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Safety of supplementing infant formula with long-chain polyunsaturated fatty acids and Bifidobacterium lactis in term infants: a randomised controlled trial

  • Robert A. Gibson (a1) (a2) (a3), Denis Barclay (a4), Helen Marshall (a1) (a5) (a6), Julie Moulin (a7), Jean-Claude Maire (a7) and Maria Makrides (a1) (a2) (a6)...
Abstract

Probiotics and long-chain PUFA (LC-PUFA) may be beneficial supplements for infants who are not breast-fed. The aim of the present study is to evaluate the safety of an infant formula containing the LC-PUFA DHA and arachidonic acid (AA) and the probiotic Bifidobacterium lactis by comparing the growth rate of infants fed the supplemented and unsupplemented formulas. One hundred and forty-two healthy, term infants were enrolled in a single-centre, randomised, double-blind, controlled, parallel-group trial, and allocated to receive either standard or probiotic and LC-PUFA-containing experimental formulas. The infants were fed with their assigned formulas for 7 months. The primary outcome (weight gain) and the secondary outcomes (length, head circumference and formula tolerance) were measured throughout the study. LC-PUFA status was assessed at 4 months of age and immune response to childhood vaccines was measured at 7 months of age. There was no significant difference in growth between the two groups. The 90 % CI for the difference in mean weight gain was − 0·08, 3·1 g in the intention-to-treat population and 0·1–3·8 g in the per protocol population, which lay within the predefined boundaries of equivalence, − 3·9–3·9. There were no significant differences in mean length and head circumference. DHA and AA concentrations were higher in infants in the experimental formula group compared with the control formula group. No influence of the supplements on the response to vaccines was observed. Growth characteristics of term infants fed the starter formula containing a probiotic and LC-PUFA were similar to standard formula-fed infants.

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Corresponding author
*Corresponding author: Maria Makrides, fax +61 8 8161 8228, email maria.makrides@cywhs.sa.gov.au
References
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1Birch, EE, Birch, DG, Hoffman, DR, et al. (1992) Dietary essential fatty acid supply and visual acuity development. Invest Ophthalmol Vis Sci 33, 32423253.
2Carlson, SE, Werkman, SH & Tolley, EA (1996) Effect of long-chain n-3 fatty acid supplementation on visual acuity and growth of preterm infants with and without bronchopulmonary dysplasia. Am J Clin Nutr 63, 687697.
3Makrides, M, Neumann, M, Simmer, K, et al. (1995) Are long-chain polyunsaturated fatty acids essential nutrients in infancy? Lancet 345, 14631468.
4Carlson, SE, Cooke, RJ, Werkman, SH, et al. (1992) First year growth of preterm infants fed standard compared to marine oil n-3 supplemented formula. Lipids 27, 901907.
5Makrides, M, Gibson, RA, Udell, T, et al. (2005) Supplementation of infant formula with long-chain polyunsaturated fatty acids does not influence the growth of term infants. Am J Clin Nutr 81, 10941101.
6Kew, S, Mesa, MD, Tricon, S, et al. (2004) Effects of oils rich in eicosapentaenoic and docosahexaenoic acids on immune cell composition and function in healthy humans. Am J Clin Nutr 79, 674681.
7Field, CJ, Thomson, CA, Van Aerde, JE, et al. (2000) Lower proportion of CD45R0+ cells and deficient interleukin-10 production by formula-fed infants, compared with human-fed, is corrected with supplementation of long-chain polyunsaturated fatty acids. J Pediatr Gastroenterol Nutr 31, 291299.
8Field, CJ, Van Aerde, JE, Robinson, LE, et al. (2008) Effect of providing a formula supplemented with long-chain polyunsaturated fatty acids on immunity in full-term neonates. Br J Nutr 99, 9199.
9Agostoni, C, Axelsson, I, Braegger, C, et al. (2004) Probiotic bacteria in dietetic products for infants: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 38, 365374.
10Balmer, SE & Wharton, BA (1989) Diet and faecal flora in the newborn: breast milk and infant formula. Arch Dis Child 64, 16721677.
11Harmsen, HJ, Wildeboer-Veloo, AC, Raangs, GC, et al. (2000) Analysis of intestinal flora development in breast-fed and formula-fed infants by using molecular identification and detection methods. J Pediatr Gastroenterol Nutr 30, 6167.
12Newburg, DS (2005) Innate immunity and human milk. J Nutr 135, 13081312.
13Isolauri, E, Arvola, T, Sutas, Y, et al. (2000) Probiotics in the management of atopic eczema. Clin Exp Allergy 30, 16041610.
14Kalliomaki, M, Salminen, S, Arvilommi, H, et al. (2001) Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 357, 10761079.
15Marteau, PR, de Vrese, M, Cellier, CJ, et al. (2001) Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr 73, 430S446S.
16Saavedra, JM, Bauman, NA, Oung, I, et al. (1994) Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 344, 10461049.
17Szajewska, H & Mrukowicz, JZ (2001) Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr 33, S17S25.
18Kullen, MJ & Bettler, J (2005) The delivery of probiotics and prebiotics to infants. Curr Pharm Des 11, 5574.
19Langhendries, JP, Detry, J, Van Hees, J, et al. (1995) Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants. J Pediatr Gastroenterol Nutr 21, 177181.
20Simmer, K (2001) Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database Syst Rev, CD000376.
21Simmer, K & Patole, S (2004) Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev, CD000375.
22Das, UN (2002) Essential fatty acids as possible enhancers of the beneficial actions of probiotics. Nutrition 18, 786.
23Hawkes, JS, Gibson, RA, Roberton, D, et al. (2006) Effect of dietary nucleotide supplementation on growth and immune function in term infants: a randomized controlled trial. Eur J Clin Nutr 60, 254264.
24National Health and Medical Research Council (2003) The Australian Immunization Handbook, 8th ed.Canberra: Australian Government Publishing Service.
25World Health Organization (1996) International Statistical Classification of Diseases and Related Health Problems. Geneva: WHO.
26Makrides, M, Hawkes, JS, Neumann, MA, et al. (2002) Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomized controlled trial. Am J Clin Nutr 75, 10841092.
27Puccio, G, Cajozzo, C, Meli, F, et al. (2007) Clinical evaluation of a new starter formula for infants containing live Bifidobacterium longum BL999 and prebiotics. Nutrition 23, 18.
28US Food and Drug Administration/American Academy of Pediatrics Committee on Nutrition (1988) Clinical testing of infant formulas with respect to nutritional suitability for term infants. http://www.cfsan.fda.gov/~dms/inf-clin.html.
29Kuczmarski, RJ, Ogden, CL, Grummer-Strawn, LM, et al. (2000) CDC Growth Charts: United States. Advance Data from Vital and Health Statistics, no. 314. Hyattsville, MD: National Center for Health Statistics.
30Carlson, SE, Werkman, SH, Peeples, JM, et al. (1993) Arachidonic acid status correlates with first year growth in preterm infants. Proc Natl Acad Sci U S A 90, 10731077.
31Makrides, M, Neumann, MA, Simmer, K, et al. (1999) Dietary long-chain polyunsaturated fatty acids do not influence growth of term infants: a randomized clinical trial. Pediatrics 104, 468475.
32Brenna, JT, Varamini, B, Jensen, RG, et al. (2007) Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr 85, 14571464.
33Field, CJ, Clandinin, MT & Van Aerde, JE (2001) Polyunsaturated fatty acids and T-cell function: implications for the neonate. Lipids 36, 10251032.
34de Vrese, M, Rautenberg, P, Laue, C, et al. (2005) Probiotic bacteria stimulate virus-specific neutralizing antibodies following a booster polio vaccination. Eur J Nutr 44, 406413.
35Kukkonen, K, Nieminen, T, Poussa, T, et al. (2006) Effect of probiotics on vaccine antibody responses in infancy – a randomized placebo-controlled double-blind trial. Pediatr Allergy Immunol 17, 416421.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
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