Effects of infant formula composition on long-term metabolic health

Abstract

Early nutrition may have long-lasting metabolic impacts in adulthood. Even though breast milk is the gold standard, most infants are at least partly formula-fed. Despite obvious improvements, infant formulas remain perfectible to reduce the gap between breastfed and formula-fed infants. Improvements such as reducing the protein content, modulating the lipid matrix and adding prebiotics, probiotics and synbiotics, are discussed regarding metabolic health. Numerous questions remain to be answered on how impacting the infant formula composition may modulate the host metabolism and exert long-term benefits. Interactions between early nutrition (composition of human milk and infant formula) and the gut microbiota profile, as well as mechanisms connecting gut microbiota to metabolic health, are highlighted. Gut microbiota stands as a key actor in the nutritional programming but additional well-designed longitudinal human studies are needed.

Infant Formula Supplemented with Biotics: Current Knowledge and Future Perspectives

“…Beneficial synergistic effects may be expected from a combination of probiotics and prebiotics, which are called synbiotics, using prebiotics to selectively increase abundance of both endogenous beneficial bacteria and beneficial microbes in the infant gut [ 113 ].…”

“…However, even if some synbiotic combinations already display promising clinical results in infants, more randomised trials with longer follow-up are needed for the determination of their physiological and metabolic impact on the host [ 113 ].…”

“…For many thousands of years, fermentation of food has been applied as a natural process to generate foods with particular properties, palatability, taste, and health benefits [ 113 ]. Most health benefits of fermented functional foods are accomplished by either the live microorganisms ingested or by postbiotics deriving from these microorganisms [ 65 ].…”

Phytosterols and their oxidative products in infant formula

“…(Rossen, Simon, & Herrick, ). Since the infant's nutrition plays a crucial role in development both short and long term (Lemaire, Le Huërou‐Luron, & Blat, ), this is the main reason why the FDA issued a Code of Federal Regulations (Title 21, Chapter I, Subchapter B, Part 107) where the requirements are outlined for the composition of IF. As it is stated by the FDA, for each 100 cal serving there has to be 300 mg of Linoleic acid and 1.8–4.5 g of protein per serving (“Code of Federal Regulations”, 2019).…”

“…New studies have started questioning the high PS content in IF, and hence, its potential oxidation process occurring during the infant formula manufacturing which generates POPs. Berger et al () recommended that children under five should not be given phytosterols since they should have high cholesterol in their diets instead (Lemaire et al, ). Therefore, a question that arises is: Do we need to modify the IF recipe or the manufacturing process to dampen its lipid oxidative load?…”