Aluminum content of infant formulas used in Turkey

In the past few years, there has been an upsurge of interest in aluminum (Al) and human health. The well-recognized manifestations of systemic Al toxicity include fracturing osteomalacia, dialysis encephalopathy, and microcytic hypochromic anemia. The role of Al in causing childhood diseases is also becoming clearer, but the safe plasma level still remains to be determined in newborns, especially in premature newborns, implying that it should be kept low. Premature infants receiving iv fluid therapy show evidence of Al loading. Additionally, the infant-feeding mixtures, especially the soy-based infant formulas, tested may be a significant additional source of Al in the diet of infants with low birthweights, and in infants and in young children with impaired renal function. Careful clinical and biochemical monitoring is warranted to determine whether it will be necessary to eliminate Al contamination of both oral and parenteral preparations used in infants and children who may be at risk for Al intoxication. In this present study, the Al content of infant feeds was measured by electrothermal atomic absorption spectrophotometry, and also compared with those of breast milk, cow’s milk, milk powder, and some starches that are commonly used for preparation of infant feed in Turkey. Our results show that Al content of commercially available powdered infant formulas, most of which are imported from Europe, ranged from 1.211 to 10.925 μg/g. The mean value was higher than that of breast milk. It was also found that the Al content of cow’s milk in various containers was higher than that of breast milk. The highest Al level among cow’s milk samples was in the aluminized carton box. In the other products tested, such as milk powder, the starches contained Al at various levels. Among these, milk powder and rice flour contained a high level of Al.     

The Content of Elements in Infant Formulas and Drinks Against Mineral Requirements of Children

The present study aimed at analysing the content of fluorine (F), calcium (Ca), magnesium (Mg), iron (Fe) and zinc (Zn) in the drinks for children and infant formulas, a popular supplement or substitute for breast milk produced from cow milk on an industrial scale. Ca, Mg, Zn and Fe concentrations were determined using atomic absorption spectrophotometer, while F levels using a potentiometric method. F levels in the examined formula samples increased with the intended age range, until the intended age of 1 year, and then decreased. A lower content of Ca, Mg and Zn was observed in formulas intended for children <1 year of age and higher for older children. Fe content increased with the age range. A statistically significant higher content of Ca, Mg, Zn and Fe in samples intended for children with phenylketonuria in comparison to those intended for healthy children or children with food allergies was noted. The content of the analysed elements in juices and nectars showed the highest contents in products intended for infants (under 6 months of age). The lowest levels of elements tested were found in drinks for children over 6 months of age. In conclusion, the concentrations of the examined elements in infant formulas and juices for children were decidedly greater than the standards for the individual age groups. Although the absorption of these elements from artificial products is far lower than from breast milk, there is still the fear of consequences of excessive concentrations of these minerals.     

A comparative study of elemental composition of human breast milk and infant milk substitutes

Instrumental neutron activation analysis (INAA) and protoninduced X-ray emission (PIXE) analysis have been employed to determine the concentration of 13 elements in human breast milk, various infant formulas, and locally produced cereals from Nigeria, as well as from various infant formulas and natural cow and goat milk available in the UK. The study shows that if the locally produced cereal is to be used on a regular basis for babies in Nigeria, then their diet must be supplemented with essential trace elements. Furthermore, parents should be discouraged from giving their infants cow and goat milk because of the high concentration of major elements compared to human breast milk.     

Antimicrobial activity of lipids added to human milk,infant formula,and bovine milk

Lipids previously shown to have antiviral and antibacterial activity in buffers were added to human milk, bovine milk, and infant formulas to determine whether increased protection from infection could be provided to infants as part of their diet. Fatty acids and monoglycerides with chain lengths varying from 8 to 12 carbons were found to be more strongly antiviral and antibacterial when added to milk and formula than long chain monoglycerides. Lipids added to milk and formula inactivated a number of pathogens including respiratory syncytial virus (RSV), herpes simplex virus type 1 (HSV-1), Haemophilus influenzae, and Group B streptococcus. The results presented in this study suggest that increased protection from infection may be provided to infants at mucosal surfaces, prior to the digestion of milk and formula triglycerides, by the addition of antimicrobial medium chain monoglycerides to an infant's diet.     

Effect of antigen load on development of milk antibodies in infants allergic to milk.

The phenomenon that large amounts of antigen, such as are absorbed during the neonatal period, suppress the IgE response while low-dose exposure enhances it was investigated by analysing the antibody responses of infants allergic to milk according to their degree of exposure to cows''-milk protein. IgG, IgA, and IgM milk-specific antibodies in these infants and in age-matched controls were measured by enzyme-linked immunosorbent assay. Milk-specific IgE and total IgE were also measured. Children allergic to milk who were breast fed and had had minimal exposure to cows'' milk had decreased titres of IgG, IgA, and IgM milk antibodies compared with infants allergic to milk who, before diagnosis, had been fed substantial volumes of cows'' milk. Conversely, the infants with minimal exposure to cows'' milk showed vastly increased total and milk-specific IgE antibodies compared with the milk-fed infants. These results support recent experimental evidence that appreciable amounts of allergen suppress rather than stimulate IgE production. These data may have important implications for dietary regimens in at-risk infants. The results also lend support for the role of IgE in immediate-type allergic reactions and suggest that various non-IgE immune mechanisms play a part in the aetiology of intolerance to cows''-milk protein in some children.     

Toward optimizing vision and cognition in term infants by dietary docosahexaenoic and arachidonic acid supplementation: A review of randomized controlled trials

The question of whether a dietary supply of docosahexaenoic acid (DHA) and arachidonic acid (ARA) imparts advantages to visual or cognitive development in term infants has been debated for many years. DHA and ARA are present in human milk, and nursing infants consume these fatty acids needed for rapid synthesis of cell membranes, particularly neural cells. The reported mean DHA and ARA levels of human milk worldwide are 0.32% and 0.47% of total fatty acids, respectively. Prior to 2002 in the US, formula-fed infants did not receive these fatty acids and relied solely on endogenous conversion of the dietary essential omega-3 (n-3) and omega-6 (n-6) fatty acids, α-linolenic and linoleic acids, to DHA and ARA, respectively. Formula-fed infants were found to have significantly less accretion of DHA in brain cortex after death than breastfed infants. Numerous studies have found positive correlations between blood DHA levels and improvements in cognitive or visual function outcomes of breastfed and formula-fed infants. Results of randomized controlled clinical trials of term formula-fed infants evaluating functional benefits of dietary DHA and ARA have been mixed, likely due to study design heterogeneity. A comparison of visual and cognitive outcomes in these trials suggests that dietary DHA level is particularly relevant. Trials with formulas providing close to the worldwide human milk mean of 0.32% DHA were more likely to yield functional benefits attributable to DHA. We agree with several expert groups in recommending that infants receive at least 0.3% DHA, with at least 0.3% ARA, in infant feedings; in addition, some clinical evidence suggests that an ARA:DHA ratio greater than 1:1 is associated with improved cognitive outcomes.     

Reevaluation of the DHA requirement for the premature infant

The long-chain polyunsaturated fatty acid (LC-PUFA) intake in preterm infants is crucial for normal central nervous system development and has the potential for long-lasting effects that extend beyond the period of dietary insufficiency. While much attention has focused on improving their nutritional intake, many premature infants do not receive an adequate DHA supply. We demonstrate that enterally fed premature infants exhibit daily DHA deficit of 20 mg/kg.d, representing 44% of the DHA that should have been accumulated. Furthermore, the DHA content of human milk and current preterm formulas cannot compensate for an early DHA deficit which may occur during the first month of life. We recommend breast-feeding, which supplies preformed LC-PUFA, as the preferred method of feeding for preterm infants. However, to fulfill the specific DHA requirement of these infants, we recommend increasing the DHA content of human milk either by providing the mothers with a DHA supplement or by adding DHA directly to the milk. Increasing the DHA content above 1% total fatty acids appears to be safe and may enhance neurological development particularly that of infants with a birth weight below 1250 g. We estimate that human milk and preterm formula should contain 1.5% of fatty acid as DHA to prevent the appearance of a DHA deficit and to compensate for the early DHA deficit.     

人乳寡糖2′-岩藻糖基乳糖的功能及其全细胞生物合成

母乳是新生儿最理想的营养剂。其中,人乳寡糖作为母乳的第三大固体组分,对新生儿的生长、发育及健康状况有重要影响,被应用于婴幼儿配方食品中。2′-岩藻糖基乳糖(2′-fucosyllactose,2′-FL),是分泌型母乳中含量最高的人乳寡糖,约占人乳寡糖总量的30%,具有重要的营养和医学价值。2′-FL能够促进婴幼儿生长发育、提高其认知能力、增强免疫力、抗过敏、抗病毒,以及调节肠道菌群,是极具潜力的新型营养强化剂。但是,2′-FL来源于母乳,依靠分离、提取获得大量2′-FL并不现实,因此亟需进行人工合成。人工合成2′-FL的方法有3种,包括：化学合成法、酶催化合成法和全细胞生物合成法。全细胞生物合成法因其成本相对低廉,且易于规模化扩大,而引起了国内外的广泛关注和研究。目前,国外很多跨国公司均开始布局2′-FL的工业化生产和应用,而我国在该领域尚处于研发阶段,因此,了解和掌握2′-FL的合成方法对我国开展2′-FL规模化生产具有重要的意义。本文旨在介绍2′-FL的功能特性,系统阐述其全细胞生物合成的关键技术和最新进展,讨论了针对限速步骤进一步提高产量的策略,旨在为2′-FL的合成和商业化生...     

Case-control study of risk of dehydrating diarrhoea in infants in vulnerable period after full weaning.

OBJECTIVES: To investigate risk factors for dehydrating diarrhoea in infants, with special interest in the weaning period. DESIGN: Case-control study. SETTING: Metropolitan area of Porto Alegre, Brazil. SUBJECTS: Cases were 192 children aged 0-23 months hospitalised with acute diarrhoea and moderate to severe dehydration. Controls were 192 children matched for age and neighbourhood who did not have diarrhoea in the previous week. MAIN OUTCOME MEASURES: Associations between dehydrating diarrhoea and child''s age, type of milk consumed, time since breast feeding stopped, and breast feeding status. RESULTS: In infants aged < 12 months the risk of dehydrating diarrhoea was significantly higher in the first 9 months of life (P < 0.001), and in those aged 12-23 months the risk was again greater in younger children (12-17 months) (P = 0.03). The type of milk consumed before start of diarrhoea episode was strongly associated with dehydration independent of socioeconomic, environmental, maternal reproductive, demographic, and health services factors. Compared with infants exclusively breast fed, bottle fed infants were at higher risk (odds ratio (95% confidence interval) for cow''s milk 6.0 (1.8 to 19.8), for formula milk 6.9 (1.4 to 33.3)). Compared with those still breast feeding, children who stopped in the previous two months were more likely to develop dehydrating diarrhoea (odds ratio 8.4 (2.4 to 29.6)). This risk decreased with time since breast feeding stopped. CONCLUSION: These results confirm the protective effect of breast feeding and suggest there is a vulnerable period soon after breast feeding is stopped, which may be of relevance for developing preventive strategies.     

Longitudinal evolution of true protein,amino acids and bioactive proteins in breast milk: a developmental perspective

The protein content of breast milk provides a foundation for estimating protein requirements of infants. Because it serves as a guideline for regulatory agencies issuing regulations for infant formula composition, it is critical that information on the protein content of breast milk is reliable. We have therefore carried out a meta-analysis of the protein and amino acid contents of breast milk and how they evolve during lactation. As several bioactive proteins are not completely digested in the infant and therefore represent “non-utilizable” protein, we evaluated the quantity, mechanism of action and digestive fate of several major breast milk proteins. A better knowledge of the development of the protein contents of breast milk and to what extent protein utilization changes with age of the infant will help improve understanding of protein needs in infancy. It is also essential when designing the composition of infant formulas, particularly when the formula uses a “staging” approach in which the composition of the formula is modified in stages to reflect changes in breast milk and changing requirements as the infant ages.     

Soluble form of ICAM-1, VCAM-1, E- and L-selectin in human milk

In breast milk and paired serum from 70 lactating women and 40 of their term, infection-free neonates, on the 2nd and 5th day postpartum slCAM-1, sVCAM-1, sE- and sL-selectin were measured by ELISA and compared with those in 26 healthy adults (controls). Seven infant formulas and fresh milk from five cows were also analyzed. Human colostrum values of slCAM-1, sVCAM-1 (similar to those in maternal and control serum), sE-selectin and sL-selectin (-10 and -100 times lower than in maternal and control serum) were significantly higher than those in milk, while they varied widely. None of the adhesion molecules was detected in fresh cow's milk or infant formulas. Exclusively breast-fed infants showed significantly higher values of slCAM-1 and sL-selectin on the 2nd day of life than those supplemented also with formula. Only slCAM-1 values correlated positively between colostrum and time-matched maternal serum. These findings show in human milk important amounts of slCAM-1 and sVCAM-1 but minimal amounts of sE- and sL-selectin, which could affect the immune system of the neonate.     

Serum Copper and Zinc Levels in Healthy Greek Children and Their Parents

The aim of this study was to investigate whether there is a correlation between copper (Cu) and zinc (Zn) levels in children and their parents, considering their nutritional habits. Cu and Zn concentrations were measured by flame atomic absorption spectrophotometry in the serum of 66 healthy children, aged 3–14 years, and their parents, residing in a region of Greece (Thrace). Cu levels were higher in mothers than those in fathers, but they were lower in both parents than those in children. They also tended to decrease with age in both parents and children, whereas Zn levels significantly increased with age in children. There was a positive correlation between children's and mothers' Zn levels, as well as children's and both parents' Cu levels. Children used to eat meat, fish, vegetables, and legumes as frequently as their parents, but they were consuming more eggs, milk, and fruits than the latest. Regarding parents' diet, higher Zn levels were depended on the consumption of meat and milk, whereas higher Cu levels were depended on the consumption of milk. Consequently, children’s Cu and Zn levels are related to their parents’ levels, which can be influenced by their nutritional habits.     

Trace elements in formulas based on cow and soy milk and in austrian cow milk determined by inductively coupled plasma mass spectrometry

With inductively coupled plasma-mass spectrometry (ICP-MS), the 18 trace elements Ba, (Be), (Bi), Cd, Co, Cs, Cu, La, Li, Mn, Mo, Pb, Rb, (Sb), (Sn), Sr, (Tl), and Zn were quantified in the digests of 13 formulas based on cow milk, of two formulas based on soy protein, of two milk powders, from which formulas were prepared, of two samples of Austrian cow milk, and in the water, with which the powders were suspended. Concentrations in parentheses were at or below the method detection limits in the formulas. The accuracy and precision of the analytical procedure tested with milk powder reference materials BCR 063 and BCR 150 were satisfactory. The concentrations of trace elements in the powders vary considerably from batch to batch. The ratios of high to low concentrations ranged from 1.1 to 4.8 and were higher for the essential trace elements Co, Cu, Mn, Mo, Sn, and Zn than for nonessential or toxic elements. The contribution of tap water from the water system of the city of Graz, Austria to the concentrations of trace elements in the formulas ranges from 45% for Pb to 0.2% for Rb and is negligible, for instance, for Cd, Cs, La, Mo, and Sn. Preformulas and follow-up formulas are partly supplemented with the essential trace elements Cu, Mn, and Zn and, therefore, concentrations of these trace elements in the formulas vary considerably. However, supplementation of a formula with a particular element must not necessarily result in higher concentrations compared to nonsupplemented formulas. Concentrations of the essential elements were in the following ranges for preformulas, follow-up formulas, soy-based formulas (in μg/kg): Co, 8.3–11.2, 4.5–13, 5.0–5.7; Cu, 330–750, 27–730, 440–530; Mn, 33–580, 40–390, 440–530; Mo, 10–32, 9–39, 44-6; Sn, <0.44-3.8, <0.44-1.0, <0.44-5.8; Zn, 3340-11,380, 4120–7100, 5590-6,840. A preformula supplemented with Mn had a 10 times higher manganese concentration than preformulas without supplementation. Concentrations of all trace elements quantified were lower in cow milk than in formulas and do not meet the dietary requirements of infants.     

Serum activity of dipeptidyl peptidase IV (DPPIV; EC 3.4.14.5) in breast-fed infants with symptoms of allergy

Beta-casomorphins, opioid peptides present in mother's milk, are a good substrate for DPPIV (EC 3.4.14.5) which is a major factor limiting the half-life of biologically active peptides. Serum DPPIV activity of two groups of infants (healthy and atopic dermatitis) and contents of beta-casomorphin-5 and -7 in their mothers' milk were determined in the study. We have found correlation between those two parameters in the group of children with atopic dermatitis syndromes, while no such a correlation was found in the control group.     

Molybdenum Content of Canadian and US Infant Formulas

Molybdenum is an essential trace nutrient in the human diet. Our purpose was to provide a comprehensive analysis of Mo content of various types of powdered infant formulas across Canada and the USA. All infant formulas, available on the day of sampling, were purchased from random supermarkets in Grand Forks, ND, USA; San Diego, CA, USA; Washington, DC, USA; and Winnipeg, MB, Canada. Reference powdered milk, human milk (HM), and formula samples were weighed and acid-digested prior to analysis by graphite furnace atomic absorption spectroscopy. Mo content in all formulas ranged from 15.4 to 80.3 μg/L (mean ± SE, 37.7 ± 1.7 μg/L). HM Mo concentration ranged from 1.5 to 9.5 μg/L (5.09 ± 0.81 μg/L). Formulas intended for full-term or for premature infants feeding contained, on average, more Mo than HM. Formulas intended for infants with special needs contained similar mean Mo levels to HM. No significant differences were detected between mean Mo values of formulas of a same type purchased from different brands and/or at different locations. High Mo intake may pose health risks, despite lower bioavailability of Mo from formula compared with HM.     

Intrinsic labeling of bovine milk with enriched stable isotopes of zinc

Bovine milk was labeled intrinsically with enriched stable isotopic zinc for human bioavailability studies. Intrajugular administration of zinc isotopes temporarily increased the plasma zinc concentration of Ayrshire cows by as much as 76%, but milk zinc concentration and the distribution of zinc between casein and whey did not change appreciably. Milk zinc isotopic enrichment reached 105 and 613 atom % excess for 67Zn and 70Zn, respectively within 4-12 hr of zinc administration and decreased gradually over several days. This degree of isotopic enrichment is sufficient for testing bioavailability to infants of intrinsic zinc from milk-based formulas.     

Glycation products in infant formulas: chemical,analytical and physiological aspects

Infant formulas are milk-based products, which are adapted to the composition of human milk. To ensure microbiological safety and long shelf life, infant formulas usually undergo rigid heat treatment. As a consequence of the special composition and the heat regimen, infant formulas are more prone to thermally induced degradation reactions than regular milk products. Degradation reactions observed during milk processing comprise lactosylation yielding the Amadori product lactulosyllysine, the formation of advanced glycation end products (AGEs), and protein-free sugar degradation products, as well as protein or lipid oxidation. Several methods have been developed to estimate the heat impact applied during the manufacturing of infant formulas, including indirect methods such as fluorescence analysis as well as the analysis of defined reaction products. Most studies confirm a higher degree of damage in infant formulas compared to regular milk products. Differences between various types of infant formulas, such as liquid, powdered or hypoallergenic formulas depend on the analyzed markers and brands. A considerable portion of protein degradation products in infant formulas can be avoided when process parameters and the quality of the ingredients are carefully controlled. The nutritional consequences of thermal degradation products in infant formulas are largely unknown.     

Milk and meat in our diet: good or bad for health?

Foods derived from animals are an important source of nutrients in the diet but there is considerable uncertainty about whether or not these foods contribute to increased risk of various chronic diseases. For milk in particular there appears to be an enormous mismatch between both the advice given on milk/dairy foods items by various authorities and public perceptions of harm from the consumption of milk and dairy products, and the evidence from long-term prospective cohort studies. Such studies provide convincing evidence that increased consumption of milk can lead to reductions in the risk of vascular disease and possibly some cancers and of an overall survival advantage from the consumption of milk, although the relative effect of milk products is unclear. Accordingly, simply reducing milk consumption in order to reduce saturated fatty acid (SFA) intake is not likely to produce benefits overall though the production of dairy products with reduced SFA contents is likely to be helpful. For red meat there is no evidence of increased risk of vascular diseases though processed meat appears to increase the risk substantially. There is still conflicting and inconsistent evidence on the relationship between consumption of red meat and the development of colorectal cancer, but this topic should not be ignored. Likewise, the role of poultry meat and its products as sources of dietary fat and fatty acids is not fully clear. There is concern about the likely increase in the prevalence of dementia but there are few data on the possible benefits or risks from milk and meat consumption. The future role of animal nutrition in creating foods closer to the optimum composition for long-term human health will be increasingly important. Overall, the case for increased milk consumption seems convincing, although the case for high-fat dairy products and red meat is not. Processed meat products do seem to have negative effects on long-term health and although more research is required, these effects do need to be put into the context of other risk factors to long-term health such as obesity, smoking and alcohol consumption.     

A high-Mr glycoprotein fraction from cow's milk potent in inhibiting replication of human rotavirus in vitro

Rotavirus is the major cause of infectious diarrhea in infants and young children all over the world. We have found that a high-M(r) glycoprotein fraction from cow's milk is potent in inhibiting replication of human rotaviruses in vitro. Since the activity seems to be unique and specific, this fraction may be useful as a novel agent for treatment or prevention of rotavirus diarrhea.     

Animal board invited review: Specialising and intensifying cattle production for better efficiency and less global warming: contrasting results for milk and meat co-production at different scales

Cattle are the world’s largest consumers of plant biomass. Digestion of this biomass by ruminants generates high methane emissions that affect global warming. In the last decades, the specialisation of cattle breeds and livestock systems towards either milk or meat has increased the milk production of dairy cows and the carcass weight of slaughtered cattle. At the animal level and farm level, improved animal performance decreases feed use and greenhouse gas emissions per kg of milk or carcass weight, mainly through a dilution of maintenance requirements per unit of product. However, increasing milk production per dairy cow reduces meat production from the dairy sector, as there are fewer dairy cows. More beef cows are then required if one wants to maintain the same meat production level at country scale. Meat produced from the dairy herd has a better feed efficiency (less feed required per kg of carcass weight) and emits less methane than the meat produced by the cow-calf systems, because the intake of lactating cows is largely for milk production and marginally for meat, whereas the intake of beef cows is entirely for meat. Consequently, the benefits of breed specialisation assessed at the animal level and farm level may not hold when milk and meat productions are considered together. Any change in the milk-to-meat production ratio at the country level affects the numbers of beef cows required to produce meat. At the world scale, a broad diversity in feed efficiencies of cattle products is observed. Where both productions of milk per dairy cow and meat per head of cattle are low, the relationship between milk and meat efficiencies is positive. Improved management practices (feed, reproduction, health) increase the feed efficiency of both products. Where milk and meat productivities are high, a trade-off between feed efficiencies of milk and meat can be observed in relation to the share of meat produced in either the dairy sector or the beef sector. As a result, in developing countries, increasing productivities of both dairy and beef cattle herds will increase milk and meat efficiencies, reduce land use and decrease methane emissions. In other regions of the world, increasing meat production from young animals produced by dairy cows is probably a better option to reduce feed use for an unchanged milk-to-meat production ratio.