Diet and faecal flora in the newborn: nucleotides.

Balmer, S E; Hanvey, Louise; Wharton, B A

doi:10.1136/fn.70.2.f137

Cited by 64 publications

(28 citation statements)

References 11 publications

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“…However, the data are conflicting (Balmer et al, 1994;Ostrom et al, 2002). There are few data from well-controlled RCTs to demonstrate that NT supplementation of term infants protects against infection.…”

Section: Discussionmentioning

confidence: 98%

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Effect of dietary nucleotide supplementation on growth and immune function in term infants: a randomized controlled trial

Hawkes

Gibson

et al. 2005

Eur J Clin Nutr

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Objective: To examine the effect of nucleotide (NT)-supplemented cow's milk-based formula on growth and biochemical indices of immune function in healthy infants. Design: Randomized controlled trial (RCT) of formula-fed term infants allocated to control formula with an innate level of NT at 10 mg/l (n ¼ 102), or formula fortified with NT at 33.5 mg/l (n ¼ 98). A parallel group of 125 breastfed infants followed the same protocol as a reference. Outcome measures: Growth was assessed at enrolment, 7 weeks, 4 months and 7 months of age. Natural killer cell activity, cytokine production and lymphocyte subpopulations were assessed at 7 weeks of age. Antibody responses to diphtheria toxoid, tetanus toxoid and Haemophilus influenzae type b (Hib) immunizations were measured at 7 months of age. Results: NT supplementation did not influence the growth of formula fed infants or any markers of immunity measured at 7 weeks of age. Antibody responses to tetanus toxoid were higher in the NT-supplemented group (n ¼ 68) compared with the control group (n ¼ 70) at 7 months of age (median (5th, 95% percentile): 1.57(0.42, 3.43) vs 1.01(0.41, 4.66) IU/ml, Po0.03). A difference between treatments was seen in response to diphtheria toxoid but this effect disappeared when adjusted for hepatitis B immunization at birth. There was no effect of treatment on antibody responses to Hib immunization. Conclusions: Supplementation of formulas with NT at 33.5 mg/l resulted in a modest improvement in antibody response consistent with RCTs that used higher levels of NT supplementation. Whether this translates to clinical benefits in well-nourished infants requires further study.

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Section: Discussionmentioning

confidence: 98%

“…However, other RCTs have been unable to confirm the reported beneficial effects of NT supplementation (Balmer et al, 1994;Woltil et al, 1995;Yau et al, 2003). Many of the trials had small sample sizes and inadequate information to assess trial quality, hence making it difficult to establish the clinical efficacy of NT supplementation.…”

Section: Introductionmentioning

confidence: 99%

Effect of dietary nucleotide supplementation on growth and immune function in term infants: a randomized controlled trial

Hawkes

Gibson

et al. 2005

Eur J Clin Nutr

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“…However, few studies have examined the effect of supplementing formula with those compounds on intestinal structure of the neonate. The effects of nucleotide-supplemented formulas on infant microbiota are contradictory: some clinical trials observed a bifidogenic effect of nucleotides on faecal microbiota (103) while others did not (104) . Intestinal permeability and pancreatic enzyme secretion were also not modified by the addition of nucleotides in the formula of neonates (66,85) .…”

Section: Nucleotidesmentioning

confidence: 99%

Breast-v.formula-feeding: impacts on the digestive tract and immediate and long-term health effects

2010

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The health benefits of breast-feeding have been recognised for a long time. In particular, breast-feeding is associated with lower incidence of necrotising enterocolitis and diarrhoea during the early period of life and with lower incidence of inflammatory bowel diseases, type 2 diabetes and obesity later in life. The higher nutritional and protective degree of human milk is related to its nutritional composition that changes over the lactation period and to the biological activities of specific components while lower growth rate of breast-fed infants may be attributed to their self-regulation of milk intake at a lower level than formula-fed infants. Many results now suggest that the developmental changes in intestinal and pancreatic function that occur postnatally are modulated by the diet. Indeed, formula-feeding induces intestinal hypertrophy and accelerates maturation of hydrolysis capacities; it increases intestinal permeability and bacterial translocation, but does not induce evident differences in microbiota composition. Whether these changes would be beneficial for enhancing absorptive capacities and for educating the gut-associated immune system remains to be further studied. Moreover, it is evident that formula-feeding increases basal blood glucose and decreases plasma ketone body concentrations, while discrepancies on postprandial glycaemia, insulin and incretin responses in both human studies and experimental studies are inconclusive. Manipulating the composition of formula, by reducing protein content, adding prebiotics, growth factors or secretory IgA can modulate intestinal and pancreatic function development, and thereby may reduce the differential responses between breast-fed and formula-fed neonates. However, the developmental responses of the digestive tract to different feeding strategies must be elucidated in terms of sensitivity to developing diseases, taking into account the major role of the intestinal microbiota.

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“…Original data from ref. 9. in the formula-fed groups, bacteroides enterococci and coliforms were more common (9).…”

Section: Faecal Floramentioning

confidence: 99%

Protein nutrition, faecal flora and iron metabolism: the role of milk‐based formulae

Wharton¹,

Balmer²,

Hm³

et al. 1994

Acta Paediatrica

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PH. Protein nutrition, faecal flora and iron metabolism: the role of milk-based formulae. Acta Paediatr 1994; (Suppl402): 24-30. Stockholm. ISSN 0803-5326.This paper explores the role of milk-based formulae in achieving four aspects of nutritional health in infants and toddlers: in the suckling, to mimic the amino acid metabolism and the faecal flora of a breast-fed baby; in the weanling, to achieve adequate protein intakes in later infancy and beyond and to achieve satisfactory haemoglobin concentrations in the early toddler years. Milk-based formulae have two roles in infant nutrition: as so-called breast milk substitutes and as a safety net during the weaning period; the latter role may be the more important. Brian A Wharton, The Old Rectory, Belbroughton, Worcestershire, U KIn previous reviews we have described the manufacture and properties of infant formulae and follow-on milks (1, 2). This paper explores their role in promoting the nutritional health of sucklings and weanlings concentrating on four areas that we have investigated and including some previously unpublished data. The sucklingBreast milk remains the gold standard for the nutrition of young infants. Milk-based formulae need to be similar in composition to that of breast milk and to have similar effects in the baby. Two aspects of mimicking breast milk and the breast-fed baby that we have been concerned with are presented. Amino acid metabolismOver the years, the quantity of protein in milk-based formulae has been reduced gradually. A major argument in favour of the reduction is the consequent fall in the renal solute load generated by excessive amounts of protein. Moreover, methods for producing lower protein formulae usually result in lower concentrations of minerals, including phosphate (1,2), and so the prevalence of late neonatal hypocalcaemic convulsions has fallen (3).As protein quantity is reduced, questions of protein quality and amino acid content become more important. Compared to a gram of breast milk protein, a gram of cows' milk protein contains less cysteine (about 50% of that in breast milk) and less tryptophan (about 65%). Cows' milk protein also contains slightly less alanine and glycine (about 95%) and they might be conditionally essential in the newborn.As the amount of cows' milk protein in formulae is reduced, so there will be an increasing likelihood of the baby receiving a lower intake of cysteine and tryptophan than a breast-fed baby. Figure 1 shows plasma amino acid concentrations in normal healthy newborn babies in the first 3 weeks of life. The formulafed babies had higher plasma concentrations of many amino acids but lower concentrations of a few, including tryptophan (4).Cysteine. Babies consuming l00ml of breast milk receive about 24 mg of cysteine, whereas those receiving 100 ml of a casein-dominant formula (1.5 g of protein) receive only 14mg.We did not find that the lower intake of cysteine was accompanied by lower plasma cysteine concentrations in either low birthweight or normal-sized babies (see Fig. I), but ...

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Diet and faecal flora in the newborn: nucleotides.

Abstract: Breast milk contains nucleotide salts that

Cited by 64 publications

References 11 publications

Effect of dietary nucleotide supplementation on growth and immune function in term infants: a randomized controlled trial

Effect of dietary nucleotide supplementation on growth and immune function in term infants: a randomized controlled trial

Breast-v.formula-feeding: impacts on the digestive tract and immediate and long-term health effects

Protein nutrition, faecal flora and iron metabolism: the role of milk‐based formulae

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