A Novel Infant Formula with Medium- and Long-Chain Triacylglycerols and sn-2 Palmitate Supports Adequate Growth and Lipid Absorption in Healthy Term Infants

<b>Background:</b> Medium- and long-chain triacylglycerols (MLCTs) and <i>sn</i>-2 palmitate constitute approximately 70~80% of total breast milk fat. The structured lipid MLCTs and <i>sn</i>-2 palmitate, mimicking human milk, have demonstrated improvement in lipid absorption and energy metabolism in vitro and in animal experiments. However, clinical trials on infant formula supplied with MLCTs and <i>sn</i>-2 palmitate have yet to be conducted. <b>Objectives:</b> This study was designed to evaluate the effects on growth and lipid absorption of a novel formula with structured lipid MLCTs and <i>sn</i>-2 palmitate on healthy infants born at term. <b>Methods:</b> Infants were enrolled at 30 d postpartum and assigned to three groups based on their feeding conditions: (1) a novel formula with MLCTs and <i>sn</i>-2 palmitate (Novel-F group, <i>n</i> = 65); (2) a control formula with vegetable oils and no structured lipids (Contr-F group, <i>n</i> = 46); or (3) breastfeeding (BF group, <i>n</i> = 66). Growth measurements (including weight, length, and head circumference), stool characteristics, and fecal lipid composition (both soap and non-soap fatty acids) were analyzed at both baseline (30 d postpartum) and endline visits (90 d postpartum). <b>Results:</b> The Novel-F group had significantly higher weight gains (2195 ± 595 g) during the intervention compared to the Contr-F group (1897 ± 483 g) but similar weight gains to the BF group (2081 ± 614 g), with the changes in Z_w/a following a similar pattern. Z_l/a increased in the Novel-F group (0.04, (95% CI: -0.21 to 0.28)) and decreased in both the Contr-F (-0.23 (95% CI: -0.52 to 0.06)) and BF groups (-0.20 (95% CI: -0.44 to 0.05)). The stools of infants in the Novel-F group had similar undigested triacylglycerols and total fatty acids compared to breastfed infants but had significantly lower levels than infants fed with the control formula at both baseline and endline visits. <b>Conclusions:</b> The novel infant formula with MLCTs and <i>sn</i>-2 palmitate is safe and well tolerated, and supports adequate weight gain and improves lipid absorption.