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Lactose-Reduced Infant Formulas with Corn Syrup Associated with Higher Obesity
Pennsylvania Ag Connection - 09/22/2022

Lactose-reduced infant formula made with corn syrup solids was associated with higher obesity risk among Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participants in Southern California, according to a new study by researchers from Public Health Foundation Enterprises (PHFE) WIC, a program of Heluna Health; and Children's Hospital Los Angeles.

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Research shows that certain infant formula may lead to higher risk of childhood obesity.

The study, published on August 23, 2022 in the American Journal of Clinical Nutrition, is the first to assess the relationship between infant formula type and child obesity risk among WIC participants.

WIC is a federal nutrition assistance program that serves pregnant and postpartum women, and infants and children under age five years who live in low-income households. The WIC program serves about half of all infants born in the United States and provides infant formula for infants who are not fully breastfed. Over half of participating infants under age one year receive infant formula from WIC by two months of age. The types of infant formula available to mothers are determined by multi-year contracts awarded to formula manufacturers by state WIC agencies to provide all non-therapeutic infant formula for the program in that state.

Lactose-reduced infant formula made with corn syrup solids is typically marketed for "fussy babies" suspected of having lactose intolerance or other allergies related to dairy. Lactose is the most abundant carbohydrate in milk and is a sugar made by joining two smaller sugars together, glucose and galactose. Corn syrup solids is a carbohydrate source that is entirely glucose-based. Lead author Christopher E. Anderson, PhD, an Associate Research Scientist at PHFE WIC, stated that the study findings "suggest that glucose-based infant formulas like lactose-reduced infant formula made with corn syrup solids could increase obesity risk up to 10% among children who receive them, which is critical to understand for policymakers considering how to ensure that the WIC Program maximizes the program's health benefits for all participating children."

Anderson and Shannon E. Whaley, PhD, Director of Research and Evaluation at PHFE WIC collaborated with Michael I. Goran, PhD, Professor of Pediatrics at Children's Hospital Los Angeles and the University of Southern California for this research. The researchers used infant feeding and health data from over 15,000 formula-fed infants served by the PHFE WIC program in the Los Angeles metropolitan area. The WIC program serves over 270,000 participants every month in Los Angeles County.

The study compared infants who had stopped breastfeeding by three months of age by type of formula received from WIC: those who ever received a lactose-reduced infant formula made with corn syrup solids and those who received only other types of infant formula. Children who ever received a lactose-reduced infant formula made with corn syrup solids had 10% higher obesity risk at age two years, 8% higher obesity risk at age three years, and 7% higher obesity risk at age four years compared to children who received only the other types of formula. Associations did not differ between boys and girls, nor between Hispanic and non-Hispanic children.

"The national epidemic of childhood obesity is driven by much higher levels among children from low-income households, including those served by WIC. Among WIC participants, obesity is more common among children who are formula-fed. If WIC can use data from studies like this one to refine how it determines the types of infant formula it provides to participants, the program could help alleviate the burden of childhood obesity among its formula-feeding infants," Goran said.

The predominant carbohydrate in breastmilk and cow's milk (and infant formula made from cow's milk) is lactose, and this study suggests that infant formulas that replace lactose with glucose in the form of corn syrup solids contribute to an increased risk of obesity. This could be through the development of stronger preferences for sweet tastes, through the higher glycemic load of the corn syrup solids-based formula, or through differences that develop in the infant gut microbiome in response to the glucose-based formula instead of a lactose-based one.

Data from the current study were collected and analyzed prior to the current nationwide shortage of infant formula, a situation that has laid bare the vulnerability of the formula supply chain and drawn attention to the complex formula contracting process that supports the purchase of formula for WIC families. The shortage has led to families needing to purchase any formula they can find on the shelves, and to federal legislation allowing the import of formulas from other countries to fill supply gaps. Whaley stated, "As the nation emerges from this crisis, there is significant opportunity to reconsider how different types of formula are authorized for purchase in the WIC program, and what nutritionally appropriate formula options can be made available for infants that do not include corn syrup solids."

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