Formula Series 5 – Protein: Hydro-what?

Protein – The Basics … Hydro-what??

There is one final topic in protein I have to tell you about.  It’s something I feel quite passionate about.  This is – hydrolysate protein.  Hydrolysis is a process that chops up, or pre-digests protein so that the protein amino-acid chains are smaller.  Protein that has undergone hydrolysis is referred to as “hydrolyzed”.  Healthy infants’ intestines are capable of, and should work to digest protein.  However, cow and soy milk proteins are bigger and harder to digest and more allergenic than breast milk proteins.  Hydrolyzed proteins are easier for baby to digest while still teaching her stomach and intestines how to handle protein.   Thus, the process of hydrolyzing proteins evens the playing field for formula-fed babies.  The research on hydrolysate protein is very promising, both for digestive and immune issues.  Hydrolyzed proteins are less allergenic or immune-response-inducing for babies who are at risk for food allergies or immune diseases.  In fact, there has been good research to show that infants fed hydrolysate formula develop less atopic disease (like eczema) (7, 8).  The American Academy of Pediatrics actually recommends that infants who are at risk for atopic disease, which are skin conditions like eczema, be fed hydrolysate formula (9).   This could be as high as 33% of all infants (10) !  A very interesting study also found that infants who had a family history of Type 1 diabetes were less likely to develop autoantibodies indicative of diabetes if they were fed hydrolysate protein formula as opposed to standard formula (11).  For all these reasons, I am a huge fan of hydrolysate protein for infants!  This is one of the first things I recommend parents look for this on the label.

 You have to look in the ingredients list and look for the words “partially hydrolyzed” before the protein.  I’ll repeat my mantra here: You must read the list of ingredients!  If you just look at the chart that lists grams of protein per serving, you have no idea if that protein is from cow’s milk, soy, has extra whey, or is hydrolyzed.  Both cow’s milk and soy based protein can be hydrolyzed but you have to look!  For your convenience, below is a list of all the mainstream brands of formula for healthy term infants, and the type of protein they provide.

 

Gerber® Good Start

Gentle, Protect, and Soothe 100% Partially Hydrolyzed Whey protein
Soy 100% Partially Hydrolyzed Soy protein

Enfamil®

Premium Nonfat cow milk protein plus extra whey protein
Gentlease Partially hydrolyzed nonfat cow milk plus extra whey protein
A.R. Nonfat cow milk (mix of mostly casein and some whey protein)
ProSobee (Soy based) Soy Protein Isolate

Similac®

Advance Whey Protein Isolate
Advance Organic Organic Nonfat cow milk (mix of mostly casein and some whey protein)
Total Comfort Hydrolyzed Whey Protein
Sensitive Early Shield Cow milk protein isolate (mix of mostly casein and some whey protein)
Soy Isomil Soy Protein Isolate
For Spit Up Cow milk protein isolate (mix of mostly casein and some whey protein)

 

If hydrolyzed protein is so much better for little stomachs, why aren’t all formulas made that way?  Answer:  it’s more expensive.  This is the cold-truth of capitalism.  That’s why, if you only read one of these articles, this one gives you the most bang-for-your-buck!  I always recommend choosing a hydrolysate formula.

In the next article, I’ll talk about all the other important macro – and micro nutrients in formula: the carbs, the fat, the vitamins, and the minerals.

 

Bonus Reading:

The protein in formula can be hydrolyzed to varying degrees.  Most mainstream hydrolyzed formulas are “partially hydrolyzed”, and this is enough to provide the benefits I described above.  Other formulas can be extensively hydrolyzed so the proteins are in even smaller chains, and finally there are a few commercial formulas that only have free amino acids and no intact proteins at all.  Free amino-acid formulas are for infants with rather severe digestive tract issues that are incapable of digesting intact protein.  Feeding an infant such a formula should be done only under the direction and care of your pediatrician and gastroenterologist.

 

Take-Home Messages:

  • Hydrolysis chops up large proteins into smaller, more easily digestible pieces.
  • Partially hydrolyzed protein may help prevent atopic disease, food allergy, and type 1 diabetes in babies who are at risk for these diseases.
  • Look for the words “partially hydrolyzed” before the protein on the list of ingredients!

7.         Jin, Y. Y., Cao, R. M., Chen, J., Kaku, Y., Wu, J., Cheng, Y., Shimizu, T., Takase, M., Wu, S. M., and Chen, T. X. (2011) Partially hydrolyzed cow’s milk formula has a therapeutic effect on the infants with mild to moderate atopic dermatitis: a randomized, double-blind study. Pediatr. Allergy Immunol. 22, 688-694

8.         Alexander, D. D., and Cabana, M. D. (2010) Partially hydrolyzed 100% whey protein infant formula and reduced risk of atopic dermatitis: a meta-analysis. J. Pediatr. Gastroenterol. Nutr. 50, 422-430

9.         Greer, F. R., Sicherer, S. H., Burks, A. W., American Academy of Pediatrics Committee on, N., American Academy of Pediatrics Section on, A., and Immunology. (2008) Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics 121, 183-191

10.       Martinez, J. A., and Ballew, M. P. (2011) Infant formulas. Pediatr. Rev. 32, 179-189; quiz 189

11.       Knip, M., Virtanen, S. M., Seppa, K., Ilonen, J., Savilahti, E., Vaarala, O., Reunanen, A., Teramo, K., Hamalainen, A. M., Paronen, J., Dosch, H. M., Hakulinen, T., and Akerblom, H. K. (2010) Dietary intervention in infancy and later signs of beta-cell autoimmunity. N.Engl J.Med. 363, 1900-1908