Milk fat globule membrane (INPULSE) enriched formula milk decreases febrile episodes and may improve behavioral regulation in young children.
OBJECTIVE
Polar lipids constitute an important part of cellular membranes. The mucosal surface of the gastrointestinal tract is a critical barrier between noxious and immunogenic substances in the lumen and the mucosal immune system.


METHODS
We conducted a prospective, double-blinded, randomized, controlled trial in healthy children to evaluate the acceptability, safety, effect on intestinal comfort (constipation), common infectious symptoms (fever, diarrhea, cough), and behavioral regulation of a 4-mo daily intake of 200-mL formula with or without enrichment of the milk fat globule membrane (INPULSE). Data were collected from parental diaries. The primary endpoints for analysis were the number of days with fever, diarrhea, coughing, or constipation. The secondary endpoints were the number of doctor visits, medication intake, number of missed schooldays, acceptability of the test drinks, and safety. The Achenbach System of Empirically Based Assessment, a validated questionnaire to assess behavior, was submitted to parents at the end of the intervention period.


RESULTS
Initially 253 children were included, but 71 dropped out (these were subjects with <80% intake or for <90 d). No adverse effects led to the discontinuation. Per-protocol analysis was performed in 97 girls and 85 boys. The group (n = 182) was normally distributed, with a mean age of 4.4 ± 0.9 y. The amount of product taken each day and the acceptability were similar in the intervention and control groups. The number of days with fever (>38.5°C) and the number of short (<3 d) febrile periods were significantly (P < 0.03) decreased in the intervention group (1.7 ± 2.5 vs 2.6 ± 3.1 d) This significant difference in febrile episodes appeared after 6 wk of consecutive intake. Other outcome parameters (diarrhea, constipation, cough, doctor visit, and days of school absence) were similar in the two groups. An analysis of the 169 Achenbach System of Empirically Based Assessment questionnaires (two-tailed t test) showed significant differences in the internal (P < 0.003), external (P < 0.004), and total (P < 0.002) problem scores in favor of the intervention group. Between-subjects effects were highly correlated (internal, P < 0.003; external, P < 0.005; total, P < 0.002, one-way analysis of variance).


CONCLUSIONS
Regular consumption of formula enriched with a concentrated milk fat membrane (INPULSE) product by preschool children was safe, well tolerated, and, based on per-protocol analysis, is associated with a significant decrease in the number of short febrile episodes and leads to improved behavioral regulation.
Pediatric GI & Nutrition, Queen Paola Children's Hospital-ZNA, Antwerp, Belgium. gveereman@gmail.com
Gigi
G
Veereman-Wauters
Sofie
S
Staelens
Roeland
R
Rombaut
Koen
K
Dewettinck
Dirk
D
Deboutte
Robert-Jan
RJ
Brummer
Marc
M
Boone
Pasale
P
Le Ruyet
D000818:Animals; D001530:Belgium / Q000453:epidemiology; D002099:Cacao; D002648:Child; D002652:Child Behavior; D002657:Child Development; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005518:Food Preferences; D005527:Food, Fortified / Q000009:adverse effects / Q000032:analysis*; D006017:Glycolipids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006023:Glycoproteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D056747:Immunomodulation; D007239:Infections / Q000276:immunology / Q000503:physiopathology; D066292:Lipid Droplets; D008297:Male; D008892:Milk / Q000009:adverse effects / Q000737:chemistry*; D010743:Phospholipids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015995:Prevalence
D006017:Glycolipids; D006023:Glycoproteins; D010743:Phospholipids; C110367:milk fat globule