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Nik Azmi NNA, Tan TC, Ang MY, Leong YH. Occurrence and risk assessment of 3-monochloropropanediols esters (3-MCPDE), 2-monochloropropanediol esters (2-MCPDE), and glycidyl esters (GE) in commercial infant formula samples from Malaysia. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2023; 40:212-221. [PMID: 36602442 DOI: 10.1080/19440049.2022.2163054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The presence of 3-monochloropropanediol esters (3-MCPDE), 2-monochloropropanediol esters (2-MCPDE) and glycidyl esters (GE) in infant formula products has raised serious concerns. They incorporate vegetable oils, particularly palm-based oils, which are well-known to contain large amounts of these process contaminants. An analysis was conducted on infant formula samples (n = 16) obtained from the Malaysian market to determine the levels of 3-MCPDE, 2-MCPDE and GE using gas chromatography-mass spectrometry (GC-MS). The method was validated, with a limit of quantification (LOQ) on instrument of 0.10 µg/g for all analytes. The median concentrations of 3-MCPDE, 2-MCPDE and GE in infant formula in this study were 0.008 µg/g, 0.003 µg/g and 0.002 µg/g respectively. The estimated dietary intakes calculated from consumption of infant formula show higher exposures to infants within the age group of 0 to 5 months, highest for GE (1.61 µg/kg bw/day), followed by 3-MCPDE (0.68 µg/kg bw/day) and 2-MCPDE (0.41 µg/kg bw/day) compared to the age group of 6 to 12 months. Only one sample, relating to GE exposure is a potential risk for both age groups with MOE value below 25,000.
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Affiliation(s)
| | - Thuan-Chew Tan
- Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia, Penang, Malaysia.,Renewable Biomass Transformation Cluster, School of Industrial Technology, Universiti Sains Malaysia, Penang, Malaysia
| | - May Yen Ang
- Shimadzu Malaysia Sdn Bhd, Kota Damansara, Selangor, Malaysia
| | - Yin-Hui Leong
- National Poison Centre, Universiti Sains Malaysia, Penang, Malaysia
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Hussain M, Sun Y, Pan Y, Liu L, Zhang X, Wang Q, Shuang L, Qayum A, Hussain K, Li X. Formulation, invitro digestive study, and comparative fatty acid analysis of walnut oil-based infant formula, with human milk, animal milk, and commercial infant formula. INNOV FOOD SCI EMERG 2023. [DOI: 10.1016/j.ifset.2023.103279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Shertukde SP, Cahoon DS, Prado B, Cara KC, Chung M. Calcium Intake and Metabolism in Infants and Young Children: A Systematic Review of Balance Studies for Supporting the Development of Calcium Requirements. Adv Nutr 2022; 13:1529-1553. [PMID: 35038320 PMCID: PMC9526821 DOI: 10.1093/advances/nmac003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/16/2021] [Accepted: 01/10/2022] [Indexed: 01/28/2023] Open
Abstract
Determining calcium requirements for infants and children is vital due to high calcium needs for growth. Balance studies enable comprehensive measurement of calcium metabolism and can support nutrient requirement development. This systematic review summarizes evidence from mass balance and isotopic studies in children aged 0-4 y to address key questions on calcium loss and absorption/retention identified by an expert group developing calcium requirements. Literature searches were implemented in multiple electronic databases to June 2020. Balance studies assessing calcium intake, loss, absorption, or retention in healthy children were eligible. A newly developed risk-of-bias assessment tool was used for balance studies, and a modified Grades of Recommendation, Assessment, Development, and Evaluation approach determined strength of evidence. Altogether, 23 studies (15 mass balance; 8 isotope) with 485 total participants were included. Only 3 studies were of children >6 mo. Mass balance studies suggested infant feed components may influence calcium balance. The random-effects model meta-regression on 42 mass balance study arms showed an average net calcium retention of 40.4% among infants aged 0-6 mo (β = 0.404 [95% CI: 0.302, 0.506]). Isotope studies suggested calcium intake of 240 to 400 mg/d may promote optimal calcium absorption with minimal loss, and intake from human milk may lead to greater absorption and retention efficacy than formula or solid foods. Most studies had low risk of bias. Strength of evidence was low due to variability in infant feedings, limited endogenous and dermal calcium loss measures, and few studies isolating calcium effects. To improve certainty of the body of evidence, more balance studies isolating effects of calcium intake in this age group are needed. Future work on calcium needs should incorporate both balance measures and biological endpoints of importance (e.g. bone mineral density or content) to determine adequate calcium intake for growth in infants and children.
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Affiliation(s)
- Shruti P Shertukde
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA,Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA
| | - Danielle S Cahoon
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA,Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA
| | - Belen Prado
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kelly Copeland Cara
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA,Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, USA
| | - Mei Chung
- Address correspondence to MC (e-mail: )
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Smith ME, Cisbani G, Lacombe RJS, Bazinet RP. A Scoping Review of Clinical Studies in Infants Fed Formulas Containing Palm Oil or Palm Olein and Sn-2 Palmitate. J Nutr 2021; 151:2997-3035. [PMID: 34510181 PMCID: PMC8485903 DOI: 10.1093/jn/nxab246] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/14/2021] [Accepted: 06/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Palmitic acid (PA; 16:0) is added to infant formula in the form of palm oil/palm olein (PO/POL) and stereospecific numbered-2 palmitate (SN2). Several studies have examined the effects of PO/POL and or SN2 in formulas on health outcomes, mainly growth, digestion, and absorption of nutrients. However, the roles of PA, PO/POL, and SN2 on neurodevelopment remains unknown. OBJECTIVES The objective of this scoping review was to map out studies in infants fed formula with PO/POL or SN2 to identify current knowledge on the role of PA in infant nutrition, specifically neurodevelopment. METHODS Data sources, including Medline, Embase, CAB Abstracts, and the Cochrane Database, were searched. Eligible articles were randomized controlled trials (RCTs) and observational studies examining outcomes in term singleton infants fed formula containing PO/POL or SN2. Studies examining preterm infants or infants with infections, mixed-feeding interventions, or outcomes not concerned with PO/POL or SN2 were excluded. Screening and data extraction were performed by 2 independent reviewers, and results were charted into 10 outcome categories. RESULTS We identified 28 RCTs and 2 observational studies. Only 1 RCT examined a neurodevelopmental outcome, reporting infants fed SN2 formula had higher fine motor skill scores compared to those fed a vegetable oil formula with a lower amount of SN2; however, only after adjustment for maternal education and at an earlier, but not a later time point. Anthropometric measures do not appear to be influenced by PO/POL or SN2 within formulas. Alternatively, it was reported that infants fed PO/POL within formulas had a decreased absorption of calcium, total fat, and PA compared to those fed vegetable oil formulas. However, studies were heterogenous, making it difficult to isolate the effects of PO/POL or SN2 in formulas. CONCLUSIONS Our review reiterates the need for future studies to address the effects of PO/POL and SN2 on neurodevelopment in infants. This study is registered at Open Science Framework as osf.io/697he.
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Affiliation(s)
- Mackenzie E Smith
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Giulia Cisbani
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - R J Scott Lacombe
- Department of Pediatrics, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Padial-Jaudenes M, Castanys-Munoz E, Ramirez M, Lasekan J. Physiological Impact of Palm Olein or Palm Oil in Infant Formulas: A Review of Clinical Evidence. Nutrients 2020; 12:nu12123676. [PMID: 33260586 PMCID: PMC7759907 DOI: 10.3390/nu12123676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 01/17/2023] Open
Abstract
Palm oil/olein (PO/POL) is used in infant formulas to imitate the fatty acid profile of human milk (HM) and achieve similar levels of palmitic acid (PA). However, the positions of fatty acids on the triacylglyceride differ between PO/POL and HM, which affect fat absorption and produce unintended physiological consequences. Recent papers have reviewed evidence for physiological benefits of PO/POL and beta-palmitate (sn-2-palmitate) in infant formulas. The aim of the present review is to supplement the assessment of available clinical evidence on the physiological effects of PO/POL formulas in healthy infants. We intend to focus on PO/POL and not on sn-2-palmitate, since the latter was recently extensively reviewed. Clinical evidence supports that PO/POL in infant formulas leads to a lower fat, DHA, palmitate and calcium absorption, and bone mineralization; soft stools; and growth (weight accretion) compared to formulas without PO/POL. Consequently, it seems prudent to be considerate and cautious when adding PO/POL to infant formulas. While HM is the gold standard for infant nutrition, the development of infant formula should be based on achieving positive physiological outcomes, rather than just replicating HM nutrient composition.
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Affiliation(s)
- Maria Padial-Jaudenes
- Abbott Nutrition R&D, Granada University Science Park, 18016 Granada, Spain; (M.P.-J.); (E.C.-M.)
| | - Esther Castanys-Munoz
- Abbott Nutrition R&D, Granada University Science Park, 18016 Granada, Spain; (M.P.-J.); (E.C.-M.)
| | - Maria Ramirez
- Abbott Nutrition R&D, Abbott Laboratories, 18004 Granada, Spain;
| | - John Lasekan
- Scientific & Medical Affairs, Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA
- Correspondence: ; Tel.: +1-011-614-624-3822
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Variation in Infant Formula Macronutrient Ingredients Is Associated with Infant Anthropometrics. Nutrients 2020; 12:nu12113465. [PMID: 33198077 PMCID: PMC7698212 DOI: 10.3390/nu12113465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background: There is wide variation in the macronutrient ingredient base of infant formula. How variation in macronutrient ingredients may impact infant growth remains largely unknown. Methods: The 2015–2016 National Health and Nutrition Examination Survey (NHANES) dataset was utilized, including infant anthropometrics and dietary intake. The protein, fat, and carbohydrate sources of formulas consumed were assembled and considered as potential predictors in multivariable models of infant Z-scores among infants < 6 months, 6–12 months and all infants combined (0–12 months). Results: The following relationships represent ingredient covariates within the final multivariable models of infant Z-scores. Consuming formula with palm oil was associated with higher weight-for-length Z-scores among infants < 6 months, but lower weight-for-age and weight-for-length Z-scores among infants 6–12 months. Consuming soy-protein formulas was associated with lower weight-for-length, head circumference-for-age and abdominal circumference-for-age Z-scores among infants < 6 months. Consuming sucrose-containing formula was associated with higher weight-for-length and abdominal circumference-for-age Z-score among infants 0–12 months. Conclusions: These data provide proof-of-concept that all formulas are not the same. Variation in macronutrient ingredients within the standard formula category is associated with differences in infant anthropometric outcomes. Long-term and mechanistic studies are warranted to pursue these findings; especially for palm oil, soy protein, and sucrose.
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MELO CWBD, Bandeira MDJ, MACIEL LF, BISPO EDS, SOUZA COD, SOARES SE. Chemical composition and fatty acids profile of chocolates produced with different cocoa (Theobroma cacao L.) cultivars. FOOD SCIENCE AND TECHNOLOGY 2020. [DOI: 10.1590/fst.43018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Human Milk Omega-3 Fatty Acid Composition is Associated with Infant Temperament. Nutrients 2019; 11:nu11122964. [PMID: 31817237 PMCID: PMC6949911 DOI: 10.3390/nu11122964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/21/2019] [Accepted: 11/27/2019] [Indexed: 01/31/2023] Open
Abstract
There is growing evidence that omega-3 (n-3) polyunsaturated fatty-acids (PUFAs) are important for the brain development in childhood and are necessary for an optimal health in adults. However, there have been no studies examining how the n-3 PUFA composition of human milk influences infant behavior or temperament. To fill this knowledge gap, 52 breastfeeding mothers provided milk samples at 3 months postpartum and completed the Infant Behavior Questionnaire (IBQ-R), a widely used parent-report measure of infant temperament. Milk was assessed for n-3 PUFAs and omega-6 (n-6) PUFAs using gas-liquid chromatography. The total fat and the ratio of n-6/n-3 fatty acids in milk were also examined. Linear regression models revealed that infants whose mothers' milk was richer in n-3 PUFAs had lower scores on the negative affectivity domain of the IBQ-R, a component of temperament associated with a risk for internalizing disorders later in life. These associations remained statistically significant after considering covariates, including maternal age, marital status, and infant birth weight. The n-6 PUFAs, n-6/n-3 ratio, and total fat of milk were not associated with infant temperament. These results suggest that mothers may have the ability to shape the behavior of their offspring by adjusting the n-3 PUFA composition of their milk.
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Bronsky J, Campoy C, Embleton N, Fewtrell M, Mis NF, Gerasimidis K, Hojsak I, Hulst J, Indrio F, Lapillonne A, Molgaard C, Moltu SJ, Verduci E, Vora R, Domellöf M. Palm Oil and Beta-palmitate in Infant Formula: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2019; 68:742-760. [PMID: 31022096 DOI: 10.1097/mpg.0000000000002307] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Palm oil (PO) is used in infant formulas in order to achieve palmitic acid (PA) levels similar to those in human milk. PA in PO is esterified predominantly at the SN-1,3 position of triacylglycerol (TAG), and infant formulas are now available in which a greater proportion of PA is in the SN-2 position (typical configuration in human milk). As there are some concerns about the use of PO, we aimed to review literature on health effects of PO and SN-2-palmitate in infant formulas. METHODS PubMed and Cochrane Database of Systematic Reviews were systematically searched for relevant studies on possible beneficial effects or harms of either PO or SN-2-palmitate in infant formula on various health outcomes. RESULTS We identified 12 relevant studies using PO and 21 studies using SN-2-palmitate. Published studies have variable methodology, subject characteristics, and some are underpowered for the key outcomes. PO is associated with harder stools and SN-2-palmitate use may lead to softer stool consistency. Bone effects seem to be short-lasting. For some outcomes (infant colic, faecal microbiota, lipid metabolism), the number of studies is very limited and summary evidence inconclusive. Growth of infants is not influenced. There are no studies published on the effect on markers of later diseases. CONCLUSIONS There is insufficient evidence to suggest that PO should be avoided as a source of fat in infant formulas for health reasons. Inclusion of high SN-2-palmitate fat blend in infant formulas may have short-term effects on stool consistency but cannot be considered essential.
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Affiliation(s)
- Jiri Bronsky
- Department of Paediatrics, University Hospital Motol, Prague, Czech Republic
| | | | - Nicholas Embleton
- Newcastle Neonatal Service, Newcastle Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Mary Fewtrell
- Childhood Nutrition Research Centre, UCL GOS Institute of Child Health, London, UK
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital, University Medical Centre Ljubljana, Slovenia
| | - Konstantinos Gerasimidis
- Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Glasgow, UK
| | - Iva Hojsak
- Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jessie Hulst
- Department of Paediatric Gastroenterology, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Flavia Indrio
- Ospedale Pediatrico Giovanni XXIII University of Bari, Bari, Italy
| | - Alexandre Lapillonne
- Paris Descartes University, APHP Necker-Enfants Malades hospital, Paris, France.,CNRC, Baylor College of Medicine, Houston, Texas
| | - Christian Molgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen.,Pediatric Nutrition Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, Department of Health Sciences, University of Milan, Milan, Italy
| | - Rakesh Vora
- Leeds teaching hospitals NHS trust, Leeds, UK
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
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