Palm oil and beta-palmitate in infant formula: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition

TY - JOUR

T1 - Palm oil and beta-palmitate in infant formula

T2 - A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition

AU - Bronsky, Jiri

AU - Campoy, Cristina

AU - Embleton, Nicholas

AU - Fewtrell, Mary

AU - Mis, Nataša Fidler

AU - Gerasimidis, Konstantinos

AU - Hojsak, Iva

AU - Hulst, Jessie

AU - Indrio, Flavia

AU - Lapillonne, Alexandre

AU - Mølgaard, Christian

AU - Moltu, Sissel Jennifer

AU - Verduci, Elvira

AU - Vora, Rakesh

AU - Domellöf, Magnus

AU - ESPGHAN Committee on Nutrition

N1 - CURIS 2019 NEXS 135

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background:Palm oil (PO) is used in infant formulas in order to achieve palmitic acid (PA) levels similar to those in human milk. PA in PO is esterified predominantly at the SN-1,3 position of triacylglycerol (TAG), and infant formulas are now available in which a greater proportion of PA is in the SN-2 position (typical configuration in human milk). As there are some concerns about the use of PO, we aimed to review literature on health effects of PO and SN-2-palmitate in infant formulas.Methods:PubMed and Cochrane Database of Systematic Reviews were systematically searched for relevant studies on possible beneficial effects or harms of either PO or SN-2-palmitate in infant formula on various health outcomes.Results:We identified 12 relevant studies using PO and 21 studies using SN-2-palmitate. Published studies have variable methodology, subject characteristics, and some are underpowered for the key outcomes. PO is associated with harder stools and SN-2-palmitate use may lead to softer stool consistency. Bone effects seem to be short-lasting. For some outcomes (infant colic, faecal microbiota, lipid metabolism), the number of studies is very limited and summary evidence inconclusive. Growth of infants is not influenced. There are no studies published on the effect on markers of later diseases.Conclusions:There is insufficient evidence to suggest that PO should be avoided as a source of fat in infant formulas for health reasons. Inclusion of high SN-2-palmitate fat blend in infant formulas may have short-Term effects on stool consistency but cannot be considered essential.

AB - Background:Palm oil (PO) is used in infant formulas in order to achieve palmitic acid (PA) levels similar to those in human milk. PA in PO is esterified predominantly at the SN-1,3 position of triacylglycerol (TAG), and infant formulas are now available in which a greater proportion of PA is in the SN-2 position (typical configuration in human milk). As there are some concerns about the use of PO, we aimed to review literature on health effects of PO and SN-2-palmitate in infant formulas.Methods:PubMed and Cochrane Database of Systematic Reviews were systematically searched for relevant studies on possible beneficial effects or harms of either PO or SN-2-palmitate in infant formula on various health outcomes.Results:We identified 12 relevant studies using PO and 21 studies using SN-2-palmitate. Published studies have variable methodology, subject characteristics, and some are underpowered for the key outcomes. PO is associated with harder stools and SN-2-palmitate use may lead to softer stool consistency. Bone effects seem to be short-lasting. For some outcomes (infant colic, faecal microbiota, lipid metabolism), the number of studies is very limited and summary evidence inconclusive. Growth of infants is not influenced. There are no studies published on the effect on markers of later diseases.Conclusions:There is insufficient evidence to suggest that PO should be avoided as a source of fat in infant formulas for health reasons. Inclusion of high SN-2-palmitate fat blend in infant formulas may have short-Term effects on stool consistency but cannot be considered essential.

KW - Faculty of Science

KW - Palm olein

KW - Palmitic acid

KW - Colic

KW - Constipation

KW - Growth

KW - Lipids

U2 - 10.1097/MPG.0000000000002307

DO - 10.1097/MPG.0000000000002307

M3 - Journal article

C2 - 31022096

SN - 0277-2116

VL - 68

SP - 742

EP - 760

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

IS - 5

ER -