Quantitative determination of selected elements in infant baby formulae and baby food cereals commercially available in Serbia using the ICP OES method.

The aim of this paper was the quantitative determination of some macro and trace elements, especially potentially toxic elements in the samples of infant baby formulae and baby food cereals commercially available in Serbia using the inductively coupled plasma optical emission spectrometry (ICP OES) method. Among the macro elements, K is the most abundant in all infant formulae samples, followed by Ca, P, Na and Mg. On the other hand, the analysis of food cereals showed that P is presents in the highest contents, followed by K, Ca, Na, and Mg. Potentially toxic elements As, Pb, Hg, and Cd were not detected in any sample of infant formulae, while Cd was detected and quantified in cereal foods. Also, the calculated values of Estimated Tolerable Weekly Intake (ETWI) as well as the Estimated Tolerable Monthly Intake (ETMI) were lower than recommended values for a tolerable weekly intake (TWI) and provisional tolerable monthly intake (PTMI).

Dynamic In Vitro Gastric Digestion Behaviour of Commercial Infant Formulae Made with Cow, Goat and Sheep Milk.

There are a wide range of commercial infant formulae available on the market. These are made using milk from different species, such as goat, sheep, and cow. The different protein compositions of these milks and the process used during infant-formulae manufacture, such as heat treatment, may impact the digestion of nutrients. This study compared the effect of protein composition and heat treatment on the in vitro gastric digestion behaviour of commercial infant formulae made with cow, goat, and sheep milk using a dynamic infant human gastric simulator (IHGS). During the simulated dynamic gastric digestion, the goat milk infant formula (GIF) showed earlier signs of aggregate formation compared to cow milk infant formula (CIF) and sheep milk infant formula (SIF). In addition, the microstructures of GIF chyme showed fragmented and porous structures. On the contrary, CIF formed dense protein networks that trapped oil droplets, whereas SIF exhibited a microstructure of smooth oil droplets surrounded by fewer protein networks. The different aggregation behaviours and aggregate structures of the three infant-formulae chyme were related to their different protein compositions, especially the different casein compositions. Furthermore, the open fragile structure of GIF aggregates provided easier access to pepsin, allowing it to hydrolyse protein. The results from the present study provided some information to assist in understanding the coagulation and digestion behaviours of commercial infant formulae made from different species of milk.

Lipids and lipid signaling molecules in human milk and infant formula, a chemical characterization of relevant biochemical components.

Breastfeeding is the gold standard in infant nutrition and continuous researches aim to optimize infant formula composition as the best alternative available. Human milk lipid content provides more than 50% of energy requirements for infants together with essential vitamins, polyunsaturated fatty acids, and other bioactive components. While fatty acids and vitamins human milk content has been extensively studied and, when needed those have been added to infant formulas, less is known about polyunsaturated fatty acids functional derivatives and other bioactive components. Here we describe the comparison of lipid compositions in breast milk from 22 healthy volunteers breastfeeding mothers and the six most common infant formula devoting particular attention to two families of signaling lipids, endocannabinoids, and eicosanoids. The main differences between breast milk and formulas lie in a variety of saturated fatty and unsaturated fatty acids, in the total amount (45-95% less in infant formula) and a variety of endocannabinoids and eicosanoids (2-AG, 5(s)HETE, 15(S)-HETE and 14,15-EET).

Infant formulae - Key components, nutritional value, and new perspectives.

Breastfeeding is the most effective strategy for meeting the nutritional demands of infants, whilst infant formulae are manufactured foods that mimic human milk and can be safely used to replace breastfeeding. In this paper, the compositional differences between human milk and other mammalian milk are reviewed, and thus nutritional profiles and compositions of standard bovine milk-based formulae as well as special formulae are discussed. Differences between breast milk and other mammalian milk in composition and content affect their digestion and absorption in infants. Characteristics and mimicking of breast milk have been intensively studied with the objective of narrowing the gap between human milk and infant formulae. The functions of the key nutritional components in infant formulae are examined. This review detailed recent developments in the formulation of different types of special infant formulae and efforts for their humanization, and summarized safety and quality control of infant formulae.

Estimation of exposure to phthalate esters from consumption of powdered infant formula sampled in Turkey.

Phthalate esters (PAEs) adversely affect the human endocrine and reproductive systems. These chemical toxic compounds are used as plasticizers, in particular to improve the mechanical properties of different food packing materials. Daily food consumption is the predominant source of exposure for PAEs, especially for infants. In this study, residue profiles and levels for eight PAEs were determined in 30 infant (stage I, II and special A and B) formulas of 12 brands in Turkey and health risk assessments were performed. The average level of PAEs were different for each formula group and packing type except for BBP (p < 0.01). The highest average mean level of PAEs was detected in paperboard type packing, while the lowest average mean level of PAEs was detected in metal can type packing. The highest average level of PAEs detected was DEHP in special formulas (22.1 ng g-1). The average hazard quotient (HQ) value was calculated as 8.43 × 10-5-8.94 × 10-5 for BBP, 1.49 × 10-3-1.58 × 10-3 for DBP, 2.06 × 10-2-2.18 × 10-2 for DEHP, and 7.21 × 10-4-7.65 × 10-4 for DINP. The average HI values were calculated as 2.29 × 10-2 for 0-6 months old infants, 2.39 × 10-2 for 6-12 months old infants, and 2.43 × 10-2 for 12-36 months old infants. These calculated results show that commercial infant formulas were a source of exposure to PAEs but did not present a significant health risk.

Latin American Considerations for Infant and Young Child Formulae.

Infant formula is the only acceptable substitute for breastmilk from 0 to 6 months old when human milk cannot be provided in sufficient amounts. Manufacturers have developed options that intend to meet the changing needs of the child aged from six to twelve months (follow-on formulae) and after the age of one year (young child formulae). The international code for marketing breast milk substitute stipulates standards for marketing practices of these products. In Latin America there are local variations of marketing practices. Novel marketing strategies such as advertising through social media and influencers pose new threats for breastfeeding success in Latin America. This review aims to examine variations in local regulations for marketing of infant formulae and to analyze the emerging phenomenon of influencer advertising. We reviewed the local norms for Latin American countries and examined differences and possible gaps. Emerging evidence of influencer marketing was explored. The results indicate that national regulations differ among Latin American countries, particularly with respect to product labelling and the requirement to use a local native language, highlighting the cost of the product, and different regulations prohibiting certain messages and illustrations. Regarding new marketing strategies, there is limited evidence on advertising infant formula through social media influencers, where different categories of marketing strategies can be described. More transparent reporting of social marketing by formula providers and more independent research on novel marketing strategies are needed.

Levels of Trace Elements in Human Breast Milk in Jordan: a Comparison with Infant Formula Milk Powder.

Human breast milk and infant formula milk powder (IFMP) are the main nutritional sources for infants. In the literature, there is a lack of studies concerning levels of trace elements in human milk and IMP in Jordan. The aim of this research was the determination of levels of 24 trace elements in human breast milk from Jordanian mothers (n = 76) and IFMP from Jordanian market (n = 22). Elements were classified to essential (Mg, Fe, Zn, Cu, Mn, Ni, Cr, Mo, Co, and Se), non-essential (Al, Ag, Ba, Bi, Cs, Ga, Li, Rb, Sr, U, and V), and potentially toxic (As, Cd, and Pb). Inductively coupled plasma-mass spectrometry (ICP-MS) following a microwave digestion of samples with concentrated nitric acid and hydrogen peroxide was performed. Our results featured levels of each targeted element in human milk and IFMP (mean, standard deviation (SD), median, and range). Statistical analysis included a one-way analysis of variance (ANOVA), and Pearson's correlations. A sample toxicological analysis study for toxic elements As, Cd, and Pb was performed, and results were inspected. Levels of most elements including toxic elements are larger than in human milk samples, and comparable to in IFPMs to literature results. Mean levels of majority of the elements (17 out of 24) in human milk were significantly different than respective means in IFMP solutions. Positive correlation was observed between total toxic elements and Al, Cu, and Fe in human milk samples. Results of toxicological analysis demonstrated that most of IFMP samples do not represent a health hazard to infants regarding As, Cd, and Pb. The same applies for Cd in human milk samples. However, levels of As and Pb in 70% of human milk samples exceed the provisional tolerable weekly intake (PTWI) for As and Pb.

Lead and cadmium in infant milk and cereal based formulae marketed in Nigeria: a probabilistic non-carcinogenic human health risk assessment.

BACKGROUND: There has been concern on the likelihood of contamination of infant formulae and consequent health risk in children. OBJECTIVE: This study has assessed and compared the lead and cadmium levels in infant formulae commonly consumed in Nigeria with international regulatory limits. It has also compared the estimated daily intake with Joint FAO/WHO Expert Committee on Food Additives (JECFA) and Proposition 65 Provisional Tolerable Daily Intake. MATERIAL AND METHODS: Lead and cadmium levels in 26 different brands of infant formulae purchased from stores in Port-Harcourt, Rivers state, Nigeria in January 2018 were assayed by Atomic Absorption Spectrophotometry. RESULTS: The lead and cadmium levels in milk based infant formulae ranged from 0.61-3.50 mg/kg and 0.01-0.55 mg/kg respectively whereas the range of the lead and cadmium levels in the cereal and cereal mix based were 0.29-1.95 mg/kg and 0.02-0.37 mg/kg, and 0.47-2.34 mg/kg and 0.001-0.46 mg/kg respectively. The mean lead level in the milk-based formulae (1.49 0.89 mg/kg) was slightly higher than other groups of formulae but the difference was not significant (p<0.05). The mean level of cadmium (0.17 mg/kg) in milk-based infant formulae was higher than levels in cereal and cereal mix but there was no significant statistical difference (p<0.05) between the samples. The lead and cadmium level in milk, cereal and cereal mixed based infant formulae were above the food safe limits. CONCLUSIONS: The consumption of infant formulae may add to the body burden of cadmium and lead of children with attendant public health implication. Regular monitoring and safety assessment of metals contamination of these infant formulae is advised.

Occurrence of MCPD and glycidyl fatty acid esters in standard and specialised infant formula in Denmark.

Standard infant formula and specialised infant formula for medical purposes in Denmark (n = 42) were assessed for the levels of 2-MCPDEs, 3-MCPDEs, and GEs. Similar concentrations of GEs were observed in both standard and specialised powder infant formula at around 11.5 µg/kg. For 2-MCPDEs and 3-MCPDEs, significantly higher concentrations were observed in specialised products (18.0 and 49.8 µg/kg, respectively) in comparison with the standard ones (11.8 and 31.0 µg/kg, respectively). The concentration profiles also revealed discrepancies in MCPDEs and GEs concentrations not only between different manufacturers but also in terms of infant formula variety. For instance, the hypoallergenic powder formula showed twice as much MCPDEs as the normal formula variety. Exposure estimation using average contaminant concentrations in each variety suggested no potential risk of 3-MCPDEs and GEs intake for Danish infants via infant formula consumption. However, special attention is required for a few specific products where risks might occur in terms of 3-MCPDEs and/or GEs consumption.

Association between parental self-reported knowledge on soy and phytoestrogen and their children's intake of soy-based infant formulae-a cross-sectional study of Israeli parents.

OBJECTIVES: Though natural phytoestrogen (PE) is a major factor in health authorities' considerations regarding soy-based infant formula (SBIF), missing their concentrations may interfere with parents' informed decision. METHODS: We performed an Internet survey investigating soy-related knowledge of parents. We built multiple logistic regression models adjusted for personal covariates for the association between parental knowledge on PE and children intake of SBIF and checked the effect of having children ≤ 2 years old on this association. RESULTS: We enrolled 304 parents, 48.3% men, mean age 33.8 (standard deviation, SD 4.9), mostly with higher education. Of them, 76% had children under two years of age. Mean parental knowledge on PE was 9.83 (SD 3.28) from 20 possible points. Parental knowledge on PE reduced children's intake of SBIF (odds ratio, OR = 0.85 [95% confidence interval 0.70; 1.02]). Stronger inverse association was found for parents with children ≤ 2 comparing with those with older children (OR = 0.85 [0.67; 1.09] and OR = 0.68 [0.39; 1.18], respectively), although these differences were not statistically significant. CONCLUSIONS: Adding PE content to information on SBIF may support informed decision.

Aflatoxin M1 Determination in Infant Formulae Distributed in Monterrey, Mexico.

The occurrence of aflatoxin M1 (AFM1) in infant formulae commercialized in the metropolitan area of Monterrey (Nuevo León, Mexico) was determined by using immunoaffinity column clean-up followed by HPLC determination with fluorimetric detection. For this, 55 infant formula powders were classified in two groups, starter (49 samples) and follow-on (6 samples) formulae. Eleven of the evaluated samples (20%) presented values above the permissible limit set by the European Union for infant formulae (25 ng/L), ranging from 40 to 450 ng/L. The estimated daily intake (EDI) for AFM1 was determined employing the average body weight (bw) of the groups of age in the ranges of 0-6 and 6-12 months, and 1-2 years. The results evidenced high intake values, ranging from 1.56 to 14 ng/kg bw/day, depending on the group. Finally, with the EDI value, the carcinogenic risk index was determined, presenting a high risk for all the evaluated groups. Based on these results, it is a necessary extra effort by the regulatory agencies to reduce the AFM1 presence in infant formulae consumed in Mexico.

Consumption of Minerals, Toxic Metals and Hydroxymethylfurfural: Analysis of Infant Foods and Formulae.

Infant foods and formulae may contain toxic substances and elements which can be neo-formed contaminants or derived from raw materials or processing. The content of minerals, toxic elements, and hydroxymethylfurfural (HMF) in infant foods and formulae were evaluated. The effect of storage temperature on HMF formation in infant formulae and its potential as a quality parameter was also evaluated. Prune-based foods contained the highest HMF content. HMF significantly increased when the storage temperature was elevated to 30 °C for 21 days. All trace elements were present in adequate amounts, while the concentration of nickel was higher when compared to those of other studies. The study indicates that HMF can be used as a quality indicator for product shelf-life and that the concentrations of minerals and toxic elements vary greatly due to the diverse compositions of foods and formulae. Such contaminants need to be monitored as infants represent a vulnerable group compared to adults.

Optimization and validation of the kinetic spectrophotometric method for quantitative determination of the pesticide atrazine and its application in infant formulae and cereal-based baby food.

BACKGROUND: Pesticides are potentially toxic to humans and can produce both acute and chronic health effects, depending on the quantity and the ways in which a person is exposed. Exposure to pesticides can cause serious health problems. Infants and young children are particularly sensitive to these contaminants because their brains and organ systems are not fully developed. For this reason, it is important to determine the quantities of pesticides in baby food. RESULTS: The aim of this study was to develop a kinetic-spectrophotometric method for atrazine determination and to apply it to determine pesticide in baby-food samples, using solid-phase extraction (SPE) followed by the kinetic-spectrophotometric method and the high-performance liquid chromatography (HPLC) method. This method is based on the inhibition effect of atrazine (the oxidation of sulfanilic acid (SA) by hydrogen peroxide in the alkaline medium in the presence of the Co2+ ion). Under the experimental conditions used, atrazine showed a linear dynamic range of 0.5 to 5.0 µg mL-1 , and from 5.0 to 70.00 µg mL-1 with relative standard deviations (RSD) from 1.91% to 9.41%. The limit of detection and the limit of quantification were 0.074 and 0.225 µg mL-1 , respectively. The kinetic method was successfully applied to determine the atrazine concentration in spiked samples after SPE of samples. High-performance liquid chromatography was used to verify the results. CONCLUSION: The proposed method is highly sensitive, simple, easy, requires cheap reagents, and leads to good recovery levels. It is linear, precise, and accurate. It can be used successfully for the routine analysis of atrazine in infant formulae and cereal-based food samples. © 2019 Society of Chemical Industry.

Flow Cytometry to Assess the Counts and Physiological State of Cronobacter sakazakii Cells after Heat Exposure.

Cronobacter sakazakii is an opportunistic pathogen that is associated with outbreaks of neonatal necrotizing enterocolitis, septicaemia, and meningitis. Reconstituted powdered infant formulae is the most common vehicle of infection. The aim of the present study is to gain insight into the physiological states of C. sakazakii cells using flow cytometry to detect the compromised cells, which are viable but non-culturable using plate-based methods, and to evaluate the impact of milk heat treatments on those populations. Dead-cell suspensions as well as heat-treated and non-heat-treated cell suspensions were used. After 60 or 65 °C treatments, the number of compromised cells increased as a result of cells with compromised membranes shifting from the heat-treated suspension. These temperatures were not effective at killing all bacteria but were effective at compromising their membranes. Thus, mild heat treatments are not enough to guarantee the safety of powered infant formulae. Flow cytometry was capable of detecting C. sakazakii's compromised cells that cannot be detected with classical plate count methods; thus, it could be used as a screening test to decrease the risk derived from the presence of pathogenic viable but non-culturable cells in this food that is intended for newborns' nutrition.

Appropriateness of Essentials Trace Metals in Commonly Consumed Infant Formulae in Nigeria.

BACKGROUND: Mothers who feed their children with infant food have increased have over the years leaving a large percentage of children who consume other types of liquid food for supplementation or as alternatives. AIM: Determining the levels of essential trace metals in these formulae with the aim of ascertain their appropriateness is considered important. METHODS: Iron, zinc, manganese, chromium and cobalt in 26 infant formulae purchased from Port Harcourt city, Nigeria were determined by Atomic Absorption Spectrophotometry. The estimated daily intake EDI and percentage of EDI to the recommended daily allowance of these essential trace metals were used in the exposure assessment. RESULTS: The highest mean concentration of Mn, Cr and Co was found in the milk based (0.15 ± 0.09 mg/kg), (0.61 ± 0.70 mg/kg), (0.12 ± 0.32 mg/kg) compared to the cereal based and cereal mix based but the differences was also not significant. The EDI of chromium in the infant formulae exceeded the RDA. CONCLUSION: Infant formulae may add to the chromium body burden of infants in Nigeria.

The Role of Lipids in Human Milk and Infant Formulae.

The quantity and quality of dietary lipids in infant formulae have a significant impact on health outcomes, especially when fat storing and/or absorption are limited (e.g., preterm birth and short bowel disease) or when fat byproducts may help to prevent some pathologies (e.g., atopy). The lipid composition of infant formulae varies according to the different fat sources used, and the potential biological effects are related to the variety of saturated and unsaturated fatty acids. For example, since lipids are the main source of energy when the normal absorptive capacity of the digestive tract is compromised, medium-chain saturated fatty acids might cover this requirement. Instead, ruminant-derived trans fatty acids and metabolites of n-3 long-chain polyunsaturated fatty acids with their anti-inflammatory properties can modulate immune function. Furthermore, dietary fats may influence the nutrient profile of formulae, improving the acceptance of these products and the compliance with dietary schedules.

Estimated US infant exposures to 3-MCPD esters and glycidyl esters from consumption of infant formula.

A dietary exposure assessment was conducted for 3-monochloropropane-1,2-diol (3-MCPD) esters (3-MCPDE) and glycidyl esters (GE) in infant formulas available for consumption in the United States. 3-MCPDE and GE are food contaminants generated during the deodorisation of refined edible oils, which are used in infant formulas and other foods. 3-MCPDE and GE are of potential toxicological concern because these compounds are metabolised to free 3-MCPD and free glycidol in rodents and may have the same metabolic fate in humans. Free 3-MCPD and free glycidol have been found to cause adverse effects in rodents. Dietary exposures to 3-MCPDE and GE from consumption of infant formulas are of particular interest because formulas are the sole or primary food source for some infants. In this analysis, US Food and Drug Administration data on 3-MCPDE and GE concentrations (as 3-MCPD and glycidol equivalents, respectively) in a small convenience sample of infant formulas were used to estimate exposures from consumption of formula by infants 0-6 months of age. 3-MCPDE and GE exposures based on mean concentrations in all formulas were estimated at 7-10 and 2 µg/kg bw/day, respectively. Estimated mean exposures from consumption of formulas produced by individual manufacturers ranged from 1 to 14 µg/kg bw/day for 3-MCPDE and from 1 to 3 µg/kg for GE.

From Culture-Medium-Based Models to Applications to Food: Predicting the Growth of B. cereus in Reconstituted Infant Formulae.

Predictive models of the growth of foodborne organisms are commonly based on data generated in laboratory medium. It is a crucial question how to apply the predictions to realistic food scenarios. A simple approach is to assume that the bias factor, i.e., the ratio between the maximum specific growth rate in culture medium and the food in question is constant in the region of interest of the studied environmental variables. In this study, we investigate the validity of this assumption using two well-known link functions, the square-root and the natural logarithm, both having advantageous properties when modeling the variation of the maximum specific growth rate with temperature. The main difference between the two approaches appears in terms of the respective residuals as the temperature decreases to its minimum. The model organism was Bacillus cereus. Three strains (B594, B596, and F4810/72) were grown in Reconstituted Infant Formulae, while one of them (F4810/72) was grown also in culture medium to calculate the bias factor. Their growth parameters were estimated using viable count measurements at temperatures ranging from 12 to 25°C. We utilized the fact that, if the bias factor is independent of the temperature, then the minimum growth temperature parameter of the square-root model of Ratkowsky et al. (1982) is the same for culture medium and food. We concluded, supported also by mathematical analysis, that the Ratkowsky model works well but its rearrangement for the natural logarithm of the specific growth rate is more appropriate for practical regression. On the other hand, when analyzing mixed culture data, available in the ComBase database, we observed a trend different from the one generated by pure cultures. This suggests that the identity of the strains dominating the growth of mixed cultures depends on the temperature. Such analysis can increase the accuracy of predictive models, based on culture medium, to food scenarios, bringing significant saving for the food industry.

The European Food Safety Authority recommendation for polyunsaturated fatty acid composition of infant formula overrules breast milk, puts infants at risk, and should be revised.

The European Food Safety Authority (EFSA) has concluded from a limited review of the literature that although docosahexaenoic acid (DHA) is required for infant formula, arachidonic acid is not required "even in the presence of DHA" (EFSA Journal, 12 (2014) 3760). This flawed opinion is grounded in human trials which tested functionality of DHA in neural outcomes and included arachidonic acid ostensibly to support growth. The EFSA report mistakes a nutrient ubiquitous in the diets of newborn infants, through breast milk and with wide-ranging health and neurodevelopmental effects, for an optional drug targeted to a particular outcome that is properly excluded when no benefit is found for that particular outcome. Arachidonic acid has very different biological functions compared to DHA, for example, arachidonic acid has unique functions in the vasculature and in specific aspects of immunity. Indeed, the overwhelming majority of trials include both DHA and arachidonic acid, and test development specific to DHA such as neural and visual development. DHA suppresses membrane arachidonic acid concentrations and its function. An infant formula with DHA and no arachidonic acid runs the risk of cardio and cerebrovascular morbidity and even mortality through suppression of the favorable oxylipin derivatives of arachidonic acid. The EFSA recommendation overruling breast milk composition should be revised forthwith, otherwise being unsafe, ungrounded in most of the evidence, and risking lifelong disability.

Perchlorate: water and infant formulae contamination in France and risk assessment in infants.

Perchlorate ions ClO4(-), known to inhibit competitively the uptake of iodine by the thyroid, have been detected in drinking water in France as well as in infant formulae. A tolerable daily intake (TDI) has been established at 0.7 µg kg(-1) bw day(-1) based on the inhibition of iodine uptake. Due to this mechanism of action, the iodine status could strongly influence the biological effect of perchlorate. Perchlorate concentrations in water and infant formulae were measured and the exposure of children under 6 months of age calculated. It appeared that the TDI could be exceeded in some children. As the iodine status is not optimal within the entire French population, there appears to be a need to clarify the sources of perchlorate ultimately to decrease exposure.