Highlights
- •Gastrointestinal tolerance, fat and calcium absorption are different between formula and breastfed babies.
- •Evidence suggests palmitic acid and its distribution on triglycerides are important.
- •Myristic and stearic acids in sn-1, 3 position can contribute to these differences.
- •Reducing the amount of sn-1, 3 myristic, palmitic, stearic acids may improve outcomes.
- •This work published a set of quite unique results on the fatty acid structure.
Abstract
Gastrointestinal tolerance and fat and calcium (Ca) absorption are different between
breast-fed (BF) and formula-fed (FF) infants. Certain components and/or structural
particularities in human milk (HM), can contribute to favorable outcomes in BF infants.
In HM, the long-chain saturated fatty acid (LCSFA) palmitic acid has a different stereospecific
distribution (sn-2 position) compared to most infant formula (IF) (primarily sn-1,
3 positions), which may contribute to unfavorable outcomes. Evidence suggests palmitic
acid is important in the formation of stool FA-mineral (or FA-Ca) soaps, associated
with harder stools in FF infants. Partial replacement by structured palmitic acid-rich
triacylglycerols (TAGs) promotes palmitic acid absorption. However, evidence for stool
softening, improved fat absorption and reduced Ca excretion in stools is inconsistent.
IFs with less palmitic acid can improve fat and Ca absorption, and stool consistency.
The presence of other LCSFAs (myristic and stearic acids) in sn-1, 3 positions may
also contribute to reduced absorption of fat and Ca, and stool hardness, in FF infants.
Nevertheless, little attention has been given to modifying these other LCSFAs in IF.
We review literature comparing the effect of HM and IF with different lipid compositions
on stool patterns and/or fat and Ca absorption in healthy, term infants. Based on
available data, we estimate a maximum level for sn-1, 3 LCSFAs of 13% of TAGs, under
which fat and Ca absorption and stool consistency are improved. IF designed according
to this threshold could efficiently improve nutrient absorption and stool patterns
in healthy infants who cannot be breast-fed.
Keywords
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Article info
Publication history
Published online: June 04, 2017
Accepted:
May 30,
2017
Received in revised form:
April 12,
2017
Received:
January 6,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
