a portion of energy intake from beikost. Our approach was to consider the probable nutrient intakes of a 6-month-old hypothetic infant receiving 80% of energy intake from a standard formula and 20% from beikost, and nutrient intakes of a 10-month-old hypothetic infant receiving 50% of energy intake from a standard formula and 50% from beikost. The assortment of beikost items consumed by infants is moderately high in protein and low in fat. Calculated nutrient intakes of the 10-month-old hypothetic infant were compared with intakes of infants of similar age in two national surveys. We conclude that standard infant formulas designed for young infants are reasonably well suited to meeting the nutrient needs of infants during the latter half of the first year of life.

Aging↗

PubMed2004

High faecal calprotectin concentrations in newborn infants.

BACKGROUND: Calprotectin, a major component of soluble cytosolic proteins in human neutrophil granulocytes, is excreted in excess in stools during inflammatory bowel disease in adults and children. Faecal calprotectin concentrations are also higher during the first year of life than in adults. OBJECTIVES: To measure faecal calprotectin concentrations in the neonatal period and define reference values according to the mode of feeding: standard infant formula, prebiotic infant formula (Calisma, Blédina SA, France), or breast feeding. PATIENTS AND METHODS: A prospective study was carried out over three months in 69 full term, healthy newborns with a median gestational age of 39.8 weeks (range 37-41.5) and a birth weight of 3300 g (range 2600-4460). Three groups were formed depending on the mode of feeding: group 1 (n = 18) received a standard infant formula, group 2 (n = 19) the prebiotic infant formula, and group 3 (n = 32) was breast fed. One stool sample was taken from each newborn on day 4 (3-7), and faecal calprotectin analysed using a commercial enzyme linked immunoassay (Calprest, Eurospital, Italy). RESULTS: Faecal calprotectin concentrations (median 167 micro g/g) were higher than reference values in healthy adults. The concentration was below the upper reference limit for adults (50 micro g/g) for three infants only, one fed the standard formula and two fed the prebiotic formula. Concentrations did not differ significantly according to method of feeding. CONCLUSIONS: Compared with healthy adults, newborns have high calprotectin concentrations in the first days of life. There is no obvious influence of the mode of feeding.

Breast Feeding↗

PubMed2005

Induction of cytochrome P450 1A by cow milk-based formula: a comparative study between human milk and formula.

During the treatment of neonatal apnea, formula-fed infants, compared to breastfed infants, show nearly three-fold increase in clearance of caffeine, a substrate of cytochrome P450 1A (CYP1A) and in part CYP3A4. However, human milk is known to contain higher concentrations of environmental pollutants than infant formula, which are potent CYP1A inducers. To gain insight into the mechanism underlying this apparent contradiction, we characterized CYP1A and CYP3A4 induction by human milk and cow milk-based infant formula. The mRNA and protein expression of CYP1A1/1A2 were significantly induced by cow milk-based formula, but not by human milk, in HepG2 cells. Luciferase reporter assay demonstrated that cow milk-based formula but not human milk activated aryl hydrocarbon receptor (AhR) significantly. The cotreatment of 3,4-dimethoxyflavone, an AhR antagonist, abolished the formula-induced CYP1A expression. In addition, AhR activation by dibenzo[a,h]anthracene, a potent AhR agonist, was significantly suppressed by infant formula and even more by human milk. In contrast, CYP3A4 mRNA expression was only mildly induced by formula and human milk. Consistently, neither formula nor human milk substantially activated pregnane X receptor (PXR). Effects of whey and soy protein-based formulas on the AhR-CYP1A and the PXR-CYP3A4 pathways were similar to those of cow milk-based formula. In conclusion, infant formula, but not human milk, enhances in vitro CYP1A expression via an AhR-mediated pathway, providing a potential mechanistic basis for the increased caffeine elimination in formula-fed infants.

Animals↗

PubMed1997

Randomised controlled trial of a synthetic triglyceride milk formula for preterm infants.

AIMS: To test whether use of infant formula containing synthetic structured triglycerides results in: (i) increased palmitate absorption; (ii) increased total fat absorption; (iii) reduction in calcium soap formation in the gut; and hence (iv) increased calcium absorption. METHODS: A randomised study was made of 24 infants comparing three formulas, one containing the synthetic fat Betapol with 74% of palmitate in the 2-position, which was substantially higher than in the two comparison diets (8.4% and 28%). The hypothesised outcomes were tested using balance studies, detailed chemical analysis of stool specimens and dual calcium isotope tracers (44calcium orally and 46calcium intravenously). RESULTS: Three of the four hypotheses were confirmed: use of a formula rich in 2-position palmitate (i) improved palmitate (16:0) and also (18:0) absorption; (ii) reduced the formation of insoluble calcium soaps in the stool; and (iii) improved calcium absorption, determined by the dual tracer technique from 42 (SE 3)% to 57 (7)%. CONCLUSION: Synthetic triglycerides that mimic the stereoisometric structure of those in breast milk may have a valuable role in the design of formulas used for preterm infants in neonatal intensive care units.

Animals↗

PubMedDate not supplied

Water and formula fluoride concentrations: significance for infants fed formula.

The independent contributions of formula and water to the total fluoride (F) intake from the diet of formula-fed infants is not fully documented. Although the precise timing and mechanism by which dental fluorosis occurs has not been fully defined, water F levels can be an important consideration in the risk of dental fluorosis for formula-fed infants. An assessment of 1,308 participants younger than 2 years old revealed that: 81% of homes received public water; 19% received well water; 26% of participants used bottled water; and 11% used some kind of filtration system. In this study, virtually all formulas consumed by the birth cohort and water sources used in the reconstitution of these formulas were assayed for F using a F ion specific electrode and direct read method, except for soy-based formulas, which were analyzed by microdiffusion (modified Taves). Among 78 commercially available bottled waters in Iowa, F levels ranged from 0.02 to 1.36 ppm (mean 0.18 ppm), 83% from 0.02 to 0.16 ppm, 7% from 0.34 to 0.56 ppm, 1% had a F level of 0.88, and 9% had F levels > 1.0 ppm. Among 47 casein (milk)-based formulas, 16 ready-to-feed (RTF) formulas had levels of 0.04-0.55 ppm F (mean 0.17 ppm), 14 liquid concentrates (LC) reconstituted with distilled water had levels of 0.04-0.19 ppm F (mean 0.12 ppm), and 17 powdered concentrates (PC) reconstituted with distilled water had levels of 0.05-0.28 ppm F (mean 0.14 ppm). The 17 soy-based formulas had a range of 0.04-0.47 ppm F (mean 0.26 ppm).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1986

A comparative trial of casein or whey-predominant formulae in healthy infants.

This study compared two infant formulae, one casein-predominant, Vitamilk and the other whey-predominant, Nurture. The nutritional components of Nurture were modified to be more similar to breast milk. This was a six week prospective double blind study of 100 healthy infants whose mothers had decided to bottle feed. The infants receiving Nurture showed significantly greater weight gain (p less than 0.005) and growth in head circumference (p less than 0.05) than those given Vitamilk. Analysis of the red cell membrane fatty acid profiles of the two groups showed significant differences which reflected the different fatty acids in the formulae. Nurture fed infants had significantly higher oleic and linoleic acid levels (p less than 0.001) and similar arachidonic acid levels to those fed Vitamilk. In both groups the concentrations of the essential fatty acids linoleic and linolenic were satisfactory. The blood urea concentrations were significantly lower (p less than 0.001) and the serum albumin concentrations significantly higher (p less than 0.01) in the infants fed Nurture. The formulae were well tolerated by all but seven infants. Four infants fed Vitamilk changed to a different formula because of constipation accompanied by sleeping problems, while three of those fed Nurture were changed, one for constipation and two with an atopic family history because of rashes and other symptoms. Constipation was significantly less frequent (p less than 0.01) in the infants receiving Nurture. While both formulae are satisfactory milk preparations for healthy infants, Nurture appeared to be superior.

Animals↗

PubMed1999

Effect of DHA-containing formula on growth of preterm infants to 59 weeks postmenstrual age.

Between May 1993, and September 1994, a randomized, blinded clinical trial was conducted to evaluate measures of growth and body composition in 63 (32 males; 31 females) healthy, low-birth-weight infants (940-2250 g) who were randomly assigned to an infant formula with docosahexaenoic acid (22:6n3, DHA, 0.2 wt%) from fish oil or to a control formula. A preterm formula with or without DHA was fed beginning at 7-10 days prior to hospital discharge through 43 weeks postmenstrual age (PMA). Then, from 43-59 weeks PMA, infants were fed a term infant formula with or without a corresponding amount of DHA. Growth (weight, length, head circumference), regional body fatness (triceps, subscapular, suprailiac skinfold thicknesses), circumferences (arm, abdominal, chest), and estimates of body composition determined by total body electrical conductivity (TOBEC) (fat-free mass [FFM]) were evaluated. Growth was slower in males fed the DHA formula. They had significantly (P < 0.05) smaller gains in weight, length, and head circumference between study enrollment to 59 weeks PMA than those fed the control formula. At 51 weeks PMA, males in the DHA group had significantly smaller head circumferences (P < 0.05) and lower FFM (P < 0.05). At 59 weeks PMA, males in the DHA group weighed less (P < 0.05), had shorter recumbent lengths (P < 0.01), smaller head circumferences (P < 0.05), and lower FFM (P < 0.01) than those fed the control formula. Energy intakes from formula (kcal/d), however, were lower at 51 weeks (P < 0.05) and 59 weeks (P < 0.05) PMA in males fed the DHA formula. Adjusted for body weight (kcal/kg/d), mean energy intakes from formula at 51 and 59 weeks PMA were not significantly different between feeding groups. The differences in recumbent length, head circumference, and FFM remained statistically significant after controlling for energy and protein intakes (P < 0.01). For all males, neither FFM nor total body fat (TBF), when expressed as a percentage of total body weight, differed significantly between feeding groups. Among females, there were no significant differences between the feeding groups in measures of growth, body composition, or energy intake. The results indicated that infant formula with fish oil containing DHA and EPA in a 5:1 ratio had a significant, negative effect on growth and body composition in males during the first 6 months of life. It is not clear why the growth deficits were limited to males and not females. The eicosanoids, bioactive metabolites of omega-3 and omega-6 fatty acids, may mediate several important growth hormones. The present results do not support the addition of DHA alone in infant formulas. Am. J. Hum. Biol. 11:457-467, 1999. Copyright 1999 Wiley-Liss, Inc.

Journal Article↗

PubMed1994

Ratios of linoleic acid to alpha-linolenic acid in formulas for term infants.

Commercial infant formulas with a ratio of linoleic acid (LA) to alpha-linolenic acid (ALA) of 10:1 or higher are nutritionally inadequate; the tissue levels of docosahexaenoic acid (DHA) are lower and the visual function indices are reduced in infants who are fed these formulas. All the evidence points to using LA:ALA ratios of less than 8:1, but there has been only one study in infants that used formulas with reduced LA:ALA ratios, and only biochemical indices were monitored. There is a need for both short-term studies to establish the ratios of LA to ALA that will make possible the accumulation of DHA to levels close to those in breast-fed infants and long-term trials to determine the effects of such fat blends on growth and development.

Breast Feeding↗

PubMed2005

Colon microflora in infants fed formula with galacto- and fructo-oligosaccharides: more like breast-fed infants.

OBJECTIVES: The intestinal flora of breast-fed infants is generally dominated by Bifidobacteria. We aimed to investigate whether an infant formula supplemented with galacto-oligosaccharides and fructo-oligosaccharides (GOS/FOS) is able to establish a bifido-dominant microflora, not only in numbers but also with respect to the metabolic activity in the colon. METHODS: Two groups of infants fed infant formula with 0.8 g/100 ml GOS/FOS in a ratio of 9:1 (OSF group), or control formula (SF group) were evaluated in a randomised, double blind, placebo controlled intervention study. A breast-fed group was studied in parallel. At study onset and after 4 and 6 weeks, faecal samples were examined for the number of bifidobacteria, pH, short chain fatty acids and lactate. RESULTS: After 6 weeks, the mean proportion of bifidobacteria was significantly higher in the OSF group (59.6% versus 49.5% in the SF group; P < 0.05). Compared with controls, infants in the OSF group had a lower stool mean pH and an increased proportion of acetate and a decreased proportion of propionate. The mean pH in the OSF and SF groups were 5.7 and 6.3, respectively (P < 0.001). CONCLUSIONS: The addition of the prebiotic GOS/FOS mixture to an infant formula has a stimulating effect on the growth of bifidobacteria and on the metabolic activity of the total intestinal flora. The changes in short chain fatty acids, lactate and pH in the prebiotic group represent a fermentation profile that is closer to that observed in breast-fed infants compared to infants fed control formula.

Bifidobacterium↗

PubMed1996

Medium-chain triacylglycerols in formulas for preterm infants: effect on plasma lipids, circulating concentrations of medium-chain fatty acids, and essential fatty acids.

Limited information is available on the metabolic fate of medium-chain triacylglycerols (triglycerides) after intestinal absorption and on their influence on essential fatty acid metabolism. We studied in preterm infants the effect of two infant formulas, one with a high (HMCT) and one with a low (LMCT) medium-chain triacylglycerol content, on plasma fatty acids. The HMCT formula contained 46 mol% 8:0 + 10:0 and the LMCT formula (4.8 mol% 8:0 + 10:0) had approximately twice the amount of long-chain saturated and monounsaturated fatty acids as the HMCT. Both formulas had similar contents of linoleic and linolenic acids. Plasma lipids and fatty acids were determined at birth and on day 24 of life in 20 infants fed the LMCT (n = 12) or HMCT (n = 8) formula. Significant amounts of medium-chain fatty acids were found in the systemic circulation of the infants fed the HMCT formula, mainly in plasma fatty acids and triacylglycerols. Despite striking dietary differences, palmitic and stearic acids were not different between groups, indicating de novo synthesis of long-chain fatty acids with the HMCT formula. Plasma phospholipid docosahexaenoic acid was significantly lower in the HMCT group than in the LMCT infants (1.38 +/- 0.07 compared with 1.73 +/- 0.07 mol%, P = 0.002). Our data indicate that a high MCT intake in preterm infants increases lipogenesis, and dietary nonessential fatty acids interfere with the metabolism of docosahexaenoic acid.

Fatty Acids↗

PubMedDate not supplied

Aluminium levels in Canadian infant formulate and estimation of aluminium intakes from formulae by infants 0-3 months old.

Aluminium was determined in 282 cans of infant formulae and evaporated milks sold in Canada using graphite furnace atomic absorption spectrometry. Milk-based formulae contained average (range) concentrations of 0.129 (0.010-0.36), 0.217 (0.17-0.56) and 0.717 (0.19-2.49) micrograms/g ('as sold') in ready-to-use, concentrated liquid and powder formulae, respectively. The corresponding concentrations in the soy-based formulae were 1.98 (0.40-6.4), 1.41 (0.59-2.29) and 9.44 (3.15-18.0) micrograms/g. Evaporated milk contained 0.093 (0.022-0.34) micrograms/g. The levels varied extensively according to formula brand; e.g. for ready-to-use formulae, the range of average concentrations by formula brand were 0.42-3.28 micrograms/g for soy-based and 0.020-0.22 micrograms/g for milk-based products. Estimated aluminium ingestion from formula or milk by infants up to 3 months old ranged from 0.5 microgram per kg body weight per day (microgram/kg/day) or 2 micrograms/day for 0-1 month olds fed cow milk exclusively to 219 micrograms/kg/day (1260 micrograms/day) for 1-3 month olds fed only soy-based formulae. Consumption of only the formulae brand having the highest mean aluminium level (3.28 micrograms/g) by 1-3 month old infants could result in an intake of 363 micrograms/kg/day (2088 micrograms/day). The estimates assume that the sole source of aluminium is the formula or milk and do not include any potential contribution from other foods or water.

Aluminum↗