26. Advanced glycation end products in infant formulas

Abstract

This chapter describes the formation of Maillard reaction products (MRPs) in food matrices, particularly focusing on their occurrence in infant formulas (IFs) during industrial processing and storage. Experimental and clinical data on the bioavailability of the main infant formuladerived Amadori product – lactulosyllysine and advanced glycation end product – Nᵋ-carboxymethyllysine, and their fate in the organism are reviewed. Potential health effects of dietary MRPs are discussed in relationship to the effects of in vivo formed analogues of MRP – advanced glycation end products. In summary, the content of MRPs in IFs, particularly the hydrolyzed ones, exceeds that of breast milk hundreds-folds. Plasma levels and particularly urinary excretion rate of MRPs, as well as their accumulation on skin collagen as reflected by skin autofluorescence, are significantly higher in IF-fed infants than their breast-milk receiving counterparts. We focused on the clinical implications of high dietary IFs-derived MRPs load in infants on insulin sensitivity, renal effects, handling of iron and minerals, and food allergy. Data from limited number of short-term small studies in healthy infants do not provide direct evidence on acute negative health effects of high dietary load with MRPs in early infancy. However, the effects in vulnerable and sensitive groups, as well as on the future health state, or the predisposition/susceptibility to particularly non-communicable degenerative diseases in adulthood, remain unclear.