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Purkiewicz A, Pietrzak-Fiećko R. Changes in the Fatty Acid Profile of Lactating Women Living in Poland-A Comparison with the Fatty Acid Profile of Selected Infant Formulas. Nutrients 2024; 16:2411. [PMID: 39125292 PMCID: PMC11314165 DOI: 10.3390/nu16152411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
The present study examined the fatty acid content of human milk from Polish women living in the Warmia and Mazury region with regard to different lactation periods and compared it with the fatty acid content of selected infant formulas. The analysis included samples of breast milk-colostrum (n = 21), transitional milk (n = 26), and mature milk (n = 22). Fat was extracted using the Rose-Gottlieb method, and the fatty acid profile was determined by gas chromatography with a flame ionization detector (FID). The proportion of SFAs (saturated fatty acids) > MUFAs (monounsaturated fatty acids) > PUFAs (polyunsaturated fatty acids) was determined in each fraction of breast milk and infant formula. Palmitic, oleic, and linoleic acids predominated in breast milk and infant formulas. Colostrum contained lower contents of selected SFAs (caprylic, capric, lauric) and higher contents of selected MUFAs (ercucic) and PUFAs (arachidonic and docosahexaenoic) (p < 0.05) relative to transitional and mature milk. Infant formulas were distinguished from human milk in terms of their SFA (caproic, caprylic, lauric, arachidic), MUFA (oleic), and PUFA (linoleic, α-linoleic) content. It should be noted that infant formulas contained significantly lower trans fatty acid (TFA) content-more than thirty-six and more than nineteen times lower than in human milk. Furthermore, human milk contained branched-chain fatty acids (BCFAs) at 0.23-0.28%, while infant formulas contained only trace amounts of these acids. The average ratio of n-6 to n-3 fatty acids for human milk was 6.59:1 and was close to the worldwide ratio of 6.53 ± 1.72:1. Both principal component analysis (PCA) and cluster analysis (CA) indicated significant differences in the fatty acid profile relative to lactation and a different profile of infant formulas relative to breast milk.
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Affiliation(s)
- Aleksandra Purkiewicz
- Department of Commodity Science and Food Analysis, Faculty of Food Science, University of Warmia and Mazury, Plac Cieszyński 1, 10-718 Olsztyn, Poland;
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Cavalcanti MB, Silva IDCGD, Lamarca F, de Castro IRR. Research on commercial milk formulas for young children: A scoping review. MATERNAL & CHILD NUTRITION 2024:e13675. [PMID: 38956436 DOI: 10.1111/mcn.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 07/04/2024]
Abstract
A scoping review of publications about commercial milk formulas intended for or consumed by children 12-36 months (CMF 12-36) was conducted. This review aimed to comprehensively map the existing literature, identify key concepts in the field and understand its evolution through time. A total of 3329 articles were screened and 220 were included, published between 1986 and 2024. Most works were published after 2016 (70.0%) and in high-income countries (71.8%). Original studies were the vast majority (81.8%) of publications. Most publications dealt with feeding practices or analysed the composition and/or contamination of specific products (44.1% and 35.9%), but since the late 2000s, publications about marketing, policy, legislation, and consumer perception started to appear. Most published works (65.5%) did not focus exclusively on CMF 12-36 and included formulas for other demographics or other foods. About half of the works (55.5%) did not consider CMF 12-36 to be a breast milk substitute. We found 81 distinct product denominations used to refer to CMF 12-36, Growing Up Milk was the most common (25.9%). CMF industry was involved in 41.8% of all analysed works, and industry participation and funding were not always clearly informed (22.5% lacked a conflict of interest statement, and 25.5% did not present any information about funding). In the last decade, publications about CMF 12-36 have increased in volume and diversified in scope and subject matter. CMF-industry participation has always been and still is present in the field, so possible vested interests should be taken into account when appreciating the literature.
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Affiliation(s)
| | | | - Fernando Lamarca
- Department of Applied Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Cheng X, Jiang C, Jin J, Jin Q, Akoh CC, Wei W, Wang X. Medium- and Long-Chain Triacylglycerol: Preparation, Health Benefits, and Food Utilization. Annu Rev Food Sci Technol 2024; 15:381-408. [PMID: 38237045 DOI: 10.1146/annurev-food-072023-034539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Medium- and long-chain triacylglycerol (MLCT) is a structured lipid with both medium- and long-chain fatty acids in one triacylglycerol molecule. Compared with long-chain triacylglycerol (LCT), which is mainly present in common edible oils, and the physical blend of medium-chain triacylglycerol with LCT (MCT/LCT), MLCT has different physicochemical properties, metabolic characteristics, and nutritional values. In this article, the recent advances in the use of MLCT in food formulations are reviewed. The natural sources and preparation of MLCT are discussed. A comprehensive summary of MLCT digestion, absorption, transport, and oxidation is provided as well as its health benefits, including reducing the risk of overweight, hypolipidemic and hypoglycemic effects, etc. The potential MLCT uses in food formulations, such as infant formulas, healthy foods for weight loss, and sports foods, are summarized. Finally, the current safety assessment and regulatory status of MLCT in food formulations are reviewed.
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Affiliation(s)
- Xinyi Cheng
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Chenyu Jiang
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Jun Jin
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Qingzhe Jin
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Casimir C Akoh
- Department of Food Science and Technology, University of Georgia, Athens, Georgia, USA
| | - Wei Wei
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Xingguo Wang
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, China; ,
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, China
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Kantaras P, Kokkinopoulou A, Hageman JHJ, Hassapidou M, Androutsos O, Kanaki M, Bovee-Oudenhoven I, Karaglani E, Kontochristopoulou AM, Bos R, Manios Y. Growth and gut comfort of healthy term infants exclusively fed with a partially hydrolysed protein-based infant formula: a randomized controlled double-blind trial. Front Pediatr 2024; 12:1328709. [PMID: 38827219 PMCID: PMC11141394 DOI: 10.3389/fped.2024.1328709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Objective This study aimed to investigate growth and gut comfort of healthy infants fed with a partially hydrolysed cow's milk protein-based infant formula (pHF) compared to a standard intact cow's milk protein-based formula (IPF). Methods A double-blind, multi-center, randomized, controlled trial was performed. Healthy full-term, exclusively formula-fed infants (n = 345), aged ≤28 days were allocated to consume either a pHF (n = 173) or an IPF (n = 172) until the age of 17 weeks. The primary outcome was equivalence of weight gain (g/d) until the age of 17 weeks. The secondary outcomes were equivalence of other growth parameters, i.e., infants' weight, length, head circumference, body mass index (BMI) and anthropometric Z-scores, while tertiary outcomes were gut comfort, formula intake, and adverse events (AEs). Results Overall, 288 infants completed the study (pHF group: 138, IPF group: 150). No differences were observed between the two groups in weight gain (g/d) during the three-months intervention [p = 0.915 for the Per Protocol (PP) population]. The 90% CI was [-1.252 to 1.100] being within the pre-defined equivalence margin of ±3.0 g/d. Similar findings were observed in the Full Analysis Set (FAS) and the sensitivity analysis. Regarding the secondary outcomes, no differences over the intervention period were shown between the two groups in both the PP and FAS analysis sets. Average Z-scores were in the normal range based on World Health Organization (WHO) growth standards for both groups at all time points in both analysis sets. Stool consistency, amount, and colour were different in the two groups. No differences were observed in gut comfort, stool frequency, and formula intake, between the two groups. In total 14 AEs and 22 serious adverse events (SAEs) were reported of which 15 (12%) and 1 (5%) were considered as (possibly) related to the study product, respectively. Conclusions The study demonstrates that the consumption of pHF results in adequate infant growth, equivalent to that of infants consuming IPF. Furthermore, the overall gut comfort was comparable between the two groups. Therefore, it can be concluded that the pHF is safe for and well tolerated by healthy infants. Clinical Trial Registration https://clinicaltrials.gov/study/NCT05757323?id=NCT05757323&rank=1, identifier (NCT05757323).
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Affiliation(s)
- Paris Kantaras
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Anna Kokkinopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | | | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Odysseas Androutsos
- Lab of Clinical Nutrition-Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Maria Kanaki
- Lab of Clinical Nutrition-Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | - Rolf Bos
- FrieslandCampina, Amersfoort, Netherlands
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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TSUBOI M, TERAHARA M, NAGATA M, KATSUMATA T, ISHII T, KATO M, NAKAMURA Y. Safety evaluation of a heat-treated Bifidobacterium bifidum OLB6378 concentrate. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2023; 43:81-91. [PMID: 38188656 PMCID: PMC10767320 DOI: 10.12938/bmfh.2023-044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/11/2023] [Indexed: 01/09/2024]
Abstract
Several bacterial strains, including probiotic strains, have undergone evaluations for their safety and potential beneficial health effects. Some of these strains have been introduced into various markets, including that for infant products. However, certain probiotic strains have been linked to serious infections in infants, such as septicemia and meningitis. Given this, it is crucial to assess the safety of each probiotic strain, including those of Bifidobacterium, which is a common genus of probiotics. One such strain, Bifidobacterium bifidum OLB6378 (NITE BP-31), referred to as OLB6378 hereafter, has been selected for use in infants. To determine its genotoxicity and general toxicity potential, a heat-treated OLB6378 concentrate was subjected to various tests, including the bacterial reverse mutation test, in vitro chromosome aberration test, in vivo micronucleus test, and single- and 90-day oral gavage toxicity studies in rats. No significant differences were observed compared with negative controls in any of genotoxicity tests. The single-dose toxicity study employed dose levels of 560, 1,693, and 5,092 mg/kg, representing the total solid contents of culture concentrates containing OLB6378 (equivalent to 8.1 × 1011, 2.4 × 1012, and 7.4 × 1012 cells/kg of Bifidobacterium, respectively). In the 90-day toxicity study, dose levels of 280, 853, and 2,546 mg/kg/day were used (equivalent to 4.0 × 1011, 1.2 × 1012, and 3.7 × 1012 cells/kg/day, respectively). Importantly, the heat-treated OLB6378 concentrate did not induce any signs of toxicity in any of the conducted toxicity studies. In conclusion, the heat-treated OLB6378 concentrate exhibited no genotoxicity potential, and the no-observed-adverse-effect level in the 90-day toxicity study was determined to be 2,546 mg/kg/day (equivalent to 3.7 × 1012 cells/kg/day). This suggests that heat-treated OLB6378 can be safely utilized as a food source.
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Affiliation(s)
- Misato TSUBOI
- Food Microbiology and Function Research Laboratories, Meiji
Co., Ltd., 1-29-1 Nanakuni, Hachioji-shi, Tokyo 192-0919, Japan
| | - Masaki TERAHARA
- Wellness Science Labs, Meiji Holdings Co., Ltd., Meiji Co.,
Ltd., 1-29-1 Nanakuni, Hachioji-shi, Tokyo 192-0919, Japan
| | - Masashi NAGATA
- Wellness Science Labs, Meiji Holdings Co., Ltd., Meiji Co.,
Ltd., 1-29-1 Nanakuni, Hachioji-shi, Tokyo 192-0919, Japan
| | - Toyohisa KATSUMATA
- Gotemba Laboratory, BoZo Research Center Inc., 1284 Kamado,
Gotemba-shi, Shizuoka 412-0039, Japan
| | - Takahiro ISHII
- Gotemba Laboratory, BoZo Research Center Inc., 1284 Kamado,
Gotemba-shi, Shizuoka 412-0039, Japan
| | - Masayuki KATO
- Formerly at CMIC Bioresearch Center, CMIC Pharma Science Co.,
Ltd., 10221 Kobuchizawa-cho, Hokuto-shi, Yamanashi 408-0044, Japan
| | - Yoshitaka NAKAMURA
- Food Microbiology and Function Research Laboratories, Meiji
Co., Ltd., 1-29-1 Nanakuni, Hachioji-shi, Tokyo 192-0919, Japan
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Vass RA, Mikó É, Gál C, Kőszegi T, Vass CI, Bokor S, Molnár D, Funke S, Kovács K, Bódis J, Ertl T. The Effect of Holder Pasteurization and Different Variants on Breast Milk Antioxidants. Antioxidants (Basel) 2023; 12:1857. [PMID: 37891936 PMCID: PMC10604438 DOI: 10.3390/antiox12101857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After birth, breast milk (BM) is a known essential source of antioxidants for infants. We analyzed the non-enzymatic total antioxidant capacity (TAC), oxygen radical absorbance capacity (ORAC), and glutathione, calcium, transferrin, and total protein levels of human breast milk before and after Holder pasteurization (HoP). METHODS The collected donor BM samples were pasteurized with HoP. RESULTS HoP decreased TAC (-12.6%), ORAC (-12.1%), transferrin (-98.3%), and total protein (-21.4%) levels; HoP did not influence the glutathione concentration, and it increased the total calcium (+25.5%) concentration. Mothers who gave birth via Cesarean section had significantly lower TAC in their BM. TAC and glutathione levels were elevated in the BM of mothers over the age of 30. BM produced in the summer had higher glutathione and calcium levels compared to BM produced in the winter. The glutathione concentration in term milk samples was significantly higher in the first two months of lactation compared to the period between the third and sixth months. The transferrin level of BM for female infants was significantly higher than the BM for boys, and mothers with a BMI above 30 had increased transferrin in their samples. CONCLUSIONS Antioxidant levels in human milk are influenced by numerous factors. Environmental and maternal factors, the postpartum age at breast milk collection, and Holder pasteurization of the milk influence the antioxidant intake of the infant.
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Affiliation(s)
- Réka Anna Vass
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Éva Mikó
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Microbiology, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csenge Gál
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Kőszegi
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Laboratory Medicine, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csaba I Vass
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Szilvia Bokor
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Dénes Molnár
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Simone Funke
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Kálmán Kovács
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - József Bódis
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- HUN-REN-PTE Human Reproduction Research Group, 7624 Pécs, Hungary
| | - Tibor Ertl
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
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Purkiewicz A, Stasiewicz M, Nowakowski JJ, Pietrzak-Fiećko R. The Influence of the Lactation Period and the Type of Milk on the Content of Amino Acids and Minerals in Human Milk and Infant Formulas. Foods 2023; 12:3674. [PMID: 37835327 PMCID: PMC10572789 DOI: 10.3390/foods12193674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: This study investigated the effect of the lactation period and the type of infant formula on the content of amino acids and selected minerals in an infant's food; (2) Methods: The study material consisted of breast milk (colostrum, n = 38; transitional milk, mature milk, n = 38) and three types of infant formulas (for first and follow-on feeding). Amino acid content was determined using an automatic amino acid analyzer, while minerals were determined by the atomic absorption spectrometry (AAS) technique; (3) Results: Breast milk and infant formulas contained a full range of essential amino acids. In most cases, the content of individual amino acids and minerals decreased with increasing lactation. In infant formulas, there were higher contents of phenylalanine, glutamic acid, proline, serine, and tyrosine in follow-on milk (p < 0.05). The EAA/TAA ratio in breast milk and infant formulas was similar, but the milk differed in their qualitative composition. Infant formulas contained levels of individual minerals that were several times higher-especially Mg, Ca, Mn, and Fe.; (4) Conclusions: Colostrum is more concentrated, and the level of amino acids and minerals is higher in it; as the milk matures, it decreases. In most cases, the content of individual amino acids and minerals is higher in infant formulas than in human milk, which is established through strict Codex Alimentarius procedures to ensure the proper development of infants.
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Affiliation(s)
- Aleksandra Purkiewicz
- Department of Commodity Science and Food Analysis, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Plac Cieszyński 1, 10-726 Olsztyn, Poland;
| | - Małgorzata Stasiewicz
- Department of Animal Nutrition and Feed Management, Faculty of Animal Bioengineering, University of Warmia and Mazury in Olsztyn, Oczapowskiego 5, 10-719 Olsztyn, Poland;
| | - Jacek J. Nowakowski
- Department of Ecology and Environmental Protection, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Plac Łódzki 3, 10-727 Olsztyn, Poland;
| | - Renata Pietrzak-Fiećko
- Department of Commodity Science and Food Analysis, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Plac Cieszyński 1, 10-726 Olsztyn, Poland;
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Jung C, González Serrano A, Batard C, Seror E, Gelwane G, Poidvin A, Lavallée I, Elbez A, Brussieux M, Prosser C, Gallier S, Bellaïche M. Whole Goat Milk-Based Formula versus Whey-Based Cow Milk Formula: What Formula Do Infants Enjoy More?-A Feasibility, Double-Blind, Randomized Controlled Trial. Nutrients 2023; 15:4057. [PMID: 37764840 PMCID: PMC10537215 DOI: 10.3390/nu15184057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: While goat milk formula (GMF) is an alternative to cow milk formula (CMF), infants' preferences for one over the other have not been formally assessed. Specifically, our aim in this study was to determine whether infants experience fewer feeding behavior problems with whole milk-based GMF than with conventional whey-based CMF. (2) Methods: This was a multicenter, double-blind, randomized controlled trial with two-arm parallel assignment conducted in six pediatricians' offices in or near Paris, France, between June 2018 and 31 December 2021. Overall, 64 healthy infants (≤4 months old), predominantly formula-fed, were randomly assigned to either the whole milk-based GMF (n = 33) or whey-based CMF (n = 31) arm. Parents completed the Baby Eating Behavior Questionnaire (BEBQ) and the modified QUALIN questionnaire to evaluate infant feeding behavior and quality of life (psychomotor and socioemotional development), respectively, at inclusion (1 to 5 days before milk delivery) and the final visit (day 28 ± 3 after milk delivery). Informed consent was obtained for all recruited patients, and an ethical committee approved the study. (3) Results: Changes in BEBQ Enjoyment of Food and Slowness in Eating subscale scores from inclusion to final visit did not differ between arms. However, there were significant improvements in subscale scores for Food Responsiveness (GMF: 0.15 ± 1; CMF: -0.48 ± 0.81; p = 0.010) and General Appetite (GMF: 0.26 ± 1.2; CMF: -0.48 ± 0.88; p = 0.012), and modified QUALIN (GMF: 4.6 ± 9.4; CMF: -0.40 ± 7.6; p = 0.03) scores in favor of the GMF group. (4) Conclusions: In this double-blind, randomized controlled trial, GMF-fed infants exhibited a greater general appetite than CMF-fed infants, possibly due to differences in the composition of these formulas (i.e., protein and lipid profiles). In addition, GMF-fed infants enjoyed a better quality of life. There was no difference in food enjoyment between groups. These findings suggest that whole-milk-based GMF could be an attractive alternative to whey-based CMF. Clinical trial registration: NCT03488758 (clinicaltrials.gov).
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Affiliation(s)
- Camille Jung
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
- Inserm, IMRB, Université Paris-Est-Créteil, 94000 Créteil, France;
| | | | | | - Elisa Seror
- Private Pediatric Practice, 75000 Paris, France
| | - Georges Gelwane
- Private Pediatric Practice, 92012 Boulogne-Billancourt, France
| | - Amélie Poidvin
- Private Pediatric Practice, 92035 La Garenne-Colombes, France
| | | | - Annie Elbez
- Private Pediatric Practice, 94700 Maisons-Alfort, France
| | - Maxime Brussieux
- Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Colin Prosser
- Dairy Goat Co-Operative (N.Z.) Ltd., Hamilton 3204, New Zealand (S.G.)
| | - Sophie Gallier
- Dairy Goat Co-Operative (N.Z.) Ltd., Hamilton 3204, New Zealand (S.G.)
| | - Marc Bellaïche
- Department of Pediatric Gastroenterology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France;
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10
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Wu T, Lan QY, Tian F, Xiong XY, Yang MT, Huang SY, Chen XY, Kuchan MJ, Li X, Zhao YR, Mao YY, Zhu HL. Longitudinal changes in choline concentration and associated factors in human breast milk. Clin Nutr 2023; 42:1647-1656. [PMID: 37515842 DOI: 10.1016/j.clnu.2023.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Human breast milk is the primary source of choline and choline-containing compounds for infants at early stages of life. Choline data across lactation in Chinese human milk were limited. OBJECTIVE This study aimed to quantify the five choline compounds in Chinese human breast milk and explore associated factors. METHODS A total of 540 lactating mothers from the MUAI (Maternal Nutrition and Infant Investigation) study were included. The content of water-soluble choline (free choline, phosphocholine, glycerophosphocholine) and lipid-soluble choline (phosphatidylcholine, sphingomyelin) in 892 human milk samples collected from 0 to 400 days postpartum were examined, and associated factors were explored. RESULTS Choline concentrations in human milk varied from postpartum day 0-400 (92.06 ± 65.22 to 171.01 ± 47.84 mg/L). Water-soluble choline was the major component (88.6%-93.8%) in human milk and ranged from 793.03 (659.22) to 1544.43 (443.32) μmol/L. Its trajectory followed that of total choline, increasing from colostrum to transitional milk and then declining in mature milk. In contrast, lipid-soluble choline accounted for 6.2%-11.4% over lactation and had an opposite trajectory. Choline composition varied by delivery mode and parity history. CONCLUSION The concentrations of individual choline and choline-containing compounds during lactation in Chinese human breast milk were described for the first time. Our results address gaps in extant Chinese human milk choline data and support tailored dietary reference intakes for Chinese lactating women and infants. Our data describes the level and profile of choline from 0 to 400 days postpartum in Chinese human breast milk. This is the most updated data on choline and also the first report of water-soluble choline as the predominant type in Chinese human milk. Our results compensate for the deficiencies in data on choline in Chinese human milk. CLINICAL TRIAL REGISTRATION Clinical Trial Registry number: ChiCTR1800015387. Web link to study on registry: https://www.chictr.org.cn/index.aspx.
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Affiliation(s)
- Tong Wu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiu-Ye Lan
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fang Tian
- Abbott Nutrition Research & Development Center, Shanghai, Abbott Laboratories, Shanghai 200233, China
| | - Xiao-Ying Xiong
- Abbott Nutrition Research & Development Center, Shanghai, Abbott Laboratories, Shanghai 200233, China
| | - Meng-Tao Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Si-Yu Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Yan Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Matthew J Kuchan
- Abbott Nutrition Research & Development Center, Columbus, Abbott Laboratories, Ohio, 43219, USA
| | - Xiang Li
- Abbott Nutrition Research & Development Center, Shanghai, Abbott Laboratories, Shanghai 200233, China
| | - Yan-Rong Zhao
- Abbott Nutrition Research & Development Center, Shanghai, Abbott Laboratories, Shanghai 200233, China
| | - Ying-Yi Mao
- Abbott Nutrition Research & Development Center, Shanghai, Abbott Laboratories, Shanghai 200233, China.
| | - Hui-Lian Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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11
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Conway R, Esser S, Steptoe A, Smith AD, Llewellyn C. Content analysis of on-package formula labelling in Great Britain: use of marketing messages on infant, follow-on, growing-up and specialist formula. Public Health Nutr 2023; 26:1696-1705. [PMID: 36710005 PMCID: PMC10427444 DOI: 10.1017/s1368980023000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/19/2022] [Accepted: 01/23/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To explore on-package formula messaging with reference to legislation and government-issued guidance in Great Britain (GB). DESIGN Formula products were identified, pictures of all sides of packs collated and on-package text and images were coded. Compliance with both GB legislation and guidance issued by the Department of Health and Social Care (DHSC) was assessed. SETTING All formula packs that were available for sale over the counter in GB between April and October 2020. PARTICIPANTS Formula packs (n 71) including infant formula, follow-on formula, growing-up formula and specialist formula were identified, coded and analysed. RESULTS In total, 41 % of formula packs included nutrition claims, and 18 % included health claims that may be considered non-permitted, according to DHSC guidance. Additionally, 72 % of products showed images considered 'non-permitted'. Breast Milk Substitute (BMS) legislation states infant and follow-on formula packs should be clearly distinguishable but does not provide criteria to assess similarity. Based on DHSC guidance, 72 % of infant and follow-on formula packs were categorised as showing a high degree of similarity. Marketing practices not covered by current legislation were widespread, such as 94 % of infant formula packs including advertisements for follow-on or growing-up formula. CONCLUSIONS Text and images considered non-permitted according to DHSC guidance for implementing BMS legislation were widespread on formula products available in GB. As terms such as 'similarity' are not defined in BMS legislation, it was unclear if breaches had occurred. Findings support the WHO call for loopholes in domestic legislation to be closed as a matter of urgency.
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Affiliation(s)
- Rana Conway
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Sara Esser
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
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12
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Bakshi S, Paswan VK, Yadav SP, Bhinchhar BK, Kharkwal S, Rose H, Kanetkar P, Kumar V, Al-Zamani ZAS, Bunkar DS. A comprehensive review on infant formula: nutritional and functional constituents, recent trends in processing and its impact on infants' gut microbiota. Front Nutr 2023; 10:1194679. [PMID: 37415910 PMCID: PMC10320619 DOI: 10.3389/fnut.2023.1194679] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Human milk is considered the most valuable form of nutrition for infants for their growth, development and function. So far, there are still some cases where feeding human milk is not feasible. As a result, the market for infant formula is widely increasing, and formula feeding become an alternative or substitute for breastfeeding. The nutritional value of the formula can be improved by adding functional bioactive compounds like probiotics, prebiotics, human milk oligosaccharides, vitamins, minerals, taurine, inositol, osteopontin, lactoferrin, gangliosides, carnitine etc. For processing of infant formula, diverse thermal and non-thermal technologies have been employed. Infant formula can be either in powdered form, which requires reconstitution with water or in ready-to-feed liquid form, among which powder form is readily available, shelf-stable and vastly marketed. Infants' gut microbiota is a complex ecosystem and the nutrient composition of infant formula is recognized to have a lasting effect on it. Likewise, the gut microbiota establishment closely parallels with host immune development and growth. Therefore, it must be contemplated as an important factor for consideration while developing formulas. In this review, we have focused on the formulation and manufacturing of safe and nutritious infant formula equivalent to human milk or aligning with the infant's needs and its ultimate impact on infants' gut microbiota.
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Affiliation(s)
- Shiva Bakshi
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vinod Kumar Paswan
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Satya Prakash Yadav
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Basant Kumar Bhinchhar
- Department of Livestock Production Management, Sri Karan Narendra Agriculture University, Jobner, India
| | - Sheela Kharkwal
- Department of Agriculture Economics, Sri Karan Narendra Agriculture University, Jobner, India
| | - Hency Rose
- Division of Dairy Technology, ICAR—National Dairy Research Institute, Karnal, India
| | - Prajasattak Kanetkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vishal Kumar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Zakarya Ali Saleh Al-Zamani
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
- Department of Food Technology and Science, Faculty of Agriculture and Veterinary Medicine, Ibb University, Ibb, Yemen
| | - Durga Shankar Bunkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
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13
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Decsi T, Marosvölgyi T, Szabó É. Docosahexaenoic Acid in Formulas for Term Infants: The Way from Pioneer Idea to Mandatory Dietary Recommendation. Life (Basel) 2023; 13:1326. [PMID: 37374109 DOI: 10.3390/life13061326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
Docosahexaenoic acid (DHA) is a novel mandatory constituent of breast-milk-substitute infant formula in Europe. The aim of the present narrative review was to summarize available data in connection with the background of the novel European mandatory dietary recommendation to add at least 20 mg/100 kcal (4.8 mg/100 kJ) DHA to infant formula. The literature search with the expression "docosahexaenoic acid with (infant or human milk or formula)" revealed nearly 2000 papers, including more than 400 randomized controlled trials (RCTs). DHA is a persistent constituent of human milk (HM) with a worldwide mean level of 0.37% (standard deviation: 0.11%) of all fatty acids in HM. RCTs on supplementing DHA to lactating women showed some indications, though no direct evidence of the beneficial effect of enhanced HM DHA on the development of breastfed infants. The most-recent Cochrane review of RCTs investigating the effect of DHA supplementation to infant formula for full-term infants reported no evidence for recommending supplementation. The controversy between the Cochrane view and the actual recommendation may be related to the numerous hurdles in organizing high-quality studies in this field. On the basis of the official food composition recommendation, today in Europe, DHA should be considered as a fatty acid essential for infants.
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Affiliation(s)
- Tamás Decsi
- Department of Pediatrics, Medical School and Clinical Centre, University of Pécs, 7623 Pécs, Hungary
- Cochrane Hungary, Clinical Centre, University of Pécs, 7623 Pécs, Hungary
| | - Tamás Marosvölgyi
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Éva Szabó
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, 7624 Pécs, Hungary
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14
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Chouraqui JP, Brancato S, Delmas B, Hanh T. Effectiveness of a starch thickened infant formula with reduced lactose content, probiotics and prebiotics on quality of life and clinical outcome in infants with regurgitation and/or colic. Front Nutr 2023; 10:1164722. [PMID: 37305080 PMCID: PMC10249472 DOI: 10.3389/fnut.2023.1164722] [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: 02/13/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Regurgitation and colic are quite common in young infants, leading to a reduced quality of life (QoL) and to parental distress. Their management is challenging and aims to effectively reassure and relieve symptoms. This study aimed to assess the effectiveness over 30 days of a starch thickened formula with a reduced lactose content, Limosilactobacillus reuteri (Lactobacillus reuteri) DSM 17938 and FOS/GOS. Methods A real-world prospective multicenter experimental study was conducted in a before-after design within subject. Full term infants 0-5 months with regurgitation or colic or both symptoms and without intercurrent illness were included after parental informed consent and received the studied formula. The primary endpoint was the improvement in QoL using the QUALIN infant's questionnaire. Secondary endpoints were the symptoms outcome and the formula tolerance. Results Of the 101 infants included (age: 6.2 ± 4.3 weeks), 33 had regurgitation, 34 colic and 34 had both. At D30, the QoL score was improved in 75% of infants in per protocol analysis (n = 68; +8.2 ± 13.7; p < 0.001), more in those with colic or both symptoms. Meanwhile, in intention to treat analysis (all p < 0.001), the daily number of regurgitations decreased by 61% and the weekly number of days with colic by 63% while the daily cumulative duration of crying decreased by 82 ± 106 mn. These improvements were observed within the first week by 89 and 76% of parents, respectively. Conclusion The study formula associated with reassurance is shown to be quickly effective in the management of infant's regurgitation or/and colic in routine clinical practice. Clinical trial registration https://clinicaltrials.gov/, identifier NCT04462640.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Pediatric Gastroenterology and Nutrition, University Hospital Grenoble-Alpes, La Tronche, France
| | - Sandra Brancato
- Association Française de Pédiatrie Ambulatoire (AFPA), Brignon, France
| | - Berenice Delmas
- Département Médical Nutrition Infantile, Nestlé France, Issy-les-Moulineaux, France
| | - Thierry Hanh
- Département Médical Nutrition Infantile, Nestlé France, Issy-les-Moulineaux, France
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15
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Mousavi ZE, Hunt K, Koolman L, Butler F, Fanning S. Cronobacter Species in the Built Food Production Environment: A Review on Persistence, Pathogenicity, Regulation and Detection Methods. Microorganisms 2023; 11:1379. [PMID: 37374881 DOI: 10.3390/microorganisms11061379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
The powdered formula market is large and growing, with sales and manufacturing increasing by 120% between 2012 and 2021. With this growing market, there must come an increasing emphasis on maintaining a high standard of hygiene to ensure a safe product. In particular, Cronobacter species pose a risk to public health through their potential to cause severe illness in susceptible infants who consume contaminated powdered infant formula (PIF). Assessment of this risk is dependent on determining prevalence in PIF-producing factories, which can be challenging to measure with the heterogeneity observed in the design of built process facilities. There is also a potential risk of bacterial growth occurring during rehydration, given the observed persistence of Cronobacter in desiccated conditions. In addition, novel detection methods are emerging to effectively track and monitor Cronobacter species across the food chain. This review will explore the different vehicles that lead to Cronobacter species' environmental persistence in the food production environment, as well as their pathogenicity, detection methods and the regulatory framework surrounding PIF manufacturing that ensures a safe product for the global consumer.
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Affiliation(s)
- Zeinab Ebrahimzadeh Mousavi
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
- School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, D04 V1W8 Dublin, Ireland
- Department of Food Science and Engineering, Faculties of Agriculture and Natural Resources, University of Tehran, Karaj 6719418314, Iran
| | - Kevin Hunt
- School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, D04 V1W8 Dublin, Ireland
| | - Leonard Koolman
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Francis Butler
- School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, D04 V1W8 Dublin, Ireland
| | - Séamus Fanning
- UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
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16
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Meng F, Uniacke-Lowe T, Lanfranchi E, Meehan G, O'Shea CA, Dennehy T, Ryan AC, Stanton C, Kelly AL. A longitudinal study of fatty acid profiles, macronutrient levels, and plasmin activity in human milk. Front Nutr 2023; 10:1172613. [PMID: 37229467 PMCID: PMC10203173 DOI: 10.3389/fnut.2023.1172613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/11/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction Human milk provides nutrients essential for infant growth and health, levels of which are dynamic during lactation. Methods In this study, changes in macronutrients, fatty acids, and plasmin activities over the first six months of lactation in term milk were studied. Results There was a significant influence of lactation stage on levels of protein and plasmin activities, but not on levels of fat and carbohydrate in term milk. Concerning fatty acids in term milk, levels of caproic acid and α-linolenic acid increased significantly (p < 0.05), whereas those of arachidonic acid and docosahexaenoic acid decreased, in the six months after birth. Significant impacts of maternal pre-pregnancy BMI and infant gender on fatty acid profiles were also found. Multivariate statistical analysis showed that protein level, plasmin activity, and several fatty acids (α-linolenic acid, lignoceric acid, and docasadienoic acid) contributed strongly to discrimination of milk from different lactational stages. Discussion The study demonstrates that not all but some fatty acids were influenced by lactation, whereas protein and protease levels showed clear decreasing trends during lactation, which may help in understanding the nutritional requirements of infants.
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Affiliation(s)
- Fanyu Meng
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | | | - Elisa Lanfranchi
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Grainne Meehan
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
| | - Carol-Anne O'Shea
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
| | - Theresa Dennehy
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Anthony C. Ryan
- Brookfield School of Medicine and Health, University College Cork, Cork, Ireland
| | - Catherine Stanton
- Teagasc Food Research Centre, Moorepark, Cork, Ireland
- APC Microbiome, Cork, Ireland
| | - Alan L. Kelly
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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17
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Einerhand AWC, Mi W, Haandrikman A, Sheng XY, Calder PC. The Impact of Linoleic Acid on Infant Health in the Absence or Presence of DHA in Infant Formulas. Nutrients 2023; 15:2187. [PMID: 37432333 DOI: 10.3390/nu15092187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
Both linoleic acid (LA) and α-linolenic acid (ALA) are essential dietary fatty acids, and a balanced dietary supply of these is of the utmost importance for health. In many countries across the globe, the LA level and LA/ALA ratio in breast milk (BM) are high. For infant formula (IF), the maximum LA level set by authorities (e.g., Codex or China) is 1400 mg LA/100 kcal ≈ 28% of total fatty acid (FA) ≈ 12.6% of energy. The aims of this study are: (1) to provide an overview of polyunsaturated fatty acid (PUFA) levels in BM across the world, and (2) to determine the health impact of different LA levels and LA/ALA ratios in IF by reviewing the published literature in the context of the current regulatory framework. The lipid composition of BM from mothers living in 31 different countries was determined based on a literature review. This review also includes data from infant studies (intervention/cohort) on nutritional needs regarding LA and ALA, safety, and biological effects. The impact of various LA/ALA ratios in IF on DHA status was assessed within the context of the current worldwide regulatory framework including China and the EU. Country averages of LA and ALA in BM range from 8.5-26.9% FA and 0.3-2.65% FA, respectively. The average BM LA level across the world, including mainland China, is below the maximum 28% FA, and no toxicological or long-term safety data are available on LA levels > 28% FA. Although recommended IF LA/ALA ratios range from 5:1 to 15:1, ratios closer to 5:1 seem to promote a higher endogenous synthesis of DHA. However, even those infants fed IF with more optimal LA/ALA ratios do not reach the DHA levels observed in breastfed infants, and the levels of DHA present are not sufficient to have positive effects on vision. Current evidence suggests that there is no benefit to going beyond the maximum LA level of 28% FA in IF. To achieve the DHA levels found in BM, the addition of DHA to IF is necessary, which is in line with regulations in China and the EU. Virtually all intervention studies investigating LA levels and safety were conducted in Western countries in the absence of added DHA. Therefore, well-designed intervention trials in infants across the globe are required to obtain clarity about optimal and safe levels of LA and LA/ALA ratios in IF.
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Affiliation(s)
| | - Wiola Mi
- Bunge Loders Croklaan Nutrition, Shanghai 200051, China
| | | | - Xiao-Yang Sheng
- Department of Developmental Behavioral Pediatric & Children Healthcare, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200051, China
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
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18
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Otten L, Schelker E, Petersen H, Nomayo A, Fleddermann M, Arendt BM, Britzl T, Haberl EM, Jochum F. Safety and Suitability of an Infant Formula Manufactured from Extensively Hydrolysed Protein in Healthy Term Infants. Nutrients 2023; 15:1901. [PMID: 37111119 PMCID: PMC10146495 DOI: 10.3390/nu15081901] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
We aimed to demonstrate that healthy term infants experience noninferior growth with infant formula manufactured from extensively hydrolysed whey protein (eHF) compared to intact cow's milk protein (control formula, CF). This prospective, randomised, double-blind, parallel-group, controlled, multicentre trial included healthy term infants who were exclusively formula-fed. Infants ≤ 25 days of age received eHF or CF for at least three months up to 120 days of age, with a follow-up until 180 days of age. A reference group included exclusively breastfed infants (BF). Of 318 infants randomised, 297 (148 CF, 149 eHF) completed the study per protocol. Weight gain up to 120 days of age was noninferior (margin -3.0 g/day) in eHF (28.95 (95% CI: 27.21; 30.68) g/day) compared to CF (28.85 (95% CI: 27.10; 30.61) g/day) with a difference in means of 0.09 g/day and a lower limit of the one-sided 97.5% CI of -0.86 g/day (p < 0.0001 for noninferiority testing). Weight gain remained comparable during follow-up. Further anthropometric parameters did not differ between the infant formula groups throughout the study. Growth was comparable in BF. No relevant safety issues were observed. To conclude, eHF meets infant requirements for adequate growth during the first six months of life and can be considered safe and suitable.
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Affiliation(s)
- Lindsey Otten
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Elisabeth Schelker
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Hanna Petersen
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Antonia Nomayo
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
| | - Manja Fleddermann
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Bianca M. Arendt
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Theresa Britzl
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Elisabeth M. Haberl
- HiPP GmbH & Co. Vertrieb KG, Georg-Hipp-Str. 7, 85276 Pfaffenhofen an der Ilm, Germany; (M.F.); (B.M.A.); (T.B.); (E.M.H.)
| | - Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Stadtrandstr. 555, 13589 Berlin, Germany; (L.O.); (E.S.); (H.P.); (A.N.)
- Brandenburg Medical School Theodor Fontane (MHB), Fehrbelliner Str. 38, 16816 Neuruppin, Germany
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19
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Brusati M, Baroni L, Rizzo G, Giampieri F, Battino M. Plant-Based Milk Alternatives in Child Nutrition. Foods 2023; 12:foods12071544. [PMID: 37048365 PMCID: PMC10094203 DOI: 10.3390/foods12071544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Plant-based milk alternatives can be distinguished in two main categories, differing in production processes and regulation: plant-based formulas and plant-based drinks. They are now a widely accepted class of products on the international market. The various plant-based milk alternatives differ in nutritional characteristics due to their origin and manufacturing; more importantly, whereas formulas from plant and cow origin can be used interchangeably, plant-based drinks are nutritionally different from cow's milk and can be consumed by children subsequently to the use of formula. Several scientific organizations have expressed differing opinions on the use of these products in the diets of children. In the face of unanimous conclusions regarding the use of these products during the first year of life, in subsequent ages there were conflicting opinions regarding the timing, quantities, and type of product to be used. From the viewpoint of the child's overall diet and health, it could be suggested that these foods be considered not as simple substitutes for cow's milk, but as part of a varied diet, within individual advice of use. We suggest accepting the presence of these products in a baby's diet (omnivores included), planning their use correctly in the context of a balanced diet, according to the specific product and the needs of the individual.
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Affiliation(s)
- Marco Brusati
- Pediatric and Educational Center "La Volpe e il Canguro", 25062 Concesio, Italy
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
| | - Maurizio Battino
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
- Department of Clinical Specialistic and Odontostomatological Sciences, University Polytechnic of Marche, 60131 Ancona, Italy
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20
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Carrasco Cabrera L, Di Piazza G, Dujardin B, Medina Pastor P. The 2021 European Union report on pesticide residues in food. EFSA J 2023; 21:e07939. [PMID: 37122284 PMCID: PMC10130741 DOI: 10.2903/j.efsa.2023.7939] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Under European Union legislation (Article 32, Regulation (EC) No 396/2005), EFSA is to provide an annual report assessing the pesticide residue levels in foods on the European market. In 2021, 96.1% of the overall 87,863 samples analysed fell below the maximum residue level (MRL), 3.9% exceeded this level, of which 2.5% were non-compliant, i.e. samples exceeding the MRL after accounting for the measurement uncertainty. For the EU-coordinated multiannual control programme subset, 13,845 samples were analysed of which 2.1% exceeded the MRL and 1.3% were non-compliant. To assess acute and chronic risk to consumer health, dietary exposure to pesticide residues was estimated and compared with available health-based guidance values (HBGVs). A new pilot methodology based on probabilistic assessment was introduced to provide the probability of subjects being expose to an exceedance of the HBGV. Recommendations to risk manager are given to increase the effectiveness of European control systems and to ensure a high level of consumer protection throughout the EU.
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21
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Byrne ME, Arranz E, Bot F, Gómez-Mascaraque LG, Tobin JT, O’Mahony JA, O’Callaghan TF. The Protein Composition and In Vitro Digestive Characteristics of Animal- versus Plant-Based Infant Nutritional Products. Foods 2023; 12:foods12071469. [PMID: 37048290 PMCID: PMC10094249 DOI: 10.3390/foods12071469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
The protein composition and digestive characteristics of four commercially available infant formulae (IF) manufactured using bovine (B-IF), caprine (C-IF), soy (S-IF), and rice (R-IF) as a protein source were examined in this study. Plant-based formulae had significantly higher crude protein and non-protein nitrogen (NPN) concentrations. Static in vitro gastrointestinal digestion of these formulae, and subsequent analysis of their digestates, revealed significantly higher proteolysis of B-IF at the end of gastrointestinal digestion compared to the other formulae, as indicated by the significantly higher concentration of free amine groups. Furthermore, differences in structure formation during the gastric phase of digestion were observed, with formation of a more continuous, firmer coagulum by C-IF, while R-IF demonstrated no curd formation likely due to the extensive hydrolysis of these proteins during manufacture. Differences in digestive characteristics between formulae manufactured from these different protein sources may influence the bio-accessibility and bioavailability of nutrients, warranting additional study.
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22
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Garcia-Iborra M, Castanys-Munoz E, Oliveros E, Ramirez M. Optimal Protein Intake in Healthy Children and Adolescents: Evaluating Current Evidence. Nutrients 2023; 15:nu15071683. [PMID: 37049523 PMCID: PMC10097334 DOI: 10.3390/nu15071683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
High protein intake might elicit beneficial or detrimental effects, depending on life stages and populations. While high protein intake in elder individuals can promote beneficial health effects, elevated protein intakes in infancy are discouraged, since they have been associated with obesity risks later in life. However, in children and adolescents (4–18 years), there is a scarcity of data assessing the effects of high protein intake later in life, despite protein intake being usually two- to three-fold higher than the recommendations in developed countries. This narrative review aimed to revise the available evidence on the long-term effects of protein intake in children and adolescents aged 4–18 years. Additionally, it discusses emerging techniques to assess protein metabolism in children, which suggest a need to reevaluate current recommendations. While the optimal range is yet to be firmly established, available evidence suggests a link between high protein intake and increased Body Mass Index (BMI), which might be driven by an increase in Fat-Free Mass Index (FFMI), as opposed to Fat Mass Index (FMI).
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Affiliation(s)
- Maria Garcia-Iborra
- Abbott Nutrition R & D, Granada University Science Park, 18016 Granada, Spain; (M.G.-I.); (E.C.-M.)
| | - Esther Castanys-Munoz
- Abbott Nutrition R & D, Granada University Science Park, 18016 Granada, Spain; (M.G.-I.); (E.C.-M.)
| | - Elena Oliveros
- Abbott Nutrition R & D, Abbott Laboratories, 18004 Granada, Spain;
| | - Maria Ramirez
- Abbott Nutrition R & D, Abbott Laboratories, 18004 Granada, Spain;
- Correspondence: ; Tel.: +34-669127998
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23
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Abrams SA, Bergner EM. Is It Time to Revise the Current Nutrient Requirements for Infant Formulas Principally Established in 1980? Adv Nutr 2023; 14:426-431. [PMID: 36878358 DOI: 10.1016/j.advnut.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
Because of the production of nutrient-deficient infant formulas (IFs), the United States Congress passed regulations on the composition and production of IF, referred to as the Infant Formula Act (IFA), in 1980, which was amended in 1986. More detailed FDA rules have been created since then, specifying the ranges or minimum intakes of nutrients and providing details for the safe production and evaluation of infant formulas. Although generally effective in ensuring safe IF, recent events have made it clear that a re-evaluation of aspects of all the nutrient composition regulations for IF is needed, including consideration of adding requirements related to bioactive nutrients not mentioned in the IFA. We propose that, as principal examples, the requirement for iron content needs to be re-evaluated and that DHA and AA should be considered for addition to the nutrient requirements after scientific review by a panel such as those established by the National Academies of Sciences, Engineering, and Medicine. Additionally, there is no specific requirement in current FDA regulations for the energy density of IF, and this should be added alongside potential revisions of the protein requirement. It would also be ideal to have specific FDA rules on nutrient intakes for premature infants as these are exempted from the specific nutrient regulations of the amended IFA.
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Affiliation(s)
- Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas, Austin, TX, United States.
| | - Erynn M Bergner
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, United States
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24
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De Bhowmick G, Guieysse B, Everett DW, Reis MG, Thum C. Novel source of microalgal lipids for infant formula. Trends Food Sci Technol 2023. [DOI: 10.1016/j.tifs.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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25
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Phenylalanine free infant formula in the dietary management of phenylketonuria. Orphanet J Rare Dis 2023; 18:16. [PMID: 36698214 PMCID: PMC9878783 DOI: 10.1186/s13023-023-02621-9] [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: 11/07/2022] [Accepted: 01/15/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Phenylalanine-free infant formula is an essential source of safe protein in a phenylalanine restricted diet, but its efficacy is rarely studied. We report a multicentre, open, longitudinal, prospective intervention study on a phenylalanine-free infant formula (PKU Start: Vitaflo International Ltd.). RESULTS This was a 2-part study: part I (28 days short term evaluation) and part II (12 months extension). Data was collected on infant blood phenylalanine concentrations, dietary intake, growth, and gastrointestinal tolerance. Ten infants (n = 8 males, 80%), with a median age of 14 weeks (range 4-36 weeks) were recruited from 3 treatment centres in the UK. Nine of ten infants completed the 28-day follow-up (one caregiver preferred the usual phenylalanine-free formula and discontinued the study formula after day 14) and 7/9 participated in study part II. The phenylalanine-free infant formula contributed a median of 57% (IQR 50-62%) energy and 53% (IQR 33-66%) of total protein intake from baseline to the end of the part II extension study. During the 12-month follow-up, infants maintained normal growth and satisfactory blood phenylalanine control. Any early gastrointestinal symptoms (constipation, colic, vomiting and poor feeding) improved with time. CONCLUSION The study formula was well tolerated, helped maintain good metabolic control, and normal growth in infants with PKU. The long-term efficacy of phenylalanine-free infant formula should continue to be observed and monitored.
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More SJ, Bampidis V, Benford D, Bragard C, Halldorsson TI, Hernández‐Jerez AF, Bennekou SH, Koutsoumanis K, Lambré C, Machera K, Mullins E, Nielsen SS, Schlatter JR, Schrenk D, Turck D, Younes M, Boon P, Ferns GAA, Lindtner O, Smolders E, Wilks M, Bastaki M, de Sesmaisons‐Lecarré A, Ferreira L, Greco L, Kass GEN, Riolo F, Leblanc J. Re-evaluation of the existing health-based guidance values for copper and exposure assessment from all sources. EFSA J 2023; 21:e07728. [PMID: 36694841 PMCID: PMC9843535 DOI: 10.2903/j.efsa.2023.7728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Copper is an essential micronutrient and also a regulated product used in organic and in conventional farming pest management. Both deficiency and excessive exposure to copper can have adverse health effects. In this Scientific Opinion, the EFSA 2021 harmonised approach for establishing health-based guidance values (HBGVs) for substances that are regulated products and also nutrients was used to resolve the divergent existing HBGVs for copper. The tightly regulated homeostasis prevents toxicity manifestation in the short term, but the development of chronic copper toxicity is dependent on copper homeostasis and its tissue retention. Evidence from Wilson disease suggests that hepatic retention is indicative of potential future and possibly sudden onset of copper toxicity under conditions of continuous intake. Hence, emphasis was placed on copper retention as an early marker of potential adverse effects. The relationships between (a) chronic copper exposure and its retention in the body, particularly the liver, and (b) hepatic copper concentrations and evidence of toxicity were examined. The Scientific Committee (SC) concludes that no retention of copper is expected to occur with intake of 5 mg/day and established an Acceptable Daily Intake (ADI) of 0.07 mg/kg bw. A refined dietary exposure assessment was performed, assessing contribution from dietary and non-dietary sources. Background copper levels are a significant source of copper. The contribution of copper from its use as plant protection product (PPP), food and feed additives or fertilisers is negligible. The use of copper in fertilisers or PPPs contributes to copper accumulation in soil. Infant formula and follow-on formula are important contributors to dietary exposure of copper in infants and toddlers. Contribution from non-oral sources is negligible. Dietary exposure to total copper does not exceed the HBGV in adolescents, adults, elderly and the very elderly. Neither hepatic copper retention nor adverse effects are expected to occur from the estimated copper exposure in children due to higher nutrient requirements related to growth.
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27
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Plaza-Diaz J, Ruiz-Ojeda FJ, Morales J, de la Torre AIC, García-García A, de Prado CN, Coronel-Rodríguez C, Crespo C, Ortega E, Martín-Pérez E, Ferreira F, García-Ron G, Galicia I, Santos-García-Cuéllar MT, Maroto M, Ruiz P, Martín-Molina R, Viver-Gómez S, Gil A. Effects of a Novel Infant Formula on Weight Gain, Body Composition, Safety and Tolerability to Infants: The INNOVA 2020 Study. Nutrients 2022; 15:147. [PMID: 36615804 PMCID: PMC9823847 DOI: 10.3390/nu15010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Exclusive breastfeeding is recommended for the first six months of life to promote adequate infant growth and development, and to reduce infant morbidity and mortality. However, whenever some mothers are not able to breastfeed their infants, infant formulas mimicking human milk are needed, and the safety and efficacy of each formula should be tested. Here, we report the results of a multicenter, randomized, blinded, controlled clinical trial that aimed to evaluate a novel starting formula on weight gain and body composition of infants up to 6 and 12 months, as well as safety and tolerability. For the intervention period, infants were divided into three groups: group 1 received formula 1 (Nutribén® Innova 1 (Alter Farmacia S.A., Madrid, Spain) or INN (n = 70)), with a lower amount of protein, a lower casein to whey protein ratio by increasing the content of α-lactalbumin, and a double amount of docosahexaenoic acid/arachidonic acid than the standard formula; it also contained a thermally inactivated postbiotic (Bifidobacterium animalis subsp. lactis, BPL1TM HT). Group 2 received the standard formula or formula 2 (Nutriben® Natal (Alter Farmacia S.A., Madrid, Spain) or STD (n = 70)) and the third group was exclusively breastfed for exploratory analysis and used as a reference (BFD group (n = 70)). During the study, visits were made at 21 days and 2, 4, 6, and 12 months of age. Weight gain was higher in both formula groups than in the BFD group at 6 and 12 months, whereas no differences were found between STD and INN groups either at 6 or at 12 months. Likewise, body mass index was higher in infants fed the two formulas compared with the BFD group. Regarding body composition, length, head circumference and tricipital/subscapular skinfolds were alike between groups. The INN formula was considered safe as weight gain and body composition were within the normal limits, according to WHO standards. The BFD group exhibited more liquid consistency in the stools compared to both formula groups. All groups showed similar digestive tolerance and infant behavior. However, a higher frequency of gastrointestinal symptoms was reported by the STD formula group (n = 291), followed by the INN formula (n = 282), and the BFD groups (n = 227). There were fewer respiratory, thoracic, and mediastinal disorders among BFD children. Additionally, infants receiving the INN formula experienced significantly fewer general disorders and disturbances than those receiving the STD formula. Indeed, atopic dermatitis, bronchitis, and bronchiolitis were significantly more prevalent among infants who were fed the STD formula compared to those fed the INN formula or breastfed. To evaluate whether there were significant differences between formula treatments, beyond growth parameters, it would seem necessary to examine more precise health biomarkers and to carry out long-term longitudinal studies.
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Affiliation(s)
- Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Francisco Javier Ruiz-Ojeda
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- RG Adipocytes and Metabolism, Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Center Munich, Neuherberg, 85764 Munich, Germany
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. Armilla, 18016 Granada, Spain
| | - Javier Morales
- Product Development Department, Alter Farmacia SA, 28880 Madrid, Spain
| | | | - Antonio García-García
- Instituto Fundación Teófilo Hernando (IFTH), Parque Científico de Madrid, UAM. C/ Faraday 7, Edificio CLAID, 28049 Madrid, Spain
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Carlos Nuñez de Prado
- Consulta Privada Carlos Núñez, C/Santiago Apóstol 10, Majadahonda, 28220 Madrid, Spain
| | - Cristóbal Coronel-Rodríguez
- Centro de Salud Amante Laffón, Distrito de Atención Primaria Sevilla, Servicio Andaluz de Salud, 41010 Sevilla, Spain
| | - Cyntia Crespo
- Centro de Salud Amante Laffón, Distrito de Atención Primaria Sevilla, Servicio Andaluz de Salud, 41010 Sevilla, Spain
| | - Eduardo Ortega
- CAP Nova Lloreda, Av. De Catalunya 62-64, 08917 Badalona, Spain
| | | | - Fernando Ferreira
- Consulta Externa Hospital Privado Santa Ángela de la Cruz, Av. De Jerez 59, 41013 Sevilla, Spain
| | - Gema García-Ron
- CS La Rivota, C/de las Palmeras s/n, Alcorcón, 28922 Madrid, Spain
| | - Ignacio Galicia
- Instituto Fundación Teófilo Hernando (IFTH), Parque Científico de Madrid, UAM. C/ Faraday 7, Edificio CLAID, 28049 Madrid, Spain
| | | | - Marcos Maroto
- Instituto Fundación Teófilo Hernando (IFTH), Parque Científico de Madrid, UAM. C/ Faraday 7, Edificio CLAID, 28049 Madrid, Spain
| | - Paola Ruiz
- CS Las Américas, Av. De América 6, Parla, 28983 Madrid, Spain
| | | | - Susana Viver-Gómez
- CS Valle de la Oliva, C/Enrique Granados 2, Majadahonda, 28222 Madrid, Spain
| | - Angel Gil
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Centre of Biomedical Research, University of Granada, Avda. del Conocimiento s/n. Armilla, 18016 Granada, Spain
- CIBEROBN (CIBER Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Cow's Milk in Human Nutrition and the Emergence of Plant-Based Milk Alternatives. Foods 2022; 12:foods12010099. [PMID: 36613315 PMCID: PMC9818304 DOI: 10.3390/foods12010099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/21/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Cow's milk is considered a complete food, providing high-quality protein and essential micronutrients, including vitamins and minerals. For medical reasons or as a lifestyle choice, consumers are replacing cow's milk with plant-based milk alternatives (PBMA); some perceive them as healthier alternatives to cow's milk due to their low saturated fatty acid content and no cholesterol content. However, the nutritional composition of PBMA is quite variable between different types and even within, which makes a comparison with cow's milk a complex issue. Furthermore, the consumption of PBMA has been associated with the development of some diseases in infants and children. Meanwhile, the consumption of cow's milk in human health is a controversial issue since it has been associated with a favorable effect in some diseases (such as obesity, type 2 diabetes, and Alzheimer's) and a negative effect in others (such as prostate cancer risk and Parkinson's disease); while in some diseases, there is no consensus in the cow's milk consumption effect. The aim of this review is to make a nutritional comparison of cow's milk with PBMA and to clarify the potential health issues related to their consumption.
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Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch‐Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Marchelli R, Neuhäuser‐Berthold M, Poulsen M, Prieto Maradona M, Schlatter JR, van Loveren H, Colombo P, Noriega Fernández E, Knutsen HK. Safety of 2'-fucosyllactose (2'-FL) produced by a derivative strain (APC199) of Corynebacterium glutamicumATCC 13032 as a novel food pursuant to Regulation (EU) 2015/2283. EFSA J 2022; 20:e07647. [PMID: 36531695 PMCID: PMC9749449 DOI: 10.2903/j.efsa.2022.7647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 2'-fucosyllactose (2'-FL) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human-identical milk oligosaccharide (HiMO) 2'-FL, but it also contains d-lactose, l-fucose, 3-fucosyllactose, difucosyllactose, d-glucose and d-galactose. The NF is produced by fermentation with a genetically modified strain (APC199) of Corynebacterium glutamicum ATCC 13032. 2'-FL, when chemically synthesised or produced by fermentation with derivative strains of Escherichia coli K-12 DH1 or E. coli BL21 (DE3), is already authorised and included in the EU list of NFs. This application refers to a change in the production process and specifications, while target population, conditions of use and consequently, the anticipated intake remain unchanged. The information provided on the identity, production process, composition and specifications of the NF does not raise safety concerns. The intake of other carbohydrate-type compounds structurally related to 2'-FL is also considered of no safety concern. In line with other milk oligosaccharides that are natural components of human milk, the safety assessment of this NF is mainly based on the comparison between the intake of breastfed infants and the estimated intake as NF. Given that the NF would be consumed at the same extent as the already authorised 2'-FL, the Panel considers that the consumption of the NF at the proposed uses and use levels does not raise safety concerns. The Panel concludes that the NF is safe under the proposed conditions of use.
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Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch‐Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Marchelli R, Neuhäuser‐Berthold M, Poulsen M, Prieto Maradona M, Schlatter JR, van Loveren H, Colombo P, Noriega Fernández E, Knutsen HK. Safety of 6'-sialyllactose (6'-SL) sodium salt produced by derivative strains of Escherichia coli BL21 (DE3) as a novel food pursuant to Regulation (EU) 2015/2283. EFSA J 2022; 20:e07645. [PMID: 36507098 PMCID: PMC9728050 DOI: 10.2903/j.efsa.2022.7645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 6'-sialyllactose (6'-SL) sodium salt as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human-identical milk oligosaccharide (HiMO) 6'-SL, but it also contains d-lactose, 6'-sialyllactulose, sialic acid, N-acetyl-d-glucosamine and a small fraction of other related oligosaccharides. The NF is produced by fermentation with two genetically modified strains of Escherichia coli BL21 (DE3), the production strain and the optional degradation strain. The information provided on the identity, manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow-on formula, food for special medical purposes and food supplements. The target population is the general population. In some scenarios at the maximum use levels, the estimated intakes per kg body weight were higher than the high average natural intake of 6'-SL from human milk. However, given the intrinsic nature of human milk oligosaccharides (HMOs), the wide range of intakes from human milk, and considering that infants are naturally exposed to similar amounts of these substances, the Panel considers that the consumption of the NF at the proposed conditions of use does not raise safety concerns. The intake of 6'-SL in breastfed infants on a body weight basis is also expected to be safe for other population groups. The intake of other carbohydrate-type compounds structurally related to 6'-SL is also considered of no safety concern. Food supplements are not intended to be used if other foods with added 6'-SL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.
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Alonso-Miravalles L, Barone G, Waldron D, Bez J, Joehnke MS, Petersen IL, Zannini E, Arendt EK, O'Mahony JA. Formulation, pilot-scale preparation, physicochemical characterization and digestibility of a lentil protein-based model infant formula powder. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2022; 102:5044-5054. [PMID: 33682129 DOI: 10.1002/jsfa.11199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/25/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Infant formula is a human milk substitute for consumption during the first months of life. The protein component of such products is generally of dairy origin. Alternative sources of protein, such as those of plant origin, are of interest due to dairy allergies, intolerances, and ethical and environmental considerations. Lentils have high levels of protein (20-30%) with a good amino acid profile and functional properties. In this study, a model lentil protein-based formula (LF), in powder format, was produced and compared to two commercial plant-based infant formulae (i.e., soy; SF and rice; RF) in terms of physicochemical properties and digestibility. RESULTS The macronutrient composition was similar between all the samples; however, RF and SF had larger volume-weighted mean particle diameters (D[4,3] of 121-134 μm) than LF (31.9 μm), which was confirmed using scanning electron and confocal laser microscopy. The larger particle sizes of the commercial powders were attributed to their agglomeration during the drying process. Regarding functional properties, the LF showed higher D[4,3] values (17.8 μm) after 18 h reconstitution in water, compared with the SF and RF (5.82 and 4.55 μm, respectively), which could be partially attributed to hydrophobic protein-protein interactions. Regarding viscosity at 95 °C and physical stability, LF was more stable than RF. The digestibility analysis showed LF to have similar values (P < 0.05) to the standard SF. CONCLUSION These results demonstrated that, from the nutritional and physicochemical perspectives, lentil proteins represent a good alternative to other sources of plant proteins (e.g., soy and rice) in infant nutritional products. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
| | - Giovanni Barone
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - David Waldron
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Juergen Bez
- Fraunhofer Institute for Process Engineering and Packaging, Freising, Germany
| | | | - Iben Lykke Petersen
- Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Emanuele Zannini
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Elke K Arendt
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - James A O'Mahony
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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Probabilistic Risk Assessment of Dietary Exposure to Cadmium in Residents of Guangzhou, China—Young Children Potentially at a Health Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159572. [PMID: 35954928 PMCID: PMC9367776 DOI: 10.3390/ijerph19159572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022]
Abstract
Cadmium (Cd) and its compounds are hazardous environmental pollutants with renal toxicity and human carcinogenicity, with ingestion of contaminated foods representing the major mode of exposure. There have been a number of reports evaluating the Cd content in various foods; however, regarding the actual risk posed by dietary cadmium exposure, only a few reports are available in which single point evaluation (less accurate than multiple point evaluation) was employed. In this study, we used a margin of exposure (MOE) model and @RISK software (for multiple evaluation) to evaluate Cd-related health risk in the local Guangzhou residents at varying ages, through a comparison between the estimated monthly exposures and the provisional tolerable monthly intake (0.025 mg/kg body weight (b.w.)), based on the Cd contents in various food categories available locally (a total of 3964 food samples were collected from each of the 13 districts of Guangzhou between 2015 and 2019), which were determined by using inductively coupled plasma mass spectrometry. In this study, Cd was detected in 69.6% of the samples (averaged 0.120 mg/kg), and rice and its products, leafy vegetables, bivalves, and shrimp and crabs contributed most to Cd exposure (8.63, 3.18, 2.79, and 1.48 ng/kg b.w./day, respectively). The MOE values demonstrated the following tendency: the younger age group, the lower MOE, and its 95% confidence range for the (youngest) 3~6 year old group started from 0.92, indicating a health risk of young children, while that for the other age groups were all above 1.0. Our preliminary findings warrant further clarification using biomarker assays in the relevant population.
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He T, Woudstra F, Panzer F, Haandrikman A, Verkade HJ, van Lee L. Goat Milk Based Infant Formula in Newborns: A Double-Blind Randomized Controlled Trial on Growth and Safety. J Pediatr Gastroenterol Nutr 2022; 75:215-220. [PMID: 35666856 PMCID: PMC9278712 DOI: 10.1097/mpg.0000000000003493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
OBJECTIVES We aimed to determine the growth and safety parameters in newborns fed a goat milk based infant formula (GMF) using a randomized double-blind trial, in which a cow milk formula (CMF) served as a control and a breast fed (BF) group as a reference. METHODS Healthy term infants (n = 218) aged up to 14 days were recruited from 25 European study centers and randomized to GMF or CMF. Weight, length, head circumference were measured at baseline, and at 14, 28, 56, 84, and 112 days at the study clinics. Adverse events were recorded and stool characteristics, reflux, fussiness, colic, and flatulence were self-reported by parents in 3-day diaries. Anthropometric measurements were transformed to WHO standardized age- and sex-adjusted z -scores. Analyses of covariance and linear mixed modeling were used to statistically analyze growth, while adjusting for potential confounders when studying the breast-fed group (n = 86). RESULTS Comparing the GMF to the CMF group, weight gain [mean difference 227.8 g (95% CI -16.6 to -439.0)] and z-scores for anthropometric measurements were similar after 112 days intervention. Infant formula groups showed greater mean (SD) weight z-scores than the BF group from 84 days onwards (GMF: 0.28 (0.84), CMF: 0.12 (0.88), BF -0.19 (1.02), P < 0.05), whereas length and head circumference z-scores were similar. Incidences of serious adverse events and reflux, fussiness, colic, and flatulence were similar among the three groups. CONCLUSION Our data demonstrate that GMF provides adequate growth, has a good tolerability, and is safe to use in infants.
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Affiliation(s)
- T He
- From the Ausnutria B.V., Zwolle, The Netherlands
| | - F Woudstra
- From the Ausnutria B.V., Zwolle, The Netherlands
| | - F Panzer
- the Private Office for Paediatrics and Adolescent Medicine, Mannheim, Germany
| | | | - H J Verkade
- the Pediatric Gastroenterology & Hepatology, Dept. Pediatrics, Beatrix Children's Hospital/ University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - L van Lee
- From the Ausnutria B.V., Zwolle, The Netherlands
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Infant formulas with synthetic oligosaccharides and respective marketing practices. Mol Cell Pediatr 2022; 9:14. [PMID: 35831686 PMCID: PMC9279532 DOI: 10.1186/s40348-022-00146-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2022] [Indexed: 02/06/2023] Open
Abstract
Human milk contains more than 150 different oligosaccharides, which together are among to the quantitatively predominant solid components of breast milk. The oligosaccharide content and composition of human milk show large inter-individual differences. Oligosaccharide content is mostly influenced by genetic variants of the mother’s secretor status. Oligosaccharides in human milk are utilized by infants’ intestinal bacteria, affecting bacterial composition and metabolic activity. Maternal secretor status, and respective differing fucosylated oligosaccharide content, has been associated both with reduced and increased risk of infection in different populations of breastfed infants, possibly due to environmental conditions and the infant’s genotype. There are no safety concerns regarding the addition of previously approved oligosaccharides to infant formula; however, no firm conclusions can be drawn about clinically relevant benefits either. Therefore, infant formulas with synthetic oligosaccharide additives are currently not preferentially recommended over infant formulas without such additives. We consider the use of terms such as “human milk oligosaccharides” and corresponding abbreviations such as “HMO” in any advertising of infant formula to be an inappropriate idealization of infant formula. Manufacturers should stop this practice, and such marketing practices should be prevented by responsible supervisory authorities. Pediatricians should inform families that infant formulas supplemented with synthetic oligosaccharides do not resemble the complex oligosaccharide composition of human milk.
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Hydrolysierte Säuglingsnahrung für die Allergieprävention – wissenschaftliche Evidenz und Empfehlungen für die Praxis. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund
Laut S3-Leitlinie „Allergieprävention“ (Update 2021) soll bei nicht (voll) gestillten Säuglingen mit erhöhtem Allergierisiko geprüft werden, ob eine Säuglingsnahrung mit nachgewiesener allergiepräventiver Wirksamkeit verfügbar ist. Einige Hersteller bewerben ihre Produkte entsprechend.
Ziel der Arbeit
Der Artikel gibt einen Überblick über die wissenschaftliche Evidenz und internationale Empfehlungen zum Einsatz von hydrolysierter Säuglingsnahrung (sog. hypoallergene [HA-]Nahrung) zur Prävention von atopischen Erkrankungen.
Materialien und Methoden
In medizinischen Datenbanken wurde eine Literaturrecherche (Zeitraum: 2016–2021) zum Nutzen von hydrolysierten Säuglingsnahrungen für die Allergieprävention bei Risikokindern und zu entsprechenden internationalen Leitlinien durchgeführt. Auf dieser Basis wurden die aktuelle Empfehlung der deutschen S3-Leitlinie sowie die Produkte auf dem deutschen Markt eingeordnet.
Ergebnisse
Es gibt keine hinreichenden Belege für einen generellen allergiepräventiven Nutzen von Säuglingsnahrungen mit Proteinhydrolysat bei Säuglingen mit erhöhtem Allergierisiko. Die GINI-Interventionsstudie deutet darauf hin, dass eine der eingesetzten Hydrolysatnahrungen zur Prävention atopischer Dermatitis bei Risikokindern wirksam gewesen sein könnte. Die Ergebnisse können aber, auch angesichts methodischer Schwächen, nicht als alleinige Basis für eine allgemeine Empfehlung zur Verwendung von HA-Nahrung herangezogen werden. Internationale Fachgesellschaften sprechen sich seit einigen Jahren eher gegen eine solche Empfehlung aus.
Diskussion
Für die derzeit in Deutschland vermarkteten Säuglingsnahrungen auf Basis von partiell hydrolysiertem Protein fehlen Wirksamkeitsbelege. Sie können daher nicht zur Allergieprävention empfohlen werden.
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Wells JM, Gao Y, de Groot N, Vonk MM, Ulfman L, van Neerven RJJ. Babies, Bugs, and Barriers: Dietary Modulation of Intestinal Barrier Function in Early Life. Annu Rev Nutr 2022; 42:165-200. [PMID: 35697048 DOI: 10.1146/annurev-nutr-122221-103916] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The intestinal barrier is essential in early life to prevent infection, inflammation, and food allergies. It consists of microbiota, a mucus layer, an epithelial layer, and the immune system. Microbial metabolites, the mucus, antimicrobial peptides, and secretory immunoglobulin A (sIgA) protect the intestinal mucosa against infection. The complex interplay between these functionalities of the intestinal barrier is crucial in early life by supporting homeostasis, development of the intestinal immune system, and long-term gut health. Exclusive breastfeeding is highly recommended during the first 6 months. When breastfeeding is not possible, milk-based infant formulas are the only safe alternative. Breast milk contains many bioactive components that help to establish the intestinal microbiota and influence the development of the intestinal epithelium and the immune system. Importantly, breastfeeding lowers the risk for intestinal and respiratory tract infections. Here we review all aspects of intestinal barrier function and the nutritional components that impact its functionality in early life, such as micronutrients, bioactive milk proteins, milk lipids, and human milk oligosaccharides. These components are present in breast milk and can be added to milk-based infant formulas to support gut health and immunity. Expected final online publication date for the Annual Review of Nutrition, Volume 42 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Jerry M Wells
- Host Microbe Interactomics, Wageningen University and Research, Wageningen, The Netherlands
| | - Yifan Gao
- Cell Biology and Immunology, Wageningen University and Research, Wageningen, The Netherlands
| | | | | | | | - R J Joost van Neerven
- Cell Biology and Immunology, Wageningen University and Research, Wageningen, The Netherlands.,FrieslandCampina, Amersfoort, The Netherlands;
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Hokkanen S, Frey AD, Yang B, Linderborg KM. Similarity Index for the Fat Fraction between Breast Milk and Infant Formulas. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:6191-6201. [PMID: 35543583 PMCID: PMC9136929 DOI: 10.1021/acs.jafc.1c08029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/15/2022] [Accepted: 05/02/2022] [Indexed: 06/14/2023]
Abstract
The similarity of the fat fraction in infant formulas rich in either bovine milk fat (MF) or vegetable oil (VO) to breast milk was evaluated by analyzing their lipid composition. Milk fat-rich formulas were highly similar (average similarity index 0.68) to breast milk compared to the VO-rich formulas (average similarity index 0.56). The highest difference in the indices was found in the contents of cholesterol (0.66 vs 0.28 in MF- and VO-rich formulas, respectively, on average) and polar lipids (0.84 vs 0.53), the positional distribution of fatty acids in the sn-2 position of triacylglycerols (0.53 vs 0.28), and fatty acid composition (0.72 vs 0.54). The VO-based formulas were superior in similarity in n - 6 PUFA. Thus, the addition of bovine MF fractions is an effective way to increase the similarity between the lipid composition of infant formulas and human milk.
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Affiliation(s)
- Sanna Hokkanen
- Molecular
Biotechnology, Department of Bioproducts and Biosystems, School of
Chemical Engineering, Aalto University, 02150 Espoo, Finland
| | - Alexander D. Frey
- Molecular
Biotechnology, Department of Bioproducts and Biosystems, School of
Chemical Engineering, Aalto University, 02150 Espoo, Finland
| | - Baoru Yang
- Food
Chemistry and Food Development, Department of Life Technologies, University of Turku, 20500 Turku, Finland
| | - Kaisa M. Linderborg
- Food
Chemistry and Food Development, Department of Life Technologies, University of Turku, 20500 Turku, Finland
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Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch-Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Marchelli R, Neuhäuser-Berthold M, Poulsen M, Prieto Maradona M, Schlatter JR, van Loveren H, Colombo P, Noriega Fernández E, Knutsen HK. Safety of 3-fucosyllactose (3-FL) produced by a derivative strain of Escherichia coli BL21 (DE3) as a Novel Food pursuant to Regulation (EU) 2015/2283. EFSA J 2022; 20:e07329. [PMID: 35646167 PMCID: PMC9131588 DOI: 10.2903/j.efsa.2022.7329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 3‐fucosyllactose (3‐FL) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human‐identical milk oligosaccharide (HiMO) 3‐FL, but it also contains d‐lactose, l‐fucose, d‐glucose and d‐galactose, and a small fraction of other related saccharides. The NF is produced by fermentation with a genetically modified strain of Escherichia coli BL21 (DE3). The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow‐on formula, food for infants and young children, food for special medical purposes and food supplements. The target population is the general population. The anticipated daily intake of 3‐FL from both proposed and combined (authorised and proposed) uses at their respective maximum use levels in all population categories does not exceed the highest intake level of 3‐FL from human milk in infants on a body weight basis. The intake of 3‐FL in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate‐type compounds structurally related to 3‐FL is also considered of no safety concern. Food supplements are not intended to be used if other foods with added 3‐FL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.
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Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch‐Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Marchelli R, Neuhäuser‐Berthold M, Poulsen M, Prieto Maradona M, Schlatter JR, van Loveren H, Colombo P, Noriega Fernández E, Knutsen HK. Safety of lacto‐N‐tetraose (LNT) produced by derivative strains of Escherichia coli BL21 (DE3) as a Novel Food pursuant to Regulation (EU) 2015/2283. EFSA J 2022; 20:e07242. [PMID: 35600267 PMCID: PMC9109231 DOI: 10.2903/j.efsa.2022.7242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on lacto‐N‐tetraose (LNT) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is a powdered mixture mainly composed of the human‐identical milk oligosaccharide (HiMO) LNT, but it also contains d‐lactose, lacto‐N‐triose II and para‐lacto‐N‐hexaose, and a small fraction of other related saccharides. The NF is produced by fermentation with two genetically modified strains of Escherichia coli BL21 (DE3), the production strain and the optional degradation strain. The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant and follow‐on formula, food for infants and young children, food for special medical purposes and food supplements. The target population is the general population. The anticipated daily intake of LNT from the NF at the maximum proposed use levels does not exceed the intake level of naturally occurring LNT in breastfed infants on a body weight basis. The intake of LNT in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate‐type compounds structurally related to LNT is also considered of no safety concern. Food supplements are not intended to be used if other foods with added LNT or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.
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40
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Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch‐Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Marchelli R, Neuhäuser‐Berthold M, Poulsen M, Prieto Maradona M, Schlatter JR, van Loveren H, Colombo P, Noriega Fernández E, Knutsen HK. Safety of 3’‐sialyllactose (3’‐SL) sodium salt produced by derivative strains of Escherichia coli BL21 (DE3) as a Novel Food pursuant to Regulation (EU) 2015/2283. EFSA J 2022; 20:e07331. [PMID: 35646166 PMCID: PMC9131611 DOI: 10.2903/j.efsa.2022.7331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 3’‐sialyllactose (3’‐SL) sodium salt as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human‐identical milk oligosaccharide (HiMO) 3’‐SL, but it also contains d‐lactose, 3’‐sialyllactulose, sialic acid, N‐acetyl‐d‐glucosamine and a small fraction of other related oligosaccharides. The NF is produced by fermentation with two genetically modified strains of Escherichia coli BL21 (DE3), the production strain and the optional degradation strain. The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow‐on formula, food for infants and young children, food for special medical purposes and food supplements. The target population is the general population. The anticipated daily intake of 3’‐SL from both proposed and combined (authorised and proposed) uses at their respective maximum use levels in all population categories does not exceed the highest intake level of 3’‐SL from human milk in infants on a body weight basis. The intake of 3’‐SL in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate‐type compounds structurally related to 3’‐SL is also considered of no safety concern. Food supplements are not intended to be used if other foods with added 3’‐SL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.
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Vandenplas Y, Ksiażyk J, Luna MS, Migacheva N, Picaud JC, Ramenghi LA, Singhal A, Wabitsch M. Partial Hydrolyzed Protein as a Protein Source for Infant Feeding: Do or Don't? Nutrients 2022; 14:nu14091720. [PMID: 35565688 PMCID: PMC9103110 DOI: 10.3390/nu14091720] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/25/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Exclusive breastfeeding until the age of six months is the recommended feeding method for all infants. However, this is not possible for every infant. Therefore, a second choice of feeding, as close as possible to the gold standard, is needed. For historical reasons, this has been cow’s-milk-based feeding. This paper discusses if this second-choice feeding method should contain intact protein or partially hydrolyzed proteins. The limited data available indicates that mother’s milk is relatively rich in bioactive peptides. Whether partially hydrolyzed protein might be a protein source closer to human milk protein content than intact cow’s milk needs further research. However, more research on protein and bioactive peptides in mother’s milk should be a priority for future scientific development in this field. Results of such research will also provide an answer to the question of which option would be the best second choice for infant feeding if sufficient breast milk is not available.
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Affiliation(s)
- Yvan Vandenplas
- KidZ Health Castle, Vrije Universiteit Brussel (VUB), 1090 Brussel, Belgium
- Correspondence: ; Tel.: +32-475748794
| | - Janusz Ksiażyk
- Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Manuel Sanchez Luna
- Neonatology Division and NICU, Hospital General Universitario “Gregorio Marañón”, Complutense University of Madrid, 28009 Madrid, Spain;
| | - Natalia Migacheva
- Department of Pediatrics, Samara State Medical University, 443084 Samara, Russia;
| | - Jean-Charles Picaud
- Department of Neonatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, F69677 Lyon, France;
- CarMen Laboratory, INSERM, INRA, Claude Bernard University Lyon1, F69310 Pierre-Benite, France
| | - Luca A. Ramenghi
- Department of Neuroscience, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16147 Genoa, Italy;
| | - Atul Singhal
- Childhood Nutrition Research Centre, PPP Department, UCL GOS Institute of Child Health, London WC1N 1EH, UK;
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Ulm, 89075 Ulm, Germany;
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Chouraqui JP. Dietary Approaches to Iron Deficiency Prevention in Childhood—A Critical Public Health Issue. Nutrients 2022; 14:nu14081604. [PMID: 35458166 PMCID: PMC9026685 DOI: 10.3390/nu14081604] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 12/15/2022] Open
Abstract
Iron is an essential nutrient, and individual iron status is determined by the regulation of iron absorption, which is driven by iron requirements. Iron deficiency (ID) disproportionately affects infants, children, and adolescents, particularly those who live in areas with unfavorable socioeconomic conditions. The main reason for this is that diet provides insufficient bioavailable iron to meet their needs. The consequences of ID include poor immune function and response to vaccination, and moderate ID anemia is associated with depressed neurodevelopment and impaired cognitive and academic performances. The persistently high prevalence of ID worldwide leads to the need for effective measures of ID prevention. The main strategies include the dietary diversification of foods with more bioavailable iron and/or the use of iron-fortified staple foods such as formula or cereals. However, this strategy may be limited due to its cost, especially in low-income countries where biofortification is a promising approach. Another option is iron supplementation. In terms of health policy, the choice between mass and targeted ID prevention depends on local conditions. In any case, this remains a critical public health issue in many countries that must be taken into consideration, especially in children under 5 years of age.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Pediatric Nutrition and Gastroenterology Unit, Woman, Mother and Child Department, University Hospital of Lausanne, 1011 Lausanne, Switzerland
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43
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Martinot P, Adjibade M, Taine M, Davisse-Paturet C, Lioret S, Charles MA, de Lauzon-Guillain B, Bernard JY. LC-PUFA enrichment in infant formula and neurodevelopment up to age 3.5 years in the French nationwide ELFE birth cohort. Eur J Nutr 2022; 61:2979-2991. [PMID: 35318492 DOI: 10.1007/s00394-022-02863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE For decades, consistent associations between breastfeeding and children's neurodevelopment have been attributed to breastmilk content in long-chain polyunsaturated fatty acids (LC-PUFAs). However, the beneficial effect of LC-PUFA enrichment of infant formula on neurodevelopment remains controversial. This study examined the association of LC-PUFA enrichment of infant formulas with neurodevelopment up to age 3.5 years. METHODS Analyses were based on 9372 children from the French nationwide ELFE birth cohort. Monthly from 2 to 10 months, parents declared their infant's feeding mode, including breastfeeding and the name of the infant formula, which allowed for identifying formulas enriched in arachidonic (ARA), eicosapentaenoic (EPA) and/or docosahexaenoic (DHA) acids. Neurodevelopment was assessed at age 1 and 3.5 years with the Child Development Inventory (CDI-1 and CDI-3.5); at 2 years with the MacArthur-Bates Communicative Development Inventories (MB-2); and at 3.5 years with the Picture Similarities subtest of the British Ability Scale (BAS-3.5). Associations were assessed by linear regression adjusted for any breastfeeding duration and main confounding factors, including socioeconomic characteristics. RESULTS One-third of formula-fed infants consumed LC-PUFA-enriched formulas. Most of these formulas were enriched in both DHA and ARA, and about 10% of infants consumed formula further enriched in EPA. LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores at age 1 (CDI-1, - 0.16 [- 0.39, 0.07]), age 2 (MB-2, 0.78 [- 0.33, 1.89]), or age 3.5 (CDI-3.5, - 0.05 [- 0.27, 0.17]; BAS-3.5, - 0.93 [- 2.85, 0.98]). CONCLUSION In the ELFE study, LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores up to 3.5 years.
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Affiliation(s)
- Pauline Martinot
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France
| | - Moufidath Adjibade
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France
| | - Marion Taine
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France
| | - Camille Davisse-Paturet
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France
| | - Sandrine Lioret
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France.,Unité mixte Inserm-Ined-EFS ELFE, Ined, 93322, Aubervilliers, France
| | - Blandine de Lauzon-Guillain
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France.
| | - Jonathan Y Bernard
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, 75004, Paris, France.,Agency for Science, Technology and Research (A*STAR), Singapore Institute for Clinical Sciences (SICS), Singapore, Singapore
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44
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Nieto-Ruiz A, García-Santos JA, Verdejo-Román J, Diéguez E, Sepúlveda-Valbuena N, Herrmann F, Cerdó T, De-Castellar R, Jiménez J, Bermúdez MG, Pérez-García M, Miranda MT, López-Sabater MC, Catena A, Campoy C. Infant Formula Supplemented With Milk Fat Globule Membrane, Long-Chain Polyunsaturated Fatty Acids, and Synbiotics Is Associated With Neurocognitive Function and Brain Structure of Healthy Children Aged 6 Years: The COGNIS Study. Front Nutr 2022; 9:820224. [PMID: 35356726 PMCID: PMC8959863 DOI: 10.3389/fnut.2022.820224] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
Background Adequate nutrient intake during the first few months of life plays a critical role on brain structure and function development. Objectives To analyze the long-term effects of an experimental infant formula (EF) on neurocognitive function and brain structure in healthy children aged 6 years compared to those fed with a standard infant formula or breastfed. Methods The current study involved 108 healthy children aged 6 years and participating in the COGNIS Study. At 0-2 months, infants were randomized to receive up to 18 months of life a standard infant formula (SF) or EF enriched with milk fat globule membrane (MFGM), long-chain polyunsaturated fatty acids (LC-PUFAs) and synbiotics. Furthermore, a reference group of breastfed (BF) infants were also recruited. Children were assessed using neurocognitive tests and structural Magnetic Resonance Imaging (MRI) at 6 years old. Results Experimental infant formula (EF) children showed greater volumes in the left orbital cortex, higher vocabulary scores and IQ, and better performance in an attention task than BF children. EF children also presented greater volumes in parietal regions than SF kids. Additionally, greater cortical thickness in the insular, parietal, and temporal areas were found in children from the EF group than those fed with SF or BF groups. Further correlation analyses suggest that higher volumes and cortical thickness of different parietal and frontal regions are associated with better cognitive development in terms of language (verbal comprehension) and executive function (working memory). Finally, arachidonic acid (ARA), adrenic acid (AdA), docosahexaenoic acid (DHA) levels in cheek cell glycerophospholipids, ARA/DHA ratio, and protein, fatty acid, and mineral intake during the first 18 months of life seem to be associated with changes in the brain structures at 6 years old. Conclusions Supplemented infant formula with MFGM components, LC-PUFAs, and synbiotics seems to be associated to long-term effects on neurocognitive development and brain structure in children at 6 years old. Clinical Trial Registration https://www.clinicaltrials.gov/, identifier: NCT02094547.
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Affiliation(s)
- Ana Nieto-Ruiz
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - José A. García-Santos
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Juan Verdejo-Román
- Department of Personality, Assessment & Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
| | - Estefanía Diéguez
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Natalia Sepúlveda-Valbuena
- Nutrition and Biochemistry Department, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Florian Herrmann
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Tomás Cerdó
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
- Carlos III Health Institute, Madrid, Spain
| | | | | | - Mercedes G. Bermúdez
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Miguel Pérez-García
- Department of Personality, Assessment & Psychological Treatment, School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Centre—CIMCYC, University of Granada, Granada, Spain
| | - M. Teresa Miranda
- Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain
| | - M. Carmen López-Sabater
- Department of Nutrition, Food Sciences and Gastronomy, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentària de la UB (INSA-UB), Barcelona, Spain
- National Network of Research in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III (Barcelona's Node), Madrid, Spain
| | - Andrés Catena
- Mind, Brain and Behavior Research Centre—CIMCYC, University of Granada, Granada, Spain
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
| | - Cristina Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Health Sciences Technological Park, Granada, Spain
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, Granada, Spain
- National Network of Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III (Granada's Node), Madrid, Spain
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Abstract
Under European Union legislation (Article 32, Regulation (EC) No 396/2005), the EFSA provides an annual report which examines pesticide residue levels in foods on the European market. This report is based on data from the official national control activities carried out by EU Member States, Iceland and Norway and includes a subset of data from the EU-coordinated control programme, which uses a randomised sampling strategy. For 2020, 94.9% of the overall 88,141 samples analysed fell below the maximum residue level (MRL), 5.1% exceeded this level, of which 3.6% were non-compliant, i.e. samples exceeding the MRL after taking the measurement uncertainty into account. For the subset of 12,077 samples analysed as part of the EU-coordinated multiannual control programme, 1.7% exceeded the MRL and 0.9% were non-compliant. To assess acute and chronic risk to consumer health, dietary exposure to pesticide residues was estimated and compared with health-based guidance values. Dietary exposure to pesticides for which health-based guidance values were available is unlikely to pose a risk to EU consumer health. In the rare cases where dietary exposure for a specific pesticide/product combination was calculated to exceed the health-based guidance value, and for those pesticides for which no health-based guidance value could be established, the competent authorities took appropriate and proportionate corrective measures to address potential risks to consumers. Recommendations are proposed to increase the effectiveness of European control systems, thereby continuing to ensure a high level of consumer protection throughout the EU.
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Jochum F, Abdellatif M, Adel A, Alhammadi A, Alnemri A, Alohali E, AlSarraf K, Al Said K, Elzalabany M, Isa HMA, Kalyanasundaram S, Reheim NA, Saadah O. Burden of Early Life Obesity and Its Relationship with Protein Intake in Infancy: The Middle East Expert Consensus. Pediatr Gastroenterol Hepatol Nutr 2022; 25:93-108. [PMID: 35360379 PMCID: PMC8958054 DOI: 10.5223/pghn.2022.25.2.93] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/13/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
Adequate nutrition in early life is proposed to shape a child's future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.
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Affiliation(s)
- Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany.,Pediatric Medicine, Brandenburg Medical School (MHB) Theodor Fontane, Neuruppin, Germany
| | | | - Ashraf Adel
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | - Ahmed Alhammadi
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | | | - Eman Alohali
- Dietetics Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled AlSarraf
- Department of Pediatrics-Pediatric Gastroenterology, Amiri Hospital, Sharq, Kuwait
| | - Khoula Al Said
- Department of Child Health, Royal Hospital, Muscat, Oman
| | - Mahmoud Elzalabany
- Pediatrics Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Hasan M A Isa
- Pediatric Department, Salmaniya Medical Complex/Arabian Gulf University, Manama, Bahrain
| | | | | | - Omar Saadah
- Pediatrics Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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47
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An Infant Formula with Large, Milk Phospholipid-Coated Lipid Droplets Supports Adequate Growth and Is Well-Tolerated in Healthy, Term Asian Infants: A Randomized, Controlled Double-Blind Clinical Trial. Nutrients 2022; 14:nu14030634. [PMID: 35276993 PMCID: PMC8838783 DOI: 10.3390/nu14030634] [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: 12/21/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/06/2023] Open
Abstract
Lipids are essential for healthy infant growth and development. The structural complexity of lipids in human milk is not present in infant milk formula (IF). A concept IF was developed mimicking more closely the structure and composition of human milk fat globules. The current study evaluates whether a concept IF with large, milk phospholipid-coated lipid droplets (mode diameter 3 to 5 μm) is equivalent to standard IF with regard to growth adequacy and safety in healthy, term Asian infants. In this randomized, double-blind, controlled trial, infants were randomized after parents decided to introduce formula. Infants received a standard IF with (Control) or without the specific prebiotic mixture scGOS/lcFOS (9:1 ratio; Control w/o prebiotics), or a Concept IF with large, milk phospholipid-coated lipid droplets and the prebiotic mixture. A group of 67 breastfed infants served as a reference. As a priori defined, only those infants who were fully intervention formula-fed ≤28 days of age were included in the equivalence analysis (Control n = 29; Control w/o prebiotics n = 28; Concept n = 35, per-protocol population). Primary outcome was daily weight gain during the first four months of life, with the difference between the Concept and Control as the key comparison of interest. Additionally, adverse events, growth and tolerance parameters were evaluated. Equivalence of daily weight gain was demonstrated between the Concept and Control group after additional correction for ethnicity and birthweight (difference in estimated means of 0.1 g/d, 90%CI [-2.30, 2.47]; equivalence margin +/- 3 g/d). No clinically relevant group differences were observed in secondary growth outcomes, tolerance outcomes or number, severity or relatedness of adverse events. This study corroborates that an infant formula with large, milk phospholipid-coated lipid droplets supports adequate growth and is well tolerated and safe for use in healthy infants.
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Barone G, O'Regan J, Kelly AL, O'Mahony JA. Interactions between whey proteins and calcium salts and implications for the formulation of dairy protein‐based nutritional beverage products: A review. Compr Rev Food Sci Food Saf 2022; 21:1254-1274. [DOI: 10.1111/1541-4337.12884] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 01/29/2023]
Affiliation(s)
- Giovanni Barone
- School of Food and Nutritional Sciences University College Cork Cork Ireland
| | - Jonathan O'Regan
- Nestlé Development Centre Nutrition Wyeth Nutritionals Ireland Askeaton Limerick Ireland
| | - Alan L. Kelly
- School of Food and Nutritional Sciences University College Cork Cork Ireland
| | - James A. O'Mahony
- School of Food and Nutritional Sciences University College Cork Cork Ireland
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49
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Giuffrida F, Fleith M, Goyer A, Samuel TM, Elmelegy-Masserey I, Fontannaz P, Cruz-Hernandez C, Thakkar SK, Monnard C, De Castro CA, Lavalle L, Rakza T, Agosti M, Al-Jashi I, Pereira AB, Costeira MJ, Marchini G, Vanpee M, Stiris T, Stoicescu S, Silva MG, Picaud JC, Martinez-Costa C, Domellöf M, Billeaud C. Human milk fatty acid composition and its association with maternal blood and adipose tissue fatty acid content in a cohort of women from Europe. Eur J Nutr 2022; 61:2167-2182. [PMID: 35072787 PMCID: PMC9106604 DOI: 10.1007/s00394-021-02788-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 12/17/2021] [Indexed: 11/29/2022]
Abstract
Purpose Human milk (HM) composition is influenced by factors, like maternal diet and body stores, among other factors. For evaluating the influence of maternal fatty acid (FA) status on milk FA composition, the correlation between FA content in HM and in maternal plasma, erythrocytes, and adipose tissue was investigated. Methods 223 European women who delivered at term, provided HM samples over first four months of lactation. Venous blood and adipose tissue (only from mothers who consented and underwent a C-section delivery) were sampled at delivery. FAs were assessed in plasma, erythrocytes, adipose tissue, and HM. Evolution of HM FAs over lactation and correlations between FA content in milk and tissues and between mother’s blood and cord blood were established. Results During lactation, arachidonic acid (ARA) and docosahexaenoic acid (DHA) significantly decreased, while linoleic acid (LA), alpha-linolenic acid (ALA), and eicosapentaenoic acid (EPA) remained stable. Positive correlations were observed between HM and adipose tissue for palmitic, stearic, oleic, and polyunsaturated fatty acids (PUFAs). Correlations were found between milk and plasma for oleic, LA, ARA, ALA, DHA, monounsaturated fatty acids (MUFAs), and PUFAs. No correlation was observed between erythrocytes and HM FAs. LA and ALA were more concentrated in maternal blood than in infant blood, contrary to ARA and DHA, supporting that biomagnification of LCPUFAs may have occurred during pregnancy. Conclusions These data show that maternal adipose tissue rather than erythrocytes may serve as reservoir of PUFAs and LCPUFAs for human milk. Plasma also supplies PUFAs and LCPUFAs to maternal milk. If both, adipose tissue and plasma PUFAs, are reflection of dietary intake, it is necessary to provide PUFAs and LCPUFAs during pregnancy or even before conception and lactation to ensure availability for mothers and enough supply for the infant via HM. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02788-6.
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Affiliation(s)
| | - Mathilde Fleith
- Nestlé Research, Vers-chez les-Blanc, 1000 Lausanne 26, Switzerland
| | - Amélie Goyer
- Nestlé Research, Vers-chez les-Blanc, 1000 Lausanne 26, Switzerland
| | - Tinu Mary Samuel
- Nestlé Product Technology Center-Nutrition, Société des Produits Nestlé S.A., 1800 Vevey, Switzerland
| | | | - Patric Fontannaz
- Nestlé Research, Vers-chez les-Blanc, 1000 Lausanne 26, Switzerland
| | | | | | | | | | - Luca Lavalle
- Nestlé Research, Vers-chez les-Blanc, 1000 Lausanne 26, Switzerland
| | - Thameur Rakza
- Centre d’Investigation Clinique de Lille, Hôpital Jeanne de Flandre, 59777 Lille, France
| | | | | | | | | | | | | | | | | | | | - Jean-Charles Picaud
- Hospices Civils de Lyon, Neonatology, Hôpital de La Croix Rousse, Hospices civils de Lyon, 69004 Lyon, France
- Univ. Lyon, Carmen Laboratory, INSERM, INRA, Université Claude Bernard Lyon 1, 69921 Oullins, France
| | | | - Magnus Domellöf
- Department of Clinical Sciences/Pediatrics, Umeå University, Umeå, Sweden
| | - Claude Billeaud
- Neonatology & Nutrition, CIC Pédiatrique 1401 Inserm, CHU de Bordeaux, Bordeaux, France
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Hamed NF, Alamri SA, Hamdi NH. Overview of the Updates in Nutrient Profiles, Types, Indications and Side Effects of Infant Formula. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/confqadrfw] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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