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Determination of cholecalciferol (vitamin D3) in selected foods by liquid chromatography: NMKL collaborative study.

Results are presented from an NMKL (Nordic Committee on Food Analysis) collaborative study of a method for the determination of cholecalciferol (vitamin D3) in foods. The method is based on the addition of an internal standard (vitamin D2), followed by saponification and extraction with n-heptane. The fraction that contains vitamin D2/D3 is separated by preparative normal-phase liquid chromatography (LC), and the analytes are determined by reversed-phase LC with UV detection at 265 nm. The method was tested by 8 participating laboratories. In this study 6 different matrixes were analyzed for cholecalciferol content: milk, liquid infant formula (gruel), cooking oil, margarine, infant formula, and fish oil. The contents varied from 0.4 to 12 microg/100 g. Three matrixes (milk, gruel, and margarine) were fortified with vitamin D3. In the other matrixes, vitamin D3 was added at 3 different levels at the Swedish National Food Administration. The milk was analyzed as a blind duplicate, whereas the other matrixes were analyzed as split-level pairs. The recoveries from the samples with vitamin D3 added varied from 93 to 102%. The repeatability relative standard deviation (RSDr) values for accepted results varied between 2.2% (fish oil) and 7.4% (cooking oil), whereas the reproducibility relative standard deviation (RSD(R)) values varied between 6.8% (margarine) and 24% (cooking oil).

Algorithms↗

Production of ethanol from infant food formulas by common yeasts.

Four common yeasts (Candida albicans, Candida tropicalis, Torulopsis glabrata and Saccharomyces cerevisiae) were combined with five infant food formulas and/or supplements (Isomil, Nutramigen, 5% glucose, Coca Cola and Similac) and incubated at 37 degrees C. Gas chromatography was used to measure ethanol production after 24 and 48 h incubation. The quantities of ethanol produced suggest a possible explanation for patients exhibiting the 'Auto-Brewery Syndrome' and raises interest in the role auto-produced ethanol could have in explaining the etiology of Sudden Infant Death.

Ethanol↗

Plasma GLP-2 levels and intestinal markers in the juvenile pig during intestinal adaptation: effects of different diet regimens.

Adaptation of the residual small bowel following resection is dependent on luminal and humoral factors. We aimed to establish if circulating levels of glucagon-like peptide (GLP-2) change under different dietary regimens following resection and to determine if there is a relationship between plasma GLP-2 levels and markers of intestinal adaptation. Four-week-old piglets underwent a 75% proximal small bowel resection (n = 31) or transection (n = 14). Postoperatively they received either pig chow (n = 14), nonpolymeric (elemental) infant formula (n = 7), or polymeric infant formula alone (n = 8) or supplemented either with fiber (n = 6) or with bovine colostrum protein concentrate (CPC; n = 10) for 8 weeks until sacrifice. Plasma GLP-2 levels were measured at weeks 0, 2, 4, and 8 postoperatively. In addition, end-stage parameters were studied at week 8 including weight gain, ileal villus height, crypt depth, and disaccharidase levels. Plasma GLP-2 levels were higher in resected animals compared to transected animals fed the same diet. Plasma GLP-2 levels were significantly increased in the colostrum protein isolate-supplemented animals following resection compared to all other diet groups. The increase in plasma GLP-2 (pM) was greatest in the first 2 weeks postresection (week 0, 15.5; week 2, 30.9), followed by a plateau at weeks 2 to 4 and a decrease in GLP-2 levels from week 4 to week 8. At week 8, no relationships were found between the plasma GLP-2 levels and the measurements of weight gain, villus height, lactase, sucrase, maltase, crypt depth, or villus/crypt ratio. Plasma GLP-2 levels increase in the first weeks following massive small intestinal resection. The increase in plasma GLP-2 levels was enhanced by supplementation of the diet with CPC. The changes in GLP-2 levels observed in this study may suggest that GLP-2 plays a role in the adaptive response in the intestine following resection in this preclinical model.

Adaptation, Physiological↗

Practical applications of fish oil (Omega-3 fatty acids) in primary care.

BACKGROUND: Fish oil (Omega-3 fatty acids) has been studied for more than 30 years. However, recent concerns of mercury and environmental toxins have clouded fish oil's potential clinical benefits. This article aims to review practical, evidence-based applications of fish oil for the primary care physician. METHODS: PubMed search using key words 'fish oil,' 'docosahexaenoic,' and 'eicosapentaenoic' in title/abstract. Limited to human clinical trials. Articles were further scanned for relevant sources. RESULTS: For secondary prevention of cardiovascular disease, 1 g of fish oil has shown to reduce overall and cardiovascular mortality, myocardial infarction, and sudden cardiac death. Higher doses may be used for its potent triglyceride-lowering effects and for patients with rheumatoid arthritis to reduce nonsteroidal anti-inflammatory use. Omega-3 fatty acid supplementation of infant formula has shown benefit in infant neural growth and development. With the potential health benefits of fish, women of childbearing age should be encouraged to eat 1 to 2 low-mercury fish meals per week. CONCLUSIONS: Fish oil has numerous practical applications for the primary care physician. Understanding the diverse clinical research of Omega-3 fatty acids and fish oil is important in determining its role in primary care practices.

Adult↗

High nutrient intakes--the toxicologist's view.

At sufficiently high intake all substances, including essential nutrients, can be toxic. Toxicity may be described by characteristics of the symptoms (identity, severity and degree of persistence) and by the dose-response relationship (threshold, slope, limit, susceptibility to modulation by other substances and tendency to bioaccumulate). Some nutrient toxicities are deleterious exaggerations of essential functions, whereas others are not. The therapeutic indices for nutrients should be defined as the ratio of the lowest toxic dose to the recommended intake, the ratio of the medians of the effective and the toxic doses commonly used in pharmacology. For infant formulas, a ratio of the lowest toxic concentration to the maximum concentration allowed is an analogous ratio. Nutrients with low therapeutic indices and small physical size of a toxic dose require special caution to avoid excessive intake. Modulation of absorption, metabolism or excretion, as well as the physiological state of the exposed individual, may alter the minimum toxic intake of a nutrient and hence alter the risk of toxicity. Extrapolation to estimate the toxic dose can be made on the basis of body weight, body surface area or food intake. Nutrient minimums and maximums in infant formula are set on a 100-kcal basis and thus are related to heat loss and surface area. Evaluation of vitamin A toxicity cases on a dose per 100-kcal basis suggest that the current maximum in infant formula is appropriate. Extrapolation from toxicity data in adults can be made on the dose per 100-kcal basis to estimate appropriate infant formula maximums for nutrients for which maximums have not been set.

Adult↗

Characterisation of infant food modifications in the European Union.

Improvements in the understanding of human milk composition, in dietetic effects on physiological outcomes in infants, and in food technology have lead to modifications in infant formulas and other dietetic products for infants. In Europe, new ingredients may be added to infant formula and follow-on formulas if their suitability for particular use by infants from birth has been established by generally accepted scientific data. However, there is uncertainty as to the nature of the evaluation needed to evaluate whether modifications in dietetic products for infants can be regarded as suitable and safe. Moreover, there is no agreement on the nature of evidence required to justify the scientific validity of potential effects on infant health and well-being, which might provide the basis for the communication of such effects to health professionals and consumers. Therefore, a scientific workshop was held under the auspices of the Child Health Foundation, Munich, Germany, and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition to discuss issues arising in this area among participants representing academia, infant food industry, consumer organisations, the European Commission, and food regulatory bodies of some European Union member states. This article summarises the outcomes of this workshop. The participants agreed on general concepts of evaluation of innovations and on establishing evidence for benefits, but felt that further discussion would be necessary on the principles and practicalities involved in setting up a central register of clinical trials and of a central repository of trial data.

Clinical Trials as Topic↗

Putative virulence factor expression by clinical and food isolates of Bacillus spp. after growth in reconstituted infant milk formulae.

Forty-seven strains representing 14 different Bacillus species isolated from clinical and food samples were grown in reconstituted infant milk formulae (IMF) and subsequently assessed for adherence to, invasion of, and cytotoxicity toward HEp-2 and Caco-2 cells. Cell-free supernatant fluids from 38 strains (81%) were shown to be cytotoxic, 43 strains (91%) adhered to the test cell lines, and 23 strains (49%) demonstrated various levels of invasion. Of the 21 Bacillus cereus strains examined, 5 (24%) were invasive. A larger percentage of clinically derived Bacillus species (20%) than of similar species tested from the food environment were invasive. Increased invasion occurred after growth of selected Bacillus species in reconstituted IMF containing glucose. While PCR primer studies revealed that many different Bacillus species contained DNA sequences encoding the hemolysin BL (HBL) enterotoxin complex and B. cereus enterotoxin T, not all of these isolates expressed these diarrheagenic genes after growth in reconstituted IMF. Of the 47 Bacillus isolates examined, 3 isolates of B. cereus and 1 isolate of B. subtilis produced the HBL enterotoxin after 18 h of growth in brain heart infusion broth. However, eight isolates belonging to the species B. cereus, B. licheniformis, B. circulans, and B. megaterium were found to produce this enterotoxin after growth in reconstituted IMF when assessed with the B. cereus enterotoxin (diarrheal type) reversed passive latex agglutination (RPLA) kit. It is concluded that several Bacillus species occurring occasionally in clinical specimens and food samples are of potential medical significance due to the expression of putative virulence factors.

Animals↗

[Early introduction of dairy formulas in infant feeding].

Frequency, main features and factors associated to introduction of supplemental artificial milk formula at the first month of life were studied in 365 infants born from June 1st, through October 31, 1980, who were under control at a well baby clinic of Santiago, Chile, along years 1986 throughout 1987. By means of life-table analysis, time length of breast feeding was measured and compared in children with and without early formula introduction. In 22.5% of infants an artificial milk formula was given (82/365). In 80% of the cases (66/82) this was done upon instructions of health personnel on grounds of poor weight increase. Early introduction of formula negatively influenced duration of breast feeding which attained a median length of three months in artificially fed infant against ten months in those exclusively breast fed. Main features of infants and mothers prone to early formula introduction were maternal age 35 years or over, previous breast feeding shorter than six months, illegitimacy or first child, fourth or over in birth order, low birth weight and, or, hospital admission in the first four weeks of life. No influence was identified from educational level, of maternal work, desired or unwanted pregnancy, maternal nutritional status in the last three months of pregnancy, child spacing, type of delivery, sex and gestational age of the infants.

Age Factors↗

Effect of renutrition on natural and cell-mediated immune response in infants with severe malnutrition.

BACKGROUND: The purpose of this study was to evaluate whether a 4-week nutritional recovery period with a starting infant formula and 3.35 kJ/mL energy density would favorably affect the natural and cell-mediated immune response in infants with severe and primary protein-energy malnutrition. METHODOLOGY: The study included 12 severely malnourished infants, 3 to 18 months of age. For 2 weeks, infants were fed a starting infant formula, with energy density increased to 0.8 kcal/mL, through a nasogastric tube. Infants were fed "ad libitum" for 2 more weeks. On the fifth day, 837 kJ/kg and 4 g/kg protein were given daily. At the beginning and at the end of the 4-week period, weight, length, phagocytosis, microbicidal activity, chemotaxis, and cell proliferation indices were measured. Null hypothesis was rejected with a paired t test and a P value less than 0.05. RESULTS: After the 4-week period of nutritional recovery, the weight and length indicators and the four immunologic assays showed significant increase (P < 0.005). CONCLUSION: The study demonstrated that a 4-week nutritional recovery period with a starting infant formula and 0.8 kcal/mL energy density favorably affected the natural and cell-mediated immune response in infants with severe protein-energy malnutrition.

Chemotaxis↗

Polyamines in human and rat milk influence intestinal cell growth in vitro.

BACKGROUND: Polyamines are required for intestinal growth and development. In this study, we examined whether milk can supply the polyamines needed for growth of IEC-6 cells, a line on non-transformed rat intestinal crypt cells. METHODS: Human, bovine, and rat milk, and cow's milk-based infant formula were studied. Human, bovine, and rat milk were defatted and sterilized by filtration. IEC-6 cells were stabilized in Dulbecco's modified Eagle's medium (DMEM) containing 0.5% fetal bovine serum, 5 mM L-glutamine, 100 U/mL penicillin and 100 microg/mL streptomycin for 24 h at 37 degrees C. Thereafter, to initiate active growth, cells were placed in fresh DMEM containing 5% FBS (plus the other ingredients) supplemented with 5% (vol/vol) milk or infant formula. In some experiments, cells were also treated with difluoromethylornithine (2.5 mM) (DFMO), an inhibitor of polyamine synthesis, or dialyzed milk plus DFMO. After 44 hours of culture, cells were pulsed with 3H-thymidine (3H-TdR) for 4 hours, harvested and the radioactivity incorporated into DNA was measured. RESULTS: Human and rat milk stimulated proliferation of IEC-6 cells (p < 0.05 compared to controls); addition of DFMO did not reverse the stimulatory effect. Bovine milk and the infant formula did not stimulate proliferation or prevent the growth inhibition induced by DFMO. After dialysis, human milk had less ability to reverse the DFMO inhibition (p < 0.05). CONCLUSIONS: These experiments suggest that both human and rat milk, but neither bovine milk nor the infant formula, contain sufficient bioactive polyamines to sustain cell growth during inhibition of polyamine synthesis.

Animals↗

Risk of overweight among adolescents who were breastfed as infants.

CONTEXT: Overweight during adolescence predicts short- and long-term morbidity as well as obesity in adulthood. The prevalence of overweight among adolescents is high and continues to increase. Physiological and behavioral mechanisms and preliminary epidemiologic data suggest that breastfeeding could lower the risk of subsequent obesity in adolescence. OBJECTIVE: To examine the extent to which overweight status among adolescents is associated with the type of infant feeding (breast milk vs infant formula) and duration of breastfeeding. DESIGN, SETTING, AND SUBJECTS: Survey of 8186 girls and 7155 boys, aged 9 to 14 years, who are participants in the Growing Up Today Study, a nationwide cohort study of diet, activity, and growth. In the fall of 1996 we mailed a questionnaire to each of the subjects, and in the spring of 1997, we mailed a supplemental questionnaire to their mothers, who are participants in the Nurses' Health Study II. MAIN OUTCOME MEASURE: Overweight status defined as body mass index exceeding the 95th percentile for age and sex from US national data. RESULTS: In the first 6 months of life, 9553 subjects (62%) were only or mostly fed breast milk, and 4744 (31%) were only or mostly fed infant formula. A total of 7186 subjects (48%) were breastfed for at least 7 months while 4613 (31%) were breastfed for 3 months or less. At ages 9 to 14 years, 404 girls (5%) and 635 boys (9%) were overweight. Among subjects who had been only or mostly fed breast milk, compared with those only or mostly fed formula, the odds ratio (OR) for being overweight was 0.78 (95% confidence interval [CI], 0.66-0.91), after adjustment for age, sex, sexual maturity, energy intake, time watching television, physical activity, mother's body mass index, and other variables reflecting social, economic, and lifestyle factors. Compared with subjects who had been breastfed for 3 months or less, those who had been breastfed for at least 7 months had an adjusted OR for being overweight of 0.80 (95% CI, 0.67-0.96). Timing of introduction of solid foods, infant formula, or cow's milk was not related to risk of being overweight. CONCLUSION: Infants who were fed breast milk more than infant formula, or who were breastfed for longer periods, had a lower risk of being overweight during older childhood and adolescence.

Adolescent↗

Small changes of dietary (n-6) and (n-3)/fatty acid content ration alter phosphatidylethanolamine and phosphatidylcholine fatty acid composition during development of neuronal and glial cells in rats.

It has been suggested that the fat composition of infant formula should provide arachidonic acid [20:4(n-6)] and docosahexaenoic acid [22:6(n-3)] or increased alpha-linolenic acid [18:3(n-3)] to optimize the (n-3) and (n-6) fatty acid content of brain during infant development. This experiment examined the effects of feeding increased levels of 18:3(n-3), 20:4(n-6) and 22:6(n-3) on brain development in neonatal rats. Diets varying in (n-6) and (n-3) fatty acid content with or without 20:4(n-6) or 22:6(n-3), at levels proposed for infant formula, were fed to nursing dams from parturition and subsequently to weaned pups until 6 wk of age. Neuronal and glial cells were isolated from the frontal region, cerebellum and hippocampus of the brain. Fatty acid analyses of ethanolamine- and choline-phosphoglycerides indicated that small changes in the dietary (n-6)/(n-3) ratio significantly altered neuronal and glial membrane fatty acid composition. Brain regions and cell types varied in amount and rate of 20:4(n-6) and 22:6(n-3) accretion. Fatty acid composition of individual phosphoglycerides was distinct and exhibited changes with age. Inclusion of both 20:4(n-6) and 22:6(n-3) in the diet resulted in alteration of brain fatty acid composition reflecting the fatty acid composition of the diet. If analogous developmental changes occur in human brain, then these results imply that addition of 20:4(n-6) and 22:6(n-3) or a reduced 18:2(n-6):18:3(n-3) ratio in infant formula may result in fatty acid profiles of neuronal and glial cells in formula-fed infants similar to those observed in breast-fed infants.

Aging↗

Normal values for random urinary calcium to creatinine ratios in infancy.

OBJECTIVE: To determine normal values for the urinary calcium/creatinine ratio (UCa/Cr) in infants. To assess the impact of short-term supplementation of infant formula with calcium and phosphorus on UCa/Cr in a group of infants. DESIGN: We determined UCa/Cr in randomly collected urine samples from a group of children and adults. Short-term supplementation of infant formula with calcium glycerophosphate was carried out in 21 infants, and UCa/Cr was monitored in a before-and-after trial. SETTING: A pediatric clinic at an academic center (infants and adults), and a day-care center (older children). PARTICIPANTS: A total of 103 infants between 5 days and 7 months of age, 40 infants between 8 and 17 months of age, 41 children between 18 months and 6 years, and 31 adults. RESULTS: The 95th percentiles for molar UCa/Cr for the different age groups were as follows: less than 7 months, 2.42 (0.86 mg/mg); 7 to 18 months, 1.69 (0.60 mg/mg); 19 months to 6 years, 1.18 (0.42 mg/mg); and adults, 0.61 (0.22 mg/mg). Regression analysis indicated a statistically significant decline in average UCa/Cr with age (R2 = 0.115, p < 0.0001 for log (UCa/Cr) vs log (age)). The geometric means for the two groups of infants were significantly greater than those of the older children and the adults (p < 0.05). Values for UCa/Cr in adults in our sample were comparable to those previously reported. We detected no significant changes in mean UCa/Cr during week-long periods of calcium supplementation of up to 1.8 gm of calcium and 1.39 gm of phosphorus per liter of formula. CONCLUSION: We conclude that normal values for UCa/Cr are much higher in infants than in older children and adults; UCa/Cr is age-related and declines gradually in the first several years of life, and short-term supplementation of infant formula with calcium glycerophosphate has minimal effect on UCa/Cr.

Adult↗

Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement for silicone.

In response to concerns about contamination of human breast milk from silicone gel-filled breast implants, and because silicon levels are assumed to be a proxy measurement for silicone, we compared silicon levels in milk from lactating women with and without implants. Two other sources of infant nutrition, cow's milk and infant formulas, were also analyzed for silicon. The survey took place at the Breast-feeding Clinic at Women's College Hospital in Toronto. A convenience sample of lactating women, 15 with bilateral silicone gel-filled implants and 34 with no implants, was selected. Women with foam-covered or saline implants or with medically related silicone exposures were ineligible. Collection of samples was scrupulously controlled to avoid contamination. Samples were prepared in a class 100 "ultraclean" laboratory and analyzed using graphite furnace atomic absorption spectrophotometry. Silicon levels were analyzed in breast milk, whole blood, cow's milk, and 26 brands of infant formulas. Comparing implanted women to controls, mean silicon levels were not significantly different in breast milk (55.45 +/- 35 and 51.05 +/- 31 ng/ml, respectively) or in blood (79.29 +/- 87 and 103.76 +/- 112 ng/ml, respectively). Mean silicon level measured in store-bought cow's milk was 708.94 ng/ml, and that for 26 brands of commercially available infant formula was 4402.5 ng/ml (ng/ml = parts per billion). We concluded that lactating women with silicone implants are similar to control women with respect to levels of silicon in their breast milk and blood. Silicon levels are 10 times higher in cow's milk and even higher in infant formulas.

Adult↗

A collaborative study to evaluate qualitatively powdered baby food validation samples artificially contaminated with Salmonella anatum.

Nineteen laboratories participated in a collaborative study to evaluate the performance of validation samples consisting of powdered infant formula and cereal-based weaning food artificially contaminated with low levels of Salmonella anatum. The Standard method BS EN ISO 6579:2002 was to be followed for the trial. Salmonella counts in each baby food were around 10 CFU/25 g (low) or 10 CFU/g (high level). Trial participants received five samples of each sample type and five blank samples. All samples contained Pseudomonas aeruginosa and Lactobacillus spp. at concentrations between 10(4) and 10(5) CFU/g as background flora. Precision data for the powdered infant formula were similar for the solid selective plating-out medium xylose-lysine-deoxycholate (XLD) and a 2nd choice of agar suitable to isolate Salmonella spp. The sensitivity was 91.3%, accordance 82.5% and concordance 83.9% for the low and 100% for the high level in all cases. For the cereal-based weaning food, the precision data for the high level were similar for XLD and the 2nd choice medium (98.8%, 97.5% and 97.5%). A slight difference was observed for the low level where XLD obtained values of 82.5%, 73.8%, 70.6% for sensitivity, accordance and concordance and the second choice medium values of 81.5%, 72.5% and 69%. The specificity, accordance and concordance of blanks for the infant formula and cereal-based weaning food were 100%.

Agar↗

Morbidity and mortality in breastfed and formula-fed infants of HIV-1-infected women: A randomized clinical trial.

CONTEXT: Breastfeeding among women infected with human immunodeficiency virus type 1 (HIV-1) is associated with substantial risk of HIV-1 transmission, but little is known about the morbidity risks associated with formula feeding in infants of HIV-1-infected women in resource-poor settings. OBJECTIVE: To compare morbidity, nutritional status, mortality adjusted for HIV-1 status, and cause of death among formula-fed and breastfed infants of HIV-1-infected women. DESIGN: Randomized clinical trial conducted between 1992 and 1998. SETTING: Four antenatal clinics in Nairobi, Kenya. PARTICIPANTS: Of 401 live-born, singleton, or first-born twin infants of randomized HIV-1-seropositive mothers, 371 were included in the analysis of morbidity and mortality. INTERVENTIONS: Mothers were randomly assigned either to use formula (n = 186) or to breastfeed (n = 185) their infants. MAIN OUTCOME MEASURES: Mortality rates, adjusted for HIV-1 infection status; morbidity; and nutritional status during the first 2 years of life. RESULTS: Two-year estimated mortality rates among infants were similar in the formula-feeding and breastfeeding arms (20.0% vs 24.4%; hazard ratio [HR], 0.8; 95% confidence interval [CI], 0.5-1.3), even after adjusting for HIV-1 infection status (HR, 1.1; 95% CI, 0.7-1.7). Infection with HIV-1 was associated with a 9.0-fold increased mortality risk (95% CI, 5.3-15.3). The incidence of diarrhea during the 2 years of follow-up was similar in formula and breastfeeding arms (155 vs 149 per 100 person-years, respectively). The incidence of pneumonia was identical in the 2 groups (62 per 100 person-years), and there were no significant differences in incidence of other recorded illnesses. Infants in the breastfeeding arm tended to have better nutritional status, significantly so during the first 6 months of life. CONCLUSIONS: In this randomized clinical trial, infants assigned to be formula fed or breastfed had similar mortality rates and incidence of diarrhea and pneumonia during the first 2 years of life. However, HIV-1-free survival at 2 years was significantly higher in the formula arm. With appropriate education and access to clean water, formula feeding can be a safe alternative to breastfeeding for infants of HIV-1-infected mothers in a resource-poor setting.

Adult↗

Diet and faecal flora in the newborn: iron.

The faecal flora of a baby receiving a modern infant formula is substantially different from that of a breast fed baby. This difference is a little less when whey based formulas are used. The addition of bovine lactoferrin has no effect and there is some evidence that the presence of added iron in a formula moved the faecal flora further away from that of a breast fed baby. the iron content of currently used infant formulas is much higher than that of breast milk. The effect of the addition of iron to both whey and casein based formulas on the faecal flora was examined in further detail. Faecal flora were examined at 14 days of age in 33 babies receiving a whey formula fortified with iron, 29 babies receiving a whey formula without iron, 29 babies receiving a casein formula fortified with iron, and 24 babies receiving casein formula without iron. Subsequently fewer babies in each group were examined at week 7, 11, and 15. The addition of iron to both casein and whey formulas discouraged colonisation and growth of staphylococci and bacteroids but encouraged the colonisation and growth of clostridia and enterococci. The type of protein and not the iron content had more effect upon the growth of bifidobacteria; both whey formulas, fortified or not, encouraged the colonisation by bifidobacteria. If an infant formula, for use in the first few months, is to mimic the physiological effects of breast milk, there may be microbiological arguments for not fortifying it with iron. However, large empirical trials would be necessary before advocating such a policy.

Bacteria↗

Longitudinal study of the body composition of weight gain in exclusively breast-fed and intake-measured whey-based formula-fed infants to age 3 months.

Body composition and the composition of weight gain in 82 healthy infants during the first 3 months of life were measured in relation to the type of feeding and nutrient intakes by serial measurements of total body potassium (TBK), anthropometry, and formula intake. Infants were exclusively fed either breast milk (n = 34, B fed) or whey-based formula (n = 48, F fed). Formula intakes were substantially lower than WHO-FAO recommendations (although serial weights paralleled standards), and were significantly greater in male infants, who had greater gains in weight and lean tissue than females. In both sexes, tissues low in K (fat and extracellular water) were added faster to the body weight than lean tissue. Overall, compared with B fed infants, F fed infants gained less weight between birth and 10 days and more weight between 10 and 90 days, although mean actual weights at 90 days were similar; formula feeding caused greater fat deposition in males and greater daily gains in lean mass in females. Differences in both quantity and quality of ingested nutrients account for these differences although the biological importance of these findings is speculative. These studies further elucidate the nature of growth in relation to modern feeding practices and the question of optimal versus maximal nutrient intake and growth in early life.

Anthropometry↗