Numerous infant formulas make bold claims, asserting that they contribute to brain development, boost immunity, and support overall growth and development in children.
A research team led by Imperial College London has conducted a study to examine the validity of these claims made by infant formulas. The findings of this study have been published in the prestigious medical journal BMJ.
The research group from Imperial College London has concluded that many of the purported health benefits and nutritional properties claimed by infant formulas are not supported by substantial evidence. According to their findings, most of these claims lack sufficient scientific backing.
The claims made by infant formulas as a substitute for breast milk have sparked controversy, as they can create a misleading impression that these formulas are on par with or superior to breast milk, despite lacking scientific substantiation for such claims.
Many breastfeeding mums in Norway
The research conducted by the Imperial College London team encompassed a wide range of products from 15 different countries, including Norway, which has a strong tradition of breastfeeding. In Norway, breastfeeding is prevalent, with four out of five infants still receiving breast milk at six months of age, and only a small percentage (two percent) never receiving any breast milk, according to Norwegian data.
Melanie Rae Simpson, an associate professor at NTNU's Department of Public Health and Nursing, who contributed data to the study, attributes the high rates of breastfeeding in Norway to supportive social arrangements and extended parental leave. She also highlights that strict regulations on marketing of breast milk substitutes prevent advertising from influencing breastfeeding practices in Norway.
Despite these favorable social arrangements, some infant formulas still make lofty promises, as highlighted by the research findings.
Norwegian claims maybe not so crazy, but could be better
Simpson notes that in Norway, a relatively higher proportion of infant formula products available in the market make claims about health benefits. However, she clarifies that this may not necessarily indicate a negative situation in Norway. Due to the prevalent culture of breastfeeding in Norway, there may be fewer types of infant formulas available in grocery stores compared to other countries included in the study, with a larger proportion sold in pharmacies and specifically formulated for children with special needs.
Simpson emphasizes that these specialized infant formulas in Norway often make claims that are relevant to the specific needs of those children. However, she acknowledges that not all claims are always supported by evidence. Despite Norway having clear legislation to prevent undocumented claims related to breast milk substitutes, the challenges around transparency, independence from industry influence, and scientific quality are still present, similar to what the research group observed in other countries.
608 out of 757 made claims
To gather data, the research group conducted a thorough examination of the websites and packaging of various companies that produce infant formula. They meticulously cross-checked the health and nutrition claims against the available documentation. The findings revealed that a total of 41 different ingredients were associated with these claims. However, it was also observed that some companies marketed their products without explicitly mentioning specific ingredients.
In total, the research group analyzed 757 products, out of which 608 products, encompassing 31 different claims related to nutrition and health, were identified. This suggests that a significant proportion of the infant formula products assessed made claims about their nutritional and health benefits.
Industry runs its own research
The research group discovered that out of the 608 products that made claims about nutrition and health, only 161 of them (approximately 26%) referred to scientific research to support their claims. However, a mere 14% of these investigations were clinical trials conducted on human subjects.
Disturbingly, the researchers also found that 90% of these clinical investigations had a high risk of biased results, either due to funding from the industry or the research being conducted by the industry itself, raising concerns about potential conflicts of interest.
Furthermore, a significant portion of the so-called "research" relied on reviews, opinions, and other forms of research that did not meet high-quality requirements, including research conducted on non-human species.
On average, the infant formula products examined made two claims. However, the level of aggressive marketing varied significantly across countries, with an average of one claim in Australia, and as many as four claims in the USA, highlighting the substantial variation in marketing practices across different regions.
Calls for stricter rules
The research group is advocating for stricter regulations to better protect consumers and prevent aggressive marketing from potentially compromising children's health. Professor Nigel Rollins from the World Health Organization (WHO) supports the researchers' findings and emphasizes that self-regulation by the industry, where research on product effectiveness is largely conducted by the industry itself, is inadequate. He suggests that regulatory authorities in different countries should consider taking action to improve the current conditions.
Products from Norway, Australia, Canada, Germany, India, Italy, Japan, Nigeria, Pakistan, Russia, Saudi Arabia, South Africa, Spain, Great Britain and the USA were included in the study.
Reference: Cheung K Y, Petrou L, Helfer B, Porubayeva E, Dolgikh E, Ali S et al. Health and nutrition claims for infant formula: international cross sectional survey, BMJ 2023; 380 doi:10.1136/bmj-2022-071075