Comparison of the phospholipid classes in human milk in Japanese mothers of term and preterm infants

Lipid analysis of breast milk and formula for preterm infants and the application and prospects of novel structural lipids - a comprehensive review

Preterm infants, often characterized by lower birth weights and underdeveloped physiologies, necessitate specialized nutritional care. While breast milk stands as the ideal nutritional source, offering substantial energy through its fatty acid content to support the infants' growth and developmental needs, its usage might not always be feasible. Fatty acids in breast milk are critical for the development of these infants. In scenarios where breast milk is not an option, formula feeding becomes a necessary alternative. Thus, a comprehensive understanding of the fatty acid profiles in both breast milk and formulas is crucial for addressing the distinct nutritional requirements of preterm infants. This paper aims to summarize the effects of lipid composition, structure, and positioning in breast milk and formula on the growth and development of preterm infants. Furthermore, it explores recent advancements in the use of novel structural lipids in formulas, laying the groundwork for future innovations in formula design specifically catered to the needs of preterm infants.

Comparison of glycerophospholipid and sphingolipid in mature milk from different sampled regions in the Chinese human milk project (CHMP) study

Milk phospholipids (PLs) are critical components of infant growth. This study aimed to discover PL in mature human milk (HM) from China (n = 201) and mainly assessed the effect caused by sampled regions. The average total PL concentration was quantified from 3.65 to 11.25 mg per g of lipid, and the major PL class identified was sphingomyelin (SM, 38.06-47.62 %), followed by phosphatidylcholine (PC, 29.61-34.39 %), and phosphatidylethanolamine (PE, 10.54-24.46 %). In addition, the 36:2 (18:0/18:2), 38:6 (16:0/22:6), 40:1 (d18:1/22:0), and 42:2 (d18:1/24:1) were the most abundant molecular species identified in glycerophospholipid and SM molecular species respectively. Some PL molecular species were strongly related with region of sampling, like lysophosphatidylinositol 18:1 was only detected in Beijing. In conclusion, those findings showed that the PL molecular species and concentration of HM had significant regional diversity, and it will give the Chinese human milk database more accurate PL data.

Milk polar lipids composition and functionality: a systematic review

Polar lipids including glycerophospholipids and sphingophospholipids are important nutrients and milk is a major source, particularly for infants. This systematic review describes the human and bovine milk polar lipid composition, structural organization, sources for formulation, and physiological functionality. A total of 2840 records were retrieved through Scopus, 378 were included. Bovine milk is a good source of polar lipids, where yield and composition are highly dependent on the choice of dairy streams and processing. In milk, polar lipids are organized in the milk fat globule membrane as a tri-layer encapsulating triglyceride. The overall polar lipid concentration in human milk is dependent on many factors including lactational stage and maternal diet. Here, reasonable ranges were determined where possible. Similar for bovine milk, where differences in milk lipid concentration proved the largest factor determining variation. The role of milk polar lipids in human health has been demonstrated in several areas and critical review indicated that brain, immune and effects on lipid metabolism are best substantiated areas. Moreover, insights related to the milk fat globule membrane structure-function relation as well as superior activity of milk derived polar lipid compared to plant-derived sources are emerging areas of interest regarding future research and food innovations.

Direct infusion and ultra-high-performance liquid chromatography/electrospray ionization tandem mass spectrometry analysis of phospholipid regioisomers

RATIONALE

Phospholipids are important components of cell membranes that are linked to several beneficial health effects such as increasing plasma HDL cholesterol levels, improving cognitive abilities and inhibiting growth of colon cancer. The role of phospholipid (PL) regioisomers in all these health effects is, however, largely not studied due to lack of analytical methods.

METHODS

Electrospray ionization mass spectrometry in negative mode produces structurally informative fragment ions resulting from differential dissociation of fatty acids (FAs) from the sn-1 and sn-2 positions, primarily high-abundance [RCOO]^- ions. The fragment ion ratios obtained with different ratios of regiopure phospholipid reference compounds were used to construct calibration curves, which allow determination of regioisomeric ratios of an unknown sample. The method was developed using both direct infusion mass spectrometry (MS) and ultra-high-performance liquid chromatography and hydrophilic interaction liquid chromatography mass spectrometry (UHPLC-HILIC-MS).

RESULTS

The produced calibration curves have high coefficients of determination (R²  >0.98) and the fragment ion ratios in replicate analyses were very consistent. A test mixture containing 60/40% ratios of all available regioisomer pairs was analyzed to test and validate the functionality of the calibration curves. The results were accurate and reproducible. However, regioisomeric quantification of certain chromatographically overlapping compounds is restricted by the relatively wide window in precursor ion selection of the MS instrument used.

CONCLUSIONS

This method establishes a framework for analysis of phospholipid regioisomers. Specific regioisomers can be quantified using the existing data, and method development will continue with improving chromatographic separation and exploring the fragmentation patterns and efficiencies of different PL classes and FA combinations, ultimately to refine this method for routine analysis of natural fats and oils.

New Insights Into Microbiota Modulation-Based Nutritional Interventions for Neurodevelopmental Outcomes in Preterm Infants

Gut microbiota and the central nervous system have parallel developmental windows during pre and post-natal life. Increasing evidences suggest that intestinal dysbiosis in preterm infants predisposes the neonate to adverse neurological outcomes later in life. Understanding the link between gut microbiota colonization and brain development to tailor therapies aimed at optimizing initial colonization and microbiota development are promising strategies to warrant adequate brain development and enhance neurological outcomes in preterm infants. Breast-feeding has been associated with both adequate cognitive development and healthy microbiota in preterms. Infant formula are industrially produced substitutes for infant nutrition that do not completely recapitulate breast-feeding benefices and could be largely improved by the understanding of the role of breast milk components upon gut microbiota. In this review, we will first discuss the nutritional and bioactive component information on breast milk composition and its contribution to the assembly of the neonatal gut microbiota in preterms. We will then discuss the emerging pathways connecting the gut microbiota and brain development. Finally, we will discuss the promising microbiota modulation-based nutritional interventions (including probiotic and prebiotic supplementation of infant formula and maternal nutrition) for improving neurodevelopmental outcomes.

Comparative Lipidomics Analysis of Human Milk and Infant Formulas Using UHPLC-Q-TOF-MS

The lipidome and fatty acid composition of human milk and different infant formulas with animal- and/or plant-based fat sources are analyzed and compared in this study. The results obtained using positive and negative ionization modes indicate that there are 48 and 71 lipid species, respectively, that are common between the human milk and infant formulas. Moreover, the fatty acid composition in infant formulas varies significantly, depending on the fat source. Human milk is rich in triacylglycerols that contain linoleic acid, α-linolenic acid, arachidonic acid, and docosahexaenoic acid. Meanwhile, the triacylglycerols in IFB comprise long-chain fatty acids at the sn-1,3 position. Compared to human milk, IFC has the same level of sphingomyelin species. Based on univariate and multivariate analyses, there are 37, 34, 31, and 36 lipid species that can be used to distinguish between human milk and infant formulas. Overall, the results reported herein are useful in designing new milk formulas that better mimic human milk.

Microbiome and metabolic changes in milk in response to artemisinin supplementation in dairy cows

This study aimed to explore the effects of artemisinin (ART) on the milk microbiome and metabolites of dairy cow. A total of 12 mid-lactation Holstein dairy cows with similar parity, days in milk were randomly divided into 2 groups receiving either a total mixed ration (TMR) as the control group or this TMR and 120 g/d/head ART as the ART group. The milk samples were collected weekly to determine the contents, and end-of-trial (week 8) milk samples were used to identify microbial species and metabolite profiles by 16S rRNA sequencing and LC–MS analyses, respectively. We observed that the milk fat content significantly increased by ART treatment (P < 0.05). The bacterial community richness was significantly lower in the ART group (P < 0.05), while the diversity showed no difference (P > 0.05). Compared with its abundance in the control (CON) group, Firmicutes was significantly decreased, whereas Proteobacteria was significantly increased. Furthermore, in the ART group, the relative abundances of the genera Aerococcus, Staphylococcus, Corynebacterium_1 and Facklamia were significantly lower (P < 0.01). Metabolomics analysis revealed that ART significantly increasing the concentrations of glycerophospholipids, glycerolipids and flavonoids compared with those in the CON group. An enrichment analysis of the different metabolites showed that ART mainly affected glycerophospholipid metabolism and the pantothenate and CoA biosynthesis pathways. These findings revealed that ART supplementation could affect the milk microbiota and metabolites, that glycerophospholipids and glycerolipids could be potential biomarkers in the milk response to ART feed in dairy cows, and that ART changes substances in milk by maintaining lipid metabolism in the mammary gland.

Effect of gestational age (preterm or full term) on lipid composition of the milk fat globule and its membrane in human colostrum

Human colostrum is the first milk secreted by the mother after birth and constitutes the ideal food for the newborn, because its chemical composition, rich in immunoglobulins, antimicrobial peptides, growth factors, bioactive lipids, and other important molecules, is perfectly adapted to the metabolic, digestive, and immunological immaturity of the newborn. An incomplete gestational period can affect the maturity of the mammary gland and its ability to secrete milk with the proper composition for the newborn's condition. Previous studies indicate that the mammary gland modulates the profiles of bioactive lipids present in the different phases of lactation from colostrum to mature milk. Given the key role played by the polar lipids (PL) (phospho- and sphingolipids) of the milk fat globule membrane (MFGM) in the immune system and cognitive development of the newborn, it is crucial to analyze whether the content and distribution of the PL are affected by gestation period. Therefore, this study aimed to determine the milk fat globule (MFG) and MFGM lipid compositions of human colostrum samples from 20 healthy preterm and full-term mothers. Lipid characterization using chromatographic techniques (gas chromatograph mass spectrometry and HPLC-evaporative light-scattering detection) revealed differences related to length of gestation in the profiles of lipid classes and fatty acid and triacylglyceride contents of colostrum. This comparative analysis leads to noteworthy outcomes about the changing roles of the PL, considering the preterm or full-term condition. We found a lack of correlation of some PL (such as phosphatidylcholine, phosphatidylinositol, and phosphatidylserine) with the delivery term; these could be denoted as structural category lipids. However, sphingomyelin and phosphatidyl-ethanolamine exhibited trends to decrease in full-term colostrum, indicating that in the final stage of pregnancy specific accretion of some PL occurs, which should be denoted as a nutritional redistribution.

31P NMR-Based Phospholipid Fingerprinting of Powdered Infant Formula

Infant formula (IF), regarded as the optimal substitute for human breast milk, is very important for infant growth and development. Phospholipids (PLs) are ubiquitous components of infant formula as they have good emulsifier properties in addition to their nutritional and biological functions. In this study, the PL contents in four different commercial IF brands (indicated as A, M, O, and W) were characterized and quantified using optimized ³¹P NMR spectroscopy. PLs (nine) were identified and quantified, and among these, phosphatidylethanolamine and sphingomyelin occurred at lower concentrations (5.72 and 8.89 mg/100 g, respectively) in IFs from brand O, whereas phosphatidic acid was higher (2.83 mg/100 g) in IFs from brand W. In summary, ³¹P NMR spectroscopy, combined with the multivariate data analysis, proved to be an effective analytical toolbox for evaluating the PL contents in IF and the comparative differences between IF brands.

A new dilution-enrichment sample preparation strategy for expanded metabolome monitoring of human breast milk that overcomes the simultaneous presence of low- and high-abundance lipid species

The complex nature of human breast milk (HBM) makes samples difficult to analyze, requiring several extraction techniques and analytical platforms to obtain high metabolome coverage. In this work, we combined liquid-liquid extraction (LLE) and solid-phase extraction (SPE) techniques to prepare HBM samples to overcome the challenge of low- and high-abundance lipid species, enabling the semiquantitative analysis of total HBM lipids in one liquid chromatography-mass spectrometry (LC-MS) run. A nonorganic fraction obtained during the LLE step was used to analyze small polar metabolites. This analytical approach allows extensive metabolome coverage, especially for low-abundance glycerophospholipids and sphingolipids. The method was applied to monitor short-term metabolome changes in HBM composition within individual mothers and the results showed variable metabolite composition patterns. Simultaneous detection of high-abundance glycerolipids and low-abundance but not less significant phospholipids in one LC-MS run saves time, decreases cost, and enables comprehensive insight into the dynamics of HBM composition.

Quantification of Human Milk Phospholipids: the Effect of Gestational and Lactational Age on Phospholipid Composition

Human milk (HM) provides infants with macro- and micronutrients needed for growth and development. Milk phospholipids are important sources of bioactive components, such as long-chain polyunsaturated fatty acids (LC-PUFA) and choline, crucial for neural and visual development. Milk from mothers who have delivered prematurely (<37 weeks) might not meet the nutritional requirements for optimal development and growth. Using liquid chromatography tandem-mass spectrometry, 31 phospholipid (PL) species were quantified for colostrum (<5 days postpartum), transitional (≥5 days and ≤2 weeks) and mature milk (>2 weeks and ≤15 weeks) samples from mothers who had delivered preterm (n = 57) and term infants (n = 22), respectively. Both gestational age and age postpartum affected the PL composition of HM. Significantly higher concentrations (p < 0.05) of phosphatidylcholine (PC), sphingomyelin (SM) and total PL were found in preterm milk throughout lactation, as well as significantly higher concentrations (p < 0.002) of several phosphatidylethanolamine (PE), PC and SM species. Multivariate analysis revealed that PLs containing LC-PUFA contributed highly to the differences in the PL composition of preterm and term colostrum. Differences related to gestation decreased as the milk matured. Thus, gestational age may impact the PL content of colostrum, however this effect of gestation might subside in mature milk.

Compositional Dynamics of the Milk Fat Globule and Its Role in Infant Development

Human milk is uniquely optimized for the needs of the developing infant. Its composition is complex and dynamic, driven primarily by maternal genetics, and to a lesser extent by diet and environment. One important component that is gaining attention is the milk fat globule (MFG). The MFG is composed of a triglyceride-rich core surrounded by a tri-layer membrane, also known as the milk fat globule membrane (MFGM) that originates from mammary gland epithelia. The MFGM is enriched with glycerophospholipids, sphingolipids, cholesterol, and proteins, some of which are glycosylated, and are known to exert numerous biological roles. Mounting evidence suggests that the structure of the MFG and bioactive components of the MFGM may benefit the infant by aiding in the structural and functional maturation of the gut through the provision of essential nutrients and/or regulating various cellular events during infant growth and immune education. Further, antimicrobial peptides and surface carbohydrate moieties surrounding the MFG might have a pivotal role in shaping gut microbial populations, which in turn may promote protection against immune and inflammatory diseases early in life. This review seeks to: (1) understand the components of the MFG, as well as maternal factors including genetic and lifestyle factors that influence its characteristics; (2) examine the potential role of this milk component on the intestinal immune system; and (3) delineate the mechanistic roles of the MFG in infant intestinal maturation and establishment of the microbiota in the alimentary canal.

Phospholipids in Human Milk and Infant Formulas: Benefits and Needs for Correct Infant Nutrition

The composition of human milk has served as a basis for the development of infant formulas, which are used when breastfeeding is not possible. Among the human milk nutrients, 50% of the total energetic value corresponds to fat, with a high level of fatty acids and 0.2-2.0% present in the form of phospholipids (PLs). The PL contents and fatty acid distribution in PL species have been investigated as bioactive elements for the production of infant formulas, since they offer potential benefits for the optimum growth and health of the newborn infant. The differences in the amount of PLs and in fatty acid distribution in PL species between human milk and infant formulas can imply biologically significant differences for newborn infants fed with infant formulas versus human milk-mainly due to the greater proportion of sphingomyelin with respect to phosphatidylcholine in infant formulas. The limited information referred to the characterization of fatty acid distribution in PL species in infant formulas or in ingredients used to enrich them merits further research in order to obtain products with benefits similar to those of human milk in terms of infant growth, visual acuity, and neurological development. The present review establishes the scientific basis for helping to adjust formulations to the requirements of infant nutrition.

The human gut microbiota and undernutrition

Childhood malnutrition is a global health problem that cannot be attributed to food insecurity alone. The gut microbiota may contribute to this devastating health disorder. In this Perspective, we call for the application of tools and concepts emerging from studies of the human gut microbiota to better understand the nutritional needs of infants and children and the role of the microbiota in the pathogenesis and treatment of undernutrition. This effort will require elucidation of the interrelationships between breast milk composition and the development of the microbiota and immune system in the context of the maternal-infant dyad.

Differences in preterm and term milk fatty acid compositions may be caused by the different hormonal milieu of early parturition

INTRODUCTION

The hormonal milieus of pregnancy and lactation are driving forces of nutrient fluxes supporting infant growth and development. The decrease of insulin sensitivity with compensatory hyperinsulinemia with advancing gestation, causes adipose tissue lipolysis and hepatic de novo lipogenesis (DNL).

SUBJECTS AND METHODS

We compared fatty acid (FA) contents and FA-indices for enzyme activities between preterm (28-36 weeks) and term (37-42) milks, and between colostrum (2-5 days), transitional (6-15) and mature (16-56) milks. We interpreted FA differences between preterm and term milks, and their changes with lactation, in terms of the well known decrease of insulin sensitivity during gestation and its subsequent postpartum restoration, respectively.

RESULTS

Compared with term colostrum, preterm colostrum contained higher indices of DNL in the breast (DNL-breast) and medium chain saturated-FA (MCSAFA), and lower DNL-liver and monounsaturated-FA (MUFA). Preterm milk also had higher docosahexaenoic acid (DHA) in colostrum and transitional milk and higher arachidonic acid (AA) in mature milk. Most preterm-term differences vanished with advancing lactation. In both preterm and term milks, DNL-breast and MCSAFA increased with advancing lactation, while DNL-liver, MUFA, long chain SAFA and AA decreased. DHA decreased in term milk. MUFA was inversely related to MCSAFA in all samples, correlated inversely with PUFA in colostrum and transitional milks, but positively in mature milk. MCSAFA correlated inversely with PUFA in mature milk.

CONCLUSION

Higher maternal insulin sensitivity at preterm birth may be the cause of lower MUFA (a proxy for DNL-liver) and higher MCSAFA (a proxy for DNL-breast) in preterm colostrum, compared with term colostrum. Restoring insulin sensitivity after delivery may be an important driving force for milk FA-changes in early lactation.

Blood lysophosphatidylcholine (LPC) levels and characteristic molecular species in neonates: prolonged low blood LPC levels in very low birth weight infants

Lysophosphatidylcholine (LPC) has various stimulatory effects on many types of immune cells. The purpose of our study was to characterize blood LPC levels and to determine the composition of LPC molecular species (LPCs) in the neonatal period. Thirty-six neonates were enrolled in this study and then grouped according to birth-weight as follows: non-very low birth weight (NVLBW); >or=1,500 g (n=17), and very low birth weight (VLBW); <1,500 g (n=19). Sixteen healthy normal adults were used as controls. Levels of total blood LPC and LPCs (16:0-, 18:0-, 18:1-, 18:2-, and 20:4-LPC species) were measured using HPLC coupled with tandem mass spectrometry. Total blood LPC levels at birth in neonates in both groups (NVLBW and VLBW) were significantly lower than those of adult levels. In NVLBW infants, LPC levels reached adult levels at postnatal day 3 compared with VLBW infants, who attained adult levels after postnatal day 57 (around full-term). The composition of the LPCs was different not only between neonates and adults, but between NVLBW and VLBW infants. These findings may be associated with the difference of immunity among adults, NVLBW, and VLBW infants.