Amino acid-based formula

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Amino acid-based formula is a type of infant milk formula made from individual amino acids. It is hypoallergenic and intended for infants suffering from severe allergy to milk and various gastrointestinal conditions, such as food protein-induced enterocolitis syndrome and malabsorption syndromes. [1] [2] It is sometimes referred to as elemental formula but this is considered a misleading name. [2] Issues with the use of amino acid-based formula include its high cost and its unpalatable taste. [3] Intake of amino-acid formula for healthy infants shows no advantage in growth. [4]

Contents

Background

Amino acids are the building blocks of protein and together they form the protein requirements in formula needed for growth and development. The amino acids are in the simplest form, making it easy for the body to process and digest. Amino acid-based formula may be considered hypoallergenic since it does not contain peptides that may trigger an immune response. [3]

Because infants and children have different nutritional needs, amino acid-based formulas are typically formulated either for infants 0–1 years of age or for children 1–10 years of age. [5]

Uses

Amino acid-based formulas may be used for those with cow's milk or soy protein allergy. However, most infants who suffer from food allergy respond well to extensively hydrolysed formulas, and only few of those with the most severe form of the illness require the use of amino acid-based formulas. [1] [6] It may also be used for other medical conditions requiring an amino acid-based diet, such as short bowel syndrome, and transition from parenteral to enteral nutrition.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Kwashiorkor</span> Severe protein malnutrition

Kwashiorkor is a form of severe protein malnutrition characterized by edema and an enlarged liver with fatty infiltrates. It is thought to be caused by sufficient calorie intake, but with insufficient protein consumption, which distinguishes it from marasmus. Recent studies have found that a lack of antioxidant micronutrients such as β-carotene, lycopene, other carotenoids, and vitamin C as well as the presence of aflatoxins may play a role in the development of the disease. However, the exact cause of kwashiorkor is still unknown. Inadequate food supply is correlated with occurrences of kwashiorkor; occurrences in high income countries are rare. It occurs amongst weaning children to ages of about five years old.

<span class="mw-page-title-main">Infant formula</span> Manufactured food designed for feeding infants

Infant formula, also called baby formula, simply formula, baby milk or infant milk, is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid. The U.S. Federal Food, Drug, and Cosmetic Act (FFDCA) defines infant formula as "a food which purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk".

<span class="mw-page-title-main">Casein</span> Family of proteins found in milk

Casein is a family of related phosphoproteins that are commonly found in mammalian milk, comprising about 80% of the proteins in cow's milk and between 20% and 60% of the proteins in human milk. Sheep and Cow milk have a higher casein content than other types of milk with human milk having a particularly low casein content.

An essential amino acid, or indispensable amino acid, is an amino acid that cannot be synthesized from scratch by the organism fast enough to supply its demand, and must therefore come from the diet. Of the 21 amino acids common to all life forms, the nine amino acids humans cannot synthesize are valine, isoleucine, leucine, methionine, phenylalanine, tryptophan, threonine, histidine, and lysine.

<span class="mw-page-title-main">Whey</span> Liquid remaining after milk has been curdled and strained

Whey is the liquid remaining after milk has been curdled and strained. It is a byproduct of the manufacturing of cheese or casein and has several commercial uses. Sweet whey is a byproduct resulting from the manufacture of rennet types of hard cheese, like cheddar or Swiss cheese. Acid whey is a byproduct brought out during the making of acid types of dairy products, such as strained yogurt.

<span class="mw-page-title-main">Food allergy</span> Hypersensitivity reaction to a food

A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure. This typically occurs within minutes to several hours of exposure. When the symptoms are severe, it is known as anaphylaxis. A food intolerance and food poisoning are separate conditions, not due to an immune response.

<span class="mw-page-title-main">Whey protein</span> Protein supplement

Whey protein is a mixture of proteins isolated from whey, the liquid material created as a by-product of cheese production. The proteins consist of α-lactalbumin, β-lactoglobulin, serum albumin and immunoglobulins. Glycomacropeptide also makes up the third largest component but is not a protein. Whey protein is commonly marketed as a protein supplement, and various health claims have been attributed to it. A review published in 2010 in the European Food Safety Authority Journal concluded that the provided literature did not adequately support the proposed claims. For muscle growth, whey protein has been shown to be slightly better compared to other types of protein, such as casein or soy.

Hydrolyzed protein is a solution derived from the hydrolysis of a protein into its component amino acids and peptides. While many means of achieving this exist, most common is prolonged heating with hydrochloric acid, sometimes with an enzyme such as pancreatic protease to simulate the naturally occurring hydrolytic process.

<span class="mw-page-title-main">Milk substitute</span> Alternative substance that resembles milk

A milk substitute is any substance that resembles milk and can be used in the same ways as milk. Such substances may be variously known as non-dairy beverage, nut milk, grain milk, legume milk, mock milk and alternative milk.

<span class="mw-page-title-main">Soy allergy</span> Type of food allergy caused by soy

Soy allergy is a type of food allergy. It is a hypersensitivity to ingesting compounds in soy, causing an overreaction of the immune system, typically with physical symptoms, such as gastrointestinal discomfort, respiratory distress, or a skin reaction. Soy is among the eight most common foods inducing allergic reactions in children and adults. It has a prevalence of about 0.3% in the general population.

<span class="mw-page-title-main">Goat milk</span> Liquid food produced by female goats

Goat milk is the milk of domestic goats. Goats produce about 2% of the world's total annual milk supply. Some goats are bred specifically for milk. Goat milk naturally has small, well-emulsified fat globules, which means the cream will stay in suspension for a longer period of time than cow's milk; therefore, it does not need to be homogenized. Eventually, the cream will rise to the top over a period of a few days. If the milk is to be used to make cheese, homogenization is not recommended, as this changes the structure of the milk, affecting the culture's ability to coagulate the milk and the final quality and yield of cheese.

<span class="mw-page-title-main">Milk allergy</span> Type of food allergy caused by milk

Milk allergy is an adverse immune reaction to one or more proteins in cow's milk. Symptoms may take hours to days to manifest, with symptoms including atopic dermatitis, inflammation of the esophagus, enteropathy involving the small intestine and proctocolitis involving the rectum and colon. However, rapid anaphylaxis is possible, a potentially life-threatening condition that requires treatment with epinephrine, among other measures.

<span class="mw-page-title-main">Protein (nutrient)</span> Nutrient for the human body

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue and can also serve as a fuel source. As a fuel, proteins provide as much energy density as carbohydrates: 4 kcal per gram; in contrast, lipids provide 9 kcal per gram. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.

<span class="mw-page-title-main">Donkey milk</span> Milk produced by female donkeys

Donkey milk is the milk from the domesticated donkey (Equus asinus). It has been used since antiquity for cosmetic purposes as well as infant nutrition.

<span class="mw-page-title-main">Nutricia North America</span>

Nutricia is a specialized medical nutrition company. It is part of the Medical Nutrition Division of Groupe Danone, Paris. Nutricia manufactures products used in the management of severe allergic and gastrointestinal disorders, metabolic conditions as well as other conditions requiring nutritional therapy, including intractable epilepsy.

Food protein-induced enterocolitis syndrome (FPIES) is a systemic, non IgE-mediated response to a specific trigger within food - most likely food protein. FPIES presents in two different forms: an acute form and a chronic form. In its acute form, FPIES presents with vomiting that usually begins 1 to 4 hours after trigger food ingestion. Vomiting is often followed by a paleness to the skin, lethargy, and potentially watery, perhaps blood-tinged diarrhea. In the severe form of acute FPIES, a person will vomit until dehydration and until a shock-like state, which occurs in 15% of patients. In its chronic form, which can be difficult to diagnose until a person has already met diagnostic criteria for acute FPIES, after repeated or regular ingestion of the trigger food, the person presents with chronic or episodic vomiting, failure to thrive, and watery, perhaps blood-tinged diarrhea. FPIES can potentially develop at any age but seems most commonly to develop within the first few years of life. FPIES has mainly been documented in young infants, but can exist in older children and adults. Some people develop both FPIES and an IgE-mediated type of reaction to the same food, and having FPIES can increase a person's risk of also developing IgE-mediated food allergies.

Fish protein powder (FPP) describes a food grade powder product designated primarily for human consumption applications. It differs significantly from fish meal products which are designated for animal feed applications. Fish protein powders have various sanitary processing, purity and functional characteristics which establish them as human food ingredients. Production plants registered for the USA market are located in Peru and France.

Protein quality is the digestibility and quantity of essential amino acids for providing the proteins in correct ratios for human consumption. There are various methods that rank the quality of different types of protein, some of which are outdated and no longer in use, or not considered as useful as they once were thought to be. The Protein Digestibility Corrected Amino Acid Score (PDCAAS), which was recommended by the Food and Agriculture Organization of the United Nations (FAO), became the industry standard in 1993. FAO has recently recommended the newer Digestible Indispensable Amino Acid Score (DIAAS) to supersede PDCAAS. The dairy industry is in favor of this, because while PDCAAS truncates all protein types that exceed the essential amino acid (EAA) requirements to 1.0, DIAAS allows a higher than 1.0 ranking: while for example both soy protein isolate and whey isolate are ranked 1.0 according to PDCAAS, in the DIAAS system, whey has a higher score than soy.

Soy formula is a substitute for human breast milk. It is a commercial product based on the proteins found in soybeans. Soy infant formula uses processed soybeans as its source of protein, and comes in powdered or liquid form. Usually lactose-free, soy infant formula contains a different sugar. Infants who are intolerant of cows' milk protein may also be intolerant of soy protein. It differs from human breast milk in a number of ways. Soy protein inhibits the absorption of iron. The soy-based formulas discussed by the World Health Organization reports that soy formula is fortified with iron to compensate for this effect. One naturally occurring plant-based compound found in soy-based infant formula is phytic acid. It is also a strong inhibitor of iron absorption, though it can be removed in processing. It is not known how many manufacturers of soy-based formula incorporate this practice. China and Vietnam have regulated soy-based infant formulas to include NaFeEDTA to fortify the formula and enhance the absorption of iron by the infant. When iron compounds are added to soy-based infant formula, the iron compound is encapsulated to prevent it from making the formula dark.

<span class="mw-page-title-main">Hypoallergenic dog food</span>

Hypoallergenic dog food diets are created for dogs that experience food-related allergies causing adverse effects to their physical health.Super Hypoallergenic is enzymatic hydrolyzed hypoallergenic ostrich protein. The molecules that usually become allergens are intact proteins or glycoproteins. Hypoallergenic dog food diets offer a variety of protein sources that are unique by using proteins that are not recognized by the dog's antibodies as being antigens, minimizing allergic reactions for example Ostrich meat, bones and sinews. Adding novel protein sources, such as novel meats that a dog or its ancestors have never been exposed to is one method. Novel proteins can also be created by chemically modifying well known protein sources using hydrolysis techniques, rendering proteins unrecognizable by the gastrointestinal tract. Not all antigens are specific to proteins, however, and it is possible for anything that the body ingests to become an allergen. Providing diets with a limited amount of ingredients can be used for diagnostic purposes, as well as for dogs who are allergic to the common ingredients that are used in pet food. Certain nutrients are commonly incorporated into hypoallergenic dog food to help alleviate the symptoms of an allergic reaction. These ingredients include omega-3 fatty acids, Vitamins A and E, zinc, novel carbohydrates, and fiber.

References

  1. 1 2 Leonard, Stephanie Ann; Nowak-Węgrzyn, Anna (2011). Food Allergy. Saunders. p. 151. ISBN   978-1-4557-3981-3.
  2. 1 2 Tsai, Patrika; Duggan, Christopher (20 July 2005). Encyclopedia of Human Nutrition. Vol. 3. p. 201. ISBN   978-0-08-045428-3.
  3. 1 2 Andreae, D.; Nowak-Węgrzyn, A. (2017). Early Nutrition and Long-Term Health. Woodhead Publishing. p. 142. ISBN   978-0-08-100186-8.
  4. Borschel, Marlene W.; Baggs, Geraldine E.; Oliver, Jeffery S. (2018). "Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas". Nutrients. 10 (3): 289. doi: 10.3390/nu10030289 . PMC   5872707 . PMID   29494498.
  5. Patel, Jalpa K.; Rouster, Audra S. (2023), "Infant Nutrition Requirements and Options", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32809593 , retrieved 2023-10-03
  6. Hill DJ, Murch SH, Rafferty K, Wallis P, Green CJ (June 2007). "The efficacy of amino acid-based formulas in relieving the symptoms of cow's milk allergy: a systematic review". Clin Exp Allergy. 37 (6): 808–22. doi:10.1111/j.1365-2222.2007.02724.x. PMID   17517094. S2CID   5564593.