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Palm Oil and Beta-Palmitate in Infant Formula - A Position Paper by the ESPGHAN Committee on Nutrition

Despite available data on potential benefits of SN-2-palmitate and potential nonbeneficial effects of PO/POL used in infant formulas, the current evidence remains inconsistent and does not allow definite conclusions to be drawn. Published studies have variable methodology, differ in subject characteristics, and some of them are underpowered for the key outcomes. Many of the studies combine different interventions, such as partially hydrolyzed protein, prebiotic oligosaccharides, and in some studies experimental and control formula differ in other aspects-like protein source and composition, carbohydrates, or mineral content. Changes in Ca and PA absorption have been reported that may represent the physiological background for some clinical situations, such as infantile colic, constipation, or lower BMC and BMD. PO/POL seem to be associated with harder stools, on the contrary, SN-2-palmitate use may lead to softer stool consistency. Bone effects seem to be short-lasting. For some of the outcomes (infant colic, faecal microbiota, lipid metabolism), the number of studies is very limited and summary evidence inconclusive. There are no studies published on the effect of PO/POL/SN-2 in infant formulas and long-term outcomes/markers of later diseases (CVD, T2DM, obesity, hypertension, cancer, or long-lasting changes in lipid profile). Growth and infant health-related quality of life seems not to be influenced irrespective of PO/POL/SN-2 content of the formula. The majority of the studies are supported by (or performed by employees of) infant formula producers. Moreover, in several studies, high SN-2 palmitate formula remains inferior to breast feeding. Thus, because of the lack of high-quality evidence and inconsistency in the findings of the studies presented here, current guidelines do not mandate the inclusion of high SN-2 palmitate in infant formulas. EFSA successively rejected 2 health claim petitions for beta-palmitate in 2011 and 2014, respectively. There are also other potential health benefits of high dietary SN-2 palmitate suggested in animals, like reduced gut inflammation in a colitis model and altered tissue endocannabinoid concentrations that warrant further scientific attention.

colic ; constipation ; growth ; lipids ; palm olein ; palmitic acid

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