Soy Formula Research Articles

In vitro lipolysis of dairy and soy based infant formula

Hydrolysed and non-hydrolysed dairy and soy proteins with vegetable oils are commonly used in infant formulations. Lipid digestion of these infant formula emulsions was studied under an in vitro gastrointestinal condition for 60 min in the stomach and 120 min in the small intestine (with and without the presence of enzyme proteases). The distribution of oil droplets, the released free fatty acids, and micro-structure changes of the digesta were monitored over the digestion period. Oil droplet coalescence was observed during gastric phase but not in the intestinal phase for most of formulations. The emulsion structure and the oil-water interface of the oil droplets play an important part in lipolysis kinetics. Higher rate of lipolysis in infant formula emulsion stabilized by hydrolysed proteins was noted. The obtained results suggest that digestive proteases had a limited impact on lipolysis of infant formulations.

Attitudes towards cow's milk protein allergy management by Spanish gastroenterologist

Abstract Introduction Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. Methods A 50 item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list. Results Seventy-three questionnaires were received back out of 321. Only 3 of the items achieved concordance greater than 90%. Thirty-three percent considered oral challenge to be necessary for the diagnosis of CMPA under any circumstance. Twenty-five percent considered that symptom improvement after cow's milk removal was enough for the diagnosis. Oral challenge was performed at home by 83.5% in non-IgE mediated cases. Extensively hydrolyzed casein formulas were the treatment of choice for 69.9%. Soy formulas were the last option. Almost all respondents were aware of the existence of clinical guidelines on CMPA, being European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines the most followed (64.4%). Twenty-three percent considered that their knowledge about allergy was inadequate. Conclusions Although CMPA is a prevalent condition that pediatric gastroenterologists have been treating for decades, we found a huge variability on its management. There is potential for improvement in this field among pediatric gastroenterologist in the future.

Manejo de la alergia a proteína de leche de vaca por los gastroenterólogos españoles

Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. A fifty item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list. Seventy-three questionnaires were received back out of 321. Only 3 of the items achieved concordance greater than 90%. Thirty-three percent considered oral challenge to be necessary for the diagnosis of CMPA under any circumstance. Twenty-five percent considered that symptom improvement after cow's milk removal was enough for the diagnosis. Oral challenge was performed at home by 83.5% in non-IgE mediated cases. Extensively hydrolyzed casein formulas were the treatment of choice for 69.9%. Soy formulas were the last option. Almost all respondents were aware of the existence of clinical guidelines on CMPA, being European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines the most followed (64.4%). Twenty-three percent considered that their knowledge about allergy was inadequate. Although CMPA is a prevalent condition that pediatric gastroenterologists have been treating for decades, we found a huge variability on its management. There is potential for improvement in this field among pediatric gastroenterologist in the future.

Applying quantitative metabolomics based on chemical isotope labeling LC-MS for detecting potential milk adulterant in human milk

There is an increasing demand for donor human milk to feed infants for various reasons including that a mother may be unable to provide sufficient amounts of milk for their child or the milk is considered unsafe for the baby. Selling and buying human milk via the Internet has gained popularity. However, there is a risk of human milk sold containing other adulterants such as animal or plant milk. Analytical tools for rapid detection of adulterants in human milk are needed. We report a quantitative metabolomics method for detecting potential milk adulterants (soy, almond, cow, goat and infant formula milk) in human milk. It is based on the use of a high-performance chemical isotope labeling (CIL) LC-MS platform to profile the metabolome of an unknown milk sample, followed by multivariate or univariate comparison of the resultant metabolomic profile with that of human milk to determine the differences. Using dansylation LC-MS to profile the amine/phenol submetabolome, we could detect an average of 4129 ± 297 (n = 9) soy metabolites, 3080 ± 470 (n = 9) almond metabolites, 4256 ± 136 (n = 18) cow metabolites, 4318 ± 198 (n = 9) goat metabolites, 4444 ± 563 (n = 9) infant formula metabolites, and 4020 ± 375 (n = 30) human metabolites. This high level of coverage allowed us to readily differentiate the six different types of samples. From the analysis of binary mixtures of human milk containing 5, 10, 25, 50 and 75% other type of milk, we demonstrated that this method could be used to detect the presence of as low as 5% adulterant in human milk. We envisage that this method could be applied to detect contaminant or adulterant in other types of food or drinks.

Soy-Based Infant Formulas: A Review of Developmental and Nutritional Considerations

Soy-Based Infant Formulas: A Review of Developmental and Nutritional Considerations

Simultaneous Determination of Soyasaponins and Isoflavones in Soy (Glycine max L.) Products by HPTLC-densitometry-Multiple Detection.

A new high-throughput method was developed for the simultaneous analysis of isoflavones and soyasaponnins in Soy (Glycine max L.) products by high-performance thin-layer chromatography with densitometry and multiple detection. Silica gel was used as the stationary phase and ethyl acetate:methanol:water:acetic acid (100:20:16:1, v/v/v/v) as the mobile phase. After chromatographic development, multi-wavelength scanning was carried out by: (i) UV-absorbance measurement at 265 nm for genistin, daidzin and glycitin, (ii) Vis-absorbance measurement at 650 nm for Soyasaponins I and III, after post-chromatographic derivatization with anisaldehyde/sulfuric acid reagent. Validation of the developed method was found to meet the acceptance criteria delineated by ICH guidelines with respect to linearity, accuracy, precision, specificity and robustness. Calibrations were linear with correlation coefficients of >0.994. Intra-day precisions relative standard deviation (RSD)% of all substances in matrix were determined to be between 0.7 and 0.9%, while inter-day precisions (RSD%) ranged between 1.2 and 1.8%. The validated method was successfully applied for determination of the studied analytes in soy-based infant formula and soybean products. The new method compares favorably to other reported methods in being as accurate and precise and in the same time more feasible and cost-effective.

Identification of cross-reactive B-cell epitopes between Bos d 9.0101(Bos Taurus) and Gly m 5.0101 (Glycine max) by epitope mapping MALDI-TOF MS.

Exposure to cow's milk constitutes one of the most common causes of food allergy. In addition, exposure to soy proteins has become relevant in a restricted proportion of milk allergic pediatric patients treated with soy formulae as a dairy substitute, because of the cross-allergenicity described between soy and milk proteins. We have previously identified several cross-reactive allergens between milk and soy that may explain this intolerance. The purpose of the present work was to identify epitopes in the purified αS1-casein and the recombinant soy allergen Gly m 5.0101 (Gly m 5) using an α-casein-specific monoclonal antibody (1D5 mAb) through two different approaches for epitope mapping, to understand cross-reactivity between milk and soy. The 1D5 mAb was immobilized onto magnetic beads, incubated with the peptide mixture previously obtained by enzymatic digestion of the allergens, and the captured peptides were identified by MALDI-TOF MS analysis. On a second approach, the peptide mixture was resolved by RP-HPLC and immunodominant peptides were identified by dot blot with the mAb. Finally, recognized peptides were sequenced by MALDI-TOF MS. This novel MS based approach led us to identify and characterize four peptides on α-casein and three peptides on Gly m 5 with a common core motif. Information obtained from these cross-reactive epitopes allows us to gain valuable insight into the molecular mechanisms of cross-reactivity, to further develop new and more effective vaccines for food allergy.

Formula diet driven microbiota shifts tryptophan metabolism from serotonin to tryptamine in neonatal porcine colon\ufeff

BackgroundThe gut microbiota of breast-fed and formula-fed infants differ significantly, as do the risks for allergies, gut dysfunction, and upper respiratory tract infections. The connections between breast milk, various formulas, and the profiles of gut bacteria to these childhood illnesses, as well as the mechanisms underlying the effects, are not well understood.MethodsWe investigated distal colon microbiota by 16S RNA amplicon sequencing, morphology by histomorphometry, immune response by cytokine expression, and tryptophan metabolism in a pig model in which piglets were sow-fed, or fed soy or dairy milk-based formula from postnatal day (PND) 2 to 21.ResultsFormula feeding significantly (p < 0.05) altered the colon microbiota relative to the sow feeding. A significant reduction in microbial diversity was noted with formula groups in comparison to sow-fed. Streptococcus, Blautia, Citrobacter, Butrycimonas, Parabacteroides, Lactococcus genera were increased with formula feeding relative to sow feeding. In addition, relative to sow feeding, Anaerotruncus, Akkermansia, Enterococcus, Acinetobacter, Christensenella, and Holdemania were increased in milk-fed piglets, and Biliophila, Ruminococcus, Clostridium were increased in soy-fed piglets. No significant gut morphological changes were noted. However, higher cytokine mRNA expression (BMP4, CCL11, CCL21) was observed in the distal colon of formula groups. Formula feeding reduced enterochromaffin cell number and serotonin, but increased tryptamine levels relative to sow feeding.ConclusionOur data confirm that formula diet alters the colon microbiota and appears to shift tryptophan metabolism from serotonin to tryptamine, which may lead to greater histamine levels and risk of allergies in infants.

The Effect of Prenatal and Postnatal Administration of Manganese Chloride on the Developing Caudate Nucleus of the Corpus Striatum in Male Albino Rats and the Possible Beneficial Role of Vitamin E Supplementation: A Histological and Immunohistochemical study

Background: Although low levels of manganese (Mn) intake are necessary for human health but may also be toxic at high concentrations. Infants are subjected to risk of elevated Mn exposure from soy-based infant formulas and contaminated well-water which contain Mn at high levels. Young children are susceptible to be exposed to an elevated Mn levels because the developing brain is vulnerable to the chemical insult, as well as an increased absorption and retention of ingested Mn in comparison to the adults. Vitamin E is an antioxidant and is protectective to the biological membranes from oxidative stress.Aim of work: To investigate the effect of adminstration of manganese chloride (MnCL2) during pregnancy and lactation on the postnatal development of the caudate nucleus of the rat corpus striatum and to evaluate the role of vitamin E. Also, this work aimed to detect the effect of MnCL2 withdrawal..Material and Methods: Forty-pregnant female albino rats were divided into two equal groups (20 rats each): group I (control) and group II (MnCl2-treated). Litters of the control dams were sacrificed at the age of one day (group Ia), 10 days (group Ib), 20 days (group Ic) and 2 months (group Id). MnCl2-treated dams received MnCl2 at a dose of 50 mg /kg b.w. orally daily throughout conception till 20th day postnatally. Half of their male litters were sacrificed at the age of one day (group IIa), 10 days (group IIb) and 20 days (group IIc). The other half was sudivided at the age of 20 days into 3 equal groups: group IId received the same dose of MnCl2 till the age of 2 months, group IIe received vitamin E at a dose of 48 mg/kg b.w. orally daily till the age of 2 months concomitantly with MnCl2 and group IIf received distilled water orally daily till the age of 2 months. Animals in the previous three groups were sacrificed at the age of 2 months. Brains were processed to be studied using Einarson’s gallocyanin stain, H&E, transmission electron microscopy and immunohistochemical study for glial fibrillary acidic protein (GFAP).Results: As regard the postnatal development of the caudate nucleus, there was a gradual increase in the amount of Nissl's granules and the size of the neuronal nuclei with the presence of an apparent decrease in neuronal density. A gradual increase in the density of GFAP positive cells was noticed. Maternal MnCl2 administration affected the development of the caudate of the offsprings at the different ages studied. Many cells revealed degenerative changes in the form of darkly stained pyknotic or irregular rarified nuclei and vacuolated cytoplasm. There was progressive reduction in the amount of Nissl's granules. More abundant GFAP positive cells were noticed comparable to those in the control ages. On electron microscopic study, there were dark degenerated cells and deformed myelin sheath with splitting and fragmentation of their lamellae. Swollen mitochondria with disrupted cristae were noticed in the cytoplasm of many cells. These histological and immunohistochemical changes were found to be corrected with the administration of vitamin E and the cells had nearly normal appearance. These changes revealed no improvement on withdrawal of MnCl2 and it is nearly like that under usage.Conclusion: Gestational and lactational administration of MnCl2 had harmful effects on the structure of the caudate nucleus of the offsprings at different ages. Vitamin E can be used for prevention and treatment of these effects as an adjuvant therapy.

Sex Hormones, Gonadotropins, and Sex Hormone-binding Globulin in Infants Fed Breast Milk, Cow Milk Formula, or Soy Formula

Measurement of endogenous hormones in early life is important to investigate the effects of hormonally active environmental compounds. To assess the possible hormonal effects of different feeding regimens in different sample matrices of infants, 166 infants were enrolled from two U.S hospitals between 2006 and 2009. The children were classified into exclusive soy formula, cow milk formula or breast milk regimens. Urine, saliva and blood samples were collected over the first 12 months of life. Estradiol, estrone, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels were measured in the three matrices. Lower estradiol and LH levels were found in urine and saliva samples of soy formula-fed boys compared to cow formula-fed boys. Higher LH level was found in urine samples of soy formula-fed girls compared to cow formula-fed girls. However, we found neither a neonatal testosterone rise in the boys nor a gender-specific difference in testosterone levels, which suggests that urinary testosterone levels may not accurately reflect blood levels during mini-puberty. Nevertheless, our study shows that blood, urine and saliva samples are readily collectible and suitable for multi-hormone analyses in children and allow examination of hypotheses concerning endocrine effects from dietary compounds.

Infant formula feeding alters the proliferative status of neonatal mammary glands independent of estrogen signaling

Soy infant formula contains many phytochemicals, including phytoestrogens, which are structurally similar to estradiol (E2). The mammary gland is particularly sensitive to estrogens, and there are concerns that use of soy‐based infant formulas may potentially have adverse effects on mammary tissue development. In this study, we fed female piglets a soy‐based infant formula, a dairy milk‐based infant formula, or milk formula supplemented with E2, in comparison to piglets receiving sow's breast milk from postnatal day 2–21. Interestingly, we observed a slight but significant increase in terminal end bud number in the mammary glands of the all formula fed groups compared to the sow's milk control. Microarray analysis identified 976 differentially expressed genes between mammary glands from milk formula, soy formula and milk formula supplemented with E2 vs sow fed piglets (±1.5 fold, P&lt;0.05). Of these genes, 45% were held in common between all formula groups. E2 supplemented milk formula altered 369 genes. Milk and soy formula altered 45 and 69 genes, respectively, in comparison to the sow's milk control. Functional annotation analysis indicated up‐regulation of angiogenesis, adipocyte differentiation, and canonical Wnt signaling pathways in the formula fed groups. Real‐time RT‐PCR confirmed decreased Wnt10b mRNA expression, and increased Wnt2b, cyclin D and n‐myc expression, suggesting an heightened proliferative state in the mammary glands of formula fed piglets compared to piglets receiving sow's milk, P&lt;0.05. Pathways unique to the soy formula group had no apparent relevance to mammary gland development and/or function. Real time RT‐PCR expression of the E2‐responsive genes progesterone receptor (Pgr) and transforming growth factor beta‐2 (Tgfb2) were significantly up‐regulated in the E2‐supplemented formula group, compared to the milk formula and soy formula groups and the sow's milk control. These data show that dietary exposure to phytoestrogens associated with soy infant formula do not elicit an estrogenic response in the developing mammary gland. However, the neonatal mammary gland is generally quiescent. Our data also suggest that infant formula feeding may initiate proliferative and cell differentiation pathways independent of estrogenic signaling.Support or Funding InformationThis work was funded by USDA‐ARS Project 6026‐5100‐010‐05S.

Male testicular development is affected by estrogens but not altered in neonatal piglets receiving soy infant formula

Soy infant formula contains many phytochemicals, including phytoestrogens, which are structurally similar to estradiol (E2). As a result of their potentially estrogenic properties, soy infant formulas have been the subject of concern with regards to reproductive toxicity. To address these concerns regarding male reproductive development, we fed male piglets a soy‐based infant formula, a dairy milk‐based infant formula, milk formula supplemented with E2, or milk formula supplemented with putative estrogenic soy phytonutrient genistein (GEN), in comparison with piglets receiving sow's breast milk from postnatal day 2–21. In the E2 supplemented group, serum testosterone and testicular weight were significantly reduced compared to the milk formula‐fed and sow's milk controls. Testis tubule area, Sertoli cell and germ cell numbers were also increased in the E2 supplemented group compared to milk formula controls, P&lt;0.05. When compared to the sow's milk control, RNAseq analysis in testes showed that E2 supplemented milk formula altered expression of 2012 testicular genes (±1.5 fold, P&lt;0.100). Functional annotation analysis indicated up‐regulation of several pathways in the E2 supplemented group, including canonical Wnt signaling, cell differentiation and migration, angiogenesis and spermatogenesis. E2 also down‐regulated cholesterol and androgen synthesis pathways. Real‐time RT‐PCR confirmed the decrease in steroidogenic acute regulatory protein (Star) mRNA in the E2 supplemented group, suggesting a potential mechanism for the observed decrease in serum testosterone in this diet group. In contrast, GEN supplementation of milk formula altered 104 genes, soy formula 49 genes, and the pathways impacted had no clear links to testes function or sex organ development. These data show that early infant diet exposure to phytoestrogens in soy‐based infant formula are not estrogenic in the male reproductive system.Support or Funding InformationThis work was funded by USDA‐ARS Project 6026‐5100‐010‐05S.

Developmental Changes in Resting Gamma Power from Age Three Months to Five Years Are Modulated by Infant Diet

Gamma band activity (30–50 Hz) is a significant EEG component related to intelligence, memory and language processes, but there is limited information regarding the early development of this activity and none considering how infant diet may influence this development. The present study examined changes in gamma power from 3 months through 5 years in 497 healthy children who were breast‐fed (BF: 168, 84 boys), or fed milk formula (MF: 169, 89 boys), or soy formula (SF: 160, 90 boys) as infants. Recordings of resting EEG (5 min; eyes open) were obtained quarterly during infancy and then yearly. We used ANOVAs adjusted for relevant growth and environmental factors (gender, head circumference, gestation, birth and visit weight, SES and mother's IQ) to compare group, age, and group by age changes in gamma EEG power from 44 homologous sites distributed over frontal, central, temporal, parietal and occipital scalp regions. Across sites and groups, gamma power was lowest at 3 months (all p &lt; .001), and across age gamma power was consistently higher at frontal than other sites (all p &lt; .05). From 3 to 6 months gamma power increased dramatically at all sites for all groups [all p &lt; .001; mean increase &gt;100% for all sites, greatest for central‐parietal regions (187% mean increase across groups)]. After 6 months, gamma power generally increased across sites until a time after which significant (p &lt; .05) decreases became evident relative to preceding peak levels. The ages after which decreases became evident varied within and across brain regions, with site‐specific time points of change ranging from 1 to 4 years and occurring later (after 3–4 years) in anterior frontal than other regions. Temporal sites differed from others in showing sharp decreases both early (after 9 months or 1 year) and later (after 3 years). Group variations in site‐related time points of change were most evident for frontal and occipital regions. Infant diet‐related effects were evident at 3 months [BF &lt; MF, SF (p ≤ .001) and were generally sustained across age‐‐ particularly at parietal‐occipital sites where BF &lt; MF differences (p &lt; .05) were most prominent. These findings provide new information regarding the regional development of EEG gamma activity from infancy to the onset of middle childhood, and show that this development is modified by infant diet. Previous reports of negative associations between resting gamma and measures of language skills and intelligence suggest potential developmental advantages for breastfed infants.Support or Funding InformationFunded by USDA‐ARS Project 6026‐51000‐010‐05S

Parte 2: Manejo de la Alergia a la Proteína de Leche de Vaca

La lactancia materna es un excelente factor protector y una forma inigualable de facilitar el alimento ideal para el crecimiento y desarrollo saludable. Es imprescindible su recomendación exclusiva durante los primeros 6 meses de vida y de ser posible continuar con la lactancia materna durante la alimentación complementaria hasta los 2 años de edad; solo se debe recurrir a fórmulas especiales cuando la madre no pueda amamantar. Para estos casos se dispone de varias fórmulas hidrolizadas, soja y elementales. Las fórmulas hidrolizadas pueden ser extensa o parcialmente hidrolizadas, y ser séricas o de caseína. Las fórmulas extensamente hidrolizadas, han sido sometidas a ensayos clínicos donde se comprueba su hipoalergenicidad al eliminar los síntomas de la Alergia a la Proteína de la Leche de Vaca (APLV) luego de su inicio. Estudios recientes demuestran que la adición de Lactobacillusr hamnosus (LGG) a una fórmula de caseína extensamente hidrolizada acelera la adquisición de tolerancia en estos niños en comparación con los pacientes que recibieron fórmula sin adición. La fórmula de soja, aunque no es hipoalergénica, se puede emplear para tratar la APLV, pero no antes de los 6 meses. No se pueden emplear como tratamiento de APLV fórmulas parcialmente hidrolizadas, ni leche de otros rumiantes, como oveja o cabra. En pacientes con altos niveles de sensibilización o con antecedente de reacción anafiláctica, se recomienda la administración de fórmula elemental. El objetivo de la presente revisión es dar a conocer el manejo y uso racional de las fórmulas hidrolizadas y elementales en niños con APLV y así evitar el uso indiscriminado de estas en niños con trastornos funcionales.Palabras clave Fórmulas infantiles, hidrolizados de proteína, Lactobacillus rhamnosus, leche de soja, aminoácidos

Trends in Provider Management of Patients with Food Protein–Induced Enterocolitis Syndrome

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. To better understand provider-level variation in FPIES knowledge and management. A 23-question online survey was administered to AAAAI members during the spring and summer of2014. Among 470 respondents, 64% reported "full understanding" of FPIES diagnosis/management; 78.8% reported managing 1 or more patient with FPIES; and 80.4% correctly identified an FPIES case vignette. FPIES was correctly differentiated from infantile colic or food protein-induced allergic proctocolitis by 82.5% and 71.3%, respectively. Among providers currently managing patients with FPIES, 47.5% indicated soy formula, 73.8% breast milk, and 94.5% elemental formula as appropriate substitutes in cow milk (CM)-FPIES. Skin testing is performed by 73.4%; 62.2% obtain serum food-specific IgE testing, 12.7% patch testing, 36.8% oral challenge,and 28% perform no tests. Eighty-four percent provide patients with FPIES with allergy action plans, 72.8% provide a personalized action plan, and 21% prescribe epinephrine autoinjectors. Odds of prescribing epinephrine were lower among those reporting "full understanding" of FPIES (odds ratio [OR], 0.41; 95% CI, 0.21-0.79). Academic providers had higher odds of providing an action plan (OR, 2.4; 95% CI, 1.17-4.98) and performing diagnostic oral food challenge (OR, 1.99; 95% CI, 1.99-3.25), but not of correct vignette differentiation of FPIES from other conditions, correct identification of appropriate CM-FPIES substitutes, or timing for food reintroduction. More years in practice wereassociated with lower odds of reporting full understanding of FPIES diagnosis/management (OR, 0.96; 95% CI, 0.94-0.99). Nearly one-third of respondents reported poor familiarity with FPIES. Considerable variation exists in the use of diagnostic tests, management, and choice of "safe" nutrition, indicating a strong need for FPIES practice guidelines.

Allergy march of Chinese children with infantile allergic symptoms: a prospective multi-center study.

Allergy march refers to progression of allergic diseases from infantile food allergy to the development of asthma and allergic rhinitis (AR). Evidence come mostly from studies in European countries. This study aimed to investigate allergy march in Chinese children with infantile food protein allergy (FPA) with a special focus on the effect of different formula interventions. From 2008 to 2010, 153 infants diagnosed with FPA were recruited in five tertiary hospitals across China. They were randomly treated with amino-acid-based formula or soy-protein-based formula for a period of 3 months. Long-term follow-up was performed when they reached early school age, using questionnaires, physical examinations, and serum-specific immunoglobulin E. The overall follow-up rate was 73.20%. In patients who reached their early school years, the prevalence of physician-diagnosed AR and asthma were 43.75% and 23.21%, respectively. Only 40% of the subjects remained positive for food sensitizations upon follow-up. Twenty-six subjects receiving aeroallergen screening tests in infancy all proved negative, but upon follow-up, 65.57% were sensitized to aeroallergens (P=0.005). No significant difference between the effects of amino-acid-based formula and soy-protein-based formula on children's allergy march was observed. A high proportion (47.32%) of Chinese infants with early allergic symptoms developed respiratory allergies by their early school years. Most food-sensitized infants outgrew their condition several years later, but then aeroallergen sensitization often occurred. Amino-acid-based formula showed no advantages over soy protein-based formula with respect to arresting the allergy march.

Intestinal absorption of iron and calcium from soy and cow's milk-based infant formulas in weanling rats pups

ABSTRACT Objective: This study aimed to compare the intestinal absorption of iron and calcium between soy-based and cow's milk-based infant formulas in weanling rats. Methods: Twenty male Wistar rats, twenty-one days old on the first day of weaning, were used in this experiment, divided in two Groups, one Group was fed soy protein-based infant formula the other, cow's milk protein-based infant formula. During the study period (ten consecutive days) the animals received food and water ad libitum. Hematocrit and hemoglobin were evaluated on the first, fifth, and tenth days by the Wintrobe and cyanomethemoglobin methods. Feces and urine were collected, beginning on the fifth day, for three consecutive days. On the tenth day, hepatic iron content was also analyzed. Hepatic iron as well as fecal and urinary iron and calcium analyses were performed using an atomic absorption spectrophotometer. At thirty-one days of age, the animals were anesthetized with ketamine and xylazine and sacrificed by exsanguination via the vena cava. Results: The final concentration of hemoglobin in the group soy-based infant formula and milk-based infant formula were: 10.3±1.3g/dL and 10.9±1.0g/dL (p=0.310). The apparent absorption of iron and calcium, in that order, were: 73.4±10.2% and 70.2±9.5%; 97.2±0.7% and 97.6±1.0% (p=0.501; p=0.290). The apparent calcium retention was: 88.4% ±2.2 and 88.6±2.6% (p=0.848). Hepatic iron content was: 522.0±121.1mg/g and 527.8±80.5mg/g (p=0.907) . Conclusion: Intestinal iron and calcium absorption from soy-based infant formula is similar to that from milk-based infant formula in weanling rats.

Food Protein-Induced Enterocolitis Syndrome.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-, cell-mediated food allergy of unknown prevalence and pathophysiology. Onset is typically during the first year of life; seafood-induced FPIES may start in adulthood. Acute FPIES manifests within 1-4 hours after ingestion with repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15% of cases. Chronic FPIES manifests with intermittent emesis, watery diarrhea, and poor growth progressing to dehydration and hypovolemic shock over a period of days to weeks. Chronic FPIES has been only reported in infants aged less than 3 months fed with cow milk (CM) or soy formula. The most common triggers are CM, soy, rice, and oat. Diagnosis of FPIES relies on recognition of a pattern of clinical symptoms and may be missed owing to the absence of typical allergic symptoms (eg, urticaria, wheezing) and delayed onset in relation to food ingestion. Physician-supervised food challenge is recommended if diagnosis or the trigger food is not clear and to evaluate for resolution. Testing for food-specific IgE is usually negative, although a subset of patients, usually with CM-induced FPIES may develop sensitization to foods. Such atypical FPIES tends to have a more prolonged course. Despite the potential severity of the reactions, no fatalities have been reported, and FPIES has a favorable prognosis. In most cases, FPIES resolves by age 3-5 years, although persistence of CM-induced FPIES and soy FPIES into adulthood has been reported. The first international consensus guidelines on diagnosis and management of FPIES were published in 2017. Given that the pathophysiology of FPIES is poorly understood, there are no diagnostic biomarkers and no therapies to accelerate resolution. These unmet needs warrant future investigations to improve the care of patients with FPIES.

Soy-Based Therapeutic Baby Formulas: Testable Hypotheses Regarding the Pros and Cons.

Soy-based infant formulas have been consumed in the United States since 1909, and currently constitute a significant portion of the infant formula market. There are efforts underway to generate genetically modified soybeans that produce therapeutic agents of interest with the intent to deliver those agents in a soy-based infant formula platform. The threefold purpose of this review article is to first discuss the pros and cons of soy-based infant formulas, then present testable hypotheses to discern the suitability of a soy platform for drug delivery in babies, and finally start a discussion to inform public policy on this important area of infant nutrition.

Effects of Post-Weaning Consumption of Soy Isoflavones on Prepubertal and Postpubertal Serum Levels of Some Reproductive Hormones of Male Wistar Rats

Chemically, soy contains a group of phytoestrogens called isoflavones, pre-dominantly genistein and daidzein. The aim of the present study was to determine the effects of post weaning consumption of dietary soy isoflavones on prepubertal and postpubertal serum levels of some reproductive hormones of male Wistar rats. The study involved investigating the effects of different doses of isoflavones in the diet. Male rats were weaned on either soy isoflavone free diet or on isoflavone containing diets, formulated by adding increasing amounts of Novasoy, a commercially available isoflavone supplement to the isoflavone free diet to give varying concentrations of isoflavones. Three isoflavone containing diets were used and these had 74.5, 235.6 and 1046.6 mg total isoflavones/kg pelleted diet. These diets represented the isoflavone concentration lower, equal to and more than that found in soy-based infant formulas respectively. The results obtained showed that; administration of low doses soy isoflavones (74.5 mg/kg) produced significant (p < 0.05) increase in serum Antimullerian Hormone levels both in prepubertal and post pubertal rats, when compared to the control groups. Administration of moderate doses of isoflavones (235.6 mg/kg) produced significant (p < 0.05) increase in serum levels of Antimullerian Hormone and Inhibin in both prepubertal and post pubertal rats when compared to the control groups. Administration of high doses of isoflavones (1046.6 mg/kg) produced significant (p < 0.05) increase in serum levels of Inhibin in both prepubertal and post pubertal rats when compared to the control groups. From this study, it was concluded that post-weaning consumption soy isoflavones produced significant changes in serum Inhibin and Antimullerian Hormone both in prepubertal and post pubertal male Wistar rats and the changes were dose dependent.