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Original Research Communications |
1 From the MRC Childhood Nutrition Research Centre, Institute of Child Health, London; MRC Human Nutrition Research, Cambridge, United Kingdom; Menzies Centre for Population Research, Tasmania, Australia; The Clinical Epidemiology and Biostatistics Unit, University of Melbourne Department of Paediatrics, Melbourne, Australia; the Royal Children's Hospital Research Institute, Melbourne; Unilever Research, Bedford, United Kingdom; the Nutrition Department, Nutricia UK Ltd, Trowbridge, United Kingdom; and Nutricia Research, Zoetermeer, Netherlands.
Background: The low sn-2 palmitate content of infant formulas results in formation of fatty acid calcium soaps in the stools and reduced calcium absorption.
Objective: Our objective was to test the hypotheses that increasing the proportion of sn-2 palmitate in formula for term infants would result in greater skeletal mineral deposition and reduced stool hardness.
Design: Healthy term neonates were randomly assigned to receive standard formula (n = 103) or formula containing 50% sn-2 palmitate (high–sn-2 formula; n = 100) for 12 wk. One hundred twenty breast-fed infants were also studied. The main outcome measures were 1) radial (single-photon absorptiometry) and whole-body (dual-energy X-ray absorptiometry) bone mineral content (WBBMC) at 12 wk and 2) stool frequency, volume, and consistency at 6 and 12 wk. Secondary outcome measures included stool fatty acid content.
Results: Infants receiving high–sn-2 formula had higher WBBMC (128.1 ± 9.7 compared with 122.7 ± 10.1 g, adjusted for size and sex), softer stools at 6 and 12 wk, and a lower proportion of stool soap fatty acids than did infants receiving the control formula. Breast-fed infants had adjusted WBBMC values (128.3 ± 9.1 g) similar to those of infants fed high–sn-2 formula and significantly higher than those of infants fed the control formula.
Conclusions: Changing the stereoisomeric structure of palmitate in infant formula resulted in higher WBBMC, reduced stool soap fatty acids, and softer stools more like those of breast-fed infants. The greater bone mass measured could be important if it persists beyond the trial period; this merits further investigation.
Key Words: Term infants • full-term infants • synthetic triacylglycerol • palmitate • stool characteristics • stool biochemistry • bone mineralization • infant formula
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