Trace element absorption in infants as a foundation to setting upper limits for trace elements in infant formulas.

The bioavailability of the trace elements iron, zinc, copper and manganese from human milk is high compared to cow's milk and infant formulas. This high bioavailability may be explained by the presence of lactoferrin in human milk, which may facilitate iron and manganese uptake via an intestinal receptor for this protein. High concentrations of ascorbate and citrate may also facilitate uptake of trace elements from human milk and milk formulas, while a high concentration of casein in cow's milk and cow's milk formulas may limit trace element absorption from these diets. Trace element absorption from soy formula is low, mostly due to the presence of phytate but possibly also due to some protein fraction. Trace elements sharing absorptive pathways compete for uptake, and imbalances in the ratios between trace elements (Fe/Zn, Zn/Cu, Fe/Mn) in formulas may impair trace element absorption. These factors need to be taken into consideration when setting upper limits for trace elements in formulas. With our present knowledge, an upper limit for iron of 14 mg/l, for zinc, 12 mg/l, copper, 1.2 mg/l, and manganese, 0.6 mg/l are suggested. The capacity of infants to homeostatically adapt to varying intakes of trace elements needs to be further evaluated.