Essentials for Infants & Young Children

Essentials for infants and young children

Health benefit solutions DSM’s Position on the Importance of Breastfeeding

Human milk represents the nutritional gold standard for infant nutrition and we strongly support the WHO recommendation that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and long-term health. Thereafter, older infants and young children should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or more. We believe that breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants and is also an integral part of the reproductive process with important implications for the health of mothers.

For many reasons, however, not every infant will be fed breast milk exclusively for 6 months. Indeed, some mothers choose not to breastfeed; some mothers may breastfeed only part of the time and a small percentage perhaps cannot breastfeed their babies. Infant formula, although it can never equal breast milk, is formulated in an attempt to ensure that the most nutritionally complete substitute possible is made available for babies who are not breastfed. Breast milk should be the nutritional gold standard by which formula milk should be assessed. The industry’s goal over the years has been to continually improve the quality and safety of infant formula. We believe that components like DHA and ARA, as well as other infant nutrition innovations, help achieve this goal. http://www.dsm.com/corporate/sustainability/ managing-sustainability/position-papers.html

2 Essentials for infants and young children Essentials for infants and young children 3 1,000 days between the onset of a woman’s pregnancy and her child’s second birthday Building a Foundation for offer a unique window of opportunity for nutrition to shape healthier futures. Optimal Growth and Development

Mounting research through the past few decades and develop — although at a slower in rate, Protect their Health continues to highlight the role nutrition plays throughout early childhood. During this critical The immune system begins to develop in the womb during infancy and its effect on factors relevant to time, the brain is producing billions of cells and and continues to mature during the first two years health later in life including cardiovascular health, forming connecting pathways between different of life.6 Many of the key antibodies (disease fighting allergies, bone health, and the development of regions of the brain. These pathways are essential proteins) transferred to the fetus during pregnancy obesity.1 The first 1,000 days between the onset for the successful development of cognitive, motor, disappear within the first three months of life, leaving of a woman’s pregnancy and her child’s second and sensory skills. Optimal nutrition plays a very infants with immature immune systems. Breast milk birthday offer a unique window of opportunity for important role in ensuring the structural maturation provides immunological support from mother to infant, nutrition to shape healthier futures. It is essential of the brain and proper functioning of the nervous providing infants with a blend of key nutrients such as that infants (0-12 months) and young children (1-3 system. Inadequate brain growth can result in DHA, ARA, nucleotides, vitamins, and minerals.7–10 As years) receive the necessary nutrients at appropriate behavioral and cognitive deficits, lower IQ, and weaning foods are introduced in the infant diet, the levels to help set them on a path to a long, healthy poor school performance, all of which can have demand for key nutrients to support immunity remains life. Breast milk continues to be the nutritional gold life-long consequences. To facilitate healthy brain high. Traditionally, parents begin by introducing fortified standard for infant feeding, but in situations where growth, infants must be provided with a key blend of baby cereals into their infant’s diet, which contains all breast milk is not available to the infant, parents nutrients including: long chain-polyunsaturated fatty the essential proteins, fibers, vitamins and minerals rely on formulas and fortified foods designed to acids (LC-PUFAS) such as omega-3 docosahexaenoic needed to support a healthy immune system. Nutrition deliver the nutrients needed for optimal growth and acid (DHA) and omega-6 arachidonic acid (ARA), is not only a key source of antigens, which are foreign development. These key nutrients promote healthy carotenoids, amino acids, vitamins and minerals to substances that the immune system needs to recognize growth and development by supporting brain and support this time of critical development. and tolerate, but also provides factors which might eye development, maintaining a healthy immune support immune maturation and response. system, and ensuring normal skeletal development. Support their Vision At birth, two of the main anatomical structures of the Build Strong Bones Empower their Minds eye (retina and fovea) are poorly developed, thus Skeletal growth and development during infancy sets The human brain begins forming very early in newborns can only discern vague shapes at a high the stage for bone health throughout life. Bones are prenatal life. Gestation through the first years of contrast to their surroundings. Infancy and early living, dynamic tissues that are continually being life marks the most rapid period of brain growth childhood are periods of rapid eye development remodeled. The body maintains a delicate balance and development.2–4 The brain continues to grow with visual acuity improving to near adult levels by between the process of bone formation and resorption. four years of age.5 Healthy eyes and vision play a To support infants’ rapidly growing bodies, it is fundamental role in how infants and young children fundamental to ensure they receive optimal levels of learn as well as perceive the world around them. A vitamins and minerals to maximize their peak bone proper balance of nutrients is essential for optimal mass. Peak bone mass determines the resistance eye development. Shortages of key nutrients can and susceptibility to bone fracture. Proper nutrition result in vision problems and developmental delays. results in higher peak bone mass during infancy, Nutrients that support eye health in infants and which lays the groundwork for maintaining bone young children include DHA, lutein, zeaxanthin and health throughout life.11,12 Key nutrients for bone vitamins A and E. health include minerals such as calcium, phosphorus, magnesium, zinc, and vitamins B6, C, D, and K. 4 Essentials for infants and young children Essentials for infants and young children 5 Nutritional Lipids

Docosahexaenoic acid (DHA) and arachidonic milk always contains both DHA and ARA. Infant acid (ARA) are long chain omega-3 and omega-6 formula supplemented with DHA and ARA provides polyunsaturated fatty acids (LC-PUFAS) that are an alternative source of these fatty acids for those found in all cells of the body. DHA is the most infants whose mothers are unable to or elect not to abundant omega-3 fatty acid in the brain and the breast feed. retina of the eye, representing about 97% and 93% of all the omega-3 fatty acids found in the brain For nearly 20 years, there has been a research focus and eyes, respectively. ARA is the primary omega-6 on the role of DHA and ARA in infant health and fatty acid in the brain, representing about 48% of development. On the basis of this clinical evidence, the omega-6 fats found there.3,4,13,14 To indicate their recommendations have been made by several expert importance in nutrition, DHA and ARA often are groups to assure the adequate intake of DHA and referred to as “conditionally essential nutrients” for ARA during infancy.36–42 Breast feeding studies also the development and function of infant cognition highlight the importance of DHA during early life, and vision. These fatty acids also contribute to an and mothers can increase the levels of DHA in their infant’s cardiovascular and immune function. The breast milk through supplementation. Maternal metabolism and functional activity of these two fatty DHA supplementation during lactation results in acids are interconnected and their health benefits mental development advantages in children43–46 are best characterized when considered together. including improved psychomotor development (such as eye-hand coordination) at 2.5 years of age45 and Maternal intake of DHA during pregnancy influences improved attention skills at 5 years of age.46 the DHA status of the developing fetus and infant. DHA supplementation studies conducted during Infants fed DHA and ARA-supplemented pregnancy identify important health benefits for formula exhibited better visual acuity than the infant, but also the young child. Cognitive,15–21 that of the non-supplemented infants, and vision,17,22,23 and immune function24–26 benefits are the supplemented infants’ visual acuity was reported in the offspring of mothers who had a similar to that of breast-fed infants.60–62 higher DHA intake and/or status during pregnancy. DHA and ARA are natural components of breast milk27 and studies have consistently shown infant blood DHA and ARA levels decrease significantly following birth, unless the infant receives a source either from breast milk or, if not possible, a supplemented infant formula.28–35 Breast feeding is the optimal method for infant feeding, and breast

6 Essentials for infants and young children Essentials for infants and young children 7 Empower their Minds Support their Vision Guard their Heart The physiological demand for DHA and ARA begins DHA is the most abundant omega-3 fatty acid in Infants fed formula supplemented with DHA and ARA early in life. The brain grows rapidly during the last the retina of the eye, and is important for healthy had significantly lower blood pressure compared to months of gestation and throughout the first years of visual development.3–4 Infants who were breast-fed infants fed non-supplemented formula, similar to life.2,47,48 Infants born prematurely do not have time and then weaned to formula supplemented with that of breast-fed infants. Because blood pressure to accumulate DHA to the same level as their full- DHA and ARA demonstrated more mature visual tends to track from childhood into adult life, it term counterparts. When fed formula supplemented acuity (clearness of vision) than those breast-fed has been suggested that early intake of DHA and with DHA and ARA, preterm infants achieved infants weaned to non-supplemented formula.58–59 ARA may reduce the risk of cardiovascular disease normal growth in terms of weight, length, and head Infants fed DHA and ARA-supplemented formula later in life.67 A recent study of 12-year-old children circumference,49–52 and demonstrated improved exhibited better visual acuity than that of the non- reported those receiving higher levels of omega-3 visual and mental development compared to infants supplemented infants, and the supplemented LC-PUFA in breast milk exhibited improved fed formula without DHA and ARA.52 infants’ visual acuity was similar to that of breast- blood pressure parameters at 12 years of fed infants.60–62 age, compared to those who did not.68 This Many studies demonstrate improved mental benefit was unrelated to their current development in term infants fed DHA and ARA Protect their Health omega-3 LC-PUFA status. supplemented formula compared to those receiving In addition to the key role DHA and ARA play in brain unsupplemented formula. These benefits extend and eye development and function, recent studies well beyond the period of supplementation and have shown LC-PUFAs may help modulate immune continue into childhood.53–55 For example, infants responses. DHA and ARA are used by the body to fed DHA and ARA supplemented formula scored 7 make molecules that regulate inflammation and the points higher on the Bayley Mental Development immune response including resistance to infection Index at 18 months than those fed unsupplemented and tolerance to allergens.63 One study showed that formula.52 This test measures a child’s level of infants fed formula supplemented with DHA and ARA cognitive, motor, and behavioral development. In had fewer episodes of bronchiolitis and bronchitis a follow-up study of those same children at age 4, at ages 5, 7, and 9 months compared to infants fed visual acuity and verbal IQ scores were higher in non-supplemented formula.64 Infants fed formula those children who had received supplemented supplemented with DHA and ARA during infancy had formula compared with those who received formula reduced incidence of upper respiratory infections lacking DHA and ARA.55 Furthermore, omega-3 and common allergic diseases at age 3.65 Another supplementation during weaning also demonstrates study examining the relationship between DHA positive effects on brain development. Infants and respiratory health in children concluded that supplemented with omega-3 from 9–12 months increases in DHA intake in toddlers might improve of age, exhibited positive effects on scores of immune function and development, including attention.56 Additional research conducted and respiratory health.66 measured using the same methods has shown a positive link between scores of attention and stronger vocabulary in childhood.57

8 Essentials for infants and young children Essentials for infants and young children 9 Lutein and Zeaxanthin

Lutein and zeaxanthin may be important not only for The visual cortex is located in the occipital lobe of visual and cognitive health in adult life, but also for the brain, where visual information is interpreted the healthy development of the eyes and brain and understood. during gestation and early infancy.69 Recent research suggests that these two powerful antioxidants may Scientists have found that lutein and zeaxanthin influence maturation and/or play protective roles are highly concentrated within the infant brain in during critical periods of fetal and neonatal the hippocampus, occipital lobe, frontal cortex and development.70 During gestation and lactation the auditory lobe — areas involved in sight, memory infant is dependent on its mother’s nutritional status and learning.76 to get adequate levels of lutein and zeaxanthin.71 Upgrade their Vision Infants who are breast-fed obtain these critical Similar to other carotenoids, lutein and zeaxanthin nutrients through colostrum and breast milk, while are effective antioxidants, protecting cells against formula-fed infants can only get lutein and damage induced by free radicals.77 Lutein and zeaxanthin from a supplemented infant formula. zeaxanthin are highly concentrated in the macula, a Colostrum, the first of the mother’s breast milk, is small area of the retina responsible for central uniquely adapted to fulfill the needs of the newborn vision, and are the only carotenoids present in this by supplying critical immune components, including tissue.78 Lutein may protect the neonate’s retina protein and a high amount of lutein. Lutein is highly from light-induced oxidative damage that it may concentrated in colostrum.72 Over the course of a few encounter in the first months of life.5,69,79 The retina weeks, the lutein content of breast milk gradually is highly vulnerable to damage by ultraviolet light in decreases by about half.72 This suggests that Nature infancy, which is one reason why newborn infants has found a way to concentrate lutein in colostrum need antioxidant protection. The presence of lutein to deliver an initial “bolus” dose that protects the in breast milk may represent a means of providing newborn infant. Most infant formulas do not contain this protection. Newborn infants are vulnerable to lutein and zeaxanthin, which may explain why oxidative stress because of their high metabolism breast-fed infants typically have significantly higher and low levels of antioxidant enzymes. A study in blood plasma levels of lutein and zeaxanthin than healthy newborns found that infants supplemented formula-fed infants.73–74 with lutein had better antioxidant protection and lower levels of markers of oxidative stress.80 Empower their Minds Furthermore, lutein supports retinal health in Lutein and zeaxanthin are concentrated in the infant preterm infants. A new study in premature infants brain.75 It is known that the “eyes are windows to the shows that supplementation of breast milk with brain” and that the macula of the retina is the lutein enhances rod photoreceptor sensitivity, an sensitive neurological tissue that transmits information indicator of retinal health.81 to the visual cortex.

10 Essentials for infants and young children Essentials for infants and young children 11 Nucleotides

Nucleotides are vital components of all living cells. Protect their Health They play major roles in almost all physiological Periods of rapid growth, during pregnancy and in processes, particularly in cells that replicate and infancy, increase the demand for nucleotides in proliferate rapidly, such as in developing and tissues with fast turnover, such as the digestive repairing tissues. They are building blocks of DNA and immune systems.82 Research has shown and RNA and have an important function in cellular that nucleotides are present in breast milk as energy and metabolism. they are required for the production of new cells in the rapidly growing infant.83–85 It appears that supplementation of infant formula with nucleotides results in better growth and increased resistance to infections by enhancing responses to vaccines, while promoting the growth of ‘good’ bacteria which protect the gut against harmful bacteria and thus reduce the incidence of diarrhea.86 Infants fed formula supplemented with nucleotides show similar immune responses to breast-fed infants.87

Oat Beta-Glucan

Dietary fiber plays an important role in the body Protect their Health as its helps to maintain gut health, regulate bowel Oat beta-glucan may promote gut health via movements and increase fecal bulk.88,89 Dietary improvement in digestion in young children, as fibers can be found in fruits, vegetables, whole-grain they may become agitated from constipation or gas. products, nuts, seeds, beans and other legumes. Oat beta-glucan may help to alleviate constipation Oat bran is an excellent source of both insoluble and through improvement of bowel function by soluble fibers and is used to contribute to the increasing fecal bulk89. Currently, oat beta-glucan daily recommended dietary fiber intake. The can be used to fortify cereals for young children beneficial properties of (ages 1-3 years old) in the European Union, but oat are attributed to the regulatory approval may vary on a global basis. soluble fibers that occur naturally in the grain, which are called beta-glucan.

12 Essentials for infants and young children Essentials for infants and young children 13 Vitamins and Minerals

Vitamins and minerals are essential for good Empower their Minds Upgrade their Vision health in every stage of the human lifecycle. They All nutrients are important for brain development, The minerals iron, zinc and copper play instrumental Vitamins A and E are essential for healthy are essential for normal metabolism, growth and but some appear to have greater effects on the roles in infant brain development.92 The growing eyesight.96,97 Vitamin A is needed for black and white physical well-being, including supporting disease developing brain.91 The B-complex vitamins (B1, infant brain has a high demand for iron, as it is an differentiation, which may help vision at night.98,99 prevention. Vitamin deficiency disorders may B2, B6, B12, Biotin and Folic Acid) are relevant to essential nutrient for rapidly proliferating and/or Vitamin E’s antioxidant function protects the eyes occur when dietary intake does not meet metabolic brain structure and neurological function because differentiating tissues in the brain. 93 Iron also helps from high levels of oxidation, which can result in demands. Infants need optimal vitamin and mineral they are needed for the synthesis of several to transport oxygen to the brain.92 An iron deficiency cell damage, thus compromising cell function and status to promote postnatal growth and reduce neurotransmitters.92 in early life may result in learning and memory altering maturation.100 infant morbidity and mortality.90 Each of the 13 deficits.94 Zinc is found in high concentrations in vitamins known today have specific functions in the the brain. It is critical for structural aspects of brain body, which makes every one of them unique and development and may also play a role in behavioral irreplaceable. Vitamins are essential for life! and cognitive aspects of brain function.95

14 Essentials for infants and young children Essentials for infants and young children 15 Protect their Health Mellitus.115,116 Unfortunately, a recent study found Antioxidants such as vitamin A, C and E and that less than 25% of U.S. infants are getting the carotenoids have an immune boosting impact as recommended amount of vitamin D per day.117 This they can both protect and repair cells affected by study exemplifies the increased need for attention free radicals.101,102 Free radicals have the potential to to adequate vitamin D status. Similar to the role damage DNA, proteins, carbohydrates, lipids and cell of vitamin D, vitamin A is required for the normal membranes.103 The balance of free radical production functioning of the immune system and plays a and the level of antioxidant defenses have important central role in the development and differentiation disease and health implications.104 If there are too of white blood cells, the body’s defense against many free radicals produced and too few antioxidants pathogens.118 Also, adequate intake of vitamins B6, to combat them, a condition of oxidative stress folate, B12, and zinc, selenium, copper, and iron develops and can lead to chronic injury. help to maintain an effective immune response.111 Many research articles highlight the potential role of select vitamins and trace elements in supporting Build Strong Bones immune function;105 it is prudent, therefore, to The blueprint for strong bones begins early in life ensure adequate intake of vitamins and trace and essential nutrients play a vital role in elements. Low vitamin C status is associated with a guiding bone development over the years.119 reduction in the bacterial killing efficiency of white Calcium and zinc are the essential minerals for blood cells.106 Studies have shown that vitamin C bone development and formation.120,121 Furthermore, may help to decrease the duration and/or severity calcium intake is positively associated with of the common cold.107 Vitamin E is the principal increases in bone mass and bone structure in fat soluble antioxidant in cell membranes, and it children.119,122 Magnesium, zinc, fluorine, and supports improved immune function by helping to phosphorus are necessary for building healthy prevent the spread of free radical reactions.108-110 bones as they are components of the bone matrix.123,124 Vitamin D plays a critical role in Vitamin D is a critical micronutrient for strengthening maintaining the mineral balance in the body and the immune system by facilitating regulation and is required for the absorption of calcium and differentiation of immune cells.111–113 The American phosphate to facilitate bone mineralization and Academy of Pediatrics (AAP) has doubled its healthy bone formation.125 Studies have shown that recommended dose of vitamin D for infants and vitamin D supplementation in infants and young children because of growing evidence to support children is associated with higher bone mineral the role of vitamin D in maintaining general mass in adolescence.126-129However, vitamin D immunity and preventing disease. Vitamin D may does not work alone in supporting healthy bone help protect the respiratory tract from infections114 formation. Vitamin K activates a protein that and has emerged as a potential risk modifier for binds calcium into the structure of the bone,130 autoimmune diseases including Type 1 Diabetes and vitamins C and B6 are necessary for collagen synthesis, an essential part of the organic material that binds bones together.131,132

16 Essentials for infants and young children Essentials for infants and young children 17 Nutritional solutions for infants and young children

Ingredient Function for Infants and Toddlers Recommended Daily Intakes1 Vitamins2 Quali-®A (Vitamin A) Vision; skin, mucous membranes; bones; red blood cells; immune 0–6 mts: 400 µg. 6–12 mts: 500 µg function 1–3 years: 300 µg Quali-®B Involved in protein, carbohydrate and fat metabolism; nucleic acid 0–3: At recommended dietary allowance (Vitamins B1, B2, B3, B5, B6, metabolism B12, folic acid) Quali-®C (Vitamin C) Immune function; collagen formation; iron absorption; antioxidant, 0–6 mts: 40 mg. 6–12 mts: 50 mg phagocyte function 1–3 years: 15 mg How can we Health you? Quali-®D (Vitamin D) Calcium and phosphorus absorption and metabolism; 0–6 mts: 10 µg. 6–12 mts: 10 µg cardiovascular health; blood pressure; bone health; muscle 1–3 years: 15 µg strength; immune function; dental health The first 1,000 days between the onset of a woman’s pregnancy and Quali-®E (Vitamin E) Red blood cells and tissues; antioxidant 0–6 mts: 4 mg. 6–12 mts: 5 mg 1–3 years: 6 mg her child’s second birthday offer a unique window of opportunity for Quali-®K (Vitamin K) Blood clotting; bone health 0–6 mts: 2.0 µg. 6–12 mts: 2.5 µg 1–3 years: 30 µg nutrition to shape healthier futures. It is essential that infants and Biotin (Vitamin H) Involved in protein, carbohydrate and fat metabolism as well as 0–6 mts: 5 µg. 6–12 mts: 6 µg young children receive the necessary nutrients at appropriate levels to many other cellular reactions 1–3 years: 8 µg Carotenoids help set them on a path to a long, healthy life. DSM’s tailored nutrients ®3 FloraGLO (Lutein) Concentrated in the macula; filters high-energy light 0–12 mts: 250 µg/l can support infants and young children to grow to their full potential. 1–3 years: 0–2 mg/kg bw/day Nutritional Lipids4,5 life’sDHA® (DHASCO®) Brain and eye development and function; heart health; immune 0–6 mts: 62-112 mg. / MEG-3® DHA (Vegetarian/ function, growth and development 6–12 mts: 87-104 mg DSM’s broad portfolio of innovative, high-quality and safe nutrients, Marine Omega-3 LCPUFA) 1–3 years: 0.1-0.4% Energy combined with our consumer insights, market knowledge and life’sARA™ (Omega-6 LC Brain and eye development and function; immune function, growth 0–6 mts: 124-187 mg. 6–12 mts: 153 mg. PUFA, ARASCO™) and development 1–3 years: 0.1-0.25% Energy application expertise, can help you create products with appealing Nutraceuticals health solutions. OatWell™ 6 May promote gut health via improvement in digestion, can be used 1–3 years: Dietary fiber: 10 g/day (Oat beta-glucan) to contribute to the daily recommended dietary fiber intake Minerals and Trace Elements Calcium Bones; teeth; blood clotting; muscle contractions; heart beat; nerve 0–6 mts: 200 mg. 6–12 mts: 260 mg We are the only integrated premix, vitamin and nutraceutical function; blood pressure 1–3 years: 700 mg manufacturer capable of creating and delivering tailor-made Copper Red blood cells; bone formation. 0–6 mts: 200 µg. 6–12 mts: 220 µg Deficiency depresses the adaptive immune response 1–3 years: 340 µg formulations to you anywhere. Blend in our extensive scientific Iron Cofactor in immune-related enzymes; red blood cells 0–6 mts: 0.27 mg. 6–12 mts: expertise, technical know-how, global presence and total quality 11 mg. 1–3 years: 7 mg. Magnesium Muscle relaxation; nerve function; hearth rhythm 0–6 mts: 30 mg. 6–12 mts: 75 mg assurance for your peace-of-mind. 1–3 years: 80 mg Phosphorus Bone formation; cell formation and growth; energy reactions 0–6 mts: 100 mg. 6–12 mts: 275 mg 1–3 years: 460 mg Via our global network of blend facilities we create value-adding Selenium Antioxidant enzymes. 0–6 mts: 15 µg. 6–12 mts: 20 µg ® Deficiency depresses antibody production 1–3 years: 20 µg nutrient combinations custom-made for you. Our Fortitech Premixes Zinc Protein metabolism. 0–6 mts: 2 mg. 6–12 mts: 3 mg can offer the right balance of ingredients supporting infants and young Deficiency depresses production of lymphocytes 1–3 years: 3 mg Nucleotides7 childrens’ health. Total Added Nucleotides May promote healthy growth and development of the immune system 0 – 12 mts: 5 mg Cytidine-5’- Monophosphate May promote healthy growth and development of the immune system 0 – 12 mts: 1.75 mg Free Acid Uridine-5’- Monophosphate May promote healthy growth and development of the immune system 0 – 12 mts: 1.5 mg Disodic DSM can help you develop appealing health solutions. Inosine-5’- Monophosphate May promote healthy growth and development of the immune system 0 – 12 mts: 1.0 mg Disodic Guanosine-5’- May promote healthy growth and development of the immune system 0 – 12 mts: 0.5 mg Monophosphate Disodic Adenosine-5’-Monophosphate May promote healthy growth and development of the immune system 0 – 12 mts: 1.5 mg Free Acid

1 Allowable levels of nutrients vary depending on national regulations and the final application. The above information is based on scientific studies, and a list of the latest references is available on request. 2 Based on 2010 Dietary Reference Intakes (DRIs): Recommended Dietary Allowances and Adequate Intakes, Vitamins and Elements from the Food and Nutrition Board, Institute of Medicine, National Academies. 3 FloraGLO® is a trademark of Kemin Industries, Inc. The EFSA Journal (2008) 823, 1-24, EFSA Journal 2010; 8(7):1678. 4 Based on 2004 FAO WHO energy requirements for humans. Kcal per day averaged for males/females 0-6 mo age and 6-12 mo age. 5 Based energy needs on average energy requirements of boys/girls 1-3 from Guidance from the Conseil Supérieur de la Santé. Recommandations nutritionnelles pour la Belgique, 2009, n° 8309. Bruxelles: Conseil Supérieur de la Santé; 2009 tables 7, 8 and 9. 6 EFSA, Scientific Opinion on the substantiation of health claims related to oat and barley grain fibre and increase in faecal bulk (ID 819, 822) pursuant to Article 13(1) of Regulation (EC) No 1924/2006, in EFSA Journal 2011, N.a.A.N. EFSA Panel on Dietetic Products, Editor. 2011. 7 Koletzko et al., J Pediatr Gastroenterol Nutr, Vol. 41, No. 5, November 2005.

18 Essentials for infants and young children DSM Nutritional Products For more information on this Health Benefit Solution by DSM, visit www.dsm.com/human-nutrition or e-mail [email protected]

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