Perspective: Moving Toward Desirable Linoleic Acid Content in Infant Formula

Susan E Carlson,Lidewij Schipper,J Thomas Brenna,Carlo Agostoni,Philip C Calder,Stewart Forsyth,Philippe Legrand,Marieke Abrahamse-Berkeveld,Bert J M Van De Heijning,Eline M Van Der Beek,Berthold V Koletzko,Beverly Muhlhausler

doi:10.1093/advances/nmab076

Abstract

ABSTRACTInfant formula should provide the appropriate nutrients and adequate energy to facilitate healthy infant growth and development. If conclusive data on quantitative nutrient requirements are not available, the composition of human milk (HM) can provide some initial guidance on the infant formula composition. This paper provides a narrative review of the current knowledge, unresolved questions, and future research needs in the area of HM fatty acid (FA) composition, with a particular focus on exploring appropriate intake levels of the essential FA linoleic acid (LA) in infant formula. The paper highlights a clear gap in clinical evidence as to the impact of LA levels in HM or formula on infant outcomes, such as growth, development, and long-term health. The available preclinical information suggests potential disadvantages of high LA intake in the early postnatal period. We recommend performing well-designed clinical intervention trials to create clarity on optimal levels of LA to achieve positive impacts on both short-term growth and development and long-term functional health outcomes.

Highlights

Exclusive breastfeeding is recommended for infants up to 6 months of age, with continued breastfeeding thereafter in conjunction with appropriate complementary feeding until 2 years of age or beyond [1]
This paper provides a narrative review of the current knowledge, unresolved questions, and future research needs in the area of human milk (HM) fatty acid (FA) composition, with a particular focus on exploring appropriate intake levels of the essential FA linoleic acid (LA) in infant formula
To the best of our knowledge, there are no clinical trials to date in which the effects of LA and ALA levels in infant formula are studied in the presence of preformed long-chain PUFAs (LCPUFAs)

Summary

Introduction

Exclusive breastfeeding is recommended for infants up to 6 months of age, with continued breastfeeding thereafter in conjunction with appropriate complementary feeding until 2 years of age or beyond [1]. Data from preclinical studies suggest that exposure to a high LA supply early in life predisposes an infant to later life metabolic diseases, including obesity and hepatic steatosis [3, 127, 129,130,131], whereas low LA intake, as well as dietary n–3 LCPUFA supplementation, may program an infant toward reduced fat mass accumulation [132, 133].

Results

Conclusion