US Infant Formulas Contain Primarily Added Sugars: An Analysis of the Infant Formulas on the US Market

Objective: Consumption of added sugars is contraindicated for infants <2 years old due to potentially harmful metabolic effects. However, recent research revealed that most US-produced infant formulas contain added sugars. The current study examined the proportion of added sugars in US infant formulas to determine whether US formulas contain primarily added sugars, which may present a risk to infant metabolic health, or whether formulas contain primarily naturally occurring lactose (the sugar present in human breastmilk). Methods: Data were obtained from the Nutrition Data System for Research and represented US the infant formula market as of 2022 (N=73). Formulas were categorized into three mutually exclusive types by their marketing labels: standard (n=31), gentle (n=27), and lactose-free (n=15). The proportion of added sugars from each type of sugar were calculated, as was the percent of naturally occurring lactose. Differences across formula types were examined using Bayesian modeling. Results: The median percent added sugars was high in standard (M=59.7%; IQR=22.0), gentle (M=85.0%; IQR=39.5), and lactose-free formulas (M=90.0%; IQR=54.3). Gentle formulas had significantly lower proportional lactose (OR=0.22, 95% HDI=[0.11, 0.44], pd=99.3%) and had >2 fold higher proportional added sugar contents compared to standard formulas (ORs=2.11 to 2.57, 95% HDI > 0, pd=99.1-99.99%). Lactose-free formulas had 4-8 times higher proportional sucrose (OR=8.92, 95% HDI=[3.86, 20.8], pd=100%) and maltose (OR=4.91, 95% HDI=[2.51, 9.56], pd=100%) relative to standard and gentle formulas (sucrose 95% CI=[-1.67, -0.26], maltose 95% CI=[-0.35, -0.04]). Conclusions: Most infant formulas on the US market contained primarily added sugars.