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Open Access 01-12-2018 | Research article

No effect of adding dairy lipids or long chain polyunsaturated fatty acids on formula tolerance and growth in full term infants: a randomized controlled trial

Authors: Maria Lorella Gianni, Paola Roggero, Charlotte Baudry, Catherine Fressange-Mazda, Pascale le Ruyet, Fabio Mosca

Published in: BMC Pediatrics | Issue 1/2018

Abstract

Background

When breastfeeding is not possible, infants are fed formulas in which lipids are usually of plant origin. However, the use of dairy fat in combination with plant oils enables a lipid profile in formula closer to breast milk in terms of fatty acid composition, triglyceride structure and cholesterol content. The objectives of this study were to investigate the impact on growth and gastrointestinal tolerance of a formula containing a mix of dairy lipids and plant oils in healthy infants.

Methods

This study was a monocentric, double-blind, controlled, randomized trial. Healthy term infants aged less than 3 weeks whose mothers did not breastfeed were randomly allocated to formula containing either: a mix of plant oils and dairy fat (D), only plant oils (P) or plant oils supplemented with long-chain polyunsaturated fatty acids (PDHA). Breastfed infants were included in a reference group (BF). Anthropometric parameters and body composition were measured after 2 and 4 months. Gastrointestinal tolerance was evaluated during 2 day-periods after 1 and 3 months thanks to descriptive parameters reported by parents. Nonrandomized BF infants were not included in the statistical analysis.

Results

Eighty eight formula-fed and 29 BF infants were enrolled. Gains of weight, recumbent length, cranial circumference and fat mass were similar between the 3 formula-fed groups at 2 and 4 months and close to those of BF. Z-scores for weight, recumbent length and cranial circumference in all groups were within normal ranges for growth standards. No significant differences were noted among the 3 formula groups in gastrointestinal parameters (stool frequency/consistency/color), occurrence of gastrointestinal symptoms (abdominal pain, flatulence, regurgitation) or infant’s behavior.

Conclusions

A formula containing a mix of dairy lipids and plant oils enables a normal growth in healthy newborns. This formula is well tolerated and does not lead to abnormal gastrointestinal symptoms. Consequently, reintroduction of dairy lipids could represent an interesting strategy to improve lipid quality in infant formulas.

Trial registration

ClinicalTrials.gov Identifier NCT01611649, retrospectively registered on May 25, 2012.

Delplanque B, Gibson R, Koletzko B, Lapillonne A, Strandvik B. Lipid quality in infant nutrition: current knowledge and future opportunities. J Pediatr Gastroenterol Nutr. 2015;61(1):8–17.PubMedPubMedCentral

Uauy R, Mena P, Wegher B, Nieto S, Salem N. Long chain polyunsaturated fatty acid formation in neonates: effect of gestational age and intrauterine growth. Pediatr Res. 2000;47(1):127–7.CrossRefPubMed

Innis SM. Fatty acids and early human development. Early Hum Dev. 2007;83(12):761–6.CrossRefPubMed

Innis SM. Dietary triacylglycerol structure and its role in infant nutrition. Adv Nutr. 2011;2(3):275–83.CrossRefPubMedPubMedCentral

Jan S, Guillou H, D’Andrea S, Daval S, Bouriel M, Rioux V, Legrand P. Myristic acid increases Delta 6-desaturase activity in cultured rat hepatocytes. Reprod Nut Dev. 2004;44(2):131–40.CrossRef

Dabadie H, Peuchant E, Bernard M, LeRuyet P, Mendy F. Moderate intake of myristic acid in sn-2 position has beneficial lipidic effects and enhances DHA of cholesteryl esters in an interventional study. J Nutr Biochem. 2005;16(6):375–82.CrossRefPubMed

Dabadie H, Motta C, Peuchant E, LeRuyet P, Mendy F. Variations in daily intakes of myristic and α-linolenic acids in sn-2 position modify lipid profile and red blood cell membrane fluidity. Br J Nutr. 2006;96(02):283–9.CrossRefPubMed

Delplanque B, Du Q, Agnani G, Le Ruyet P, Martin JC. A dairy fat matrix providing alpha-linolenic acid (ALA) is better than a vegetable fat mixture to increase brain DHA accretion in young rats. Prostaglandins, Leukot Essent Fatty Acids. 2013;88(1):115–20.CrossRef

Du Q, Martin JC, Agnani G, Pages N, Leruyet P, Carayon P, Delplanque B. Dairy fat blends high in α-linolenic acid are superior to n-3 fatty-acid-enriched palm oil blends for increasing DHA levels in the brains of young rats. J Nutr Biochem. 2012;23(12):1573–82.CrossRefPubMed

10.

Giannì ML, Roggero P, Baudry C, Ligneul A, Morniroli D, Garbarino F, Mosca F. The influence of a formula supplemented with dairy lipids and plant oils on the erythrocyte membrane omega-3 fatty acid profile in healthy full-term infants: a double-blind randomized controlled trial. BMC Pediatr. 2012;12(1):1.CrossRef

11.

Ma G, Yao M, Liu Y, Lin A, Zou H, Urlando A, Dewey KG. Validation of a new pediatric air-displacement plethysmograph for assessing body composition in infants. Am J Clin Nutr. 2004;79(4):653–60.PubMed

12.

Roggero P, Giannì ML, Amato O, Piemontese P, Morniroli D, Wong WW, Mosca F. Evaluation of air-displacement plethysmography for body composition assessment in preterm infants. Pediatr Res. 2012;72(3):316–20.CrossRefPubMed

13.

Finberg L, Bell EF, Cooke RJ, Fomon SJ, Kleinman RE, Pencharz PB, Reynolds JW, Schanler RJ, Forbes AL, AAP Task Force on Clinical Testing of Infant Formulas, Committee on Nutrition, American Academy of Pediatrics. Clinical testing of infant formulas with respect to nutritional suitability for term infants. US Food and Drug Administration, Center for Food Safety and Applied Nutrition ; 1988. pp. 1–16. (FDA contract 223-86-2117): https://wayback.archive-it.org/7993/20170722090324/https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/InfantFormula/ucm170649.htm

14.

Giannì ML, Roggero P, Morlacchi L, Garavaglia E, Piemontese P, Mosca F. Formula-fed infants have significantly higher fat-free mass content in their bodies than breastfed babies. Acta Paediatr. 2014;103(7):e277–81.PubMed

15.

Fontana M, Bianchi C, Cataldo F, Nibali SC, Cucchiara S, Casali L, Torre G. Bowel frequency in healthy children. Acta Paediatr. 1989;78(5):682–4.CrossRef

16.

Quinlan PT, Lockton S, Irwin J, Lucas AL. The relationship between stool hardness and stool composition in breast-and formula-fed infants. J Pediatr Gastroenterol Nutr. 1995;20(1):81–90.CrossRefPubMed

17.

Havlicekova Z, Jesenak M, Banovcin P, Kuchta M. Beta-palmitate–a natural component of human milk in supplemental milk formulas. Nutr J. 2016;15(1):1.

18.

Bracco U. Effect of triglyceride structure on fat absorption. Am J Clin Nutr. 1994;60(6):1002S–9S.CrossRefPubMed

19.

González HF, Vicentin D, Giumelli O, Vazzano M, Tavella M. Perfil de triacilgliceroles y porcentaje de ácido palmítico en la posición sn-2 en sustitutos de leche materna. Arch Argent Pediatr. 2012;110(3):227–30.CrossRefPubMed

20.

Hegar B, Dewanti NR, Kadim M, Alatas S, Firmansyah A, Vandenplas Y. Natural evolution of regurgitation in healthy infants. Acta Paediatr. 2009;98(7):1189–93.CrossRefPubMed

21.

Iacono G, Merolla R, D’Amico D, Bonci E, Cavataio F, Di Prima L. & Paediatric study group on gastrointestinal symptoms in infancy. Gastrointestinal symptoms in infancy: a population-based prospective study. Dig Liver Dis. 2005;37(6):432–8.CrossRefPubMed

22.

Wessel MA, Cobb JC, Jackson EB, Harris GS Jr, Detwiler AC. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics. 1954;14(5):421–35.PubMed

Title: No effect of adding dairy lipids or long chain polyunsaturated fatty acids on formula tolerance and growth in full term infants: a randomized controlled trial
Authors: Maria Lorella Gianni
Paola Roggero
Charlotte Baudry
Catherine Fressange-Mazda
Pascale le Ruyet
Fabio Mosca
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-018-0985-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

No effect of adding dairy lipids or long chain polyunsaturated fatty acids on formula tolerance and growth in full term infants: a randomized controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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