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| Name | Class |
|---|---|
| University of California | OTHER |
| Mead Johnson Nutrition | INDUSTRY |
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Breast milk is the gold standard of early infant nutrition and breastfed infants have advantages in several short and long term outcomes compared to those formula-fed.
The first aim of this study is to evaluate the effect of adding bovine lactoferrin to infant formula. The general hypothesis is that bovine lactoferrin reduces some of the previously observed differences between formula-fed and breast-fed infants with regard to health and development. The main outcome studied is the effect on immune function. The second aim is to study the effects of lower iron concentration in infant formula and to test the hypothesis that iron can be lowered without negative effects on health and development. The main outcome studied here is iron status. Other outcomes in this trial are microbiota composition, metabolomics, growth, body composition and cognitive development.
To test the lactoferrin hypothesis, formula-fed infants will be recruited and fed a low iron (2 mg/L) control formula, or the same formula supplemented with bovine lactoferrin. To test the iron hypothesis, a third group will be fed the same formula (no lactoferrin) with higher iron concentration (8 mg/L). Group allocation for all formula-fed infants will be double-blind randomized. Additionally, breast-fed infants will be recruited and used as a reference group (gold standard).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low iron, with lactoferrin | Active Comparator | Low iron, with lactoferrin |
|
| Low iron, no lactoferrin | Active Comparator | Low iron, no lactoferrin |
|
| Normal iron, no lactoferrin | Placebo Comparator | Normal iron, no lactoferrin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Formula with low iron concentration (2 mg/L) supplemented with bovine lactoferrin | Dietary Supplement |
| ||
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of infections | Morbidity journal, Health questionnaire | Up to 12 months of age |
| Cytokine levels | IL-2, TNF-alpha | At 6 months of age |
| Iron status | s-ferritin, s-transferrin, s-iron, s-transferrin receptor concentration, reticulocyte Hb | At 6 months of age |
| Measure | Description | Time Frame |
|---|---|---|
| Dietary intake | Dietary journal | At baseline, 3, 4, 5, 6 and 12 months of age |
| Growth | Anthropometric data, Body Composition (PeaPod) |
| Measure | Description | Time Frame |
|---|---|---|
| Lactoferrin in breastmilk | Analyzed from mothers to the control group of breast fed infants. | At baseline, 4 and 6 months of age |
Inclusion Criteria:
Formula-fed healthy infants at 6 +/- 2 weeks of age with:
Exclusion Criteria:
-
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| Name | Affiliation | Role |
|---|---|---|
| Staffan K Berglund, MD, PhD | Umeå University | Principal Investigator |
| Olle Hernell, Professor | Umeå University | Principal Investigator |
| Bo Lönnerdal, Professor | University of California | Principal Investigator |
| Carolyn Slupsky, PhD | University of California | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Umeå University, Department of Clinical Sciences | Umeå | SE-901 87 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34908015 | Derived | Bjormsjo M, Hernell O, Lonnerdal B, Berglund SK. Immunological Effects of Adding Bovine Lactoferrin and Reducing Iron in Infant Formula: A Randomized Controlled Trial. J Pediatr Gastroenterol Nutr. 2022 Mar 1;74(3):e65-e72. doi: 10.1097/MPG.0000000000003367. |
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| Formula with low iron concentration (2mg/L) without lactoferrin |
| Dietary Supplement |
|
| Formula with normal iron concentration (8 mg/L) without lactoferrin | Dietary Supplement |
|
| At baseline, 4, 6, 12 months of age and 6 years of age |
| Bloodpressure | At baseline, 4, 6, 12 months of age and 6 years of age |
| Antibody response to vaccines | s-levels of specific antibodies to vaccines (DTP, Hib, PC) | At baseline, 4, 6 and 12 months of age |
| Gut microbiota | Stool samples | At baseline, 4, 6, 12 months of age and 6 years of age |
| Saliva proteins | Saliva total protein content, lactoferrin, saliva-peroxidase, IgA and amylase | At 4 months of age |
| Inflammatory markers | s-hsCRP, s-calprotectin | At baseline, 4, 6 and 12 months of age and 6 years age |
| Cognitive development and behavior | Bayley III, Wechsler Intelligence Scale for Children (WISC), Behavioral questionnaire | At 1 and 6 years of age |
| s-hepcidin | At baseline, 4, 6, 12 months of age and 6 years of age |
| Metabolomics | Analyzed in urine and serum samples | At baseline, 4, 6, 12 months of age and 6 years of age |
| Amino acids | p-amino acids | At 4 and 6 months of age |
| Blood urea nitrogen | p-urea nitrogen | At 4 and 6 months of age |
| Cytokine levels | IL-2 and TNF alpha at baseline, 4 and 12 months of age and 6 years of age. Six additional cytokines at baseline, 4, 6 and 12 months of age and 6 years of age. | At baseline, 4, 6, 12 months of age and 6 years of age |
| Iron status | s-ferritin, s-transferrin, s-iron, s-transferrin saturation, s-transferrin receptor concentration, retuiculocyte Hb | At baseline, 4 and 12 months of age and 6 years of age |
| ID | Term |
|---|---|
| D005526 | Food, Formulated |
| D007781 | Lactoferrin |
| ID | Term |
|---|---|
| D019648 | Foods, Specialized |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
| D012697 | Serine Endopeptidases |
| D010450 | Endopeptidases |
| D010447 | Peptide Hydrolases |
| D006867 | Hydrolases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
| D057057 | Serine Proteases |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D061250 | Transferrins |
| D033862 | Iron-Binding Proteins |
| D002352 | Carrier Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D007782 | Lactoglobulins |
| D000067816 | Whey Proteins |
| D008894 | Milk Proteins |
| D000080224 | Animal Proteins, Dietary |
| D004044 | Dietary Proteins |
| D005916 | Globulins |
| D008667 | Metalloproteins |
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