Serum cholesterol, cholesteryl ester, and high-density lipoprotein development in newborn infants: response to formulas supplemented with cholesterol and gamma-linolenic acid.

Healthy newborn infants were either breast-fed or randomly designated to receive a standard formula, formula plus cholesterol, or formula plus gamma-linolenic acid at birth. At 0, 7, and 30 days of life, the following variables were measured: cholesteryl esters (cholesteryl arachidonate, cholesteryl oleate, cholesteryl palmitate, and cholesteryl linoleate), high-density lipoprotein (HDL) cholesterol, apoproteins (A-I, A-II, B, C-II, C-III, and E), and the cholesterol and apoprotein A-I content of the HDL subfractions HDL-2b, HDL-(2a + 3a), and HDL-(3b + 3c). Breast-fed infants had higher serum levels of cholesterol, cholesteryl oleate, cholesteryl palmitate, cholesteryl arachidonate, and HDL-2b than had formula-fed infants. Addition of gamma-linolenic acid to formula raised cholesteryl-arachidonate levels, and cholesterol and gamma-linolenic acid raised serum HDL-2b levels compared with those produced by unsupplemented formula. Our data suggest that both exogenous cholesterol and gamma-linolenic acid contribute to the maturation of HDL particles associated with human milk consumption in newborn infants. They may also promote adequate delivery of cholesterol and arachidonic acid to the developing brain.