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HUNT243 > Lecture 9: Infant Formula > Flashcards

Lecture 9: Infant Formula Flashcards

1
Q

If an infant is not BF, then an infant formula should be used until…

A

The infant is 1 year of age

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2
Q

What are the three types of infant formula products?

A
  1. Infant formula (0-12 months)
  2. Follow on formula (6-12 months)
  3. Special dietary formula
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3
Q

How is infant formula regulated in NZ?

A

HIGHLY regulated

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4
Q

What is standard 2.9.1?

A

Infant formula products

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5
Q

What is schedule 29?

A

Special purpose foods

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6
Q

What are some of the NZ formula regulations? (Standard 2.9.1 Schedule 29)

A
  • Specifies mandatory nutrient content
  • Labelling requirements
  • Controls food additives
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7
Q

What is proposal P1028?

A

Looking at making changes to the current regulations

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8
Q

What are the key amendments of proposal P1028?

A
  • Prohibiting cross-promotion
  • Mandading NIP
  • Restriction on the sale of special medical purpose products
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9
Q

Majority of infant formula health claims are…

A

poorly supported!!!

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10
Q

How many groups of ingredients have been tied to ‘claims’ in formula?

A

41 groups

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11
Q

How many claims have been made related to formula ingredients?

A

1884 claims

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12
Q

What percent of claims were not specific to an ingredient?

A

50%

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13
Q

What percent of claims were supported by evidence?

A

26%

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14
Q

What percent of ‘evidence’ relating to formula claims were funded by formula companies or had authors with industry connections?

A

88% - what influence did they have?

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15
Q

What are the 5 most common infant formula claims?

A
  • Supports brain/eyes/nervous system
  • Strengthens immune system
  • Supports growth/development
  • Easy to digest
  • Management of allergies
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16
Q

What is paleo DIY infant formula?

A

Homemade formula recommended instead of commercially made; raised major safety concern

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17
Q

What was the Paleo DIY formula made of?

A
  • Liver
  • Cod liver oil
  • Bone broth
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18
Q

What were the main paleo DIY formula safety concerns?

A
  • Immature kidneys and GI tract
  • UL for vitamin A, sodium, protein and iron
  • Microbiological risks
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19
Q

What was the end result of Pete Evans DIY paleo formula?

A
  • Book was shelved
  • Accepted changes to recipe
  • Rebranded “Happy Tummy Brew”
  • Moved to 6-12 months
  • Only once a day
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20
Q

What did Chelsea Winter do in 2020?

A

Posted a recipe for an unsafe “dairy-free toddler milk”

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21
Q

What is the issue with influential people posting their own formula recipes?

A
  • Using the word “formula” is misleading
  • Not regulated
  • ‘no nasties’ creating false ideas about formula
  • Dangerous advice
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22
Q

What alternatives are NOT recommended for infants <12 months?

A
  • Cows milk as a drink
  • Plant-based alternatives as a drink
  • Condensed milk
  • Evaporated milk
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23
Q

What are the two types of protein?

A

Casein and whey

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24
Q

Digestibility of Whey vs Casein

A

Whey is quicker whereas casein is slower

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25
Q

Why does casein have slower digestibility?

A

Casein forms curds that are more slowly digested, resulting in slower gastric emptying

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26
Q

What is the casein:whey ratio of BM?

A

40:60

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27
Q

What is the casein:whey ratio of whey dominant formula?

A

40:60 - trying to replicate breastmilk; higher cost as manipulation is required

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28
Q

What is the casein:whey ratio of casein dominant infant formula?

A

80:20 - similar to cows milk; found more in follow up formulas

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29
Q

What is the formula for when cow’s milk formula is not tolerated?

A

Soy formula - extensively hydrolysed, amino acid

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30
Q

What is the dominant whey protein in BM?

A

Alpha-lactoalbumin

31
Q

Is there alpha-lactoalbumin in formula?

A

Low levels

32
Q

What is the dominant whey protein in cows milk infant formula?

A

Beta lactoglobulin

33
Q

Is beta-lactoglobulin found in BM?

A

No

34
Q

What is the dominant casein in BM?

A

Beta-casein

35
Q

What is the dominant casein in cows milk formula?

A

Alpha-casein

36
Q

What is the dominant casein in goats milk formula?

A

Beta-casein

37
Q

What is the general casein:whey ratio for 0-6 months formula from birth?

A

40:60

38
Q

What is the general casein:whey ratio for follow on formula (6-12 months)?

A

80:20

39
Q

Why does follow-up formula have more casein?

A
  • GI tract and kidneys are now further developed
  • same composition as cows milk
40
Q

What do soy formulas NOT contain?

A
  • No cows milk
  • No casein
  • No whey
41
Q

What protein is used in soy-based infant formula?

A

Soy protein isolate

42
Q

Why is soy protein isolate highly digestible?

A

Has high amounts of essential amino acids, it is supplemented with methionine, taurine and cartinine (EAAs)

43
Q

How old are babies that soy-based infant formula recommended for?

A

over 6 months

44
Q

Which has higher protein, BM or formula?

A

Formula

45
Q

What is the protein content of BM?

A

1.5g/100 kcal

46
Q

What is the protein content of formula?

A

2.2g/100 kcal

47
Q

Formula-fed infants tend to have greater….

A

Weight gain compared to BF infants

48
Q

Protein quality in infant formula is positively associated with…

A

Increased risks of overweight and obesity, and these effects may have a long-term impact beyond the first 2 years of life

49
Q

What did nestle propose in 2019?

A

to drop the minimum requirement of protein from 0.45g/100kJ to 0.38g/100kJ for follow up formula

50
Q

How did FSANZ respond to nestle proposing changes to protein content in follow-up formula?

A

Declined - more evidence is required

51
Q

What is the major CHO in human BM, cows milk and milk-based formulas?

A

Lactose

52
Q

Is lactose intolerance common in infants?

A

Very rare

53
Q

What is the main cause of lactose intolerance in infants?

A

Lactase enzyme deficiency

54
Q

What are the two types of lactase enzyme deficiency?

A

Primary and secondary

55
Q

Is primary or secondary lactase enzyme deficiency more common?

A

Secondary; primary is uncommon before 2-3 years of age

56
Q

What are the symptoms of primary lactase enzyme deficiency?

A
  • Diarrhoea
  • Cramps
  • Bloating/gas
  • Vomiting
57
Q

What does secondary lactase enzyme deficiency result from?

A

Small bowel injury; non IgE mediated cows milk allergy or viral gastroenteritis

58
Q

What do lactose free formulas generally contain rather than lactose?

A

Corn-syrup solids

59
Q

What glucose polymers are the preferred CHO source in infant formula?

A

Lactose and glucose

60
Q

What glucose polymers should be avoided as a CHO source in infant formula? (not mandatory)

A

Sucrose and fructose

61
Q

What percent of the energy in formulas come from fat?

A

40-50% energy

62
Q

What does the ratio of PUFA to saturated fat affect?

A

Digestibility and facilitates absorption of calcium and fat from the gut; there is a required ratio

63
Q

What is the main source of fat in infant formulas?

A

Vegetable oils including:
- Corn
- Soy
- Safflower
- Coconut

64
Q

What are rules for infant formula in relation to essential fatty acids in NZ?

A

Formula MUST contain linoleic and alpha-linoleic acid within a specific ratio and range

65
Q

What are the rules in NZ for LCPUFA’s in infant formula?

A

Not required; added to formulas at a cost to the consumer (premium or “gold”)

66
Q

Why are prebiotics sometimes added to infant formula?

A

Oligosaccharides which support growth and activity of beneficial bacteria in the GI tract; Immunity?

67
Q

What are the adverse effects of adding prebiotics to infant formula?

A

Increased incidence of diarrhoea, eczema and irritability

68
Q

Why are probiotics sometimes added to infant formula?

A

For the beneficial live microorganisms

69
Q

Why are organic formulas so expensive?

A

They are required to meet formula regulations and organic regulations

70
Q

What is the NZIFMA Code of Practice 2007?

A

Applies to the marketing of infant formula, CANNOT promote 0-6 months infant formula

71
Q

How much did NZ make from infant formula exports?

A

exceeded 1.8 billion

72
Q

How much is it predicted that NZ will make in 2025 from infant formula exports?

A

2.7 billion

73
Q

What is a common thing that infant formula has been contaminated with?

A

Melamine; causing kidney stones and kidney damage

74
Q

What is melamine?

A

Used in plastics, adhesives, countertops, dish ware - organic base chemical rich in nitrogen

HUNT243 (11 decks)

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