Beyond infant formula: Industry predicts HMO growth in gut health and immunity

25 Jan 2024 --- Human milk oligosaccharides (HMOs) — found naturally in human breast milk — are increasingly common in infant dairy formulations looking to offer nutritional benefits similar to natural breastfeeding. Nutrition Insight speaks to infant nutrition experts from Chr. Hansen, dsm-firmenich and Kyowa Hakko Bio to discuss the latest in HMOs development and application in and beyond infant nutrition.

“HMOs have been authorized for usage in multiple food categories — from early life nutrition to medical nutrition, from multiple conventional foods and beverages to dietary supplements, targeting a wide range of potential consumers from infancy to elderly populations,” says Dr. Marta Miks, senior regulatory and scientific affairs manager at dsm-firmenich.

“The main focus in the market remains the application of HMOs in infant formula,” adds Veronika Müller-Wigger, head of commercial development and marketing, HMOs, at Chr. Hansen. “We can see application expansion of HMOs from regular infant formulas into hypoallergenic infant formulas, ‘food for special medical purposes’ formulas and toddler milk products. We also see growing interest in research outside of infant formula products and in children and adult populations.”

“As research on HMOs progresses, they are expected to act as ‘functional ingredients’ in addition to nutrients for infants,” comments Dr. Eri Nakazaki, senior scientist and manager of the corporate strategy department at Kyowa Hakko Bio. “In addition to their application in powdered infant formula as ingredients in breast milk, we envision their application in functional supplements and functional foods in the future.”

HMO significance for infants
Discussing the importance of HMO ingredients and their known role in infant health and development, Miks points out that “it is well established that exclusive human milk feeding for the first six months of a child’s life is the gold standard of infant nutrition.”

“Compared to formula-fed infants, exclusively breastfed infants have fewer infections, a distinct microbiota and modestly improved cognitive outcomes. There are many factors associated with breastfeeding — scientists look toward components found in human milk that are lacking or inadequate in infant formula to help explain these differences and hopefully help to close the gap between breastfed and formula-fed infants.” 

“HMOs are the third most abundant solid component of human milk after lactose and lipids and are more abundant than protein. There are three major classes of HMOs and over 200 unique structures, with each HMO potentially having its own functions and health benefits. Until a few years ago, the most significant compositional difference between infant formula and human milk was the lack of HMOs in formula,” she explains.  

Nakazaki adds: “So far, more than 200 kinds of HMOs have been found in breast milk. These oligosaccharides are known to be an important component for babies because their concentration is very low in cow’s milk and milk from other mammalian sources, and it is especially abundant in human colostrum.” 

Industry experts note a growing interest in HMOs beyond infant formula applications, particularly in the gut health space.Miks states that HMOs in human milk are associated with some of the same benefits of breastfeeding, namely, supporting immune system development and shaping the microbiota. 

“They may also play a role in brain development. The HMOs now approved by Food Standards Australia New Zealand (2’FL/DFL, LNT, 6’S and 3’SL) have been studied in the largest infant clinical trial of HMOs and shown to be safe and well tolerated, as well as supporting normal physical growth, soft stools, a bifidogenic microbiota, gastrointestinal health and the developing immune system.”

“HMOs were launched in 2016 and are still relatively new ingredients,” mentions Dr. Yannik Schönknecht, scientific advisor at Chr. Hansen. “Data from human milk research indicates that HMOs have the potential to lower the risk of allergy development, to support immune defense systems and to be important for premature babies.”

Gut solutions beyond infant nutrition
Chr. Hansen’s Müller-Wigger tells us that the market is showing a growing interest outside of infant formula applications, such as adding HMOs to foods or supplements for children. 

Miks of dsm-firmenich similarly argues: “The most obvious application is in the infant formula space where HMOs may help to close the gap between the health outcomes of breastfed and formula-fed infants.”

“However, we are just at the very beginning of understanding all of the potential benefits HMOs may offer to other populations including preterm infants, infants and children with functional gastrointestinal disorders, adults with inflammatory bowel conditions and even elderly populations, to reduce Clostridium difficile colonization and support healthy aging.”

“An area to further explore is the potential of HMOs for specific health indications, in particular gastrointestinal issues,” states Chr. Hansen’s Schönknecht. “The translation of the research from infants to adult population indicates that HMOs may be a promising tool to target gastrointestinal challenges, such as irritable bowel syndrome and similar indications.”

Experts are seeing the increasing use of HMOs beyond just premium products to now being included in standard infant formulas and toddler milks.In her statement on Kyowa Hakko Bio’s recent R&D advancements in biotechnology and nutritional solutions, Nakazaki also points to the potential application of HMOs in intestinal health products. 

“By clarifying the effects of HMO intake on the intestinal microflora and its effects on the intestinal environment, as well as the effects of HMOs on immune function through clinical studies on adults in Asia, where research has yet to be conducted, we aim to provide new health value through HMOs to as many customers as possible.” 

Market trends and innovation
Addressing what’s next for products with HMOs and her expectation for how the market is going to evolve, Müller-Wigger of Chr. Hansen sees an “increasing penetration in the use of HMOs expanding from premium products to standard infant formulas and toddler milks.” 

She further predicts an increased dosing of the level of HMOs included in an infant formula. “New HMO markets seem to be approved with minimum dosage as part of the regulatory standards for 2’-FL.”

“In such a new and growing innovation space, scientific collaboration is key,” Schönknecht of the same company comments. “We are initiating research collaborations with universities, academic groups and other industry players to explore the full potential of HMOs and their possible health effects. By this, we target to generate evidence for science-based solutions of next generation HMOs.” 

Kyowa Hakko Bio recently announced a collaboration with the Singapore Institute for Clinical Sciences (SICS) to advance HMOs R&D. Nakazaki details: “As a manufacturing supplier of HMOs, Kyowa Hakko Bio has fundamental expertise related to HMOs and SICS is a research institute with extensive experience in clinical research and has expertise in human health and well-being.” 

“The findings we obtain are to be published academically and externally, such as in conference presentations and articles. In addition, in order to disseminate and share the knowledge gained from our research globally, Kyowa Hakko Bio holds regular symposiums of the HMOs Study Group,” she further explains. 

By Milana Nikolova