Infant Formula: The Addition of Minimum and Maximum Levels of Selenium to Infant Formula and Related Labeling Requirements, 22442-22451 [2013-08855]
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Federal Register / Vol. 78, No. 73 / Tuesday, April 16, 2013 / Proposed Rules
dated September 12, 2012: Before further
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Issued in Renton, Washington, on April 4,
2013.
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[Docket No. FDA–2013–N–0067]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
Infant Formula: The Addition of
Minimum and Maximum Levels of
Selenium to Infant Formula and
Related Labeling Requirements
Food and Drug Administration.
Proposed rule.
AGENCY:
ACTION:
SUMMARY: The Food and Drug
Administration (FDA) is proposing to
amend the regulations on nutrient
specifications and labeling for infant
formula to add the mineral selenium to
the list of required nutrients and to
establish minimum and maximum
levels of selenium in infant formula.
DATES: Submit either electronic or
written comments on the proposed rule
by July 1, 2013. Submit comments on
information collection issues under the
Paperwork Reduction Act of 1995 by
May 16, 2013, (see the ‘‘Paperwork
Reduction Act of 1995’’ section of this
document).
ADDRESSES: You may submit comments,
identified by Docket No. FDA–2013–N–
0067, by any of the following methods,
except that comments on information
collection issues under the Paperwork
Reduction Act of 1995 must be
submitted to the Office of Information
and Regulatory Affairs, Office of
Management and Budget (OMB) (see the
‘‘Paperwork Reduction Act of 1995’’
section of this document):
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
Written Submissions
Submit written submissions in the
following way:
• Mail/Hand delivery/Courier (for
paper or CD–ROM submissions):
Division of Dockets Management (HFA–
305), Food and Drug Administration,
5630 Fishers Lane, Rm. 1061, Rockville,
MD 20852.
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Instructions: All submissions received
must include the Agency name and
Docket No. FDA–2013–N–0067 for this
rulemaking. All comments received may
be posted without change to https://
www.regulations.gov, including any
personal information provided. For
additional information on submitting
comments, see the ‘‘How Do You
Submit Comments on This Rule?’’
heading of the SUPPLEMENTARY
INFORMATION section of this document.
Docket: For access to the docket to
read background documents or
comments received, go to https://
www.regulations.gov and insert the
docket number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts or
go to the Division of Dockets
Management, 5630 Fishers Lane, Rm.
1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT:
With regard to the proposed rule:
Benson M. Silverman, Center for Food
Safety and Applied Nutrition (HFS–
850), Food and Drug Administration,
5100 Paint Branch Pkwy, College Park,
MD 20740, 240–402–1450.
With regard to the information
collection issues: Domini Bean, Office of
Information Management, Food and
Drug Administration, 1350 Piccard Dr.,
PI50–400T, Rockville, MD 20850,
domini.bean@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. What is the background of this
proposed rule?
Section 412(i) of the Federal Food,
Drug, and Cosmetic Act (the FD&C Act)
(21 U.S.C. 350a(i)) establishes
requirements for the nutrient content of
infant formulas. Under section 412(i)(2)
of the FD&C Act, the Secretary of Health
and Human Services (the Secretary) is
authorized to revise the list of required
nutrients and the required level for any
required nutrient, which authority has
been delegated to the Commissioner of
Food and Drugs (the Commissioner).
The table in section 412(i) of the FD&C
Act and FDA regulations, 21 CFR
107.100, specify that infant formulas
must contain 29 nutrients; minimum
levels for each nutrient and maximum
levels for 9 of the nutrients are also
specified.
At the time FDA established nutrient
specifications for infant formula,
selenium was not recognized as an
essential nutrient and was not one of the
nutrients required by statute in infant
formula. As explained in detail in this
document, selenium has subsequently
been recognized as an essential nutrient.
Therefore, we are proposing to amend
the nutrient specifications for infant
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formula in § 107.100 to include
selenium as a required nutrient and to
establish minimum and maximum
values for selenium. We are also
proposing to amend the labeling
requirements for infant formula in 21
CFR 107.10 to add selenium to the list
of nutrients along with the requirement
to list the amount of selenium per 100
kilocalories in the formula.
Selenium is an essential trace element
for humans that functions largely
through an association with proteins
known as selenoproteins. The known
biological functions of selenium include
defense against oxidative stress,
regulation of thyroid hormone action,
and regulation of the oxidation/
reduction status of vitamin C and other
molecules.
Plant foods are the major dietary
sources of selenium although selenium
is also found in some meats, seafood,
and nuts. The selenium content of a
food depends on the selenium content
of the soil where the plant was grown
or where the animal was raised. In the
United States, food distribution patterns
across the country help prevent people
living in geographic areas with lowselenium levels in the soil from having
low dietary selenium intakes. Keshan
disease, a cardiomyopathy that occurs
almost exclusively in children, has been
linked to selenium deficiency. Keshan
disease occurs in areas of China where
the population has severe selenium
deficiency. Chronic selenium toxicity
(selenosis) has also been observed in
persons consuming diets containing
high levels of selenium. Reported
characteristics include hair and nail
brittleness and loss, gastrointestinal
upsets, skin rash, garlic breath odor,
fatigue, irritability, and nervous system
abnormalities. Acute selenium toxicity
is rare and the few reports in the
literature of acute fatal or near fatal
selenium poisoning have occurred
because of accidental or suicidal
ingestion of selenium (Ref. 1).
In the United States, selenium is not
routinely added to food. An exception is
infant formula, a food that is intended
to be the sole source of nutrition for
infants and therefore, must provide
sufficient amounts of all nutrients
essential for infants. In 1989, the Food
and Nutrition Board of the National
Research Council established a
Recommended Dietary Allowance
(RDA) for selenium for infants 0 to 6
months of age of 10.0 micrograms per
day (mg/day), a level extrapolated from
adult values on the basis of body weight
and with a factor allowed for growth
(Ref. 2). Although selenium is not
currently required in infant formula by
§ 107.100, all U.S. manufacturers are
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adding selenium to their infant
formulas. Based on labeling
information, currently marketed infant
formulas contain 1.8 mg to 3.0 mg
selenium per 100 kilocalorie (kcal) of
formula.
II. What levels of selenium are we
proposing for infant formula?
As discussed in more detail in this
document, we are proposing 2.0 mg
selenium/100 kcal as the minimum
level for selenium in infant formulas
and 7.0 mg/100 kcal as the maximum
level of selenium in infant formulas
III. What scientific evidence did we
consider for the proposed requirement
to add selenium to infant formulas?
In order to add a selenium
requirement and to establish minimum
and maximum levels of selenium in
infant formula, we first identified and
reviewed three relevant technical
reports on recommended nutrient levels
for formulas for term infants and
nutrient needs of healthy term infants:
(1) The Life Sciences Research Office
(LSRO) report ‘‘Assessment of Nutrient
Requirements for Infant Formulas’’ (Ref.
3); (2) ‘‘Dietary Reference Intakes for
Vitamin C, Vitamin E, Selenium, and
Carotenoids’’ (Ref. 1); and (3) ‘‘Global
Standard for the Composition of Infant
Formula: Recommendations of an
ESPGHAN Coordinated International
Expert Group’’ (Ref. 4). These reports
are referred to as the LSRO report, the
Institute of Medicine (IOM) report, and
the European Society on Pediatric
Gastroenterology, Hepatology, and
Nutrition (ESPGHAN) report,
respectively, in the remainder of this
proposal. We also searched the
published scientific literature from 1998
through 2012 for published studies not
included in these reports or not
identified in a 2008 published study by
Daniels et al. (Ref. 5). (The Daniels et al.
study is discussed in this section of the
document.)
A. Available Evidence for Setting a
Minimum Level of Selenium in Infant
Formula
1. LSRO Report
In 1998, Raiten et al. published a
report summarizing the scientific
literature on the nutrient needs of
healthy term infants, with an emphasis
on research studies published since
1983 (Ref. 3). The report was prepared
for FDA’s Center for Food Safety and
Applied Nutrition and Health Canada’s
Health Protection Branch by the LSRO
in consultation with expert scientists
and professional organizations involved
in the field of infant nutrition. The goal
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of the deliberations of this LSRO Expert
Panel was to provide recommendations
for nutrient content of infant formulas
that could serve as the sole source of
nutrition for term infants throughout the
first year of life.
On the basis of the evidence for the
dietary essentiality of selenium, the
LSRO Expert Panel recommended that
selenium be included as a required
nutrient in infant formula. The Panel
also recommended a minimum
selenium content of 1.5 mg/100 kcal
(10.0 mg/liter (L)), which) and a
maximum level of 5.0 mg/100 kcal (33.5
mg/L). The minimum value
approximated the estimated value for
the mean minus one standard deviation
(SD) for the selenium concentration in
human milk in countries in which
selenium deficiency has not been
recognized in breast-fed infants. This
recommended minimum level would
provide an estimated 7.5 mg/day of
selenium for young infants exclusively
fed infant formula,1 an amount below
the 1989 RDA (10.0 mg/day). The LSRO
Panel was aware that there were
disparities between some of its
recommendations for nutrient levels in
infant formulas and the 1989 RDAs;
however, the history of use for a large
population in which selenium
deficiency has not been reported was
regarded as a reasonable basis for
recommending a minimum value for
selenium in infant formula.
2. IOM Report
In 2000, the IOM published Dietary
Reference Intakes (DRI) for selenium.
The DRI concept evolved from the
Recommended Dietary Allowances
reports that have been published
periodically since 1941 by the National
Academies of Science. As described by
the IOM (Ref. 1), the term Dietary
Reference Intake encompasses three
nutrient-based reference values in
addition to the RDA. The RDA and the
three nutrient-based reference values
were described by the IOM as follows:
• The Recommended Dietary
Allowance (RDA) is the average dietary
intake level that is sufficient to meet the
nutrient requirements of nearly all (97
to 98 percent) healthy individuals in a
particular life stage and gender group.
1 This estimate is based on a calculation used to
convert nutrient intake values (e.g., milligram (mg)/
day) to formula nutrient content values (e.g., mg/
100 kcal) (Raiten, et al., 1998; Koletzko, et al, 2006).
The calculation is based on the following
assumptions: (1) The mean intake of formulas for
infants 0 to 6 months of age is 750 milliliter (ml)/
day; (2) a representative body weight for infants
over this period is 5 kilogram (kg); and (3) a
representative caloric intake of infants over this
period is 500 kcal/day (or 100 kcal/kg/day).
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The RDA is intended to be the goal for
daily intake by individuals.
• The Estimated Average
Requirement (EAR) is the daily intake
value that is estimated to meet the
requirement, as defined by the specified
indicator of adequacy, in half of the
healthy individuals in a life stage and
gender group. The EAR is used to set the
RDA. If the standard deviation (SD) of
the EAR is available and the
requirement for the nutrient is normally
distributed, the RDA is defined as the
EAR plus two SDs of the EAR.
• An Adequate Intake (AI) is
established for a nutrient when
sufficient scientific evidence is not
available to calculate an EAR. An AI is
based on experimentally-derived intake
levels of approximations of observed
mean nutrient intakes by a group of
healthy people. The AI for children and
adults is expected to meet or exceed the
amount needed to maintain a defined
nutritional state or exceed the amount
needed to maintain a defined nutritional
state or criterion of adequacy in
essentially all members of a specific
healthy population because it is set
using healthy populations. Like the
RDA, the AI is intended to be the goal
for individual intake and it is intended
to cover the needs of nearly all persons
in a life stage group.
• The Tolerable Upper Intake Level
(UL) is the highest daily intake level of
a nutrient that is likely to pose no risk
of adverse health effects in almost all
individuals in a life stage group.
At the time of its report, the IOM did
not find sufficient evidence to calculate
an EAR for selenium for infants during
the first year of life and, therefore, did
not have a basis to set an RDA for
selenium for infants. For this reason, the
IOM set an AI for selenium for infants
0 to 6 months of age, the age when the
recommended sole source of nutrition is
human milk, infant formula, or a
combination of the two.
The IOM’s primary basis for deriving
an AI for most nutrients for the first 6
months of life was the average intake by
full term infants born to healthy, wellnourished mothers and exclusively fed
human milk. To derive the AI values for
infants ages 0 to 6 months of age, the
mean intake of a nutrient was calculated
based on the average concentration of
the nutrient in human milk from 2 to 6
months of lactation, using agreed-upon
values from several reported studies and
an average volume of milk intake. To
calculate the AI for selenium, IOM used
the average concentration of selenium in
human milk from mothers in the United
States and Canada (18.0 mg/L) and an
intake of 0.78 L/day, as reported from
differences in weights of full-term
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infants before and after feedings. A
reference weight of 7 kg for infants 2 to
6 months of age, adapted from National
Health and Nutrition Examination
Survey (NHANES) III 1988–1994 data
(Ref. 6), was used by the IOM to
calculate the AI on a body weight basis.
(Ref. 1). The IOM established a selenium
AI of 15.0 mg/day (approximately 2.1 mg/
kg body weight/day) for infants 0 to 6
months of age (IOM, 2000). Assuming a
typical intake of 100 kcal/kg/day for
infants 0 to 6 months of age, this
approximates a need for selenium,
relative to energy consumption, of 2.1
mg/100 kcal.
3. ESPGHAN Report
In 2005, an International Expert
Group (IEG) coordinated by the
Committee on Nutrition of the
ESPGHAN prepared a report on nutrient
levels in infant formula, based on
scientific analysis and taking into
account existing scientific reports on
current infant formula nutrient content
(Ref. 4). The report was prepared at the
request of the Codex Committee on
Nutrition and Foods for Special Dietary
Uses for use by that Committee in
revising the Codex Standard for Infant
Formula and Formulas for Special
Medical Purposes Intended for Infants
(Codex Stan 72–1981) (Ref. 7). The goal
of establishing minimum and maximum
nutrient values for the Codex standard
was to ensure that infant formulas
adhering to the Standard would be safe
and would meet infants’ normal
nutritional requirements.
The ESPGHAN IEG reported that their
recommended minimum nutrient values
were based on scientific evidence of the
amounts needed to meet infants’
nutritional requirements when such
information was available. When
scientific information was lacking, an
established history of apparent safe use
was taken into account. The IEG
recommended a minimum selenium
value of 1 mg/100 kcal for infant formula
and they indicated that the reported
median selenium content of human
milk and values set for infant reference
nutrient intakes formed the basis for
their recommendation. Further detail
was not provided on how this
information was used by the IEG in
making their recommendation.
4. Recent Published Literature
One recent report in the published
scientific literature also provides
important information on necessary
infant selenium intake levels. Daniels, et
al. reported the results of a randomized,
double-blinded dose-response study of
healthy term infants fed infant formula
containing selenium at three
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concentrations (6.0 mg/liter, 13.0 mg/
liter, or 21.0 mg/liter) and a breast-fed
reference group (Ref. 5). The
concentrations of selenium in the study
formulas correspond to 0.9 mg/100 kcal
(low selenium control), 1.9 mg/100 kcal,
and 3.1 mg/100 kcal, respectively. The
mean concentration of selenium in
breast milk reported in this study was
11.0 mg/liter (1.6 mg/100 kcal). Infants
participating in the study consumed the
assigned infant formula or breast milk as
the sole source of nutrition from birth to
16 weeks of age.
Consumption of formulas containing
both of the higher levels of selenium
(1.9 mg/100 kcal and 3.1 mg/100 kcal)
resulted in changes in plasma and
erythrocyte indicators of selenium
status at the end of the study that did
not differ statistically from each other or
from the breast-fed control group.
However, indicators of selenium status
for all of these groups differed
statistically from the plasma and
erythrocyte indicators of selenium
status in the infants fed the control
formula containing only 0.9 mg
selenium/100 kcal. A dose-related
increase in urinary selenium excretion
in the formula-fed groups was also
reported. When infants consumed
formulas containing selenium at levels
of 1.9 mg/100 kcal or 3.1 mg/100 kcal,
there were no statistically significant
dose-related changes in plasma and
erythrocyte indicators of selenium
status. However, there was a statistically
significant increase in urinary selenium
excretion in the infants fed the formula
containing 3.1 mg/100 kcal compared to
the infants fed the formula containing
1.9 mg/100 kcal. This latter finding, in
combination with the finding of no
dose-related changes in the circulating
indicators of selenium status, suggests
that infants fed the formula containing
a level of 1.9 mg selenium/100 kcal
received sufficient selenium to meet
their nutritional needs and that by
virtue of the body’s homeostatic
mechanisms, it would appear that much
of the selenium intake above the level
of 1.9 mg selenium/100 kcal was
eliminated from the body.
B. Available Evidence for Setting a
Maximum Level for Selenium in Infant
Formula
1. LSRO Report
The LSRO Expert Panel recommended
a maximum selenium level for infant
formula of 5.0 mg/100 kcal (33.5 mg/L)
(Ref. 3). This recommendation was
based on the upper limit of the range of
selenium in human milk, which was
considered to represent a history of use
for a large population in which
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selenium toxicity had not been reported.
The LSRO report also indicated that, on
a body weight basis, this level is far
below the intake associated with the
development of selenosis in adults.
2. IOM Report
The IOM established an upper limit
(UL) for selenium for infants 0 to 6
months of age relying on data on the
concentration of selenium in human
milk, which is not associated with
known adverse effects. The IOM
calculated an UL of 47.0 mg/day or
approximately 7.0 mg/kg body weight/
day for infants 0 to 6 months of age,
which approximates 7.0 mg/100 kcal.
3. ESPGHAN Report
The ESPGHAN IEG recommended a
maximum level of 9 mg/100 kcal for
selenium in infant formula. The IEG
based their recommendations for
maximum nutrient values on scientific
evidence regarding the absence of
adverse effects, when such information
was available. When scientific
information was lacking, an established
history of apparent safe use was taken
into account. Further detail was not
provided on how this information was
used by the IEG in making its
recommendation.
IV. Which products are subject to this
proposed rule?
Products that meet the statutory
definition of ‘‘infant formula’’ in section
201(z) of the FD&C Act (21 U.S.C.
321(z)) (‘‘a food which purports to be or
is represented for special dietary use
solely as a food for infants by reason of
its simulation of human milk or its
suitability as a complete or partial
substitute for human milk’’) are subject
to this proposed rule.
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V. What does this proposed rule do?
This proposed rule, if finalized, will
add selenium to the list of required
nutrients for infant formulas and
establish minimum and maximum
levels of selenium in FDA’s nutrient
specifications regulations for infant
formulas under § 107.100(a). In
addition, the proposed rule would add
selenium to the list of nutrients that
must be listed in the table of nutrition
information required on infant formula
labeling by § 107.10(a)(2).
A. Revision to § 107.100(a) Nutrient
Specifications
We are proposing to mandate that
selenium be added to infant formula by
requiring that this mineral be listed in
the table of nutrients for infant formulas
in § 107.100(a). We are also proposing to
establish minimum and maximum
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levels for selenium in infant formula
because evidence exists for both
deficiency and toxicity of selenium, and
there is no room for error in production
of a food that serves as the sole source
of nutrition for infants.
1. Proposed Minimum Level of
Selenium in Infant Formulas
After considering the scientific
reports discussed previously in this
document and evidence published by
Daniels, et al. after those reports were
completed, we are proposing 2.0 mg
selenium/100 kcal as the minimum
level for selenium in infant formulas.
This proposed minimum level is based
on the IOM’s AI for selenium for infants
0 to 6 months of age (2.1 mg/day) (Ref.
1) and the level suggested by the data in
the study by Daniels, et al. (1.9 mg/100
kcal) (Ref. 5), rounded to the nearest
whole microgram. As noted, the
Daniels, et al. study demonstrated that
infants who consumed infant formula
containing 1.9 mg selenium/100 kcal had
plasma and erythrocyte indicators of
selenium status that were statistically
higher than those of infants consuming
formula containing less selenium (0.9
mg/100 kcal) but these levels did not
differ from those of infants consuming
infant formula containing more
selenium (3.1 mg/100 kcal). Infants
consuming the formula containing 3.1
mg/100 kcal of selenium also had
significantly higher urinary excretion of
selenium. In the absence of statistically
significant changes in plasma and
erythrocyte indicators of selenium
status, the substantially higher urinary
excretion of selenium of the infants fed
the 3.1 mg selenium formula compared
to that of the infants fed the 1.9 mg
selenium formula, suggests that a
selenium intake of 3.1 mg/100 kcal is
likely to be greater than the amount
needed to meet an infant’s nutritional
needs. Thus, FDA tentatively concludes
that 2.0 mg selenium/100 kcal is an
appropriate required minimum for
selenium in infant formulas.
We also propose to correct a
typographical error in the table that
appears in § 107.100(a). In the second
column of that table, each abbreviation
for ditto (‘‘do’’) will now be followed by
a period.
2. Proposed Maximum Level of
Selenium in Infant Formulas
FDA is also proposing to set a
maximum level for selenium in infant
formula of 7.0 mg/100 kcal. This level is
based on the UL for infants 0 to 6
months of age established by the IOM
(Ref. 1), and defined as highest level of
daily nutrient intake that is likely to
pose no risk of adverse health effects in
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the population of interest. FDA is
relying on the IOM’s recommendation
because the IOM report was the most
transparent in terms of the basis for its
recommended UL. Also, unlike the
minimum level, there is no study that
provides direct evidence to establish a
maximum level and thus, in proposing
a maximum level, the agency must rely
on a recommendation for an intake level
that is likely to pose no risk of adverse
health effects.
3. Comments Specifically Requested
We find that there is scientific
evidence sufficient to support the
minimum proposed level of 2.0 mg
selenium/100 kcal and the proposed
maximum level of 7.0 ug selenium/100
kcal, although there is less evidence
directly applicable to the proposed
maximum level. While we are interested
in comments regarding the proposed
minimum level for selenium, we are
particularly interested in comments
regarding the proposed maximum level
of 7.0 mg selenium/100 kcal, including
whether such a maximum level is
needed and the scientific data or
information that form the basis of any
comments.
Although, in our judgment, it will be
feasible for formula manufacturers to
achieve consistent production of infant
formulas with selenium levels that are
at or above the proposed minimum level
of 2.0 mg/100 kcal while not exceeding
the proposed maximum level of 7.0 mg/
100 kcal, we specifically request
comments about whether the proposed
minimum and maximum selenium
levels provide sufficient flexibility and
can be achieved from a practical
manufacturing standpoint. In addition,
because unduly high levels of nutrients
should be avoided in products that
serve as the sole source of nutrients for
infants, a population that is particularly
vulnerable to nutritional inadequacies
and excesses, we are also particularly
interested in receiving comments about
available means to ensure that nutrient
levels in infant formulas, including
selenium, are not excessive.
B. Revision to § 107.10(a)(2) Nutrient
Information
We are proposing to add selenium to
the statement of the amounts of
nutrients required for infant formula
labeling in § 107.10(a)(2). This
additional mineral would be required to
be listed between iodine and sodium, as
directed by § 107.10(b)(5).
VI. What is the legal authority for this
proposed rule?
Section 412(i) of the FD&C Act
contains a table of nutrients (including
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minimum and, in some cases, maximum
levels for such nutrients) that are
required to be in an infant formula.
Section 412(i)(2) of the FD&C Act
authorizes the Secretary to revise the
statutory table of nutrients and to revise
the level of any required nutrient. The
Secretary has delegated this authority to
the Commissioner. In the Federal
Register of October 31, 1985, FDA
published a final rule revising the
statutory table of nutrients, which was
published as § 107.100. This proposed
rule, if finalized, would amend
§ 107.100. Accordingly, the legal
authority for the proposed revision to
§ 107.100, which revises the statutory
list of nutrients required for infant
formula, is section 412(i)(2) of the FD&C
Act.
Additionally, this proposed rule, if
finalized, would require the addition of
selenium to the statement of the
amounts of nutrients required for infant
formula labeling in § 107.10(a)(2). As
noted previously in this document,
‘‘infant formula’’ is defined as a food for
‘‘special dietary use’’ under section
201(z) of the FD&C Act. Under sections
403(j) and 701(e) of the FD&C Act (21
U.S.C. 343(j) and 21 U.S.C. 371(e)), the
Secretary, and by delegation the
Commissioner, may prescribe
regulations concerning the vitamin and
mineral content of foods for special
dietary uses, in order to fully inform
purchasers as to the value of the food for
such uses. As such, FDA has the
authority to revise the statement of the
amounts of nutrients required for infant
formula labeling in § 107.10(a)(2) under
sections 201(z), 403(j), 412(i), and 701(e)
of the FD&C Act. When the Agency
issues a final rule for the provisions in
proposed § 107.10(a)(2), it will provide
an opportunity for filing objections and
requests for a formal evidentiary public
hearing under 21 CFR part 12.
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VII. What is the environmental impact
of this proposed rule?
FDA has determined under 21 CFR
25.32(n) that this action is of a type that
does not individually or cumulatively
have a significant effect on the human
environment. Therefore, neither an
environmental assessment nor an
environmental impact statement is
required.
VIII. Federalism
FDA has analyzed this proposed rule
in accordance with the principles set
forth in Executive Order 13132. FDA
has determined that the proposed rule,
if finalized, would not contain policies
that have substantial direct effects on
the States, on the relationship between
the National Government and the States,
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or on the distribution of power and
responsibilities among the various
levels of government. Accordingly, the
Agency concludes that the proposed
rule does not contain policies that have
federalism implications as defined in
the Executive order and, consequently,
a federalism summary impact statement
is not required.
IX. Analysis of Impacts
FDA has examined the impacts of the
proposed rule under Executive Order
12866, Executive Order 13563, the
Regulatory Flexibility Act (5 U.S.C.
601–612), and the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104–4).
Executive Orders 12866 and 13563
direct Agencies to assess all costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety,
and other advantages; distributive
impacts; and equity). The Agency
believes that this proposed rule is not a
significant regulatory action as defined
by Executive Order 12866.
The Regulatory Flexibility Act
requires Agencies to analyze regulatory
options that would minimize any
significant impact of a rule on small
entities. Because only one firm is
affected by this rule, and it is
considered large by Small Business
Administration standards, the Agency
proposes to certify that the final rule
will not have a significant economic
impact on a substantial number of small
entities.
Section 202(a) of the Unfunded
Mandates Reform Act of 1995 requires
that Agencies prepare a written
statement, which includes an
assessment of anticipated costs and
benefits, before proposing ‘‘any rule that
includes any Federal Mandate that may
result in the expenditure by State, local,
and tribal governments, in the aggregate,
or by the private sector, of $100,000,000
or more (adjusted annually for inflation)
in any one year.’’ The current threshold
after adjustment for inflation is $136
million, using the most current (2010)
Implicit Price Deflator for the Gross
Domestic Product. FDA does not expect
this proposed rule to result in any 1year expenditure that would meet or
exceed this amount.
X. Regulatory Impact Analysis
A. Need for This Regulation
FDA is proposing to amend its infant
formula nutrient requirement
regulations. If the proposed rule is
finalized, infant formulas will be
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Sfmt 4702
required to contain selenium at a level
not less than 2.0 mg and not more than
7.0 mg for each 100 kilocalories of the
infant formula in the form prepared for
consumption as directed on the
container. This regulation is needed
because selenium is now recognized as
an essential nutrient for humans.
Additionally, if finalized, this
proposed rule will require that infant
formula manufacturers add selenium to
the list of nutrients on infant formula
labels, and to list the amount of
selenium per 100 kilocalories in the
formula.
Selenium is a trace mineral that is
essential to good health but required
only in small amounts. Selenium is
incorporated into proteins to make
selenoproteins, which are important
antioxidant enzymes, the natural byproducts of oxygen metabolism that may
contribute to the development of
chronic diseases such as cancer and
heart disease. In most countries
throughout the world, plant foods are
major dietary sources of selenium.
However, selenium is also found in
some meats, seafood, and nuts. In the
United States, food distribution patterns
across the country help prevent people
in geographic areas with low-selenium
levels in the soil from having low
dietary selenium intakes. Food is not
generally fortified with selenium in the
United States, but an exception to this
is infant formula.
B. Regulatory Options
In formulating the analysis of this
proposed rule, three options were
analyzed: (1) No new regulatory action
(baseline); (2) require the provisions of
this proposed rule and make the
provisions of the rule effective 180 days
after publication; and (3) require the
provisions of this proposed rule, but
make the provisions of the rule effective
12 months after publication.
Option 1: No New Regulatory Action
(Baseline)
The first option is no new regulatory
action. We include it here because OMB
cost-benefit analysis guidelines
recommend discussing statutory
requirements that affect the selection of
regulatory approaches. These guidelines
also recommend analyzing the
opportunity cost of legal constraints that
prevent the selection of the regulatory
action that best satisfies the philosophy
and principles of Executive Order
12866. There are zero costs and benefits
associated with this option, and it
serves as the baseline against which
other options will be measured for
assessing costs and benefits.
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Option 2: Finalize the proposed rule
and make the provisions effective 180
days after publication.
XI. Costs
One cost of this proposal, if finalized,
will be reformulation costs resulting
from firms adding selenium to infant
formulas in order to comply with this
rule. Currently, there are five firms that
produce infant formula in the United
States. Of these firms, only one will
need to add slightly more selenium to
its infant formulas. Based on
information provided by the infant
formula industry, it appears that all
other infant formula manufacturers
already added selenium to their infant
formula products at a level within the
range identified by the proposed rule.
Therefore, any reformulation cost of this
proposal will come from a single firm
adding slightly more selenium to its
infant formula products that currently
do not meet the proposed minimum
level of 2.0 mg/100 kcal.
Table 1 of this document outlines
low, medium, and high cost estimates
based on a change in the formulation of
infant formula. Costs are estimated
using a reformulation model, developed
under contract with Research Triangle
Institute (RTI). This model provides
estimates of the costs of reformulation of
the range of food, dietary supplement,
and cosmetic products under FDA’s
jurisdiction, including infant formulas,
and has been adjusted to reflect 2012
dollars. In this model, the cost of the
reformulation depends on the affected
ingredient and the likely response of
manufacturers. The cost per infant
formula associated with reformulation is
estimated to be a function of product
research, product development,
coordinating activities, startup and
verification, and nutrient testing of
finished product. To the extent that any
of these activities is not necessary for
adding selenium to an infant formula
that already has selenium added, costs
will be overestimated. Table 1 of this
document presents total estimated low,
medium, and high costs of
reformulation for this proposed rule.
The totals are based on the
reformulation of 46 separate infant
formulas manufactured by one firm, the
current formulation of which would not
meet the requirements of this rule, if
finalized. Therefore, the total industry
costs are each of the low, medium, and
high costs multiplied by 46.
TABLE 1—ESTIMATION OF FIRST-YEAR COSTS OF INFANT FORMULA REFORMULATION, PER INFANT FORMULA
Variable
Low
Medium
High
$1,685
4,598
2,938
1,442
15
$16,853
13,023
8,818
7,207
15
$33,706
28,259
14,690
15,890
15
Total Per Formula .................................................................................................................
Total Industry Cost of Reformulation (Cost × 46 infant formulas) .......................................
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Product Research ........................................................................................................................
Product Development ..................................................................................................................
Coordinating Activities .................................................................................................................
Startup and Verification ...............................................................................................................
Nutrient Testing of the Finished Product .....................................................................................
10,678
497,188
45,916
2,112,136
92,560
4,257,760
Another component of the costs of
this option is cost related to the
relabeling of reformulated infant
formula. The proposed rule requires
infant formula manufacturers to include
selenium in the nutrient content
statement on containers of infant
formula. All manufacturers currently
disclose selenium in the nutrient list as
specified under § 107.10(b)(5). However,
as noted previously in this document,
one manufacturer would be required to
add more selenium to its formulas
under this proposal. Therefore, it is
estimated that the same firm that would
be required to add more selenium to its
formulas under this proposal will also
incur relabeling costs to comply with
this proposed rule.
Table 2 of this document outlines
low, medium, and high cost estimates of
relabeling based on a minor change to
the infant formula label and an effective
date of 180 days after publication. Costs
are estimated using a relabeling model
developed under contract by RTI. This
model estimates the costs of relabeling
food, dietary supplements, and cosmetic
products under FDA’s jurisdiction and
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these estimates have been adjusted to
reflect 2012 dollars. In this model,
relabeling costs depend on the type of
change (major, minor, or extensive) and
the effective date of the rule. This model
estimates that longer periods of time
before a rule becomes effective are
associated with lower relabeling costs
because any change is more likely to be
able to be coordinated with a change in
a label that may already be scheduled,
and will diminish the need to, for
example, purchase and apply stickers to
packages affected by the change. The
Agency acknowledges the uncertainty in
this estimation and how it may
specifically apply to the infant formula
industry and requests comment
regarding the extent to which the
effective date is likely to affect the cost
of compliance with this proposed rule.
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TABLE 2—ESTIMATED FIRST YEAR
RELABELING COSTS
Low
Medium
High
$3,565,880
$8,735,802
The final component of cost is related
to one firm assembling information for
submission to the Agency related to the
reformulated infant formulas, as
required under section 412(d)(3) of the
FD&C Act. The addition of more
selenium constitutes a change in the
formulation of these formulas that the
Agency considers may affect whether
the formulas are adulterated; therefore,
we are including the submission of
information about the change in the
formulas before the first processing of
such formulas as a cost.
It is estimated that a scientist from
one firm will spend 10 hours
assembling the information to be
submitted, which will address the 46
reformulated infant formulas. This is
estimated as a one-time cost. It is
estimated that this scientist is paid a
wage of $52.88; that is, $35.25 plus 50
percent overhead. Therefore, 10 hours ×
$52.88 = $528.80.
$23,619,959
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TABLE 3—SUMMARY OF TOTAL COST OF OPTION 1
Low
Medium
Reformulation Cost ...........................................................................................
First Year Relabeling Costs ..............................................................................
First Year Submission Costs ............................................................................
$491,188 ...................
$3,467,560 ................
$529 ..........................
$2,112,136 ................
$8,735,802 ................
$529 ..........................
$4,257,760.
$23,619,959.
$529.
Total Cost of Option 1 ...............................................................................
$3.95 million ..............
$10.85 million ............
$27.88 million.
selenium deficiency is manifested as
Keshan disease, an endemic fatal
cardiomyopathy. Because infant formula
may be an infant’s only source of
nutrition, the potential for developing a
deficiency is averted if selenium is
added to the formula.
As seen in table 3 of this document, the
total cost of this option ranges from
$3.95 million to $27.88 million, with
the majority of cost coming from
relabeling.
XII. Benefits
The potential benefits from this
proposed rule, if finalized, are any cases
of selenium deficiency that are avoided
as a result of infant formulas meeting
the 2.0 mg/100 kcal requirement.
However, selenium deficiency is
extremely rare, occurring primarily in
areas of the world where the levels of
selenium in the environment are low,
such as China (Ref. 1). Therefore, it is
not possible to quantify benefits accrued
as a result of this rule and benefits will
be discussed qualitatively.
The consequences of selenium
deficiency may be of greatest concern in
infants and children, who have
relatively greater requirements for
selenium than adults due to their rapid
growth (Ref. 1). According to Daniels, et
al. (2008), suboptimal selenium status is
associated with a range of negative
health outcomes including thyroid and
immune dysfunction, viral infection,
cardiovascular disease, inflammatory
conditions, infertility, and an increased
risk of some cancers (Ref. 5). Overt
XIII. Summary of Costs and Benefits of
This Proposed Rule
The total costs of this proposed rule,
if finalized, consist of one time
reformulation costs, one time
submission costs and one time
relabeling costs. The total cost ranges
between about $4 million and $28
million. Because the costs of this
proposed rule are one time only costs,
no annual costs are estimated for this
proposal. Furthermore, because
selenium deficiency is so rare, it is not
possible to quantify benefits from any
final rule resulting from this proposal.
Option 3: Finalize the proposed rule
and make the provisions effective 12
months after publication.
In this option, firms are required to
meet the requirements of the proposed
rule for infant formula, that is, have
formulas contain selenium at 2.0 mg and
not more than 7.0 mg for each 100
kilocalories of the infant formula, and
have manufacturers add selenium to the
High
list of nutrients on infant formula labels.
However, under Option 3, industry
would have at least 12 months before
they were required to comply with the
rule.
XIV. Costs of Option 3
For this option, the primary costs of
this proposed rule will be reformulation
costs resulting from the firm that needs
to add slightly more selenium to certain
infant formulas in order to comply with
any final rule resulting from this
proposal, along with relabeling and
submission costs. These costs are
presented in 2012 dollars. In contrast to
Option 2, relabeling costs for this option
are less, because of the estimation of the
cost model that, over a longer period of
time, any labeling change is more likely
to be able to be coordinated with a
change in a label that may already be
scheduled, and will diminish the need
to, for example, purchase and apply
stickers to packages affected by the
change. As in Option 2, the Agency
acknowledges the uncertainty in this
estimation and how it may specifically
apply to the infant formula industry and
requests comment regarding the extent
to which the effective date is likely to
affect the cost of compliance with this
proposed rule.
TABLE 4—SUMMARY OF COSTS OF OPTION 3
Low
Medium
Reformulation Cost ......................................................................................................................
One Time Submission Cost .........................................................................................................
Relabeling Costs ..........................................................................................................................
$491,188
529
438,747
$2,112,136
529
765,439
$4,257,760
529
1,271,285
Total Cost of Option 3 ..........................................................................................................
930,464
2,878,104
5,529,574
deficiency is extremely rare, occurring
primarily in areas of the world where
the levels of selenium in the
environment are low (Ref. 1).
Therefore, the costs from this rule, as
shown in table 4, range from about
$930,464 to about $5.5 million.
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XV. Benefits of Option 3
Benefits from this option are identical
to Option 2, however, under this option,
benefits are delayed by 6 months. The
potential benefits from this proposed
option are any cases of selenium
deficiency avoided as a result of infant
formulas meeting the 2.0 ug/100kcal
requirement. As stated earlier, selenium
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XVI. Preliminary Regulatory Flexibility
Analysis
FDA has examined the economic
implications of this proposed rule as
required by the Regulatory Flexibility
Act (5 U.S.C. 601–612). If a rule has a
significant economic impact on a
substantial number of small entities, the
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High
Regulatory Flexibility Act requires
Agencies to analyze regulatory options
that would lessen the economic effect of
the rule on small entities. FDA finds
that, under the Regulatory Flexibility
Act (5 U.S.C. 605(b)), this proposal, if
finalized, will not have a significant
impact on a substantial number of small
entities, as only one firm is affected by
this rule and it is considered large by
Small Business Administration
standards.
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XVII. Paperwork Reduction Act of 1995
This proposed rule contains
information collection provisions that
are subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520). A description of
these provisions is given in this section
of the document with an estimate of the
annual third-party disclosure burden.
Included in the burden estimate is the
time for reviewing instructions,
searching existing data sources,
gathering and maintaining the data
needed, and completing and reviewing
each collection of information.
FDA invites comments on the
following topics: (1) Whether the
proposed collection of information is
necessary for the proper performance of
FDA’s functions, including whether the
information will have practical utility;
(2) the accuracy of FDA’s estimate of the
burden of the proposed collection of
information, including the validity of
the methodology and assumptions used;
(3) ways to enhance the quality, utility,
and clarity of the information to be
collected; and (4) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques,
when appropriate, and other forms of
information technology.
Title: Third-Party Disclosure
Requirements for Selenium in Infant
Formula
Description of Respondents: The
respondents to this information
collection are manufacturers of infant
formula marketed in the United States.
Description: The proposed rule, if
finalized, would revise § 107.10(a) to
require that selenium be listed in the
nutrient list on the label for all infant
formulas. In particular, in the nutrient
list, selenium would be required to be
listed between iodine and sodium and
the amount per 100 calories declared;
and, because selenium would be a
required ingredient in infant formula,
selenium would also be required to be
declared in the formula’s ingredient
statement by its common or usual name
and positioned according to the
descending order of its predominance in
the formula, under § 101.4. The present
22449
version of § 107.10(a) is approved by
OMB in accordance with the PRA and
has been assigned OMB control number
0910–0256. This proposed rule, if
finalized, would modify the information
collection associated with the present
version of § 107.10(a) by adding 23
hours to the burden associated with the
collection. A manufacturer not in
compliance with the new minimum and
maximum levels for selenium in infant
formula would be required to make a
one-time change to the nutrient list
information disclosed to consumers on
the label of its infant formula, to
account for the required change in the
amount of selenium in its products. The
nutrient information disclosed by
manufacturers on the infant formula
label is necessary to inform purchasers
of the value of the infant formula. As
discussed previously in this document,
FDA has the authority to revise the
statement of the amounts of nutrients
required for infant formula labeling in
§ 107.10(a)(2).
FDA estimates the burden of this
collection of information as follows:
TABLE 5—ESTIMATED ANNUAL THIRD-PARTY DISCLOSURE BURDEN 1
21 CFR section
Number of
respondents
Number of
disclosures
per
respondent
Total annual
disclosures
Average burden
per disclosure
Total hours
Total capital
cost
§ 107.10 Nutrient labeling for infant formula.
1
46
46
0.5 (30 minutes)
23
$765,439
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1 There
are no operating and maintenance costs associated with this collection of information.
FDA tentatively concludes that the
additional burden to disclose selenium
in the ingredient statement resulting
from the proposed amendment of
§ 107.10 would be negligible because all
U.S. infant formula manufacturers
currently add selenium as an ingredient
to their infant formula products, and all
manufacturers currently disclose the
selenium in the ingredient statement, as
specified by § 101.4. Additionally, all
manufacturers currently disclose
selenium in the nutrient list, as required
by § 107.10(b)(5). Only one
manufacturer produces infant formula
that would not meet the requirements of
this rule, if finalized, and would thus
need to be reformulated. Under
proposed § 107.10(a)(2), this one
manufacturer would need to make a
one-time labeling change to modify its
nutrient list to account for the addition
of more selenium to its infant formula.
The third-party disclosure burden
consists of the setup time required to
design a revised label and incorporate it
into the manufacturing process. Based
upon its knowledge of food and dietary
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supplement labeling, FDA estimates that
the affected manufacturer would require
less than 0.5 hour per product to modify
the label’s nutrient list to reflect the
addition of more selenium to the
product. The Regulatory Impact
Analysis estimates that this
manufacturer produces 46 separate
infant formulas that would need to be
reformulated, and thus require
relabeling. The one-time third-party
disclosure burden for the proposed rule
is estimated in table 5 of this document.
The final column of table 5 gives the
estimated capital cost associated with
relabeling. This is the cost of designing
a revised label and incorporating it into
the manufacturing process. The cost
stated in table 5, $765,439, is based on
the estimate in the Regulatory Impact
Analysis under Option 3, which
assumes that the proposed rule is
finalized with an effective date of 1 year
after publication. These costs are based
on the estimation of the cost model that,
over a longer period of time, any
labeling change is more likely to be able
to be coordinated with a change in a
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Sfmt 4702
label that may already be scheduled,
and will diminish the need to, for
example, purchase and apply stickers to
packages affected by the change.
Additionally, because of the change in
formulation of its products that would
be required if the rule is finalized as
proposed, a manufacturer would need to
determine whether they are required to
make a one-time submission to FDA
before the first processing of its
formulas, as required by section
412(d)(3) of the FD&C Act. This
reporting requirement is approved by
OMB under OMB control number 0910–
0256. The current hour burden
approved by OMB for section 412(d) of
the FD&C Act is 10 hours per report.
Based on the Agency’s experience with
infant formula submissions, FDA
estimates that the affected manufacturer
will submit one report that will cover all
46 reformulated infant formulas. In a
future request for extension of the 0910–
0256 information collection, FDA will
include the additional report in its
estimates.
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To ensure that comments on
information collection are received,
OMB recommends that written
comments be faxed to the Office of
Information and Regulatory Affairs,
OMB, Attn: FDA Desk Officer, FAX:
202–395–6974, or emailed to
oira_submission@omb.eop.gov. All
comments should be identified with the
title ‘‘Third-Party Disclosure
Requirements for Selenium in Infant
Formula.’’
In compliance with the Paperwork
Reduction Act of 1995 (44 U.S.C.
3407(d)), the Agency has submitted the
information collection provisions of this
proposed rule to OMB for review.
Interested persons are requested to send
comments regarding information
collection by May 16, 2013, to the Office
of Information and Regulatory Affairs,
OMB.
XVIII. How do you submit comments on
this rule?
Interested persons may submit either
electronic comments regarding this
document to https://www.regulations.gov
or written comments to the Division of
Dockets Management (see ADDRESSES). It
is only necessary to send one set of
comments. Identify comments with the
docket number found in brackets in the
heading of this document. Received
comments may be seen in the Division
of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday, and
will be posted to the docket at https://
www.regulations.gov.
XIX. References
The following references have been
placed on display in the Dockets
Management Branch (see ADDRESSES)
and may be seen by interested persons
between 9 a.m. and 4 p.m., Monday
through Friday.
1. Food and Nutrition Board. Institute of
Medicine. Dietary Reference Intakes for
Vitamin C, Vitamin E, Selenium, and
Carotenoids. Washington, DC: National
Academy Press, p. 21–33; 292–299; 315–
316, 2000.
2. Food and Nutrition Board. National
Research Council. Recommended Dietary
Allowances. 10th Edition. Washington,
DC: National Academy Press, p. 221,
1989.
3. Raiten, D. J., J. M. Talbot, and J. H. Waters,
‘‘Assessment of Nutrient Requirements
for Infant Formulas,’’ Journal of
Nutrition, 128: 2059S–2249S, 1998.
4. Koletzko, B., S. Baker, G. Cleghorn, U. F.
Neto, et al., ‘‘Global Standard for the
Composition of Infant Formula.
Recommendations of an ESPGHAN
Coordinated International Expert
Group,’’ Journal of Pediatric
Gastroenterology and Nutrition, 41:584–
599, 2005.
5. Daniels, L., R.A. Gibson, K. Simmer, P.
Van Dael, M. Makrides, ‘‘Selenium
Status of Term Infants Fed SeleniumSupplemented Formula in a Randomized
Dose-Response Trial,’’ American Journal
of Clinical Nutrition, 88:70–76, 2008.
6. Centers for Disease Control and Prevention
(CDC). National Center for Health
Statistics (NCHS). National Health and
Nutrition Examination Survey Data.
Hyattsville, MD: U.S. Department of
Health and Human Services, Centers for
Disease Control and Prevention, 2013.
7. Codex Alimentarius Commission,
‘‘Standards for Infant Formulas for
Special Medical Purposes Intended for
Infants, 72–1981,’’ 1981.
List of Subjects in 21 CFR Part 107
Exempt infant formulas, Food
labeling, General provisions, Infant
formula, Infant formula recalls, Infants
and children, Labeling, Nutrition,
Nutrient requirements, Reporting and
recordkeeping requirements, Signs and
symbols.
Therefore, under the Federal Food,
Drug, and Cosmetic Act and under
authority delegated to the Commissioner
of Food and Drugs, 21 CFR part 107 is
proposed to be amended as follows:
PART 107—INFANT FORMULA
The authority citation for 21 CFR part
107 continues to read as follows:
Authority: 21 U.S.C. 321, 343, 350a, 371.
1. In § 107.10, revise paragraph (a)(2)
to read as follows:
■
§ 107.10
Nutrient Information.
(a) * * *
(2) A statement of the amount of each
of the following nutrients supplied by
100 kilocalories:
Protein .................
Fat .......................
Carbohydrate ......
Water ...................
Linoleic acid ........
Vitamins:
Vitamin A .........
Vitamin D .........
Vitamin E .........
Vitamin K .........
Thiamine (Vitamin B1).
Riboflavin (Vitamin B2).
Vitamin B6 ........
Vitamin B12 ......
Niacin ...............
Folic acid
(Folacin).
Pantothenic
acid.
Biotin ................
Vitamin C
(Ascorbic
acid).
Choline ............
Inositol .............
Minerals:
Calcium ............
Phosphorus .....
Magnesium ......
Iron ..................
Zinc ..................
Manganese ......
Copper .............
Iodine ...............
Selenium ..........
Sodium ............
Potassium ........
Chloride ...........
mstockstill on DSK4VPTVN1PROD with PROPOSALS
Grams.
Do.
Do.
Do.
Milligrams.
International Units.
Do.
Do.
Micrograms.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Milligrams.
Do.
Do.
Milligrams.
Do.
Do.
Do.
Do
Micrograms.
Do.
Do.
Do.
Milligrams.
Do.
Do.
*
*
*
*
*
■ 2. In § 107.100, revise paragraph (a) to
read as follows:
§ 107.100
Nutrient specifications.
(a) An infant formula shall contain the
following nutrients at a level not less
than the minimum specified and not
more than the maximum level specified
for each 100 kilocalories of the infant
formula in the form prepared for
consumption as directed on the
container:
Nutrients
Unit of measurement
Protein .....................................................................................................
Fat ...........................................................................................................
Grams ............................................
do ...................................................
Percent calories .............................
Milligrams .......................................
Percent calories .............................
Linoleic acid ............................................................................................
..................................................................................................................
Unit of
measurement
Nutrients
Minimum level
Maximum level
1.8
3.3
30
300
2.7
4.5
6.0
54
..........................
..........................
250
40
0.7
750
100
..........................
Vitamins
Vitamin A .................................................................................................
Vitamin D .................................................................................................
Vitamin E .................................................................................................
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do ...................................................
do ...................................................
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16APP1
Federal Register / Vol. 78, No. 73 / Tuesday, April 16, 2013 / Proposed Rules
Nutrients
Unit of measurement
Minimum level
Vitamin K .................................................................................................
Thiamine (Vitamin B1) .............................................................................
Riboflavin (Vitamin B2) ............................................................................
Vitamin B6 ...............................................................................................
Vitamin B12 ..............................................................................................
Niacin 1 ....................................................................................................
Folic Acid (folacin) ...................................................................................
Pantothenic acid ......................................................................................
Biotin 2 .....................................................................................................
Vitamin C (ascorbic acid) ........................................................................
Choline 2 ..................................................................................................
Inositol 2 ...................................................................................................
Micrograms ....................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
Milligrams .......................................
do ...................................................
do ...................................................
22451
Maximum level
4
40
60
35
0.15
250
4
300
1.5
8
7
4
..........................
..........................
..........................
..........................
..........................
..........................
..........................
..........................
..........................
..........................
..........................
..........................
60
30
6
0.15
0.5
5
60
5
2
20
80
55
..........................
..........................
..........................
3.0
..........................
..........................
..........................
75
7
60
200
150
Minerals
Calcium ...................................................................................................
Phosphorus .............................................................................................
Magnesium ..............................................................................................
Iron ..........................................................................................................
Zinc ..........................................................................................................
Manganese ..............................................................................................
Copper .....................................................................................................
Iodine .......................................................................................................
Selenium .................................................................................................
Sodium ....................................................................................................
Potassium ................................................................................................
Chloride ...................................................................................................
1 The
do ...................................................
do ...................................................
do ...................................................
do ...................................................
do ...................................................
Micrograms ....................................
do ...................................................
do ...................................................
do ...................................................
Milligrams .......................................
do ...................................................
do ...................................................
generic term ‘‘niacin’’ includes niacin (nicotinic acid) and niacinamide (nicotinamide).
only for non-milk-based infant formulas.
2 Required
*
*
*
*
*
DEPARTMENT OF EDUCATION
Dated: April 10, 2013.
Leslie Kux,
Assistant Commissioner for Policy.
34 CFR Chapter II
RIN 1810–AB17
[Docket ID ED–2013–OS–0050]
[FR Doc. 2013–08855 Filed 4–15–13; 8:45 am]
BILLING CODE 4160–01–P
Proposed Priorities, Requirements,
Definitions, and Selection Criteria—
Race to the Top—District [CFDA
Number: 84.416.]
DEPARTMENT OF THE INTERIOR
Office of Surface Mining Reclamation
and Enforcement
30 CFR Parts 701, 736, 737, 738, and
750
[Docket ID OSM–2012–0003]
RIN 1029–AC65
Cost Recovery for Permit Processing,
Administration, and Enforcement
mstockstill on DSK4VPTVN1PROD with PROPOSALS
Correction
In proposed rule document R1–2013–
06950, appearing on pages 20394–20408
in the issue of Thursday, April 4, 2013,
make the following correction:
§ 738.11
[Corrected]
In the table on page 20407, in the
third row, fourth column, ‘‘1,300’’
should read ‘‘13,000’’.
[FR Doc. C1–2013–06950 Filed 4–15–13; 8:45 am]
BILLING CODE 1505–01–D
VerDate Mar<15>2010
16:42 Apr 15, 2013
Jkt 229001
Office of the Deputy Secretary,
Department of Education.
ACTION: Proposed priorities,
requirements, definitions, and selection
criteria.
AGENCY:
SUMMARY: The Secretary proposes
priorities, requirements, definitions, and
selection criteria under the Race to the
Top—District program. The Secretary
may use one or more of these priorities,
requirements, definitions, and selection
criteria for competitions using funds
from fiscal year (FY) 2013 and later
years. The Race to the Top—District
program builds on the experience of
States and districts in implementing
reforms in the four core educational
assurance areas through Race to the Top
and other key programs and supports
applicants that demonstrate how they
can personalize education for all
students in their schools. The U.S.
Department of Education (Department)
conducted one competition under the
Race to the Top—District program in FY
2012, and we propose to maintain the
PO 00000
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Fmt 4702
Sfmt 4702
overall purpose and structure of the FY
2012 Race to the Top—District
competition. These proposed priorities,
requirements, definitions, and selection
criteria are almost identical to the ones
we used in the FY 2012 competition.
We describe the changes at the
beginning of each section of this
document.
DATES: We must receive your comments
on or before May 16, 2013, and we
encourage you to submit comments well
in advance of this date.
ADDRESSES: Submit your comments
through the Federal eRulemaking Portal
or via postal mail, commercial delivery,
or hand delivery. We will not accept
comments by fax or by email. To ensure
we do not receive duplicate comments,
please submit your comments only
once. In addition, please include the
Docket ID and the phrase ‘‘Race to the
Top—District-Comments’’ at the top of
your comments.
Federal eRulemaking Portal: Go to
www.regulations.gov to submit your
comments electronically. Information
on using Regulations.gov, including
instructions for accessing agency
documents, submitting comments, and
viewing the docket, is available on the
site under ’’How to use
Regulations.gov’’ in the Help section.
Postal Mail, Commercial Delivery, or
Hand Delivery. If you mail or deliver
your comments about these proposed
priorities, requirements, definitions, and
selection criteria, address them to the
E:\FR\FM\16APP1.SGM
16APP1
Agencies
[Federal Register Volume 78, Number 73 (Tuesday, April 16, 2013)]
[Proposed Rules]
[Pages 22442-22451]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-08855]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 107
[Docket No. FDA-2013-N-0067]
Infant Formula: The Addition of Minimum and Maximum Levels of
Selenium to Infant Formula and Related Labeling Requirements
AGENCY: Food and Drug Administration.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is proposing to amend
the regulations on nutrient specifications and labeling for infant
formula to add the mineral selenium to the list of required nutrients
and to establish minimum and maximum levels of selenium in infant
formula.
DATES: Submit either electronic or written comments on the proposed
rule by July 1, 2013. Submit comments on information collection issues
under the Paperwork Reduction Act of 1995 by May 16, 2013, (see the
``Paperwork Reduction Act of 1995'' section of this document).
ADDRESSES: You may submit comments, identified by Docket No. FDA-2013-
N-0067, by any of the following methods, except that comments on
information collection issues under the Paperwork Reduction Act of 1995
must be submitted to the Office of Information and Regulatory Affairs,
Office of Management and Budget (OMB) (see the ``Paperwork Reduction
Act of 1995'' section of this document):
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments.
Written Submissions
Submit written submissions in the following way:
Mail/Hand delivery/Courier (for paper or CD-ROM
submissions): Division of Dockets Management (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
Instructions: All submissions received must include the Agency name
and Docket No. FDA-2013-N-0067 for this rulemaking. All comments
received may be posted without change to https://www.regulations.gov,
including any personal information provided. For additional information
on submitting comments, see the ``How Do You Submit Comments on This
Rule?'' heading of the SUPPLEMENTARY INFORMATION section of this
document.
Docket: For access to the docket to read background documents or
comments received, go to https://www.regulations.gov and insert the
docket number, found in brackets in the heading of this document, into
the ``Search'' box and follow the prompts or go to the Division of
Dockets Management, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: With regard to the proposed rule:
Benson M. Silverman, Center for Food Safety and Applied Nutrition (HFS-
850), Food and Drug Administration, 5100 Paint Branch Pkwy, College
Park, MD 20740, 240-402-1450.
With regard to the information collection issues: Domini Bean,
Office of Information Management, Food and Drug Administration, 1350
Piccard Dr., PI50-400T, Rockville, MD 20850, domini.bean@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. What is the background of this proposed rule?
Section 412(i) of the Federal Food, Drug, and Cosmetic Act (the
FD&C Act) (21 U.S.C. 350a(i)) establishes requirements for the nutrient
content of infant formulas. Under section 412(i)(2) of the FD&C Act,
the Secretary of Health and Human Services (the Secretary) is
authorized to revise the list of required nutrients and the required
level for any required nutrient, which authority has been delegated to
the Commissioner of Food and Drugs (the Commissioner). The table in
section 412(i) of the FD&C Act and FDA regulations, 21 CFR 107.100,
specify that infant formulas must contain 29 nutrients; minimum levels
for each nutrient and maximum levels for 9 of the nutrients are also
specified.
At the time FDA established nutrient specifications for infant
formula, selenium was not recognized as an essential nutrient and was
not one of the nutrients required by statute in infant formula. As
explained in detail in this document, selenium has subsequently been
recognized as an essential nutrient. Therefore, we are proposing to
amend the nutrient specifications for infant
[[Page 22443]]
formula in Sec. 107.100 to include selenium as a required nutrient and
to establish minimum and maximum values for selenium. We are also
proposing to amend the labeling requirements for infant formula in 21
CFR 107.10 to add selenium to the list of nutrients along with the
requirement to list the amount of selenium per 100 kilocalories in the
formula.
Selenium is an essential trace element for humans that functions
largely through an association with proteins known as selenoproteins.
The known biological functions of selenium include defense against
oxidative stress, regulation of thyroid hormone action, and regulation
of the oxidation/reduction status of vitamin C and other molecules.
Plant foods are the major dietary sources of selenium although
selenium is also found in some meats, seafood, and nuts. The selenium
content of a food depends on the selenium content of the soil where the
plant was grown or where the animal was raised. In the United States,
food distribution patterns across the country help prevent people
living in geographic areas with low-selenium levels in the soil from
having low dietary selenium intakes. Keshan disease, a cardiomyopathy
that occurs almost exclusively in children, has been linked to selenium
deficiency. Keshan disease occurs in areas of China where the
population has severe selenium deficiency. Chronic selenium toxicity
(selenosis) has also been observed in persons consuming diets
containing high levels of selenium. Reported characteristics include
hair and nail brittleness and loss, gastrointestinal upsets, skin rash,
garlic breath odor, fatigue, irritability, and nervous system
abnormalities. Acute selenium toxicity is rare and the few reports in
the literature of acute fatal or near fatal selenium poisoning have
occurred because of accidental or suicidal ingestion of selenium (Ref.
1).
In the United States, selenium is not routinely added to food. An
exception is infant formula, a food that is intended to be the sole
source of nutrition for infants and therefore, must provide sufficient
amounts of all nutrients essential for infants. In 1989, the Food and
Nutrition Board of the National Research Council established a
Recommended Dietary Allowance (RDA) for selenium for infants 0 to 6
months of age of 10.0 micrograms per day ([mu]g/day), a level
extrapolated from adult values on the basis of body weight and with a
factor allowed for growth (Ref. 2). Although selenium is not currently
required in infant formula by Sec. 107.100, all U.S. manufacturers are
adding selenium to their infant formulas. Based on labeling
information, currently marketed infant formulas contain 1.8 [mu]g to
3.0 [mu]g selenium per 100 kilocalorie (kcal) of formula.
II. What levels of selenium are we proposing for infant formula?
As discussed in more detail in this document, we are proposing 2.0
[mu]g selenium/100 kcal as the minimum level for selenium in infant
formulas and 7.0 [mu]g/100 kcal as the maximum level of selenium in
infant formulas
III. What scientific evidence did we consider for the proposed
requirement to add selenium to infant formulas?
In order to add a selenium requirement and to establish minimum and
maximum levels of selenium in infant formula, we first identified and
reviewed three relevant technical reports on recommended nutrient
levels for formulas for term infants and nutrient needs of healthy term
infants: (1) The Life Sciences Research Office (LSRO) report
``Assessment of Nutrient Requirements for Infant Formulas'' (Ref. 3);
(2) ``Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and
Carotenoids'' (Ref. 1); and (3) ``Global Standard for the Composition
of Infant Formula: Recommendations of an ESPGHAN Coordinated
International Expert Group'' (Ref. 4). These reports are referred to as
the LSRO report, the Institute of Medicine (IOM) report, and the
European Society on Pediatric Gastroenterology, Hepatology, and
Nutrition (ESPGHAN) report, respectively, in the remainder of this
proposal. We also searched the published scientific literature from
1998 through 2012 for published studies not included in these reports
or not identified in a 2008 published study by Daniels et al. (Ref. 5).
(The Daniels et al. study is discussed in this section of the
document.)
A. Available Evidence for Setting a Minimum Level of Selenium in Infant
Formula
1. LSRO Report
In 1998, Raiten et al. published a report summarizing the
scientific literature on the nutrient needs of healthy term infants,
with an emphasis on research studies published since 1983 (Ref. 3). The
report was prepared for FDA's Center for Food Safety and Applied
Nutrition and Health Canada's Health Protection Branch by the LSRO in
consultation with expert scientists and professional organizations
involved in the field of infant nutrition. The goal of the
deliberations of this LSRO Expert Panel was to provide recommendations
for nutrient content of infant formulas that could serve as the sole
source of nutrition for term infants throughout the first year of life.
On the basis of the evidence for the dietary essentiality of
selenium, the LSRO Expert Panel recommended that selenium be included
as a required nutrient in infant formula. The Panel also recommended a
minimum selenium content of 1.5 [mu]g/100 kcal (10.0 [mu]g/liter (L)),
which) and a maximum level of 5.0 [mu]g/100 kcal (33.5 [mu]g/L). The
minimum value approximated the estimated value for the mean minus one
standard deviation (SD) for the selenium concentration in human milk in
countries in which selenium deficiency has not been recognized in
breast-fed infants. This recommended minimum level would provide an
estimated 7.5 [mu]g/day of selenium for young infants exclusively fed
infant formula,\1\ an amount below the 1989 RDA (10.0 [mu]g/day). The
LSRO Panel was aware that there were disparities between some of its
recommendations for nutrient levels in infant formulas and the 1989
RDAs; however, the history of use for a large population in which
selenium deficiency has not been reported was regarded as a reasonable
basis for recommending a minimum value for selenium in infant formula.
---------------------------------------------------------------------------
\1\ This estimate is based on a calculation used to convert
nutrient intake values (e.g., milligram (mg)/day) to formula
nutrient content values (e.g., mg/100 kcal) (Raiten, et al., 1998;
Koletzko, et al, 2006). The calculation is based on the following
assumptions: (1) The mean intake of formulas for infants 0 to 6
months of age is 750 milliliter (ml)/day; (2) a representative body
weight for infants over this period is 5 kilogram (kg); and (3) a
representative caloric intake of infants over this period is 500
kcal/day (or 100 kcal/kg/day).
---------------------------------------------------------------------------
2. IOM Report
In 2000, the IOM published Dietary Reference Intakes (DRI) for
selenium. The DRI concept evolved from the Recommended Dietary
Allowances reports that have been published periodically since 1941 by
the National Academies of Science. As described by the IOM (Ref. 1),
the term Dietary Reference Intake encompasses three nutrient-based
reference values in addition to the RDA. The RDA and the three
nutrient-based reference values were described by the IOM as follows:
The Recommended Dietary Allowance (RDA) is the average
dietary intake level that is sufficient to meet the nutrient
requirements of nearly all (97 to 98 percent) healthy individuals in a
particular life stage and gender group.
[[Page 22444]]
The RDA is intended to be the goal for daily intake by individuals.
The Estimated Average Requirement (EAR) is the daily
intake value that is estimated to meet the requirement, as defined by
the specified indicator of adequacy, in half of the healthy individuals
in a life stage and gender group. The EAR is used to set the RDA. If
the standard deviation (SD) of the EAR is available and the requirement
for the nutrient is normally distributed, the RDA is defined as the EAR
plus two SDs of the EAR.
An Adequate Intake (AI) is established for a nutrient when
sufficient scientific evidence is not available to calculate an EAR. An
AI is based on experimentally-derived intake levels of approximations
of observed mean nutrient intakes by a group of healthy people. The AI
for children and adults is expected to meet or exceed the amount needed
to maintain a defined nutritional state or exceed the amount needed to
maintain a defined nutritional state or criterion of adequacy in
essentially all members of a specific healthy population because it is
set using healthy populations. Like the RDA, the AI is intended to be
the goal for individual intake and it is intended to cover the needs of
nearly all persons in a life stage group.
The Tolerable Upper Intake Level (UL) is the highest daily
intake level of a nutrient that is likely to pose no risk of adverse
health effects in almost all individuals in a life stage group.
At the time of its report, the IOM did not find sufficient evidence
to calculate an EAR for selenium for infants during the first year of
life and, therefore, did not have a basis to set an RDA for selenium
for infants. For this reason, the IOM set an AI for selenium for
infants 0 to 6 months of age, the age when the recommended sole source
of nutrition is human milk, infant formula, or a combination of the
two.
The IOM's primary basis for deriving an AI for most nutrients for
the first 6 months of life was the average intake by full term infants
born to healthy, well-nourished mothers and exclusively fed human milk.
To derive the AI values for infants ages 0 to 6 months of age, the mean
intake of a nutrient was calculated based on the average concentration
of the nutrient in human milk from 2 to 6 months of lactation, using
agreed-upon values from several reported studies and an average volume
of milk intake. To calculate the AI for selenium, IOM used the average
concentration of selenium in human milk from mothers in the United
States and Canada (18.0 [mu]g/L) and an intake of 0.78 L/day, as
reported from differences in weights of full-term infants before and
after feedings. A reference weight of 7 kg for infants 2 to 6 months of
age, adapted from National Health and Nutrition Examination Survey
(NHANES) III 1988-1994 data (Ref. 6), was used by the IOM to calculate
the AI on a body weight basis. (Ref. 1). The IOM established a selenium
AI of 15.0 [mu]g/day (approximately 2.1 [mu]g/kg body weight/day) for
infants 0 to 6 months of age (IOM, 2000). Assuming a typical intake of
100 kcal/kg/day for infants 0 to 6 months of age, this approximates a
need for selenium, relative to energy consumption, of 2.1 [mu]g/100
kcal.
3. ESPGHAN Report
In 2005, an International Expert Group (IEG) coordinated by the
Committee on Nutrition of the ESPGHAN prepared a report on nutrient
levels in infant formula, based on scientific analysis and taking into
account existing scientific reports on current infant formula nutrient
content (Ref. 4). The report was prepared at the request of the Codex
Committee on Nutrition and Foods for Special Dietary Uses for use by
that Committee in revising the Codex Standard for Infant Formula and
Formulas for Special Medical Purposes Intended for Infants (Codex Stan
72-1981) (Ref. 7). The goal of establishing minimum and maximum
nutrient values for the Codex standard was to ensure that infant
formulas adhering to the Standard would be safe and would meet infants'
normal nutritional requirements.
The ESPGHAN IEG reported that their recommended minimum nutrient
values were based on scientific evidence of the amounts needed to meet
infants' nutritional requirements when such information was available.
When scientific information was lacking, an established history of
apparent safe use was taken into account. The IEG recommended a minimum
selenium value of 1 [mu]g/100 kcal for infant formula and they
indicated that the reported median selenium content of human milk and
values set for infant reference nutrient intakes formed the basis for
their recommendation. Further detail was not provided on how this
information was used by the IEG in making their recommendation.
4. Recent Published Literature
One recent report in the published scientific literature also
provides important information on necessary infant selenium intake
levels. Daniels, et al. reported the results of a randomized, double-
blinded dose-response study of healthy term infants fed infant formula
containing selenium at three concentrations (6.0 [mu]g/liter, 13.0
[mu]g/liter, or 21.0 [mu]g/liter) and a breast-fed reference group
(Ref. 5). The concentrations of selenium in the study formulas
correspond to 0.9 [mu]g/100 kcal (low selenium control), 1.9 [mu]g/100
kcal, and 3.1 [mu]g/100 kcal, respectively. The mean concentration of
selenium in breast milk reported in this study was 11.0 [mu]g/liter
(1.6 [mu]g/100 kcal). Infants participating in the study consumed the
assigned infant formula or breast milk as the sole source of nutrition
from birth to 16 weeks of age.
Consumption of formulas containing both of the higher levels of
selenium (1.9 [mu]g/100 kcal and 3.1 [mu]g/100 kcal) resulted in
changes in plasma and erythrocyte indicators of selenium status at the
end of the study that did not differ statistically from each other or
from the breast-fed control group. However, indicators of selenium
status for all of these groups differed statistically from the plasma
and erythrocyte indicators of selenium status in the infants fed the
control formula containing only 0.9 [mu]g selenium/100 kcal. A dose-
related increase in urinary selenium excretion in the formula-fed
groups was also reported. When infants consumed formulas containing
selenium at levels of 1.9 [mu]g/100 kcal or 3.1 [mu]g/100 kcal, there
were no statistically significant dose-related changes in plasma and
erythrocyte indicators of selenium status. However, there was a
statistically significant increase in urinary selenium excretion in the
infants fed the formula containing 3.1 [mu]g/100 kcal compared to the
infants fed the formula containing 1.9 [mu]g/100 kcal. This latter
finding, in combination with the finding of no dose-related changes in
the circulating indicators of selenium status, suggests that infants
fed the formula containing a level of 1.9 [mu]g selenium/100 kcal
received sufficient selenium to meet their nutritional needs and that
by virtue of the body's homeostatic mechanisms, it would appear that
much of the selenium intake above the level of 1.9 [mu]g selenium/100
kcal was eliminated from the body.
B. Available Evidence for Setting a Maximum Level for Selenium in
Infant Formula
1. LSRO Report
The LSRO Expert Panel recommended a maximum selenium level for
infant formula of 5.0 [mu]g/100 kcal (33.5 [mu]g/L) (Ref. 3). This
recommendation was based on the upper limit of the range of selenium in
human milk, which was considered to represent a history of use for a
large population in which
[[Page 22445]]
selenium toxicity had not been reported. The LSRO report also indicated
that, on a body weight basis, this level is far below the intake
associated with the development of selenosis in adults.
2. IOM Report
The IOM established an upper limit (UL) for selenium for infants 0
to 6 months of age relying on data on the concentration of selenium in
human milk, which is not associated with known adverse effects. The IOM
calculated an UL of 47.0 [mu]g/day or approximately 7.0 [mu]g/kg body
weight/day for infants 0 to 6 months of age, which approximates 7.0
[mu]g/100 kcal.
3. ESPGHAN Report
The ESPGHAN IEG recommended a maximum level of 9 [mu]g/100 kcal for
selenium in infant formula. The IEG based their recommendations for
maximum nutrient values on scientific evidence regarding the absence of
adverse effects, when such information was available. When scientific
information was lacking, an established history of apparent safe use
was taken into account. Further detail was not provided on how this
information was used by the IEG in making its recommendation.
IV. Which products are subject to this proposed rule?
Products that meet the statutory definition of ``infant formula''
in section 201(z) of the FD&C Act (21 U.S.C. 321(z)) (``a food which
purports to be or is represented for special dietary use solely as a
food for infants by reason of its simulation of human milk or its
suitability as a complete or partial substitute for human milk'') are
subject to this proposed rule.
V. What does this proposed rule do?
This proposed rule, if finalized, will add selenium to the list of
required nutrients for infant formulas and establish minimum and
maximum levels of selenium in FDA's nutrient specifications regulations
for infant formulas under Sec. 107.100(a). In addition, the proposed
rule would add selenium to the list of nutrients that must be listed in
the table of nutrition information required on infant formula labeling
by Sec. 107.10(a)(2).
A. Revision to Sec. 107.100(a) Nutrient Specifications
We are proposing to mandate that selenium be added to infant
formula by requiring that this mineral be listed in the table of
nutrients for infant formulas in Sec. 107.100(a). We are also
proposing to establish minimum and maximum levels for selenium in
infant formula because evidence exists for both deficiency and toxicity
of selenium, and there is no room for error in production of a food
that serves as the sole source of nutrition for infants.
1. Proposed Minimum Level of Selenium in Infant Formulas
After considering the scientific reports discussed previously in
this document and evidence published by Daniels, et al. after those
reports were completed, we are proposing 2.0 [mu]g selenium/100 kcal as
the minimum level for selenium in infant formulas. This proposed
minimum level is based on the IOM's AI for selenium for infants 0 to 6
months of age (2.1 [mu]g/day) (Ref. 1) and the level suggested by the
data in the study by Daniels, et al. (1.9 [mu]g/100 kcal) (Ref. 5),
rounded to the nearest whole microgram. As noted, the Daniels, et al.
study demonstrated that infants who consumed infant formula containing
1.9 [mu]g selenium/100 kcal had plasma and erythrocyte indicators of
selenium status that were statistically higher than those of infants
consuming formula containing less selenium (0.9 [mu]g/100 kcal) but
these levels did not differ from those of infants consuming infant
formula containing more selenium (3.1 [mu]g/100 kcal). Infants
consuming the formula containing 3.1 [mu]g/100 kcal of selenium also
had significantly higher urinary excretion of selenium. In the absence
of statistically significant changes in plasma and erythrocyte
indicators of selenium status, the substantially higher urinary
excretion of selenium of the infants fed the 3.1 [mu]g selenium formula
compared to that of the infants fed the 1.9 [mu]g selenium formula,
suggests that a selenium intake of 3.1 [mu]g/100 kcal is likely to be
greater than the amount needed to meet an infant's nutritional needs.
Thus, FDA tentatively concludes that 2.0 [mu]g selenium/100 kcal is an
appropriate required minimum for selenium in infant formulas.
We also propose to correct a typographical error in the table that
appears in Sec. 107.100(a). In the second column of that table, each
abbreviation for ditto (``do'') will now be followed by a period.
2. Proposed Maximum Level of Selenium in Infant Formulas
FDA is also proposing to set a maximum level for selenium in infant
formula of 7.0 [mu]g/100 kcal. This level is based on the UL for
infants 0 to 6 months of age established by the IOM (Ref. 1), and
defined as highest level of daily nutrient intake that is likely to
pose no risk of adverse health effects in the population of interest.
FDA is relying on the IOM's recommendation because the IOM report was
the most transparent in terms of the basis for its recommended UL.
Also, unlike the minimum level, there is no study that provides direct
evidence to establish a maximum level and thus, in proposing a maximum
level, the agency must rely on a recommendation for an intake level
that is likely to pose no risk of adverse health effects.
3. Comments Specifically Requested
We find that there is scientific evidence sufficient to support the
minimum proposed level of 2.0 [mu]g selenium/100 kcal and the proposed
maximum level of 7.0 ug selenium/100 kcal, although there is less
evidence directly applicable to the proposed maximum level. While we
are interested in comments regarding the proposed minimum level for
selenium, we are particularly interested in comments regarding the
proposed maximum level of 7.0 [mu]g selenium/100 kcal, including
whether such a maximum level is needed and the scientific data or
information that form the basis of any comments.
Although, in our judgment, it will be feasible for formula
manufacturers to achieve consistent production of infant formulas with
selenium levels that are at or above the proposed minimum level of 2.0
[mu]g/100 kcal while not exceeding the proposed maximum level of 7.0
[mu]g/100 kcal, we specifically request comments about whether the
proposed minimum and maximum selenium levels provide sufficient
flexibility and can be achieved from a practical manufacturing
standpoint. In addition, because unduly high levels of nutrients should
be avoided in products that serve as the sole source of nutrients for
infants, a population that is particularly vulnerable to nutritional
inadequacies and excesses, we are also particularly interested in
receiving comments about available means to ensure that nutrient levels
in infant formulas, including selenium, are not excessive.
B. Revision to Sec. 107.10(a)(2) Nutrient Information
We are proposing to add selenium to the statement of the amounts of
nutrients required for infant formula labeling in Sec. 107.10(a)(2).
This additional mineral would be required to be listed between iodine
and sodium, as directed by Sec. 107.10(b)(5).
VI. What is the legal authority for this proposed rule?
Section 412(i) of the FD&C Act contains a table of nutrients
(including
[[Page 22446]]
minimum and, in some cases, maximum levels for such nutrients) that are
required to be in an infant formula. Section 412(i)(2) of the FD&C Act
authorizes the Secretary to revise the statutory table of nutrients and
to revise the level of any required nutrient. The Secretary has
delegated this authority to the Commissioner. In the Federal Register
of October 31, 1985, FDA published a final rule revising the statutory
table of nutrients, which was published as Sec. 107.100. This proposed
rule, if finalized, would amend Sec. 107.100. Accordingly, the legal
authority for the proposed revision to Sec. 107.100, which revises the
statutory list of nutrients required for infant formula, is section
412(i)(2) of the FD&C Act.
Additionally, this proposed rule, if finalized, would require the
addition of selenium to the statement of the amounts of nutrients
required for infant formula labeling in Sec. 107.10(a)(2). As noted
previously in this document, ``infant formula'' is defined as a food
for ``special dietary use'' under section 201(z) of the FD&C Act. Under
sections 403(j) and 701(e) of the FD&C Act (21 U.S.C. 343(j) and 21
U.S.C. 371(e)), the Secretary, and by delegation the Commissioner, may
prescribe regulations concerning the vitamin and mineral content of
foods for special dietary uses, in order to fully inform purchasers as
to the value of the food for such uses. As such, FDA has the authority
to revise the statement of the amounts of nutrients required for infant
formula labeling in Sec. 107.10(a)(2) under sections 201(z), 403(j),
412(i), and 701(e) of the FD&C Act. When the Agency issues a final rule
for the provisions in proposed Sec. 107.10(a)(2), it will provide an
opportunity for filing objections and requests for a formal evidentiary
public hearing under 21 CFR part 12.
VII. What is the environmental impact of this proposed rule?
FDA has determined under 21 CFR 25.32(n) that this action is of a
type that does not individually or cumulatively have a significant
effect on the human environment. Therefore, neither an environmental
assessment nor an environmental impact statement is required.
VIII. Federalism
FDA has analyzed this proposed rule in accordance with the
principles set forth in Executive Order 13132. FDA has determined that
the proposed rule, if finalized, would not contain policies that have
substantial direct effects on the States, on the relationship between
the National Government and the States, or on the distribution of power
and responsibilities among the various levels of government.
Accordingly, the Agency concludes that the proposed rule does not
contain policies that have federalism implications as defined in the
Executive order and, consequently, a federalism summary impact
statement is not required.
IX. Analysis of Impacts
FDA has examined the impacts of the proposed rule under Executive
Order 12866, Executive Order 13563, the Regulatory Flexibility Act (5
U.S.C. 601-612), and the Unfunded Mandates Reform Act of 1995 (Pub. L.
104-4). Executive Orders 12866 and 13563 direct Agencies to assess all
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety, and other advantages; distributive impacts; and
equity). The Agency believes that this proposed rule is not a
significant regulatory action as defined by Executive Order 12866.
The Regulatory Flexibility Act requires Agencies to analyze
regulatory options that would minimize any significant impact of a rule
on small entities. Because only one firm is affected by this rule, and
it is considered large by Small Business Administration standards, the
Agency proposes to certify that the final rule will not have a
significant economic impact on a substantial number of small entities.
Section 202(a) of the Unfunded Mandates Reform Act of 1995 requires
that Agencies prepare a written statement, which includes an assessment
of anticipated costs and benefits, before proposing ``any rule that
includes any Federal Mandate that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100,000,000 or more (adjusted annually for
inflation) in any one year.'' The current threshold after adjustment
for inflation is $136 million, using the most current (2010) Implicit
Price Deflator for the Gross Domestic Product. FDA does not expect this
proposed rule to result in any 1-year expenditure that would meet or
exceed this amount.
X. Regulatory Impact Analysis
A. Need for This Regulation
FDA is proposing to amend its infant formula nutrient requirement
regulations. If the proposed rule is finalized, infant formulas will be
required to contain selenium at a level not less than 2.0 [mu]g and not
more than 7.0 [mu]g for each 100 kilocalories of the infant formula in
the form prepared for consumption as directed on the container. This
regulation is needed because selenium is now recognized as an essential
nutrient for humans.
Additionally, if finalized, this proposed rule will require that
infant formula manufacturers add selenium to the list of nutrients on
infant formula labels, and to list the amount of selenium per 100
kilocalories in the formula.
Selenium is a trace mineral that is essential to good health but
required only in small amounts. Selenium is incorporated into proteins
to make selenoproteins, which are important antioxidant enzymes, the
natural by-products of oxygen metabolism that may contribute to the
development of chronic diseases such as cancer and heart disease. In
most countries throughout the world, plant foods are major dietary
sources of selenium. However, selenium is also found in some meats,
seafood, and nuts. In the United States, food distribution patterns
across the country help prevent people in geographic areas with low-
selenium levels in the soil from having low dietary selenium intakes.
Food is not generally fortified with selenium in the United States, but
an exception to this is infant formula.
B. Regulatory Options
In formulating the analysis of this proposed rule, three options
were analyzed: (1) No new regulatory action (baseline); (2) require the
provisions of this proposed rule and make the provisions of the rule
effective 180 days after publication; and (3) require the provisions of
this proposed rule, but make the provisions of the rule effective 12
months after publication.
Option 1: No New Regulatory Action (Baseline)
The first option is no new regulatory action. We include it here
because OMB cost-benefit analysis guidelines recommend discussing
statutory requirements that affect the selection of regulatory
approaches. These guidelines also recommend analyzing the opportunity
cost of legal constraints that prevent the selection of the regulatory
action that best satisfies the philosophy and principles of Executive
Order 12866. There are zero costs and benefits associated with this
option, and it serves as the baseline against which other options will
be measured for assessing costs and benefits.
[[Page 22447]]
Option 2: Finalize the proposed rule and make the provisions
effective 180 days after publication.
XI. Costs
One cost of this proposal, if finalized, will be reformulation
costs resulting from firms adding selenium to infant formulas in order
to comply with this rule. Currently, there are five firms that produce
infant formula in the United States. Of these firms, only one will need
to add slightly more selenium to its infant formulas. Based on
information provided by the infant formula industry, it appears that
all other infant formula manufacturers already added selenium to their
infant formula products at a level within the range identified by the
proposed rule. Therefore, any reformulation cost of this proposal will
come from a single firm adding slightly more selenium to its infant
formula products that currently do not meet the proposed minimum level
of 2.0 [mu]g/100 kcal.
Table 1 of this document outlines low, medium, and high cost
estimates based on a change in the formulation of infant formula. Costs
are estimated using a reformulation model, developed under contract
with Research Triangle Institute (RTI). This model provides estimates
of the costs of reformulation of the range of food, dietary supplement,
and cosmetic products under FDA's jurisdiction, including infant
formulas, and has been adjusted to reflect 2012 dollars. In this model,
the cost of the reformulation depends on the affected ingredient and
the likely response of manufacturers. The cost per infant formula
associated with reformulation is estimated to be a function of product
research, product development, coordinating activities, startup and
verification, and nutrient testing of finished product. To the extent
that any of these activities is not necessary for adding selenium to an
infant formula that already has selenium added, costs will be
overestimated. Table 1 of this document presents total estimated low,
medium, and high costs of reformulation for this proposed rule. The
totals are based on the reformulation of 46 separate infant formulas
manufactured by one firm, the current formulation of which would not
meet the requirements of this rule, if finalized. Therefore, the total
industry costs are each of the low, medium, and high costs multiplied
by 46.
Table 1--Estimation of First-Year Costs of Infant Formula Reformulation, per Infant Formula
----------------------------------------------------------------------------------------------------------------
Variable Low Medium High
----------------------------------------------------------------------------------------------------------------
Product Research................................................ $1,685 $16,853 $33,706
Product Development............................................. 4,598 13,023 28,259
Coordinating Activities......................................... 2,938 8,818 14,690
Startup and Verification........................................ 1,442 7,207 15,890
Nutrient Testing of the Finished Product........................ 15 15 15
-----------------------------------------------
Total Per Formula........................................... 10,678 45,916 92,560
Total Industry Cost of Reformulation (Cost x 46 infant 497,188 2,112,136 4,257,760
formulas)..................................................
----------------------------------------------------------------------------------------------------------------
Another component of the costs of this option is cost related to
the relabeling of reformulated infant formula. The proposed rule
requires infant formula manufacturers to include selenium in the
nutrient content statement on containers of infant formula. All
manufacturers currently disclose selenium in the nutrient list as
specified under Sec. 107.10(b)(5). However, as noted previously in
this document, one manufacturer would be required to add more selenium
to its formulas under this proposal. Therefore, it is estimated that
the same firm that would be required to add more selenium to its
formulas under this proposal will also incur relabeling costs to comply
with this proposed rule.
Table 2 of this document outlines low, medium, and high cost
estimates of relabeling based on a minor change to the infant formula
label and an effective date of 180 days after publication. Costs are
estimated using a relabeling model developed under contract by RTI.
This model estimates the costs of relabeling food, dietary supplements,
and cosmetic products under FDA's jurisdiction and these estimates have
been adjusted to reflect 2012 dollars. In this model, relabeling costs
depend on the type of change (major, minor, or extensive) and the
effective date of the rule. This model estimates that longer periods of
time before a rule becomes effective are associated with lower
relabeling costs because any change is more likely to be able to be
coordinated with a change in a label that may already be scheduled, and
will diminish the need to, for example, purchase and apply stickers to
packages affected by the change. The Agency acknowledges the
uncertainty in this estimation and how it may specifically apply to the
infant formula industry and requests comment regarding the extent to
which the effective date is likely to affect the cost of compliance
with this proposed rule.
Table 2--Estimated First Year Relabeling Costs
------------------------------------------------------------------------
Low Medium High
------------------------------------------------------------------------
$3,565,880.................................. $8,735,802 $23,619,959
------------------------------------------------------------------------
The final component of cost is related to one firm assembling
information for submission to the Agency related to the reformulated
infant formulas, as required under section 412(d)(3) of the FD&C Act.
The addition of more selenium constitutes a change in the formulation
of these formulas that the Agency considers may affect whether the
formulas are adulterated; therefore, we are including the submission of
information about the change in the formulas before the first
processing of such formulas as a cost.
It is estimated that a scientist from one firm will spend 10 hours
assembling the information to be submitted, which will address the 46
reformulated infant formulas. This is estimated as a one-time cost. It
is estimated that this scientist is paid a wage of $52.88; that is,
$35.25 plus 50 percent overhead. Therefore, 10 hours x $52.88 =
$528.80.
[[Page 22448]]
Table 3--Summary of Total Cost of Option 1
----------------------------------------------------------------------------------------------------------------
Low Medium High
----------------------------------------------------------------------------------------------------------------
Reformulation Cost............ $491,188.................... $2,112,136................. $4,257,760.
First Year Relabeling Costs... $3,467,560.................. $8,735,802................. $23,619,959.
First Year Submission Costs... $529........................ $529....................... $529.
---------------------------------------------------------------------------------
Total Cost of Option 1.... $3.95 million............... $10.85 million............. $27.88 million.
----------------------------------------------------------------------------------------------------------------
As seen in table 3 of this document, the total cost of this option
ranges from $3.95 million to $27.88 million, with the majority of cost
coming from relabeling.
XII. Benefits
The potential benefits from this proposed rule, if finalized, are
any cases of selenium deficiency that are avoided as a result of infant
formulas meeting the 2.0 [mu]g/100 kcal requirement. However, selenium
deficiency is extremely rare, occurring primarily in areas of the world
where the levels of selenium in the environment are low, such as China
(Ref. 1). Therefore, it is not possible to quantify benefits accrued as
a result of this rule and benefits will be discussed qualitatively.
The consequences of selenium deficiency may be of greatest concern
in infants and children, who have relatively greater requirements for
selenium than adults due to their rapid growth (Ref. 1). According to
Daniels, et al. (2008), suboptimal selenium status is associated with a
range of negative health outcomes including thyroid and immune
dysfunction, viral infection, cardiovascular disease, inflammatory
conditions, infertility, and an increased risk of some cancers (Ref.
5). Overt selenium deficiency is manifested as Keshan disease, an
endemic fatal cardiomyopathy. Because infant formula may be an infant's
only source of nutrition, the potential for developing a deficiency is
averted if selenium is added to the formula.
XIII. Summary of Costs and Benefits of This Proposed Rule
The total costs of this proposed rule, if finalized, consist of one
time reformulation costs, one time submission costs and one time
relabeling costs. The total cost ranges between about $4 million and
$28 million. Because the costs of this proposed rule are one time only
costs, no annual costs are estimated for this proposal. Furthermore,
because selenium deficiency is so rare, it is not possible to quantify
benefits from any final rule resulting from this proposal.
Option 3: Finalize the proposed rule and make the provisions
effective 12 months after publication.
In this option, firms are required to meet the requirements of the
proposed rule for infant formula, that is, have formulas contain
selenium at 2.0 [mu]g and not more than 7.0 [mu]g for each 100
kilocalories of the infant formula, and have manufacturers add selenium
to the list of nutrients on infant formula labels. However, under
Option 3, industry would have at least 12 months before they were
required to comply with the rule.
XIV. Costs of Option 3
For this option, the primary costs of this proposed rule will be
reformulation costs resulting from the firm that needs to add slightly
more selenium to certain infant formulas in order to comply with any
final rule resulting from this proposal, along with relabeling and
submission costs. These costs are presented in 2012 dollars. In
contrast to Option 2, relabeling costs for this option are less,
because of the estimation of the cost model that, over a longer period
of time, any labeling change is more likely to be able to be
coordinated with a change in a label that may already be scheduled, and
will diminish the need to, for example, purchase and apply stickers to
packages affected by the change. As in Option 2, the Agency
acknowledges the uncertainty in this estimation and how it may
specifically apply to the infant formula industry and requests comment
regarding the extent to which the effective date is likely to affect
the cost of compliance with this proposed rule.
Table 4--Summary of Costs of Option 3
----------------------------------------------------------------------------------------------------------------
Low Medium High
----------------------------------------------------------------------------------------------------------------
Reformulation Cost.............................................. $491,188 $2,112,136 $4,257,760
One Time Submission Cost........................................ 529 529 529
Relabeling Costs................................................ 438,747 765,439 1,271,285
-----------------------------------------------
Total Cost of Option 3...................................... 930,464 2,878,104 5,529,574
----------------------------------------------------------------------------------------------------------------
Therefore, the costs from this rule, as shown in table 4, range from
about $930,464 to about $5.5 million.
XV. Benefits of Option 3
Benefits from this option are identical to Option 2, however, under
this option, benefits are delayed by 6 months. The potential benefits
from this proposed option are any cases of selenium deficiency avoided
as a result of infant formulas meeting the 2.0 ug/100kcal requirement.
As stated earlier, selenium deficiency is extremely rare, occurring
primarily in areas of the world where the levels of selenium in the
environment are low (Ref. 1).
XVI. Preliminary Regulatory Flexibility Analysis
FDA has examined the economic implications of this proposed rule as
required by the Regulatory Flexibility Act (5 U.S.C. 601-612). If a
rule has a significant economic impact on a substantial number of small
entities, the Regulatory Flexibility Act requires Agencies to analyze
regulatory options that would lessen the economic effect of the rule on
small entities. FDA finds that, under the Regulatory Flexibility Act (5
U.S.C. 605(b)), this proposal, if finalized, will not have a
significant impact on a substantial number of small entities, as only
one firm is affected by this rule and it is considered large by Small
Business Administration standards.
[[Page 22449]]
XVII. Paperwork Reduction Act of 1995
This proposed rule contains information collection provisions that
are subject to review by the Office of Management and Budget (OMB)
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). A
description of these provisions is given in this section of the
document with an estimate of the annual third-party disclosure burden.
Included in the burden estimate is the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing each collection of information.
FDA invites comments on the following topics: (1) Whether the
proposed collection of information is necessary for the proper
performance of FDA's functions, including whether the information will
have practical utility; (2) the accuracy of FDA's estimate of the
burden of the proposed collection of information, including the
validity of the methodology and assumptions used; (3) ways to enhance
the quality, utility, and clarity of the information to be collected;
and (4) ways to minimize the burden of the collection of information on
respondents, including through the use of automated collection
techniques, when appropriate, and other forms of information
technology.
Title: Third-Party Disclosure Requirements for Selenium in Infant
Formula
Description of Respondents: The respondents to this information
collection are manufacturers of infant formula marketed in the United
States.
Description: The proposed rule, if finalized, would revise Sec.
107.10(a) to require that selenium be listed in the nutrient list on
the label for all infant formulas. In particular, in the nutrient list,
selenium would be required to be listed between iodine and sodium and
the amount per 100 calories declared; and, because selenium would be a
required ingredient in infant formula, selenium would also be required
to be declared in the formula's ingredient statement by its common or
usual name and positioned according to the descending order of its
predominance in the formula, under Sec. 101.4. The present version of
Sec. 107.10(a) is approved by OMB in accordance with the PRA and has
been assigned OMB control number 0910-0256. This proposed rule, if
finalized, would modify the information collection associated with the
present version of Sec. 107.10(a) by adding 23 hours to the burden
associated with the collection. A manufacturer not in compliance with
the new minimum and maximum levels for selenium in infant formula would
be required to make a one-time change to the nutrient list information
disclosed to consumers on the label of its infant formula, to account
for the required change in the amount of selenium in its products. The
nutrient information disclosed by manufacturers on the infant formula
label is necessary to inform purchasers of the value of the infant
formula. As discussed previously in this document, FDA has the
authority to revise the statement of the amounts of nutrients required
for infant formula labeling in Sec. 107.10(a)(2).
FDA estimates the burden of this collection of information as
follows:
Table 5--Estimated Annual Third-Party Disclosure Burden \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of
21 CFR section Number of disclosures per Total annual Average burden per Total hours Total capital
respondents respondent disclosures disclosure cost
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sec. 107.10 Nutrient labeling for 1 46 46 0.5 (30 minutes)............ 23 $765,439
infant formula.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ There are no operating and maintenance costs associated with this collection of information.
FDA tentatively concludes that the additional burden to disclose
selenium in the ingredient statement resulting from the proposed
amendment of Sec. 107.10 would be negligible because all U.S. infant
formula manufacturers currently add selenium as an ingredient to their
infant formula products, and all manufacturers currently disclose the
selenium in the ingredient statement, as specified by Sec. 101.4.
Additionally, all manufacturers currently disclose selenium in the
nutrient list, as required by Sec. 107.10(b)(5). Only one manufacturer
produces infant formula that would not meet the requirements of this
rule, if finalized, and would thus need to be reformulated. Under
proposed Sec. 107.10(a)(2), this one manufacturer would need to make a
one-time labeling change to modify its nutrient list to account for the
addition of more selenium to its infant formula.
The third-party disclosure burden consists of the setup time
required to design a revised label and incorporate it into the
manufacturing process. Based upon its knowledge of food and dietary
supplement labeling, FDA estimates that the affected manufacturer would
require less than 0.5 hour per product to modify the label's nutrient
list to reflect the addition of more selenium to the product. The
Regulatory Impact Analysis estimates that this manufacturer produces 46
separate infant formulas that would need to be reformulated, and thus
require relabeling. The one-time third-party disclosure burden for the
proposed rule is estimated in table 5 of this document.
The final column of table 5 gives the estimated capital cost
associated with relabeling. This is the cost of designing a revised
label and incorporating it into the manufacturing process. The cost
stated in table 5, $765,439, is based on the estimate in the Regulatory
Impact Analysis under Option 3, which assumes that the proposed rule is
finalized with an effective date of 1 year after publication. These
costs are based on the estimation of the cost model that, over a longer
period of time, any labeling change is more likely to be able to be
coordinated with a change in a label that may already be scheduled, and
will diminish the need to, for example, purchase and apply stickers to
packages affected by the change. Additionally, because of the change in
formulation of its products that would be required if the rule is
finalized as proposed, a manufacturer would need to determine whether
they are required to make a one-time submission to FDA before the first
processing of its formulas, as required by section 412(d)(3) of the
FD&C Act. This reporting requirement is approved by OMB under OMB
control number 0910-0256. The current hour burden approved by OMB for
section 412(d) of the FD&C Act is 10 hours per report. Based on the
Agency's experience with infant formula submissions, FDA estimates that
the affected manufacturer will submit one report that will cover all 46
reformulated infant formulas. In a future request for extension of the
0910-0256 information collection, FDA will include the additional
report in its estimates.
[[Page 22450]]
To ensure that comments on information collection are received, OMB
recommends that written comments be faxed to the Office of Information
and Regulatory Affairs, OMB, Attn: FDA Desk Officer, FAX: 202-395-6974,
or emailed to oira_submission@omb.eop.gov. All comments should be
identified with the title ``Third-Party Disclosure Requirements for
Selenium in Infant Formula.''
In compliance with the Paperwork Reduction Act of 1995 (44 U.S.C.
3407(d)), the Agency has submitted the information collection
provisions of this proposed rule to OMB for review. Interested persons
are requested to send comments regarding information collection by May
16, 2013, to the Office of Information and Regulatory Affairs, OMB.
XVIII. How do you submit comments on this rule?
Interested persons may submit either electronic comments regarding
this document to https://www.regulations.gov or written comments to the
Division of Dockets Management (see ADDRESSES). It is only necessary to
send one set of comments. Identify comments with the docket number
found in brackets in the heading of this document. Received comments
may be seen in the Division of Dockets Management between 9 a.m. and 4
p.m., Monday through Friday, and will be posted to the docket at https://www.regulations.gov.
XIX. References
The following references have been placed on display in the Dockets
Management Branch (see ADDRESSES) and may be seen by interested persons
between 9 a.m. and 4 p.m., Monday through Friday.
1. Food and Nutrition Board. Institute of Medicine. Dietary
Reference Intakes for Vitamin C, Vitamin E, Selenium, and
Carotenoids. Washington, DC: National Academy Press, p. 21-33; 292-
299; 315-316, 2000.
2. Food and Nutrition Board. National Research Council. Recommended
Dietary Allowances. 10th Edition. Washington, DC: National Academy
Press, p. 221, 1989.
3. Raiten, D. J., J. M. Talbot, and J. H. Waters, ``Assessment of
Nutrient Requirements for Infant Formulas,'' Journal of Nutrition,
128: 2059S-2249S, 1998.
4. Koletzko, B., S. Baker, G. Cleghorn, U. F. Neto, et al., ``Global
Standard for the Composition of Infant Formula. Recommendations of
an ESPGHAN Coordinated International Expert Group,'' Journal of
Pediatric Gastroenterology and Nutrition, 41:584-599, 2005.
5. Daniels, L., R.A. Gibson, K. Simmer, P. Van Dael, M. Makrides,
``Selenium Status of Term Infants Fed Selenium-Supplemented Formula
in a Randomized Dose-Response Trial,'' American Journal of Clinical
Nutrition, 88:70-76, 2008.
6. Centers for Disease Control and Prevention (CDC). National Center
for Health Statistics (NCHS). National Health and Nutrition
Examination Survey Data. Hyattsville, MD: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention,
2013.
7. Codex Alimentarius Commission, ``Standards for Infant Formulas
for Special Medical Purposes Intended for Infants, 72-1981,'' 1981.
List of Subjects in 21 CFR Part 107
Exempt infant formulas, Food labeling, General provisions, Infant
formula, Infant formula recalls, Infants and children, Labeling,
Nutrition, Nutrient requirements, Reporting and recordkeeping
requirements, Signs and symbols.
Therefore, under the Federal Food, Drug, and Cosmetic Act and under
authority delegated to the Commissioner of Food and Drugs, 21 CFR part
107 is proposed to be amended as follows:
PART 107--INFANT FORMULA
The authority citation for 21 CFR part 107 continues to read as
follows:
Authority: 21 U.S.C. 321, 343, 350a, 371.
0
1. In Sec. 107.10, revise paragraph (a)(2) to read as follows:
Sec. 107.10 Nutrient Information.
(a) * * *
(2) A statement of the amount of each of the following nutrients
supplied by 100 kilocalories:
------------------------------------------------------------------------
Nutrients Unit of measurement
------------------------------------------------------------------------
Protein............................... Grams.
Fat................................... Do.
Carbohydrate.......................... Do.
Water................................. Do.
Linoleic acid......................... Milligrams.
Vitamins:
Vitamin A........................... International Units.
Vitamin D........................... Do.
Vitamin E........................... Do.
Vitamin K........................... Micrograms.
Thiamine (Vitamin B1)............... Do.
Riboflavin (Vitamin B2)............. Do.
Vitamin B6.......................... Do.
Vitamin B12......................... Do.
Niacin.............................. Do.
Folic acid (Folacin)................ Do.
Pantothenic acid.................... Do.
Biotin.............................. Do.
Vitamin C (Ascorbic acid)........... Milligrams.
Choline............................. Do.
Inositol............................ Do.
Minerals:
Calcium............................. Milligrams.
Phosphorus.......................... Do.
Magnesium........................... Do.
Iron................................ Do.
Zinc................................ Do
Manganese........................... Micrograms.
Copper.............................. Do.
Iodine.............................. Do.
Selenium............................ Do.
Sodium.............................. Milligrams.
Potassium........................... Do.
Chloride............................ Do.
------------------------------------------------------------------------
* * * * *
0
2. In Sec. 107.100, revise paragraph (a) to read as follows:
Sec. 107.100 Nutrient specifications.
(a) An infant formula shall contain the following nutrients at a
level not less than the minimum specified and not more than the maximum
level specified for each 100 kilocalories of the infant formula in the
form prepared for consumption as directed on the container:
----------------------------------------------------------------------------------------------------------------
Nutrients Unit of measurement Minimum level Maximum level
----------------------------------------------------------------------------------------------------------------
Protein...................................... Grams........................... 1.8 4.5
Fat.......................................... do.............................. 3.3 6.0
Percent calories................ 30 54
Linoleic acid................................ Milligrams...................... 300 ...............
Percent calories................ 2.7 ...............
----------------------------------------------------------------------------------------------------------------
Vitamins
----------------------------------------------------------------------------------------------------------------
Vitamin A.................................... International Units............. 250 750
Vitamin D.................................... do.............................. 40 100
Vitamin E.................................... do.............................. 0.7 ...............
[[Page 22451]]
Vitamin K.................................... Micrograms...................... 4 ...............
Thiamine (Vitamin B1)........................ do.............................. 40 ...............
Riboflavin (Vitamin B2)...................... do.............................. 60 ...............
Vitamin B6................................... do.............................. 35 ...............
Vitamin B12.................................. do.............................. 0.15 ...............
Niacin \1\................................... do.............................. 250 ...............
Folic Acid (folacin)......................... do.............................. 4 ...............
Pantothenic acid............................. do.............................. 300 ...............
Biotin \2\................................... do.............................. 1.5 ...............
Vitamin C (ascorbic acid).................... Milligrams...................... 8 ...............
Choline \2\.................................. do.............................. 7 ...............
Inositol \2\................................. do.............................. 4 ...............
----------------------------------------------------------------------------------------------------------------
Minerals
----------------------------------------------------------------------------------------------------------------
Calcium...................................... do.............................. 60 ...............
Phosphorus................................... do.............................. 30 ...............
Magnesium.................................... do.............................. 6 ...............
Iron......................................... do.............................. 0.15 3.0
Zinc......................................... do.............................. 0.5 ...............
Manganese.................................... Micrograms...................... 5 ...............
Copper....................................... do.............................. 60 ...............
Iodine....................................... do.............................. 5 75
Selenium..................................... do.............................. 2 7
Sodium....................................... Milligrams...................... 20 60
Potassium.................................... do.............................. 80 200
Chloride..................................... do.............................. 55 150
----------------------------------------------------------------------------------------------------------------
\1\ The generic term ``niacin'' includes niacin (nicotinic acid) and niacinamide (nicotinamide).
\2\ Required only for non-milk-based infant formulas.
* * * * *
Dated: April 10, 2013.
Leslie Kux,
Assistant Commissioner for Policy.
[FR Doc. 2013-08855 Filed 4-15-13; 8:45 am]
BILLING CODE 4160-01-P