Fatty acids in substitute formulas for cow's milk allergy

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Abstract
The role of dietary fats in food-related allergic symptoms is increasingly being investigated, since the pivotal role of fat-derived inflammatory substances, e.g., leukotrienes, has been realized. The objective of this study was to describe the fatty acid composition of several commercially available infant formulas that are used as substitutes for adapted cow's milk formulas. Samples of nine formulas (two soy, two extensively hydrolyzed casein, three extensively hydrolyzed whey, and two amino-acid-based formulas) and human milk as control were analyzed by gas chromatography. The quantity of fatty acids in the formulas was within the breast-milk range. The percentage of energy derived from fat was below the European Society for Pediatric Gastroenterology and Nutrition recommendations in two cases, but, in the others, it roughly met the recommendations. The percentage of energy derived from linoleic acid was as recommended in all but two cases, where it was higher than recommended. As indicated by a quality indicator, the linoleic to α-linolenic acid ratio, altogether four formulas were within either the recommendations or the analyzed breast-milk range. In three cases, it was 1.5-2.5 and in two cases 4-5 times higher than recommended. There are recommendations for infant formulas to meet nutritional requirements of fat intake, and the analyzed formulas are in most cases within the suggested ranges. However, little is known of requirements in allergic or inflammatory conditions, and whether these described fatty acid compositions are pro- or anti-inflammatory.