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Effect of High -Palmitate Content in Infant Formula on the Intestinal Microbiota of Term Infants

Yaron, Sima*; Shachar, Dina*; Abramas, Lee*; Riskin, Arik; Bader, David; Litmanovitz, Ita; Bar-Yoseph, Fabiana§; Cohen, Tzafra§; Levi, Liora§; Lifshitz, Yael§; Shamir, Raanan||; Shaoul, Ron

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e31827e1ee2
Original Articles: Hepatology and Nutrition

Objectives: Palmitic acid (PA) constitutes 17% to 25% of the human milk fatty acids, and ∼70% is esterified in the sn-2 position of triglycerides (β-palmitate). In the sn-2 position, PA is not hydrolyzed and thus is efficiently absorbed. The PA in palm oils, commonly used in infant formulas, is esterified in the sn-1 and sn-3 positions. In these positions, PA is hydrolyzed and forms poorly absorbed calcium complexes. The present study assessed whether high β-palmitate in infant formulas affects the intestinal flora.

Methods: Thirty-six term infants were enrolled: 14 breast-fed (BF group) and 22 formula-fed infants who were randomly assigned to receive formula containing high β-palmitate (HBP group, n = 14), or low β-palmitate (LBP group, n = 8), where 44% and 14% of the PA was β-palmitate, respectively. The total amount of PA in the formulas was 19% and 22% in the LBP and HBP groups, respectively. Neither formula contained pre- or probiotics. Stool samples were collected at enrollment and at 6 weeks for the quantification of bacteria.

Results: At 6 weeks, the HBP and BF groups had higher Lactobacillus and bifidobacteria counts than the LBP group (P < 0.01). The Lactobacillus counts at 6 weeks were not significantly different between the HBP and BF groups. Lactobacillus counts were 1.2 × 1010, 1.2 × 1011, and 5.6 × 1010 CFU/g for LBP, HBP, and BF groups, respectively. Bifidobacteria counts were 5.1 × 109, 1.2 × 1011, and 3.9 × 1010 CFU/g for LBP, HBP, and BF groups, respectively.

Conclusions: HBP formula beneficially affected infant gut microbiota by increasing the Lactobacillus and bifidobacteria counts in fecal stools.

Author Information

*Technion—Israel Institute of Technology

Department of Neonatology, Bnai Zion Medical Center affiliated with Rappaport Faculty of Medicine, Technion, Haifa

Department of Neonatology, Meir Medical Center, Kfar Saba Sackler School of Medicine, Tel Aviv University, Tel-Aviv

§Enzymotec Ltd, Kfar Baruch

||Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv

Pediatric Gastroenterology Unit, Meyer Children Hospital, Rambam Medical Center, Haifa, Israel.

Address correspondence and reprint requests to Dr Sima Yaron, Faculty of Biotechnology and Food Engineering, Department of Biotechnology and Food Engineering, Technion–Israel Institute of Technology, Haifa 32000, Israel (e-mail:

Received 9 July, 2012

Accepted 14 November, 2012

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website ( registration number: NCT01116115.

The study was funded by Enzymotec Ltd.

F.B-Y., T.C., L.L., and Y.L. are employees of Enzymotec. The other authors report no conflicts of interest.

Copyright 2013 by ESPGHAN and NASPGHAN