Feeding premature newborn infants palmitic acid in amounts and stereoisomeric position similar to that of human milk: effects on fat and mineral balance

Abstract

The effect of the structure of human milk triglycerides on intestinal fat absorption remains controversial. Twelve infants were each fed, for 1 wk in a crossover design, two formulas that differed only in triglyceride configuration. The "beta" formula contained triglycerides similar to those in human milk (26% palmitic acid, esterified predominantly to the sn-2 position) whereas in the "alpha" formula, which contained triglycerides similar to those in formulas currently marketed, palmitate was mainly at the sn-1,3 positions. Fatty acid, fat, and mineral balances were measured at the end of each 1-wk period. Myristic, palmitic, and stearic acids were absorbed better from the beta formula, but total fat excretion was not reduced. During the feeding of beta formula fecal calcium excretion was lower, urinary calcium higher, and urinary phosphate lower. A formula containing triglycerides similar to those in human milk has significant effects on fatty acid intestinal absorption and improves mineral balance in comparison with a conventional formula.

Fatty acid and sn-2 fatty acid composition in human milk from Granada (Spain) and in infant formulas

“…Similar results had been obtained in preterm infants (Carnielli et al, 1995) and rats (Aoyama et al, 1996;de Fown et al, 1994;Lien et al, 1993;Renaud et al, 1995;Tomarelli et al, 1968).…”

“…Palmitic acid was also absorbed more with formulas rich in palmitic acid esterified at the sn-2 position of the triglycerides than with formulas containing palmitic acid largely esterified to the sn-1, 3 positions. These results were obtained in studies carried out on term infants (Carnielli et al, 1996;Filler et al, 1969), preterm infants (Carnielli et al, 1995) and rats (Aoyama et al, 1996;de Fown et al, 1994;Lien et al, 1993;Renaud et al, 1995;Tomarelli et al, 1968). Moreover, the location of palmitic acid in the sn-2 position in infant formulas improves the absorption of calcium in the small intestine (Lucas et al, 1997;Carnielli et al, 1996;Nelson et al, 1996).…”

The Composition of Human Milk as a Model for the Design of Infant Formulas: Recent Findings and Possible Applications

“…Carnielli et al (1994) recently evaluated the effects of two formulas for preterm infants, differing only in the isomeric position of palmitic acid, on the absorption of fat and fatty acids and on mineral balance in a crossover study in preterm infants. The palmitic acid content of both formulas was 25-26% of total fatty acids.…”

Scientific Opinion on the substantiation of a health claim related to beta‐palmitate and increased calcium absorption pursuant to Article 14 of Regulation (EC) No 1924/2006

“…However, these two studies showed that a high degree of palmitic acid in the sn-2 position of dietary triglycerides resulted in a significant decrease in faecal calcium excretion as calcium soaps (Carnielli et al, 1995;Lucas et al, 1997).…”

“…Three of the studies (Carnielli et al, 1995(Carnielli et al, , 1996Lucas et al, 1997) used calcium balance methods and included measures of calcium absorption, whereas one study (Kennedy et al, 1999) assessed the effects of beta-palmitate on BMD and BMC. Carnielli et al (1995) conducted a randomised, double-blind, controlled, cross-over intervention study to address the effects of beta-palmitate on fat and mineral balance in 12 healthy preterm infants (birth weight 1.4±0.2 kg, weight during study period 2.1±0.3 kg, postnatal age 38±7 days). The intervention and control formulae only differed in the percentage of palmitic acid in the sn-2 position of dietary triglycerides (58 % in the intervention "beta" formula versus 9.8 % in the control formula without beta-palmitate) and were administered for one week each with no washout period.…”