Fluorinated liquid-crystal monomers in infant formulas and implication for health risk.

Fluorinated liquid-crystal monomers (FLCMs), a new class of potential persistent, bioaccumulative and toxic (PBT) emerging pollutants, are extensively utilized in the display panel of various electronic devices. These compounds have been found in various environmental matrixes and dietary. Our previous studies have documented their ubiquitous occurrence in high fat foodstuffs. Infants, a vulnerable group, are more susceptible to the impacts of these pollutants compared to adults. Herein, we provided an assessment of the health risks posed by FLCMs to infants, focusing on their exposure through infant formula. The presence of FLCMs was detected in all infant formulas, with median concentration of 16.5 ng/g dry weight (dw) and the 95th percentile concentration of 65.7 ng/g dw. The most prevalent pollutant in these formulas was 2-fluoro-4-[4'-propyl-1,1'-bi(cyclohexyl)-4-yl] phenyl trifluoromethyl ether (FPrBP), with median and a 95th percentile concentration of 12.2 ng/g dw and 23.8 ng/g dw, accounting for 55.2% to the total FLCMs. Infants aged 0-6 months had the highest estimated daily intakes (EDIs) of FLCMs, with the EDImedian of 267 ng/kg bw/day. FPrBP and 4-[trans-4-(trans-4-Propylcyclohexyl) cyclohexyl]-1-trifluoromethoxybenzene (PCTB) together made up 83.3% of the total EDIs in median exposure scenario of 0-6 months infant. The highest EDI value was 1.30 × 103 ng/kg bw/day, 77.1% of which was attributed to a combination of FPrBP, 4″-ethyl-2'-fluoro-4-propyl-1,1':4',1″-terphenyl (EFPT), 2-[4'-[difluoro(3,4,5-trifluoro-2-methyl-phenoxy)methyl]-3',5'-difluoro-[1,1'-biphenyl]-4-yl]-5-ethyl-tetrahydro-pyran (DTMPMDP), 4-[Difluoro-(3,4,5-trifluoro-2-methyl-phenoxy)-methyl]-3,5-difluoro-4'-propyl-1,1-biphenyl (DTMPMDB), 2,3-difluoro-1-methyl-4-[(trans, trans)-4'-pentyl[1,1'-bicyclohexyl]-4-yl]benzene (DMPBB) and PCTB. It's worth noting that FLCMs have higher exposure risk. Based on the threshold of toxicological concern (TTC) method, the EDImedian of FPrBP (183 ng/kg bw/day) and FPCB (3.27 ng/kg bw/day) were beyond their TTC values (2.5 ng/kg bw/day) in 0-6 months infant, implying their prospective health risk.

Trace elements in commercially available infant formulas in Iran: Determination and estimation of health risks.

Infants are significantly more vulnerable to trace elements from their foods. The objective of the present study was to ascertain the concentrations of some trace elements namely; arsenic, cadmium, chromium, copper, nickel and lead in infant formulas sold in Iran and to estimate the potential health risks to the infants through consumption of these products. The mean concentrations of As, Cd, Cr, Cu, Ni and Pb in infant formula samples were 0.006, 0.040, 0.3980, 2.014, 0.166 and 0.285 mg/kg, respectively. The mean levels of the trace elements were in the following order: Cu > Cr > Pb > Ni > Cd > As. For arsenic, cadmium and copper, calculated EWIs (estimated weekly intakes) were within the PTWIs (provisional tolerated weekly intakes) recommended by FAO/WHO. For chromium, nickel and lead, the calculated EWIs were higher than the PTWIs in 88.8 %, 75 %, and 61.1 % of the formulas. HQs of Pb, Cu, Cd and As were above the safe limits, indicating health concerns from the consumption of some infant formulas. Based on the CR classification, CR values of some elements including Cd, Cr and Ni were above 1 × 10-4 in some brands, indicating that exposure to these elements from infant formulas may cause health risks. Therefore, regular monitoring of all the raw materials, stages of production and storage of infant formulas is essential to limit the exposure of this vulnerable age group to toxic trace elements.

Escenarios lácteos y microbiota intestinal en los primeros 1000 días / Milk scenarios and gut microbiota in the first 1000 days of life

La leche humana es el estándar de oro para la nutrición del bebé y debe iniciarse en la primera hora de vida. La leche de vaca, de otros mamíferos o las bebidas vegetales no se deben ofrecer antes del año de vida. Sin embargo, algunos niños requieren, al menos en parte, de fórmulas infantiles. Aun con las sucesivas mejoras a lo largo de la historia mediante la incorporación de oliogosacáridos, probióticos, prebióticos, sinbióticos y postbióticos, las fórmulas infantiles siguen siendo perfectibles para reducir la brecha de salud entre los bebés amamantados y aquellos alimentados con fórmula. En este sentido, se espera que la complejidad de las fórmulas siga aumentando a medida que se conozca mejor cómo modular el desarrollo de la microbiota intestinal. El objetivo de este trabajo fue realizar una revisión no sistemática del efecto de los diferentes escenarios lácteos sobre la microbiota intestinal.

Human milk is the gold standard for infant nutrition, and breastfeeding should be started within the first hour of life. Cow's milk, other mammalian milk, or plant-based beverages should not be offered before 1 year of age. However, some infants require, at least in part, infant formulas. Even with subsequent enhancements throughout history, with the addition of oligosaccharides, probiotics, prebiotics, synbiotics, and postbiotics, infant formulas still have room for improvement in reducing the health gap between breastfed and formula-fed infants. In this regard, the complexity of infant formulas is expected to continue to increase as the knowledge of how to modulate the development of the gut microbiota is better understood. The objective of this study was to perform a non-systematic review of the effect of different milk scenarios on the gut microbiota.

Effects of lipids from multiple sources on glyceride composition, concentration, and structure of infant formulas benchmarked to human milk.

The important parameters affecting the nutritional properties of lipids were analyzed and compared between human milk (HM), infant formulas (IFs), mammalian milk, and substitute fat, including molecular species, fatty acid composition, glyceride content, and important structural triacylglycerols (TAGs). The molecular species of triacylglycerols with functional fatty acids were significantly different between HM and IFs, and their contents in HM were significantly higher than those in IFs. Accordingly, the evaluation scores of fatty acid composition and glyceride content in IFs were less than 50 compared to HM. Although the introduction of vegetable oils effectively improved the unsaturation of IF lipid, the excessive addition of TAGs rich in oleic and linoleic acid resulted in an imbalance of TAG composition and structure. Only 36.84 % of IFs were supplemented with structured lipids, but those still lacked sn-2 palmitate TAGs. The adoption of multiple lipids and novel processing technologies is required for novel IFs to match the composition, content, positional structure and spherical membrane structure of HM as closely as possible.

Quantitation of bioactive components in infant formulas: Milk oligosaccharides, sialic acids and corticosteroids.

Human milk is considered the optimal food for infants with abundant nutrients and bioactive components, which play key roles in infant health and development. Infant formulas represent appropriate substitutes for human milk. There are many brands of infant formula with different ingredient sources and functions on the market. The present study aims to quantify important bioactive components, i.e., milk oligosaccharides (MOS), sialic acids (Sia) and corticosteroids, in different infant formulas and compare these to human milk. In total, 12 different infant formulas available on the Dutch market were analyzed in this study. The concentrations of MOS and Sia were characterized by UHPLC-FLD and LC-MS, while corticosteroids were determined using established UHPLC-MS/MS methods. Among infant formulas, 15 structures of oligosaccharides were identified, of which 2'-Fucosyllactose (2'FL), 3'-Galactosyllactose (3'GL) and 6'-Galactosyllactose (6́'GL) were found in all infant formulas. The oligosaccharide concentrations differed between milk source and brands and were 3-5 times lower than in human milk. All infant formulas contained Sia, N-acetylneuraminic acid (Neu5Ac) was dominant in bovine milk-based formulas, while N-glycolylneuraminic acid (Neu5Gc) was major in goat milk-based formula. All infant formulas contained corticosteroids, yet, at lower concentrations than human milk. Insight in concentrations of bioactive components in infant formula compared to human milk may give direction to dietary advices and/or novel formula design.

Levels of organic pollutants and metals/metalloids in infant formula marketed in Brazil: Risks to early-life health.

Infant formula intake is recommended to ensure comprehensive nutritional and caloric fulfillment when exclusive breastfeeding is not possible. However, similarly to breast milk, infant formulas may also contain pollutants capable of inducing endocrine-disrupting and neurotoxic effects. Thus, considering the sensitivity of their developing physiological systems and that infants have heightened susceptibility to environmental influences, this study was aimed at assessing the contents of essential elements, and inorganic and organic pollutants in infant formulas marketed in Brazil. Additionally, health risk assessments for selected contaminants were also performed. Measured contents of essential elements (Ca, Fe, Mg, Mn, Cu, Se, and Zn) were congruent with label information. Nevertheless, some toxic elements (Pb, Cd, As, Ni, and Al) were also detected. Notably, in the upper-bound scenario, Pb and Cd surpassed established threshold values when comparing the estimated daily intake (EDI) and tolerable daily intake (TDI - 3.57 and 0.36 µg/kg bw, respectively). Bisphenol P (BPP) and benzyl butyl phthalate (BBP) were frequently detected (84 % detection rate both) with elevated contents (BPP median = 4.28 ng/g and BBP median = 0.24 ng/g). Furthermore, a positive correlation (0.41) was observed between BPP and BBP, implying a potential co-occurrence within packaging materials. Methyl-paraben also correlated positively with BBP (0.57), showing a detection rate of 53 %. The cumulative PBDE contents ranged from 0.33 to 1.62 ng/g, with BDE-154 and BDE-47 the dominant congeners. When comparing EDI values with TDIs, all organic pollutants remained below the thresholds across all exposure scenarios. Moreover, non-carcinogenic risks were below the threshold (HQ > 1) when dividing the EDIs by the respective reference doses for chronic exposure. While the current findings may suggest that infant formula intake poses no immediate risk in terms of the evaluated chemicals, it remains imperative to conduct further research to safeguard the health of infants considering other chemicals, as well as their potential cumulative effects.

Postbiotics: A new member in the biotics family. / Postbióticos: un nuevo miembro en la familia de los bióticos.

Postbiotics were defined in 2021 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) as a "preparation of inanimate microorganisms and/or their cellular components that confers a health benefit to the host." The field of postbiotics is a new area within the biotics family; numerous products have already been developed for clinical applications, such as immune stimulation, the management of diarrhea in children and adults, the management of irritable bowel syndrome, and 3 infant formulas. In particular, infant formulas with postbiotics obtained from milk fermented with Bifidobacterium breve C50 and Streptococcus thermophilus O65 -and their metabolites-, including the oligosaccharide 3'-GL, have demonstrated to be safe and to contribute to the development of the gut microbiota and the gutassociated immune system. These modifications help to prevent and manage functional gastrointestinal disorders in infants.

Los postbióticos fueron definidos en 2021 por la Asociación Científica Internacional de Probióticos y Prebióticos (ISAPP) como "una preparación de microorganismos inanimados y/o sus componentes celulares capaces de conferir un efecto benéfico al hospedador". El campo de los postbióticos es un área nueva dentro de la familia de los bióticos; se han desarrollado ya numerosos productos con aplicaciones clínicas, como la estimulación inmunológica, el manejo de diarreas en niños y adultos, el abordaje del intestino irritable, además de tres fórmulas infantiles. En particular, las fórmulas infantiles con postbióticos obtenidos a partir de la fermentación de la leche con Bifidobacterium breve C50 y Streptococcus thermophilus O65, y sus metabolitos, incluido el oligosacárido 3'-GL, han demostrado seguridad y contribución al desarrollo de la microbiota intestinal y el sistema inmune asociado al intestino. Estas modificaciones contribuyen a la prevención y el manejo de los trastornos funcionales digestivos del lactante.

Current topics in pediatric enteral nutrition safety.

Enteral nutrition is a cornerstone of nutrition support therapy in patients of all ages and across the care continuum. Safe delivery of enteral nutrition to patients is paramount. This review article will focus on current topics in enteral nutrition safety primarily in children including safety with home-made blenderized feeds, recent infant and enteral formula shortages largely due to formula contamination at the manufacturer level, and concerns with importing infant formulas.

Gut Immunobiosis and Biomodulators.

The human gastrointestinal (GI) tract hosts complex and dynamic populations of microorganisms (gut microbiota) in advantageous symbiosis with the host organism through sophisticated molecular cross-talk. The balance and diversification within microbial communities (eubiosis) are crucial for the immune and metabolic homeostasis of the host, as well as for inhibiting pathogen penetration. In contrast, compositional dysregulation of the microbiota (dysbiosis) is blamed for the determinism of numerous diseases. Although further advances in the so-called 'omics' disciplines are needed, dietary manipulation of the gut microbial ecosystem through biomodulators (prebiotics, probiotics, symbionts, and postbiotics) represents an intriguing target to stabilize and/or restore eubiosis. Recently, new approaches have been developed for the production of infant formulas supplemented with prebiotics (human milk oligosaccharides [HMOs], galacto-oligosaccharides [GOS], fructo-oligosaccharides [FOS]), probiotics, and postbiotics to obtain formulas that are nutritionally and biologically equivalent to human milk (closer to the reference).

Determination of vitamin K in infant formulas by liquid chromatography-online electrochemical reduction based on porous Pt/Ti electrode-fluorescence detection.

A highly sensitive and selective HPLC method for the determination of vitamin K vitamers including phylloquinone (PK) and menaquinones (MK-4) in infant formulas is described. The K vitamers were quantified with a fluorescence detector after online post-column electrochemical reduction occurring in a laboratory-made electrochemical reactor (ECR) equipped with platinum plated porous titanium (Pt/Ti) electrodes. The morphology of the electrode showed that the grain size of Pt was homogeneous and well plated on the porous Ti substrate, resulting in largely improved electrochemical reduction efficiency due to the large specific surface area. In addition, the operation parameters such as mobile phase/supporting electrolyte and working potential were optimized. The detection limits of PK and MK-4 were 0.81 and 0.78 ng g-1. Infant formula varying in stages were detected, showing PK ranged from 26.4 to 71.2 µg/100 g, while MK-4 was not detected.

Endocrine-Disrupting Chemicals and Persistent Organic Pollutants in Infant Formulas and Baby Food: Legislation and Risk Assessments.

Human milk is the healthiest option for newborns, although, under specific circumstances, infant formula is a precious alternative for feeding the baby. Except for the nutritional content, infant formulas and baby food must be pollutant-free. Thus, their composition is controlled by continuous monitoring and regulated by establishing upper limits and guideline values for safe exposure. Legislation differs worldwide, although there are standard policies and strategies for protecting vulnerable infants. This work presents current regulations and directives for restricting endocrine-disrupting chemicals and persistent organic pollutants in infant formulas. Risk assessment studies, which are limited, are necessary to depict exposure variations and assess the health risks for infants from dietary exposure to pollutants.

Milk scenarios and gut microbiota in the first 1000 days of life. / Escenarios lácteos y microbiota intestinal en los primeros 1000 días.

Human milk is the gold standard for infant nutrition, and breastfeeding should be started within the first hour of life. Cow's milk, other mammalian milk, or plant-based beverages should not be offered before 1 year of age. However, some infants require, at least in part, infant formulas. Even with subsequent enhancements throughout history, with the addition of oligosaccharides, probiotics, prebiotics, synbiotics, and postbiotics, infant formulas still have room for improvement in reducing the health gap between breastfed and formula-fed infants. In this regard, the complexity of infant formulas is expected to continue to increase as the knowledge of how to modulate the development of the gut microbiota is better understood. The objective of this study was to perform a non-systematic review of the effect of different milk scenarios on the gut microbiota.

La leche humana es el estándar de oro para la nutrición del bebé y debe iniciarse en la primera hora de vida. La leche de vaca, de otros mamíferos o las bebidas vegetales no se deben ofrecer antes del año de vida. Sin embargo, algunos niños requieren, al menos en parte, de fórmulas infantiles. Aun con las sucesivas mejoras a lo largo de la historia mediante la incorporación de oliogosacáridos, probióticos, prebióticos, sinbióticos y postbióticos, las fórmulas infantiles siguen siendo perfectibles para reducir la brecha de salud entre los bebés amamantados y aquellos alimentados con fórmula. En este sentido, se espera que la complejidad de las fórmulas siga aumentando a medida que se conozca mejor cómo modular el desarrollo de la microbiota intestinal. El objetivo de este trabajo fue realizar una revisión no sistemática del efecto de los diferentes escenarios lácteos sobre la microbiota intestinal.

Analysis of labeling infant's formulas to children allergic to the protein in cow's milk / Análise da rotulagem de fórmulas infantis para lactentes com alergia a proteína do leite de vaca

Introduction: breastfeeding is the most effective way to feed the child in the first six months of life exclusively and up to two years as a complementary form, as it provides a healthy development. However, in some situations it is impossible among them in children with food allergies such as Cow's Milk Protein Allergy (APLV). This condition can be defined as an adverse reaction of the immune system, caused by antigens present in the food that triggers the allergy.Objective: analyze the information on the labeling of infant formulas for infants with allergies to cow's milk protein (APLV), sold in pharmacies in Sobral/CE.Methods: cross-sectional, exploratory, quantitative and qualitative study. After data collection, the labels were analyzed based on a check list composed by the current legislation in accordance with RDC 45/2011, measuring the number of adjustments and inadequacies.Results: of the seven formulas analyzed, five were 100% adequate, when considering all the provisions that made up the check list. Of these were FAB-1 B, FAB-1 C, FAB-1 E, FAB-1 F, FAB-2 A, they were all in accordance with the dimensions established by RDC 45/2011, it is already in relation to formulas with inadequacy we observed that FAB-1 A was 2.22% in dimension two in which the micronutrient riboflavin was above the recommended range and FAB-1 D was 2.22% in dimension two, the carbohydrate macronutrient above the recommended range. In view of this, what we observed was that most of the formulas analyzed were within the labeling standards specified in Resolution RDC 45/2011, despite the many regulatory standards that govern the labeling and marketing of infant foods, it was realized that there is still a need for regulation stricter in this regard so that the legislation is fully complied with.Conclusion: according to what was evaluated about formulas for infants with APLV in relation to the labeling standards of the current legislation, some inadequacies were found. Therefore, this study showed a greater number of non-conformities in relation to the essential characteristics of composition and quality, despite the many regulatory standards that govern the labeling and marketing of infant foods, it is clear that they are still not fully complied with. It was found that we still need to evolve in the Elaboration, execution and inspection of the labels of formulas for infants with Allergy to Cow's Milk Protein (APLV), in order to minimize these non-conformities and offer the best food within the recommended standard, however these studies are necessary in order to better show and discuss the legislation referring to these products.

Introdução: a amamentação é a forma mais eficaz de alimentar a criança nos primeiros seis meses de vida exclusivamente e até os dois anos como forma complementar, pois proporciona um desenvolvimento saudável. No entanto, em algumas situações, é impossível entre eles em crianças com alergia alimentar, como a alergia à proteína do leite de vaca (APLV). Essa condição pode ser definida como uma reação adversa do sistema imunológico, causada por antígenos presentes nos alimentos que desencadeiam a alergia.Objetivo: analisar as informações sobre a rotulagem de fórmulas infantis para lactentes com alergia à proteína do leite de vaca (APLV), comercializadas em farmácias de Sobral/CE.Método: estudo transversal, exploratório, quantitativo e qualitativo. Após a coleta de dados, os rótulos foram analisados com base em um check list composto pela legislação vigente de acordo com a RDC 45/2011, mensurando o número de adequações e inadequações.Resultados: das sete fórmulas analisadas, cinco foram 100% adequadas, quando consideradas todas as disposições que compunham o check list. Destes eram FAB -1 B, FAB -1 C, FAB -1 E, FAB -1 F, FAB -2 A, todos estavam de acordo com as dimensões estabelecidas pela RDC 45/2011, já está em relação às fórmulas com inadequação observamos que FAB-1 A foi de 2,22% na dimensão dois em que a micronutriente riboflavina estava acima da faixa recomendada e FAB-1 D foi de 2,22% na dimensão dois, o macronutriente carboidrato acima da faixa recomendada. Diante disso, o que observamos foi que a maioria das fórmulas analisadas estava dentro dos padrões de rotulagem especificados na Resolução, apesar das inúmeras normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebeu-se que ainda existe necessidade de regulamentação mais rigorosa nesse sentido, para que a legislação seja integralmente cumprida.Conclusão: de acordo com o que foi avaliado sobre as fórmulas para lactentes com APLV em relação aos padrões de rotulagem da legislação vigente foram encontradas algumas inadequações. Portanto esse estudo apresentou maior número de inconformidades em relação as características essênciais de composição e qualidade, apesar das muitas normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebe-se que ainda não são totalmente cumpridas. Verificou-se que ainda precisamos evoluir na Elaboração, execussão e fiscalização dos rótulos das fórmulas para lactentes com Alergia a Proteína do Leite de Vaca (APLV), a fim de minimizar essas não conformidades e ofererer o melhor alimento dentro do padrão preconizado, no entanto faz-se necessários estes estudos a fim de mostrar e discutir melhor as legislações referentes a esses produtos.

Elucidating gut microbiota and metabolite patterns shaped by goat milk-based infant formula feeding in mice colonized by healthy infant feces.

The gut microbiota plays an evolutionarily conserved role in host metabolism, which is influenced by diet. Here, we investigated differences in shaping the gut microbiota and regulating metabolism in cow milk-based infant formula, goat milk-based infant formula, and mix milk-based infant formula compared with pasteurized human milk. 16S rRNA results showed that goat milk-based infant formula selectively increased the relative abundance of Blautia, Roseburia, Alistites and Muribaculum in the gut compared to other infant formulas. Metabolomics identification indicated that goat milk-based infant formula mainly emphasized bile acid biosynthesis, arachidonic acid metabolism and steroid biosynthesis metabolic pathways. Metabolites associated with these metabolic pathways were positively associated with increased microorganisms in goat milk-based infant formula, particularly Alistipes. Furthermore, we found a deficiency of Akkermansia abundance in three infant formula-fed compared to pasteurizedhuman milk-fed. This study presents new insights into the improvement and application of goat milk-based infant formulas in terms of intestinal microecology.

ZIF-8 sacrificial-templated hollow COF architectures enabled highly efficient enrichment, determination and regulation of food hazards from infant formulas.

Integration of functional micro-/nano-frameworks with various analytical techniques is favored to produce advanced and practical methods for identification, inspection, and regulation of hazards in agro-food products. Herein, two novel synthetic strategies were developed for preparation of core-shell structured ZIF-8@COF by using metal halides as the catalyst, and further construction of hollow-structured covalent organic frameworks (HCOFs) with a sacrificial template method. The HCOFs adsorbent exhibited high stability, universality and adsorption affinity for advanced glycation end products (AGEs) and aflatoxins (AFTs) than pristine COF. Combined with HPLC and HPLC-MS/MS, the applicability of this method was verified by infant formula samples with satisfying recoveries of 87.3%-98.9%. Furthermore, HCOF showed potential ability of adsorbing and removing AGEs from plasma without causing other risk. This work opens up the road for further research on the simple method to synthesis HCOF, besides, provides a technological basis for monitoring and controlling AGEs and AFTs in milk powder.

Role and Importance of Functional Food Packaging in Specialized Products for Vulnerable Populations: Implications for Innovation and Policy Development for Sustainability.

Specialized products can be needed to help meet the nutrition requirements of vulnerable populations, including infants and young children, those who are ill, and older adults. Laws and regulations delineate distinct categories for such products including medical foods or formulated liquid diets, foods for special dietary use (FSDUs), infant formulas, and natural health products (NHPs). Yet, the literature is limited regarding the role and importance of functional and sustainable packaging for specialized products. This perspective review describes these unique product categories and the role of packaging as well as regulatory considerations. Furthermore, reviewed are how waste reduction strategies and emerging legislative/regulatory policies in the United States and Canada may not adequately address the functional packaging requirements for specialized products. The paper concludes by offering perspectives for emerging innovations and policy development for sustainability.

Model infant formulas: Influence of types of whey proteins and lipid composition on the in vitro static digestion behavior.

This work aimed at evaluating the influence of types of whey proteins (lactoferrin, whey protein isolate and/or whey protein hydrolysates) and lipid composition (high oleic sunflower oil, coconut oil and/or medium chain triacylglycerols) on the behavior of model infant formulas (IFs) under simulated conditions of the infant gastrointestinal tract using an in vitro static digestion model. The physicochemical conditions of the gastric medium resulted in the aggregation of oil the droplets and partial hydrolysis of the proteins, considering whey proteins were resistant to the gastric conditions. However, after intestinal digestion the proteins from all the IFs were extensively hydrolyzed. The lipid composition of the IFs did not influence the protein hydrolysis, but the protein composition of the IFs altered the release of free fatty acids. The presence of lactoferrin in the IFs resulted in a higher free fatty acids release compared to IFs of same lipid composition. In terms of lipid composition, IFs containing coconut oil and medium chain triacylglycerols showed extremely higher free fatty acids release than those containing only long chain triacylglycerols. These results are promising for the design of infant foods containing fast-absorbing functional ingredients.

Elaboração e validação de lista de verificação dos processos produtivos de dietas pediátricas em lactários hospitalares / Elaboration and validation of the checklist of the production processes of pediatric diets in hospital lactaries

Resumo Este trabalho visou elaborar e validar uma lista de verificação dos processos produtivos de dietas pediátricas para uso em lactários hospitalares. Para a elaboração do instrumento realizou-se pesquisa bibliográfica. A validação do conteúdo foi realizada com 5 especialistas, pela Técnica Delphi - utilizando a escala Likert de 5 pontos. A validação de aparência foi realizada por 3 nutricionistas, no mesmo ambiente, dia e horário. O instrumento incluiu cabeçalho, guia de instruções de preenchimento e 225 itens de avaliação que obtiveram o conteúdo validado. Os valores mínimos e máximos para o índice de validade de conteúdo (IVC) foi, respectivamente, 0,88 e 0,96. O coeficiente de correlação intraclasse (CCI) e Alfa de Cronbach (α) foi >0,80 em mais de 90% dos itens avaliados. Os valores mínimos e máximos para o índice de validade de aparência (IVA) foi, respectivamente, 0,73 e 0,93. O teste de Kruskal Wallis não apresentou diferença significativa durante as avaliações (p valor>0,05) para os blocos da versão rotina e versão gestão. As versões do instrumento apresentaram em mais de 80% dos blocos α e CCI>0,80. Portanto, o instrumento apresentou conteúdo e aparência validados tendo reprodutibilidade e confiabilidade, ou seja, viabilidade de utilização na prática do nutricionista.

Abstract This work aimed to draft and validate a checklist of the production processes of pediatric diets for use in hospital lactaries. A bibliographic search was carried out in order to draft the instrument. Content validation was performed with 5 experts, using the Delphi technique and the 5-point Likert scale. Appearance validation was performed by 3 nutritionists, in the same environment, day, and time. The instrument included a header, a guide to completion instructions, and 225 assessment items that obtained validated content. The minimum and maximum values for the content validity index (CVI) were 0.88 and 0.96, respectively. The intraclass correlation coefficient (ICC) and Cronbach's alpha (α) was >0.80 in more than 90% of the items evaluated. The minimum and maximum values for the Appearance Validity Index (AVI) were, respectively, 0.73 and 0.93. The Kruskal Wallis test showed no significant difference during the evaluations (p-value>0.05) for the blocks of the routine version and the management version. The instrument versions presented in more than 80% of the α and ICC blocks > 0.80. Therefore, the instrument presented validated content and appearance, presenting reproducibility and reliability in terms of the feasibility of use in a nutritionist's practice.

Assessment of Cariogenicity by pH-value Decrement of Plaque Solution with Four Infant Milk Formulas: An In Vitro Study.

Introduction: People all over the world use a wide variety of infant formulas to nourish the infants. Recent studies demonstrated the high caries-inducing potential of infant formulas. This indicates a need for awareness toward the possible role of the infant formulas in the etiology of early childhood caries (ECC). Aim: The present study was undertaken to evaluate and comparatively assess the change in plaque pH solutions after fermenting four commonly used infant milk formulas. Materials and methods: This simple randomized study was carried out on 40 healthy children aged 4-6 years old. The children received full-mouth prophylaxis before examination. They were asked not to implicate oral hygiene for 24 hours and not to have anything at least 2 hours prior the study. Supragingival plaque from the buccal surface of posterior teeth was collected using a Hu-Friedy's curette. Four commonly used infant milk formulas were prepared and given to children for rinsing. The pH of plaque samples were measured at 30 and 60 minutes at 37°C. Results: The present study showed that all of the four infant milk formulas decreased the mean pH values in plaque solutions significantly after 30 and 60 minutes of preparation. Conclusion: Our results showed that the plaque pH varied in response to the oral rinsing with the various infant formulas and most of infant formulas were able to reduce the pH significantly below the pH before the rinse. Based upon this study further evaluation of the cariogenicity of infant formulas is recommended. How to cite this article: Pandey A, Pathivada L, Kajapuram P, et al. Assessment of Cariogenicity by pH-value Decrement of Plaque Solution with Four Infant Milk Formulas: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(3):263-266.

Infant exposure to trace elements in breast milk, infant formulas and complementary foods from southern China.

Excessive intake of essential trace elements or exposure to potentially toxic elements above certain thresholds may cause adverse health effects in humans. To date, there is scarce evidence concerning Chinese infant exposure to trace elements and the associated risks. In this study, we collected 61 breast milk, 54 infant formula and 90 complementary food samples from southern China to investigate the levels of cobalt (Co), chromium (Cr), copper (Cu), selenium (Se), zinc (Zn), arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). The concentrations of these elements in the breast milk samples ranged from under the limit of detection (