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Table 1 Characteristics of studies investigating the influence of β-palmitate on infant’s health

From: Beta-palmitate – a natural component of human milk in supplemental milk formulas

Authors [Reference] Patients Duration of the study Type of study Results
Bongers et al., 2007 [25] 38 constipated infants (3–20 weeks) randomised to standard formula (n = 18) and modified formula (n = 20) 3 weeks RCT Significant tendency towards softer stools in constipated infants fed formula containing sn-2 palmitic acid, mixture of prebiotic oligosaccharides and partially hydrolysed whey protein; no difference in stool frequency.
Carnielli et al., 1995 [18] Preterm infants (n = 12) 1 week RCT A formula containing triglycerides similar to human milk (26 % palmitic acid, esterified predominantly to the sn-2 position) had significant effects on fatty acid intestinal absorption, and improved mineral balance in comparison with a conventional formula.
Carnielli et al., 1996 [11] Healthy, term infants (n = 9) At least 5 weeks RCT Dietary triacylglycerols containing palmitic acid predominantly at the β-position, as in human milk, had significant beneficial effects on the intestinal absorption of fat and calcium in healthy term infants.
Innis et al., 1994 [2] Breastfed (n = 17) and formula-fed infants (n = 18) 3 months Not specified 16:0 triacylglycerols were absorbed from human milk similar to sn-2 monoacylglycerols.
Kennedy et al., 1999 [20] Healthy, term neonates fed with standard formula (n = 103), high sn-2 formula (n = 100) and breastfed infants (n = 120) 12 weeks RCT Infants receiving high sn-2 formula, similar to breastfed infants, had higher bone mineral content, softer stools and a lower proportion of stool soap fatty acids than infants receiving a standard formula.
Litmanowitz et al., 2013 [21] 83 term infants fed with high β-palmitate formula (n = 30), standard formula (n = 28) and breastfed (n = 25) 12 weeks RCT Infants consuming high β-palmitate formula had changes in the bone speed of sound that were comparable to breastfed infants and favourable compared to infants on low β-palmitate formula.
Litmanowitz et al., 2014 [30] Formula-fed infants with high β-palmitate (n = 21), standard vegetable oil mix (n = 21) or breastfed infants (n = 21) 12 weeks RCT Consumption of a high β-palmitate formula, comparable to breast-feeding, affects infant crying patterns during the first weeks of life.
Lopéz-Lopéz et al., 2001 [3] 36 healthy full-term infants: 12 infants fed with human milk, 12 infants fed with formula containing 19 % palmitic acid esterified in the β-position (α-formula) for 2 months, 12 infants fed with the α-formula during the first month and with the β-formula (44.5 % palmitic acid in β-position) during the second month 2 months RCT of formula-fed infants, non-randomised group of breastfed infants Consumption of a high β-palmitate formula significantly reduced the contents of total fatty acids and palmitic acid in faeces.
Lopéz A. et al., 2002 [36] 120 term infants with different formulas (40 colostrum, 40 transitional milk, 40 mature milk, 11 infant formulas) 15 days RCT of formula-fed infants, non-randomised group of breastfed infants Human milk in Spain had low saturated fatty acids, high monounsaturated fatty acids and high linolenic acid. Infant formulas resemble the fatty acid profile of human milk, but the distribution of fatty acids at the sn-2 position was markedly different.
Lucas et al., 1997 [27] 24 preterm infants fed with formula that differed in content of palmitate in the sn-2 position in the formula (74, 8.4 and 28 %). 4 days RCT Use of a formula rich in sn-2 position palmitate improved palmitate absorption, reduced the formation of insoluble calcium soaps in the stool, and improved calcium absorption.
Nelson and Innis, 1999 [15] 87 healthy, full-term infants (40 breastfed, 22 fed with the standard formula and 25 fed with the formula containing synthesised triacylglycerol (39 % of the 16:0 esterified at the triacylglycerol 2 position). 120 days RCT of formula-fed infants, non-randomised group of breastfed infants 50 % of the dietary triacylglycerol 2-position 16:0 is conserved through digestion, absorption and chylomicron triacylglycerol synthesis in breastfed and formula-fed Infants. Infants fed the synthesised triacylglycerol formula had significantly lower HDL-cholesterol and apolipoprotein A-I and higher apolipoprotein B concentrations than infants fed the standard formula.
Nowacki et al., 2014 [24] 165 healthy, term infants fed with standard formula (n = 54), formula containing high sn-2 palmitate (n = 56), or formula containing high sn-2 palmitate plus oligofructose (n = 55), and 55 breastfed infants 25–45 days RCT of formula-fed infants, non-randomised group of breastfed infants Increasing sn-2 palmitate in infant formula reduced stool palmitate soaps. A combination of high sn-2 palmitate and oligofructose reduced stool palmitate soaps, total soaps and calcium, while promoting softer stools.
Quinlan et al., 1995 [23] 20 formula-fed and 10 breastfed infants 7 days Single blinded trial Differences in lipids between formula- and breastfed infants’ stools were due almost entirely to FAs (mainly C16:0 and C18:0) excreted as soaps. FA soaps, predominantly saturated, accounted for one-third of the stool dry weight. These data support the hypothesis that calcium FA soaps are positively related to stool hardness.
Savino et al., 2006 [29] 199 formula-fed infants with infantile colic fed with standard formula and simethicone (n = 103) and special formula (partially hydrolysed whey proteins, mixture of oligosaccharides, low lactose level and modified vegetable oil with 41 % palmitic acid in the β-position and starch, n = 96) 14 days RCT The use of special formula (containing partially hydrolysed whey proteins, prebiotic oligosaccharides with a high β-palmitic acid content) reduced crying episodes in infants with colic compared with a standard formula and simethicone
Yao et al., 2014 [26] 300 healthy, formula-fed, term infants, fed with four formulas: standard formula (n = 75), high sn-2 palmitate term infant formula (n = 74), an identical formula supplemented with oligofructose at two concentrations (3 vs. 5 g) (n = 76, n = 75), and breastfed infants (n = 73) 8 weeks RCT High sn-2-palmitate formulas led to reduced stool soaps, softer stools and increased bifidobacteria, whereas addition of oligofructose further improved stool consistency.
Yaron et al., 2013 [34] 36 term infants: 14 breastfed, 22 formula-fed who were randomly assigned into high β-palmitate (n = 14) or low β-palmitate (n = 8) formula-fed infants 6 week RCT High β-palmitate formula beneficially affected infant gut microbiota by increasing the Lactobacillus and bifidobacteria counts in faecal stools.