Yael Lifshitz

Effect of high β-palmitate content in infant formula on the intestinal microbiota of term infants.

Objectives: Palmitic acid (PA) constitutes 17% to 25% of the human milk fatty acids, and ∼70% is esterified in the sn-2 position of triglycerides (&bgr;-palmitate). In the sn-2 position, PA is not hydrolyzed and thus is efficiently absorbed. The PA in palm oils, commonly used in infant formulas, is esterified in the sn-1 and sn-3 positions. In these positions, PA is hydrolyzed and forms poorly absorbed calcium complexes. The present study assessed whether high &bgr;-palmitate in infant formulas affects the intestinal flora. Methods: Thirty-six term infants were enrolled: 14 breast-fed (BF group) and 22 formula-fed infants who were randomly assigned to receive formula containing high &bgr;-palmitate (HBP group, n = 14), or low &bgr;-palmitate (LBP group, n = 8), where 44% and 14% of the PA was &bgr;-palmitate, respectively. The total amount of PA in the formulas was 19% and 22% in the LBP and HBP groups, respectively. Neither formula contained pre- or probiotics. Stool samples were collected at enrollment and at 6 weeks for the quantification of bacteria. Results: At 6 weeks, the HBP and BF groups had higher Lactobacillus and bifidobacteria counts than the LBP group (P < 0.01). The Lactobacillus counts at 6 weeks were not significantly different between the HBP and BF groups. Lactobacillus counts were 1.2 × 1010, 1.2 × 1011, and 5.6 × 1010 CFU/g for LBP, HBP, and BF groups, respectively. Bifidobacteria counts were 5.1 × 109, 1.2 × 1011, and 3.9 × 1010 CFU/g for LBP, HBP, and BF groups, respectively. Conclusions: HBP formula beneficially affected infant gut microbiota by increasing the Lactobacillus and bifidobacteria counts in fecal stools.

The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints: a pilot study

Objective To evaluate the efficacy and safety of soybean-derived phosphatidylserine (SB-PS) (300 mg/day) in improving cognitive performance in elderly with memory complaints, following a short duration of 12 weeks’ SB-PS administration. Methods SB-PS was administered daily for 12 weeks to 30 elderly volunteers with memory complaints (age range 50–90 years). Cognitive performance was determined by a computerized test battery and by the Rey Auditory Verbal Learning Test (Rey-AVLT). Physical examination and blood safety parameters were part of the extensive safety analysis of PS that was performed. Results The computerized test results showed that SB-PS supplementation significantly increased the following cognitive parameters: memory recognition (P = 0.004), memory recall (P = 0.006), executive functions (P = 0.004), and mental flexibility (P = 0.01). The Rey-AVLT indicated that, following SB-PS administration, total learning and immediate recall improved significantly (P = 0.013 and P = 0.007, respectively). Unexpected results from the safety tests suggested that SB-PS significantly reduces both systolic (P = 0.043) and diastolic (P = 0.003) blood pressure. SB-PS consumption was well tolerated and no serious adverse events were reported during the study. Conclusion This exploratory study demonstrates that SB-PS may have favorable effects on cognitive function in elderly with memory complaints. In addition, the study suggests that SB-PS is safe for human consumption and may serve as a safe alternative to phosphatidylserine extracted from bovine cortex. These results encourage further extended studies in order to establish the safety and efficacy of SB-PS treatment.

Review of sn-2 palmitate oil implications for infant health

Human milk provides the optimal balanced nutrition for the growing infant in the first months after birth. The human mammary gland has evolved with unusual pathways, resulting in a specific positioning of fatty acids at the outer sn-1 and sn-3, and center sn-2 of the triacylglyceride, which is different from the triglycerides in other human tissues and plasma. The development of structured triglycerides enables mimicking the composition as well as structure of human milk fat in infant formulas. Studies conducted two decades ago, together with very recent studies, have provided increasing evidence that this unusual positioning of 16:0 in human milk triglycerides has a significant role for infant health in different directions, such as fat and calcium absorption, bone health, intestinal flora and infant comfort. This review aims to unravel the relevance of human milk triglyceride sn-2 16:0 for intestinal health and inflammatory pathways and for other post-absorption effects.

High beta-palmitate fat controls the intestinal inflammatory response and limits intestinal damage in mucin Muc2 deficient mice.

Background Palmitic-acid esterified to the sn-1,3 positions of the glycerol backbone (alpha, alpha’-palmitate), the predominant palmitate conformation in regular infant formula fat, is poorly absorbed and might cause abdominal discomfort. In contrast, palmitic-acid esterified to the sn-2 position (beta-palmitate), the main palmitate conformation in human milk fat, is well absorbed. The aim of the present study was to examine the influence of high alpha, alpha’-palmitate fat (HAPF) diet and high beta-palmitate fat (HBPF) diet on colitis development in Muc2 deficient (Muc2−/−) mice, a well-described animal model for spontaneous enterocolitis due to the lack of a protective mucus layer. Methods Muc2−/− mice received AIN-93G reference diet, HAPF diet or HBPF diet for 5 weeks after weaning. Clinical symptoms, intestinal morphology and inflammation in the distal colon were analyzed. Results Both HBPF diet and AIN-93G diet limited the extent of intestinal erosions and morphological damage in Muc2−/− mice compared with HAPF diet. In addition, the immunosuppressive regulatory T (Treg) cell response as demonstrated by the up-regulation of Foxp3, Tgfb1 and Ebi3 gene expression levels was enhanced by HBPF diet compared with AIN-93G and HAPF diets. HBPF diet also increased the gene expression of Pparg and enzymatic antioxidants (Sod1, Sod3 and Gpx1), genes all reported to be involved in promoting an immunosuppressive Treg cell response and to protect against colitis. Conclusions This study shows for the first time that HBPF diet limits the intestinal mucosal damage and controls the inflammatory response in Muc2−/− mice by inducing an immunosuppressive Treg cell response.

SN2-Palmitate Reduces Fatty Acid Excretion in Chinese Formula-fed Infants.

Objectives: Palmitic acid (PA) comprises 17% to 25% of human milk fatty acids, of which 70% to 75% are esterified to the SN2 position of the triglyceride (SN2-palmitate). In vegetable oils, which are commonly used in infant formulas, palmitate is primarily esterified to other positions, resulting in reduced calcium and fat absorption and hard stools. The aim of this study was to elucidate the effects of SN2-palmitate on nutrient excretion. Methods: In total, 171 Chinese infants were included (within 14 days of birth) in this multicenter study. Formula-fed infants were randomly assigned to receive either SN2-palmitate formula (INFAT, n = 57) or control formula (n = 57). The formulas (Biostime, China) differed only in their SN2 PA proportions. Stool was collected at 6 postnatal weeks. Results: The stool dry weight and fat content of the SN2-palmitate group were lower compared with the control group (dry weight 4.25 g vs 7.28 g, P < 0.05; fat 0.8 g vs 1.2 g, P < 0.05). The lipid component was also significantly lower for the SN2-palmitate group (0.79 g vs 1.19 g, P < 0.05). PA, representing ∼50% of the saponified fatty acids, was significantly lower in the SN2-palmitate group compared with the control group (0.3 g vs 0.7 g, P < 0.01). Breast-fed infants had a significantly lower stool dry weight, fat content, and saponified fat excretion compared with formula-fed infants (P < 0.01). Conclusions: Similar to breast milk, the SN2-palmitate infant formula primarily reduced calcium-saponified fat excretion. The results of this study further emphasize the nutritional importance of SN2-palmitate structured fat for infants.

SN2-Palmitate Improves Crying and Sleep in Infants Fed Formula withPrebiotics: A Double-Blind Randomized Clinical Trial

Background and Aim: Palmitic acid (PA, C16:0), one of the major saturated fatty acids in human milk fat being 17-25% of the fatty acids, is esterified mainly at the SN2-position (SN2-palmitate). Contrary in vegetable oils, which are commonly used as fat source in infant formulas, PA is esterified mainly at the outer positions, i.e, SN1 and SN3 positions, resulting in reduced fat absorption and harder stools. SN2-palmitate and prebiotics have been shown to improve digestion and reduce stool hardness. Our aim was to study the potential effects of SN2-palmitate in addition to prebiotics in formula-fed Chinese infants. Methods: 171 healthy term infants were included (within 14 days from birth) in the study. Formula-fed infants were randomly assigned to receive either SN2-palmitate containing formula (INFAT®, Advanced Lipids), (n=57) or a Control formula (n=57). The two study formulas (Biostime, China) differed only in the ratio of PA at the SN2-position (43% vs. 13%). A similar group of breastfed infants (n=57) was included as a reference. Results: The pattern of crying and sleep differed between the formula-fed groups. Fewer infants in the SN2 group cried at 12 weeks (23.2% vs. 45.5%, p<0.05); they had fewer crying episodes (2.0 vs. 3.6, at 6 weeks, p<0.05 and 1.0 vs. 2.2 at 12 weeks, p<0.02) and the duration of crying was lower (25.1 vs. 41.3 min at 6 weeks, p<0.05 and 11.2 vs. 21.2 min at 12 weeks, p<0.01) similar to the crying pattern of breastfed infants. Moreover, the infants in the SN2 group had longer daily sleep duration. Conclusions: SN2-palmitate formula improves crying and sleeps patterns in addition to prebiotics in the first weeks of life. Thereby, SN2-palmitate improves the well-being of formula-fed infants and consequently the quality of life of their parents, further emphasizing the importance of SN2-palmitate for infant nutrition.