medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-17-246-252medsovet-2727Research ArticleШкола педиатраSchool for pediatricianЧто мы знаем сегодня о жировом профиле грудного молока и современных искусственных смесей для питания детей с рождения?What do we know today about the fat profile of breast milk and modern artificial infant formulas?ЗахароваИ. Н.ZakharovaI. N.

Захарова Ирина Николаевна – доктор медицинских наук, профессор, заведующая кафедрой педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанско

Москва

КасьяноваА. Н.KasyanovaA. N.

Касьянова Анна Николаевна – клинический ординатор кафедры педиатрии с курсом поликлинической педиатрии им. Г.Н. Сперанского

Москва

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Vocational Education of the Ministry of Health of RussiaRussian Federation201822102018017246253Copyright © Захарова И.Н., Касьянова А.Н., 20182018Захарова И.Н., Касьянова А.Н.Zakharova I.N., Kasyanova A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2727

В статье представлен современный взгляд на жировой профиль грудного молока (ГМ) и современных искусственных смесей. Молочный жир ГМ является основным источником энергии в организме младенца. Основу жирового компонента ГМ составляют триглицериды, которые представлены жировыми глобулами молока. ГМ характеризуется также оптимальным содержанием и соотношением жирных кислот. В нем присутствуют эссенциальные полиненасыщенные жирные кислоты (ПНЖК), такие как линолевая и α-линоленовая кислоты с производными. ПНЖК включаются в состав молока, оказывая как краткосрочное, так и долгосрочное влияние на развитие младенца. В статье приведены результаты исследований, показавшие роль добавок рыбьего жира в рацион беременных и кормящих женщин, что приводило к значительному увеличению содержания докозагексаеновой кислоты в молоке. Доказано, что ПНЖК обеспечивают формирование головного мозга, нейросетчатки у младенцев, участвуют в иммунологических процессах. Пальмитиновая кислота является наиболее распространенным насыщенным жиром в ГМ. Если в организм младенца поступает пальмитиновая кислота, расположенная в Sn-1 и Sn-3 положении, это оказывает влияние на образование нерастворимых кальциевых мыл и появление более плотного стула. Эти свойства β-пальмитата учитываются при разработке новых подходов к созданию смесей для питания детей, приближая их жировой состав к составу ГМ. Уникальный запатентованный компонент DigestX®, входящий в состав смесей на основе козьего молока Kabrita®Gold, разработан с целью приближения жирового компонента смесей к уникальной структуре жира ГМ. Показано, что смеси с высоким содержанием β-пальмитата обеспечивают различные метаболические функции, а также влияют на формирование иммунитета малыша, состав его кишечного микробиома. Немаловажное значение придается смесям с β-пальмитатом в формировании костного матрикса организма ребенка.

The article presents a modern view of the fat acid profile of breast milk (BM) and modern artificial formulas. Milk fat of BM is the main source of energy for baby. Triglycerides, which are represented by fat globules of milk form the basis of the fat component of BM. BM is also characterized by the optimal content and ratio of fatty acids. It contains essential polyunsaturated fatty acids (PUFA), such as linoleic and α-linolenic acids with derivatives. PUFAs are included in the milk composition, providing both short-term and long-term effects on infant development. The article presents the results of studies showing the role of fish oil supplements in the diet of pregnant and lactating women, which led to a significant increase of docosahexaenoic acid content in the milk. It is proved that PUFAs are involved in the formation of the brain, neuroretina in infants, participate in immunological processes. Palmitic acid is the most common saturated fat in the BM. If palmitic acid, located in Sn-1 and Sn-3 position, is included in the infant feeding, it affects the formation of insoluble calcium soaps and the formation of a stiffer stool. These properties of β-palmitate are taken into account when developing new approaches to creating formlulas for feeding children, bringing their fat composition closer to the composition of GM. The unique patented DigestX® component, which is part of Kabrita® Gold’s goat milk mixes, is designed to bring the fat component of the blends closer to the unique structure of BM fat. It is shown that mixtures with a high content of β-palmitate provide various metabolic functions, and affect the formation of the infant immunity, the composition of its intestinal microbiota. The formulas with β-palmitate play an important role in forming the bone matrix of the child.

грудное молокоискусственное вскармливаниежировой компонентмолочный жирсоставмембраны жировых глобул молокатриглицеридыполиненасыщенные жирные кислотыминеральная плотность костной тканиβ-пальмитатпальмитиновая кислотакомпонентDigestX®breast milkartificial feedingfat componentmilk fatcompositionmilk fat globule membranestriglyceridespolyunsaturated fatty acidsbone mineral densityβ-palmitatepalmitic acidcomponentDigestX®ReferencesЗахарова И.Н., Мачнева Е.Б., Облогина И.С. Грудное молоко – живая ткань! Как сохранить грудное вскармливание? Медицинский совет, 2017, 19: 24-29.Zakharova IN, Machneva EB, Oblogina IS. Breast milk is a living tissue! How to keep breastfeeding? Meditsinsky Sovet, 2017, 19: 24-29.Demmelmair H, Koletzko B. Lipids in human milk. Best Pract Res Clin Endocrinol Metab, 2018, 32(1): 57-68. doi: 10.1016/j.beem.2017.11.002.Demmelmair H, Koletzko B. Lipids in human milk. Best Pract Res Clin Endocrinol Metab, 2018, 32(1): 57-68. doi: 10.1016/j.beem.2017.11.002.Saarela T, Kokkonen J, Koivisto M. Macronutrient and energy contents of human milk fractions during the first six months of lactation. Acta Paediatr, 2005, 94: 1176e81.Saarela T, Kokkonen J, Koivisto M. Macronutrient and energy contents of human milk fractions during the first six months of lactation. Acta Paediatr, 2005, 94: 1176e81.Delplanque B, Gibson R, Koletzko B et al. Lipid quality in infant nutrition: current knowledge and future opportunities. J Pediatr Gastroenterol Nutr, 2015, 61: 8e17.Delplanque B, Gibson R, Koletzko B et al. Lipid quality in infant nutrition: current knowledge and future opportunities. J Pediatr Gastroenterol Nutr, 2015, 61: 8e17.Kent JC, Mitoulas LR, Cregan MD et al. Volume and frequency of breastfeedings and fat content of breast milk throughoutthe day. Pediatrics, 2006, 117: e387e95.Kent JC, Mitoulas LR, Cregan MD et al. Volume and frequency of breastfeedings and fat content of breast milk throughoutthe day. Pediatrics, 2006, 117: e387e95.Marangoni F, Agostoni C, Lammardo AM et al. Polyunsaturated fatty acid concentrations in human hindmilk are stable throughout 12-months of lactation and provide a sustained intake to the infant during exclusive breastfeeding: an Italian study. Br J Nutr, 2000, 84: 103e9.Marangoni F, Agostoni C, Lammardo AM et al. Polyunsaturated fatty acid concentrations in human hindmilk are stable throughout 12-months of lactation and provide a sustained intake to the infant during exclusive breastfeeding: an Italian study. Br J Nutr, 2000, 84: 103e9.Захарова И.Н., Дмитриева Ю.А., Гордеева Е.А. Мембрана жировых глобул молока: инновационные открытия уже сегодня. Российский вестник перинатологии и педиатрии, 2015, 60 (6): 15-21.Zakharova IN, Dmitrieva YuA, Gordeeva EA. Milk fat globules membrane: innovative discoveries today. Rossiyskiy Vestnik Perinatologii i Pediatrii, 2015, 60 (6): 15-21.Neville MC, Picciano MF. Regulation of milk lipid secretion and composition. Annu Rev Nutr, 1997, 17: 159e84.Neville MC, Picciano MF. Regulation of milk lipid secretion and composition. Annu Rev Nutr, 1997, 17: 159e84.Koletzko BV, Shamir R. Infant formula: does one size fit all? Curr Opin Clin Nutr Metab Care, 2016, 19: 205e7.Koletzko BV, Shamir R. Infant formula: does one size fit all? Curr Opin Clin Nutr Metab Care, 2016, 19: 205e7.Dewettinck K, Rombaut R, Thienpont N et al. Nutritional and technological aspects of milk fat globule membrane material. Int Dairy J, 2008, 18: 436e57.Dewettinck K, Rombaut R, Thienpont N et al. Nutritional and technological aspects of milk fat globule membrane material. Int Dairy J, 2008, 18: 436e57.Cilla A, Diego Quintaes K, Barbera R et al. Phospholipids in human milk and infant formulas: benefits and needs for correct infant nutrition. Crit Rev Food Sci Nutr, 2016, 56: 1880e92.Cilla A, Diego Quintaes K, Barbera R et al. Phospholipids in human milk and infant formulas: benefits and needs for correct infant nutrition. Crit Rev Food Sci Nutr, 2016, 56: 1880e92.Claumarchirant L, Cilla A, Matencio E et al. Addition of milk fat globule membrane as an ingredient of infant formulas for resembling the polar lipids of human milk. Int Dairy J, 2016, 61: 228e38.Claumarchirant L, Cilla A, Matencio E et al. Addition of milk fat globule membrane as an ingredient of infant formulas for resembling the polar lipids of human milk. Int Dairy J, 2016, 61: 228e38.Thakkar SK, Giuffrida F, Cristina CH et al. Dynamics of human milk nutrient composition of women from Singapore with a special focus on lipids. Am J Hum Biol, 2013, 25: 770e9.Thakkar SK, Giuffrida F, Cristina CH et al. Dynamics of human milk nutrient composition of women from Singapore with a special focus on lipids. Am J Hum Biol, 2013, 25: 770e9.Nilsson A. Role of sphingolipids in infant gut health and immunity. J Pediatr, 2016, 173(Suppl: S53e9).Nilsson A. Role of sphingolipids in infant gut health and immunity. J Pediatr, 2016, 173(Suppl: S53e9).Motouri M, Matsuyama H, Yamamura J et al. Milk sphingomyelin accelerates enzymatic and morphological maturation of the intestine in artificially reared rats. J Pediatr Gastroenterol Nutr, 2003, 36: 241e7.Motouri M, Matsuyama H, Yamamura J et al. Milk sphingomyelin accelerates enzymatic and morphological maturation of the intestine in artificially reared rats. J Pediatr Gastroenterol Nutr, 2003, 36: 241e7.Haruta-Ono Y, Setoguchi S, Ueno HM et al. Orally administered sphingomyelin in bovine milk is incorporated into skin sphingolipids and is involved in the water-holding capacity of hairless mice. J Dermatol Sci, 2012, 68: 56e62.Haruta-Ono Y, Setoguchi S, Ueno HM et al. Orally administered sphingomyelin in bovine milk is incorporated into skin sphingolipids and is involved in the water-holding capacity of hairless mice. J Dermatol Sci, 2012, 68: 56e62.Oshida K, Shimizu T, Takase M et al. Effects of dietary sphingomyelin on central nervous system myelination in developing rats. Pediatr Res, 2003, 53: 589e93.Oshida K, Shimizu T, Takase M et al. Effects of dietary sphingomyelin on central nervous system myelination in developing rats. Pediatr Res, 2003, 53: 589e93.Детское питание: Руководство для врачей. Под ред. В.А. Тутельна, И.Я. Коня. 4-е изд., перераб. и доп. М.: ООО «Медицинское информационное агентство», 2017. 784 с.Baby nutrition: A guide for doctors. Ed. by Tutelna VA, Konya IYa. 4th ed., updated and reviewed. M.: Medical Information Agency LLC, 2017. 784 p.Nakamura T, Aizawa T, Kariya R, Okada S, Demura M, Kawano K, Makabe K, Kuwajima K. Molecular mechanisms of the cytotoxicity of human α-lactalbumin made lethal to tumor cells (HAMLET) and other protein-oleic acid complexes. J Biol Chem, 2013, 288(20): 1440816. doi: 10.1074/jbc.M112.437889.Nakamura T, Aizawa T, Kariya R, Okada S, Demura M, Kawano K, Makabe K, Kuwajima K. Molecular mechanisms of the cytotoxicity of human α-lactalbumin made lethal to tumor cells (HAMLET) and other protein-oleic acid complexes. J Biol Chem, 2013, 288(20): 1440816. doi: 10.1074/jbc.M112.437889.Hakansson AP, Roche-Hakansson H, Mossberg AK, Svanborg C. Apoptosis-like death in bacteria induced by HAMLET, a human milk lipidprotein complex. PLoS One, 2011 Mar 10, 6(3): e17717. doi: 10.1371/journal.pone.0017717.Hakansson AP, Roche-Hakansson H, Mossberg AK, Svanborg C. Apoptosis-like death in bacteria induced by HAMLET, a human milk lipidprotein complex. PLoS One, 2011 Mar 10, 6(3): e17717. doi: 10.1371/journal.pone.0017717.Nakatani H, Maki K, Saeki K, Aizawa T, Demura M, Kawano K, Tomoda S, Kuwajima K. Equilibrium and kinetics of the folding and unfolding of canine milk lysozyme. Biochemistry, 2007 May 1, 46(17): 5238-51.Nakatani H, Maki K, Saeki K, Aizawa T, Demura M, Kawano K, Tomoda S, Kuwajima K. Equilibrium and kinetics of the folding and unfolding of canine milk lysozyme. Biochemistry, 2007 May 1, 46(17): 5238-51.Nakamura T, Makabe K, Tomoyori K, Maki K, Mukaiyama A, Kuwajima K. Different folding pathways taken by highly homologous proteins, goat alpha-lactalbumin and canine milk lysozyme. J Mol Biol, 2010 Mar 12, 396(5): 1361-78. doi: 10.1016/j.jmb.2010.01.021.Nakamura T, Makabe K, Tomoyori K, Maki K, Mukaiyama A, Kuwajima K. Different folding pathways taken by highly homologous proteins, goat alpha-lactalbumin and canine milk lysozyme. J Mol Biol, 2010 Mar 12, 396(5): 1361-78. doi: 10.1016/j.jmb.2010.01.021.Kamijima T, Ohmura A, Sato T, Akimoto K, Itabashi M, Mizuguchi M, Kamiya M, Kikukawa T, Aizawa T, Takahashi M, Kawano K, Demura M. Heat-treatment method for producing fatty acid-bound alpha-lactalbumin that induces tumor cell death. Biochem Biophys Res Commun, 2008 Nov 7, 376(1): 211-4. doi: 10.1016/j.bbrc.2008.08.127.Kamijima T, Ohmura A, Sato T, Akimoto K, Itabashi M, Mizuguchi M, Kamiya M, Kikukawa T, Aizawa T, Takahashi M, Kawano K, Demura M. Heat-treatment method for producing fatty acid-bound alpha-lactalbumin that induces tumor cell death. Biochem Biophys Res Commun, 2008 Nov 7, 376(1): 211-4. doi: 10.1016/j.bbrc.2008.08.127.Fischer W, Gustafsson L, Mossberg AK, Gronli J, Mork S, Bjerkvig R, Svanborg C. Human alphalactalbumin made lethal to tumor cells (HAMLET) kills human glioblastoma cells in brain xenografts by an apoptosis-like mechanism and prolongs survival. Cancer Res, 2004 Mar 15, 64(6): 2105-12.Fischer W, Gustafsson L, Mossberg AK, Gronli J, Mork S, Bjerkvig R, Svanborg C. Human alphalactalbumin made lethal to tumor cells (HAMLET) kills human glioblastoma cells in brain xenografts by an apoptosis-like mechanism and prolongs survival. Cancer Res, 2004 Mar 15, 64(6): 2105-12.Mossberg AK, Wullt B, Gustafsson L, Mansson W, Ljunggren E, Svanborg C. Bladder cancers respond to intravesical instillation of HAMLET (human alpha-lactalbumin made lethal to tumor cells). Int J Cancer, 2007, 121(6): 1352-9.Mossberg AK, Wullt B, Gustafsson L, Mansson W, Ljunggren E, Svanborg C. Bladder cancers respond to intravesical instillation of HAMLET (human alpha-lactalbumin made lethal to tumor cells). Int J Cancer, 2007, 121(6): 1352-9.Gustafsson L, Leijonhufvud I, Aronsson A, Mossberg AK, Svanborg C. Treatment of skin papillomas with topical alpha-lactalbumin-oleic acid. N Engl J Med, 2004, 350(26): 2663-72.Gustafsson L, Leijonhufvud I, Aronsson A, Mossberg AK, Svanborg C. Treatment of skin papillomas with topical alpha-lactalbumin-oleic acid. N Engl J Med, 2004, 350(26): 2663-72.Kim H, Kang S, Jung BM et al. Breast milk fatty acid composition and fatty acid intake of lactating mothers in South Korea. Br J Nutr, 2017, 117: 556e61.Kim H, Kang S, Jung BM et al. Breast milk fatty acid composition and fatty acid intake of lactating mothers in South Korea. Br J Nutr, 2017, 117: 556e61.Yuhas R, Pramuk K, Lien EL. Human milk fatty acid composition from nine countries varies most in DHA. Lipids, 2006, 41: 851e8.Yuhas R, Pramuk K, Lien EL. Human milk fatty acid composition from nine countries varies most in DHA. Lipids, 2006, 41: 851e8.Brenna JT, Varamini B, Jensen RG et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr, 2007, 85: 1457e64.Brenna JT, Varamini B, Jensen RG et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr, 2007, 85: 1457e64.Koletzko B, Cetin I, Brenna JT et al. Dietary fat intakes for pregnant and lactating women. Br J Nutr, 2007, 98: 873e7.Koletzko B, Cetin I, Brenna JT et al. Dietary fat intakes for pregnant and lactating women. Br J Nutr, 2007, 98: 873e7.Del Prado M, Villalpando S, Elizondo A et al. Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet. Am J Clin Nutr, 2001, 74: 242e7.Del Prado M, Villalpando S, Elizondo A et al. Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet. Am J Clin Nutr, 2001, 74: 242e7.Demmelmair H, Kuhn A, Dokoupil K et al. Human lactation: oxidation and maternal transfer of dietary (13)C-labelled alpha-linolenic acid into human milk. Isot Environ Health Stud, 2016, 52: 270e80.Demmelmair H, Kuhn A, Dokoupil K et al. Human lactation: oxidation and maternal transfer of dietary (13)C-labelled alpha-linolenic acid into human milk. Isot Environ Health Stud, 2016, 52: 270e80.Fidler N, Sauerwald T, Pohl A et al. Docosahexaenoic acid transfer into human milk after dietary supplementation: a randomized clinical trial. J Lipid Res, 2000, 41: 1376e83.Fidler N, Sauerwald T, Pohl A et al. Docosahexaenoic acid transfer into human milk after dietary supplementation: a randomized clinical trial. J Lipid Res, 2000, 41: 1376e83.Sherry CL, Oliver JS, Marriage BJ. Docosahexaenoic acid supplementation in lactating women increases breast milk and plasma docosahexaenoic acid concentrations and alters infant omega 6: 3 fatty acid ratio. Prostagl Leukot Essent Fat Acids, 2015, 95: 63e9.Sherry CL, Oliver JS, Marriage BJ. Docosahexaenoic acid supplementation in lactating women increases breast milk and plasma docosahexaenoic acid concentrations and alters infant omega 6: 3 fatty acid ratio. Prostagl Leukot Essent Fat Acids, 2015, 95: 63e9.Helland IB, Saarem K, Saugstad OD et al. Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil. Eur J Clin Nutr, 1998, 52: 839e45.Helland IB, Saarem K, Saugstad OD et al. Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil. Eur J Clin Nutr, 1998, 52: 839e45.Makrides M, Neumann MA, Gibson RA. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr, 1996, 50: 352e7.Makrides M, Neumann MA, Gibson RA. Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition. Eur J Clin Nutr, 1996, 50: 352e7.Brenna JT, Lapillonne A. Background paper on fat and fatty acid requirements during pregnancy and lactation. Ann Nutr Metab, 2009, 55: 97e122.Brenna JT, Lapillonne A. Background paper on fat and fatty acid requirements during pregnancy and lactation. Ann Nutr Metab, 2009, 55: 97e122.Lattka E, Rzehak P, Szabo E et al. Genetic variants in the FADS gene cluster are associated with arachidonic acid concentrations of human breast milk at 1.5 and 6 mo postpartum and influence the course of milk dodecanoic, tetracosenoic, and trans-9-octadecenoic acid concentrations over the duration of lactation. Am J Clin Nutr, 2011, 93: 382e91.Lattka E, Rzehak P, Szabo E et al. Genetic variants in the FADS gene cluster are associated with arachidonic acid concentrations of human breast milk at 1.5 and 6 mo postpartum and influence the course of milk dodecanoic, tetracosenoic, and trans-9-octadecenoic acid concentrations over the duration of lactation. Am J Clin Nutr, 2011, 93: 382e91.Morales E, Bustamante M, Gonzalez JR et al. Genetic variants of the FADS gene cluster and ELOVL gene family, colostrums LC-PUFA levels, breastfeeding, and child cognition. Plos One, 2011, 6, e17181.Morales E, Bustamante M, Gonzalez JR et al. Genetic variants of the FADS gene cluster and ELOVL gene family, colostrums LC-PUFA levels, breastfeeding, and child cognition. Plos One, 2011, 6, e17181.Molto-Puigmarti C, Plat J, Mensink RP et al. FADS1 FADS2 gene variants modify the association between fish intake and the docosahexaenoic acid proportions in human milk. Am J Clin Nutr, 2010, 91: 1368e76.Molto-Puigmarti C, Plat J, Mensink RP et al. FADS1 FADS2 gene variants modify the association between fish intake and the docosahexaenoic acid proportions in human milk. Am J Clin Nutr, 2010, 91: 1368e76.Yeates AJ, Love TM, Engstrom K et al. Genetic variation in FADS genes is associated with maternal long-chain PUFA status but not with cognitive development of infants in a high fish-eating observational study. Prostagl Leukot Essent Fat Acids, 2015, 102e103: 13e20.Yeates AJ, Love TM, Engstrom K et al. Genetic variation in FADS genes is associated with maternal long-chain PUFA status but not with cognitive development of infants in a high fish-eating observational study. Prostagl Leukot Essent Fat Acids, 2015, 102e103: 13e20.Мосин И.М., Захарова И.Н., Суркова Е.Н. Роль ω-З полиненасыщенных жирных кислот в формировании зрительных функций. Рефракционная хирургия и офтальмология, 2010, 10(3): 47-50.Mosin IM, Zakharova IN, Surkova EN. The role of ω-3 polyunsaturated fatty acids in the formation of visual functions. Refraktsionnaya Khirurgiya i Oftalmologiya, 2010, 10 (3): 47-50.Demmelmair H, Koletzko B. Importance of fatty acids in the perinatal period. World Rev Nutr Diet, 2015, 112: 31e47.Demmelmair H, Koletzko B. Importance of fatty acids in the perinatal period. World Rev Nutr Diet, 2015, 112: 31e47.Havlicekova Z, Jesenak M, Banovcin P, Kuchta M. Beta-palmitate – a natural component of human milk in supplemental milk formulas. Nutr J, 2016, 17, 15: 28. doi: 10.1186/s12937016-0145-1.Havlicekova Z, Jesenak M, Banovcin P, Kuchta M. Beta-palmitate – a natural component of human milk in supplemental milk formulas. Nutr J, 2016, 17, 15: 28. doi: 10.1186/s12937016-0145-1.Innis SM, Dyer R, Nelson CM. Evidence that palmitic acid is absorbed as sn-2 monoacylglycerol from human milk by breast-fed infants. Lipids, 1994, 29: 541-5.Innis SM, Dyer R, Nelson CM. Evidence that palmitic acid is absorbed as sn-2 monoacylglycerol from human milk by breast-fed infants. Lipids, 1994, 29: 541-5.Lopez-Lopez A, Castellote-Bargallo AI, CampoyFolgoso C, Rivero-Urgel M, Tormo-Carnice R, Infante-Pina D, Lopez-Sabater MC. The influence of dietary palmitic acid triglyceride position on the fatty acid, calcium and magnesium contents of at term new born faeces. Early Hum Dev, 2001, 65(Suppl): 83–94.Lopez-Lopez A, Castellote-Bargallo AI, CampoyFolgoso C, Rivero-Urgel M, Tormo-Carnice R, Infante-Pina D, Lopez-Sabater MC. The influence of dietary palmitic acid triglyceride position on the fatty acid, calcium and magnesium contents of at term new born faeces. Early Hum Dev, 2001, 65(Suppl): 83–94.Rogalska E, Ransac S, Verger R. Stereoselectivity of lipases. II. Stereoselective hydrolysis of triglycerides by gastric and pancreatic lipases. J Biol Chem, 1990, 265: 20271-6.Rogalska E, Ransac S, Verger R. Stereoselectivity of lipases. II. Stereoselective hydrolysis of triglycerides by gastric and pancreatic lipases. J Biol Chem, 1990, 265: 20271-6.Quinlan PT, Lockton S, Irwin J, Lucas AL. The relationship between stool hardness and stool composition in breastand formula-fed infants. J Pediatr Gastroenterol Nutr, 1995, 20: 81–90.Quinlan PT, Lockton S, Irwin J, Lucas AL. The relationship between stool hardness and stool composition in breastand formula-fed infants. J Pediatr Gastroenterol Nutr, 1995, 20: 81–90.Gil A, Ramirez M, Gil M. Role of long-chain polyunsaturated fatty acids in infant nutrition. Eur J Clin Nutr, 2003, 35 Suppl 1: S31-4.Gil A, Ramirez M, Gil M. Role of long-chain polyunsaturated fatty acids in infant nutrition. Eur J Clin Nutr, 2003, 35 Suppl 1: S31-4.Yao M, Lien EL, Capeding MR, Fitzgerald M, Ramanujam K, Yuhas R, Nortington R, Lebumfacil J, Wang L, DeRusso PA. Effects of term infant formulas containing high sn-2 palmitate with and without oligofructose on stool composition, stool characteristics, and bifidogenicity: a randomized, double-blind, controlled trial. J Pediatr Gastroenterol Nutr. 2014, 59: 440-8.Yao M, Lien EL, Capeding MR, Fitzgerald M, Ramanujam K, Yuhas R, Nortington R, Lebumfacil J, Wang L, DeRusso PA. Effects of term infant formulas containing high sn-2 palmitate with and without oligofructose on stool composition, stool characteristics, and bifidogenicity: a randomized, double-blind, controlled trial. J Pediatr Gastroenterol Nutr. 2014, 59: 440-8.Bongers MEJ, de Lorijn F, Reitsma JB, Groeneweg M, Taminiau JAJM, Benninga MA. The clinical effect of a new infant formula in term infants with constipation: a double-blind, randomized cross-over trial. Nutr J, 2007, 6: 8.Bongers MEJ, de Lorijn F, Reitsma JB, Groeneweg M, Taminiau JAJM, Benninga MA. The clinical effect of a new infant formula in term infants with constipation: a double-blind, randomized cross-over trial. Nutr J, 2007, 6: 8.Carnielli VP, Luijendik IHT, van Goudoever JB, Sulkers EJ, Boerla AA, Degenhart HJ, Sauer PJ. Structural position and amount of palmitic acid in formulas: effects on fat, fatty acid, and mineral balance. J Pediatr Gastroenterol Nutr, 1996, 23: 554-60.Carnielli VP, Luijendik IHT, van Goudoever JB, Sulkers EJ, Boerla AA, Degenhart HJ, Sauer PJ. Structural position and amount of palmitic acid in formulas: effects on fat, fatty acid, and mineral balance. J Pediatr Gastroenterol Nutr, 1996, 23: 554-60.Kennedy K, Fewtrell MS, Morley R, Abbott R, Quinlan PT, Wells JCK, Bindels JG. Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr, 1997, 70: 920-7.Kennedy K, Fewtrell MS, Morley R, Abbott R, Quinlan PT, Wells JCK, Bindels JG. Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr, 1997, 70: 920-7.Savino F, Palumeri E, Castagno E, Cresi F, Dalmoso P, Cacallo F, Oggero R. Reduction of crying episodes owing to infantce colic: a randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr, 2006, 60: 1304-10.Savino F, Palumeri E, Castagno E, Cresi F, Dalmoso P, Cacallo F, Oggero R. Reduction of crying episodes owing to infantce colic: a randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr, 2006, 60: 1304-10.Yao M, Lien EL, Capeding MR, Fitzgerald M, Ramanujam K, Yuhas R, Nortington R, Lebumfacil J, Wang L, DeRusso PA. Effects of term infant formulas containing high sn-2 palmitate with and without oligofructose on stool composition, stool characteristics, and bifidogenicity: a randomized, double-blind, controlled trial. J Pediatr Gastroenterol Nutr, 2014, 59: 440-8.Yao M, Lien EL, Capeding MR, Fitzgerald M, Ramanujam K, Yuhas R, Nortington R, Lebumfacil J, Wang L, DeRusso PA. Effects of term infant formulas containing high sn-2 palmitate with and without oligofructose on stool composition, stool characteristics, and bifidogenicity: a randomized, double-blind, controlled trial. J Pediatr Gastroenterol Nutr, 2014, 59: 440-8.Yaron S, Shachar D, Abramas L, Riskin A, Bader D, Litmanovitz I, Bar-Yoseph F, Cohen T, Levi L, Lifshitz Y, Shamir R Shaoul. Effect of high β-palmitate content in infant formula on the intestinal microbiota of term infants. J Pediatr Gastroenterol Nutr, 2013, 56: 376-81.Yaron S, Shachar D, Abramas L, Riskin A, Bader D, Litmanovitz I, Bar-Yoseph F, Cohen T, Levi L, Lifshitz Y, Shamir R Shaoul. Effect of high β-palmitate content in infant formula on the intestinal microbiota of term infants. J Pediatr Gastroenterol Nutr, 2013, 56: 376-81.Jakusova L, Jesenak M, Schudichova J, Banovcin P. Bone metabolism in cow milk allergic children. Indian Pediatr, 2013, 50: 706.Jakusova L, Jesenak M, Schudichova J, Banovcin P. Bone metabolism in cow milk allergic children. Indian Pediatr, 2013, 50: 706.Lu P, Bar-Yoseph F, Levi L, Lifshitz Y, WitteBouma J, de Bruijn ACJM, Korteland-van Male AM, van Goudoever JB, Renes IB. High beta-palmitate fat controls the intestinal inflammatory response and limits intestinal damage in mucin Muc2 deficient mice. PLoS One, 2013, 8: e65878.Lu P, Bar-Yoseph F, Levi L, Lifshitz Y, WitteBouma J, de Bruijn ACJM, Korteland-van Male AM, van Goudoever JB, Renes IB. High beta-palmitate fat controls the intestinal inflammatory response and limits intestinal damage in mucin Muc2 deficient mice. PLoS One, 2013, 8: e65878.

The authors declare that there are no conflicts of interest present.