Effect of Milk-Based Infant Formula Fortified with PUFAs on Lipid Profile, Growth and Micronutrient Status of Young Children: A Randomized Double-Blind Clinical Trial

Abstract

Background: Polyunsaturated fatty acids (PUFAs) are essential to child growth and development. Objective: To assess the effect of PUFAs-fortified infant formula on lipid profile, growth and micronutrient status in children 12 to 30 months old. Methods: This study is a double-blind randomized controlled clinical trial. Two study groups were assessed: (a) milk-based infant formula with micronutrients and PUFAs (PUFAs) and (b) milk-based infant formula with micronutrients, no PUFAs added (Non-PUFAs). Children received prepared formula (240 mL) twice a day, according to the color-code assigned to each infant. Anthropometric measurements and venous blood samples were taken at each day-care center at baseline, and again after four months. Total serum lipid extraction was 0.5 mL. Samples were treated and modified by the Folch method and analyzed with gas chromatography. Results: Changes in serum lipid profile (expressed as % FA) between baseline and four months showed a statistically significant increase in docosahexaenoic acid (DHA) (0.22 vs. −0.07, p < 0.05) and Alpha-Linoleic acid (0.08 vs. 0.02, p < 0.05) in infants who consumed PUFAs-fortified formula compared to Non-PUFAs-fortified formula. Infants increased their length/height-for-age Z-score: median change for the PUFAs group was 0.16 (95% CI = 0.08, 0.28) and 0.23 (95% CI = 0.14, 0.33) for Non-PUFAs, with no differences between groups. Median folate level was significantly higher among the PUFAs group compared to Non-PUFAs: −0.87 (95% CI = −1.38, −0.44) and −3.83 (95% CI = −4.65, −3.03) respectively. Consumption of both supplements was adequate and stable during the intervention. Conclusion: A significant improvement was observed in the lipid profile of children who received the PUFAs-fortified milk-based formula.

Beneficial Outcomes of Omega-6 and Omega-3 Polyunsaturated Fatty Acids on Malnourished Children: A Scoping Review

“…A double-blind, randomized clinical research study showed that children who received infant formula enhanced with micronutrients and PUFAs had better lipid profiles compared to children who only got micronutrientfortified formula. Infants in both groups improved their length/height-for-age Z-score (16). Additionally, the findings was consistent with another study reporting that supplementing stunted children under age five with 350 -500 mg of omega-3 fatty acid may help them grow taller (18).…”

“…Thirteen out of thirty-five studies discovered the beneficial impact of supplementing omega-6 or omega-3 FA towards children's growth whether they are healthy or malnourished children. The supplementation of omega-3 or omega-6 FA is associated with increased height or length and weight gain amongst children who are short stature or have normal health (10,(15)(16)(17)(18)(19)(20)(21). In contrast, two studies reported no significant effects of PUFA supplementation on body weight (22,23).…”

New Perspectives on the Associations between Blood Fatty Acids, Growth Parameters, and Cognitive Development in Global Child Populations

“…Finally, a randomized controlled trial among 12-30-month-old Mexican infants demonstrated that supplementation of formula with ~1240 mg LA + 156 mg ALA + 33 mg DHA/day for 4 months did not significantly improve health outcomes (all p > 0.05) despite significantly increasing ALA and DHA serum levels (both p < 0.05) [71]. This study may not have seen an association because relative to other studies discussed [38], the amount of DHA supplemented was quite low [71]. Despite these limitations, these studies demonstrate that n-3 PUFAs may not affect growth outcomes in childhood as much as other FAs, notably n-6 PUFAs.…”

“…The lack of an effect in this study could be due to the fact that these preterm infants had a wide range of birthweights and gestational ages, which could make it more difficult to detect the effect of supplementation, or the supplementation was not long enough to effect short-term growth or adiposity [73]. Finally, a randomized controlled trial among 12-30-month-old Mexican infants demonstrated that supplementation of formula with ~1240 mg LA + 156 mg ALA + 33 mg DHA/day for 4 months did not significantly improve health outcomes (all p > 0.05) despite significantly increasing ALA and DHA serum levels (both p < 0.05) [71]. This study may not have seen an association because relative to other studies discussed [38], the amount of DHA supplemented was quite low [71].…”

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

“…There are also a growing number of published clinical studies showing value with beneficial short-term effects of YCFs ( Table 2 ). These double-blind, randomized, controlled, clinical trials were of strong study designs, although there were a limited number and heterogeneity in populations, formulations, duration, serving sizes, and ages [ 35 , 36 , 37 , 38 ]. All but one clinical study demonstrated beneficial effects of primary outcomes that ranged from nutrient status with improved lipid profile, increased folate levels [ 36 ], and preserved iron status [ 35 ] to body composition with a lower percentage of body fat [ 37 ] to immune parameters with increased total blood immunoglobulin A level [ 38 ].…”