| 1. |
- Callahan, Emily A., et al.
(författare)
-
Assessing the safety of bioactive ingredients in infant formula that affect the immune system : recommendations from an expert panel
- 2022
-
Ingår i: American Journal of Clinical Nutrition. - : Oxford University Press. - 0002-9165 .- 1938-3207. ; 115:2, s. 570-587
-
Tidskriftsartikel (refereegranskat)abstract
- Bioactive ingredients for infant formula have been sought to reduce disparities in health outcomes between breastfed and formula-fed infants. Traditional food safety methodologies have limited ability to assess some bioactive ingredients. It is difficult to assess the effects of nutrition on the infant immune system because of coincident developmental adaptations to birth, establishment of the microbiome and introduction to solid foods, and perinatal environmental factors. An expert panel was convened to review information on immune system development published since the 2004 Institute of Medicine report on evaluating the safety of new infant formula ingredients and to recommend measurements that demonstrate the safety of bioactive ingredients intended for that use. Panel members participated in a 2-d virtual symposium in November 2020 and in follow-up discussions throughout early 2021. Key topics included identification of immune system endpoints from nutritional intervention studies, effects of human milk feeding and human milk substances on infant health outcomes, ontologic development of the infant immune system, and microbial influences on tolerance. The panel explored how "nonnormal" conditions such as preterm birth, allergy, and genetic disorders could help define developmental immune markers for healthy term infants. With consideration of breastfed infants as a reference, ensuring proper control groups, and attention to numerous potential confounders, the panel recommended a set of standard clinical endpoints including growth, response to vaccination, infection and other adverse effects related to inflammation, and allergy and atopic diseases. It compiled a set of candidate markers to characterize stereotypical patterns of immune system development during infancy, but absence of reference ranges, variability in methods and populations, and unreliability of individual markers to predict disease prevented the panel from including many markers as safety endpoints. The panel's findings and recommendations are applicable for industry, regulatory, and academic settings, and will inform safety assessments for immunomodulatory ingredients in foods besides infant formula.
|
|
| 2. |
- Domellöf, Magnus, 1963-, et al.
(författare)
-
Iron absorption in breast-fed infants : effects of age, iron status, iron supplements, and complementary foods.
- 2002
-
Ingår i: American Journal of Clinical Nutrition. - : American Society for Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 76:1, s. 198-204
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Iron supplements are often recommended for older breast-fed infants, but little is known about factors affecting iron absorption from human milk or supplements. OBJECTIVE: We investigated the effects of age, iron status, and iron intake on iron absorption in healthy, term, breast-fed infants. DESIGN: Twenty-five infants were randomly assigned to receive either 1) iron supplements (1 mg x kg(-1) x d(-1)) from 4 to 9 mo of age, 2) placebo from 4 to 6 mo and iron supplements from 6 to 9 mo, or 3) placebo from 4 to 9 mo. Infants were exclusively breast-fed to 6 mo and partially breast-fed to 9 mo of age. Iron absorption was assessed by giving (58)Fe with mother's milk at 6 and 9 mo. Blood samples were obtained at 4, 6, and 9 mo, and complementary food intake was recorded at 9 mo. RESULTS: At 6 mo, mean (+/-SD) fractional iron absorption from human milk was relatively low (16.4 +/- 11.4%), with no significant difference between iron-supplemented and unsupplemented infants. At 9 mo, iron absorption from human milk remained low in iron-supplemented infants (16.9 +/- 9.3%) but was higher (P = 0.01) in unsupplemented infants (36.7 +/- 18.9%). Unexpectedly, iron absorption at 9 mo was not correlated with iron status but was significantly correlated with intake of dietary iron, including supplemental iron. CONCLUSIONS: Changes in the regulation of iron absorption between 6 and 9 mo enhance the infant's ability to adapt to a low-iron diet and provide a mechanism by which some, but not all, infants avoid iron deficiency despite low iron intakes in late infancy.
|
|
| 3. |
- Domellöf, Magnus, et al.
(författare)
-
Iron supplementation does not affect copper and zinc absorption in breastfed infants.
- 2009
-
Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 89:1, s. 185-190
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Iron supplements are commonly recommended for infants but were suggested to inhibit zinc and copper absorption. OBJECTIVE: The objective of this study was to investigate potential effects of iron supplementation, infant age, and mineral status on zinc and copper absorption in infants at 6 and 9 mo of age. DESIGN: Twenty-five healthy breastfed term infants were recruited from a larger randomized iron supplementation trial. Six of these infants received iron supplements (1 mg . kg(-1) . d(-1)) from 4 to 9 mo, 8 were supplemented from 6 to 9 mo, and 11 received placebo only. Zinc and copper absorption was measured at 6 and 9 mo of age, using orally administered (70)Zn and (65)Cu and fecal monitoring of recovered stable isotopes. RESULTS: Mean (+/-SD) zinc absorption was 51.9 +/- 17.9%, and mean copper absorption was 79.0 +/- 13.5%. No significant difference was observed in zinc or copper absorption between 6 and 9 mo of age. When combining all measurements, no significant effect of prior iron supplementation was observed on zinc or copper absorption. No significant correlation was observed between plasma zinc and zinc absorption or between plasma copper and copper absorption. No significant correlation was observed between erythrocyte copper-zinc-dependent superoxide dismutase activity and copper absorption. CONCLUSIONS: The study does not support the contention that iron supplements inhibit the absorption of zinc or copper in healthy breastfed infants at 6-9 mo of age. In addition, we did not find any age-related changes in zinc or copper absorption between 6 and 9 mo of age.
|
|
| 4. |
- Domellöf, Magnus, et al.
(författare)
-
Iron, zinc, and copper concentrations in breast milk are independent of maternal mineral status.
- 2004
-
Ingår i: The American journal of clinical nutrition. - 0002-9165. ; 79:1, s. 111-5
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about the regulation of iron, zinc, and copper in breast milk and the transport of these minerals across the mammary gland epithelium. OBJECTIVE: The objective was to study associations between breast-milk concentrations of iron, zinc, and copper and maternal mineral status. DESIGN: Milk samples from 191 Swedish and Honduran mothers were collected at 9 mo postpartum. Iron, zinc, and copper concentrations were measured by atomic absorption spectrometry. Blood samples from mothers were analyzed for plasma zinc and copper and 4 indexes of iron status: hemoglobin, plasma ferritin, soluble transferrin receptors, and zinc protoporphyrin. Complementary food energy (CFE) intake was used as an inverse proxy for breast-milk intake. RESULTS: Mean (+/-SD) breast-milk concentrations of iron were lower in the Honduran than in the Swedish mothers (0.21 +/- 0.25 compared with 0.29 +/- 0.21 mg/L; P < 0.001), and mean breast-milk concentrations of zinc and copper were higher in the Honduran than in the Swedish mothers [0.70 +/- 0.18 compared with 0.46 +/- 0.26 mg/L (P < 0.001) and 0.16 +/- 0.21 compared with 0.12 +/- 0.22 mg/L (P = 0.001), respectively]. Milk iron was positively correlated with CFE intake (r = 0.24, P = 0.001) but was not significantly correlated with any iron-status variable. Milk zinc was negatively correlated with CFE intake (r = -0.24, P = 0.001) but was not significantly correlated with maternal plasma zinc. Milk copper was not significantly correlated with CFE intake or maternal plasma copper. CONCLUSIONS: Milk iron, zinc, and copper concentrations at 9 mo postpartum are not associated with maternal mineral status, which suggests active transport mechanisms in the mammary gland for all 3 minerals. Milk iron concentrations increase and milk zinc concentrations decrease during weaning [corrected]
|
|
| 5. |
|
|
| 6. |
- Johansson, Ulrica, 1974-, et al.
(författare)
-
A randomized, controlled trial of a Nordic, protein-reduced complementary diet in infants : effects on body composition, growth, biomarkers, and dietary intake at 12 and 18 months
- 2023
-
Ingår i: American Journal of Clinical Nutrition. - : Elsevier. - 0002-9165 .- 1938-3207. ; 117:6, s. 1219-1231
-
Tidskriftsartikel (refereegranskat)abstract
- Background: High intake of protein and low intake of plant-based foods during complementary feeding can contribute to negative long-term health effects.Objectives: To investigate the effects of a protein-reduced, Nordic complementary diet on body composition, growth, biomarkers, and dietary intake, compared with current Swedish dietary recommendations for infants at 12 and 18 mo.Methods: Healthy, term infants (n = 250) were randomly allocated to either a Nordic group (NG) or a conventional group (CG). From 4 to 6 mo, NG participants received repeated exposures of Nordic taste portions. From 6 to 18 mo, NG was supplied with Nordic homemade baby food recipes, protein-reduced baby food products, and parental support. CG followed the current Swedish dietary recommendations. Measurements of body composition, anthropometry, biomarkers, and dietary intake were collected from baseline and at 12 and 18 mo.Results: Of the 250 infants, 82% (n = 206) completed the study. There were no group differences in body composition or growth. In NG, protein intake, blood urea nitrogen and plasma IGF-1 were lower compared to CG at 12 and 18 mo. Infants in NG consumed 42% to 45% more fruits and vegetables compared to CG at 12 and 18 mo, which was reflected in a higher plasma folate at 12 and 18 mo. There were no between-group differences in EI or iron status.Conclusions: Introduction of a predominantly plant-based, protein-reduced diet as part of complementary feeding is feasible and can increase fruit and vegetable intake.This trial was registered at clinicaltrials.gov as NCT02634749.
|
|
| 7. |
- Koletzko, Berthold, et al.
(författare)
-
Should formula for infants provide arachidonic acid along with DHA? : A position paper of the European Academy of Paediatrics and the Child Health Foundation
- 2020
-
Ingår i: American Journal of Clinical Nutrition. - : OXFORD UNIV PRESS. - 0002-9165 .- 1938-3207. ; 111:1, s. 10-16
-
Tidskriftsartikel (refereegranskat)abstract
- Recently adopted regulatory standards on infant and follow-on formula for the European Union stipulate that from February 2020 onwards, all such products marketed in the European Union must contain 20-50 mg omega-3 DHA (22:6n-3) per 100 kcal, which is equivalent to about 0.5-1% of fatty acids (FAs) and thus higher than typically found in human milk and current infant formula products, without the need to also include co-6 arachidonic acid (AA; 20:4n-6). This novel concept of infant formula composition has given rise to concern and controversy because there is no accountable evidence on its suitability and safety in healthy infants. Therefore, international experts in the field of infant nutrition were invited to review the state of scientific research on DHA and AA, and to discuss the questions arising from the new European regulatory standards. Based on the available information, we recommend that infant and follow-on formula should provide both DHA and AA. The DHA should equal at least the mean content in human milk globally (0.3% of FAs) but preferably reach 0.5% of FAs. Although optimal AA intake amounts remain to be defined, we strongly recommend that AA should be provided along with DHA. At amounts of DHA in infant formula up to similar to 0.64%, AA contents should at least equal the DHA contents. Further well-designed clinical studies should evaluate the optimal intakes of DHA and AA in infants at different ages based on relevant outcomes.
|
|
| 8. |
- Lind, Torbjörn, et al.
(författare)
-
Effects of weaning cereals with different phytate contents on hemoglobin, iron stores, and serum zinc : a randomized intervention in infants from 6 to 12 mo of age
- 2003
-
Ingår i: American Journal of Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 78:1, s. 168-175
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Weaning foods frequently contain phytate, an inhibitor of iron and zinc absorption, which may contribute to the high prevalence of iron and zinc deficiency seen in infancy. Objective: The objective was to investigate whether either an extensive reduction in the phytate content of infant cereals or the use of milk-based, iron-fortified infant formula would improve iron and zinc status in infants. Design: In a double-blind design, infants (n = 300) were randomly assigned to 3 cereal groups from 6 to 12 mo of age: commercial milk-based cereal drink (MCD) and porridge (CC group), phytate-reduced MCD and phytate-reduced porridge (PR group), or milk-based infant formula and porridge with the usual phytate content (IF group). Venous blood samples were collected at 6 and 12 mo. Dietary intake was recorded monthly. After the intervention, 267 infants remained in the analysis. Results: Hemoglobin concentrations of < 110 g/L, serum ferritin concentrations of < 12 µg/L, and serum zinc concentrations of < 10.7 µmol/L had overall prevalences at baseline and 12 mo of 28% and 15%, 9% and 18%, and 22% and 27%, respectively. After the intervention, there were no significant differences in any measure of iron or zinc status between the CC and the PR groups. However, hemoglobin was significantly higher (120 g/L compared with 117 g/L; P = 0.012) and the prevalence of anemia was lower (13% compared with 23%; P = 0.06) in the PR group than in the IF group, which could be explained by differences in daily iron intake between the 2 groups. Conclusion: Extensive reduction in the phytate content of weaning cereals had little long-term effect on the iron and zinc status of Swedish infants.
|
|
| 9. |
- Lind, Torbjörn, et al.
(författare)
-
Effects of weaning cereals with different phytate contents on hemoglobin, iron stores, and serum zinc: a randomized intervention in infants from 6 to 12 mo of age
- 2003
-
Ingår i: American Journal of Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 78:1, s. 168-175
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Weaning foods frequently contain phytate, an inhibitor of iron and zinc absorption, which may contribute to the high prevalence of iron and zinc deficiency seen in infancy. Objective: The objective was to investigate whether either an extensive reduction in the phytate content of infant cereals or the use of milk-based, iron-fortified infant formula would improve iron and zinc status in infants. Design: In a double-blind design, infants (n = 300) were randomly assigned to 3 cereal groups from 6 to 12 mo of age: commercial milk-based cereal drink (MCD) and porridge (CC group), phytate-reduced MCD and phytate-reduced porridge (PR group), or milk-based infant formula and porridge with the usual phytate content (IF group). Venous blood samples were collected at 6 and 12 mo. Dietary intake was recorded monthly. After the intervention, 267 infants remained in the analysis. Results: Hemoglobin concentrations of less than 110 g/L, serum ferritin concentrations of less than 12 mug/L, and serum zinc concentrations of less than 10.7 mumol/L had overall prevalences at baseline and 12 mo of 28% and 15%, 9% and 18%, and 22% and 27%, respectively. After the intervention, there were no significant differences in any measure of iron or zinc status between the CC and the PR groups. However, hemoglobin was significantly higher (120 g/L compared with 117 g/L; P = 0.012) and the prevalence of anemia was lower (13% compared with 23%; P = 0.06) in the PR group than in the IF group, which could be explained by differences in daily iron intake between the 2 groups. Conclusion: Extensive reduction in the phytate content of weaning cereals had little long-term effect on the iron and zinc status of Swedish infants.
|
|
| 10. |
|
|
