Abstract
BackgroundEffects of palm olein (POL) on calcium and fat metabolic balance and gastrointestinal (GI) tolerance have been clinically evaluated but its use in combination with palm kernel oil (PKO), and canola oil has not been similarly assessed in infants.MethodsCalcium and fat balance and GI tolerance were evaluated in 33 healthy term infants (age = 68-159d) in a randomized, double-blinded, 14d crossover trial at a day care center in Salvador, Brazil; followed by a 4d hospital ward metabolic balance study in 17 of the male subjects. The study compared two commercially available milk-based powdered formulas in Brazil; one containing POL (44% of total fat), PKO (21.7%) and canola oil (18.5%) as predominant fats (PALM), and the other containing none (NoPALM). Occasional human milk (HM) supplementation was allowed at home.ResultsFormula and HM intakes, and growth were not different (p > 0.05). Calcium absorption (%) for infants fed NoPALM (58.8 ± 16.7%; means ± SD) was higher (p = 0.023) than those fed PALM (42.1 ± 19.2%), but was not significant (p = 0.104) when calcium intake was used as a covariate. Calcium intake was higher (p < 0.001) in NoPALM versus PALM fed infants. However, calcium retention (%) was higher in infants fed NoPALM compared to PALM with (p = 0.024) or without (p = 0.015) calcium intake as a covariate. Fat absorption (%) for NoPALM was greater than PALM fed infants (NoPALM = 96.9 ± 1.2 > PALM = 95.1 ± 1.5; p = 0.020 in Study Period I). Mean rank stool consistency was softer in infants fed NoPALM versus PALM (p < 0.001; metabolic period). Adverse events, spit-up/vomit, fussiness and gassiness were not different (p > 0.05). Formula acceptability was high and comparable for both formula feedings, regardless of HM supplementation.ConclusionsTerm infants fed PALM based formula (containing palm olein, palm kernel and canola oils) demonstrated lower calcium retention and fat absorption, and less softer stool consistency versus infants fed NoPALM based formula. Study suggested formula fat differences may affect GI function in infants.Clinical trial registrationClinical Trial.Gov # ( http://www.clinicaltrials.gov): NCT00941564.
Highlights
Effects of palm olein (POL) on calcium and fat metabolic balance and gastrointestinal (GI) tolerance have been clinically evaluated but its use in combination with palm kernel oil (PKO), and canola oil has not been assessed in infants
Percent calcium retention was higher in the NoPALM versus Milk-based powdered commercial formula containing palm olein (PALM) feeding groups (p = 0.015), and remained higher (p = 0.024) even when calcium intake was used as a covariate in the analyses (Figure 2)
The results of the current study successfully demonstrated that calcium metabolic balance was significantly higher with the NoPALM formula feeding compared to the PALM formula feeding
Summary
Effects of palm olein (POL) on calcium and fat metabolic balance and gastrointestinal (GI) tolerance have been clinically evaluated but its use in combination with palm kernel oil (PKO), and canola oil has not been assessed in infants. Palm olein (POL) is included in the fat blend of most infant formulas globally to mimic the relative amount of palmitic acid (PA) in human milk [1]. The positional distribution of individual fatty acids on the triacylglyceride molecules (which affects fat absorption) differs between vegetable oils and human milk (HM) fat [1,2,3,4]. In vegetable oils, including those used in infant formulas, the long chain saturated fatty acids are located primarily on the sn1- and sn3-positions [5]. The free PA and stearic acid (SA) conjugate with calcium to form insoluble calcium soaps [6] resulting in reduced fat and calcium absorption. PA and SA are found primarily on the sn2-positions (or beta-positions) on triacylglycerides, and are well absorbed after digestion as 2-monoacylglycerides
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