Moya M, Cortés E, Juste M, Vera A, González de Dios J
Departamento de Pediatría, Universidad Miguel Hernández.
An Esp Pediatr. 1998 May;48(5):515-21.
Lactose absence implies a decrease in calcium absorption. If not absorbed, calcium soaps can be produced with the intestinal fatty acids. Absorption and retention of total fat, individual fatty acids, calcium, magnesium and phosphate have been compared between two groups of children, one fed with lactose free formula and higher levels of calcium (FSL) and the other with standard starting formula (FI). None of them had additional arachidonic or docosahexaenoic acids.
A randomized prospective study was made on 19 term newborn babies by means of metabolic balance measurement during an 8 day period (four days of a stabilization period on the formula, 3 days of the balance period and the final day for feces collection). Both groups were selected following the same criteria for gestational age, balance age, and weight and length at both time periods. Aliquos from the formula were collected daily, as well as all feces and urine during the balance period. Calcium and magnesium quantification of the corresponding ashed products was performed by means of atomic absorption, while Pi was with a colorimetric assay. Total fat was extracted by organic solvents and quantified by gravimetry. Lipid phase fatty acids were methylated, extracted and quantified by means of gas chromatography with a detector of flame ionization.
Total fat content and the percentages of each fatty acid did not differ, only calcium concentration in FSL was slightly higher (64.9 +/- 6.9 vs 58.9 +/- 7.0 mg/100 g). No differences were found between groups in relation to ingestion, excretion and retention. The percentages of calcium and total fat retention, however, were slightly superior in the FI in relation to the FSL group. Ca: 68 +/- 22 mg/kg/d, 49 +/- 14% vs 56 +/- 23 mg/kg/d, 48 +/- 17% and total fat: 6.6 +/- 1.2 g/kg/d, 92 +/- 8% vs 6.8 +/- 1.5 g/kg/d, 90 +/- 9%. Absorption of MC fatty acids was 99% for C8. Linoleic and alfalinolenic acid showed an absorption of around 90% despite the big differences in their intake (10/1). Net retention of linoleic acid was 933 +/- 168 mg/kg/d (FI) and 963 +/- 190 mg/kg/d (FSL) and the amount of alpha-linolenic acid was 95 +/- 16 (FI) and 100 +/- 22 mg/kg/d (FSL). No correlation could be found between the amount of excreted calcium and the total amount of fat in feces or with any of the fatty acids studied. This was true for each group studied separately or when considered as a single group.
The absorptive pattern of fatty acids in full term babies, when quantified did not show any conspicous alterations in relation to the accepted values of other ages. The absence of lactose (FSL) in a formula does not make any change in the absorption of total fat and the individual fatty acids when compared to lactose containing formula (FI), when these are present in the same proportions. Supplemented calcium in the formula without lactose could compensate for its lower absorbtion. The absorptive pattern of fatty acid in full term babies did not show any conspicuos alterations in relationship to the accepted values of other ages.
乳糖缺乏意味着钙吸收减少。若钙未被吸收，它会与肠道脂肪酸生成钙皂。对两组儿童的总脂肪、各脂肪酸、钙、镁及磷酸盐的吸收和潴留情况进行了比较，一组喂食不含乳糖且钙含量较高的配方奶粉（FSL），另一组喂食标准起始配方奶粉（FI）。两组儿童均未额外添加花生四烯酸或二十二碳六烯酸。
对19名足月儿进行了一项随机前瞻性研究，通过8天的代谢平衡测量（在配方奶粉上稳定4天，平衡期3天，最后一天收集粪便）。两组在胎龄、平衡期年龄以及两个时间段的体重和身长方面均按照相同标准选取。每天收集配方奶粉的等分试样，以及平衡期内的所有粪便和尿液。通过原子吸收法对相应灰化产物进行钙和镁定量，通过比色法对无机磷进行定量。用有机溶剂提取总脂肪并通过重量法进行定量。脂质相脂肪酸经甲基化、提取后，通过带有火焰离子化检测器的气相色谱法进行定量。
总脂肪含量及各脂肪酸百分比无差异，仅FSL中的钙浓度略高（64.9±6.9 vs 58.9±7.0毫克/100克）。两组在摄入、排泄和潴留方面未发现差异。然而，FI组中钙和总脂肪潴留的百分比相对于FSL组略高。钙：68±22毫克/千克/天，49±14% 对比 56±23毫克/千克/天，48±17%；总脂肪：6.6±1.2克/千克/天，92±8% 对比 6.8±1.5克/千克/天，90±9%。C8中中链脂肪酸的吸收率为99%。亚油酸和α-亚麻酸尽管摄入量差异很大（10/1），但其吸收率约为90%。亚油酸的净潴留量为933±168毫克/千克/天（FI）和963±190毫克/千克/天（FSL），α-亚麻酸的量为95±16（FI）和100±22毫克/千克/天（FSL）。排泄的钙量与粪便中总脂肪量或所研究的任何一种脂肪酸之间均未发现相关性。单独研究每组或将两组视为一个整体时均是如此。
对足月儿脂肪酸吸收模式进行定量时，与其他年龄段的公认值相比未显示出任何明显变化。与含乳糖配方奶粉（FI）相比，配方奶粉中不含乳糖（FSL）且各脂肪酸比例相同时，总脂肪和各脂肪酸的吸收没有任何变化。不含乳糖的配方奶粉中补充的钙可弥补其较低的吸收率。足月儿脂肪酸吸收模式与其他年龄段的公认值相比未显示出任何明显变化。
