Reduced bone mineralization in infants fed palm olein-containing formula: a randomized, double-blinded, prospective trial.
OBJECTIVE
Palm and palm olein (PO) oils are used in some infant formula fat blends to match the fatty acid profile of human milk, but their presence has been shown to lower calcium and fat absorption. We aimed to determine if the reported differences in calcium absorption could affect skeletal development by comparing bone mineral accretion in healthy term infants fed a milk-based formula with (PMF) or without PO.


METHODS
Whole body bone mineralization was evaluated in healthy term infants fed 1 of 2 coded, commercially available, ready-to-feed infant formulas in a randomized, double-blind, parallel study. Subjects were fed either 1). PMF formula (Enfamil with iron; Mead Johnson Division of Bristol Myers, Evansville, IN; N = 63) containing PO/coconut/soy/high-oleic sunflower oils (45/20/20/15% oil); or 2). milk-based formula without PO (Similac with iron; Ross Products Division Abbott Laboratories, Columbus, OH; N = 65), containing high-oleic safflower/coconut/soy oils (40/30/30% oil) from enrollment by 2 weeks after birth until 6 months. Anthropometrics and formula intake were determined monthly; total body bone mineral content (BMC) and bone mineral density (BMD) were measured at baseline, 3, and 6 months of age using dual energy x-ray absorptiometry.


RESULTS
Intent-to-treat analyses indicated no significant differences between feeding groups in weight, length, head circumference, or formula intake throughout the study. BMC and BMD were not different at baseline but repeated measures analyses show that infants fed PMF had significantly lower BMC and BMD at 3 and 6 months.


CONCLUSIONS
Healthy term infants fed a formula containing PO as the predominant oil in the fat blend had significantly lower BMC and BMD than those fed a formula without PO. The inclusion of PO in infant formula at levels needed to provide a fatty acid profile similar to that of human milk leads to lower bone mineralization.
Department of Pediatrics, Hutzel Hospital, Wayne State University, Detroit, Michigan 48201, USA. wkoo@wayne.edu
Winston W K
WW
Koo
Mouhanad
M
Hammami
Dean P
DP
Margeson
Chuks
C
Nwaesei
Michael B
MB
Montalto
John B
JB
Lasekan
D015502:Absorptiometry, Photon / Q000379:methods; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D002113:Calcification, Physiologic / Q000502:physiology*; D000074263:Coconut Oil; D004032:Diet / Q000009:adverse effects; D004041:Dietary Fats / Q000378:metabolism; D004042:Dietary Fats, Unsaturated / Q000009:adverse effects / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects*; D007231:Infant, Newborn; D008297:Male; D008892:Milk / Q000378:metabolism; D000073878:Palm Oil; D010938:Plant Oils / Q000009:adverse effects* / Q000378:metabolism*; D011446:Prospective Studies; D013024:Soybean Oil / Q000378:metabolism; D000074242:Sunflower Oil
D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D010938:Plant Oils; D000074242:Sunflower Oil; D000073878:Palm Oil; D013024:Soybean Oil; D000074263:Coconut Oil