Effects of Early Cholesterol Intake on Cholesterol Biosynthesis and Plasma Lipids Among Infants Until 18 Months of Age

Abstract

Background. The endogenous cholesterol fractional synthesis rate (FSR) is related inversely to infant dietary cholesterol at 4 months of age; however, it remains to be established whether this effect is permanent, possibly contributing to later hypercholesterolemia. Objective. To determine whether levels of dietary cholesterol in infancy induced changes in FSR and plasma lipid levels that persisted at 18 months. Methods. A prospective clinical trial was conducted with 47 infants, from their first week of life until 18 months of age, who received human milk (HM) until weaned (n = 15) or were randomized to receive modified cow's milk formula (MCF) with added cholesterol (n = 15) or cow's milk formula (CF) (n = 17) for 12 months. Cholesterol contents of HM, MCF, and CF were 120, 80, and 40 mg/L, respectively. FSR and plasma lipid levels were measured at 4 and 18 months. Results. At 4 months, total cholesterol and low-density lipoprotein cholesterol levels were higher for infants fed HM and MCF, compared with CF. High-density lipoprotein cholesterol levels were higher in the MCF group than in the HM and CF groups. FSR in the HM group (0.034 ± 0.005 pools per day) was lower than that in the CF group (0.052 ± 0.005 pools per day). There was no difference between the HM and MCF (0.047 ± 0.005 pools per day) groups or between the MCF and CF groups. At 18 months, there were no differences in FSRs or plasma lipid profiles between the groups. Conclusion. Although cholesterol intake before weaning affects FSRs and plasma lipid profiles at 4 months, these differences do not persist after weaning to an unrestricted diet at 18 months. This provides additional evidence that there is no imprinting of FSR in infancy with differing dietary levels of cholesterol.

Low-density lipoprotein profile changes during the neonatal period

“…It was previously reported that the effects of milk source and early cholesterol intake on TC and LDL cholesterol concentrations do not persist at 12 months. 24 In a large meta-analysis study, however, TC concentrations are lower in adults that were breast-fed. 23 Longterm changes in cholesterol metabolism may be based on early nutritional status.…”

Breast-feeding and cardiovascular risk factors and outcomes in later life: evidence from epidemiological studies

“…Adjustment for adult socio-economic position, BMI and smoking status had little impact on these differences, although the possibility that other potential confounders might partially explain these differences remains (22) . These findings suggest nutritional programming of cholesterol synthesis by exposure to breast milk in early life, although, the biological mechanism for this process remains unclear (23)(24)(25)(26) . The long-term cholesterol lowering effect associated with breast-feeding has been replicated in a limited follow-up (25 %) of adolescents, who were preterm at birth and randomised to breast or formula milk (10) .…”

Faut-il enrichir les laits infantiles avec du cholestérol ?

“…Néanmoins, les statistiques indiquent qu'ils subissent a contrario un taux élevé de pathologies néonatales et une mortalité plus grande [7]. À l'inverse, les enfants alimentés au lait maternel ont des apports en cholestérol trop élevés, accompagnés d'une lipémie inquiétante à un mois et souffriraient même de dyslipémie à 4 mois [8]. Cette cholestérolémie élevée des enfants allaités n'est en outre pas compensée par les taux de synthèse fractionnée abaissés du cholestérol [8,9].…”