Toxic by-product in heat-treated baby formulas increases infant diabetes risk – study

Heat treatment of infant formula milk during processing produces elevated levels of a toxin that could contribute to a significantly increased risk of children developing health problems including diabetes, according to US scientists.

The research from the Mount Sinai School of Medicines found that levels of Advanced Glycation End (AGEs) product tested were up to 100 times higher in baby formula compared to human breast milk as a result of heat processing undergone during manufacture.

AGEs - toxic glucose by-products previously tied to high blood sugar - are found in most heated foods and, in great excess, in commercial infant formulas, said the team led by Helen Vlassara MD, professor and director of the Division of Experimental Diabetes and Aging, and professor of medicine Jaime Uribarri.

The British Specialist Nutrition Association (BSNA) told FoodProductionDaily.com it was aware of concerns over AGEs but said that heat processing was vital in ensuring the microbiological safety of infant formula. Current research suggested that AGEs “do not seem” to cause health problems, it added.

AGE exposure

The study, published in the journal Diabetes Care, found that excessive AGEs can be present in infants both through the passive transfer of the inflammatory food toxin from maternal blood and by the ingestion of commercial baby formulas.

The research, which looked at 60 women and their babies, examined passive transfer through blood and found that “newborn infants, expected to be practically AGE-free, had levels of AGEs in their blood as high as their adult mothers”.

The team also established that after switching from breast milk to infant formulas, the amount of AGEs in babies doubled to levels comparable to those suffering from diabetes. Many also showed elevated insulin levels.

The scientists said formulas that are processed under high heat can contain 100 times more AGEs than human breast milk, delivering a huge and potential toxic AGE surplus to infants.

Limitations of the study included its small sample size, restricted access to infant blood samples and lack of detailed food intake assessment, said the scientists. While the ELISA-based AGE tests used in the tests have been highly-validated, criticism s of the method have been made by some, they added.

"Modern food AGEs can overwhelm the body's defences, a worrisome fact especially for young children," said Dr Vlassara. "More research is certainly needed, but the findings confirm our studies in genetic animal models of diabetes. Given the rise in the incidence of diabetes in children, safe and low cost AGE-less approaches to children's diet should be considered by clinicians and families."

Industry response

Trade body BSNA said that adequate heat processing of infant formula was a “prerequisite” to ensure the produce was microbiologically safe.

It acknowledged that heat processing can form AGEs through, for example, the Maillard browning reaction during processing when mixtures containing protein and carbohydrates are heated. She also said that AGEs can also be formed endogenously in the body.

“Due to the heat processes that are required to produce safe infant formulas, it would therefore be expected that infant formulas would contain higher levels of AGEs than breast milk,” said BSNA spokeswoman Amy-Jane Valender.

The BSNA said research was currently underway to assess the health impact of dietary AGEs. However, the lack of reliable analytical methods was hampering investigations.

“Based on currently available knowledge from animal studies, dietary AGEs do not seem to induce adverse effects in healthy individuals and more research is required,” said Valender.

She added: “The infant formula industry is aware of the concerns around the end products of heat processing, and has worked hard to reduce the amount of heat processing used whilst ensuring the microbiological safety of the formulas. We will continue with these efforts and will monitor the research findings closely.”

Maternally Transmitted and Food-Derived Glycotoxins by Cecilia Piccardo, Weijing Cai, Xue Chen, Li Zhu, Gary E Striker, Helen Vlassara and Jaime Uribarri published in Diabetes Care DOI: 10.2337/dc10-1058