Trace element content in human milk during lactation of preterm newborns

2014

EFSA Journal

280

124

Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel's opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant's metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded. There is scientific consensus that breast milk is the preferred food for all healthy infants and provides an adequate supply of all nutrients to support growth and development (with the exception of vitamin K during the first weeks of life and of vitamin D). Whereas the composition of infant formula remains stable over time, breast milk composition changes continuously and therefore infant formula cannot imitate breast milk. © EuropeanAll formulae intended for infants must be safe and suitable to meet the nutritional requirements and promote growth and development of infants born at term when used as a sole source of nutrition during the first months of life, and when used as the principal liquid element in a progressively diversified diet after the introduction of appropriate complementary feeding. Nutrients and substances should be added to formulae for infants only in amounts that serve a nutritional or other benefit. The addition in amounts higher than those serving a benefit or the inclusion of unnecessary substances in formulae may put a burden on the infant's metabolism and/or on other physiological functions, as substances which are not used or stored have to be excreted.The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first half of the first year of life in its previous opinion and an average amount of daily energy intake from formula during this period (500 kcal/day). These minimum amounts should be understood as target values which cover the nutritional needs of virtually all infants born at term for optimal growth and devel...

Section: Chromium Content Of Human Milkmentioning

confidence: 99%

Scientific Opinion on the essential composition of infant and follow-on formulae

2014

EFSA Journal

280

124

“…3.8 ± 0.2 3.1 ± 0.1 Anderson (1992) 7 (84) USA Not reported Up to 5 months 7.0 Aquilio et al (1996) 8 Italy Not reported 2-6 days 3.9 ± 0.1 12-16 days 3.9 ± 0.3 21 days 4.1 ± 0.1 Arnaud and Favier (1995) 82 (143) France Not reported day 1 6.04 ± 3.29 day 2 11.81 ± 5.77 day 3 7.14 ± 4.12 day 4 5.49 ± 2.75 day 5 3.29 ± 1.10 day 6 3.02 ± 1.65 day 7…”

Section: Appendicesmentioning

confidence: 99%

Scientific Opinion on Dietary Reference Values for manganese

2013

EFS2

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for manganese. Manganese is an essential dietary mineral which is a component of a number of metalloenzymes involved in amino acid, lipid and carbohydrate metabolism. A specific manganese deficiency syndrome has not been described in humans. The body is able to adapt to a wide range of manganese intakes by regulating both efficiency of absorption in the intestine and the quantity excreted via bile. There are no reliable and validated biomarkers of manganese intake or status and data on manganese intakes versus health outcomes are not available for DRVs for manganese. As there is insufficient evidence available to derive an average requirement or a population reference intake, an Adequate Intake (AI) is proposed. Mean intakes of manganese in adults in the EU are around 3 mg/day. In addition, null or positive balances have consistently been observed with intakes of manganese above 2.5 mg/day. An AI of 3 mg/day is proposed for adults, including pregnant and lactating women. For infants aged from 7 to 11 months, an AI of 0.02-0.5 mg/day is proposed, which reflects the wide range of manganese intakes that appear to be adequate for this age group. The AI for children and adolescents is based on extrapolation from the adult AI using isometric scaling and reference body weights of the respective age groups. Manganese is an essential dietary element for mammals. It is a component of metalloenzymes such as superoxide dismutase, arginase and pyruvate carboxylase, and is involved in amino acid, lipid and carbohydrate metabolism. A specific manganese deficiency syndrome has not been described in humans.Absorption of manganese in the intestine is low (< 10 %). Regulation at the level of absorption appears to be one of the adaptive responses to dietary manganese intake and such regulation allows manganese homeostasis to be maintained over a wide range of intakes. A reduction in the biological half-life of manganese has been observed with increased dietary manganese intakes indicating the role of whole-body turnover rate in manganese homeostasis. Elimination of manganese is primarily via the faeces.The assessment of manganese intake or status using biological markers is difficult owing to the rapid excretion of manganese into bile, to homeostatic mechanisms and to the lack of sensitivity of biomarkers over the normal range of intakes. Therefore, there are no reliable and validated biomarkers of manganese intake or status.Nuts, chocolate, cereal-based products, crustaceans and molluscs, pulses, and fruits and fruit products are rich sources of manganese. The main contributors to the manganese intake of adults are cerealbased products, vegetables, fruits and fruit products and beverages. In the EU, estimated mean manganese intakes of adults range from 2 to 6 mg/day, with a majority of values around 3 mg/day. Estimated mean manganese intakes range from 1.5 to 3.5 mg/day in ...

“…Molybdenum concentrations of human milk appear to be highest during the first few days of breastfeeding, and decrease during the course of lactation (Dang et al, 1984;Casey and Neville, 1987;Bouglé et al, 1988;Aquilio et al, 1996;Krachler et al, 1998;Friel et al, 1999) (Appendix A). In mature human milk 6 from women in Europe, mean molybdenum concentrations were reported to range from 0.72 to 4 µg/L.…”

Section: Breast Milkmentioning

confidence: 99%

Scientific Opinion on Dietary Reference Values for molybdenum

2013

EFSA Journal

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for molybdenum. Molybdenum is efficiently and rapidly absorbed at a wide range of intakes, and the body is able to maintain homeostasis through the regulation of excretion via the urine. Molybdenum deficiency in otherwise healthy humans has not been observed and there are no biomarkers of molybdenum status. Various metabolic balance studies have been performed to establish molybdenum requirements. However, only one balance study, which was performed with a constant diet and under controlled conditions in adult men, was considered to be of sufficient duration. In this small study, balance was reported to be near zero when molybdenum intakes were 22 µg/day. Biochemical changes or symptoms suggestive of molybdenum deficiency were not observed, and it is possible that humans may be able to achieve molybdenum balance at even lower intakes. Data on molybdenum intakes and health outcomes were unavailable for the setting of DRVs for molybdenum. As the evidence required to derive an Average Requirement and a Population Reference Intake was considered insufficient, an Adequate Intake (AI) is proposed. Observed molybdenum intakes from mixed diets in Europe were taken into consideration in setting this value. An AI of 65 µg/day is proposed for adults; a figure that is based on molybdenum intakes at the lower end of the wide range of observed intakes. It is suggested that the adult AI also applies to pregnant and lactating women. An AI is also proposed for infants from seven months and for children based on extrapolation from the adult AI using isometric scaling and the reference body weights of the respective age groups. Molybdenum is an essential component of certain enzymes that catalyse redox reactions and contain, in addition to molybdenum, other prosthetic groups such as flavin adenine dinucleotide or haem. In humans, sulphite oxidase, xanthine oxidoreductase, aldehyde oxidase and mitochondrial amidoxime reducing component require molybdenum linked with a pterin (molybdopterin) as the cofactor. These enzymes are involved in the metabolism of aromatic aldehydes and the catabolism of sulphurcontaining amino acids and heterocyclic compounds, including purines, pyrimidines, pteridins and pyridines. © EuropeanIn humans, a single case report of a syndrome suggestive of dietary molybdenum deficiency in a patient on total parenteral nutrition for several months has been reported, but clinical signs of molybdenum deficiency in otherwise healthy humans have not been observed. A distinct molybdenum deficiency syndrome has not been observed in animals when subjected to molybdenum restriction, despite considerable reduction in the activity of molybdoenzymes.Water-soluble molybdates are efficiently and rapidly absorbed from the digestive tract at a wide range of intakes, and the body is able to adapt to this wide intake range by regulating excretion via the urine. Storage of ...