Triacylglycerol containing medium-chain fatty acids (MCFA-TAG): The gap between human milk and infant formulas

Novel Human Milk Fat Substitutes Based on Medium- and Long-Chain Triacylglycerol Regulate Thermogenesis, Lipid Metabolism, and Gut Microbiota Diversity in C57BL/6J Mice

Human milk is naturally rich in medium- and long-chain triacylglycerols (MLCT), accounting for approximately 30% of the total fat. However, infant formula fat is prepared using a physical blend of vegetable oils, which rarely contains MLCT, similar to human milk. The differences in MLCT between human milk and infant formulas may cause different lipid metabolisms and physiological effects on infants, which are unknown. This study aimed to analyze the metabolic characteristics of formula lipid containing novel human milk fat substitutes based on MLCT (FL-MLCT) and compare their effects with those of the physical blend of vegetable oils (FL-PB) on lipid metabolism and gut microbiota in mice. Compared with the FL-PB group, the FL-MLCT group showed increased energy expenditure, decreased serum triacylglycerol level, and significantly lower aspartate aminotransferase level, epididymal and perirenal fat weight, and adipocyte size. Moreover, the abundances of Firmicutes/Bacteroidota, Actinobacteriota, and Desulfovibrionaceae were significantly decreased in the FL-MLCT group. Novel human milk fat substitutes MLCT could inhibit visceral fat accumulation, improve liver function, and modulate the mice gut microbiota composition, which may contribute to controlling obesity.

Novel trends and challenges in fat modification of next-generation infant formula: Considering the structure of milk fat globules to improve lipid digestion and metabolism of infants

Differences in the composition and structure of lipid droplets in infant formula (IF) and human milk (HM) can affect the fat digestion of infants, leading to high risk of metabolic diseases during later stages of growth. Recently, interest in simulating HM fat (HMF) has gradually increased due to its beneficial functions for infants. Much research focuses on the simulation of fatty acids and triacylglycerols. Enzymatic combined with new technologies such as carbodiimide coupling immobilization enzymes, solvent-free synthesis, and microbial fermentation can improve the yield of simulated HMF. Furthermore, fat modification in next-generation IF requires attention to the impact on the structure and function of milk fat globules (MFG). This review also summarizes the latest reports on MFG structure simulation, mainly related to the addition method and sequence of membrane components, and other milk processing steps. Although some of the simulated HMF technologies and products have been applied to currently commercially available IF, the cost is still high. Furthermore, understanding the fat decomposition of simulated HMF during digestion and assessing its nutritional effects on infants later in life is also a huge challenge. New process development and more clinical studies are needed to construct and evaluate simulated HMF in the future.

Effects of lipids from multiple sources on glyceride composition, concentration, and structure of infant formulas benchmarked to human milk

The important parameters affecting the nutritional properties of lipids were analyzed and compared between human milk (HM), infant formulas (IFs), mammalian milk, and substitute fat, including molecular species, fatty acid composition, glyceride content, and important structural triacylglycerols (TAGs). The molecular species of triacylglycerols with functional fatty acids were significantly different between HM and IFs, and their contents in HM were significantly higher than those in IFs. Accordingly, the evaluation scores of fatty acid composition and glyceride content in IFs were less than 50 compared to HM. Although the introduction of vegetable oils effectively improved the unsaturation of IF lipid, the excessive addition of TAGs rich in oleic and linoleic acid resulted in an imbalance of TAG composition and structure. Only 36.84 % of IFs were supplemented with structured lipids, but those still lacked sn-2 palmitate TAGs. The adoption of multiple lipids and novel processing technologies is required for novel IFs to match the composition, content, positional structure and spherical membrane structure of HM as closely as possible.

Medium- and long-chain triacylglycerols and di-unsaturated fatty acyl-palmitoyl-glycerols in Chinese human milk: Association with region during the lactation

The triacylglycerols (TAGs) of medium- and long-chain triacylglycerols (MLCT) and di-unsaturated fatty acyl-palmitoyl-glycerols (UPU) in human milk provide better nutritional effects, and should be prioritized as crucial focuses on neonatal nutrition research. However, little has been done on the influences of the lactation stage and regional diversity on MLCT and UPU. In this study, we collected 204 human milk samples during colostrum, 1st and 4th month from the north (Baotou), central (Beijing), east (Jinan), southwest (Kunming), southeast (Shenzhen), and northwest (Xining) regions of China. There were 122 species of TAGs detected with UPLC-Q-TOF-MS, including 60 kinds of MLCT and 15 kinds of UPU. The MLCT and UPU type TAGs in human milk were ~27 and ~38%, respectively. The sum content of MLCT and UPU in human milk was stable. Compared to the regional diversity, lactation stages showed more obvious influences on MLCT and UPU composition. Moreover, a summary of TAG studies indicated that Chinese human milk showed a higher ratio of O-P-L to O-P-O than in western countries.

Role Medium-Chain Fatty Acids in the Lipid Metabolism of Infants

Human breastmilk, the ideal food for healthy infants, naturally contains a high concentration of medium-chain fatty acids (MCFAs, about 15% of total fatty acids). MCFAs are an important energy source for infants due to their unique digestive and metabolic properties. MCFA-enriched oils are widely used in an infant formula, especially the formula produced for preterm infants. Recently, there has been a growing interest in the triglyceride structure of MCFAs in human milk, their metabolism, and their effects on infant health. This study summarized the MCFA composition and structure in both human milk and infant formula. Recent studies on the nutritional effects of MCFAs on infant gut microbiota have been reviewed. Special attention was given to the MCFAs digestion and metabolism in the infants. This paper aims to provide insights into the optimization of formulations to fulfill infant nutritional requirements.

Digestion of Medium- and Long-Chain Triacylglycerol and sn-2 Palmitate in Infant Formula: A Study Based on Dynamic In Vitro Simulation of Infant Gastrointestinal Lipolysis

In this study, lipolysis of triacylglycerols (TAGs) in infant formula (IF) composed of different oils and supplied with different structured TAGs, including medium- and long-chain triacylglycerol (MLCT) and sn-2 palmitate, was studied using a dynamic digestion model simulating the infant gastrointestinal tract. The molecular species of digestion products released during digestion, including diacylglycerols, monoacylglycerols (MAGs), and free fatty acids, as well as undigested TAGs, were identified and quantified using liquid chromatography-mass spectrometry. We observed clearly different lipolysis degrees (LDs), with diversity in digestion products of different IFs. IFs supplied with MLCT showed moderate medium-chain fatty acid release during gastric digestion and higher LD after intestinal digestion. The presence of sn-2 palmitate in IF was associated with higher content of MAG-16:0 in digestion products. The species and contents of digestion products in IF were highly influenced by structured TAGs.

Evaluation of total, sn-2 fatty acid, and triacylglycerol composition in commercial infant formulas on the Chinese market: A comparative study of preterm and term formulas

Preterm infants with physiological immaturity require higher lipid provision than term infants. This study compared the lipid composition, including total, sn-2 fatty acid, and triacylglycerol (TAG) compositions in 14 preterm formulas and 25 term formulas in the Chinese market, in 2020-2021. Preterm formula had higher medium-chain fatty acid (MCFA) and comparable C22:6n-3 (DHA) contents than term formula. Notably, significantly lower C16:0 and C18:0 (p < 0.001) were distributed on the sn-2 position in preterm formula. Two hundred and thirteen kinds of TAG molecular species were identified using UPLC-Q-TOF-MS. In preterm formula, significantly higher Ca-Ca-Cy and Ca-Ca-Ca (p < 0.001) existed. These clear distinctions showed the challenge of the progress in preterm formula, such as DHA status, MCFA pattern, and TAG esterified with palmitic acid on the sn-2 position.

Preparation of Human Milk Fat Substitutes: A Review

Human milk is generally regarded as the best choice for infant feeding. Human milk fat (HMF) is one of the most complex natural lipids, with a unique fatty acid composition and distribution and complex lipid composition. Lipid intake in infants not only affects their energy intake but also affects their metabolic mode and overall development. Infant formula is the best substitute for human milk when breastfeeding is not possible. As the main energy source in infant formula, human milk fat substitutes (HMFSs) should have a composition similar to that of HMF in order to meet the nutritional needs of infant growth and development. At present, HMFS preparation mainly focuses on the simulation of fatty acid composition, the application of structured lipids and the addition of milk fat globule membrane (MFGM) supplements. This paper first reviews the composition and structure of HMF, and then the preparation development of structured lipids and MFGM supplements are summarized. Additionally, the evaluation and regulation of HMFSs in infant formula are also presented.

Odor-active volatile compounds in preterm breastmilk

BACKGROUND

Volatile compounds in breastmilk (BM) likely influence flavor learning and, through the cephalic phase response, metabolism, and digestion. Little is known about the volatile compounds present in preterm BM. We investigated whether maternal or infant characteristics are associated with the profile of volatile compounds in preterm BM.

METHODS

Using solid-phase microextraction coupled with gas chromatography/mass spectrometry, we analyzed volatile compounds in 400 BM samples collected from 170 mothers of preterm infants.

RESULTS

Forty volatile compounds were detected, mostly fatty acids and their esters (FA and FAe), volatile organic compounds (VOCs), aldehydes, terpenoids, alcohols, and ketones. The relative concentration of most FA and FAe increased with advancing lactation and were lower in BM of most socially deprived mothers and those with gestational diabetes (p < 0.05), but medium-chain FAs were higher in colostrum compared to transitional BM (p < 0.001). Infant sex, gestational age, and size at birth were not associated with the profile of volatile compounds in preterm BM.

CONCLUSIONS

Sensory-active volatile FA and FAe are the major contributors to the smell of preterm BM. The associations between lactation stage, maternal characteristics, and volatile compounds, and whether differences in volatile compounds may affect feeding behavior or metabolism, requires further research.

IMPACT

Sensory-active volatile FAs are major contributors to the smell of preterm BM and are influenced by the lactation stage and maternal characteristics. Longitudinal analysis of volatile compounds in preterm BM found that FAs increased with advancing lactation. Colostrum had a higher concentration of medium-chain FAs compared to transitional BM and the concentration of these is associated with socioeconomic status, gestational diabetes, and ethnicity.

Identification and Quantification of Triacylglycerols Using Ultraperformance Supercritical Fluid Chromatography and Quadrupole Time-of-Flight Mass Spectrometry: Comparison of Human Milk, Infant Formula, Other Mammalian Milk, and Plant Oil

Triacylglycerol (TAG) components in human milk during different lactation periods, infant formulas with different fat sources, other mammalian milk (cow, goat, donkey, and yak milk), and plant oil (sunflower, rapeseed, corn, soybean, palm, palm kernel, and coconut oil) were analyzed and compared using ultraperformance supercritical fluid chromatography and quadrupole time-of-flight mass spectrometry (UPSFC-Q-TOF-MS). We identified 191 TAGs (86, 102, 101, and 54 TAGs in human milk, infant formula, mammalian milk, and plant oil, respectively). TAGs esterified with palmitic acid (16:0) were major TAG structures in human milk (59.08% of total TAGs) and contained 30 TAG types. The sn-O/P/O regioisomer constituted more than 80% of the O/P/O content of human milk, whereas the sn-O/O/P levels were higher in other samples. The carbon number (CN) 52 content was higher than the CN 54 content in human milk, with the opposite observed in infant formula. TAGs with CN < 40 content were abundant in cow, goat, and yak milk; donkey milk was rich in CN 52 content. TAGs composed of medium-chain fatty acids (MCFAs) and long-chain fatty acids (LCFAs) were rich in human milk, while TAGs with three MCFAs were rich in infant formula. The TAG characteristics of infant formula were directly related to its fat resource. TAGs with fewer double bonds were abundant in the plant oil formula; however, highly unsaturated TAGs were prominent in the cow and goat milk formulas, similar to plant oil and mammalian milk. Significant differences in the TAG distribution were observed among the different species.

Effect of nisin and potassium sorbate additions on lipids and nutritional quality of Tan sheep meat

Nisin and potassium sorbate as preservatives are used in a broad range of meat. A lipidomic evaluation was performed on Tan sheep meat treated by two types of preservatives. The addition of potassium sorbate resulted in higher lipid losses compared with nisin treatment. Furthermore, 106 significant lipids of 12 lipid classes (PC, PS, LPS, LPC, PE, PI, LPE, TG, Cer, DG, SM, Sph) with variable importance in projection scores greater than 1.0 were detected and qualified to distinguish different preservatives added meat using UHPLC-Q-Orbitrap MS/MS. LOD and LOQ were 0.12-0.32 μg kg^-1 and 0.35-0.89 μg kg^-1, indicating high sensitivity and excellent analytical characteristics in the study. Nisin was confirmed to be the better preservative for prolonging the shelf life of Tan sheep meat while reducing the loss of nutrients. These results could provide a strong cornerstone for future research on preservatives in meat products.

Lipid Composition, Digestion, and Absorption Differences among Neonatal Feeding Strategies: Potential Implications for Intestinal Inflammation in Preterm Infants

Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in the neonatal population. Formula feeding is among the many risk factors for developing the condition, a practice often required in the cohort most often afflicted with NEC, preterm infants. While the virtues of many bioactive components of breast milk have been extolled, the ability to digest and assimilate the nutritional components of breast milk is often overlooked. The structure of formula differs from that of breast milk, both in lipid composition and chemical configuration. In addition, formula lacks a critical digestive enzyme produced by the mammary gland, bile salt-stimulated lipase (BSSL). The gastrointestinal system of premature infants is often incapable of secreting sufficient pancreatic enzymes for fat digestion, and pasteurization of donor milk (DM) has been shown to inactivate BSSL, among other important compounds. Incompletely digested lipids may oxidize and accumulate in the distal gut. These lipid fragments are thought to induce intestinal inflammation in the neonate, potentially hastening the development of diseases such as NEC. In this review, differences in breast milk, pasteurized DM, and formula lipids are highlighted, with a focus on the ability of those lipids to be digested and subsequently absorbed by neonates, especially those born prematurely and at risk for NEC.

Triacylglycerol Containing Medium-Chain Fatty Acids: Comparison of Human Milk and Infant Formulas on Lipolysis during In Vitro Digestion

Medium-chain triacylglycerol (MCT) is widely used in infant formulas (IFs) to provide medium-chain fatty acids (MCFAs) for infants with special fat absorption requirements. However, MCFAs naturally present in human milk are medium-and long-chain triacylglycerols (MLCTs). This study investigated the effect of triacylglycerol containing MCFAs (MLCT vs MCT) on lipolysis by comparison of human milk and IFs containing 0, 20, 30, and 55% of MCT (IF 1 to IF 4) using an in vitro digestion model. Rabbit gastric lipase showed an extent of digestion within the expected range, and was selected as the alternative to human gastric lipase. All IFs showed a lower lipolysis degree compared with human milk. There was no significant difference (p = 0.175) among IFs supplemented with MCT at the end of intestinal digestion. In addition, the digestion of IFs with different MCT contents led to different free fatty acid profiles, which may have health effects on infants.