Bioactive nutrient-enriched infant formula may enhance neurocognitive outcomes

A new infant formula supplemented with bioactive nutrients — containing MFGM* components, LC-PUFAs**, and synbiotics — may improve neurocognitive function and brain development in healthy children at 6 years of age, according to the COGNIS*** study presented at WCPGHAN 2021.

“Where breastfeeding may not be possible, infant formulas are needed. Infant formula has evolved greatly [over the] years to enhance the performance of formulas to a level at or nearer to human milk,” said Dr Cristina Campoy from the Department of Paediatrics at the University of Granada in Granada, Spain, who presented the study. [WCPGHAN 2021, abstract N-O-007]

The study involved 170 healthy infants who were randomized to receive either standard formula (SF; n=58) or experimental formula (EF; n=86) enriched with bioactive nutrients during their first 6 months of life. Of these, only 30 and 25 children aged 6 years were analysed in the SF and EF groups, respectively. BENCI⁺, K-BIT⁺⁺, and PLOR-R⁺⁺⁺ tests were performed to evaluate neurocognitive outcomes. MRI was used to obtain anatomical images of the brain, and brain volumes, areas, and cortical thickness were assessed. [WCPGHAN 2021, abstract N-O-013]

After adjusting for potential confounders, children who were fed with EF achieved better verbal comprehension and memory, as shown by BENCI test direct scores (11.73 vs 10.5; p=0.011 and 11.55 vs 10.35; p=0.036, respectively), as well as fewer perseveration errors of semantic fluency (0.14 vs 0.39; p=0.044) than those fed with SF at 6 years.

Compared with the SF group, those in the EF group also showed higher brain volumes in the parietal regions, including right parietal (p=0.002), right superior parietal gyrus (p=0.016), right post-central gyrus (p=0.019), and right precuneus (p=0.001).

Children who received EF also had a greater cortical thickness in left temporal (p=0.048) and groove temporoparietal (p=0.007) regions, which are related to memory, language, and information processing, than those who received SF.

When the participants were assessed according to sex and study group (boys: EF, n=17 and SF, n=20; girls: EF, n=8 and SF, n=10), boys who were fed with EF than with SF had higher brain volumes in regions of the right parietal lobule (p=0.014), left precuneus (p=0.019), left occipital (p=0.001), left groove postcentral (p=0.007), and right precuneus (p=0.012). These regions are all related to working memory and executive functioning.

As there was no difference in brain structure between the girls in the EF and SF groups, “the structural effects observed in the brain of those children fed with EF seems to be more apparent in boys than in girls at 6 years [of age],” Campoy said.

Boys fed with EF also achieved higher IQ level (K-BIT score, 113.57 vs 104.19; p=0.043) and were better at use of language (PLON-R score, 59.42 vs 47.87; p=0.049) than those fed with SF.

EF-fed vs SF-fed boys also demonstrated better verbal comprehension and working memory, as shown by BENCI test direct scores (12 vs 9.94; p=0.004 and 4.86 vs 4.19; p=0.025, respectively), as well as fewer errors of commission in a go/no-go task (2.14 vs 4.31; p=0.006).

“[Overall,] children fed with EF showed higher IQ, and better performance in language, working memory, sustained attention, and processing speed tasks [than those fed with SF],” said Campoy.

“Our findings suggest that MFGM, LC-PUFAs, and synbiotics enriched-infant formula could be associated to beneficial long-term effects on brain structure … and neurocognitive performance in children aged 6 years,” she concluded.

“Analysis of brain structure could provide new knowledge about neural structure underlying neurocognitive function and origins and progression of [the] brain and mental disorders,” Campoy noted.

“The present study suggests future opportunities to develop preventive strategies against brain and mental disorders based on ensuring adequate and individualized nutrition during the first 18 months of life,” she added.

*MFGM: Milk fat globule membrane

**LC-PUFAs: Long-chain polyunsaturated fatty acids

***COGNIS: A neurocognitive and immunological study of a new formula for healthy infants

⁺BENCI: Computerized battery for neuropsychological evaluation of children

⁺⁺K-BIT: Kaufman Brief Intelligence Test

⁺⁺⁺ PLOR-R: Oral Language Test of Navarra-Revised