Effects on Fatty Acid Metabolism of a New Powdered Human Milk Fortifier Containing Medium-Chain Triacylglycerols and Docosahexaenoic Acid in Preterm Infants

Preterm infants require fortification of human milk (HM) with essential fatty acids (FA) to ensure adequate post-natal development. As part of a larger randomized controlled study, we investigated FA metabolism in a subset of 47 clinically stable preterm infants (birth weight ≤1500 g or gestational age ≤32 weeks). Infants were randomized to receive HM supplemented with either a new HM fortifier (nHMF; n = 26) containing 12.5 g medium-chain FA (MCFA), 958 mg linoleic acid (LA), 417 mg α-linolenic acid (ALA), and 157 mg docosahexaenoic acid (DHA) per 100 g of powder (in compliance with the latest guidelines) or a fat-free HMF (cHMF; n = 21). Plasma phospholipid (PL) and triacylglycerol (TAG), and red blood cell phosphatidylcholine (RBC-PC) and phosphatidylethanolamine (RBC-PE) FA profiles were assessed before and after 21 days of feeding. In the nHMF group, significantly increased levels of n-9 monounsaturated fatty acids were observed, formed most likely by elongation and desaturation of dietary saturated fatty acids present in HM. ALA fortification increased ALA assimilation into plasma TAG. Similarly, DHA fortification enriched the DHA content in RBC-PE, which, in this compartment, was not associated with lower arachidonic acid levels as observed in plasma TAG and phospholipids. RBC-PE, a reliable indicator of FA metabolism and accretion, was the most sensitive compartment in this study

Implication des acides gras trans chez la femme enceinte et allaitante

BORDEAUX1-BU Sciences-Talence (335222101) / SudocSudocFranceF

The First 1000 Days of Infant

The third edition of the Nursing and Pediatrics Congress was held in Paris from 16–19 June 2021, with the aim of contributing the experiences and reflections of relevant health professionals (pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians, and lactation consultants) to the knowledge of the most critical period of human life: its first 1000 days [...

Nutritional implications of trans fatty acids during perinatal period, in French pregnant women

Some studies have demonstrated the transfer of trans fatty acids (TFA) across the human placenta. It was suggested that TFA might disturb the metabolism of essential fatty acids (EFA) in fetus and consequently might affect intrauterine human growth more or less according to the TFA intake level of the mother. In this context, the objective of this study was to assess, for French pregnant women, possible impact of their TFA intake on parameters of their term infants: 1/ TFA composition of the umbilical cord (plasma lipids and parietal phospholipids), 2/ birth weight and head circumference. The TFA composition of maternal and umbilical plasma lipids, and parietal phospholipids of umbilical cord were determined by gas chromatography, associated with a thin-layer chromatography for the phospholipids. Because TFA content of adipose tissue is a reliable biochemical indicator of the usual TFA intake level, maternal adipose tissue was also analyzed. Trans fatty acid (TFA) percentage was significantly higher (p = 0.001) in maternal (0.9% of total fatty acids) than in umbilical plasma total lipids (0.6%) thus confirming their placental passage. Moreover, trans isomer pattern of cord plasma lipids was different from the maternal’s one, especially regarding trans isomers of linoleic acid (9c,12c-18:2). Percentage values of 9c,13t + 9t,12t and 9t,12c isomers were respectively, 2 and 3 times higher (p < 0.001) in umbilical than in maternal plasma (Except trans 16:1 acids). All trans isomers observed in umbilical plasma lipids were detected in both parietal and vessel (vein and arteries) phospholipids of umbilical cord. Nevertheless, 9c13t + 9t12t isomer mix level was significantly higher (p < 0.001) in artery than in vein TPL. Moreover, in artery TPL, percentage value of 9c13t+9t12t isomer mix was inversely correlated (r = - 0.703, p = 0.003) with arachidonic acid content. Nevertheless, for this French population, there was no relation between either weight or head circumference of newborn and the TFA levels in both adipose tissue and plasma lipids of their mother

Nutritional implications of trans fatty acids during perinatal period, in French pregnant women

Some studies have demonstrated the transfer of trans fatty acids (TFA) across the human placenta. It was suggested that TFA might disturb the metabolism of essential fatty acids (EFA) in fetus and consequently might affect intrauterine human growth more or less according to the TFA intake level of the mother. In this context, the objective of this study was to assess, for French pregnant women, possible impact of their TFA intake on parameters of their term infants: 1/ TFA composition of the umbilical cord (plasma lipids and parietal phospholipids), 2/ birth weight and head circumference. The TFA composition of maternal and umbilical plasma lipids, and parietal phospholipids of umbilical cord were determined by gas chromatography, associated with a thin-layer chromatography for the phospholipids. Because TFA content of adipose tissue is a reliable biochemical indicator of the usual TFA intake level, maternal adipose tissue was also analyzed. Trans fatty acid (TFA) percentage was significantly higher (p = 0.001) in maternal (0.9% of total fatty acids) than in umbilical plasma total lipids (0.6%) thus confirming their placental passage. Moreover, trans isomer pattern of cord plasma lipids was different from the maternal’s one, especially regarding trans isomers of linoleic acid (9c,12c-18:2). Percentage values of 9c,13t + 9t,12t and 9t,12c isomers were respectively, 2 and 3 times higher (p < 0.001) in umbilical than in maternal plasma (Except trans 16:1 acids). All trans isomers observed in umbilical plasma lipids were detected in both parietal and vessel (vein and arteries) phospholipids of umbilical cord. Nevertheless, 9c13t + 9t12t isomer mix level was significantly higher (p < 0.001) in artery than in vein TPL. Moreover, in artery TPL, percentage value of 9c13t+9t12t isomer mix was inversely correlated (r = - 0.703, p = 0.003) with arachidonic acid content. Nevertheless, for this French population, there was no relation between either weight or head circumference of newborn and the TFA levels in both adipose tissue and plasma lipids of their mother

Nutrition of Pregnant and Lactating Women in the First 1000 Days of Infant

Nutrition for pregnant and breastfeeding women is fundamental to the development of the child in its first 1000 days and beyond. To evaluate the adequacy of this nutrition, we have relied on historical dietary surveys and on personal French studies (4 studies from 1997 to 2014) involving dietary surveys over 3 days (3D-Diet). Furthermore, our team specialized in lipids has measured the fatty acids of breast milk, which reflect the dietary intake of lipids, from breast milk (1997–2014) and from the lipids of cord blood and maternal fat tissue, in 1997. According to our results, pregnancy needs require an additional 300 Kcal, but surveys show a bad equilibrium of macronutrients: an excess of proteins of fetus [17% of total energy intake (TEI) vs. 15%], excess of fats (45% vs. 35%), excess of saturated fatty acids (SFA), not enough polyunsaturated fatty acids (PUFA), particularly omega 3, and a deficit in carbohydrates (45% vs. 55%). There is also a deficiency in calcium, iron, magnesium, zinc, and vitamins D, B6, B5, and folates. Breast milk adequately provides all the macronutrients necessary for the growth of the child. Proteins and carbohydrates vary little according to the mother’s diet; on the other hand, its composition in lipids, trace elements, and vitamins is highly variable with the mother’s diet of breast milk. In our study in 2014, in 80 participants, the diet was low in calories (1996 Kcal vs. 2200 Kcal RDA), normoprotidic, normolipidic, but low in carbohydrate, especially polysaccharides. We note a very insufficient intake of fish and dairy products, and therefore calcium, but also magnesium, zinc, iron, and vitamins D, E, B6, and folate. Consequently, if the mother does not achieve a diet adequate to her needs during pregnancy and breastfeeding, it will be necessary to resort to medicinal supplements in minerals, trace elements, vitamins, and omega 3

A new high hydrostatic pressure process to assure the microbial safety of human milk while preserving the biological activity of its main components

Background: The main process used to pasteurize human milk is the low-temperature, long-time Holder method. More recently, the high-temperature, short-time method has been investigated. Both processes lead to the appropriate inactivation of vegetative bacterial forms but are ineffective against bacterial spores. Research Aims/Questions: We aimed to accomplish two main objectives: inactivation of all pathogens, including spores; and preservation of the activity of milk components. Design/Methods: Recently, a novel high-hydrostatic pressure process has been developed by HPBioTECH. Using the same raw human milk samples, we compared the effects of this method with those of the Holder method on vegetative and spore forms of pathogens and on bioactive components (lipase activity, immunoproteins). Results: Two main microbial strains were selected: Staphylococcus aureus (as a reference for vegetative forms) and Bacillus cereus (as a reference for spores). Use of the high-hydrostatic pressure process led to microbial decontamination of 6 log for both S. aureus and B. cereus. Additionally, the bioactivity of the main components of human milk was preserved, with activities of lipase, a -lactalbumin, casein, lysozyme, lactoferrin, and sIgA of similar to 80, 96-99, 98-100, 95-100, 93-97, and 63-64%, respectively. Conclusions: Use of this novel high-hydrostatic pressure process to generate microbiologically safe human milk may provide important benefits for preterm infants, including improved assimilation of human milk (leading increased weight gain) and improved resistance to infections. Because 10% of all human milk collected is contaminated by B. cereus, use of this method will also prevent waste

Safety and Tolerance Evaluation of Milk Fat Globule Membrane-Enriched Infant Formulas: A Randomized Controlled Multicenter Non-Inferiority Trial in Healthy Term Infants

Objective This multicenter non-inferiority study evaluated the safety of infant formulas enriched with bovine milk fat globule membrane (MFGM) fractions. Methods Healthy, full-term infants ( n = 119) age ≤14 days were randomized to standard infant formula (control), standard formula enriched with a lipid-rich MFGM fraction (MFGM-L), or standard formula enriched with a protein-rich MFGM fraction (MFGM-P). Primary outcome was mean weight gain per day from enrollment to age 4 months (non-inferiority margin: –3.0 g/day). Secondary (length, head circumference, tolerability, morbidity, adverse events) and exploratory (phospholipids, metabolic markers, immune markers) outcomes were also evaluated. Results Weight gain was non-inferior in the MFGM-L and MFGM-P groups compared with the control group. Among secondary and exploratory outcomes, few between-group differences were observed. Formula tolerance rates were high (>94%) in all groups. Adverse event and morbidity rates were similar across groups except for a higher rate of eczema in the MFGM-P group (13.9% vs control [3.5%], MFGM-L [1.4%]). Conclusion Both MFGM-enriched formulas met the primary safety endpoint of non-inferiority in weight gain and were generally well tolerated, although a higher rate of eczema was observed in the MFGM-P group