An infant formula containing dairy lipids increased red blood cell membrane Omega 3 fatty acids in 4 month-old healthy newborns: a randomized controlled trial

Maria Lorella Gianni, Paola Roggero, Charlotte Baudry, Catherine Fressange-Mazda, Claudio Galli, Carlo Agostoni, Pascale le Ruyet, Fabio Mosca, Maria Lorella Gianni, Paola Roggero, Charlotte Baudry, Catherine Fressange-Mazda, Claudio Galli, Carlo Agostoni, Pascale le Ruyet, Fabio Mosca

Abstract

Background: When breastfeeding is not possible, infants are fed formulas (IF) in which lipids are usually of plant origin. However, the use of dairy fat in combination with plant oils enables a lipid profile closer to breast milk in terms of fatty acid (FA) composition, triglyceride structure, polar lipids and cholesterol contents. The objective of this study was to determine the effect of an IF containing a mix of dairy fat and plant oils on Omega-3 FA content in red blood cells (RBC).

Methods: This study was a monocentric, double-blind, controlled, randomized trial. Healthy term infants were fed formulas containing a mix of dairy fat and plant oils (D), plant oils (P) or plant oils supplemented with ARA and DHA (PDHA). Breastfed infants were enrolled as a reference group (BF). FA in RBC phosphatidylethanolamine was evaluated after 4 months and FA in whole blood were evaluated at enrollment and after 4 months by gas chromatography. Differences between groups were assessed using an analysis of covariance with sex and gestational age as covariates.

Results: Seventy IF-fed and nineteen BF infants completed the protocol. At 4 months, RBC total Omega-3 FA levels in infants fed formula D were significantly higher than in group P and similar to those in groups PDHA and BF. RBC DHA levels in group D were also higher than in group P but lower than in groups PDHA and BF. RBC n-3 DPA levels in group D were higher than in groups P, PDHA and BF. A decrease in proportions of Omega-3 FA in whole blood was observed in all groups.

Conclusions: A formula containing a mix of dairy lipids and plant oils increased the endogenous conversion of Omega-3 long-chain FA from precursor, leading to higher total Omega-3, DPA and DHA status in RBC than a plant oil-based formula. Modifying lipid quality in IF by adding dairy lipids should be considered as an interesting method to improve Omega-3 FA status.

Trial registration: Identifier NCT01611649 , retrospectively registered on May 25, 2012.

Keywords: Dairy fat; Erythrocyte membrane fatty acids; Fatty acids; Infant formula; Infant nutrition; Lipid quality; Omega 3; Red blood cells membrane fatty acids.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the local Ethical Committee of the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy and conducted in accordance with Good Clinical Practice and the principles and rules of the Declaration of Helsinki. Parents or legal caregivers provided written informed consent prior to enrollment of their infants in the study.

Consent for publication

Not applicable.

Competing interests

This study was funded by Lactalis Nutrition Europe, Torcé, France. Study formulas were provided by Milumel®, Lactalis, Craon, France. CB, CFM and PLR are employees of the Lactalis group, France. MLG is a member of the editorial board of BMC Pediatrics.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow of study subjects. Formula D contained a mixture of dairy lipids and plant oils; formula P contained only plant oils and formula PDHA contained plant oils supplemented with ARA and DHA. GI (gastrointestinal) symptoms included regurgitation, reflux, constipation, colic and flatulence
Fig. 2
Fig. 2
Total Omega 3, DHA and DPA levels (% of total FA) in PE of RBC membrane after 4 months. Formula D (n = 23) contained a mixture of dairy lipids and plant oils; formula P (n = 24) contained only plant oils and formula PDHA (n = 23) contained plant oils supplemented with ARA and DHA. BF: breastfed reference group (n = 18). PE: phosphatidylethanolamine. Comparison of the 4 groups by ANOVA with 3 fixed factors (Sex, gestational age, group) and post-hoc Tukey’s adjustments. a ≠ b ≠ c; p < 0.05
Fig. 3
Fig. 3
Changes in total Omega 3 and DHA levels in whole blood between 4 months and enrollment expressed as deltas (% of total FA). Formula D (n = 23) contained a mixture of dairy lipids and plant oils; formula P (n = 24) contained only plant oils and formula PDHA (n = 23) contained plant oils supplemented with ARA and DHA. BF: breastfed reference group (n = 18). Comparison of the 4 groups by ANOVA with 3 fixed factors (Sex, gestational age, group) and post-hoc Tukey’s adjustments. a ≠ b ≠ c; p < 0.05

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