Micronutrient, Metabolic, and Inflammatory Biomarkers through 24 Months of Age in Infants Receiving Formula with Added Bovine Milk Fat Globule Membrane through the First Year of Life: A Randomized Controlled Trial.

BACKGROUND: Bovine milk fat globule membrane (MFGM) added in infant formula supports typical growth and safety through 24 mo of age in term infants. OBJECTIVES: To assess micronutrient (zinc, iron, ferritin, transferrin receptor), metabolic [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), insulin-like growth factor-1 (IGF-1), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], and inflammatory (leptin, adiponectin, high sensitivity C-reactive protein) secondary outcomes through 24 mo of age in infants who received standard cow's milk-based infant formula (SF), similar formula with added bovine MFGM (EF), or human milk (HM) through 1 y. METHODS: Infants whose parents agreed to a blood draw at baseline (<120 d of age) (SF = 80; EF = 80; HM = 83) were included. Subsequent collections (2-4 h fasting) occurred at D180, D365, and D730. Biomarker concentrations were analyzed and group changes tested using generalized estimating equations models. RESULTS: Only serum iron (+22.1 µg/dL) and HDL-C (+2.5 mg/dL) were significantly higher for EF compared with SF at D730. Prevalence of zinc deficiency for EF (-17.4%) and SF (-16.6%) at D180 and depleted iron stores for SF (+21.4%) at D180 and EF (-34.6%) and SF (-28.0%) at D365 were significantly different compared with HM. IGF-1 (ng/mL) for EF and SF was significantly higher at D180 (+8.9) and for EF (+8.8) at D365, and (+14.5) at D730 compared with HM. Insulin (µUI/mL) for EF (+2.5) and SF (+5.8) and HOMA-IR for EF (+0.5) and SF (+0.6) were significantly higher compared with HM at D180. TGs (mg/dL) for SF (+23.9) at D180, for EF (+19.0) and SF (+17.8) at D365, and EF (+17.3) and SF (+14.5) at D730 were significantly higher compared with HM. Zinc, ferritin, glucose, LDL-C and total cholesterol changes were higher in formula groups compared with HM between various time points. CONCLUSIONS: Micronutrient, metabolic, and inflammatory biomarkers were generally similar through 2 y in infants who received infant formula with or without added bovine MFGM. Over the 2 y, differences were observed between infant formulas and HM reference group. This trial was registered at clinicaltrials.gov as NTC02626143.

[Nutritional recovery. An unresolved challenge]. / Recuperación nutricional. Un desafío pendiente.

Factors that modulate catch up growth influence the quantity and quality of the recovered tissue. Insulin and IGF-1 respond to dietary changes in carbohydrates and proteins; evidence shows that IGF-1 and leptin may be good indicators of nutritional recovery. The optimal diet to promote catch up growth is still controversial. There is consensus on the need to adjust the energy-protein intake to the growth velocity observed, without encouraging excessive eating, to avoid obesity. Zinc supplementation and physical activity appear as relevant factors to promote the synthesis of lean mass. In some models of early malnutrition, a better catch up growth during childhood, is associated with a higher frequency of chronic diseases and mortality in adulthood. In this context, we will review some factors that seem relevant to the modulation of catch up growth, which should be taken into account when reviewing the therapeutic guidelines to treat malnourished children.

Recuperación nutricional: un desafío pendiente / Catch up growth: an unresolved challenge

Factors that modulate catch up growth influence the quantity and quality of the recovered tissue. Insulin and IGF-1 respond to dietary changes in carbohydrates and proteins; evidence shows that IGF-1 and leptin may be good indicators of nutritional recovery. The optimal diet to promote catch up growth is still controversial. There is consensus on the need to adjust the energy-protein intake to the growth velocity observed, without encouraging excessive eating, to avoid obesity. Zinc supplementation and physical activity appear as relevant factors to promote the synthesis of lean mass. In some models of early malnutrition, a better catch up growth during childhood, is associated with a higher frequency of chronic diseases and mortality in adulthood. In this context, we will review some factors that seem relevant to the modulation of catch up growth, which should be taken into account when reviewing the therapeutic guidelines to treat malnourished children