Development of fat digestion in infancy

Manson, William; Coward, W. A.; Harding, M.; Weaver, Lawrence T.

doi:10.1136/fn.80.3.f183

Cited by 18 publications

(61 citation statements)

References 18 publications

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“…At specific postnatal ages, two stable isotope tests were simultaneously performed in neonates in a longitudinal fashion. By directly measuring the appearance of stable isotopically labeled fatty acids in serum, rather than quantifying postabsorptive metabolites as 13 CO 2 in breath, we expect to have overcome at least part of the difficulties that have been reported on quantitatively relating fat absorption with 13 CO 2 expiration after enteral administration of labeled fat (34). The results from the two tests used in the present study, the 13 C-PG test and the 13 C-SA test (discussed below), provide strong indications that the development of fat absorption efficacy in preterm and term infants is not functionally related to the capability to hydrolyze dietary triacylglycerols, but rather to the intestinal capability to take up LCFA from the lumen.…”

Section: Discussionmentioning

confidence: 99%

Functional Development of Fat Absorption in Term and Preterm Neonates Strongly Correlates with Ability to Absorb Long-Chain Fatty Acids from Intestinal Lumen

Rings

Minich²,

Vonk³

et al. 2002

Pediatr Res

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Our goal for this study was to determine whether the maturation of fat absorption in neonatal life is functionally related to an increased ability to hydrolyze dietary fat, to absorb long-chain fatty acids, or to do both. In 16 preterm and in eight term neonates, the intestinal ability to hydrolyze triacylglycerols and the capacity to absorb long-chain fatty acids were determined at several times between birth and 5 mo after the term age. These processes were compared with the percentage of fat absorption (formula-fed infants) or with fecal fat excretion (breast-fed infants). The functional capacity to digest triacylglycerols and to absorb the lipolytic products was evaluated by measuring serum concentrations of the lipolytic product [1-13 C]palmitate after the enteral administration of tri-1-13 C palmitoyl-glycerol. Longchain fatty acids absorption (i.e. independent of lipolysis) was determined by measuring serum concentrations of [1-13 C]stearate after its enteral administration. The efficacy of fat absorption increased in preterm infants (formula-fed) from 91.2 Ϯ 1.1% (mean Ϯ SEM) at 32. Efficient absorption of fat from the diet is important for energy supply, growth, and development, especially during development (1). At the neonatal age, and particularly in the case of prematurity, a considerable part of dietary fat is not absorbed from the intestine, but is excreted via the feces (2-5). Fat absorption involves digestion, requiring lipolysis by lipolytic enzymes, and the subsequent intestinal absorption of the hydrolyzed fatty acids and monoacylglycerols (6). The uptake of lipolytic products encompasses intraluminal solubilization of lipolytic products, their subsequent translocation across the small intestine, and their incorporation into chylomicrons that are subsequently secreted into the lymph (7). The importance and relative contribution of incomplete digestion and a decreased ability for fatty acid absorption to the causes of increased fecal fat loss during (preterm) infancy is only partly understood. Several studies suggest that lipolysis of fats could be the rate-limiting step in (preterm) neonatal dietary fat absorption. In the human gastrointestinal system several lipases are active on dietary triacylglycerols: gastric lipase (8, 9), pancreatic (colipase-dependent) lipase (10, 11), and bile salt-stimulated lipase (12). Several investigators have demonstrated a decreased intraduodenal concentration of both pan-

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Section: Discussionmentioning

confidence: 99%

Functional Development of Fat Absorption in Term and Preterm Neonates Strongly Correlates with Ability to Absorb Long-Chain Fatty Acids from Intestinal Lumen

Rings

Minich²,

Vonk³

et al. 2002

Pediatr Res

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“…About 50 % of the FAs in human milk are saturated; these require BSs for their solubilization and subsequent absorption [101]. Thus, infants with bile acid malabsorption may run into digestive problems regarding their lipid dietary intake.…”

Section: The Lipid Paradox and Functionality Of Bile Saltsmentioning

confidence: 99%

Development of the Digestive System—Experimental Challenges and Approaches of Infant Lipid Digestion

Abrahamse

Minekus²,

Aken

et al. 2012

Food Dig.

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At least during the first 6 months after birth, the nutrition of infants should ideally consist of human milk which provides 40–60 % of energy from lipids. Beyond energy, human milk also delivers lipids with a specific functionality, such as essential fatty acids (FA), phospholipids, and cholesterol. Healthy development, especially of the nervous and digestive systems, depends fundamentally on these. Epidemiological data suggest that human milk provides unique health benefits during early infancy that extend to long-lasting benefits. Preclinical findings show that qualitative changes in dietary lipids, i.e., lipid structure and FA composition, during early life may contribute to the reported long-term effects. Little is known in this respect about the development of digestive function and the digestion and absorption of lipids by the newborn. This review gives a detailed overview of the distinct functionalities that dietary lipids from human milk and infant formula provide and the profound differences in the physiology and biochemistry of lipid digestion between infants and adults. Fundamental mechanisms of infant lipid digestion can, however, almost exclusively be elucidated in vitro. Experimental approaches and their challenges are reviewed in depth.

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“…The fat digestion capabilities of formulafed term (age 1-234 d) and preterm (age 10-57 d) infants were investigated by measuring the oxidation of an oral pulse dose (10-20 mg/kg body weight) of 1,3-distearoyl-2-[ 13 Ccarboxy]-octanoyl-glycerol (36). Carbon-13 enrichment did not increase in breath CO 2 from three of five preterm infants younger than 20 d. This result suggests impaired fat digestion capability in the preterm infants.…”

Section: Kinetic Studiesmentioning

confidence: 99%

Stable isotope approaches, applications, and issues related to polyunsaturated fatty acid metabolism studies

Emken

2001

Lipids

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The use of stable isotope tracers for investigating fatty acid metabolism in human subjects has increased substantially over the last decade. Advances in analytical instrumentation, commercial availability of labeled substrates, and safety considerations are major reasons for this increased use of stable isotope tracers. Several experimental design options are available for using either deuterium or carbon-13 as tracers for fatty acid and lipid studies. Options include feeding a pulse dose of labeled fat or a mixture containing two or more labeled fats. Multiple doses of the labeled fat can be fed at timed intervals to increase enrichments. Administration by injection or continuous intravenous infusion is an alternative. Another option is to use diets containing foods from plants that have slightly higher natural carbon-13 enrichment. Each basic experimental design has its specific strengths, and the best choice of experimental design depends on the study objectives. Stable isotope studies have been used to address a variety of questions related to unsaturated fatty acid metabolism in humans. Examples are provided that illustrate the use of stable isotopes to investigate oxidation of docosahexaenoic acid, desaturation of linoleic and linolenic acids in infants and adults, incorporation of long-chain n-6 and n-3 fatty acids, bioequivalency of linolenic acid in primates, 13C nuclear magnetic resonance spectra of arachidonic acid in living rat brain, and effect of triacylglycerol structure on absorption. Radioisotope and stable isotope tracer studies in animals and humans are responsible for much of our understanding of fatty acid and lipid metabolism. However, tracer studies have limitations, and there are some unresolved issues associated with isotope studies. Examples of unresolved issues are quantification of isotope data, validity of in vivo fatty acid metabolite results, kinetic modeling, subject variability, and use of blood lipid data as a reflection of tissue lipid metabolism. Resolving these issues, developing novel methodology, and applying stable isotope tracer methods to questions related to PUFA metabolism are broad areas of interesting and challenging research opportunities.

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Development of fat digestion in infancy

Cited by 18 publications

References 18 publications

Functional Development of Fat Absorption in Term and Preterm Neonates Strongly Correlates with Ability to Absorb Long-Chain Fatty Acids from Intestinal Lumen

Functional Development of Fat Absorption in Term and Preterm Neonates Strongly Correlates with Ability to Absorb Long-Chain Fatty Acids from Intestinal Lumen

Development of the Digestive System—Experimental Challenges and Approaches of Infant Lipid Digestion

Stable isotope approaches, applications, and issues related to polyunsaturated fatty acid metabolism studies

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