Supplementation Of Infant Formula Research Articles

Introduction of complementary foods to the infant diet within the first year of life: evaluation of general recommendations using Achievable Benchmarks of Care®

The primary objective of the present study was to assess the effect of DHA and arachidonic acid (ARA) supplementation of infant formulas on the incidence of respiratory illnesses during the first year of life. Enrolment for this multicentre prospective open-label 12-month observational study was conducted from 2002 to 2003 and included 1392 children from 357 Spanish paediatricians (the GENERACION Study Group). Infants were assigned in the proportion 4.4 :1 to receive a formula supplemented with 3.2 g DHA and 6.4 g ARA/kg or a low or non-supplemented control formula. Eligible infants were healthy, born at a gestational age that exceeded 36 weeks and non-breast-fed. Infants were to visit the paediatrician at baseline and months 1, 3, 5, 7, 9, and 12. At each subsequent visit records were taken of: anthropometric measurements; month of introduction for gluten-free cereal, gluten, fruits, vegetables, meat, fish, egg yolk, whole egg, cow's milk and legumes; the occurrence of clinical symptoms associated with common ailments in infancy. Results of the main objective have been published elsewhere (1,2) , and showed a significantly lower incidence of bronchitis or bronchiolitis in DHA + ARA-fed children. The secondary objective was to determine the adherence to paediatricians' recommendations to guidelines (3,4) on the introduction of complementary foods to the infant's diet. Achievable Benchmarks of Care (ABC) 1 ratios were also calculated to determine the standards of excellence attained by the 10 % of top performers (5) and identify areas for improving adherence to guidelines on the introduction of complementary foods (6) . The Table summarizes the findings from the study. Overall, the adherence was appropriate for most recommendations, but some recommendations need to be reinforced, such as the introduction of fruits, fish, cow's milk and legumes.

Quantification of water-soluble vitamins in milk-based infant formulae using biosensor-based assays

Vitamin analysis is essential for quality control and development of functional foods. In this study, a biosensor-based technology developed by Biacore AB was evaluated for analysis of water-soluble vitamins B 2, B 12, folic acid, biotin, and pantothenic acid used to supplement infant formula samples. Performance parameters such as accuracy, repeatability and recovery for the five vitamins were studied. The repeatability was measured in terms of relative standard deviation (RSD) and HORRAT r value. The RSD for all vitamins was below 2% and the values of HORRAT r were 0.16, 0.10, 0.15, 0.11 and 0.22, for B 2, B 12, folic acid, biotin, and pantothenic acid, respectively. The recovery of vitamins ranged from 94.7% to 109.1%. Linear analyses indicated that the square of the correlation coefficient ( R 2) for B 2, B 12, folic acid, biotin, and pantothenic acid were 0.993, 0.997, 0.993, 0.993 and 0.995, respectively. The results showed that the biosensor-based vitamin analysis technology is a sensitive, reliable and realistic alternative to other methods.

The intramolecular position of docosahexaenoic acid in the triacylglycerol sources used for pediatric nutrition has a minimal effect on its metabolic use

Docosahexaenoic acid (DHA) plays an important role in normal development of the brain and retina in the human. In utero, DHA is incorporated in the fetus, and its accretion continues throughout early postnatal life. Although human breast milk contains this fatty acid, several organizations recommend supplementing infant formulas with DHA for infants and premature infants. Traditionally, certain types of fish oil have been used for fortifying some infant formulas, but with the decline in world fisheries, the search for alternative sources of DHA continues. Among the viable ingredient sources of DHA is oil derived from single-cell organisms (marine microorganisms); however, these oil sources display different positional specificity of DHA in the glycerol lipids compared with that found in human breast milk lipids. In the latter, the DHA is mainly esterified in the central position of the glycerol backbone. Because of these differences in human milk and oils derived from single-cell organisms, recent research in biotechnology has focused on developing new structured triacylglycerols with an intramolecular structure resembling that found in human milk lipids. This research is justified by the potential differences in metabolism of DHA based on the hypothetical bioavailability and benefits in DHA found in human milk lipids. Presented herein is a review of the published research on the metabolism of DHA from different triacylglycerol sources including in vitro studies and animal studies. Despite small differences observed in digestion, the current data reveal a minimal effect on the parameters of development studied for the intramolecular position in which DHA is esterified.

The effect of natural prebiotic inulin to the quantitative microbiological indicators of bifidogenic effect: In vitro research

The aim of this paper was to examine and to compare microbiological parameters of bifidogenesis as important indicators of bifidogenic effect in infant formulas, with and without inulin supplement as a prebiotic; we also evaluated the rationale for inulin supplementation in order to improve biofidogenesis. Feces of healthy, breast-fed infants were used to examine and to isolate the accumulated culture of Bifidobacterium spp. Human milk and infant formulas (with or without inulin supplement) were used to examine the effect of substrate to bifidogenic effect. Pure chicory inulin was used as a natural prebiotic for the supplementation of infant formulas in concentration of 0.4 g and 0.8 g to 100/ml of substrate. In vitro effects of bifidogenesis were observed in all substrates by determining microbiological parameters at the beginning (index 0) and at the end of the experiments, after 48 hours (index 48). We observed and compared two microbiological parameters of bifidogenesis: the total number of bifidobacteria and dry biomass. Phase-contrast microscopy was used to identify Bifidobacterium spp. in accumulated mixed culture. The process of bifidogenesis was controlled by light transmission microscopy in light filed. Total number of Bifidobacterium spp. was determined by the method of serial dilution. Dry biomass was gravimetrically measured. Bifidogenic effect was calculated for each substrate. Dry biomass from the human milk substrate was used as a reference value. The obtained mean value of bifidogenic effect of standard milk formula was lower for 29% compared to mean value of bifidogenic index of human milk. The mean value of bifidogenic index of infant formula supplemented with 0.4 g and 0.8 g of inulin respectively was statistically significantly higher compared to the mean value of bifidogenic effect of human milk (>38% and >104%, respectively). The rationale for supplementation of infant formulas with inulin was confirmed.

Fishing for brain power?

The long chain polyunsaturated fatty acids (LCPUFA) arachidonic acid and docosahexaenoic acid (DHA) are predominant in the central nervous system. Neuronal synapses and photoreceptors in the retina are particularly rich...

Analysis and Quantitation of Fructooligosaccharides Using Matrix-Assisted Laser Desorption/Ionization Fourier Transform Ion Cyclotron Resonance Mass Spectrometry

Inulin is a class of fructooligosaccharide (FOS) derived from plants, which is often used as a natural food ingredient. Inulin is currently used as an additive in baked goods, dairy products, infant formula, and dietary supplements as a result of its purported health-promoting properties. The growth of health-promoting lactobacilli and bifidobacteria is supported by FOS, giving it the classification of a prebiotic; however, its ability to selectivity stimulate only beneficial bacteria has not been demonstrated. In order to better understand the role of inulin and FOS as prebiotics, matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry has been used for qualitative and quantitative analysis on bacterial growth. A method using an internal standard has been developed to quantify the consumption of FOS by Bifidobacterium longum bv. infantis using a calibration curve. Due to the differential consumption of FOS, the calibration curve was modified to include intensity components for each polymer unit in order to achieve more accurate quantitation. The method described was designed to be more rapid, precise, and robust for quantitative analysis when compared to existing methods.

Beneficial effects of probiotic bacteria isolated from breast milk

Breast milk is the best food for the neonate because it provides a unique combination of proteins, carbohydrates, lipids, minerals and vitamins that ensures the correct growth and development of the infant. In addition, it also contains bioactive compounds responsible for a wide range of beneficial effects such as the promotion of immune system maturation and the protection against infections. Among these bioactive agents, probiotic bacteria have been recently isolated from human milk. The present work reviews the beneficial effects of these bacteria both in animal models and in clinical trials. The promotion of immune system maturation and defence against infections as well as the anti-inflammatory properties are among the main healthy effects of these bacteria. The isolation of probiotic bacteria with beneficial effects for the host provides scientific support for the supplementation of infant formula with these bacteria, in order to advance the pursuit of the main goal of formula: to mimic breast milk and its functional effects as closely as possible.

Oxidative Stress in Preterm Infants Fed a Formula Containing Long-Chain Polyunsaturated Fatty Acids (LCPUFA)

Our study examined if dietary long-chain polyunsaturated fatty acids (LCPUFA) have an impact on oxidative stress in preterm infants. Serum malonyldialdehyde (MDA), total peroxide concentrations, and total antioxidant capacity were determined at mean (standard deviation [SD]) 34.7 (10.9) days of life in 104 healthy preterm infants (gestational age, 32.6 [2.9] weeks; birthweight; 1605 [285] g) who were randomly assigned to be fed since birth either a formula containing LCPUFA (arachidonic and docosahexaenoic) (group A, n = 50) or a LCPUFA-free formula with identical compositions for other nutrients (group B, n = 54). Clinical and anthropometric characteristics did not differ significantly between the two groups. Mean (SD) serum MDA levels did not differ significantly between groups A (0.23 [0.04] micromol/L) and B (0.22 [0.05] micromol/L). The concentrations of total peroxides were below the detection limits of the assay in 41 of 50 (82%) infants of group A and 43 of 54 (79%) infants of group B and not significantly different between the two infant groups. No difference was observed in serum total antioxidant capacity between groups A (340.0 [46.2] micromol/L) and B (354.7 [46.5] micromol/L). We concluded that supplementation of infant formulas with LCPUFA does not affect lipid peroxidation in healthy preterm infants.

Controversies in neonatal nutrition: docosahexanoic acid (DHA) and nucleotides

The breast-fed infant is the gold standard for infant formula research and development. The addition of long-chain polyunsaturated fatty acids and nucleotides to formula are intended to promote visual, neuro and immune development. Studies in both preterm and term infants have not consistently demonstrated efficacy with long-chain polyunsaturated fatty acids supplementation of infant formulas. Explanations for why these supplemented formulas do not always produce visual or neurodevelopmental advantages, include a small individual effect or that only a proportion of infants will benefit or the presence of confounding variables. The efficacy of nucleotides has been studied by analyzing response to vaccination in infants fed human milk versus formulas with or without additional nucleotides. Nucleotide supplemented formulas appear to enhance immune response similar to breast-fed infants with immunization. Humanizing formula with safe and well-studied nutrients may provide benefits that are discovered long after initial trials are concluded.

Effects of inorganic selenium compounds on oxidative DNA damage

Exposure of Escherichia coli or mammalian cells to H 2O 2 results in cell death due to iron-mediated DNA damage. Since selenium compounds have been examined for their ability to act as antioxidants to neutralize radical species, and inorganic selenium compounds are used to supplement protein mixes, infant formula, and animal feed, determining the effect of these compounds on DNA damage under conditions of oxidative stress is crucial. In the presence of Fe(II) and H 2O 2, the effects of Na 2SeO 4, Na 2SeO 3, SeO 2 (0.5–5000 μM), and Na 2Se (0.5–200 μM) on DNA damage were quantified using gel electrophoresis. Both Na 2SeO 4 and Na 2Se have no effect on DNA damage, whereas SeO 2 inhibits DNA damage and Na 2SeO 3 shows antioxidant or pro-oxidant activity depending on H 2O 2 concentration. Similar electrophoresis experiments with [Fe(EDTA)] 2− (400 μM) and Na 2SeO 3 or SeO 2 show that metal coordination by the selenium compound is required for antioxidant activity. In light of these results, Na 2SeO 4 may be safer than Na 2SeO 3 for nutritional supplements.

Visual acuity and cognitive outcomes at 4 years of age in a double-blind, randomized trial of long-chain polyunsaturated fatty acid-supplemented infant formula

Background While there is a large body of data on the effects of long-chain polyunsaturated fatty acid supplementation of infant formula on visual and cognitive maturation during infancy, longterm visual and cognitive outcome data from randomized trials are scarce. Aim To evaluate docosahexaenoic acid (DHA) and arachidonic acid (ARA)-supplementation of infant formula on visual and cognitive outcomes at 4 years of age. Methods Fifty-two of 79 healthy term infants who were enrolled in a single-center, double-blind, randomized clinical trial of DHA and ARA supplementation of infant formula were available for follow-up at 4 years of age. In addition, 32 breast-fed infants served as a “gold standard”. Outcome measures were visual acuity and the Wechsler Preschool and Primary Scale of Intelligence — Revised. Results At 4 years, the control formula group had poorer visual acuity than the breast-fed group; the DHA- and DHA + ARA-supplemented groups did not differ significantly from the breast-fed group. The control formula and DHA-supplemented groups had Verbal IQ scores poorer than the breast-fed group. Conclusion DHA and ARA-supplementation of infant formula supports visual acuity and IQ maturation similar to that of breast-fed infants.

The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants

Background Preterm infants have increased intestinal permeability which can render them susceptible to infections from enterobacteriae. Objectives The primary objective was to investigate whether probiotic administration to preterm infants decreases intestinal permeability. Secondary outcomes studied were: somatic growth, tolerance, rates of sepsis and necrotizing enterocolitis. Methods In a prospective randomized case–control study 41 stable preterm infants of 27 to 36 weeks gestation and 34 matched comparison infants consecutively admitted to the neonatal unit were studied. The study group received a preterm formula supplemented with Bifidobacter lactis (2 × 10 7 cfu/g of dry milk) while the control group received the same formula but without supplementation. Intestinal permeability was measured within two days of birth and then seven and thirty days later using the sugar absorption test. Additionally anthropometric parameters were recorded throughout the study as well as acceptance and tolerance of the formula. Results All infants tolerated the study formula well. Median counts of stool bifidobacteria and lactulose/mannitol ratios at baseline were comparable. After 7 days of supplementation median bifidobacteria counts were significantly higher in the study group than in the control group ( p = 0.0356) and they remained higher to the end of the study ( p at day 30 = 0.075). The L/M ratio in the study group was significantly lower at day 30 of the study as compared to the control group ( p = 0.003). Head growth was significantly higher in the study group ( p = 0.001). Conclusions The administration of a bifidobacter supplemented infant formula decreases intestinal permeability of preterm infants and leads to increased head growth.

Tolerance of prebiotic supplemented infant formula and impact on composition of fecal microbiota

Objective: To evaluate fecal bacteria, tolerance, and stooling patterns of infants fed formulas supplemented with prebiotic ingredients. Methods: Healthy, term infants were fed human milk (n = 30),...

Polyunsaturated fatty acids regulate cytokine and prostaglandin E2 production by respiratory cells in response to mast cell mediators

A protective association between breastfeeding and the development of bronchial asthma has been demonstrated. However, a mechanism remains unclear. FA present in human milk but rare in infant formula have been associated with marked immunological modulation as well as some indications of protection from asthma development. We examined the effect of in vitro manipulation of membrane phospholipid on the production of cytokines and prostaglandin (PG)E2 by respiratory epithelial cells (A549) in response to stimulation by mast cell mediators of allergic disease [histamine, tumor necrosis factor (TNF)-alpha, interleukin (IL)-4 and IL-5]. DHA and CLA significantly decreased the production of IL-8 in response to stimulation by TNF-alpha [2907 +/- 970 (DHA) and 6471 +/- 1203 (CLA) vs. 12,287 +/- 2309 (control) pg/mL; P < or = 0.05, mean +/- SEM], whereas both EPA and DHA reduced histamine-stimulated RANTES (regulation on activation, T cell-expressed and -secreted) production [2314 +/- 861 (EPA) and 877 +/- 326 (DHA) vs. 8526 +/- 1118 (control) pg/mL; P < or = 0.03]. PGE2 released in response to histamine was decreased by n-3 [1305 +/- 399 (alpha-linolenic acid), 406 +/- 73 (EPA), and 265 +/- 32 (DHA) vs. 9324 +/- 3672 (control) pg/mL; P < or = 0.05] and increased by n-6 [18,843 +/- 4439 (arachidonic acid) vs. 9324 +/- 3672 (control) pg/mL; P = 0.02], with CLA producing a decrease of the same magnitude as DHA [553 +/- 126 (CLA) vs. 9324 +/- 3672 (control) pg/mL; P = 0.03]. This study demonstrates the potential for immunological manipulation of the respiratory epithelium by FA in situ during allergic responses and suggests that further investigation into FA intervention in infants via human milk or supplemented infant formula, to prevent the development of allergic disease, may be worthwhile.

Omega-3 Fatty Acid Supplementation in Perinatal Settings

The purpose of this article is (a) to explain the role of omega-3 fatty acids in human health, specifically in fetal/neonatal development, (b) to summarize the recent research behind the innovations in infant formula manufacturing and advertisement of omega-3 fatty acid supplementation for pregnant and lactating mothers, and (c) to relate the research findings to clinical practice. Omega-3 fatty acid supplementation in perinatal settings is discussed here from three vantage points: (a) supplementation of the third-trimester pregnant woman to enhance fetal development, (b) supplementation of the lactating mother to enhance development of the breastfeeding infant, and (c) supplementation of infant formulas to enhance development of the bottle-feeding infant. Supplementation can occur by increasing one's intake of foods high in omega-3 fatty acids or by ingesting fatty acid nutritional supplements. The challenge of supplementation for vegan and vegetarian women is also addressed.

Mice raised on milk transgenically enriched with n−3 PUFA have increased brain docosahexaenoic acid

The brain contains high levels of the long-chain n-3 FA DHA (22:6n-3), mainly in the gray matter and synaptosomes. Adequate intake of DHA is crucial for optimal nervous system function, particularly in infants. Supplementation of infant formulas with DHA at levels similar to human breast milk is recommended for biochemical and functional benefits to neonates. We generated transgenic mice that produce elevated levels of n-3 PUFA in their milk by expressing the Caenorhabditis elegans n-3 FA desaturase under the control of a lactation-induced goat beta-casein promoter. To examine the postnatal effects of consuming the n-3-enriched milk, we compared the growth and brain and plasma FA composition of mouse pups raised on milk from transgenic dams with those observed for pups raised on milk from nontransgenic dams. A significant decrease in arachidonic acid (ARA, 20:4n-6) and concomitant increases in n-3 PUFA were observed in the phospholipid fraction of transgenic mouse milk. The n-6:n-3 FA ratios were 4.7 and 34.5 for the transgenic and control milk phospholipid fractions, respectively. DHA and DPA (22:5n-6) comprised 15.1% and 2.8% of brain FA from weanling mice nursed on transgenic dams, as compared with 6.9% and 9.2% for weanling mice nursed on control dams, respectively. This transgenic mouse model offers a unique approach to disassociate the effects and fetal programming resulting from a high n-6:n-3 FA ratio gestational environment from the postnatal nutritional effects of providing milk with differing n-6:n-3 FA ratios.

Probiotics and Chronic Disease

In today's climate, changed lifestyles and the increased use of antibiotics are significant factors that affect the preservation of a healthy intestinal microflora. The concept of probiotics is to restore and maintain a microflora advantageous to the human body. Probiotics are found in a number of fermented dairy products, infant formula, and dietary supplements. Basic research on probiotics has suggested several modes of action beneficial for the human body and clinical research has proven its preventive and curative features in different intestinal and extraintestinal diseases. Chronic diseases cause considerable disablement in patients and represent a substantial economic burden on healthcare resources. Research has demonstrated a crucial role of nutrition in the prevention of chronic disease. Thus, positive, strain-specific effects of probiotics have been shown in diarrheal diseases, inflammatory bowel diseases, irritable bowel syndrome, and Helicobacter pylori-induced gastritis, and in atopic diseases and in the prevention of cancer. As the majority of probiotics naturally inhabit the human intestinal microflora, their use has been regarded as very safe. However, in view of the range of potential benefits on health that might be achieved by the use of some probiotic bacteria, major and thorough evaluation is still necessary. In conclusion, probiotics act as an adjuvant in the prevention and treatment of a wide variety of chronic diseases.

Supplemented Infant Formulas: Which is the Best?

Supplemented Infant Formulas: Which is the Best?

Breastfeeding, infant formula supplementation, and Autistic Disorder: the results of a parent survey

BackgroundAlthough Autistic Disorder is associated with several congenital conditions, the cause for most cases is unknown. The present study was undertaken to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. The hypothesis is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are protective for Autistic Disorder.MethodsThis is a case-control study using data from the Autism Internet Research Survey, an online parental survey conducted from February to April 2005 with results for 861 children with Autistic Disorder and 123 control children. The analyses were performed using logistic regression.ResultsAbsence of breastfeeding when compared to breastfeeding for more than six months was significantly associated with an increase in the odds of having autistic disorder when all cases were considered (OR 2.48, 95% CI 1.42, 4.35) and after limiting cases to children with regression in development (OR 1.95, 95% CI 1.01, 3.78). Use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder when all cases were considered (OR 4.41, 95% CI 1.24, 15.7) and after limiting cases to children with regression in development (OR 12.96, 95% CI 1.27, 132).ConclusionThe results of this preliminary study indicate that children who were not breastfed or were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation were significantly more likely to have autistic disorder.

Probiotics as Flourishing Benefactors for the Human Body

This article provides a comprehensive review of the beneficial effects of various strains of probiotics in preventing and treating certain diseases. Currently, changed lifestyles as well as the increased use of antibiotics are significant factors challenging the preservation of a healthy intestinal microflora. The concept of probiotics is to restore and uphold a microflora advantageous for the human body. Probiotics are found in a number of fermented dairy products, infant formula, and dietary supplements. In the presence of prebiotics, which are nondigestible food ingredients favorable for probiotic growth, their survival in the intestine is ameliorated.