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PubMed2000

Infant vision and retinal function in studies of dietary long-chain polyunsaturated fatty acids: methods, results, and implications.

Animal and human studies have documented several effects of different dietary and tissue concentrations of long-chain polyunsaturated fatty acids (LCPUFAs) on retinal function and vision. The enhanced visual development associated with increased intakes of LCPUFAs, particularly docosahexaenoic acid (DHA), provides the strongest evidence for the importance of these fatty acids in infant nutrition. The 2 primary visual measures used to assess the efficacy of infant formula LCPUFA supplementation are the electroretinogram and visual acuity. This review briefly describes the methodology, neural basis, and interpretation of these measures, as well as other measures of visual development that may be used to extend the functional evaluation of infants fed formulas with different fatty acid compositions.

Dietary Fats↗

PubMed1984

Transient riboflavin depletion in preterm infants.

Biochemical riboflavin status was measured in 68 preterm infants who were receiving either human milk or a preterm infant formula (containing riboflavin, 1.8 mg/l) during the first few weeks of life. The relation between riboflavin status, type of diet, and time of introduction of a multivitamin supplement containing riboflavin was analysed and the duration of phototherapy was recorded. Those who received the multivitamin supplement on or before day 7 of life seldom became deficient and no significant difference between diets was seen in this group. Of those who received the supplement after day 7, human milk fed infants commonly developed abnormal riboflavin status (18 out of 23 infants) compared with a small and significantly lower incidence in the formula fed group. Dietary effects on riboflavin status seemed to outweigh in importance those of phototherapy. It is concluded that the riboflavin content of human milk, which may be lowered by photodegradation, is not sufficient to ensure normal biochemical status in preterm infants. The larger amounts provided by a multivitamin supplement or by a preterm infant formula may, however, prevent biochemical deficiency. The desirability (and safety) of routine riboflavin supplementation of preterm infants is discussed.

Age Factors↗

PubMed2000

Low erucic acid canola oil does not induce heart triglyceride accumulation in neonatal pigs fed formula.

Canola oil is not approved for use in infant formula largely because of concerns over possible accumulation of triglyceride in heart as a result of the small amounts of erucic acid (22:1n-9) in the oil. Therefore, the concentration and composition of heart triglyceride were determined in piglets fed from birth for 10 (n = 4-6) or 18 (n = 6) d with formula containing about 50% energy fat as 100% canola oil (0.5% 22:1n-9) or 100% soybean oil, or 26% canola oil or soy oil (blend) with palm, high-oleic sunflower and coconut oil, providing amounts of 16:0 and 18:1 closer to milk, or a mix of soy, high-oleic sunflower and flaxseed oils with C16 and C18 fatty acids similar to canola oil but without 22:1. Biochemical analysis found no differences in heart triglyceride concentrations among the groups at 10 or 18 d. Assessment of heart triglycerides using Oil Red O staining in select treatments confirmed no differences between 10-d-old piglets fed formula with 100% canola oil (n = 4), 100% soy oil (n = 4), or the soy oil blend (n = 2). Levels of 22:1n-9 in heart triglyceride and phospholipid, however, were higher (P<0.01) in piglets fed 100% canola oil or the canola oil blend, with higher levels found in triglycerides compared with phospholipids. The modest accumulation of 22:1n-9 associated with feeding canola oil was not associated with biochemical evidence of heart triglyceride accumulation at 10 and 18 d.

Animal Feed↗

PubMed2003

LC-MS/MS analysis of lysophospholipids associated with soy protein isolate.

Approximately 20-25% of babies consuming formula are fed formulas containing soy protein as the sole protein source. Isoflavone phytoestrogens are considered as major bioactive components present in soy protein isolate (SPI) and the most widely studied phytochemicals in human diets and soy infant formulas. In the present study, LC-MS/MS analysis of SPI phytochemical extract resulted in identifications of fifty-six lysophospholipids (lyso-PL), including eighteen lysophosphatidylcholines (lyso-PC), twelve lysophosphatidylethanolamines (lyso-PE), eleven lysophosphatidylinositols (lyso-PI), eleven lysophosphatidic acids (lyso-PA) and four lysophosphatidylglycerols (lyso-PG). The LC-MS/MS conditions were first developed using commercially available standard mixtures. Under these conditions, lyso-PL compounds could be separated by LC and yielded unique fragments and neutral losses in the electrospray ionization mass spectrometry (ESI-MS) with both positive- and negative-ion modes, quite indicative of the polar headgroups for different subclasses. This is the first characterization of lyso-PL in SPI. Lyso-PLs are important cell signaling and growth factor molecules experimentally linked to cardiovascular function and disease, cancer, and neurological disorders. These findings suggest that biological effects of PLs associated with SPI in infants clearly needs to be considered as part of an overall evaluation of potential health benefits.

Chromatography, Liquid↗

PubMed2006

The role of probiotics and prebiotics in pediatric practice.

OBJECTIVE: To review the effects of probiotics and prebiotics in clinical pediatric practice. SOURCES: MEDLINE was searched, especially for articles that addressed their practical application, in the form of reviews, clinical trials and meta-analyses. Articles that had already been analyzed by the authors were also included. SUMMARY OF THE FINDINGS: Scientific literature on probiotics and prebiotics has remarkably increased in the last 10 years. Their mechanisms of action have been experimentally investigated. Studies indicate that probiotics can act by competing with pathogens, modifying the intestinal environment by reduction in pH, as a result of fermentation products, interacting and modulating local and systemic inflammatory and immune response, among others. Clinical trials and meta-analyses show that probiotics seem to contribute towards the prevention of acute diarrhea and of antibiotic-associated diarrhea, in addition to shortening the duration of acute diarrhea. However, the data are inconsistent and there are no studies confirming their efficacy in terms of cost-benefit ratio. Preliminary studies show that probiotics in early life can reduce the occurrence of atopic dermatitis. The addition of prebiotics to infant formulas is associated with the change in the profile of the intestinal microbiota compared to infants fed milk formulas without prebiotics. CONCLUSIONS: Evidence indicates that new studies should be carried out about probiotics, prebiotics and symbiotics. The specific clinical effects that each probiotic or prebiotic may cause must be considered.

Acute Disease↗

PubMed1994

Fat needs of term infants and fat content of milk formulae.

Term infants have precise dietary fat requirements for their metabolic, energy and structural needs. The fat content of commercial milk formulae differs from maternal milk in that it contains no long-chain polyunsaturated derivatives or cholesterol. Artificially fed children thus have less of these molecules available for their biological needs, and hence lower levels of long-chain polyunsaturated derivatives in circulating and membrane lipids than breast-fed children. The functional effects of this difference have not been investigated thoroughly in term infants. Dietary lack of essential fatty acids and their derivatives is evident also in weaned children during the second half of their first year of life. Qualitative changes in the fat content of commercial milk formulae could help to correct some widely encountered dietary imbalances, using the pattern of fats provided in breast milk as the ideal.

Animals↗

PubMed2004

Associations between Intakes of fluoride from beverages during infancy and dental fluorosis of primary teeth.

OBJECTIVE: We describe associations between primary tooth fluorosis status and intakes of beverages and fluoride from these beverages during infancy. METHODS: Subjects (n = 677) are members of the Iowa Fluoride Study, a cohort of young children followed from birth. Food and nutrient intakes were obtained from 3-day diet records. Diets were analyzed at 6 weeks, 3, 6, 9, 12 and 16 months and cumulatively for 6 weeks through 16 months of age. Primary tooth fluorosis was assessed at 4.5-6.9 years of age and defined as present or absent. Multiple logistic regression analyses were used to develop models to predict fluorosis status. RESULTS: Water-based beverage intakes were higher in subjects with fluorosis than in those without. Specifically, higher intakes of water used to reconstitute formulas at 3, 6 and 9 months; any intake of water as a beverage at 16 months; and higher intakes of combined 100% juice and miscellaneous beverages at 16 months were positively associated with fluorosis (p < 0.05). Fluoride intakes from water sources were also higher in subjects with fluorosis than in those without. Specifically, higher intakes of fluoride from water used to reconstitute formulas at 3, 6, 9 and 12 months and for 6 weeks through 16 months, and higher intakes of fluoride from water as a beverage at 16 months and for 6 weeks through 16 months were positively associated with fluorosis (p < 0.05). CONCLUSION: Infant beverages, particularly infant formulas prepared with fluoridated water, can increase the risk of fluorosis in primary teeth.

Beverages↗

PubMed1995

Plasma mineral concentrations in preterm infants fed a nutrient-enriched formula after hospital discharge.

OBJECTIVE: To determine whether prolonged feeding of preterm infant formula to preterm infants can accelerate recovery to normal plasma zinc levels without affecting plasma mineral homeostasis. DESIGN: Part of concurrent prospective feeding trials in a university hospital-based population. SUBJECTS AND INTERVENTION: Preterm infants (n = 33; birth weight, 1037 +/- 157 gm) were fed a preterm infant formula with higher concentrations of zinc, copper, calcium, magnesium, and potassium until 2 months past expected term, then a term infant formula. Term infants (n = 38; birth weight, 3318 +/- 401 gm) fed this term infant formula from birth were a reference group for comparison with study infants and with published values. Plasma mineral levels were analyzed by inductively coupled plasma atomic emission spectroscopy. RESULTS: Preterm infants fed a preterm infant formula after discharge from the hospital appeared to achieve normal plasma zinc concentrations by at least 2 months past term without adverse effects on mineral homeostasis.

Adolescent↗

PubMed1994

Diet and the essential fatty acid status of term infants.

Long-chain polyunsaturated fatty acids with 20 and 22 carbon atoms (LCPs) seem to play an important role during the rapid development of the infant brain in the late fetal and early postnatal period. These LCPs are integral constituents of biological membranes and they are involved in the regulation of functional properties like fluidity, permeability and activity of membrane-bound enzymes. Human milk contains LCPs in an amount of 0.5-3 wt% of total fatty acids, whereas commercially available infant formulae are almost free of them. Recently, several clinical trials, primarily with preterm infants, have reported that the content of LCPs in the blood and a functional parameter like visual acuity correlate with the content of LCPs in the diet. In this clinical trial we studied the effect of different diets on the fatty acid pattern of plasma and erythrocyte lipids of healthy term infants during the first 3 months of life. Breast-fed infants were compared with formula-fed babies who received a commercially available formula without LCPs or a new experimental formula enriched with LCPs that was similar to human milk. The results indicate that the introduction of milk feeding leads to marked differences in the blood lipid composition during the first months of life, independent of the feeding regimen. Secondly, the supplementation of a formula with LCPs seems to result in a blood lipid composition similar to infants fed with human milk. This supports the hypothesis that the newborn term infant has a limited desaturating capacity and depends on an exogenous supply of LCPs during the first months of life.

Arachidonic Acid↗

PubMed2005

Preterm birth makes the immature intestine sensitive to feeding-induced intestinal atrophy.

Preterm birth and formula feeding predispose to small intestinal dysfunction, which may lead to necrotizing enterocolitis (NEC). In piglets, we tested whether the physiological and environmental transitions occurring at birth affect the response of the immature intestine to enteral feeding. Pig fetuses (106 days gestation, term = 115 days) were prepared with esophageal feeding tubes and fed either sow's colostrum (n = 8) or infant formula (n = 7) in utero. After 24 h of oral feeding, the pig fetuses were delivered by cesarean section and their gastrointestinal morphology and function were compared with those of preterm newborn (NB) littermates that were not fed (n = 8) or fed colostrum (n = 7) or formula (n = 13) for 24 h after birth. Before birth, both colostrum and formula feeding resulted in marked increases in intestinal mass, brush-border enzyme activities, and plasma glucagon-like peptide 2 concentrations, to levels similar to those in NB colostrum-fed piglets. In contrast, NB formula-fed piglets showed reduced intestinal growth, decreased brush-border enzyme activities, and intestinal lesions, reflecting NEC. NB formula-fed pigs also showed impaired enterocyte endocytotic function and decreased antioxidative capacity, whereas brush-border enzyme mRNA levels were unaltered, relative to NB colostrum-fed pigs. Our results indicate that the feeding-induced growth and enzyme maturation of the immature intestine are not birth dependent. However, with a suboptimal diet (milk formula), factors related to preterm birth (e.g., microbial colonization and metabolic and endocrine changes) make the immature intestine sensitive to atrophy and development of NEC.

Animals↗

PubMed1999

Growth of newborn, term infants fed soy formulas for 1 year.

Few studies have measured long-term growth in infants fed soy protein-based formulas. The effect of nucleotide (NT) supplementation of soy protein-based infant formulas on growth is unknown. Growth was therefore evaluated in healthy term infants fed a soy protein-based formula (SOY; n = 73), SOY with added NT (72 mg added NT/L) at human milk (HM) levels (SOYN, n = 73), or mixed feeding (MF, n = 67) in a randomized, masked, parallel 1-year feeding study. The MF group (a nonrandomized reference group) was fed HM exclusively from birth to 2 months of age followed by HM and/or a standard milk-based formula (Similac with Iron with no supplemental NTs) to 1 year of age. Results indicated that growth (weight, length, and head circumference) was normal and comparable among the three groups. All three groups had similar plasma albumin (at 2 months of age) and hemoglobin levels (at 12 months of age). Thus, this study demonstrated similar growth in the first year of life among infants fed MF feeding or soy formula with or without supplemental NTs.

Age Factors↗

PubMed2006

A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study.

BACKGROUND: Children allergic to cow's milk are fed a soy- or a hydrolysed cow's milk-based substitute. Neither can rule out a sensitization risk. Previous studies have shown that hydrolysed rice is tolerated by animals and children with multiple food hypersensitivities. OBJECTIVE: A prospective clinical assessment of tolerance to a rice-based hydrolysed formula was carried out in children allergic to cow's milk. Patients and methods One hundred children (42 girls and 58 boys, mean age 3.17+/-2.93 years, median 2.20, range 0.18-14.6 years) with a history of immediate reactions to cow's milk and confirmed at double-blind, placebo-controlled food challenge (DBPCFC) when not contraindicated were assessed for clinical tolerance to cow's milk proteins. Their allergy work-up included skin prick tests with whole milk, alpha-lactalbumin (ALA), beta-lactoglobulin (BLG) and total caseins, and specific IgE determinations using CAP technology were performed against whole milk, ALA, BLG and casein. Sensitization to rice and rice-based hydrolysed formula was similarly investigated. Patients' sera were evaluated at immunoblotting for specific IgE to cow's milk proteins, rice and rice-based hydrolysed formula. DBPCFC was carried out with increasing doses of a rice-based hydrolysed formula. RESULTS: All patients were sensitized to cow's milk and/or at least one cow's milk protein fraction. Eighty-seven out of 99 were positive to cow's milk and/or a cow's milk protein fraction at skin prick test. Positive (>0.35 kUA/L) specific IgE determinations were found for cow's milk and/or milk fractions (92/95), rice (21/91) and hydrolysed rice infant formula (4/91). At immunoblotting, sera from 96 children were positive to alpha-casein (n=54), beta-casein (n=38), ALA (n=57), BLG (n=37) and bovine serum albumin (n=61). Similarly, although patients' sera often contained specific IgE against rice proteins at CAP (21/91) and immunoblotting (70/96), only six very weakly positive responses were observed against rice-based hydrolysed formula. All DBPCFC with rice-based hydrolysed formula were negative. CONCLUSIONS: Rice-based hydrolysed formula is a possible alternative not only for children with multiple allergies, but also for children with cow's milk allergy.

Adolescent↗

PubMed1998

Formula supplementation with long-chain polyunsaturated fatty acids: are there developmental benefits?

OBJECTIVE: To evaluate the developmental outcomes of children who participated in an augmented randomized clinical trial of supplementing a standard infant formula with long-chain polyunsaturated fatty acids. DESIGN: Randomized clinical trial, augmented with a nonrandomized human milk comparison group. There were three randomized formula groups: standard formula, standard formula containing docosahexaenoic acid (DHA), and standard formula containing DHA and arachidonic acid. SETTING: Three clinical sites serving diverse populations: Kansas City, MO; Portland, OR; and Seattle, WA. PARTICIPANTS: A total of 274 healthy full-term infants were enrolled in the infant-feeding protocol; of these, 197 (72%) participated in assessments of developmental outcome. Formula Supplements. In the randomized trial, one group received a standard formula, another group received a formula that had been supplemented with DHA from fish oil, and a third group received a formula supplemented with both DHA and arachidonic acid from an egg phospholipid. OUTCOME MEASURES: Mental and Motor Scales of the Bayley Scales of Infant Development at 12 months of age; vocabulary and gesture communication scores from the MacArthur Communicative Development Inventories at 14 months of age. RESULTS: There were no statistically significant differences for either the Bayley Mental Scale or the Bayley Motor Scale, neither when the analysis was restricted to the three randomized formula groups nor when the analysis included all four groups. However, the DHA formula group had significantly lower scores on two of the MacArthur scales: the DHA group scored lower than the nonrandomized human milk comparison group on the Vocabulary Comprehension Scale, and the DHA group scored lower than the randomized control formula group on the Vocabulary Production Scale. Moreover, additional analyses both in the formula groups and in the human milk comparison group found significant negative correlations between DHA levels and vocabulary outcomes. CONCLUSION: We believe that additional research should be undertaken before the introduction of these supplements into standard infant formulas.

Arachidonic Acid↗

PubMed1987

Feeding low-fat milk during infancy.

Despite the widespread agreement that low-fat milk should not be used during infancy, there is a sizable portion of infants in the United States who were fed a diet that included low-fat milk (less than or equal to 2% fat). In 1985, 14% of infants 8 months old, 20% of infants 10 months old, and 32% of infants 12 months old were fed low-fat milk. The reasons given most often by mothers for low-fat milk use was their consideration that low-fat milk has less fat than whole cow's milk and that low-fat milk use was recommended/suggested by their physician. Nutrient intakes of infants fed low-fat milk are compared to those of infants fed whole cow's milk and infant formula. Except for fat, nutrient intakes of infants fed low-fat milk or whole cow's milk were similar. A majority of infants fed either low-fat milk or whole cow's milk received amounts of sodium, potassium, and chloride that exceeded the recommended safe and adequate ranges and amounts of iron below the RDA. These data are considered in relation to dietary requirements during infancy.

Animals↗

PubMed2005

The role of long-chain polyunsaturated fatty acids (LCPUFA) in growth and development.

It is debatable whether supplementation of infant formula with LCPUFA has an effect on infant growth and development. Up till now, there is little evidence of a negative effect on infant growth. A review of randomized controlled trials in term infants revealed that LCPUFA, in particularly supplementation with > or = 0.30% DHA, seems to have a beneficial effect on neurodevelopmental outcome up to 4 months of age. The studies could not demonstrate a consistent positive effect beyond that age. However, in the majority of studies neurodevelopmental outcome was assessed between 6 to 24 months, i.e. at an age where there is a 'latency' in the expression of minor neurological dysfunction. Thus it is possible that LCPUFA might have a long lasting beneficial effect on neurodevelopmental outcome at school-age and beyond. This hypothesis urgently needs testing.

Child↗

PubMedDate not supplied

Dioxins in U.S. food and estimated daily intake.

Congener-specific analyses for polychlorinated dioxins and dibenzofurans were performed on eighteen dairy, meat, and fish samples obtained from a supermarket in upstate New York. Dioxin toxic equivalents (TEqs) on a whole or wet weight basis for these food samples ranged from 0.02 to 1.5 parts per trillion (ppt). Data on American food consumption rates were used to estimate a U.S. range of dioxin intake from food. Based on these first congener-specific dioxin analyses of U.S. food, U.S. average daily intake of "International" dioxin toxic equivalents for an adult weighing 65 kilograms (kg) was estimated to be between 18 to 192 picograms TEq or 0.3 to 3.0 picograms per kilogram of body weight. Our previous results for cow's milk, human breast milk, and soy-based infant formula were used to calculate intake for infants. The relatively high level of dioxins commonly reported in human breast milk from America contributes from 35 to 53 picograms of dioxin toxic equivalents per kilogram of body weight to the nursing infant per day in its first year of life. This value greatly exceeds the U.S. Environmental Protection Agency estimated dose which would lead to one excess cancer per one million people of 0.006 pg of TCDD per kg of body weight per day over a seventy year lifetime or similar reference doses used by some other countries of up to 10/pg/kg/day over a 70 year lifetime.

Adult↗

PubMed2002

Lactoferrin in the preterm infants' diet attenuates iron-induced oxidation products.

Free radical injury is thought to play a significant role in the pathogenesis of several disease processes in low birth weight premature infants including retinopathy of prematurity and necrotizing enterocolitis. Because iron is a known catalyst in free radical-mediated oxidation reactions, the objectives of the present in vitro studies were to determine whether after exposure to air 1) iron present in infant formula, or that added to human milk or formula as medicinal iron or as iron contained in human milk fortifier, increases free radical and lipid peroxidation products; and 2) recombinant human lactoferrin added to formula or human milk attenuates iron-mediated free radical formation and lipid peroxidation. Before adding medicinal iron to formula and human milk, significantly more ascorbate and alpha-hydroxyethyl radical production and more lipid peroxidation products (i.e. thiobarbituric acid reactive substances, malondialdehyde, and ethane) were observed in formula. After the addition of medicinal iron to either formula or human milk, further increases were observed in free radical and lipid peroxidation products. When iron-containing human milk fortifier was added to human milk, free radicals also increased. In contrast, the addition of apo-recombinant human lactoferrin to formula or human milk decreased the levels of oxidative products when medicinal iron or human milk fortifier was present. We speculate that the presence of greater concentration of iron and the absence of lactoferrin in formula compared with human milk results in greater in vitro generation of free radicals and lipid peroxidation products. Whether iron-containing formula with lactoferrin administered enterally to preterm infants will result in less free radical generation in vivo has yet to be established.

Apoproteins↗

PubMed2002

Scientific review of the Welfare Food Scheme.

INTRODUCTION: The COMA Panel on Maternal and Child Nutrition has undertaken the first scientific review of the Welfare Food Scheme since its inception in 1940. It has: reviewed current dietary recommendations, identified from national data, population groups vulnerable to adverse nutritional outcomes, evaluated the contribution of the current scheme to prevention of these vulnerabilities and identified further information needs and highlighted improvements likely to be cost neutral. HISTORY AND ENTITLEMENT: Originally the Scheme incorporated universal provision. Subsequently it was targeted at the most socio-economically vulnerable. Today, a quarter of children under five are beneficiaries by virtue of their family's income. The Scheme has two principal beneficiary groups: pregnant women, mothers and young chidren in families eligible for certain social security benefits. With the exception of children under one year of age, all are entitled to a pint of milk a day (using redeemable milk tokens) and free vitamin supplements (available from designated clinics). Infant formula instead of milk is available for infants who are not breastfed. children under five years attending Scheme-registered day care facilities can receive one third of a pint of milk a day. Children aged 5-16 years not registered at school by virtue of mental or physical disability are entitled to a pint of milk a day. CURRENT DIET AND VULNERABLE GROUPS: The following adverse nutritional outcomes were considered: pregnant women and mothers low uptake of periconceptional folic acid supplements low dietary intake during pregnancy vitamin D deficiency.

Adolescent↗