The researchers previously reported results from a randomized controlled trial in which they found Swedish infants consuming an experimental low-energy, low-protein formula (EF) supplemented with bovine milk fat globule membranes (MFGMs) up to six months of age had several positive outcomes, including better performance in the cognitive domain of Bayley Scales of Infant and Toddler Development 3rd Edition at 12 months of age, and higher plasma cholesterol concentrations during the intervention, than infants consuming standard formula (SF).
The new study aimed to evaluate neurodevelopment, growth, and plasma cholesterol status of the same children at the age of six and six-and-a-half years of age.
Even though exclusive breastfeeding for six months is recommended by the WHO, the global overall rate of exclusive breastfeeding for infants younger than six months of age has been estimated at only 40%. Because not being breastfed is associated with negative health effects even in developed countries, reducing the differences in health outcomes between formula-fed and breastfed infants can have considerable health effects at the population level.
Higher protein and energy intake of formula-fed infants and the absence of factors essential for optimal development and growth present in human milk have been suggested to explain part of the observed differences between formula-fed and breastfed infants.
The milk fat globule membrane (MFGM) is a biologically active milk fraction that historically has been discarded from infant formula when milk fat is replaced by vegetable oils. Different bovine MFGM concentrates are available as nutritional supplements and outcomes of supplementation of infant formulas with MFGMs have been studied in several clinical trials.
In the long-term follow-up of infants consuming the low-energy, low-protein formula supplemented with a bovine MFGM concentrate, the researchers said they found no effect of the intervention on cognitive or executive functioning at six-and-a-half years of age.
They said one possible explanation is that, in the time period between one and six-and-a-half years of age, environmental factors other than early nutrition and genetic factors influence neurodevelopment, which is likely why the previously found differences between the EF and SF groups did not persist.
The group said a follow-up period beyond school age is needed to determine whether the intervention groups will differ in academic achievements in the future.
The study found during the intervention up to six months of age, the EF group gradually reached higher cholesterol concentrations than the SF group. Whether this effect on early cholesterol concentrations has any programming effect on later cholesterol metabolism, as suggested by earlier observational studies on breastfed and formula-fed infants, would need a longer follow-up time until adolescence or adult life, and probably a larger sample size, to evaluate.
The American Journal of Clinical Nutrition
Neurodevelopment and growth until 6.5 years of infants who consumed a low-energy, low-protein formula supplemented with bovine milk fat globule membranes: a randomized controlled trial
Niklas Timby, Marie Adamsson, Erik Domellöf, Tove Grip, Olle Hernell, Bo Lönnerdal, Magnus Domellöf