Palm Oil and Beta-Palmitate in Infant Formula.

Abstract

T o the Editor: The position paper by ESPGHAN on palm oil (PO) and beta-palmitate in infant formula (1) shows undisputed biochemical and physiological basis for the negative nutrient absorption effect of palmitic acid from plant-based PO versus that from human or animal fat; and negative clinical effects in animal and tissue models. Use of PO in infant formula results in impaired fat and calcium absorption (2,3), lower growth measurements (4), and bone mass (5). There is uncertainty whether the negative effect on growth and bone accretion persists (1) because 1 cross-sectional follow-up study lacks control for multiple confounders of growth and bone mineralization and a longitudinal follow-up study had only 28% of the original cohort. In an era of evidence-based medicine, it seems prudent to recommend caution with the addition of PO in infant formula, given the multiple potential negative biochemical, physiological, and clinical effects of PO and lack of demonstrated benefits from PO. During infancy, there is a gain of 25 to 30 cm in length and tripling of the bone mass, an amount comparable to the peak bone accretion during adolescence on an annualized basis (6). Since the achievement of optimal peak bone mass throughout childhood and young adulthood is a cornerstone in the prevention of osteoporosis (7), and no guaranteed reversal of the negative effects of PO, it seems prudent to avoid adding PO to infant formula.