Fatty acid positional distribution in colostrum and mature milk of women living in Inner Mongolia, North Jiangsu and Guangxi of China

Progress in triacylglycerol isomer detection in milk lipids

In triacylglycerols (TAGs), position differences of fatty acids on the glycerol skeleton produce various TAG isomers. These TAG isomers have different pathways of digestion, absorption, and utilization in infants, thereby affecting TAG nutritional properties of TAGs. Here, we review the progress of research on methods for detecting TAG isomers, and identify direction and thought for improving these methods, including novel chromatographic combinations, perfect algorithm, and improved equipment. The ensuing optimization of these methods is expected to provide robust guarantee for the gradual improvement of milk-derived TAG isomer detection, and is an important prerequisite for infant formula to mimic the structured lipids of human milk.

Determination of the Fatty Acid Profile and Lipid Quality Indices in Selected Infant Formulas

The quality of fat in infant milk is determined by the fatty acid profile and selected indices describing nutritional value. The aim of this study was to analyze the fatty acid profile and lipid quality indices of infant formulas and compare these data with breast milk. The study material included seven types of cow's milk-based follow-on infant formulas and samples of mature breast milk. The determination of fatty acids was performed using the gas chromatography (GC) technique. Lipid quality indices were calculated based on the relevant equations. Infant formulas contained more medium-chain fatty acids (MCFAs) and oleic acid. Moreover, they contained more than 30% more linoleic acid and more than twice as much α-linolenic acid and docosahexaenoic acid. In contrast, significant amounts of trans fatty acids (TFAs) were noted in breast milk, while infant formulas contained trace amounts. Infant formulas were characterized by a lower AI (Index of Atherogenicity) (0.49-0.98) and TI (Index of Thrombogenicity) (0.48-0.60) and a higher H/H (hypocholesterolemic/hypercholesterolemic) ratio (1.93-2.30) compared with breast milk (1.47, 1.60, and 1.21, respectively). The composition of infant formulas depended on the type of fat added at the production stage and differed significantly from breast milk, particularly in terms of polyunsaturated fatty acids and lipid quality indices.

Optimizing ARA and DHA in infant formula: A systematic review of global trends, regional disparities, and considerations for precision nutrition

In the context of precision nutrition, the addition of ARA and DHA in infant formula needs to consider more factors. This study conducted a comprehensive literature review, including 112 relevant Chinese and English articles, to summarize and analyze the global levels of ARA, DHA, and the ARA/DHA ratio in breast milk. The data were correlated with local aquatic products intake and children's IQ. The results indicated that the average level of DHA in breast milk across regions is lower than that of ARA. Variations in DHA content were identified as a primary factor influencing ARA/DHA ratio fluctuations. Breast milk ARA and DHA levels decrease with prolonged lactation periods but increase over the past 22 years. Correlation analysis revealed a significant positive relationship between aquatic products intake and breast milk DHA levels (r = 0.64, p < 0.05). Breast milk DHA levels also showed a significant positive correlation with children's IQ (r = 0.67, p < 0.01). Stable breast milk ARA content did not exhibit significant correlations with aquatic products intake or children's IQ (r = 0, p > 0.05). Among 22 infant formula products available in China, only 5 had ARA levels within the range of breast milk. Most formula products had higher ARA levels than DHA, resulting in ARA/DHA ratios generally exceeding 1. The temporal and spatial variability in breast milk ARA and DHA levels may lead to diverse health outcomes in infants. Therefore, the addition of ARA and DHA in infant formula should consider this variability, including the molecular forms and positional isomerism of the added ARA and DHA. Additionally, considering the impact of different cognitive development tests and infant's gene expression on formula assessment results, there is a need to establish a more comprehensive infant health assessment system to guide the addition of ARA and DHA in formula.

Detection and analysis of triacylglycerol regioisomers via electron activated dissociation (EAD) tandem mass spectrometry

Triacylglycerols (TGs) are important components of human diet. The positional distribution of fatty acids (FAs) on the glycerol backbone affects the chemistry and physical properties of fats. Especially for infants, the structure of TGs plays an important role in the growth and development. However, limited by detecting technology, accurately identifying regioisomers of ABA/AAB and BAC/ABC/ACB type TGs is a significant challenge for human milk utilization and the development of infant formula. For this, we exploit a novel method for identifying the regioisomers of ABA/AAB and BAC/ABC/ACB type TGs within complex lipid mixtures, via used electron activated dissociation (EAD) tandem mass spectrometry. The distribution information of acyl chains at the sn-2 and sn-1/3 positions of glycerol backbone and double bonds in unsaturated FAs can be easily obtained by fragmenting TG ions with energetic electrons (15 eV). Then, the standard curve was established by correlating the peak area intensity of sn-2 characteristic product ion with the content of TG regioisomers standard. These analytical methods successfully enabled the identification and quantification of TG regioisomers in human milk, cow milk, infant formula, palm oil, and sunflower oil. Additionally, the distribution of the double-bond positions of unsaturated FAs in these samples was also identified. Compared to traditional methods, this approach eliminates the need for complex processing and analysis procedures, enabling rapid structural characterization of ABA/AAB and BAC/ABC/ACB type TGs within 17 min. Hence, we provide a rapid and convenient methodology for detecting and analyzing ABA/AAB and BAC/ABC/ACB type TG regioisomers, thereby offering valuable assistance in the development of specialized formulations and facilitating effective process control for ensuring the quality of edible oils and fats.

Trans isomeric fatty acids in human milk and their role in infant health and development

It is well known that long chain polyunsaturated fatty acids (LCPUFAs) play an important role in neurodevelopment in the perinatal life. The most important source of these fatty acids is the diet, however, they can also be formed in the human body from their shorter chain precursors, the essential fatty acids. Since the WHO recommends exclusive breastfeeding for the first six months after birth, the exclusive source of these fatty acids for breastfed infants is human milk, which can be influenced by the mother's diet. Unsaturated fatty acids can have either cis or trans configuration double bond in their chain with distinct physiological effects. Cis isomeric unsaturated fatty acids have several beneficial effects, while trans isomers are mostly detrimental, because of their similar structure to saturated fatty acids. Trans fatty acids (TFAs) can be further subdivided into industrial (iTFA) and ruminant-derived trans fatty acids (rTFA). However, the physiological effects of these two TFA subgroups may differ. In adults, dietary intake of iTFA has been linked to atherosclerosis, insulin resistance, obesity, chronic inflammation, and increased development of certain cancers, among other diseases. However, iTFAs can have a negative impact on health not only in adulthood but in childhood too. Results from previous studies have shown that iTFAs have a significant negative effect on LCPUFA levels in the blood of newborns and infants. In addition, iTFAs can affect the growth and development of infants, and animal studies suggest that they might even have lasting negative effects later in life. Since the only source of TFAs in the human body is the diet, the TFA content of breast milk may determine the TFA supply of breastfed infants and thus affect the levels of LCPUFAs important for neurodevelopment and the health of infants. In this review, we aim to provide an overview of the TFA content in human milk available in the literature and their potential effects on infant health and development.

Maternal diet and human milk composition: an updated systematic review

Context

Exclusive breastfeeding for 6 months after birth provides infants with the best start for life. A review by Bravi et al. summarized the importance of maternal diet as a determinant of human milk composition based on data up to 2015, but evidence on nutrient intake level was limited.

Objective

We updated the review by Bravi et al., critically assessed differences in study designs and sampling methods, and graphically visualized trends and associations.

Data sources

PubMed was systematically searched for articles published between January 2015 and March 2021.

Data extraction

Article screening, selection, and data extraction was done by two independent researchers, including a risk of bias assessment based on 11 criteria. Articles were eligible when including: quantitative information, commonly used effect estimates, healthy mother-infant dyads.

Results

Twenty seven observational and five intervention studies were identified (n = 7,138) and combined with results of Bravi et al. Fatty acids were still the most studied human milk components in relation to maternal diet (n = 17 studies) with maternal fish intake being predominantly positively associated with milk ALA (r = 0.28-0.42), DHA (r = 0.24-0.46), and EPA (r = 0.25-0.28) content. PUFAs from diet were generally positively correlated with their concentrations in milk, while SFA intake was negatively associated with several fatty acids in milk. Studies on associations with maternal diet and milk carbohydrates, proteins, vitamins and minerals were limited in number and varied in methods and results.

Conclusion

This updated review shows that evidence on the association between maternal diet and human milk fatty acids is rapidly increasing, but still diversified in methodology and results. Further studies, preferably intervention studies, assessing diet and milk carbohydrates, proteins, vitamins and minerals are needed to be able draw conclusions on the importance of maternal diet for human milk composition as a whole.

Differences in Absorption and Metabolism between Structured 1,3-Oleate-2-palmitate Glycerol and 1-Oleate-2-palmitate-3-linoleate Glycerol on C57BL/6J Mice

This study investigated differences in absorption and metabolism between 1,3-oleate-2-palmitate glycerol (OPO) and 1-oleate-2-palmitate-3-linoleate glycerol (OPL) using C57BL/6J mice. OPL was associated with higher postprandial plasma total triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) concentrations, and the ratio of LDL-C to high-density lipoprotein cholesterol (HDL-C) compared to those of OPO (p > 0.05). OPO significantly increased postprandial oleic acid (OA) concentrations compared to OPL over the entire monitoring period (p < 0.05), while OPL significantly elevated linoleic acid (LA) levels compared to OPO (p < 0.05). After 1 month of feeding, the mice in both OPO and OPL groups showed lower final weight, weight gain, and liver TG, LDL-C, and LDL/HDL concentrations compared to the control (soybean oil) group. Lipidomics results showed that OPO increased the biosynthesis of very long-chain fatty acids and decreased the abundance of AcCa (16:1), AcCa (18:2), AcCa (18:1), AcCa (16:0), CarE (16:0), and CarE (16:1) relative to OPL. These lipid metabolites were positively correlated with liver TG, LDL-C, and LDL/HDL levels and negatively related to peroxisome proliferator-activated receptors α (PPARα) and acyl-CoA oxidase (ACOX1) expression. This study showed differences in physiologic functions between OPO and OPL and provided support for the future application of OPL in infant formula.

Comparative Lipidomic Analysis Reveals the Lactational Changes in the Lipid Profiles of Chinese Human Milk

Human milk (HM) lipid plays a crucial role in infant development, whereas its complex lipid profiles and its dynamic changes during prolonged lactation have not been investigated yet. Comparative lipidomic analyses were employed in investigating the lipid profiles of breast milk covering all lactation stages herein. Results revealed significant differences between colostrum and the remaining lactations. A total of 237 species of glycerolipids (GLs) and 231 phospholipids (PLs) were identified. Colostrum had the most abundant lipid species and was enriched with triacylglycerols (TGs) with a high molecular weight. TG(17:1/18:1/24:1), TG(24:1/24:1/26:1), TG(24:0/24:1/26:1), and SM(d20:1/14:1) were characteristic lipids of colostrum. Differential lipid species which were responsible for distinguishing the adjacent lactations were also indicated. Our findings can help deepen the overall understanding of HM lipid profiles and its dynamic changes, which will facilitate the development of infant formulas suitable for Chinese babies in diverse age groups.

Lipid Profiles of Human Milk and Infant Formulas: A Comparative Lipidomics Study

Infant formulas (IFs) are prevalent alternatives for human milk (HM), although their comparative lipid profiles have not been fully investigated. We adopted lipidomics to analyze and compare in-depth the lipid patterns of HM and IFs. The results indicated that the distribution of fatty acids (FAs) and the structure of triacylglycerols varied substantially in the analyzed samples. A total number of 425 species were identified during the analysis. HM was abundant in triacylglycerols that contained unsaturated and long-chain FAs (>C13), while triacylglycerols in IFs were mainly comprised of saturated and medium-chain FAs (C8-C13). Higher levels of sphingomyelin were observed in HM. Furthermore, HM and IF1 contained 67 significantly differential lipids (SDLs), and 73 were identified between HM and IF2. These SDLs were closely associated with nine metabolic pathways, of which the most significant was the glycerophospholipid metabolism. The results shed light on the differences between the lipid profiles of human and infant formula milks, and provide support for designing Chinese infant formula.

Human Milk Lipid Profiles around the World: A Systematic Review and Meta-Analysis

Reported breast milk lipid concentrations may vary with geographical region, postnatal age, and year of sample collection. In this review, we summarized data on the concentrations of total fat, total phospholipids, cholesterol, and fatty acids in human milk worldwide and their variation according to lactation stage, study area, and sample collection year. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Medline databases for English-language papers and Wanfang and China National Knowledge Infrastructure databases for Chinese-language papers. A total of 186 studies evaluating the human milk lipid profiles were included. According to random-effects models based on worldwide data, the summarized means (95% CIs) as percentages of total fat were 42.2% (41.1%, 43.3%) for SFAs, 36.6% (35.6%, 37.5%) for MUFAs, and 21.0% (19.3%, 22.7%) for PUFAs. However, the study heterogeneity was high for most types of fatty acids (I2 > 99%). Human milk from Western countries had higher concentrations of MUFAs and 18:1n-9 (ω-9), but lower concentrations of PUFAs, 18:2n-6, 20:4n-6, 18:3n-3, 20:5n-3, 22:6n-3, and total n-6 PUFA compared with those from non-Western countries (P < 0.001-0.011). Significant lactation stage differences were observed for total fat and some individual fatty acids. The concentrations of SFAs and 16:0 were significantly negatively correlated with sampling year (P < 0.001-0.028). In contrast, a significant positive correlation between the concentrations of 18:2n-6 and 18:3n-3 and sampling year was observed (P < 0.001-0.035). Our results suggest that the pooling of data on human milk lipid profiles in different studies should be done with caution due to the high between-study heterogeneity. The concentration of lipids, including total fat, cholesterol, and specific fatty acids, differs in human milk according to lactation stage, geographical region, and year of sample collection.

Profiles of total and sn-2 fatty acid of human mature milk and their correlated factors: A cross-sectional study in China

Fatty acid (FA) in breast milk is beneficial to the growth and neurodevelopment of infants. However, the structure profiles of breast milk FAs and the influencing factors which are crucial for normal function have not been fully elucidated. This study aimed to characterize the profiles of total and sn-2 FAs in human mature milk based on two representative urban areas in China and explore potential sociodemographic determinants. Mothers (n = 70) at 40–100 d postpartum from Beijing and Danyang were recruited according to unified inclusion and exclusion criteria. Total and sn-2 FA compositions were examined by gas chromatography and quantified. Using the Spearman correlation and multiple regression model, we found that the location and maternal education level were the most conspicuous correlated factor. The milk of mothers from Beijing had higher levels of the n-6 series of long-chain polyunsaturated fatty acids (LCPUFA) (C20:2, C20:3n-6, C20:4n-6, n-6PUFA/n-3PUFA, LA/ALA, and ARA/DHA) than that of Danyang, while the opposite was observed in the n-3 series of LCPUFA (C18:3n-3 and Total n-3PUFA). Compared to the milk of mothers with a high school degree or below, those with a bachelor's degree or above had lower SFAs (C10:0, C12:0, C14:0, and Total SFA), n-3 series of LCPUFA (C18:3n-3 and Total n-3PUFA), C18:1n-9t, and higher n-6 series of LCPUFA (C18:2n-6c, C20:2, C20:4n-6, Total n-6PUFA, and n-6PUFA/n-3PUFA). Maternal age, infant gender, pre-conception body mass index (BMI), parity, delivery mode, and gestational weight gain were also associated with total FAs. However, fewer associations were found between the above factors and sn-2 FAs. This study will promote an understanding of human breast milk's lipid profile and help develop a formula more suitable for infants.

Content of industrially produced trans fatty acids in breast milk: An observational study

Breast milk may contain industrially produced trans fatty acids (TFAs), which can affect the content of essential fatty acids (EFAs). This could have significant implications for the child's development. The fatty acids present in breast milk can be modified by adjusting the mother's diet. The objective of this study was to determine the content of industrially produced TFAs present in colostrum, transitional milk, and mature milk produced by mothers between 18 and 45 years of age in the state of Querétaro, Mexico, based on a longitudinal observational study. The TFA content in the breast milk of 33 lactating women was analyzed using gas chromatography. The mothers’ consumption of TFAs was also estimated by analyzing a log prepared through 24‐hr dietary recall (24HR) obtained in each period. The TFA content in the mothers’ diet was similar across the colostrum, transitional milk, and mature milk phases: 1.64 ± 1.25 g, 1.39 ± 1.01, and 1.66 ± 1.13 g, respectively. The total TFA content was 1.529% ± 1.648% for colostrum; 0.748% ± 1.033% for transitional milk and 0.945% ± 1.368% for mature milk. Elaidic acid was the TFA in the highest concentration in all three types of milk. No correlation was found between the content of industrially produced TFAs in breast milk and the anthropometric measurements of the mother or between the estimated consumption of TFAs and the content of TFAs in breast milk. Elaidic acid and total content of TFAs were negatively correlated (p < .05) with the content of docosahexaenoic acid (DHA) (0.394 ± 0.247) (R = −0.382) in colostrum. The concentration of TFAs was found to correlate with the composition of EFAs in milk.

Macronutrient content and fatty acid composition and their positional distribution in human breast milk from Zhejiang Province, China in different lactation periods

Lactational changes in macronutrient content, lipid profile, fatty acid composition, and positional distribution of human breast milk were investigated in this study. A total of 378 milk samples of six different lactation periods, including 0‒5, 6‒14, 15‒30, 31‒90, 91‒180, and 181‒360 days, were collected cross-sectionally from healthy lactating women in Zhejiang, China. As lactation progressed from 0‒5 to 15‒30 days, the lipid content and the percentages of C10:0, C12:0, C14:0, C18:2n-6, and C18:3n-3 increased significantly, while the protein concentration and the proportions of phospholipids, cholesterols, C16:0, C18:1n-9, C24:1n-9, C20:4n-6, C22:4n-6, C22:5n-3, and C22:6n-3 decreased notably. When lactation was further extended to 181‒360 days, the protein content continued to decrease, and the percentages of C12:0 and C14:0 continued to increase, whereas the levels of other tested nutrients remained stable. Although the triacylglycerol positional distributions of some fatty acids underwent significant lactational variations, C14:0, C16:0, C24:1n-9, C22:4n-6, C22:5n-3, and C22:6n-3 were located mainly at the sn-2 position, while C18:1n-9, C18:2n-6, and C18:3n-3 were primarily distributed at the sn-1,3 positions. Compared with human breast milk reported in Western countries, samples in our study demonstrated higher percentages of C18:2n-6, C18:3n-3, C20:4n-6, and C22:6n-3, but lower proportions of C12:0, C14:0, and C18:1n-9. The results from this study indicated a nutritional composition different from that of the Western countries and may provide useful data for the development of infant formulas closer to Chinese breast milk in terms of the fatty acid composition and its specified positional distribution on triglyceride structure.

Total and Sn-2 Fatty Acid Profile in Human Colostrum and Mature Breast Milk of Women Living in Inland and Coastal Areas of China

INTRODUCTION

Although lipid is the major energy source and exerts beneficial effects on infant growth, research on the composition of fatty acid (FA) at the sn-2 position of human milk (HM) in China and abroad is limited.

OBJECTIVES

This study aimed to investigate the FA positional distribution in colostrum and mature HM of women living in the inland and coastal areas of China and explore the potential influences of geographical region and lactation stage on the FA profile of Chinese women.

METHODS

Colostrum milk (n = 61) and mature milk (n = 56) samples were obtained longitudinally from healthy lactating women in Guangzhou and Chengdu, China. Gas chromatography was used to determine the total and sn-2 FA composition.

RESULTS

Significant differences were observed in the FA profile of HM between different regions and lactation stages, with differences in polyunsaturated FA levels being the most pronounced. Nearly 70% of sn-2 FAs were saturated FAs, of which C16:0 accounted for approximately 75%. C8:0, C10:0, C18:0, C20:0, C22:0, and all of the unsaturated FAs were mainly located at the sn-1 and sn-3 positions, while C14:0, C15:0, and C16:0 were mainly at the sn-2 position. The proportion of C12:0 and C17:0 at sn-2 was approximately equivalent to that at the sn-1, 3 positions.

CONCLUSIONS

The results indicate the variability in the FA profile of HM between regions and lactation stages. The contents of polyunsaturated FAs and sn-2 FAs, especially palmitic acid, should be paid more attention when optimizing infant formula.

Direct inlet negative ion chemical ionization tandem mass spectrometric analysis of triacylglycerol regioisomers in human milk and infant formulas

A previously developed direct inlet tandem mass spectrometric method for analysis of triacylglycerol (TAG) regioisomers was updated and validated for operation with current instrumentation with improved sensitivity and throughput. TAG regioisomers in pooled Chinese and Finnish human milk samples, two bovine milk samples and 11 infant formulas were identified and quantified. A total of 241 TAG regioisomers were identified and quantified, consisting of over 60 mol% of all TAGs in the human milk samples. The infant formulas deviated largely from human milk in regioisomeric composition of TAGs. In the Finnish and Chinese human milks, the most abundant ones were 1,3-dioleoyl-2-palmitoylglycerol (OPO; 7.4 and 8.8 mol% of all TAGs) and 1(3)-linoleoyl-2-palmitoyl-3(1)-oleoylglycerol (LPO; 4.7 and 8.3 mol% of all TAGs). In the infant formulas 1,2(2,3)-dioleoyl-3(1)-palmitoylglycerol (OOP) and 1(3)-linoleoyl-2-oleoyl-3(1)-palmitoylglycerol/1(3)-palmitoyl-2-linoleoyl-3(1)-oleoylglycerol (LOP/PLO) were more abundant than OPO and LPO. The differences between human milk and infant formula prompt for further development of current formulas.