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Should formula for infants provide arachidonic acid along with DHA? A position paper of the European Academy of Pediatrics and the Child Health Foundation

Should formula for infants provide arachidonic acid along with DHA? A position paper of the European Academy of Pediatrics and the Child Health Foundation
Should formula for infants provide arachidonic acid along with DHA? A position paper of the European Academy of Pediatrics and the Child Health Foundation
Recently adopted regulatory standards on infant and follow-on formula for the European Union stipulate that from 2021 onwards, all such products marketed in the European Union must contain 20-50 mg/100 kcal of omega-3 docosahexaenoic acid (DHA), which is equivalent to about 0.5-1 % of fatty acids and thus higher than typically found in human milk and current infant formula products, without the need to also include omega-6 arachidonic acid (ARA). This novel concept of infant formula composition has given rise to concern and controversy since there is no accountable evidence on the suitability and safety in healthy infants. Therefore, international experts in the field of infant nutrition were invited to review the state of scientific research on DHA and ARA, and to discuss the questions arising from the new European regulatory standards. Based on the available information, we recommend that infant and follow-on formula should provide both DHA and ARA. The DHA should equal at least the mean content in human milk globally (0.3 % of fatty acids) but preferably reach a level of 0.5 % of fatty acids. While optimal ARA intake levels remain to be defined, we strongly recommend that ARA should be provided along with DHA. At levels of DHA in infant formula up to about 0.64%, ARA contents should at least equal the DHA contents. Further well-designed clinical studies should evaluate the optimal intakes of DHA and ARA in infants at different ages based on relevant outcomes
European Commission Formula Delegated Act 2016/127, breast milk substitutes, food safety, infant nutrition, long-chain PUFAs
0002-9165
10-16
Koletzko, Berthold
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Bergmann, Karin
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Brenna, J. Thomas
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Calder, Philip
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Campoy, Cristina
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Colombo, John
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van Goudoever, Johannes B
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Bergmann, Karin
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Calder, Philip
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Mader, Silke
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Martin, Camilia R.
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Matthäus, Valerie
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Smuts, Cornelius M.
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Strain, Sean JJ
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Carlson, Susan E.
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Koletzko, Berthold, Bergmann, Karin, Brenna, J. Thomas, Calder, Philip, Campoy, Cristina, Clandinin, M. Tom, Colombo, John, Daly, Mandy, Descsi, Tamás, Demmelmair, Hans, Domellöf, Magnus, Fidler Mi, Nataša, Gonzalez-Casanova, Ines, van Goudoever, Johannes B, Hadjipanayis, Adamos, Hernell, Olle, Lapillonne, Alexandre, Mader, Silke, Martin, Camilia R., Matthäus, Valerie, Ramakrishan, Usha, Smuts, Cornelius M., Strain, Sean JJ, Tanjung, Conny, Tounian, Patrick and Carlson, Susan E. (2020) Should formula for infants provide arachidonic acid along with DHA? A position paper of the European Academy of Pediatrics and the Child Health Foundation. American Journal of Clinical Nutrition, 111 (1), 10-16. (doi:10.1093/ajcn/nqz252).

Record type: Article

Abstract

Recently adopted regulatory standards on infant and follow-on formula for the European Union stipulate that from 2021 onwards, all such products marketed in the European Union must contain 20-50 mg/100 kcal of omega-3 docosahexaenoic acid (DHA), which is equivalent to about 0.5-1 % of fatty acids and thus higher than typically found in human milk and current infant formula products, without the need to also include omega-6 arachidonic acid (ARA). This novel concept of infant formula composition has given rise to concern and controversy since there is no accountable evidence on the suitability and safety in healthy infants. Therefore, international experts in the field of infant nutrition were invited to review the state of scientific research on DHA and ARA, and to discuss the questions arising from the new European regulatory standards. Based on the available information, we recommend that infant and follow-on formula should provide both DHA and ARA. The DHA should equal at least the mean content in human milk globally (0.3 % of fatty acids) but preferably reach a level of 0.5 % of fatty acids. While optimal ARA intake levels remain to be defined, we strongly recommend that ARA should be provided along with DHA. At levels of DHA in infant formula up to about 0.64%, ARA contents should at least equal the DHA contents. Further well-designed clinical studies should evaluate the optimal intakes of DHA and ARA in infants at different ages based on relevant outcomes

Text
AJCN-D-19-00876 Rev 1_LC-PUFA infant formula-CLEAN - Accepted Manuscript
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More information

Accepted/In Press date: 9 September 2019
e-pub ahead of print date: 26 October 2019
Published date: January 2020
Keywords: European Commission Formula Delegated Act 2016/127, breast milk substitutes, food safety, infant nutrition, long-chain PUFAs

Identifiers

Local EPrints ID: 434154
URI: http://eprints.soton.ac.uk/id/eprint/434154
ISSN: 0002-9165
PURE UUID: 3028e608-0dd1-4550-b361-7cd788c2c0d2
ORCID for Philip Calder: ORCID iD orcid.org/0000-0002-6038-710X

Catalogue record

Date deposited: 13 Sep 2019 16:30
Last modified: 26 Nov 2021 06:12

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Contributors

Author: Berthold Koletzko
Author: Karin Bergmann
Author: J. Thomas Brenna
Author: Philip Calder ORCID iD
Author: Cristina Campoy
Author: M. Tom Clandinin
Author: John Colombo
Author: Mandy Daly
Author: Tamás Descsi
Author: Hans Demmelmair
Author: Magnus Domellöf
Author: Nataša Fidler Mi
Author: Ines Gonzalez-Casanova
Author: Johannes B van Goudoever
Author: Adamos Hadjipanayis
Author: Olle Hernell
Author: Alexandre Lapillonne
Author: Silke Mader
Author: Camilia R. Martin
Author: Valerie Matthäus
Author: Usha Ramakrishan
Author: Cornelius M. Smuts
Author: Sean JJ Strain
Author: Conny Tanjung
Author: Patrick Tounian
Author: Susan E. Carlson

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