Macronutrient and energy intakes in young children fed milk products containing different quantities and qualities of fat and protein.

BACKGROUND: Milk is the major source of protein and saturated fats in the diet after infancy. In the present study, the effects of different fat and protein quantity as well as fat quality in milk and dairy products on nutrient intake and growth in young children were determined. METHODS: Thirty-eight healthy children were randomly assigned to one of four feeding groups at 12 months of age: 1) Low-fat milk (1.0 g fat/dl, 3.3 g protein/dl); 2) standard-fat milk (3.5 g fat/dl, 3.3 g protein/dl); 3) partially vegetable fat and protein-reduced milk (3.5 g fat/dl, 50% vegetable; 2.2 g protein/dl); and 4) full-vegetable-fat milk (3.5 g fat/dl, 100% vegetable; 3.0 g protein/dl). Nutrient intake and growth were measured at 12, 15, and 18 months. RESULTS: The protein intake was significantly reduced with the protein-reduced milks. The intake of saturated fat was significantly lower with low-fat milk (11% of energy) or milks containing vegetable fat (13%) than in standard-fat milk (19.6%). However, the total fat intake was below 30% of energy in low-fat milk, whereas the total fat intake remained more than 30% in the other groups. Energy intake and growth were similar in all groups. CONCLUSIONS: A modified milk with reduced protein content for young children results in protein intakes closer to recommendations. A modified milk with either 50% or 100% vegetable fat and dairy products with low milk fat and high vegetable fat content results in intakes of total and saturated fats closer to international recommendations, compared with standard or low-fat milk and dairy products.     

Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

The fatty acid (FA) composition of the main plasma lipids was analysed in eight well-nourished, generally healthy Nigerian children aged 14.1±7.2 months and in 17 malnourished children (8 marasmus, 9 kwashiorkor) aged 14.6±3.8 months within the first 2 days of admission at the Dept. of Child Health, University of Benin. In comparison to the control group, the malnourished children showed a marked decrease of polyunsaturated FA with low linoleic acid, mainly in sterolesters (STE), and severely reduced linoleic acid metabolites, including arachidonic acid, in all lipid fractions. -3-FA were not altered except for a reduction of docosapentaenoic and docosahexaenoic acids in phospholipids. Clearly increased values were found for saturated FA in STE and for the non-essential monoenoic FA in all lipid classes. This pattern indicates the presence of essential fatty acid deficiency in the malnourished children. There was no significant difference between marasmus and kwashiorkor. Eight malnourished children were followed up in the early phase of recovery during hospital treatment 14.0±3.1 days after obtaining the first sample. Linoleic acid had increased again in STE, but its metabolites were as low or even lower than before. An impaired activity of delta-6-desaturase, the rate limiting enzyme of linoleic acid metabolism, in suggested by elevated substrate-product-ratios of this enzyme in untreated children with protein energy malnutrition and in the early phase of recovery, which may be due to low insulin levels, protein and zinc deficiency. The trientetraen-ratio (2039/2046) thus is not a reliable indicator of essential FA status in protein-energy malnutrition.Abbreviations EFA essential fatty acids - FA fatty acids - PEM protein energy malnutrition - PL phospholipids - STE sterolesters - TG triglycerides - PUFA polyunsaturated fatty acids Presented in part at the XIII. International Congress of Nutrition, Brighton, August 18–23, 1985     

Fatty acid balance studies in term infants fed formula milk containing long-chain polyunsaturated fatty acids

Long-chain polyunsaturated fatty acids (LCP) are thought to be required for optimal nervous system development in the newborn. A commercial milk formula containing LCP (Aptamil-LCP) with a fatty acid profile closely resembling breast milk, has recently been introduced for term infants. The absorption of fatty acids in term infants was examined in a double-blind randomized controlled trial comparing Aptamil-LCP ( n = 20) and standard Aptamil ( n = 20). Formula-fed newborn infants were studied from birth for 14 d. Fat balances (3 d) were performed from d 10. A 3-d stool collection was performed from d 10 in a parallel breastfed group ( n = 21). Plasma samples were taken on d 6. Median fat excretion (mg kg⁻¹) was 897.1, 615.0 and 355.2 with Aptamil, Aptamil-LCP and breastfeeding, respectively. The median total fat absorption coefficient in Aptamil-LCP-fed infants was higher than in those fed standard Aptamil ( p < 0:01). These findings were accounted for by differences in the excretion and absorption of long-chain saturated fatty acids (C14:0, C16:0 and C18:0). Higher fat excretion was associated with bulkier and firmer stools. Only trace amounts of LCP were detected in the stools of all groups. This accounted for less than 4% of dietary intake in Aptamil-LCP-fed infants. No differences in the utilization of LCP from Aptamil-LCP and breast milk feeding were apparent. Plasma phospholipid fatty acid composition data reflected differences in dietary LCP intake. Thus, PL LCP levels were highest in the breastfed infants and lowest in the Aptamil-fed infants, with values for the Aptamil-LCP-fed group falling in between.     

Fatty acid composition of plasma lipids in HIV-infected children. Comparison with seroreverters

Children infected with the type-1 human immunodeficiency virus (HIV) are at risk of nutritional deficiencies leading to an impaired polyunsaturated fatty acid (PUFA) status. The aim of the present study was to compare the PUFA composition of plasma lipid classes (total lipids, phospholipids (PL), cholesteryl esters (CE) and triglycerides) in well-growing HIV-infected children with an age-matched group of HIV-seroreverter children born to infected mothers. Eighteen HIV children, of both sexes, mean age 4.6 y, most of whom under combined antiretroviral regimen, were compared with 18 seroreverters, mean age 5.4 y, comparable for demographic, anthropometric and dietary characteristics. All children had adequate growth parameters (weight and height > 3rd percentile). The plasma fatty acid content was similar in the two groups. HIV seropositive subjects showed lower linoleic acid (LA) levels in all the plasma lipid fractions, with higher 20:3n-9 and 20:5n-3 levels in PL and CE. The plasma PL triene/tetraene ratio (marker of relative LA deficiency) related positively to the viral load and negatively to the blood CD4+ lymphocyte count. Compared to age-matched seroreverter subjects, HIV-seropositive children show a lipid fatty acid status suggestive of relative LA deficiency and increased turnover of the PUFA series.     

Characteristics of obese children with low content of arachidonic acid in plasma lipids

BACKGROUND: Although there have been many studies on the relationship between obesity and long-chain polyunsaturated fatty acid (LCPUFA), the results and their interpretation are controversial, especially in children. Arachidonic acid (AA), the product of n-6 LCPUFA, is reported to be related to insulin resistance. The purpose of the present paper was to investigate the LCPUFA profile in obese children and mechanisms that contribute to reduced AA content. METHOD: An age- and sex-matched control study was performed. The study subjects were 59 obese children (mean age, 11.8 years) and 53 healthy non-obese children (mean age, 12.5 years). The study parameters included anthropometric measurements, serum lipids, leptin and fatty acid composition in plasma. RESULTS: Plasma fatty acids in obese children had lower linoleic acid (P < 0.0001) and higher dihomo-gamma-linolenic acid (P = 0.0004) than those in non-obese children. In all subjects combined, delta-6 desaturase (D6D) index (ratios of [C 18:3n-6+C 20:2n-6]/C 20:4n-6 or C 20:4n-6/C 18: 2n-6) correlated with leptin (P < 0.0001). There was no significant difference in AA content between obese and non-obese. However, the AA content was low (相似文献   

Longitudinal multicentric study of plasma and red blood cell fatty acids and lipids in preterm newborns fed human milk

The present multicentric study (three centers) deals with the values of plasma and red blood cell fatty acids obtained in a group of 18 preterm newborns after 2 days (D2), 15 days (D15) and 5 weeks (37th week postconception: 37th wk) of human milk feeding. Analytical methods were randomized between the three centers and quality control was evaluated by repeated analysis of reference samples. 20:4 n-6 varied from 10.71 +/- 1.58% to 9.51 +/- 1.65 and 10.10 +/- 1.42% in plasma phospholipids and from 16.59 +/- 3.30% to 14.68 +/- 3.14 and 18.24 +/- 4.09% in red blood cell phosphatidylethanolamine (RBC-PE) at D2, D15 and 37th wk, respectively, contrasting with the important rise of the precursor (18:2 n-6) in all the fractions studied. In RBC-PE, 22:6 n-3 significantly declined from 3.52 +/- 1. 03% at D2 to 2.56 +/- 0.83% at D15 (p < 0.02) and recovered its initial level at 37th wk (4.08 +/- 1.94%). The recovery of long chain polyunsaturated fatty acid homeostasis at that time was also confirmed by the decline of 16:1 n-7 in cholesterol esters (10.69 +/- 3.92 to 4.32 +/- 2.38%).     

Fatty acid composition of plasma and red cell phospholipids of preterm babies fed on breast milk and formulae

Fatty acids of plasma and red cells of preterm babies, gestational age 28–33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breastfeed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk.Conclusion Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.     

Fatty acid balance studies in preterm infants fed formula milk containing long-chain polyunsaturated fatty acids (LCP) II

A milk formula (Prematil-LCP) containing long-chain polyunsaturated fatty acids (LCP) and with a fatty acid profile closely resembling breast milk has recently been introduced for preterm infants. A double-blind randomized controlled trial was performed comparing fatty acid absorption from Prematil-LCP (n = 10) and standard Prematil (n = 10). Formula-fed preterm infants underwent 3 d fat balances (once full enteral feeds were established) along with a parallel human milk fed group (n = 11). Plasma samples were taken on the last day. Median total fat excretion (absorption, %) was 2.34 g kg (82.0), 2.64 g kg (82.9) and 1.65 g kg (87.8) with Prematil, Prematil-LCP and human milk feeding, respectively. This reflected differences in the excretion and absorption of long-chain saturated fatty acids. All groups excreted detectable LCP. LCP disappearance was higher in infants fed human milk than in those fed Prematil-LCP, particularly for n -6 LCP (p <0:01). Nevertheless, excreted LCP equated to <30% dietary intake, with Prematil-LCP feeding. Plasma lipid fatty acid composition reflected differences in dietary LCP intake.     

Total lipid content and fatty acid composition of preterm human milk

The total lipid content and fatty acid composition of preterm human colostrum and milk were analyzed from aliquots of 24-h collections of colostrum, transitional milk, and mature milk obtained from 21 women who had delivered premature infants with a mean birth weight of 1,049 +/- 38 g (mean +/- SEM) and a mean gestational age of 29 +/- 0.4 weeks. The total lipid content increased significantly with time of lactation (p less than 0.001), from 1.99 +/- 0.25 g/dl in colostrum to 3.89 +/- 0.28 g/dl in mature milk. With respect to the fatty acid pattern, the percentages of 12:0 and 14:0 increased significantly (p less than 0.001), while those of 16:0 (p less than 0.05) and 18:1 (p less than 0.001) decreased significantly with time of lactation. The percentages of 10:0, 16:1, 18:0, 18:2, and 18:3 did not vary significantly with the duration of lactation. Similar compositional changes have been described in term human colostrum and milk as the duration of lactation progresses.     

Different quantities and quality of fat in milk products given to young children: effects on long chain polyunsaturated fatty acids and trans fatty acids in plasma

In this study we compared plasma contents of long-chain polyunsaturated fatty acids (LC-PUFAs) and trans fatty acids in triglycerides (TG), phospholipids (PL) and cholesterolesters (CE) in young children fed milk diets containing different amounts of linoleic (LA) and alpha-linolenic acid (ALA). Because the diets differed in vitamin A and E content, plasma concentrations of vitamin A and E were also studied. Thirty-seven 1-y-old children were randomly assigned to one of four feeding groups: (1) low-fat milk (LF) (1.0 g cow's milk fat/dL); (2) standard-fat milk (SF) (3.5 g cow's milk fat/dL); (3) partially vegetable fat milk (PVF) (3.5 g fat/dL; 50% vegetable fat from rapeseed oil, 50% milk fat); and (4) full vegetable fat milk (FVF) (3.5 g fat/dL; 100% vegetable fat from palm-, coconut- and soybean oil). We found higher amounts of plasma LA in the FVF group than in the LF and SF groups (p < 0.001) and higher amounts of ALA in the PVF group than in the SF (p < 0.001 in TGs, p < 0.05 in CEs) and LF (p < 0.01 in PLs and CEs, p < 0.05 in TGs) groups. However, amounts of plasma arachidonic acid (AA) were similar between groups as well as the amounts of docosahexaenoic acid (DHA) in CEs and PLs. Total trans FAs were lower in CEs in the PVF and FVF groups than in the SF group (p < 0.05 SF vs PVF; p < 0.01 SF vs FVF). Plasma concentrations of alpha-tocopherol were higher in the FVF group than in the other groups (p < 0.05 FVF vs SF, p < 0.01 FVF vs SF and PVF). Conclusion: Children consuming milk diets containing high amounts of vegetable fat present with higher plasma LA and ALA without any effects on amounts of plasma LC-PUFA. The plasma LC-PUFA status is not adversely affected by a low-fat milk diet. AHA and DHA in plasma are not affected by the diets studied, presumably because 15-mo-old children may be able to compensate for dietary influences through endogenous LC-PUFA metabolism.     

Effects of dietary fat modifications on serum lipids and blood pressure in children

Some recent studies have shown an extremely high level of serum cholesterol level among Finnish children. The aim of the present study was to test the effect of a "cholesterol lowering diet" on serum lipids and blood pressure among 36 children aged 8-18 years residing in two semirural communities in North Karelia, Finland. After a baseline period of two weeks on conventional diets, the proportion of energy derived from fat in the diet was reduced from the baseline level of 35% to 24%, and the ratio of polyunsaturated/saturated fats was increased from the baseline level of 0.18 to 0.61, during a 12-week intervention period. The children then changed back to their normal diet during a five-week switch-back period. The mean serum total cholesterol decreased 15% during the intervention, and then increased to nearly the initial level during the switch-back period. Similar changes were observed in HDL-cholesterol and also to some extent in apoproteins AI, AII and B. Blood pressure was not affected, although systolic blood pressure decreased during intervention. We conclude that the high level of serum cholesterol in Finnish children is to a great extent caused by the local dietary pattern and can be decreased by dietary modification.     

Fatty acid composition of plasma lipids in acrodermatitis enteropathica before and after zinc supplementation

The fatty acid composition of different plasma lipid fractions has been estimated in a 6-month-old girl with acrodermatitis enteropathica before and after zinc supplementation.Linoleic acid and its metabolites were extremely reduced in triglycerides and sterol-esters. In contrast, n-3-fatty acids were increased in sterol-esters and phospholipids.Zinc supplementation led to quick clinical improvement, and linoleic and arachidonic acid increased rapidly in triglycerides and sterol-esters to the values of healthy infants. Fatty acids of phospholipids remained relatively stable.Our finding could be explained by impaired enteral absorption of linoleic acid. Further attention should be directed to the supply and metabolism of essential fatty acids in acrodermatitis enteropathica.Abbreviations AE acrodermatitis enterophatica - FA fatty acids - OFC occipito-frontal circumference - PL phospholipids - STE sterol-esters - TG triglycerides     

Fatty acid composition of lipid classes in maternal and cord plasma at birth

The fatty acid composition of plasma phospholipids, triglycerides, cholesterol esters and nonesterified fatty acids was determined by high-resolution capillary gas-liquid chromatography in 41 pairs of mothers and their term infants at time of birth. The total free fatty acid content in maternal and cord plasma was positively correlated, possibly reflecting a passive, gradient dependent transplacental passage of nonesterified fatty acids. Higher percentage values of several saturated and monounsaturated fatty acids in cord than in maternal plasma phospholipids, triglycerides and nonesterified fatty acids may have resulted from an active fetal fatty acid synthesis. Trans fatty acids were found in every lipid class at similar or slightly lower percentages in neonatal as in maternal plasma, thus confirming their placental passage. Long-chain n-6 and n-3 polyunsaturated fatty acids are preferentially incorporated into phospholipids and sterolesters of both maternal and cord plasma. Linoleic and α-linolenic acids were found in smaller portions in cord than in maternal fatty acids, in contrast to strikingly higher proportions of their long-chain polyunsaturated metabolites, which may indicate a discriminating placental transport for certain physiologically important long-chain polyunsaturated fatty acids. Conclusion The fetus appears to obtain fatty acids from a combination of de novo synthesis, a passive gradient dependent transplacental passage of nonesterified fatty acids and a selective materno-fetal placental transport for certain fatty acids, such as physiologically important long-chain polyunsaturated fatty acids. Received: 17 June 1997 / Accepted in revised form: 3 November 1997