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Vitamin E status of low birthweight infants fed formula enriched with long-chain polyunsaturated fatty acids
B Koletzko1, T Decsi, G Sawatzki
1Kinderpoliklinik, Ludwig-Maximilians-Universität, Munich, Germany.
Insights
Long-chain polyunsaturated fatty acids (LCP) in infant formula may negatively impact vitamin E status in low birthweight infants (LBWI). Further research is needed to evaluate LCP effects on infant vitamin E levels.
Area of Science:
- Neonatal Nutrition
- Biochemistry
- Pediatric Health
Background:
- European recommendations advise LCP-enriched formula for low birthweight infants (LBWI) not receiving human milk (HM).
- Concerns exist regarding potential adverse effects of LCP supplementation on infant antioxidant status, specifically vitamin E (alpha-tocopherol).
Purpose of the Study:
- To investigate the impact of LCP-enriched formula on the alpha-tocopherol status of LBWI.
- To compare alpha-tocopherol levels in infants fed HM, standard formula (F), and LCP-enriched formula (LCP-F).
Main Methods:
- A study involving LBWI fed HM (n=15), F (n=8), or LCP-F (n=9) for 21 days.
- Measurement of plasma alpha-tocopherol concentrations and erythrocyte membrane alpha-tocopherol levels on days 4 and 21.
- Analysis of alpha-tocopherol to total lipid ratios in plasma and erythrocyte membranes.
Main Results:
- Plasma alpha-tocopherol significantly increased in infants fed HM, but not in those fed F or LCP-F.
- Erythrocyte membrane alpha-tocopherol to total lipid ratios decreased significantly in infants fed LCP-F.
- No significant changes in plasma alpha-tocopherol/total lipid ratios or erythrocyte membrane alpha-tocopherol concentrations were observed in any group.
Conclusions:
- LCP supplementation derived from egg lipids and fish oil may lead to a decrease in erythrocyte membrane vitamin E status in LBWI.
- Careful evaluation of different LCP forms in infant formula is crucial for understanding their effects on infant vitamin E status.
Abstract:
It is recommended in Europe that low birthweight infants (LBWI) who do not receive human milk (HM) should be fed formula enriched with long-chain polyunsaturated fatty acids (LCP). The question has been raised whether LCP supplementation to LBWI formula may have adverse effects on antioxidant status in the recipient infant, particularly on the major lipid-soluble antioxidant vitamin E (alpha-tocopherol, alpha-toc.). We studied alpha-toc. status in LBWI fed HM (n = 15) or formula either without (f, n = 8) or with LCP derived from egg lipids and fish oil (LCP-F, n = 9) on days 4 and 21 of life. Plasma alpha-toc. concentrations increased significantly in infants fed HM [d. 4: 4.53 (1.31), d. 21: 6.35 (2.18), mg/l, mean (SD), p < 0.01], whereas there were no changes in infants fed F of LCP-F. Plasma alpha-toc./total lipid ratios and erythrocyte membrane alpha-toc. concentrations did not change significantly between days 4 and 21 in either group. In contrast, erythrocyte membrane alpha-toc./total lipid ratios decreased significantly in infants fed LCP-F [0.42 (0.13) vs. 0.31 (0.06), p < 0.05], whereas no change occurred in the other two groups. We conclude that an LCP supplementation based on egg lipids and fish oil to formula may induce an early postnatal decrease of alpha-toc./total lipid ratios in erythrocyte membranes of LBWI. Therefore, the effects of different forms of LCP supplementation to infant formula on infantile vitamin E status should be carefully evaluated.