Manganese exposure assessment in formula-fed infants in Israel
1Food Risk Management Department, The National Food Service, Ministry of Health, Jaffa St. 236, Jerusalem, Israel. Jonatan.darr@moh.gov.il.
Insights
Infant formula in Israel shows excessive manganese (Mn) levels, particularly non-milk-based types. Milk-based formulas are preferable when breastfeeding isn
Area of Science:
- Pediatric Nutrition and Environmental Health
- Infant Health and Development
- Toxicology and Public Health
Background:
- Proper infant nutrition is crucial for cognitive and physical development.
- Manganese (Mn) overexposure in infants is linked to neurodevelopmental issues like lower IQ and ADHD.
- This study assesses Mn exposure in formula-fed infants in Israel.
Purpose of the Study:
- To evaluate manganese (Mn) exposure levels in formula-fed infants.
- To assess Mn intake from birth to nine months of age in Israel.
- To compare Mn levels across different infant formula types and water sources.
Main Methods:
- Analyzed over 200 infant formula samples for Mn content.
- Utilized Ministry of Health data for Mn levels in potable water.
- Calculated dietary Mn exposure from formula, water, and complementary foods.
Main Results:
- Milk-based formulas had lower Mn levels than other types.
- Nearly half of formula brands exceeded regulatory deviation tolerances.
- Excessive Mn intake was observed in formula-fed infants across brands; water contribution was negligible.
Conclusions:
- Milk-based formulas are the most suitable alternative when breastfeeding is not possible.
- Aligning potable water Mn limits with EU and USA regulations is recommended.
- Increased regulatory tolerance for mineral content deviations could facilitate infant formula importation.
Background:
Proper nutrition is fundamental to the regular mental and physical development of infants, toddlers, and children. Overexposure to manganese (Mn) in infants has been correlated to various behavioral and neurological symptoms such as lower IQ, attention deficit hyperactivity disorder, and impairment in fine motor skills. The following study aims to evaluate exposure to Mn in formula-fed infants in Israel from birth to nine months of age.
Methods:
Over 200 infant formulas of multiple brands were sampled by the Israeli National Food Service, as part of a routine monitoring of levels of various nutritional components, including Mn. Data on levels of Mn in water was drawn from routine monitoring programs carried out by the Ministry of Health (MOH). Total energy requirements were calculated based on current infant weight and growth data collected over the past decade in MOH-operated family care centers. Dietary exposure was assessed for infants from birth to six months as the sum of Mn intake from infant formula and potable water. For infants aged seven-nine months, Mn intake from complementary feeding was assessed based on national surveys of feeding behavior in infants aged nine-twelve months.
Results:
Milk-based infant formula brands consistently demonstrated lower levels of Mn compared to other formulations. Almost half of the sampled formula brands exceeded regulatory tolerance to deviation from labelling of nutritional components. Though some variation in Mn concentrations is evident in water sources across Israel, the overall contribution of water to Mn intake is negligible given the high levels of desalination in Israel. Excessive Mn intake in formula-fed infants is evident across multiple formula brands.
Conclusions:
When breastfeeding is not optional, milk-based formulas are the most suitable in terms of their relative contribution to Mn intake. Equating maximal levels of Mn in potable waters to levels set in EU and USA regulations is advisable. A greater regulatory tolerance for deviation from labelling of mineral content is advisable so as not to hinder importation of infant formulas.
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