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Background Formula-fed (FF) infants often have harder stools and higher stool concentrations of fatty acid soaps compared to breastfed infants. Feeding high sn -2 palmitate or the prebiotic oligofructose (OF) may soften stools, reduce stool soaps, and decrease fecal calcium loss. Methods We investigated the effect of high sn -2 palmitate alone and in combination with OF on stool palmitate soap, total soap and calcium concentrations, stool consistency, gastrointestinal (GI) tolerance, anthropometrics, and hydration in FF infants. This double-blind trial randomized 165 healthy term infants 25–45 days old to receive Control formula (n = 54), formula containing high sn -2 palmitate ( sn -2; n = 56), or formula containing high sn -2 palmitate plus 3 g/L OF ( sn -2+OF; n = 55). A non-randomized human milk (HM)-fed group was also included (n = 55). The primary endpoint, stool composition, was determined after 28 days of feeding, and was assessed using ANOVA accompanied by pairwise comparisons. Stool consistency, GI tolerance and hydration were assessed at baseline, day 14 (GI tolerance only) and day 28. Results Infants fed sn -2 had lower stool palmitate soaps compared to Control ( P =0.0028); while those fed sn -2+OF had reduced stool palmitate soaps compared to both Control and sn -2 (both P <0.0001). Stool total soaps and calcium were lower in the sn -2+OF group than either Control ( P <0.0001) or sn -2 ( P <0.0001). The HM-fed group had lower stool palmitate soaps, total soaps and calcium ( P <0.0001 for each comparison) than all FF groups. The stool consistency score of the sn -2+OF group was lower than Control and sn -2 ( P <0.0001), but higher than the HM-fed group ( P <0.0001). GI tolerance was similar and anthropometric z-scores were <0.2 SD from the WHO growth standards in all groups, while urinary hydration markers were within normal range for all FF infants. Conclusions Increasing sn -2 palmitate in infant formula reduces stool palmitate soaps. A combination of high sn -2 palmitate and OF reduces stool palmitate soaps, total soaps and calcium, while promoting softer stools. Trial registration This study was registered on http://www.clinicaltrials.gov: number NCT02031003 .

The main objective of this study was to evaluate the contribution of dietary cholesterol from eggs in the context of a carbohydrate restricted diet (CAD) on lipoprotein metabolism and circulating carotenoids. This was a randomized single blinded study conducted in 28 overweight/obese male subjects (BMI: 25-37 kg/m2), 40-70 y. Subjects were counseled to consume 10-15% energy from carbohydrate (CHO) and were allocated either to the EGG group [intake of 3 eggs (640 mg/d additional dietary cholesterol)] or the SUB group [equivalent amount of egg substitute (0 additional mg dietary cholesterol/d) for 12 wk. During the intervention a decrease in energy intake and energy from CHO (P < 0.05) was observed for all subjects when compared to habitual intake. In addition, reductions in body weight (P < 0.001), waist circumference (P < 0.0001) and plasma triglycerides (TG) (P < 0.001) were observed in all subjects after 12 wk. Total and LDL cholesterol as well as the LDL-C/HDL-C ratio did not change during the intervention. In contrast, the EGG group had a significant increase in HDL cholesterol (HDL-C) (P < 0.001) while there were no changes in HDL-C for the SUB group. Decreases in large and medium very low density lipoprotein subclasses (P < 0.001) and apolipoprotein (apo) B (P < 0.01) were observed for both groups. In agreement with the reduction in plasma TG, a 133% increase in apo C-II and a 65% decrease in apo C-III were observed. Subjects from the EGG group had a higher concentration of large HDL and large LDL subclasses compared to the SUB group (P < 0.01). Intake of carotenoids including lutein, zeaxanthin, criptoxanthine, β-carotene and α-carotene were similar between the EGG and SUB groups at baseline, 6 and 12 wk. However, only the EGG group presented an increase in plasma lutein (P < 0.0001) and zeaxanthin (P < 0.025) after 12 wk. From these studies, we conclude that intake of 3 eggs per day enhances the beneficial effects of CRD in lipoprotein metabolism and carotenoid absorption as demonstrated by the higher concentrations of HDL–C, the increased formation of large HDL and LDL subclasses and the higher concentrations of circulating lutein and zeaxanthine in the EGG group.