ArticleThe British journal of nutrition2018
Fat composition in infant formula contributes to the severity of necrotising enterocolitis.
Article in The British journal of nutrition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis: A Systematic Review of Experimental and Clinical Studies.Nutrients · 2021Pooled it
- High versus low medium chain triglyceride content of formula for promoting short-term growth of preterm infants.The Cochrane database of systematic reviews · 2021Pooled it
- The Role of Lipid Molecular Structure in Food Technology and Health.Molecular nutrition & food research · 2026Review
- Preterm infant formulas with glucose polymers and reduced lactose content increase the risk of necrotizing enterocolitis.Frontiers in nutrition · 2026Review
- A digestive cartridge reduces intestinal injury in a murine model of necrotizing enterocolitis.PloS one · 2026Article
- Multi-strain probiotic administration decreases necrotizing enterocolitis severity and alters the epigenetic profile in mice.Pediatric research · 2025Article
- Necrotizing enterocolitis: specific human milk oligosaccharides prevent enteric glia loss and hypomotility.Pediatric research · 2025Article
- Necrotizing Enterocolitis: A Comprehensive Review on Toll-like Receptor 4-Mediated Pathophysiology, Clinical, and Therapeutic Insights.Biomedicines · 2025Review
- Portal venous gas value in predicting surgical necrotizing enterocolitis.Pediatric research · 2025Article
- An anti-eCIRP strategy for necrotizing enterocolitis.Molecular medicine (Cambridge, Mass.) · 2024Article
- Redox Chemistry: Implications for Necrotizing Enterocolitis.International journal of molecular sciences · 2024Review
- Predigested Mixture of Arachidonic and Docosahexaenoic Acids for Better Bio-Accessibility.Marine drugs · 2024Article
- Article
- The role of human milk nutrients in preventing necrotizing enterocolitis.Frontiers in pediatrics · 2023Review
- The administration of amnion-derived multipotent cell secretome ST266 protects against necrotizing enterocolitis in mice and piglets.American journal of physiology. Gastrointestinal and liver physiology · 2022Article
- Article
- The Role of Dietary Fats in the Development and Prevention of Necrotizing Enterocolitis.Nutrients · 2021Review
- Toll-like receptor 4-mediated enteric glia loss is critical for the development of necrotizing enterocolitis.Science translational medicine · 2021Article
- Malnutrition, poor post-natal growth, intestinal dysbiosis and the developing lung.Journal of perinatology : official journal of the California Perinatal Association · 2021Review
- Plasma membrane integrity: implications for health and disease.BMC biology · 2021Review
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
Necrotising enterocolitis (NEC) is a devastating disease that typically affects formula-fed premature infants, suggesting that dietary components may influence disease pathogenesis. TAG are the major fat components of infant formula, and their digestion requires pancreatic lipases, which may be naturally deficient in premature neonates. We hypothesise that NEC develops partly from the accumulation of incompletely digested long-chain TAG-containing unsaturated fatty acids within the intestinal epithelial cells, leading to oxidative stress and enterocyte damage. We further hypothesise that the administration of a formula that contains reduced TAG ('pre-digested fat') that do not require lipase action may reduce NEC severity. To test these hypotheses, we induced NEC in neonatal mice using three different fat formulations, namely 'standard fat', 'pre-digested fat' or 'very low fat', and determined that mice fed 'standard fat' developed severe NEC, which was significantly reduced in mice fed 'pre-digested fat' or 'very low fat'. The expression level of the critical fat-digesting enzyme carboxyl ester lipase was significantly lower in the newborn compared with older pups, leading to impaired fat digestion. The accumulation of mal-digested fat resulted in the significant accumulation of fat droplets within the intestinal epithelium of the distal ileum, resulting in the generation of reactive oxygen species and intestinal inflammation. Strikingly, these changes were prevented in pups fed 'pre-digested fat' or 'very low fat' formulas. These findings suggest that nutritional formula containing a pre-digested fat system may overcome the natural lipase deficiency of the premature gut, and serve as a novel approach to prevent NEC.
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Registered trials
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