1
|
Velez-León E, Pacheco-Quito EM, Díaz-Dosque M, Tobar-Almache D. Worldwide Variations in Fluoride Content in Beverages for Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1896. [PMID: 38136098 PMCID: PMC10741400 DOI: 10.3390/children10121896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
In situations where breastfeeding is impractical, milk formulas have emerged as the primary choice for infant nutrition. Numerous global studies have scrutinized the fluoride content in these formulas, uncovering fluctuations in fluoride levels directly associated with the method of preparation. This variability poses a potential risk of elevated fluoride concentrations and, consequently, an increased susceptibility to dental fluorosis in infants. The primary objective of this review is to intricately delineate the fluoride content in dairy formulas and emphasize the variability of these values concerning their reconstitution process. The review's findings reveal that, among the 17 studies assessing fluoride levels in infant formula, milk-based formulas exhibit a range of 0.01-0.92 ppm, with only two studies exceeding 1.30 ppm. Conversely, soy-based formulas demonstrate values ranging from 0.13-1.11 ppm. In conclusion, the observed variability in fluoride levels in infant formulas is ascribed to the choice of the water source employed in the preparation process. This underscores the paramount importance of meticulously adhering to recommendations and guidelines provided by healthcare professionals concerning the utilization of these formulas and their meticulous reconstitution.
Collapse
Affiliation(s)
- Eleonor Velez-León
- Unidad Académica de Salud y Bienestar, Facultad de Odontología, Universidad Católica de Cuenca, Cuenca 010105, Ecuador;
- Grupo de Investigación Innovación y Desarrollo Farmacéutico en Odontología, Facultad de Odontología, Jefatura de Investigación e Innovación, Universidad Católica de Cuenca, Cuenca 010105, Ecuador
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
| | - Edisson-Mauricio Pacheco-Quito
- Unidad Académica de Salud y Bienestar, Facultad de Odontología, Universidad Católica de Cuenca, Cuenca 010105, Ecuador;
- Grupo de Investigación Innovación y Desarrollo Farmacéutico en Odontología, Facultad de Odontología, Jefatura de Investigación e Innovación, Universidad Católica de Cuenca, Cuenca 010105, Ecuador
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
| | - Mario Díaz-Dosque
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
- Laboratory of Pharmacology, Institute for Research in Dental Sciences (ICOD), Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380544, Chile
| | - Daniela Tobar-Almache
- Latin American Network of Research on Fluorides and Dental Fluorosis, Cartagena 130009, Colombia; (M.D.-D.); (D.T.-A.)
- Laboratory of Pharmacology, Institute for Research in Dental Sciences (ICOD), Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380544, Chile
| |
Collapse
|
2
|
Satti AS, Muppa R, Kotha RS, Koya S, Kantipudi MJN, Harika CDS. A comparative evaluation of the fluoride content in commercially available infant formulae in India: An in vitro study. J Indian Soc Pedod Prev Dent 2023; 41:328-334. [PMID: 38235820 DOI: 10.4103/jisppd.jisppd_462_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024] Open
Abstract
CONTEXT The most critical period for enamel fluorosis to develop is during the early years of life when enamel formation occurs. To minimize the risk of dental fluorosis development, monitoring fluoride intake during teeth development has been suggested. As infant formulae are major source of nutrition in infants, it is important to determine the fluoride content in them in order to monitor the fluoride intake in infants. AIMS To estimate and comparatively evaluate the fluoride content in different commercially available infant formulae in India. METHODOLOGY A total of 16 commercially available infant formulae were collected from local pharma/grocery stores, in which 14 were milk based (Group M) and 2 were soy based (Group S). Fluoride content of the formulae was evaluated using ORION F selective electrode. STATISTICAL ANALYSIS USED ANOVA test, t-test. RESULTS The mean F values for groups M and S were found to be 0.031 and 0.07 ppm, respectively. Fluoride content of milk-based formulae was significantly lesser (P < 0.001) than soy-based formulae. Daily fluoride intake through the tested formulae was in the range of 0.013 mg and 0.105 mg when calculated following the manufacturer's preparation guidelines. CONCLUSIONS Infant formulae alone were unlikely to be a risk factor for dental fluorosis, but when reconstituted with optimally fluoridated water, they can be a risk factor for the development of dental fluorosis.
Collapse
Affiliation(s)
- Asha Supriya Satti
- Department of Pediatrics and Preventive Dentistry, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Radhika Muppa
- Department of Pediatrics and Preventive Dentistry, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Krishna, Andhra Pradesh, India
| | - Ravichandra Sekhar Kotha
- Department of Pediatrics and Preventive Dentistry, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Krishna, Andhra Pradesh, India
| | - Srikanth Koya
- Department of Pediatrics and Preventive Dentistry, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Krishna, Andhra Pradesh, India
| | - Mrudhula J N Kantipudi
- Department of Pediatrics and Preventive Dentistry, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Krishna, Andhra Pradesh, India
| | - Ch Deepthi Siva Harika
- Department of Pediatrics and Preventive Dentistry, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Krishna, Andhra Pradesh, India
| |
Collapse
|
3
|
An Analytical Protocol for the Differentiation and the Potentiometric Determination of Fluorine-Containing Fractions in Bovine Milk. Molecules 2023; 28:molecules28031349. [PMID: 36771020 PMCID: PMC9921670 DOI: 10.3390/molecules28031349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
Free fluoride ions are effective in combating caries in children, and their supplementation in milk has been widely used worldwide for this purpose. Furthermore, it is known that ionic fluoride added to milk is distributed among its components, but little is known about their quantitative relationships. This is likely due to the absence of an analytical protocol aimed at differentiating and quantifying the most important forms of fluorine present in milk. For the first time, a comprehensive protocol made up of six potentiometric methods devoted to quantifying the most important fractions of fluorine in milk (i.e., the free inorganic fluoride, the inorganic bonded fluorine, the caseins-bonded fluorine, the whey-bonded fluorine, the lipid-bonded fluorine, and the total fluorine) has been developed and tested on real samples. Four of the six methods of the procedure are original, and all have been validated in terms of limit of detection and quantification, precision, and trueness. The data obtained show that 9% of all fluorine was in ionic form, while 66.3% of total fluorine was bound to proteins and lipids, therefore unavailable for human absorption. Beyond applications in dental research, this protocol could be extended also to other foods, or used in environmental monitoring.
Collapse
|
4
|
Mohd Nor NA, Chadwick BL, Farnell DJJ, Chestnutt IG. Factors associated with dental fluorosis among Malaysian children exposed to different fluoride concentrations in the public water supply. J Public Health Dent 2021; 81:270-279. [PMID: 33634490 DOI: 10.1111/jphd.12448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 01/17/2021] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the prevalence of dental fluorosis, and factors associated with its occurrence in two cohorts of children exposed to different fluoride concentrations in the Malaysian water supply. METHODS A cross-sectional study was conducted among lifelong residents (n = 1,155) aged 9 and 12 years old living in fluoridated and nonfluoridated areas. Malaysian children aged 12 years were born when the level of fluoride in the public water supply was 0.7 ppm while those aged 9 years were born after the level was reduced to 0.5 ppm. Fluorosis was blind scored using standardized photographs of maxillary central incisors using Dean's criteria. Fluoride exposures and other factors were assessed by parental questionnaire. Data were analyzed using descriptive statistics, Chi-squared analyses, and logistic regression. RESULTS Fluorosis prevalence was lower (31.9 percent) among the younger children born after the reduction of fluoride concentration in the water, compared to a prevalence of 38.4 percent in the older cohort. Early tooth brushing practices and fluoridated toothpaste were not statistically associated with fluorosis status. However, the prevalence of fluorosis was significantly associated with parents' education level, parents' income, fluoridated water, type of infant feeding method, age breast feeding ceased, use of formula milk, duration of formula milk intake, and type of water used to reconstitute formula milk via simple logistic regression. Fluoridated water remained a significant risk factor for fluorosis in multiple logistic regression. CONCLUSIONS Fluorosis was lower among children born after the adjustment of fluoride concentration in the water. Fluoridated water remained as a strong risk factor for fluorosis after downward adjustment of its fluoride concentration.
Collapse
Affiliation(s)
- Nor Azlida Mohd Nor
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Barbara L Chadwick
- Department of Applied Clinical Research and Dental Public Health, Cardiff University School of Dentistry, Cardiff, UK
| | - Damian J J Farnell
- Department of Applied Clinical Research and Dental Public Health, Cardiff University School of Dentistry, Cardiff, UK
| | - Ivor G Chestnutt
- Department of Applied Clinical Research and Dental Public Health, Cardiff University School of Dentistry, Cardiff, UK
| |
Collapse
|
5
|
Nagata ME, Delbem ACB, Kondo KY, de Castro LP, Hall KB, Percinoto C, Aguiar SMHCÁ, Pessan JP. Fluoride concentrations of milk, infant formulae, and soy-based products commercially available in Brazil. J Public Health Dent 2016; 76:129-35. [PMID: 26449642 DOI: 10.1111/jphd.12121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 08/30/2015] [Indexed: 12/07/2022]
Abstract
OBJECTIVES To assess the fluoride (F) content in commercially available milk formulae in Brazil and to estimate the F intake in children from this source in the first year of life. METHODS Samples of cow's milk (n = 51), infant formulae (n = 15), powdered milk (n = 13), and soy-based products (n = 4) purchased in Araçatuba (Brazil) had their F content measured using an ion-specific electrode, after hexamethyldisiloxane-facilitated diffusion. Powdered milk and infant formulae were reconstituted with deionized water, while ready-to-drink products were analyzed without any dilution. Using average infant body masses and suggested volumes of formula consumption for infants 1-12 months of age, possible F ingestion per body mass was estimated. Data were analyzed by descriptive analysis. RESULTS Mean F content ranged from 0.02 to 2.52 mg/L in all samples. None of the cow's milk provided F intake higher than 0.07 mg/kg. However, two infant formulae, one powdered milk, and one soy-milk led to a daily F intake above the suggested threshold for fluorosis when reconstituted with deionized water. Assuming reconstitution of products with tap water at 0.7 ppm F, two infant formulae, five powdered milk, and four soymilks led to daily F intake ranging from 0.108 to 0.851 mg/kg. CONCLUSIONS The results suggest that the consumption of some brands of infant formulae, powdered milk, and soy-based milk in the first year of age could increase the risk of dental fluorosis, reinforcing the need for periodic surveillance of the F content of foods and beverages typically consumed by young children.
Collapse
Affiliation(s)
- Mariana Emi Nagata
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | - Karina Yuri Kondo
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | - Luciene Pereira de Castro
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | - Kevin Bruce Hall
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | - Célio Percinoto
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| | | | - Juliano Pelim Pessan
- Department of Pediatric Dentistry and Public Health, Araçatuba Dental School, Univ. Estadual Paulista (UNESP), Araçatuba, SP, Brazil
| |
Collapse
|
6
|
Molska A, Gutowska I, Baranowska-Bosiacka I, Noceń I, Chlubek D. The content of elements in infant formulas and drinks against mineral requirements of children. Biol Trace Elem Res 2014; 158:422-7. [PMID: 24706326 PMCID: PMC4012161 DOI: 10.1007/s12011-014-9947-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 03/17/2014] [Indexed: 11/26/2022]
Abstract
The present study aimed at analysing the content of fluorine (F), calcium (Ca), magnesium (Mg), iron (Fe) and zinc (Zn) in the drinks for children and infant formulas, a popular supplement or substitute for breast milk produced from cow milk on an industrial scale. Ca, Mg, Zn and Fe concentrations were determined using atomic absorption spectrophotometer, while F levels using a potentiometric method. F levels in the examined formula samples increased with the intended age range, until the intended age of 1 year, and then decreased. A lower content of Ca, Mg and Zn was observed in formulas intended for children <1 year of age and higher for older children. Fe content increased with the age range. A statistically significant higher content of Ca, Mg, Zn and Fe in samples intended for children with phenylketonuria in comparison to those intended for healthy children or children with food allergies was noted. The content of the analysed elements in juices and nectars showed the highest contents in products intended for infants (under 6 months of age). The lowest levels of elements tested were found in drinks for children over 6 months of age. In conclusion, the concentrations of the examined elements in infant formulas and juices for children were decidedly greater than the standards for the individual age groups. Although the absorption of these elements from artificial products is far lower than from breast milk, there is still the fear of consequences of excessive concentrations of these minerals.
Collapse
Affiliation(s)
- A. Molska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Broniewskiego Str. 24, 71-460 Szczecin, Poland
| | - I. Gutowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Broniewskiego Str. 24, 71-460 Szczecin, Poland
| | - I. Baranowska-Bosiacka
- Department of Biochemistry, Pomeranian Medical University, Powstańców Wlkp. av. 72, 70-111 Szczecin, Poland
| | - I. Noceń
- Department of Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. av. 72, 70-111 Szczecin, Poland
| | - D. Chlubek
- Department of Biochemistry, Pomeranian Medical University, Powstańców Wlkp. av. 72, 70-111 Szczecin, Poland
| |
Collapse
|