Aluminum and bone disorders: with specific reference to aluminum contamination of infant nutrients

Aluminum (Al) impairment of bone matrix formation and mineralization may be mediated by its direct effect on bone cells or indirectly by its effect on parathyroid hormone and calcium metabolism. Its toxic effects are proportional to tissue Al load. Al contamination of nutrients depends on the amount of Al present naturally in chemicals or from the manufacturing process. Intravenous calcium, phosphorus, and albumin solutions have high Al (greater than 500 micrograms/L), whereas crystalline amino acid, sterile water, and dextrose water have low Al (less than 50 micrograms/L) content. Enteral nutrients including human and whole cow milk have low Al, whereas highly processed infant formulas with multiple additives, such as soy formula, preterm infant formula, and formulas for specific disorders are heavily contaminated with Al. Healthy adults are in zero balance for Al. The gastrointestinal tract excludes greater than 95% of dietary Al, and kidney is the dominant organ for Al excretion. However, even with normal renal function, only 30-60% of an Al load from parenteral nutrition is excreted in the urine, resulting in tissue accumulation of Al. The risk for Al toxicity is greatest in infants with chronic renal insufficiency, recipients of long term parenteral nutrition, i.e., no gut barrier to Al loading, and preterm infants with low Al binding capacity. The rapid growth of the infant would theoretically potentiate Al toxicity in all infants, although the critical level of Al loading causing bone disorders is not known. To minimize tissue burden, Al content of infant nutrients should be similar to "background" levels, i.e., similar to whole milk (less than 50 micrograms/L).     

Manganese content of large-volume parenteral solutions and of nutrient additives

Manganese (Mn) was analyzed by flameless atomic absorption spectrophotometry in a variety of commercially produced solutions and additives commonly used in total parenteral nutrition (TPN). The amount of Mn in preparations tested varied among manufacturers and among lots. It was generally present in very small amounts with amino acid preparations supplying the major portion in the TPN formulas. Among amino acid solutions, Aminosyn 10% had the highest Mn content (5.2-17.0 micrograms/liter) with Veinamine 8%, FreAmine II, 8.5%, Travasol 10%, and Nephramine having less than 6.7 micrograms/liter. Other large volume parenterals contained appreciably less Mn, eg, Dextrose 50% had 0.64-2.5 micrograms/liter. Some of the additives were high in Mn, eg, potassium phosphate--280 micrograms/liter, magnesium sulfate 50%--up to 225 micrograms/liter, and Berocca C--245.8 micrograms/liter but their actual contributions to daily TPN intake was no more than 3.3 micrograms. The calculated Mn content in TPN formulas with varying source materials ranged from 8.07-21.75 micrograms per total daily volume. These values agreed with those obtained from analysis of actual TPN solutions. The values for 10% Intralipid and 20% Liposyn were 0.5 and 3.0 micrograms/liter, respectively.     

Laits maternels et formules lactées 1 âge : péroxydation lipidique

Human milk is rich in polyunsaturated fatty acids (PUFA) that are prone to oxidation. We have measured a global (MDA) and specific end-markers of n–6 and n–3 PUFA oxidation, respectively: 4-HNE and 4-HHE, from 7 breast milk samples. Analyses were performed on milk fresh or stored 1 day at 18°C or 7 days at 4°C. Ten infant formulas, liquids or in powder, some supplemented in long chain PUFA, were also studied. The ratio [4-HHE/n–3 PUFA] was 20-fold higher in liquid infant formula than in human milk (0.19 ±0.01 μg.g⁻¹). The ratio [4-HNE/n–6 PUFA] was 300-fold higher in liquid infant formula than in human milk (0.004 ±0.000 μg.g⁻¹). Storage of human milk did not increase significantly lipid peroxidation, on the contrary to infant formula where MDA increased. The native structure of fat globules in breast milk can take part in its greater protection against oxidation compared to the artificial fat droplets in infant formulas. The health consequences of chronic infant exposure to low dietary doses of lipid peroxidation products should be investigated and infant formulas should be stored in appropriate conditions.     

Fluoride content of powdered infant formula meets Australian Food Safety Standards

Objectives: To identify the fluoride content of powdered formula for infants 0‐12 months in products available from Brisbane stores in 2006/07 and compare this with the fluoride content of infant formula products available in Australia 10 years earlier. Methods: A range of available infant formula powders were collected from major supermarkets and chemists in Brisbane, Queensland. The fluoride levels in infant formula powder samples were determined using a modification of the micro‐diffusion method of Silva and Reynolds 1 utilising perchloric acid and silver sulphate and measured with an ion selective (fluoride) electrode/meter. Fluoride content both prior to and after reconstitution, as well as estimated daily intake according to age was calculated. Results: Formula samples contained an average of 0.49 μg F/g of powder (range 0.24–0.92 μg F/g). After reconstitution with water containing 0mg/L fluoride, the fluoride content averaged 7.09μg F/100mL (range 3.367–22.72 μg F/100mL). Estimated infant fluoride intakes ranged from 0.0039 mg/kg/day for a 6‐12 month old infant when reconstituting milk‐based formula with non‐fluoridated water (0 mg/L), to 0.1735 mg/kg/day for a 0‐3 month old infant when reconstituting soy‐based formula with fluoridated water (1.0 mg/L). Conclusions: Infant formula powders contain lower levels of fluoride than previously found in Australia in 1996. Implications: This confirms that infants consume only a small amount of fluoride from milk‐based powdered infant formula. Although soy‐based infant formulas contain more fluoride than milk‐based products, the levels still comply with national food standards.     

深圳乳制品和环境中阪崎肠杆菌污染状况调查

目的 了解深圳市乳制品中阪崎肠杆菌的污染状况,分析其可能的污染途径.方法 对抽取的195份乳制品及41份环境样品进行阪崎肠杆菌荧光定量PCR检测,同时参照GB/T4789.40-2008进行分离培养和鉴定.结果 共8份乳制品和12份环境样品经荧光PCR检测,为阪崎肠杆菌阳性;其中1份婴幼儿进口配方奶粉、2份新鲜挤出牛奶和4份环境样品分离出菌株.结论 深圳市售进口婴幼儿配方粉中存在阪崎肠杆菌污染隐患.医院婴儿养育环境中存在阪崎肠杆菌污染;生奶及奶场环境阪崎肠杆菌污染风险很高.     

Whole Goat Milk as a Source of Fat and Milk Fat Globule Membrane in Infant Formula

Cow milk is the most common dairy milk and has been extensively researched for its functional, technological and nutritional properties for a wide range of products. One such product category is infant formula, which is the most suitable alternative to feed infants, when breastfeeding is not possible. Most infant formulas are based on cow milk protein ingredients. For several reasons, consumers now seek alternatives such as goat milk, which has increasingly been used to manufacture infant, follow-on and young child formulas over the last 30 years. While similar in many aspects, compositional and functional differences exist between cow and goat milk. This offers the opportunity to explore different formulations or manufacturing options for formulas based on goat milk. The use of whole goat milk as the only source of proteins in formulas allows levels of milk fat, short and medium chain fatty acids, sn-2 palmitic acid, and milk fat globule membrane (MFGM) to be maximised. These features improve the composition and microstructure of whole goat milk-based infant formula, providing similarities to the complex human milk fat globules, and have been shown to benefit digestion, and cognitive and immune development. Recent research indicates a role for milk fat and MFGM on digestive health, the gut–brain axis and the gut–skin axis. This review highlights the lipid composition of whole goat milk-based infant formula and its potential for infant nutrition to support healthy digestion, brain development and immunity. Further work is warranted on the role of these components in allergy development and the advantages of goat milk fat and MFGM for infant nutrition and health.     

2012年广东省婴幼儿食品中3种食源性致病菌污染状况调查

目的了解广东地区市场上销售的婴幼儿食品中3种食源性致病菌的污染状况。方法根据广东省人口分布情况、食品生产特点和地域分布特点选择广东省13个地区的市及县、乡镇的超市、百货、便利店和农贸市场进行采样,参照2012全国食源性致病菌监测工作手册,对婴幼儿食品（包括婴幼儿配方食品和婴幼儿谷基辅助食品）分别进行阪崎肠杆菌、蜡样芽孢杆菌和金黄色葡萄球菌的定性和定量检测。结果共采集到64个生产厂家的婴幼儿食品314份,其中婴幼儿配方奶粉92份、婴幼儿谷基辅助食品222份。314份样品中检出阪崎肠杆菌10份,检出率为3.18%,其中婴幼儿配方奶粉阳性检出率为2.17%（2/92）,谷基辅助食品阳性检出率为3.60%（8/222）;检出蜡样芽孢杆菌90份,检出率为28.67%,其中婴幼儿配方奶粉阳性检出率为30.43%（28/92）,谷基辅助食品阳性检出率为27.93%（62/222）;未检出金黄色葡萄球菌。10份阪崎肠杆菌阳性样品定量检测结果：9份〈5 MPN/100g,1份〉110 MPN/100g;90份蜡样芽孢杆菌阳性样品中66份采用MPN法检测,结果显示3份〉103MPN/100g,41份〈102MPN/100g,22份未检出,另外24份采用平板法检测,结果显示14份〈102cfu/g,10份未检出。结论广东省婴幼儿食品中阪崎肠杆菌和蜡样芽孢杆菌的污染状况不容忽视,对婴幼儿的健康可能存在风险,今后应加强婴幼儿食品的监管,预防和控制婴幼儿食源性疾病的发生。     

Composition of the non-protein nitrogen fraction of goat whole milk powder and goat milk-based infant and follow-on formulae

The non-protein nitrogen fraction of goat whole milk powder and of infant and follow-on formulae made from goat milk was characterized and compared with cow milk powder and formulae. Goat milk infant formula contained 10% non-protein nitrogen, expressed as a proportion of total nitrogen, compared with 7.1% for cow milk formula. Goat follow-on formula contained 9.3% and cow 7.4% non-protein nitrogen. Urea, at 30%, was quantitatively the most abundant component of the non-protein nitrogen fraction of goat milk and formulae, followed by free amino acids at 7%. Taurine, glycine and glutamic acid were the most abundant free amino acids in goat milk powders. Goat milk infant formula contained 4 mg/100 ml total nucleotide monophosphates, all derived from the goat milk itself. Goat milk has a very different profile of the non-protein nitrogen fraction to cow milk, with several constituents such as nucleotides at concentrations approaching those in human breast milk.     

Composition of the non-protein nitrogen fraction of goat whole milk powder and goat milk-based infant and follow-on formulae

The non-protein nitrogen fraction of goat whole milk powder and of infant and follow-on formulae made from goat milk was characterized and compared with cow milk powder and formulae. Goat milk infant formula contained 10% non-protein nitrogen, expressed as a proportion of total nitrogen, compared with 7.1% for cow milk formula. Goat follow-on formula contained 9.3% and cow 7.4% non-protein nitrogen. Urea, at 30%, was quantitatively the most abundant component of the non-protein nitrogen fraction of goat milk and formulae, followed by free amino acids at 7%. Taurine, glycine and glutamic acid were the most abundant free amino acids in goat milk powders. Goat milk infant formula contained 4 mg/100 ml total nucleotide monophosphates, all derived from the goat milk itself. Goat milk has a very different profile of the non-protein nitrogen fraction to cow milk, with several constituents such as nucleotides at concentrations approaching those in human breast milk.     

The effect of age on manganese uptake and retention from milk and infant formulas in rats

Manganese nutrition of the neonate is poorly understood, due in part to a paucity of information on the amount and availability of manganese in infant foods. We have developed a suckling pup model to assess the uptake of manganese from fluid diets by using extrinsic labeling. Human milk, cow milk and infant formulas were fed by intubation to fasted rat pups and adults. Rats were killed after varying time periods, and tissues were removed and counted. A period of 6 h was found to be adequate to allow for stomach emptying while limiting tissue redistribution; 24 h was found to reflect pup manganese retention. From human milk, manganese retention was highest (greater than or equal to 80%) in pups less than or equal to 15 days of age; in older pups average retention decreased to 40%. Using d 14 pups to assess relative Mn uptake from diets, wholebody Mn uptake was highest from cow milk (approximately 89%); uptake from human and cow milk formula was similar (approximately 80%) whereas it was lower from soy formula (approximately 60%). These findings suggest that bioavailability of Mn from infant diets is very high during the suckling period. Since most formulas contain considerably more manganese than is found in human milk, Mn deficiency may be less of a concern than possible toxicity from formulas.     

Phyto-œstrogènes du soja : problèmes posés chez le nourrisson allergique au lait de vache et consommant des formules à base de soja

This work presents isoflavones levels in soy-based infant formulas commercialised in France. These compounds are known to be both estrogenic and anti-gonadotrophic compounds. A comparison is made with soy based food supplements for estrogen deprived menopausal women. This work gives the latest scientific data on the effects of isoflavones in humans and presents the actual controversy on the effect of soy based infant formulas on human health. It gives the actual data on cow milk allergy in infants and explains what to do when cow milk allergy is suspected in infants. This paper warns paediatrics and advises them to avoid soy based infant formulas for infant below 6 months or to prefer formula with low isoflavone content if they are commercially available.     

Plasma zinc and copper levels of infants fed different milk formulas.

The plasma zinc and copper levels of 32 full-term healthy infants, aged 3-4 months, using different infant formulas, were measured. The plasma zinc levels of infants using soy formula (45.1 +/? 19.1 micrograms/dl) and iron-fortified cow's milk formula (61.6 +/? 12.9 micrograms/dl) were significantly lower than those of the infants using cow's milk formula not fortified with iron (77.5 +/? 13.4 micrograms/dl). The plasma copper levels of the infants using the different formulas were not significantly different from each other. Fortification of infant formulas with high levels of iron may reduce the zinc absorption from such formulas.     

Plasma zinc and copper levels of infants fed different milk formulas

The plasma zinc and copper levels of 32 full-term healthy infants, aged 3-4 months, using different infant formulas, were measured. The plasma zinc levels of infants using soy formula (45.1 +/- 19.1 micrograms/dl) and iron-fortified cow's milk formula (61.6 +/- 12.9 micrograms/dl) were significantly lower than those of the infants using cow's milk formula not fortified with iron (77.5 +/- 13.4 micrograms/dl). The plasma copper levels of the infants using the different formulas were not significantly different from each other. Fortification of infant formulas with high levels of iron may reduce the zinc absorption from such formulas.     

我国市售婴幼儿乳粉和米粉微生物污染水平研究

目的：了解目前市售婴幼儿乳粉和米粉的卫生状况，为预防和控制食源性疾病提供依据。方法：采集全国10省超市中销售的婴幼儿乳粉和米粉共346件进行微生物检测。结果：346件乳粉和米粉均未检出沙门氏菌、金黄色葡萄球菌、志贺氏菌和溶血性链球菌，5件乳粉和1件米粉样品细菌总数超标，分别占2．53％和0．68％；6件乳粉和17件米粉霉菌超标，分别占3．03％和11．49％。结论：霉菌污染较细菌严重；南方地区霉菌检出率高于北方；进口和合资企业产品的各项指标均优于国内企业产品。     

Osmotic load from glucose polymers

Glucose polymer is a carbohydrate source with variable chain lengths of glucose units which may result in variable osmolality. The osmolality of two commercial glucose polymers was measured in reconstituted powder infant formulas, and the change in osmolality of infant milk formulas at the same increases in energy density (67 kcal/dL to 81 and 97 kcal/dL) from the use of additional milk powder or glucose polymers was compared. All samples were prepared from powders (to nearest 0.1 mg), and osmolality was measured by freezing point depression. For both glucose polymers the within-batch variability of the measured osmolality was less than 3.5%, and between-batch variability of the measured osmolality was less than 9.6%. The measured osmolality varies linearly with energy density (p less than 0.001) and was highest in infant formula reconstituted from milk powder alone. However, there exist significant differences in the measured osmolality between different glucose polymer preparations. At high energy densities (greater than or equal to 97 kcal/dL), infant milk formulas prepared with milk powder alone or with the addition of certain glucose polymer preparation may have high osmolality (greater than or equal to 450 mosm/kg) and theoretically predispose the infant to complications of hyperosmotic feeds.     

2012 - 2016年陕西省897份婴幼儿食品中阪崎肠杆菌检测

目的 通过连续5年对陕西省婴幼儿食品中阪崎肠杆菌的监测,调查陕西省婴幼儿食品中阪崎肠杆菌的污染情况。方法 随机采集省内超市、零售店、农贸市场、网购场所的婴幼儿食品,依照食品微生物检验国家标准GB 4789.40—2010 对所采集的婴幼儿食品进行阪崎肠杆菌的检测。结果 2012 - 2016年共采集婴幼儿食品897份,总检出率为3.01%（27/897）。婴幼儿辅助食品的检出率（6.54%）高于婴儿配方食品（1.90%）,第二季度的检出率（3.82%）较高,0～6个月婴幼儿配方食品中也检出了阪崎肠杆菌,检出率为1.67%,羊奶粉的检出率（5.51%）高于牛奶粉的检出率（1.08%）。结论 陕西省婴幼儿食品存在阪崎肠杆菌污染,婴幼儿辅助食品、0～6个月婴幼儿食品以及羊奶粉中阪崎肠杆菌污染更为严重,需引起监管部门重视,加强监督和管理。     

Response of preterm infants to aluminum in parenteral nutrition

Twenty-five preterm infants with birth weights (BW) 540 to 2280 g (20 with birth weight less than 1500 g) and gestational ages 24 to 37 weeks, were studied to determine the response to 2 levels of aluminum (Al) loading from currently unavoidable contamination of various components of parenteral nutrition (PN) solution. High Al loading group (H) received solutions with measured Al content of 306 +/- 16 micrograms/liter and low A1 loading group (L) received solutions with 144 +/- 16 micrograms A1/liter. Urine Al:Creatinine (Al:Cr) ratios (micrograms:mg) became elevated and significantly higher in H (1.6 +/- 0.38 vs 0.5 +/- 0.1, p less than 0.05) at the third sampling point (mean 19 days). Serum Al concentrations were highest at onset in both groups and stabilized with study but remained consistently higher than the normal median of 18 micrograms/liter. Calculated urine Al excretion were consistently low and were 34 +/- 6% vs 28 +/- 5% in the H and L groups, respectively. One infant in the L group who died 39 days after termination of above study showed the presence of A1 in bone trabeculae and the presence of excessive unmineralized osteoid along the trabeculae. We conclude that small preterm infants are able to increase urine Al excretion with increased Al load. However urine Al excretion is incomplete with bone deposition of Al and persistently elevated serum Al concentrations.     

人乳、牛乳及婴儿奶方中脂肪酸组成比较

进一步提倡母乳喂养.方法 采用气相色谱法测定了人乳、牛乳和婴儿奶方中脂肪酸的含量.结果 显示婴儿奶方和半乳中总饱和脂肪酸(sfA)、C8:0、C14:0C16:0 、和C18:0含量都显著高于人乳,而总不饱和脂肪酸(TUFA)、总多价不饱和脂肪酸(PUFA)、亚油酸(C18:2,LA),α-亚麻酸(C18:3,LNA)和花生四烯酸(C20:4,AA)含量都显著低于人乳.人乳中可测得二十二碳六烯酸(C22:6DHA),而在婴儿奶方和年乳中都未测得DHA .结论 婴儿奶方中脂肪酸组成较牛光更接近于人乳,但不能完全替代人乳.人乳是婴儿理想的食物选择.婴儿奶方中应强化DHA.     

批发市场销售国产配方奶粉及婴幼儿食品中阪崎肠杆菌污染情况调查

目的了解批发市场销售的国产配方奶粉及婴幼儿食品中阪崎肠杜菌污染情况。方法参照GB/T4789.40-2008规定的阪崎肠杆菌的检验方法对69份样品进行检测。对检出的阪崎肠杆菌进行药敏检测。结果 69份国产配方奶粉及婴幼儿食品中共检出16株阪崎肠杆菌。16株菌均对临床常用的针对G-菌的抗生素普遍敏感。结论批发市场销售的国产配方奶粉及婴幼儿食品中阪崎肠杆菌污染严重,应引起有关部门的重视。     

Infant feeding in the 20th century: formula and beikost

The early years of the 20th century were notable for improvements in general sanitation, dairying practices and milk handling. Most infants were breast-fed, often with some formula feeding as well. Availability of the home icebox permitted safe storage of milk and infant formula, and by the 1920s, feeding of orange juice and cod liver oil greatly decreased the incidence of scurvy and rickets. Use of evaporated milk for formula preparation decreased bacterial contamination and curd tension of infant formulas. From 1930 through the 1960s, breast-feeding declined and cow's milk and beikost were introduced into the diet at earlier and earlier ages. Although commercially prepared formulas, including iron-fortified formulas replaced home-prepared formulas, few infants were breast-fed or formula fed after 4-6 mo of age. Iron deficiency was prevalent. From 1970 through 1999, a resurgence of breast-feeding was associated with a prolongation of formula feeding and an increase in usage of iron-fortified formulas. By the end of the century, formula feeding of older infants had largely replaced feeding of fresh cow's milk and the prevalence of iron deficiency had greatly decreased.