Glycation products in infant formulas: chemical, analytical and physiological aspects

Discrimination of overheated pasteurized milk using mass spectrometry-based proteomics

Milk is one of the most widely consumed foods globally. To protect consumer interests, it is essential to establish an analytical method to detect the degree of heating in milk. A novel approach using nano liquid chromatography-orbitrap fusion mass spectrometer was developed for screening and identifing thermally sensitive peptides markers in the milk heating process (below 100 °C). This method integrates untargeted proteomics and chemometric tools to analyze protein quantitation data from differently heat-treated milk. Thirteen potential markers were screened out and identified, and further confirmed using by standard substances. Then, the accurate concentrations of 13 potential markers determined by isotope-dilution ultra-performance liquid chromatography-tandem triple quadrupole mass spectrometry were further mining the highly specific and thermally sensitive peptides markers. And Four peptides-INLFDTPLETQYVR, FELLGCELNGCTEPLGLK, QFQFIQVAGR, and GEADALNLDGGYIYTAGK-were selected as marker peptides to differentiate normal pasteurized milk from overheated pasteurized milk. The concentrations of INLFDTPLETQYVR ranges from 150 ± 11 µg/L to 350 ± 23 µg/L, while the concentrations of FELLGCELNGCTEPLGLK ranges from 40 ± 5 µg/L to 92 ± 3 µg/L, can distinguish normal pasteurized milk from overheated pasteurized milk. QFQFIQVAGR indicates overheated pasteurized milk at 230 ± 21 µg/L, and GEADALNLDGGYIYTAGK signifies 750 ± 43 µg/L. This study provides new insights for distinguishing overheated pasteurized milk.

Evaluation of potentially harmful Maillard reaction products in different types of commercial formulae

Pasteurisation and spray drying are critical steps to ensure the safety and shelf-life of formulae, but these treatments also induce formation of some potentially harmful Maillard reaction products. In this study, the occurrence of potentially harmful Maillard reaction products and proximate compositions in different commercial formulae were analysed. Our results showed that infant formulae had significantly higher concentrations of furosine, Nε-(carboxymethyl)lysine (CML) and Nε-(carboxyethyl)lysine (CEL) than follow-on/toddler formula. Specialty formulae had higher concentrations of glyoxal and CML than other types of formulae. Correlation analysis indicated that concentrations of 5-hydroxymethylfurfural, 3-deoxyglucosone, CML and CEL were closely related to fat contents. These results provided insight into concentrations of potentially harmful Maillard reaction products in different types of formulae and provide a theoretical basis for further optimisation of processing.

Effect of brewer's spent grain melanoidins on maillard reaction products during storage of whey protein model systems

Maillard reaction readily takes place in dairy products because of the association between thermal treatments, extended storage and the matrix composition. Along with the impairment of protein digestion, the formation of glycation and α-dicarbonyl compounds is a concern for quality attributes of whey proteins when used as ingredients. In this paper, we outline the capacity of brewer's spent grain melanoidins in reducing the accumulation of α-dicarbonyl compounds, thus controlling the formation of dietary advanced glycation end-products in accelerated shelf life at 35 °C. Results revealed that brewer's spent grain melanoidins targeted methylglyoxal and glyoxal reactivity leading to the reduction of N-ε-carboxymethyllysine and methylglyoxal-hydroimidazolone up to 27 and 60%, respectively. We here describe that the presence of melanoidins is instrumental in limiting the undesired effects of α-dicarbonyl compounds on whey proteins.

A Gently Processed Skim Milk-Derived Whey Protein Concentrate for Infant Formula: Effects on Gut Development and Immunity in Preterm Pigs

SCOPE

Processing of whey protein concentrate (WPC) for infant formulas may induce protein modifications with severe consequences for preterm newborn development. The study investigates how conventional WPC and a gently processed skim milk-derived WPC (SPC) affect gut and immune development after birth.

METHODS AND RESULTS

Newborn, preterm pigs used as a model of preterm infants were fed formula containing WPC, SPC, extra heat-treated SPC (HT-SPC), or stored HT-SPC (HTS-SPC) for 5 days. SPC contained no protein aggregates and more native lactoferrin, and despite higher Maillard reaction product (MRP) formation, the clinical response and most gut and immune parameters are similar to WPC pigs. SPC feeding negatively impacts intestinal MRP accumulation, mucosa, and bacterial diversity. In contrast, circulating T-cells are decreased and oxidative stress- and inflammation-related genes are upregulated in WPC pigs. Protein aggregation and MRP formation increase in HTS-SPC, leading to reduced antibacterial activity, lactase/maltase ratio, circulating neutrophils, and cytotoxic T-cells besides increased gut MRP accumulation and expression of TNFAIP3.

CONCLUSION

The gently processed SPC has more native protein, but higher MRP levels than WPC, resulting in similar tolerability but subclinical adverse gut effects in preterm pigs. Additional heat treatment and storage further induce MRP formation, gut inflammation, and intestinal mucosal damage.

Ultra-High Temperature Treatment of Liquid Infant Formula, Systemic Immunity, and Kidney Development in Preterm Neonates

SCOPE

Ready-to-feed liquid infant formulas (IFs) are increasingly being used for newborn preterm infants when human milk is unavailable. However, sterilization of liquid IFs by ultra-high temperature (UHT) introduces Maillard reaction products (MRPs) that may negatively affect systemic immune and kidney development.

METHODS AND RESULTS

UHT-treated IF without and with prolonged storage (SUHT) are tested against pasteurized IF (PAST) in newborn preterm pigs as a model for preterm infants. After 5 days, blood leukocytes, markers of systemic immunity and inflammation, kidney structure and function are evaluated. No consistent differences between UHT and PAST pigs are observed. However, SUHT increases plasma TNFα and IL-6 and reduces neutrophils and in vitro response to LPS. In SUHT pigs, the immature kidneys show minor upregulation of gene expressions related to inflammation (RAGE, MPO, MMP9) and oxidative stress (CAT, GLO1), together with glomerular mesangial expansion and cell injury. The increased inflammatory status in SUHT pigs appears unrelated to systemic levels of MRPs.

CONCLUSION

SUHT feeding may impair systemic immunity and affect kidney development in preterm newborns. The systemic effects may be induced by local gut inflammatory effects of MRPs. Optimal processing and length of storage are critical for UHT-treated liquid IFs for preterm infants.

1-Amino-1-deoxy-d-fructose ("fructosamine") and its derivatives: An update

1-Amino-1-deoxy-d-fructose (fructosamine, FN) derivatives are omnipresent in all living organisms, as a result of non-enzymatic condensation and Amadori rearrangement reactions between free glucose and biogenic amines such as amino acids, polypeptides, or aminophospholipids. Over decades, steady interest in fructosamine was largely sustained by its role as a key intermediate structure in the Maillard reaction that is responsible for the organoleptic and nutritional value of thermally processed foods, and for pathophysiological effects of hyperglycemia in diabetes. New trends in fructosamine research include the discovery and engineering of FN-processing enzymes, development of advanced tools for hyperglycemia monitoring, and evaluation of the therapeutic potential of both fructosamines and FN-recognizing proteins. This article covers developments in the field of fructosamine and its derivatives since 2010 and attempts to ascertain challenges in future research.

Occurrence of dietary advanced glycation end-products in commercial cow, goat and soy protein based infant formulas

Thermal treatment is a key step during infant formula (IF) processing which causes protein glycation and formation of dietary advanced glycation end-products (dAGEs). This study aimed to evaluate the glycation degree in IF in relation to the ingredients of the formula. dAGEs concentrations have been determined by UPLC-MS/MS in a range of commercial cow-based, goat-based, and soy-based IF. Results indicated that the protein source, protein composition, and amount and type of carbohydrates determines the level of protein glycation in IFs. The investigated soy-based formula had significant higher concentrations of arginine and arginine-derived dAGEs than cow-based and goat-based formulas. IF containing hydrolyzed proteins had higher dAGEs concentrations than those containing intact proteins. Lactose-containing formula was more prone to glycation than those containing sucrose and maltodextrin. Data showed glycation degree in IF cannot be estimated by a single compound, but the complete picture of the dAGEs should be considered.

Inhibitory effect of LSOPC on AGEs formation and sensory quality in cookies

At the conclusion of the Maillard reaction (MR), free amino groups of proteins, amino acids, or lipids with the carboxyl groups of reducing sugars to form stable molecules known as advanced glycation end products (AGEs), which hasten aging and may potentially be the root cause of a number of chronic degenerative diseases. According to researches, lotus seedpod oligomeric procyanidins (LSOPC), a premium natural antioxidant produced from lotus waste, can be included in cookies to improve flavor and lower the risk of illnesses linked to AGEs. In this work, we used cookies without LSOPC as a control to examine the effects of adding various concentrations of LSOPC (0, 0.05, 0.1, 0.2, and 0.4%) on the AGEs formation and the sensory quality in cookies. The amounts of AGEs and N-ε-carboxymethyl lysine (CML) decreased with the increase of LSOPC concentration, indicating that the concentration of LSOPC was positively correlated with the ability to inhibit AGEs formation. It was also demonstrated that the amount of antioxidant capacity of the cookies increased significantly with the increase of LSOPC concentration. On the other hand, the chromaticity, texture, electronic nose, and other aspects of the cookies' sensory attributes were also evaluated. The color of the cookies deepened and the flavor varied as LSOPC added content increased. The sensory quality of the cookies was examined, and the findings indicated that LSOPC would somewhat improve that quality. These findings implied that AGEs formation could be decreased in cookies while also enhancing their sensory quality by adding LSOPC.

Protein and carbohydrate content of infant formula purchased in the United States

BACKGROUND

The protein and carbohydrate composition of formula fed infants' diets in the United States (US) has not been described. The aims of this study were to characterize these dietary exposures in infant formula purchased in the US and to estimate the proportion of formula purchased which is hypoallergenic or lactose-reduced formula.

METHODS

Powdered infant formula purchase data from all major physical stores in the US prior to the COVID-19 pandemic, between 2017 and 2019, were obtained from Information Resources, Inc. Protein and carbohydrate composition and scoop sizes for each formula were obtained from manufacturers. Ready to feed liquid products, products for premature infants and products for over 1 year old were not included.

RESULTS

Total volumes of term formula purchased were 216 million kg of formula powder (equivalent to 1.65 billion litres) over 3 years. Intact protein formula was 67.9% of formula purchased, 26.6% was partially hydrolysed and 5.5% was hypoallergenic (5.2% extensively hydrolysed protein; 0.3% amino acid based). Soy protein formula represented 5.1% of formula purchased. Carbohydrate content overall was 52.7% lactose, 42.3% glucose polymers and 5.0% sucrose. 23.7% of formula purchased included sucrose as a carbohydrate. Of all formula purchased, 59.0% was lactose reduced, containing a non-lactose carbohydrate. Of 'standard' formula, defined as intact protein, non-thickened, cow's milk formula, 32.3% was lactose reduced. The proportion of hypoallergenic formula purchased significantly exceeded the prevalence of cow's milk protein allergy and increased over the 3-year study period from 4.9% to 7.6% of all formula sold.

CONCLUSIONS

US infants are exposed to unnecessarily high levels of non-lactose carbohydrates and hypoallergenic formula, and this may represent a significant nutritional health risk.

Ultra-High Temperature Treatment and Storage of Infant Formula Induces Dietary Protein Modifications, Gut Dysfunction, and Inflammation in Preterm Pigs

SCOPE

Ready-to-feed liquid infant formula is increasingly used for preterm infants when human milk is unavailable. These formulas are sterilized by ultra-high temperature treatment, but heating and storage may reduce bioactivity and increase formation of Maillard reaction products with potential negative consequences for immature newborns.

METHODS AND RESULTS

Using preterm pigs as a model for sensitive newborn infants, the study tests the intestinal responses of feeding experimental liquid formula within 5 days. A pasteurized formula (PAST) with the same nutrient composition but less protein modifications serves as control to ultra-high temperature-treated formula without (UHT) and with prolonged storage (SUHT). Relative to PAST, UHT contains lower levels of lactoferrin and IgG. Additional storage (40 °C, 60 days, SUHT) reduces antimicrobial capacity and increases non-reducible protein aggregates and Maillard reaction products (up to 13-fold). Pigs fed SUHT have more diarrhea and show signs of intestinal inflammation (necrotizing enterocolitis) compared with pigs fed PAST and UHT. These clinical effects are accompanied by accumulation of Maillard reaction products, protein cross-links, and inflammatory responses in the gut.

CONCLUSION

The results demonstrate that feeding UHT infant formulas, particularly after prolonged storage, adversely affects gut maturation and function in preterm pigs used as a model of preterm infants.

Maillard reaction products and amino acid cross-links in liquid infant formula: Effects of UHT treatment and storage

The formation of Maillard reaction products, including Amadori compounds (determined as furosine), advanced glycation end products (AGEs), α-dicarbonyl and furfural compounds, as well as amino acid cross-links (lysinoalanine and lanthionine) was investigated in direct (DI) and indirect (IN) UHT-treated experimental liquid infant formula (IF) during storage at 40 °C. IN-IF had higher concentrations of all investigated compounds compared to DI-IF and low pasteurized IF. IN UHT treatment induced significantly higher concentrations of α-dicarbonyl compounds (glyoxal, methylglyoxal, 3-deoxyglucosone and 3-deoxygalactosone) compared to DI, which facilitated increased formation of AGEs (N-Ɛ-(carboxymethyl)lysine, methylglyoxal- and glyoxal-derived hydroimidazolones) in unstored IFs. During storage for 6 months, concentrations of furosine and AGEs increased while α-dicarbonyl compounds decreased. Principal component analysis indicated that differences between IN-IF and DI-IF disappeared after 2 months of storage. IN-IF had higher concentrations of lysinoalanine and lanthionine and lower concentrations of available lysine and arginine than DI-IF indicating higher loss of protein quality in IN-IF.

Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Cow’s milk-based infant formulas are the most common substitute to mother’s milk in infancy when breastfeeding is impossible or insufficient, as cow’s milk is a globally available source of mammalian proteins with high nutritional value. However, cow’s milk allergy (CMA) is the most prevalent type of food allergy among infants, affecting up to 3.8% of small children. Hypoallergenic infant formulas based on hydrolysed cow’s milk proteins are commercially available for the management of CMA. Yet, there is a growing demand for more options for infant feeding, both in general but especially for the prevention and management of CMA. Milk from other mammalian sources than the cow, such as goat, sheep, camel, donkey, and horse, has received some attention in the last decade due to the different protein composition profile and protein amino acid sequences, resulting in a potentially low cross-reactivity with cow’s milk proteins. Recently, proteins from plant sources, such as potato, lentil, chickpeas, quinoa, in addition to soy and rice, have gained increased interest due to their climate friendly and vegan status as well as potential lower allergenicity. In this review, we provide an overview of current and potential future infant formulas and their relevance in CMA prevention and management.

Receptor Mediated Effects of Advanced Glycation End Products (AGEs) on Innate and Adaptative Immunity: Relevance for Food Allergy

As of late, evidence has been emerging that the Maillard reaction (MR, also referred to as glycation) affects the structure and function of food proteins. MR induces the conformational and chemical modification of food proteins, not only on the level of IgG/IgE recognition, but also by increasing the interaction and recognition of these modified proteins by antigen-presenting cells (APCs). This affects their biological properties, including digestibility, bioavailability, immunogenicity, and ultimately their allergenicity. APCs possess various receptors that recognize glycation structures, which include receptor for advanced glycation end products (RAGE), scavenger receptors (SRs), galectin-3 and CD36. Through these receptors, glycation structures may influence the recognition, uptake and antigen-processing of food allergens by dendritic cells (DCs) and monocytes. This may lead to enhanced cytokine production and maturation of DCs, and may also induce adaptive immune responses to the antigens/allergens as a result of antigen uptake, processing and presentation to T cells. Here, we aim to review the current literature on the immunogenicity of AGEs originating from food (exogenous or dietary AGEs) in relation to AGEs that are formed within the body (endogenous AGEs), their interactions with receptors present on immune cells, and their effects on the activation of the innate as well as the adaptive immune system. Finally, we review the clinical relevance of AGEs in food allergies.

Consumption of differently processed milk products and the risk of asthma in children

BACKGROUND

Consumption of unprocessed cow's milk has been associated with a lower risk of childhood asthma and/or atopy. Not much is known about differently processed milk products. We aimed to study the association between the consumption of differently processed milk products and asthma risk in a Finnish birth cohort.

METHODS

We included 3053 children from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Asthma and its subtypes were assessed at the age of 5 years, and food consumption by food records, at the age of 3 and 6 months and 1, 2, 3, 4, and 5 years. We used conventional and processing (heat treatment and homogenization)-based classifications for milk products. The data were analyzed using a joint model for longitudinal and time-to-event data.

RESULTS

At the age of 5 years, 184 (6.0%) children had asthma, of whom 101 (54.9%) were atopic, 75 (40.8%) were nonatopic, and eight (4.3%) could not be categorized. Consumption of infant formulas [adjusted hazard ratio (95% confidence intervals) 1.15 (1.07, 1.23), p < .001] and strongly heat-treated milk products [1.06 (1.01, 1.10), p = .01] was associated with the risk of all asthma. Consumption of all cow's milk products [1.09 (1.03, 1.15), p = .003], nonfermented milk products [1.08 (1.02, 1.14), p = .008], infant formulas [1.23 (1.13, 1.34), p < .001], and strongly heat-treated milk products [1.08 (1.02, 1.15), p = .006] was associated with nonatopic asthma risk. All these associations remained statistically significant after multiple testing correction.

CONCLUSIONS

High consumption of infant formula and other strongly heat-treated milk products may be associated with the development of asthma.

A multifunctional study of naturally occurring pyrazines in biological systems; formation mechanisms, metabolism, food applications and functional properties

Natural pyrazines, mainly methyl- or ethyl-substituted forms, are commonly applied as flavor ingredients in raw and roasted food. Meanwhile alkylpyrazines are used as food preservatives due to their effective antimicrobial action. These natural pyrazines are widely distributed in several biological systems such as plants, animals, and insects; each with respective physiological role. Besides, pyrazines are formed in food via thermal treatment and fermentation. This review presents the most comprehensive overview of pyrazines with correlation to their chemical structures and different applications with emphasis on their food applications. The major part deals with pyrazines generated in thermally treated food, reaction mechanisms highlighting factors and optimum conditions affecting their production. Additionally, the several metabolic reactions mediating for pyrazines metabolism in humans and excretion via the kidney are discussed and on context to their effects. Lastly, a review of the different techniques applied for pyrazines isolation, detection and quantitation is presented. The study provides future considerations and direction of research on this important dietary component and their applications. Pyrazines multifunctional chemistry is of value to the food sector, by presenting the best practices for their production whilst the detrimental effects are minimized.

High hydrostatic pressure processing of human milk preserves milk oligosaccharides and avoids formation of Maillard reaction products

BACKGROUND & AIMS

High hydrostatic pressure (HHP) processing is a non-thermal method proposed as an alternative to Holder pasteurization (HoP) for the treatment of human milk. HHP preserves numerous milk bioactive components that are degraded by HoP, but no data are available for milk oligosaccharides (HMOs) or the formation of Maillard reaction products, which may be deleterious for preterm newborns.

METHODS

We evaluated the impact of HHP processing of human milk on 22 HMOs measured by liquid chromatography with fluorescence detection and on furosine, lactuloselysine, carboxymethyllysine (CML) and carboxyethyllysine (CEL) measured by liquid chromatography with tandem mass spectrometric detection (LC-MS/MS), four established indicators of the Maillard reaction. Human raw milk was sterilized by HoP (62.5 °C for 30 min) or processed by HHP (350 MPa at 38 °C).

RESULTS

Neither HHP nor HoP processing affected the concentration of HMOs, but HoP significantly increased furosine, lactuloselysine, CML and CEL levels in milk.

CONCLUSIONS

Our findings demonstrate that HPP treatment preserves HMOs and avoids formation of Maillard reaction products. Our study confirms and extends previous findings that HHP treatment of human milk provides safe milk, with fewer detrimental effects on the biochemically active milk components than HoP.

Dietary advanced glycation end-products, 2-monochloropropane-1,3-diol esters and 3-monochloropropane-1,2-diol esters and glycidyl esters in infant formulas: Occurrence, formulation and processing effects, mitigation strategies

Infant formula contains thermal processing contaminants, such as dietary advanced glycation end-products (dAGEs), glycidyl esters (GEs), 2-monochloropropane-1,3-diol esters and 3-monochloropropane-1,2-diol esters (MCPDEs). This systematic review aimed to gain insights into the occurrence of these contaminants in different types of infant formula, to understand potential effects of the formulation and processing of infant formulas on these contaminants, as well as into possible mitigation strategies. The occurrence of dAGEs in infant formula depends on the recipes and processing conditions. Hydrolyzed protein formulations promote dAGEs formation in infant formula since peptides are more prone to glycation than intact proteins, which is reflected in high dAGEs concentration in hypoallergenic infant formula. Different carbohydrates in recipes result into different glycation extents of infant formula: maltodextrin containing formulas contained less dAGEs than those with lactose. Concerning mitigation strategies, applying ultra-high-temperature (UHT) treatment during milk processing leads to less dAGEs formation than using in-bottle sterilization. Although data are limited, evidence showed that encapsulation of raw ingredients or the use of antioxidants or enzymes in recipes is promising. The occurrence of MCPDEs and GEs in infant formula fully depends on the vegetable oils used in the recipe. High levels of these contaminants can be found when relatively high amounts of palm oils or fats are used. The mitigation of MCPDEs and GEs should therefore be performed on fats and oils before their application to infant formula recipes. Data and knowledge gaps identified in this review can be useful to guide future studies.

A Literature Review on Maillard Reaction Based on Milk Proteins and Carbohydrates in Food and Pharmaceutical Products: Advantages, Disadvantages, and Avoidance Strategies

Milk has two main components that have high nutritional value—milk protein (casein and whey protein), and lactose. These components are extensively used in various areas, especially in food, i.e., as sweeteners, stabilizers, functional food ingredients, nutritional fortifiers, etc. Non-enzymatic browning refers to a series of chemical reactions between sugars and proteins that make food more appetizing. Non-enzymatic browning reactions include degradation of ascorbic acid, lipid peroxidation, caramel reaction, and the Maillard reaction (MR). The MR, as one of the four non-enzymatic browning reactions, has been well studied and utilized in food fields. Milk protein and lactose, as two main components of milk, have high chemical activities; they are used as reactants to participate in the MR, generating Maillard reaction products (MRPs). The MR involves a condensation reaction between carbonyl groups of various sugars and amino groups of amino acids/proteins. These MRPs have different applications in various areas, including food flavor, food oxidation resistance, drug carriers, etc. This work presents the positive and negative effects of the MR, based on the two main components of milk, used in food and medicine, as well as avoidance approaches to prevent the occurrence of negative effects.

Inhibition Mechanism of L-Cysteine on Maillard Reaction by Trapping 5-Hydroxymethylfurfural

The Maillard reaction (MR) can affect the color, flavor, organoleptic properties, and nutritional value of food. Sometimes, MR is undesirable due to lowering the nutrient utilization, producing harmful neo-formed compounds, etc. In this case, it is necessary to control MR. Some chemical substances, such as phenolic acid, vitamins, aminoguanidine, and thiols extracted from garlic or onion, can effectively prevent MR. In this study, L-cysteine (L-cys) was found to inhibit MR after screening 10 sulfhydryl compounds by comparing their ability to mitigate browning. The inhibition mechanism was speculated to be related to the removal of 5-hydroxymethylfurfural (HMF), a key mid-product of MR. The reaction product of HMF and L-cys was identified and named as 1-dicysteinethioacetal-5-hydroxymethylfurfural (DCH) according to the mass spectrum and nuclear magnetic resonance spectrum of the main product. Furthermore, DCH was detected in the glutamic-fructose mixture after L-cys was added. In addition, the production of DCH also increased with the addition of L-cys. It also was worth noting that DCH showed no cell toxicity to RAW 264.7 cells. Moreover, the in vitro assays indicated that DCH had anti-inflammatory and antioxidant activities. In conclusion, L-cys inhibits MR by converting HMF into another adduct DCH with higher safety and health benefits. L-cys has the potential to be applied as an inhibitor to prevent MR during food processing and storage.

Longitudinal Profiles of Dietary and Microbial Metabolites in Formula- and Breastfed Infants

The early-life metabolome of the intestinal tract is dynamically influenced by colonization of gut microbiota which in turn is affected by nutrition, i.e. breast milk or formula. A detailed examination of fecal metabolites was performed to investigate the effect of probiotics in formula compared to control formula and breast milk within the first months of life in healthy neonates. A broad metabolomics approach was conceptualized to describe fecal polar and semi-polar metabolites affected by feeding type within the first year of life. Fecal metabolomes were clearly distinct between formula- and breastfed infants, mainly originating from diet and microbial metabolism. Unsaturated fatty acids and human milk oligosaccharides were increased in breastfed, whereas Maillard products were found in feces of formula-fed children. Altered microbial metabolism was represented by bile acids and aromatic amino acid metabolites. Elevated levels of sulfated bile acids were detected in stool samples of breastfed infants, whereas secondary bile acids were increased in formula-fed infants. Microbial co-metabolism was supported by significant correlation between chenodeoxycholic or lithocholic acid and members of Clostridia. Fecal metabolites showed strong inter- and intra-individual behavior with features uniquely present in certain infants and at specific time points. Nevertheless, metabolite profiles converged at the end of the first year, coinciding with solid food introduction.

Early AGEing and metabolic diseases: is perinatal exposure to glycotoxins programming for adult-life metabolic syndrome?

Perinatal early nutritional disorders are critical for the developmental origins of health and disease. Glycotoxins, or advanced glycation end-products, and their precursors such as the methylglyoxal, which are formed endogenously and commonly found in processed foods and infant formulas, may be associated with acute and long-term metabolic disorders. Besides general aspects of glycotoxins, such as their endogenous production, exogenous sources, and their role in the development of metabolic syndrome, we discuss in this review the sources of perinatal exposure to glycotoxins and their involvement in metabolic programming mechanisms. The role of perinatal glycotoxin exposure in the onset of insulin resistance, central nervous system development, cardiovascular diseases, and early aging also are discussed, as are possible interventions that may prevent or reduce such effects.

New Advanced Glycation End Products Observed in Rat Urine by Untargeted Metabolomics after Feeding with Heat-Treated Skimmed Milk Powder

SCOPE

Milk powder is commonly consumed throughout the world. However, advanced glycation end products (AGEs) will form in milk powder during thermal processing and long-term storage. This study aimed to identify such compounds with potential as new urinary biomarkers of intake of heat-treated skimmed milk powder (HSMP).

METHODS AND RESULTS

A parallel study is performed with different dosages of HSMP as well as hydrolyzed HSMP and untreated skimmed milk powder (SMP) in 36 rats. The 24-h urine samples on day 7 or 8 are collected and profiled by untargeted UPLC-Qtof-MS metabolomics. Statistical analysis revealed 25 metabolites differentiating SMP and HSMP; nineteen of these structures are proposed as lysine- and arginine-derived AGEs, and heterocyclic compounds.

CONCLUSION

These metabolites may potentially serve as biomarkers of food intake pending further validation to assess intakes of heat-processed dairy foods and thus help to elucidate the effects of HSMP consumption or dietary AGEs on human health.

Profiles of initial, intermediate, and advanced stages of harmful Maillard reaction products in whole-milk powders pre-treated with different heat loads during 18 months of storage

This study evaluated the chemical changes in five types of whole-milk powders (WMP) with different heating loads during storage. The WMP was preheated using low-heat [low-temperature long-time (LTLT), high-temperature short-time pasteurization (HTST)] and high-heat process [ultra-pasteurization (ESL), ultra-high-temperature (UHT) treatments, and in-bottle sterilization (BS)]. Furosine increased by 2.5-3.0 times in high-heat WMP and 5.7-8.4 times in low-heat WMP during storage. 5-(hydroxymethyl)furfural (HMF) content in high-heat WMP was on average 1.4- to 2.4-fold higher than in low-heat WMP during storage. The increases in the amount of Nε-(carboxymethyl)lysine (CML) and Nε-(carboxyethyl)lysine (CEL) in high-heat WMP were more than that in low-heat WMP (CML, 3.4-4.9 vs 3.1-3.4 times; CEL, 3.4-4.2 vs 2.7-3.0 times). Pyrraline in high-heat WMP increased by 1.8- to 2.1-fold. 2-Furaldehyde, CML, and CEL increased slowly with 12 months of storage and then accelerated. Storage time significantly contributed to more furosine, HMF, CML, and CEL contents in high-heat WMP.

Impact of UHT treatment and storage on liquid infant formula: Complex structural changes uncovered by centrifugal field-flow fractionation with multi-angle light scattering

Protein modifications in liquid infant formula (IF) have been widely studied, but distinguishing between heat- and storage-induced structural changes remains challenging. A generic liquid IF was subjected to direct or indirect UHT treatment and stored at 40 °C up to 180 days. Colour and pH were monitored and structural changes were characterised by dynamic light scattering, SDS-PAGE and centrifugal field-flow fractionation (FFF) coupled with multi-angle light scattering (MALS) and UV detectors to evaluate whether heat-induced differences would level out during storage. Both direct- and indirect UHT treatment led to structural changes, where the higher heat load of the indirect UHT treatment caused more pronounced changes. Indications were that storage-induced changes in pH, browning and non-reducible cross-links were not dependent on UHT treatment. However, FFF-MALS-UV analysis allowed characterisation of complex aggregates, where structural changes continued to be most pronounced in indirect UHT treated samples, and different storage-induced aggregation behaviour was observed.

Fortification With Bovine Colostrum Enhances Antibacterial Activity of Human Milk

Objectives

Human milk (HM) is the optimal diet for neonates, but it does not provide enough nutrients for preterm infants. HM fortifiers based on highly processed mature bovine milk (BMFs) are routinely used for preterm infants despite risks of causing gut dysfunction and systemic infection. Gently‐processed bovine colostrum as a fortifier (BCF) may better protect against infection and inflammation. We hypothesized that BCF‐fortified HM has enhanced antimicrobial activity against pathogens that commonly cause neonatal sepsis, relative to BMF‐fortified HM.

Methods

Holder‐pasteurized HM samples (10 mothers) were aliquoted into 3 fractions: unfortified HM and HM fortified with either BMF or BCF. The samples were analyzed for pH, lactoferrin concentrations, and antimicrobial activities against Staphylococcus epidermidis, Escherichia coli, and Enterococcus faecalis.

Results

HM+BCF had a lower pH and higher lactoferrin levels than HM+BMF, with HM being intermediate. Relative to infant formula, HM decreased the growth of S epidermidis, E coli, and E faecalis, with no difference between preterm and term HM. Addition of BMF abolished the antimicrobial effect of HM against S epidermidis and E faecalis but not E coli. By contrast, addition of BCF into HM enhanced antimicrobial activity against S epidermidis and E coli, relative to unfortified HM. HM+BCF was superior to HM+BMF in inhibiting growth of all tested bacteria.

Conclusion

BMF fortification decreased whereas BCF fortification enhanced in vitro antimicrobial activity of HM. This effect may partly be derived from the high levels of antimicrobial factors found in BCF, including lactoferrin. BCF may be a better fortifier than BMF for preterm infants.

Cocoa melanoidins reduce the formation of dietary advanced glycation end-products in dairy mimicking system

The control of Maillard reaction in foods is important to preserve protein nutritional quality. In this study, we investigated the effects of melanoidins obtained from different roasted cocoa beans toward the formation of dietary advanced glycation end-products (d-AGEs) in aqueous solution of whey protein (WP) and glucose, glyoxal and methylglyoxal at 35 °C and pH 7.0. Cocoa melanoidins (4 mg/mL) were more effective to inhibit glyoxal-derived d-AGEs than methylglyoxal-derived d-AGEs, with 74.4% and 48% reduction of N-ε-carboxymethyllysine and methylglyoxal-hydroimidazolone formation in WP/glyoxal and WP/methylglyoxal system, respectively. Furthermore, protein-bound N-ε-fructosyllysine, measured through furosine, decreased down to 57.2% in presence of cocoa melanoidins in WP/glucose model system suggesting an effective control of the Maillard reaction in an early stage. These findings highlighted that cocoa melanoidins are functional ingredients able to mitigate protein glycation in dairy products during storage.

Mildly Pasteurized Whey Protein Promotes Gut Tolerance in Immature Piglets Compared with Extensively Heated Whey Protein

Human milk is the optimal diet for infant development, but infant milk formula (IMF) must be available as an alternative. To develop high-quality IMF, bovine milk processing is required to ensure microbial safety and to obtain a protein composition that mimics human milk. However, processing can impact the quality of milk proteins, which can influence gastro-intestinal (GI) tolerance by changing digestion, transit time and/or absorption. The aim of this study was to evaluate the impact of structural changes of proteins due to thermal processing on gastro-intestinal tolerance in the immature GI tract. Preterm and near-term piglets received enteral nutrition based on whey protein concentrate (WPC) either mildly pasteurized (MP-WPC) or extensively heated (EH-WPC). Clinical symptoms, transit time and gastric residuals were evaluated. In addition, protein coagulation and protein composition of coagulates formed during in vitro digestion were analyzed in more detail. Characterization of MP-WPC and EH-WPC revealed that mild pasteurization maintained protein nativity and reduced aggregation of β-lactoglobulin and α-lactalbumin, relative to EH-WPC. Mild pasteurization reduced the formation of coagulates during digestion, resulting in reduced gastric residual volume and increased intestinal tract content. In addition, preterm piglets receiving MP-WPC showed reduced mucosal bacterial adherence in the proximal small intestine. Finally, in vitro digestion studies revealed less protein coagulation and lower levels of β-lactoglobulin and α-lactalbumin in the coagulates of MP-WPC compared with EH-WPC. In conclusion, minimal heat treatment of WPC compared with extensive heating promoted GI tolerance in immature piglets, implying that minimal heated WPC could improve the GI tolerance of milk formulas in infants.

Peptide Release after Simulated Infant In Vitro Digestion of Dry Heated Cow's Milk Protein and Transport of Potentially Immunoreactive Peptides across the Caco-2 Cell Monolayer

Dry heating of cow’s milk protein, as applied in the production of “baked milk”, facilitates the resolution of cow’s milk allergy symptoms upon digestion. The heating and glycation-induced changes of the protein structure can affect both digestibility and immunoreactivity. The immunological consequences may be due to changes in the peptide profile of the digested dry heated milk protein. Therefore, cow’s milk protein powder was heated at low temperature (60 °C) and high temperature (130 °C) and applied to simulated infant in vitro digestion. Digestion-derived peptides after 10 min and 60 min in the intestinal phase were measured using LC-MS/MS. Moreover, digests after 10 min intestinal digestion were applied to a Caco-2 cell monolayer. T-cell epitopes were analysed using prediction software, while specific immunoglobin E (sIgE) binding epitopes were identified based on the existing literature. The largest number of sIgE binding epitopes was found in unheated samples, while T-cell epitopes were equally represented in all samples. Transport of glycated peptide indicated a preference for glucosyl lysine and lactosyl-lysine-modified peptides, while transport of peptides containing epitope structures was limited. This showed that the release of immunoreactive peptides can be affected by the applied heating conditions; however, availability of peptides containing epitopes might be limited.

Binding of CML-Modified as Well as Heat-Glycated β-lactoglobulin to Receptors for AGEs Is Determined by Charge and Hydrophobicity

Intake of dietary advanced glycation end products (AGEs) is associated with inflammation-related health problems. Nε-carboxymethyl lysine (CML) is one of the best characterised AGEs in processed food. AGEs have been described as ligands for receptors present on antigen presenting cells. However, changes in protein secondary and tertiary structure also induce binding to AGE receptors. We aimed to discriminate the role of different protein modifications in binding to AGE receptors. Therefore, β-lactoglobulin was chemically modified with glyoxylic acid to produce CML and compared to β-lactoglobulin glycated with lactose. Secondary structure was monitored with circular dichroism, while hydrophobicity and formation of β-sheet structures was measured with ANS-assay and ThT-assay, respectively. Aggregation was monitored using native-PAGE. Binding to sRAGE, CD36, and galectin-3 was measured using inhibition ELISA. Even though no changes in secondary structure were observed in all tested samples, binding to AGE receptors increased with CML concentration of CML-modified β-lactoglobulin. The negative charge of CML was a crucial determinant for the binding of protein bound CML, while binding of glycated BLG was determined by increasing hydrophobicity. This shows that sRAGE, galectin-3, and CD36 bind to protein bound CML and points out the role of negatively charged AGEs in binding to AGE receptors.

Healthy eating recommendations: good for reducing dietary contribution to the body's advanced glycation/lipoxidation end products pool?

The present review aims to give dietary recommendations to reduce the occurrence of the Maillard reaction in foods and in vivo to reduce the body's advanced glycation/lipoxidation end products (AGE/ALE) pool. A healthy diet, food reformulation and good culinary practices may be feasible for achieving the goal. A varied diet rich in fresh vegetables and fruits, non-added sugar beverages containing inhibitors of the Maillard reaction, and foods prepared by steaming and poaching as culinary techniques is recommended. Intake of supplements and novel foods with low sugars, low fats, enriched in bioactive compounds from food and waste able to modulate carbohydrate metabolism and reduce body's AGE/ALE pool is also recommended. In conclusion, the recommendations made for healthy eating by the Spanish Society of Community Nutrition (SENC) and Harvard University seem to be adequate to reduce dietary AGE/ALE, the body's AGE/ALE pool and to achieve sustainable nutrition and health.

Reduced Occurrence of Gastrointestinal Symptoms in Chinese Infants Fed Minimally Processed Commercially Available Formula: A Cross-Sectional Observational Study

Healthy Chinese infants consuming one of four commercially available infant formulas (IF) were assessed on the occurrence of gastrointestinal symptoms associated with suboptimal digestion of processed milk proteins. The IF differed in blocked lysine (BL) levels, a proxy indicator of heat processing as well as the nutritional quality of milk. A cross-sectional, observational study of one week was conducted in healthy, term, exclusively formula-fed Chinese infants (n = 452) fed with one of four commercially available IF (IF A n = 106, BL 9%; IF B n = 119, BL 12%; IF C n = 113, BL 11%; IF D n = 114 BL 20%). Parents/caretakers were requested to report feeding quantity, gastrointestinal symptoms, crying behavior, and stool characteristics daily using subject dairy and Amsterdam Infant Stool Scale (AISS). Infants fed with IF A reported less "hard" and "watery" stools and more "soft/formed" stools. Higher percentages of score I (yellow/golden) or II (orange) and less green (score III) coloured stools were noted for IF A-fed infants compared to all other formulas according to AISS. Night time crying was also significantly lower in the IF A groups compared to all other formulas. Furthermore, a higher percentage of parents/caretakers of IF A-fed infants reported absence or no complaints of abdominal distension, burping, flatulence, diarrhea, and constipation. Results suggest lower occurrence of GI symptoms and lower crying time at night in infants fed with minimally processed formula (indexed by BL levels). Future studies are required to confirm the association between minimal processing of milk formula and improved gut comfort in healthy infants.

Characteristics and antioxidant activity of Maillard reaction products from α-lactalbumin and 2'-fucosyllactose

The characteristics and antioxidant activity of Maillard reaction products (MRPs) from 2'-fucosyllactose (2'-FL), a human milk oligosaccharide, and α-lactalbumin (α-LA) were investigated. MRPs were prepared by reacting 2'-FL with α-LA at 60 °C and 79% relative humidity for up to 72 h. The absorbance and fluorescence intensity of heated α-LA-2'-FL increased as the heating time increased, while the free amino group content decreased, confirming that 2'-FL reacted with α-LA and produced various MRPs at different incubation stages. Conjugates of 2'-FL and α-LA and aggregation of α-LA were observed by SDS-PAGE. The secondary structure of α-LA did not change significantly after reacting with 2'-FL. In terms of antioxidant activity, the 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity and reducing power of α-LA-2'-FL increased significantly when compared with the protein only sample (p < 0.05). The findings provide a foundation for the characterization and functional analysis of MRPs in dairy products.

Lysine blockage of milk proteins in infant formula impairs overall protein digestibility and peptide release

High levels of blocked lysine in infant formula lead to increasing average peptide length after in vitro digestion in infants.

Comparison of Oxidative Status of Human Milk, Human Milk Fortifiers and Preterm Infant Formulas

Preterm and low birth weight infants require specific nutrition to overcome the accumulated growth deficit, and to prevent morbidities related to postnatal growth failure. In order to guarantee an adequate nutrient-intake, mother’s own milk, when available, or donor human milk, are usually fortified with additional nutrients, in particular proteins. Fortification with processed ingredients may result in additional intake in oxidative compounds, deriving from extensive heat treatments, that are applied during processing. The aim of the present work was to compare the in vitro antioxidant activity and oxidative compound content conveyed by different preterm infant foods and fortifiers, namely raw and pasteurized human milk, two different preterm infant formulas, three bovine milk-based fortifiers and two experimental donkey milk-based fortifiers. Univariate and multivariate statistical analyses revealed significant differences between the different products. The use of human milk minimizes the intake of dietary oxidative compound in comparison to infant formulas, irrespective of pasteurization or fortification, especially as far as malondialdehyde content is concerned. The addition of fortifiers to human milk increases its antioxidant capacity, and the choice of the protein source (hydrolysed vs. whole proteins) differently impacted the resulting total antioxidant capacity of the diet.

Early and advanced stages of Maillard reaction in infant formulas: Analysis of available lysine and carboxymethyl-lysine

Although the literature on the Maillard reaction in infant formulas is extensive, most studies have focused on model systems, and in only a few cases on real food systems. Therefore, the objective of the present study was to determine the status of the Maillard reaction, both the early and advanced phases, in a variety of commercial infant formulas available on the Swedish market. Ten powder and liquid milk-based infant formulas from three manufacturers were selected to determine available lysine and CML contents, the two established indicators of the reaction. The products were also characterized with respect to protein content, carbohydrates composition, water content and water activity. In order to be able to compare the impact of different processing steps applied on powder and liquid formulas, the solid formulas contained similar ingredients as their corresponding liquid ones. Our findings showed that powder and liquid formulas contained similar available lysine concentrations regardless of the manufacturer, showing 27.14-36.57% decrease in the available lysine, compared to the reference skim milk powder in this study. The CML concentrations were in a broad range of 68.77-507.99 mg / kg protein. In the case of one manufacturer, liquid infant formulas had significantly higher CML content, compared to the powder products (p < 0.05). The results from this study are a step taken towards better understanding of the extent of the Maillard reaction in real complex systems of infant formulas.

Milk-Derived Amadori Products in Feces of Formula-Fed Infants

Food processing of infant formula alters chemical structures, including the formation of Maillard reaction products between proteins and sugars. We detected early Maillard reaction products, so-called Amadori products, in stool samples of formula-fed infants. In total, four Amadori products (N-deoxylactulosyllysine, N-deoxyfructosyllysine, N-deoxylactulosylleucylisoleucine, N-deoxyfructosylleucylisoleucine) were identified by a combination of complementary nontargeted and targeted metabolomics approaches. Chemical structures were confirmed by preparation and isolation of reference compounds, LC-MS/MS, and NMR. The leucylisoleucine Amadori compounds, which most likely originate from β-lactoglobulin, were excreted throughout the first year of life in feces of formula-fed infants but were absent in feces of breastfed infants. Despite high inter- and intraindividual differences of Amadori products in the infants' stool, solid food introduction resulted in a continuous decrease, proving infant formula as the major source of the excreted Amadori products.

Anaerobic Degradation of N-ε-Carboxymethyllysine, a Major Glycation End-Product, by Human Intestinal Bacteria

Modifications of lysine contribute to the amount of dietary advanced glycation end-products reaching the colon. However, little is known about the ability of intestinal bacteria to metabolize dietary N-ε-carboxymethyllysine (CML). Successive transfers of fecal microbiota in growth media containing CML were used to identify and isolate species able to metabolize CML under anaerobic conditions. From our study, only donors exposed to processed foods degraded CML, and anaerobic bacteria enrichments from two of them used 77 and 100% of CML. Oscillibacter and Cloacibacillus evryensis increased in the two donors after the second transfer, highlighting that the bacteria from these taxa could be candidates for anaerobic CML degradation. A tentative identification of CML metabolites produced by a pure culture of Cloacibacillus evryensis was performed by mass spectrometry: carboxymethylated biogenic amines and carboxylic acids were identified as CML degradation products. The study confirmed the ability of intestinal bacteria to metabolize CML under anoxic conditions.

Effects of Protein-Derived Amino Acid Modification Products Present in Infant Formula on Metabolic Function, Oxidative Stress, and Intestinal Permeability in Cell Models

Proteins present in infant formulas are modified by oxidation and glycation during processing. Modified amino acid residues released from proteins may be absorbed in the gastrointestinal tract, and pose a health risk to infants. In this study, the markers of glycation furosine (1.7-3.5 μg per milligram of protein) and N^ε-(carboxymethyl)lysine (28-81 ng per milligram of protein) were quantitated in infant formulas. The effects of these species, and other amino acid modifications, at the levels detected in infant formulas, on 3T3-L1 (murine preadipocyte) and Caco-2 (human intestinal epithelial) cells were assessed. Incubation of 3T3-L1 cells for 48 h with amino acid side chain oxidation and glycation products (1 and 10 μM) resulted in a loss (up to 40%, p < 0.05) of cell thiols and decreased metabolic activity compared with those of the controls. In contrast, Caco-2 cells showed a stimulation (10-50%, p < 0.05) of cellular metabolism on exposure to these products for 24 or 48 h. A 28% ( p < 0.05) increase in protein carbonyls was detected upon incubation with 200 μM modified amino acids for 48 h, although no alteration in transepithelial electrical resistance was detected. Oxidation products were detected in the basolateral compartments of Caco-2 monolayers when modified amino acids were applied to the apical side, consistent with limited permeability (up to 3.4%) across the monolayer. These data indicate that modified amino acids present in infant formulas can induce effects on different cell types, with evidence of bioavailability and induction of cellular stress. This may lead to potential health risks for infants consistently exposed to high levels of infant formulas.

Glycated Whey Proteins Protect NOD Mice against Type 1 Diabetes by Increasing Anti-Inflammatory Responses and Decreasing Autoreactivity to Self-Antigens

Our previous studies suggested that early glycation products (EGPs) generated in the first step of Maillard reaction/glycation were anti-inflammatory. The objectives of the present study were to determine the effects of EGPs derived from the whey protein isolate-glucose system on type 1 diabetes (T1D), and the underlying immunological mechanisms. In non-obese diabetic (NOD) mice, EGPs at the physiological dose of 600 mg/kg/day increased glucose metabolism, decreased non-fasting blood glucose levels and T1D incidence, decreased insulin resistance, and decreased the pancreatic immune infiltration. The protective effects were accompanied with decreases in CD4^-CD8⁺ thymocytes, CD8⁺ T cells and serum insulin autoantibody levels, and increases in splenic CD4⁺CD25⁺ T cells, macrophage M2/M1 ratio and serum IL-10 level. However, similar treatment with EGPs produced minimal effect on the multiple low-dose streptozotocin-induced hyperglycemia. In conclusion, EGPs protected NOD mice against T1D via increasing anti-inflammatory immune responses and decreasing autoreactivity to self-antigens.

Diversity of advanced glycation end products in the bovine milk proteome

Milk processing relies on thermal treatments warranting microbiologically safe products with extended shelf life. However, elevated temperatures favor also Maillard reactions yielding the structurally diverse advanced glycation end products (AGEs). AGEs may alter protein functions and immunogenicity and also decrease the nutritional value of milk products. Furthermore, dietary AGEs contribute to the circulating AGE pool with potentially harmful effects. Here, 14 types of protein-derived AGEs present in raw milk or produced during processing/storage of regular and lactose-free milk products were identified by nanoRP-UPLC-ESI-MS/MS. In total, 132 peptides (118 modification sites in 62 proteins) were modified by at least one studied AGE. Amide-AGEs were the most abundant group with formyllysine being the main type. Most lysine- and arginine-derived AGEs and their modification sites have not been reported before. The number of AGE modification sites increased with the harsher processing conditions of regular milk, but remained stable during storage. This was further supported by quantitative data.