The Nutritional Adequacy of Mineral Content of Formulas

1. Derrick A. McQueen, MD 1. Chief Pediatric Resident University Hospital-New Jersey Medical School Newark, NJ 1. Trace Element Nutrition in Infants. Lonnerdal B. Ann Rev Nutrition . 1989;9:109-125 [OpenUrl][1][CrossRef][2][PubMed][3] 2. Minerals and Trace Elements in Infant Nutrition. Davidsson L. Acta Paediatrica . 1994;395(suppl):38-42 [OpenUrl][4] 3. Mineral and Vitamin D Adequacy in Infants Fed Human Milk or Formula Between 6 and 12 Months of Age. Hillman LS. J Pediatr . 1990;117 (suppl):134-142 [OpenUrl][5][CrossRef][6] 4. Formula Feeding of Term Infants. Committee on Nutrition. American Academy of Pediatrics. In: Barness MDL, ed. Pediatric Nutrition Handbook . 1993:11-22 American Academy of Pediatrics Elk Grove Village, Ill Our understanding of the minimum requirements and maximum allowable intake for specific nutrients, especially minerals, in infants still is evolving. Table 1⇓ shows the range of mineral intake recommended by the AAP Committee on Nutrition. View this table: Table 1. Recommended Mineral Density of Infant Formulas (per 100 kcal) Minerals are inorganic elements essential to the diet. Some of these elements are required in large amounts, such as calcium and phosphorus. Others—trace elements such as zinc, copper, and manganese—are required in minute amounts. The protein constituents of standard milk-based formulas are found in complexes with some of the major minerals (eg, Na, Cl, K, Ca, Mg, and P). In general, most formulas contain larger amounts of minerals than does human milk (Table 2⇓ ). However, more important than the concentration of minerals in the formula is their bioavailability, which refers to their degree of absorption and utilization. Minerals that are not sufficiently bioavailable must be supplemented to meet the nutritional needs of the infant. In commercial infant formulas (both cow milk- and soy-based), limited bioavailability and low mineral density of certain minerals have led the manufacturers to add inorganic salts of those minerals. These salts form complexes with ligands such as casein, phytoferritin, and citrate, which may bind excessively. View this table: Table 2. Formulas for Routine Infant Feeding (per L)1 Our understanding of the bioavailability of specific minerals has grown because of the substantial improvement in the techniques used to assess mineral absorption, metabolism, distribution, and excretion. Historically, the … [1]: {openurl}?query=rft.jtitle%253DAnnual%2Breview%2Bof%2Bnutrition%26rft.stitle%253DAnnu%2BRev%2BNutr%26rft.issn%253D0199-9885%26rft.aulast%253DLonnerdal%26rft.auinit1%253DB%26rft.volume%253D9%26rft.issue%253D1%26rft.spage%253D109%26rft.epage%253D125%26rft.atitle%253DTrace%2BElement%2BNutrition%2BIn%2BInfants%26rft_id%253Dinfo%253Adoi%252F10.1146%252Fannurev.nu.09.070189.000545%26rft_id%253Dinfo%253Apmid%252F2669865%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1146/annurev.nu.09.070189.000545&link_type=DOI [3]: /lookup/external-ref?access_num=2669865&link_type=MED&atom=%2Fpedsinreview%2F18%2F2%2F67.atom [4]: {openurl}?query=rft.jtitle%253DActa%2BPaediatrica.%26rft.volume%253D395%26rft.spage%253D38%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [5]: {openurl}?query=rft.jtitle%253DJ%2BPediatr.%26rft.volume%253D117%26rft.spage%253D134%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0022-3476%252805%252980011-3%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/external-ref?access_num=10.1016/S0022-3476(05)80011-3&link_type=DOI