Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization.
BACKGROUND
The low sn-2 palmitate content of infant formulas results in formation of fatty acid calcium soaps in the stools and reduced calcium absorption.


OBJECTIVE
Our objective was to test the hypotheses that increasing the proportion of sn-2 palmitate in formula for term infants would result in greater skeletal mineral deposition and reduced stool hardness.


METHODS
Healthy term neonates were randomly assigned to receive standard formula (n = 103) or formula containing 50% sn-2 palmitate (high-sn-2 formula; n = 100) for 12 wk. One hundred twenty breast-fed infants were also studied. The main outcome measures were 1) radial (single-photon absorptiometry) and whole-body (dual-energy X-ray absorptiometry) bone mineral content (WBBMC) at 12 wk and 2) stool frequency, volume, and consistency at 6 and 12 wk. Secondary outcome measures included stool fatty acid content.


RESULTS
Infants receiving high-sn-2 formula had higher WBBMC (128.1 +/- 9.7 compared with 122.7 +/- 10.1 g, adjusted for size and sex), softer stools at 6 and 12 wk, and a lower proportion of stool soap fatty acids than did infants receiving the control formula. Breast-fed infants had adjusted WBBMC values (128.3 +/- 9.1 g) similar to those of infants fed high-sn-2 formula and significantly higher than those of infants fed the control formula.


CONCLUSIONS
Changing the stereoisomeric structure of palmitate in infant formula resulted in higher WBBMC, reduced stool soap fatty acids, and softer stools more like those of breast-fed infants. The greater bone mass measured could be important if it persists beyond the trial period; this merits further investigation.
Kennedy
K
K
MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK.
Fewtrell
M S
MS
Morley
R
R
Abbott
R
R
Quinlan
P T
PT
Wells
J C
JC
Bindels
J G
JG
Lucas
A
A
D015502:Absorptiometry, Photon; D000704:Analysis of Variance; D015519:Bone Density / Q000187:drug effects*; D004311:Double-Blind Method; D002149:Energy Intake; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D008895:Milk, Human; D019308:Palmitic Acid / Q000008:administration & dosage / Q000494:pharmacology*; D014280:Triglycerides / Q000008:administration & dosage* / Q000494:pharmacology*
D004791:Enzyme Inhibitors; D014280:Triglycerides; D019308:Palmitic Acid