Infant diet and the child’s health and development – InfaDiet

The project is divided into three work packages. The 1st work package will be devoted to the influence of essential nutrients (lipids and proteins) in breast and formula milk. The 2nd work package will be devoted to other components, recently added into formula milk such as pre- and probiotics or only present in breast milk such as complex HMO, immune or inflammatory factors. Breast milk analyses are based on large-scale non-targeted («omic«) methods. In the 3rd work package, we will extend our approach to other aspects of infant feeding, such as timing and type of foods used during the complementary feeding period (including organic foods).

The project is based on two French birth cohorts. These two cohorts are complementary, as the EDEN cohort (recruitment in 2003-2006, n=2002) is a bicentric regional study that benefits from a long follow-up (up to age 12 years) and a large biological biobank, whereas the ELFE cohort is nationwide, more recent (recruitment in 2011, data already available up to age 3.5 yrs), larger (n=18,329), benefits from biobanking on specific aspects. These two cohorts will enable to analyse both short- and long-term health effects, but also to replicate analyses and assess the reproducibility of findings. Similar findings in both cohorts will reinforce the level of evidence.

During the first year of the project, we mainly focused on the characterization of infant feeding practices. Beyond breastfeeding duration and age at complementary food introduction, to describe feeding practices, it is important to account for specific food groups such as sweetened drinks and cow's milk, as well as the introduction of food pieces (Camier et al.,2020). Regarding the consumption of organic foods during the complementary feeding period (up to 10 months), 51% of infants never consumed organic foods, 24% sometimes, 15% often and 9% always or almost always (de Lauzon-Guillain et al., 2021). Consumption of organic food was also associated with longer breastfeeding and later introduction to complementary foods. We are currently investigating to which extent these feeding practices are associated with child’s health (growth, respiratory and allergic diseases) and development.
Regarding the composition of infant formulas, under real conditions of use, we found a positive association between the protein content of infant formulas consumed during the first months of life and anthropometric measurements of infants between 6 and 18 months of age (Camier et al., 2021). These results confirm the findings of randomized controlled trials across the range of infant formulas available on the market.

Analyses are ongoing to investigate the relationship between pre/probiotic or long-chain polyunsaturated fatty acid enrichment and child health.
Finally, glycomics, lipidomics and metabolomics data from breast milk are being analysed in the EDEN study and are being acquired for the ELFE study. Their associations with child’s health and development will be examined in the next period of the project.

• Camier A, Chabanet C, Davisse-Paturet C, Ksiazek E, Lioret S, Charles MA, Nicklaus S*, de Lauzon-Guillain B* (2020) Characterization of infant feeding practices during the first year of life and associated familial characteristics in the nationwide ELFE birth cohort. Nutrients. 13:E33. doi: 10.3390/nu13010033.
• de Lauzon-Guillain B, Gaudfernau F, Camier A, Davisse-Paturet C, Lioret S, Nicklaus S, Charles MA, Kesse-Guyot E (2021) Characteristics associated with feeding organic foods during complementary feeding: the nationwide ELFE birth cohort. Br J Nutr. doi: 10.1017/S0007114520005097.
• Camier A, Davisse-Paturet C, Scherdel P, Lioret S, Heude B, Charles MA, de Lauzon-Guillain B. Early growth according to protein content of infant formula: results from the EDEN and ELFE birth cohorts. Ped Obes

InfaDiet is a collaborative project, which aims at studying the influence of infant feeding (milk components & complementary feeding practices) on the child’s health (growth, infections and allergic symptoms) and neurodevelopment. Our main hypothesis is that the beneficial influence of breastfeeding on the child’s health and development is explained by nutritional components of breast milk but also by association of breastfeeding practices with specific complementary feeding practices, such as the more frequent use of fruit and vegetable. The recent evolution of formula milk composition (enrichment with long chain PUFA or with pre/probiotics) offers the opportunity to examine potential nutritional mechanisms, independently of breastfeeding-related practices. Furthermore, we propose to explore breast milk composition, with large-scale non-targeted methods, already developed, to highlight specific components related to the child’s health and neurodevelopment. In this project, child health will be defined by height and weight growth, occurrence of infections and incidence of allergy-related diseases.

Multidisciplinary, InfaDiet associates complementary expertise (4 academic partners from epidemiology, immunology, pediatrics, nutrition and food sciences).

The project is divided into five work packages. The 1st work package will be devoted to the influence of essential nutrients (lipids and proteins) in breast and formula milk. The 2nd work package will be devoted to other components, recently added into formula milk such as pre- and probiotics or only present in breast milk such as complex HMO, immune or inflammatory factors. In the 3rd work package, we will extend our approach to other aspects of infant feeding, such as timing and type of foods used during the complementary feeding period (including organic foods). WP0 will be devoted to the management of the project; and WP4 to the dissemination of its results.

The project is based on two French birth cohorts. These two cohorts are complementary, as the EDEN cohort (recruitment in 2003-2006, n=2002) is a bicentric regional study that benefits from a long follow-up (up to age 12 years) and a large biological biobank, whereas the ELFE cohort is nationwide, more recent (recruitment in 2011, data already available up to age 3.5 yrs), larger (n=18,329), benefits from biobanking on specific aspects. These two cohorts will enable to analyse both short- and long-term health effects, but also to replicate analyses and assess the reproducibility of findings. Similar findings in both cohorts will reinforce the level of evidence.

The impact of this project will be major for research and public health in the field of infant diet for which the scientific knowledge is largely insufficient in comparison with the important societal expectations. The project is innovative and transdisciplinary as it plans to unravel for the first time all the dimensions of infant diet, from infant feeding practices to nutritional content of breast and formula milk, as well as their interrelationships in connection to complementary feeding. These dimensions of infant diet will be examined in real conditions of use and related to several aspects of infant health and development. Our approach will provide original data to improve the current nutritional recommendations concerning this key period of life, as well as on the links between the use of organic foods at a very sensitive period of development and the child’s health. Finally, as the prevalence of allergic diseases increases, understanding how to prevent allergy is an urgent priority and this project could lead to early nutrition recommendations for primary prevention of allergic diseases.