Background

Recent research has uncovered the potential for excess manganese (Mn) intakes causing significant neurotoxic effects for early brain development.

Methods

We identified the Mn tolerable intakes (TI) published by the U.S. Institute of Medicine (IOM), World Health Organization (WHO), Agence nationale de sécurité sanitaire (ANSES), and U.S. Environmental Protection Agency (US EPA) and examined the primary studies on which regulatory TIs are based. We converted the TIs to μg of Mn/kg/day using standard assumptions specific to each agency. We estimated μg of Mn/kg/day intakes due to formulas. Using our estimates for formula intakes, weights, and kcal content, we converted regulatory maxima and minima from μg of Mn/100 kcals to estimates of μg of Mn/kg/day.

Results

Except for the proposed ANSES TI for drinking water, none of the primary studies on which Mn intake guidelines and regulations are based measured health outcomes. Some infant formulas may exceed the regulatory TIs, especially if prepared with water containing considerable concentrations of Mn (e.g. 250 μg/L), even while meeting national and international regulatory standards or guidelines.

Conclusions

Infant formula regulations must be revised to reduce the potential for excess manganese intakes and the practice of manganese supplementation of infant formulas should be ceased.

中文翻译：

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多少锰对婴儿是安全的？与婴儿配方奶粉锰含量相关的摄入指南和法规的科学依据综述

背景

最近的研究发现，过量摄入锰 (Mn) 可能会对早期大脑发育造成显着的神经毒性影响。

方法

我们确定了美国医学研究所 (IOM)、世界卫生组织 (WHO)、国家卫生局(ANSES) 和美国环境保护署 (US EPA)发布的锰可耐受摄入量 (TI ) 并检查了主要研究监管 TI 的基础。我们使用特定于每个机构的标准假设将 TI 转换为 μg Mn/kg/天。由于配方，我们估计了微克 Mn/kg/天的摄入量。使用我们对配方摄入量、重量和千卡含量的估计，我们将监管最大值和最小值从微克锰/100 千卡转换为微克锰/公斤/天的估计值。

结果

除了提议的饮用水 ANSES TI 外，锰摄入指南和法规所依据的主要研究均未测量健康结果。一些婴儿配方奶粉可能会超过规定的 TI，特别是如果用含有相当浓度 Mn（例如 250 μg/L）的水制备，即使满足国家和国际监管标准或准则。

结论

必须修订婴儿配方奶粉法规，以减少锰摄入过多的可能性，并应停止在婴儿配方奶粉中补充锰的做法。