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Davis A, Perrin MT. Impact of Holder Pasteurization and Preanalytical Handling Techniques on Fat Concentration in Donor Human Milk: A Scoping Review. Adv Nutr 2024; 15:100229. [PMID: 38908896 DOI: 10.1016/j.advnut.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Donor human milk (DHM) is an essential source of nutrition among high-risk infants (e.g., premature and low-birth weight). Holder pasteurization, a common step in DHM processing, is known to partially alter the composition of DHM; however, the impact on fat composition is historically inconsistent. OBJECTIVES This scoping review aimed to broadly review the literature on the impact of Holder pasteurization on the fat content in DHM, with a focus on preanalytical sample mixing. METHODS A systematic search of original, peer-reviewed research articles was conducted on 11 July, 2022. Articles were included if they compared matched raw (control) and Holder-pasteurized human milk samples and measured total lipids, cholesterol, and individual classes of fatty acids. Article review and selection was conducted by 2 independent reviewers. RESULTS The search yielded 26 original, peer-reviewed research articles published between 1978 and 2022. Overall methodology varied considerably between studies. When study methods described any mixing for collecting raw milk, 1 (17%) of the 6 of studies reported a small change in total fat concentration following pasteurization (<5%). Alternatively, among studies that did not describe methods for mixing raw milk to ensure a representative sample, 10 (56%) of the 18 reported a significant change (≥± 5%) in total fat concentration, with changes ranging from -28.6% to +19.4%. CONCLUSIONS This review suggests that inconsistent findings regarding the impact of Holder pasteurization on fat may be related to study methodologies, particularly preanalytical sample mixing. More research considering the role of preanalytical handling procedures and methodologies is necessary to help clarify the impact of Holder pasteurization on human milk composition.
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Affiliation(s)
- Autumn Davis
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Maryanne T Perrin
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, United States.
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2
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Sidirokastritis ND, Vareltzis P. Matrix effect on the Effectiveness of High Hydrostatic Pressure Treatment on Antibiotic Residues. J Food Prot 2024; 87:100278. [PMID: 38631420 DOI: 10.1016/j.jfp.2024.100278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
The use of antibiotics in agriculture and livestock poses health risks to consumers. Treatments such as High Hydrostatic Pressure (HHP) have been shown to reduce antibiotic and pesticide residues in food. This study aims to investigate the matrix effect on the effectiveness of HHP on hydrochloride tetracycline (HTC) and sulfathiazole (STZ) residues in spiked food matrices. The effect of viscosity, as well as carbohydrate, protein, and fat content on the effectiveness of HHP on antibiotic residues, was investigated. The studied matrices were full-fat and fat-free bovine milk and model food systems consisting of aqueous solutions of sugars, aqueous solutions of proteins, and oil in water emulsions. Model food systems were also used to study the viscosity effect. These systems consisted of aqueous solutions of honey, aqueous solutions of apple puree, and aqueous solutions of glycerol. The HHP processing (580 MPa, 6 min, 25 °C) took place under industrial conditions. For both antibiotics, the concentration of sugars and proteins was found to affect the effectiveness of treatment. The concentration of oils affected treatment efficacy only for HTC. Reduction of antibiotics by HHP was also affected by the type of carbohydrate and the viscosity. In conclusion, the composition and the viscosity of the food matrix exert a variable effect on the studied antibiotic residues reduction by HHP indicating different underlying mechanisms of the interactions between food constituents and antibiotics under the same process conditions.
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Affiliation(s)
- Nikolaos D Sidirokastritis
- Laboratory of Food Industries and Agricultural Industries Technology, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Patroklos Vareltzis
- Laboratory of Food Industries and Agricultural Industries Technology, Chemical Engineering Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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3
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Unger SL, O'Connor DL. Review of current best practices for human milk banking. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 4:e13657. [PMID: 38752309 PMCID: PMC11184574 DOI: 10.1111/mcn.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/19/2024]
Abstract
Mother's/parent milk is the optimal way to feed infants and when unavailable, supplemental donor human milk is preferred. A safe supply of donor human milk should be available for all low birthweight infants for whom it has been shown to reduce morbidity. Human milk banking has been in existence for more than a century, although largely shut down during the 1980s, primarily due to fears of human immunodeficiency virus transmission. With renewed security in milk banking, has come an exponential growth in human donor milk use. Guidelines for milk banking have been published in many countries including Australia, France, India, Italy, Spain, Switzerland, the United Kingdom and the nonprofit organization PATH. The European Milk Bank Association and the Human Milk Banking Association of North America have also published recommendations for milk banks throughout Europe and North America, respectively. Although there is variability among these guidelines, there is general consensus on quality control measures required to provide a supply of safe donor milk. These measures include effective donor screening, safe collection, transport and storage of milk, standardized pasteurization and bacteriological testing. Operational considerations are also critical, such as appropriate training for staff, equipment maintenance and cleaning, protocol and record keeping and inspection and accreditation. Clearly delineating these key quality control measures provides an excellent foundation for establishing international guidelines. Acceptable modifications must be established for low- and middle-income countries that do not have sufficient resources; overly burdensome guidelines may make establishing a milk bank unnecessarily prohibitive. This review presents a summary of current best practices for human milk banking.
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Affiliation(s)
- Sharon L. Unger
- Department of PediatricsSinai HealthTorontoOntarioCanada
- Department of Nutritional SciencesUniversity of TorontoTorontoOntarioCanada
- Rogers Hixon Ontario Human Milk BankTorontoOntarioCanada
- Division of NeonatologyIWK HospitalHalifaxNova ScotiaCanada
| | - Deborah L. O'Connor
- Department of PediatricsSinai HealthTorontoOntarioCanada
- Department of Nutritional SciencesUniversity of TorontoTorontoOntarioCanada
- Rogers Hixon Ontario Human Milk BankTorontoOntarioCanada
- Translational MedicineThe Hospital for Sick ChildrenTorontoOntarioCanada
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4
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Liang N, Mohamed H, Pung RF, Waite-Cusic J, Dallas DC. Optimized Ultraviolet-C Processing Inactivates Pathogenic and Spoilage-Associated Bacteria while Preserving Bioactive Proteins, Vitamins, and Lipids in Human Milk. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:12198-12208. [PMID: 38752986 DOI: 10.1021/acs.jafc.4c02120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Holder pasteurization (HoP) enhances donor human milk microbiological safety but damages many bioactive milk proteins. Though ultraviolet-C irradiation (UV-C) can enhance safety while better preserving some milk proteins, it has not been optimized for dose or effect on a larger array of bioactive proteins. We determined the minimal UV-C parameters that provide >5-log reductions of relevant bacteria in human milk and how these treatments affect an array of bioactive proteins, vitamin E, and lipid oxidation. Treatment at 6000 and 12 000 J/L of UV-C resulted in >5-log reductions of all vegetative bacteria and bacterial spores, respectively. Both dosages improved retention of immunoglobulin A (IgA), IgG, IgM, lactoferrin, cathepsin D, and elastase and activities of bile-salt-stimulated lipase and lysozyme compared with HoP. These UV-C doses caused minor reductions in α-tocopherol but not γ-tocopherol and no increases in lipid oxidation products. UV-C treatment is a promising approach for donor human milk processing.
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Affiliation(s)
- Ningjian Liang
- Nutrition Program, College of Health, Oregon State University, Corvallis, Oregon 97331, United States
| | - Hussein Mohamed
- Department of Food Science and Technology, Oregon State University, Corvallis, Oregon 97331, United States
| | - Rachel F Pung
- Department of Biochemistry and Biophysics, Oregon State University, Corvallis, Oregon 97331, United States
| | - Joy Waite-Cusic
- Department of Food Science and Technology, Oregon State University, Corvallis, Oregon 97331, United States
| | - David C Dallas
- Nutrition Program, College of Health, Oregon State University, Corvallis, Oregon 97331, United States
- Department of Food Science and Technology, Oregon State University, Corvallis, Oregon 97331, United States
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5
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Mazur K, Kusznierewicz B, Martysiak-Żurowska D, Drążkowska I, Malinowska-Pańczyk E. The Effect of Hyperbaric Storage on the Nutritional Value and Retention of Certain Bioactive Proteins in Human Milk. Nutrients 2024; 16:1455. [PMID: 38794693 PMCID: PMC11124269 DOI: 10.3390/nu16101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Human milk (HM) contains the essential macronutrients and bioactive compounds necessary for the normal growth and development of newborns. The milk collected by human milk banks is stored frozen and pasteurized, reducing its nutritional and biological value. The purpose of this study was to determine the effect of hyperbaric storage at subzero temperatures (HS-ST) on the macronutrients and bioactive proteins in HM. As control samples, HM was stored at the same temperatures under 0.1 MPa. A Miris HM analyzer was used to determine the macronutrients and the energy value. The lactoferrin (LF), lysozyme (LYZ) and α-lactalbumin (α-LAC) content was checked using high-performance liquid chromatography, and an ELISA test was used to quantify secretory immunoglobulin A (sIgA). The results showed that the macronutrient content did not change significantly after 90 days of storage at 60 MPa/-5 °C, 78 MPa/-7 °C, 111 MPa/-10 °C or 130 MPa/-12 °C. Retention higher than 90% of LYZ, α-LAC, LF and sIgA was observed in the HM stored at conditions of up to 111 MPa/-10 °C. However, at 130 MPa/-12 °C, there was a reduction in LYZ and LF, by 39 and 89%, respectively. The storage of HM at subzero temperatures at 0.1 MPa did not affect the content of carbohydrates or crude and true protein. For fat and the energy value, significant decreases were observed at -5 °C after 90 days of storage.
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Affiliation(s)
- Katarzyna Mazur
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Barbara Kusznierewicz
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Dorota Martysiak-Żurowska
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
| | - Izabela Drążkowska
- Division of Neonatology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Edyta Malinowska-Pańczyk
- Department of Food Chemistry, Technology and Biotechnology, Chemical Faculty, Gdansk University of Technology, G. Narutowicza 11/12 Str., 80-233 Gdańsk, Poland; (K.M.); (B.K.); (D.M.-Ż.)
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Núñez-Delgado A, Mizrachi-Chávez VM, Welti-Chanes J, Macher-Quintana ST, Chuck-Hernández C. Breast milk preservation: thermal and non-thermal processes and their effect on microorganism inactivation and the content of bioactive and nutritional compounds. Front Nutr 2024; 10:1325863. [PMID: 38455872 PMCID: PMC10919153 DOI: 10.3389/fnut.2023.1325863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/26/2023] [Indexed: 03/09/2024] Open
Abstract
Human Breast Milk (HBM) is widely acknowledged as the best nutritional source for neonates. Data indicates that, in 2019, 83.2% of infants in the United States received breast milk at birth, slightly reducing to 78.6% at 1 month. Despite these encouraging early figures, exclusive breastfeeding rates sharply declined, dropping to 24.9% by 6 months. This decline is particularly pronounced when direct breastfeeding is challenging, such as in Neonatal Intensive Care Units (NICU) and for working mothers. Given this, it is vital to explore alternative breast milk preservation methods. Technologies like Holder Pasteurization (HoP), High-Temperature Short-Time Pasteurization (HTST), High-Pressure Processing (HPP), UV radiation (UV), and Electric Pulses (PEF) have been introduced to conserve HBM. This review aims to enhance the understanding of preservation techniques for HBM, supporting the practice of extended exclusive breastfeeding. It explicitly addresses microbial concerns, focusing on critical pathogens like Staphylococcus aureus, Enterococcus, Escherichia coli, Listeria monocytogenes, and Cytomegalovirus, and explores how various preservation methods can mitigate these risks. Additionally, the review highlights the importance of retaining the functional elements of HBM, particularly its immunological components such as antibodies and enzymes like lysozyme and Bile Salt Stimulated Lipase (BSSL). The goal is to provide a comprehensive overview of the current state of HBM treatment, critically assess existing practices, identify areas needing improvement, and advocate for extended exclusive breastfeeding due to its vital role in ensuring optimal nutrition and overall health in infants.
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Affiliation(s)
- Alejandro Núñez-Delgado
- Tecnologico, de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey, Mexico
| | | | - Jorge Welti-Chanes
- Tecnologico, de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
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7
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Tran LC, Marousez L, Micours E, De Lamballerie M, Thys L, Gottrand F, Ley D, Lesage J, Titécat M. High hydrostatic pressure is similar to Holder pasteurization in preserving donor milk antimicrobial activity. Pediatr Res 2024:10.1038/s41390-024-03022-9. [PMID: 38280953 DOI: 10.1038/s41390-024-03022-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND The microbiological safety of donor milk (DM) is commonly ensured by Holder pasteurization (HoP, 62.5 °C for 30 min) in human milk banks despite its detrimental effects on bioactive factors. We compared the antimicrobial properties of DM after Holder pasteurization treatment or High Hydrostatic Pressure processing (HHP, 350 MPa at 38 °C), a non-thermal substitute for DM sterilization. METHODS We assessed lactoferrin and lysozyme concentrations in raw, HHP- and HoP-treated pools of DM (n = 8). The impact of both treatments was evaluated on the growth of Escherichia coli and Group B Streptococcus in comparison with control media (n = 4). We also addressed the effect of storage of HHP treated DM over a 6-month period (n = 15). RESULTS HHP milk demonstrated similar concentrations of lactoferrin compared with raw milk, while it was significantly decreased by HoP. Lysozyme concentrations remained stable regardless of the condition. Although a bacteriostatic effect was observed against Escherichia coli at early timepoints, a sharp bactericidal effect was observed against Group B Streptococcus. Unlike HoP, these results were significant for HHP compared to controls. Stored DM was well and safely preserved by HHP. CONCLUSION Our study demonstrates that this alternative sterilization method shows promise for use with DM in human milk banks. IMPACT Antimicrobial activity of donor milk after High Hydrostatic Pressure treatment has not been clearly evaluated. Donor milk lactoferrin is better preserved by High Hydrostatic Pressure than conventional Holder pasteurization, while lysozyme concentration is not affected by either treatment. As with Holder pasteurization, High Hydrostatic Pressure preserves donor milk bacteriostatic activity against E. coli in addition to bactericidal activity against Group B Streptococcus. Donor milk treated by High Hydrostatic Pressure can be stored safely for 6 months.
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Affiliation(s)
- Léa Chantal Tran
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, F-59000, Lille, France.
| | - Lucie Marousez
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Edwina Micours
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | | | - Lou Thys
- Laboratory of Bacteriology, Institute of Microbiology, CHU Lille, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, F-59000, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, F-59000, Lille, France
| | - Jean Lesage
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Marie Titécat
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Laboratory of Bacteriology, Institute of Microbiology, CHU Lille, Lille, France
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8
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Liang N, Mohamed HM, Kim BJ, Burroughs S, Lowder A, Waite-Cusic J, Dallas DC. High-Pressure Processing of Human Milk: A Balance between Microbial Inactivation and Bioactive Protein Preservation. J Nutr 2023; 153:2598-2611. [PMID: 37423385 PMCID: PMC10517232 DOI: 10.1016/j.tjnut.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Donor human milk banks use Holder pasteurization (HoP; 62.5°C, 30 min) to reduce pathogens in donor human milk, but this process damages some bioactive milk proteins. OBJECTIVES We aimed to determine minimal parameters for high-pressure processing (HPP) to achieve >5-log reductions of relevant bacteria in human milk and how these parameters affect an array of bioactive proteins. METHODS Pooled raw human milk inoculated with relevant pathogens (Enterococcus faecium, Staphylococcus aureus, Listeria monocytogenes, Cronobacter sakazakii) or microbial quality indicators (Bacillus subtilis and Paenibacillus spp. spores) at 7 log CFU/mL was processed at 300-500 MPa at 16-19°C (due to adiabatic heating) for 1-9 min. Surviving microbes were enumerated using standard plate counting methods. For raw milk, and HPP-treated and HoP-treated milk, the immunoreactivity of an array of bioactive proteins was assessed via ELISA and the activity of bile salt-stimulated lipase (BSSL) was determined via a colorimetric substrate assay. RESULTS Treatment at 500 MPa for 9 min resulted in >5-log reductions of all vegetative bacteria, but <1-log reduction in B. subtilis and Paenibacillus spores. HoP decreased immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G, lactoferrin, elastase and polymeric immunoglobulin receptor (PIGR) concentrations, and BSSL activity. The treatment at 500 MPa for 9 min preserved more IgA, IgM, elastase, lactoferrin, PIGR, and BSSL than HoP. HoP and HPP treatments up to 500 MPa for 9 min caused no losses in osteopontin, lysozyme, α-lactalbumin and vascular endothelial growth factor. CONCLUSION Compared with HoP, HPP at 500 MPa for 9 min provides >5-log reduction of tested vegetative neonatal pathogens with improved retention of IgA, IgM, lactoferrin, elastase, PIGR, and BSSL in human milk.
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Affiliation(s)
- Ningjian Liang
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Hussein Mh Mohamed
- Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States
| | - Bum Jin Kim
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Samantha Burroughs
- Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States
| | | | - Joy Waite-Cusic
- Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States
| | - David C Dallas
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States; Department of Food Science and Technology, Oregon State University, Corvallis, OR, United States.
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9
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Pitino MA, Unger S, Doyen A, Pouliot Y, Kothari A, Sergius-Ronot M, Bazinet RP, Stone D, O'Connor DL. Digestion of human milk processed by high pressure processing and Holder pasteurization using a dynamic in vitro model of the preterm infant. Food Chem 2023; 411:135477. [PMID: 36701922 DOI: 10.1016/j.foodchem.2023.135477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Holder pasteurization (HoP) (62.5 °C, 30 min) of donor human milk is widely used to inactivate potential pathogens but may lead to denaturation and aggregation of bioactive proteins, reducing their functionality. In contrast, high pressure processing (HPP) is a non-thermal technique that minimally affects assessed bioactive components; however, it is unclear how HPP affects protein digestion, and retention of functional bioactive proteins. Raw or processed (HoP; HPP[500 MPa,10 min]) pools of milk (N = 3, from 9 donors) were subjected in triplicate to in vitro digestion simulating the preterm infant gastrointestinal tract. Compared to raw or HPP, HoP increased intestinal proteolysis of lactoferrin and bioactive milk fat globule membrane proteins. Lysozyme activity was impacted by digestion following HoP (72 % to 7 %)-significantly more than HPP (75 % to 34 %) or raw (100 % to 39 %), which did not differ. Proteins in HPP-treated donor milk are digested no different than raw milk, while preserved bioactivity remains functional upon digestion.
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Affiliation(s)
- Michael A Pitino
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada; Rogers Hixon Ontario Human Milk Bank, Sinai Health System, Toronto, Ontario, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Alain Doyen
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF), Québec, Québec, Canada
| | - Yves Pouliot
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF), Québec, Québec, Canada
| | - Akash Kothari
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mélanie Sergius-Ronot
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF), Québec, Québec, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Debbie Stone
- Rogers Hixon Ontario Human Milk Bank, Sinai Health System, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada; Rogers Hixon Ontario Human Milk Bank, Sinai Health System, Toronto, Ontario, Canada.
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10
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Habinshuti I, Nsengumuremyi D, Muhoza B, Ebenezer F, Yinka Aregbe A, Antoine Ndisanze M. Recent and novel processing technologies coupled with enzymatic hydrolysis to enhance the production of antioxidant peptides from food proteins: A review. Food Chem 2023; 423:136313. [PMID: 37182498 DOI: 10.1016/j.foodchem.2023.136313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Antioxidant peptides obtained through enzymatic hydrolysis of food proteins exhibit a broad range of bioactivities both in vitro and in vivo models. The antioxidant peptides showed the potential to fight against the reactive oxygen species, free radicals and other pro-oxidative substances which are considered the source of various chronic diseases for humans. Both animals and plants have been recognized as natural protein sources and attracted much research interest over the synthetic ones in terms of safety. However, the main challenge remains to increase the antioxidant peptides yield, reduce the enzyme quantity and the reaction time. Consequently, different efficient and innovative food processing technologies such as thermal, ultrasound, microwave, high hydrostatic pressure, pulsed electric field, etc. have been developed and currently used to treat food proteins before (pretreatment) or during the enzymatic hydrolysis (assisted). Those technologies were found to significantly enhance the degree of hydrolysis and the production of substantial antioxidant peptides. These emerging technologies enhance the enzymatic hydrolysis by inducing protein denaturation/unfolding, and the enzymatic activation without altering their functional and nutritional properties. This review discusses the state of the art of thermal, ultrasound, high hydrostatic pressure, microwave, and pulsed electric field techniques, their applications while coupled with enzymatic hydrolysis, their comparison and potential challenges for the production of antioxidant peptides from food proteins.
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Affiliation(s)
- Ildephonse Habinshuti
- INES-Ruhengeri, Institute of Applied Sciences, B.P. 155, Ruhengeri, Rwanda; Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya; Thought For Food Foundation, 2101 Highland Ave, Birmingham, Alabama 35205, USA.
| | | | - Bertrand Muhoza
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, China
| | - Falade Ebenezer
- Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya
| | - Afusat Yinka Aregbe
- Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya
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11
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Smilowitz JT, Allen LH, Dallas DC, McManaman J, Raiten DJ, Rozga M, Sela DA, Seppo A, Williams JE, Young BE, McGuire MK. Ecologies, synergies, and biological systems shaping human milk composition-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 2. Am J Clin Nutr 2023; 117 Suppl 1:S28-S42. [PMID: 37173059 DOI: 10.1016/j.ajcnut.2022.11.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 05/15/2023] Open
Abstract
Human milk is universally recognized as the preferred food for infants during the first 6 mo of life because it provides not only essential and conditionally essential nutrients in necessary amounts but also other biologically active components that are instrumental in protecting, communicating important information to support, and promoting optimal development and growth in infants. Despite decades of research, however, the multifaceted impacts of human milk consumption on infant health are far from understood on a biological or physiological basis. Reasons for this lack of comprehensive knowledge of human milk functions are numerous, including the fact that milk components tend to be studied in isolation, although there is reason to believe that they interact. In addition, milk composition can vary greatly within an individual as well as within and among populations. The objective of this working group within the Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project was to provide an overview of human milk composition, factors impacting its variation, and how its components may function to coordinately nourish, protect, and communicate complex information to the recipient infant. Moreover, we discuss the ways whereby milk components might interact such that the benefits of an intact milk matrix are greater than the sum of its parts. We then apply several examples to illustrate how milk is better thought of as a biological system rather than a more simplistic "mixture" of independent components to synergistically support optimal infant health.
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Affiliation(s)
- Jennifer T Smilowitz
- Department of Food Science and Technology, University of California Davis, Davis, CA, USA; Foods for Health Institute, University of California Davis, Davis, CA, USA.
| | - Lindsay H Allen
- United States Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, University of California Davis, Davis, CA, USA
| | - David C Dallas
- Nutrition Program, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - James McManaman
- Division of Reproductive Sciences, University of Colorado, Aurora, CO, USA
| | - Daniel J Raiten
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - David A Sela
- Department of Food Science, University of Massachusetts, Amherst, MA, USA; Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, USA
| | - Antti Seppo
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Janet E Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, ID, USA
| | - Bridget E Young
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA.
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12
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Sergius-Ronot M, Suwal S, Pitino MA, Shama S, Unger S, O'Connor DL, Pouliot Y, Doyen A. Development of a human milk protein concentrate from donor milk: Impact of the pasteurization method on static in vitro digestion in a preterm newborn model. Food Res Int 2023; 164:112385. [PMID: 36737969 DOI: 10.1016/j.foodres.2022.112385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/08/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022]
Abstract
The impact of high temperature short time (HTST, 72 °C, 15 s), Holder pasteurization- (63 °C, 30 min) and high hydrostatic pressure (HHP, 600 MPa-10 min) was evaluated on the digestibility of human milk protein concentrate (HMPC) by using a static in vitro gastrointestinal digestion system. The results showed that the processing steps used to produce the HMPC induced a decrease in readily available nitrogen (non-protein nitrogen and peptides). Overall, digestibility was similar between pasteurized and raw HMPC (degree of hydrolysis ranged from 26 to 34 %). Lactoferrin was more susceptible to gastric and intestinal digestion after thermal pasteurization. Additionally, the resistance of β-casein to digestion increased after HHP and Holder pasteurization due to aggregation and changes in protein structure. During intestinal digestion, Holder pasteurization induced a higher release of arginine, phenylalanine and tyrosine from HMPC compared to raw and HHP-treated HMPC. Overall, protein structural changes induced by human milk (HM) processing (freeze-thawing and filtration) and pasteurization treatments affected HMPC proteolysis during in vitro digestion. However, protein digestion behaviors were quite similar for raw and HHP-treated HMPC compared to the thermal-treated HMPC, with no effect on lactoferrin digestion. Consequently, pasteurization of HMPC by HHP represents an interesting non-thermal process that preserves the HM bioactive proteins during digestion.
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Affiliation(s)
- Mélanie Sergius-Ronot
- Departement of Food Science, Institute for Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, Quebec, Canada
| | - Shyam Suwal
- Arla Foods Amba, Agro Food Park 19, Aarhus 8200, Denmark
| | - Michael A Pitino
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Sara Shama
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Department of Neonatology, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada; Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada; Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada
| | - Yves Pouliot
- Departement of Food Science, Institute for Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, Quebec, Canada
| | - Alain Doyen
- Departement of Food Science, Institute for Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, Quebec, Canada.
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13
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Pitino MA, Beggs MR, O'Connor DL, Doyen A, Pouliot Y, Sergius-Ronot M, Unger S. Donor human milk processing and its impact on infant digestion: A systematic scoping review of in vitro and in vivo studies. Adv Nutr 2023; 14:173-189. [PMID: 36811588 PMCID: PMC10102984 DOI: 10.1016/j.advnut.2022.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/02/2022] [Accepted: 11/23/2022] [Indexed: 12/27/2022] Open
Abstract
When there is an inadequate supply of mother's milk, pasteurized donor human milk is preferred over formula to supplement feeds for preterm infants. Although providing donor milk helps to improve feeding tolerance and reduce necrotizing enterocolitis, changes to its composition and reductions in bioactivity during processing, are thought to contribute to the slower growth often exhibited by these infants. To improve the clinical outcomes of recipient infants by maximizing the quality of donor milk, research is currently investigating strategies to optimize all aspects of processing, including pooling, pasteurization, and freezing; however, reviews of this literature typically only summarize the impact of a processing technique on composition or bioactivity. Reviews of published research investigating the impact of donor milk processing on infant digestion/absorption are lacking and thus, was the objective for this systematic scoping review, Open Science Framework (https://doi.org/10.17605/OSF.IO/PJTMW). Databases were searched for primary research studies evaluating donor milk processing for pathogen inactivation or other rationale and subsequent effect on infant digestion/absorption. Non-human milk studies or those assessing other outcomes were excluded. Overall, 24 articles from 12,985 records screened were included. Most studied thermal methods to inactivate pathogens, predominantly Holder pasteurization (HoP) (62.5°C, 30 min) and high-temperature short-time. Heating consistently decreased lipolysis and increased proteolysis of lactoferrin and caseins; however, protein hydrolysis was unaffected from in vitro studies. The abundance and diversity of released peptides remain unclear and should be further explored. Greater investigation into less-harsh methods for pasteurization, such as high-pressure processing, is warranted. Only 1 study assessed the impact of this technique and found minimal impact on digestion outcomes compared with HoP. Fat homogenization appeared to positively impact fat digestion (n = 3 studies), and only 1 eligible study investigated freeze-thawing. Identified knowledge gaps regarding optimal methods of processing should be further explored to improve the quality and nutrition of donor milk.
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Affiliation(s)
- Michael A Pitino
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Megan R Beggs
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada; Rogers Hixon Ontario Human Milk Bank, Sinai Health System, Toronto, Ontario, Canada
| | - Alain Doyen
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF) Québec, Québec, Canada
| | - Yves Pouliot
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF) Québec, Québec, Canada
| | - Mélanie Sergius-Ronot
- Université Laval, Département des Sciences des Aliments, Institut sur la nutrition et les aliments fonctionnels (INAF) Québec, Québec, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada; Rogers Hixon Ontario Human Milk Bank, Sinai Health System, Toronto, Ontario, Canada; Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada.
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14
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Carmona AS, Kakkar F, Gantt S. Perinatal Cytomegalovirus Infection. CURRENT TREATMENT OPTIONS IN PEDIATRICS 2022; 8:395-411. [PMID: 36465883 PMCID: PMC9684878 DOI: 10.1007/s40746-022-00261-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE OF REVIEW There have been recent advances in the field of congenital CMV infection (cCMV) related to antiviral treatment of pregnant women and infants, the implementation of newborn CMV screening programs, and the frequency and diagnosis of complications among infected children. In addition, postnatal CMV infection (pCMV) is increasingly recognized as a potential cause of long-term sequelae in addition to acute complications among preterm infants, raising important questions related to treatment, and prevention. RECENT FINDINGS High-dose valacyclovir appears to be safe and effective for the prevention of cCMV among women with first-trimester primary CMV infection. New studies reveal high rates of vestibular dysfunction and neuropsychiatric manifestations among children with cCMV. Some studies report associations between pCMV and long-term consequences, including neurodevelopmental delay and bronchopulmonary dysplasia, among very low birth weight infants, in addition to high risk of sepsis and death acutely, which has motivated efforts to eliminate the virus from breast milk by different methods. SUMMARY More long-term complications of cCMV are increasingly recognized among children previously thought to be asymptomatic. Although a preventive CMV vaccine may be achievable, strategies to reduce the burden of cCMV disease include maternal education about risk-reduction behaviors, antiviral treatment of pregnant women with primary infection, and newborn screening to allow timely, appropriate care. Similarly, although it remains unclear if pCMV causes long-term problems, there is growing interest in identifying and preventing disease from CMV infections among preterm infants.
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Affiliation(s)
- Alejandra Sandoval Carmona
- Department of Pediatrics, 3175 Ch. de La Côte-Sainte-Catherine, Université de Montréal, Montréal, Canada
| | - Fatima Kakkar
- Department of Pediatrics, 3175 Ch. de La Côte-Sainte-Catherine, Université de Montréal, Montréal, Canada
- Centre de Recherche du CHU Sainte-Justine, 3175 Ch. de La Côte-Sainte-Catherine, Montréal, Canada
| | - Soren Gantt
- Department of Pediatrics, 3175 Ch. de La Côte-Sainte-Catherine, Université de Montréal, Montréal, Canada
- Centre de Recherche du CHU Sainte-Justine, 3175 Ch. de La Côte-Sainte-Catherine, Montréal, Canada
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15
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Gharbi N, Marciniak A, Perreault V, Stone D, Fittipaldi N, Unger S, O'Connor DL, Pouliot Y, Doyen A. The effect of pasteurization treatment and skimming conditions on human milk proteins. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.114184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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16
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Gomez J, Wardell D. Nurse-Driven Interventions for Improving ELBW Neurodevelopmental Outcomes. J Perinat Neonatal Nurs 2022; 36:362-370. [PMID: 36288443 DOI: 10.1097/jpn.0000000000000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Survival rates for extremely low-birth-weight (ELBW) infants are improving as neurodevelopmental impairment (NDI) rates stay stable, thereby increasing the overall number of infants with NDI. Although there are many determinants of NDI in this population, nutritional factors are of interest because they are readily modifiable in the clinical setting. Nurses can influence nutritional factors such as improving access to human milk feeding, using growth monitoring, establishing feeding policies, implementing oral care with colostrum, facilitating kangaroo care, and providing lactation education for the mother. All of these measures assist in leading to a decrease in NDI rates among ELBW infants.
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Affiliation(s)
- Jessica Gomez
- Section of Neonatology, Department of Pediatrics, The University of Texas Health Science Center at Houston, Houston (Ms Gomez); and Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston (Dr Wardell)
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17
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Comparison of the Effects of High Hydrostatic Pressure and Pasteurization on Quality of Milk during Storage. Foods 2022; 11:foods11182837. [PMID: 36140965 PMCID: PMC9498420 DOI: 10.3390/foods11182837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
High hydrostatic pressure (HHP, 600 MPa/15 min), pasteurization (72 °C/15 s) and pasteurization-HHP (72 °C/15 s + 600 MPa/15 min) processing of milk were comparatively evaluated by examining their effects on microorganisms and quality during 30 days of storage at 4 °C. The counts of total aerobic bacteria in HHP-treated milk were less than 2.22 lgCFU/mL during storage, while they exceeded 5.00 lgCFU/mL in other treated milk. Although HHP changed the color, it had more advantages in maintaining the nutrient (fat, calcium and β-lactoglobulin) properties of milk during storage. Moreover, the viscosity and particle size of HHP-treated milk were more similar to the untreated milk during storage. However, consumer habits towards heat-treated milk have led to poor acceptance of HHP-treated milk, resulting in a low sensory score. In sum, compared with pasteurization- and pasteurization-HHP-treated milk, HHP-treated milk showed longer shelf life and better nutritional quality, but lower sensory acceptance.
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18
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Liu Y, Hettinga K, Liu D, Zhang L, Zhou P. Current progress of emerging technologies in human and animals' milk processing: Retention of immune-active components and microbial safety. Compr Rev Food Sci Food Saf 2022; 21:4327-4353. [PMID: 36036722 DOI: 10.1111/1541-4337.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
Human milk and commercial dairy products play a vital role in humans, as they can provide almost all essential nutrients and immune-active components for the development of children. However, how to retain more native immune-active components of milk during processing remains a big question for the dairy industry. Nonthermal technologies for milk processing are gaining increasing interest in both academic and industrial fields, as it is known that thermal processing may negatively affect the quality of milk products. Thermosensitive components, such as lactoferrin, immunoglobulins (Igs), growth factors, and hormones, are highly important for the healthy development of newborns. In addition to product quality, thermal processing also causes environmental problems, such as high energy consumption and greenhouse gas (GHG) emissions. This review summarizes the recent advances of UV-C, ultrasonication (US), high-pressure processing (HPP), and other emerging technologies for milk processing from the perspective of immune-active components retention and microbial safety, focusing on human, bovine, goat, camel, sheep, and donkey milk. Also, the detailed application, including the instrumental design, technical parameters, and obtained results, are discussed. Finally, future prospects and current limitations of nonthermal techniques as applied in milk processing are discussed. This review thereby describes the current state-of-the-art in nonthermal milk processing techniques and will inspire the development of such techniques for in-practice applications in milk processing.
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Affiliation(s)
- Yaowei Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Kasper Hettinga
- Dairy Science and Technology, Food Quality and Design Group, Wageningen, University and Research, Wageningen, The Netherlands
| | - Dasong Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Lina Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Peng Zhou
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu Province, China
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19
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Kothari A, Pitino MA, Unger S, Perreault V, Doyen A, Pouliot Y, McGeer AJ, Stone D, O’Connor DL. Preservation of Anti-cytomegalovirus Activity in Human Milk Following High-Pressure Processing Compared to Holder Pasteurization. Front Nutr 2022; 9:918814. [PMID: 35662924 PMCID: PMC9160983 DOI: 10.3389/fnut.2022.918814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Pasteurized donor human milk is recommended for hospitalized preterm infants when mother’s own milk is unavailable. Our aim was to compare the antiviral activity of human milk processed by Holder pasteurization (HoP) or high-pressure processing (HPP) against representative enveloped and non-enveloped viruses including cytomegalovirus and hepatitis A virus. Expressed milk from 20 donors collected from the Ontario Milk Bank was combined into 10 pools, each from two unique donors. Each pool was processed by HoP (62.5°C, 30 min) or HPP (500 MPa, 8 min, 4°C) and subsequently inoculated with cytomegalovirus or hepatitis A virus to achieve a final concentration of 5-log plaque-forming units/mL. Plaque reduction assays were used to quantify detectable virus after 30 min incubation (room temperature). Post hoc experiments using a 4 h incubation time were conducted if reductions were detected at 30 min. Irrespective of processing, cytomegalovirus concentrations declined in all pools after 30 min incubation (P < 0.0001). Milk processed by HoP exhibited significantly less reduction compared to raw milk (P = 0.0069). In post hoc experiments, anti-cytomegalovirus activity was maintained at 4 h, with high inter-pool variability. Hepatitis A virus concentration remained unchanged after 30 min incubation in raw and processed milk. Anti-cytomegalovirus activity in human milk is preserved following HoP and HPP, persisting up to 4 h post-inoculation; anti-hepatitis A virus activity was not observed in raw or processed milk. Further research is needed to understand how HoP or promising alternative processing methods affect the antiviral activity of donated milk, given its potential importance to recipient infants.
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Affiliation(s)
- Akash Kothari
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael A. Pitino
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, Sinai Health, Toronto, ON, Canada
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
| | - Véronique Perreault
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Alain Doyen
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Yves Pouliot
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Allison J. McGeer
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Microbiology, Sinai Health, Toronto, ON, Canada
| | - Debbie Stone
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
| | - Deborah L. O’Connor
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, Sinai Health, Toronto, ON, Canada
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
- *Correspondence: Deborah L. O’Connor,
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20
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Sergius-Ronot M, Pitino MA, Suwal S, Shama S, Unger S, O'Connor DL, Pouliot Y, Doyen A. Impact of holder, high temperature short time and high hydrostatic pressure pasteurization methods on protein structure and aggregation in a human milk protein concentrate. Food Chem 2022; 374:131808. [PMID: 35021581 DOI: 10.1016/j.foodchem.2021.131808] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 11/19/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022]
Abstract
This work evaluated the impact of high temperature short time (HTST, 72 °C, 15 s), high hydrostatic pressure (HHP, 400-600 MPa at 5 and 10 min) and Holder pasteurization (HoP, 62.5 °C, 30 min) on protein profile and aggregation in a human milk protein concentrate (HMPC). The structural changes induced in milk proteins were investigated in HMPC as well as in sedimentable and non-sedimentable fractions recovered after ultracentrifugation. The results showed that heat treatments induced more protein denaturation and aggregation than did HHP treatments. Indeed, heat-induced protein aggregates observed in HMPC and the sedimentable fraction were mainly composed of lactoferrin and α-lactalbumin. More specifically, the concentration of lactoferrin in HMPC decreased by 86% after HTST and HoP whereas no effect was observed after HHP treatment. These results show the potential of HHP processing as a pasteurization method for HMPC since it minimizes the impact on protein structure, which generally correlates to protein quality and bioactivity.
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Affiliation(s)
- Mélanie Sergius-Ronot
- Departement of Food Science, Institute of Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, QC, Canada
| | - Michael A Pitino
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Shyam Suwal
- Arla Foods Amba, Agro Food Park 19, Aarhus 8200, Denmark
| | - Sara Shama
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Department of Pediatrics, University of Toronto, Toronto, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada; Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada; Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada; Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Canada
| | - Yves Pouliot
- Departement of Food Science, Institute of Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, QC, Canada
| | - Alain Doyen
- Departement of Food Science, Institute of Nutrition and Functional Foods (INAF) and Dairy Research Centre (STELA), Laval University, QC, Canada.
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21
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de Weerth C, Aatsinki AK, Azad MB, Bartol FF, Bode L, Collado MC, Dettmer AM, Field CJ, Guilfoyle M, Hinde K, Korosi A, Lustermans H, Mohd Shukri NH, Moore SE, Pundir S, Rodriguez JM, Slupsky CM, Turner S, van Goudoever JB, Ziomkiewicz A, Beijers R. Human milk: From complex tailored nutrition to bioactive impact on child cognition and behavior. Crit Rev Food Sci Nutr 2022; 63:7945-7982. [PMID: 35352583 DOI: 10.1080/10408398.2022.2053058] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions.
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Affiliation(s)
- Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, EN Nijmegen, The Netherlands
| | - Anna-Katariina Aatsinki
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Meghan B Azad
- Department of Pediatrics and Child Health, Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Frank F Bartol
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Lars Bode
- Department of Pediatrics and Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California San Diego, La Jolla, California, USA
| | - Maria Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna, Valencia, Spain
| | - Amanda M Dettmer
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, College of Basic and Applied Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Meagan Guilfoyle
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
| | - Katie Hinde
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, Center for Neuroscience, Brain Plasticity group, University of Amsterdam, Amsterdam, The Netherlands
| | - Hellen Lustermans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, EN Nijmegen, The Netherlands
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, St Thomas' Hospital, London, UK
- School of Hygiene and Tropical Medicine, Nutrition Theme, MRC Unit The Gambia and the London, Fajara, The GambiaBanjul
| | - Shikha Pundir
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Juan Miguel Rodriguez
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| | - Carolyn M Slupsky
- Department of Nutrition and Department of Food Science and Technology, University of California, Davis, California, USA
| | - Sarah Turner
- Department of Community Health Sciences, Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Johannes B van Goudoever
- Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Anna Ziomkiewicz
- Department of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Roseriet Beijers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, EN Nijmegen, The Netherlands
- Department of Social Development, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Zhang J, Lee NA, Duley JA, Cowley DM, Shaw PN, Bansal N. Comparing the effects of hydrostatic high-pressure processing vs holder pasteurisation on the microbial, biochemical and digestion properties of donor human milk. Food Chem 2022; 373:131545. [PMID: 34839967 DOI: 10.1016/j.foodchem.2021.131545] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 01/08/2023]
Abstract
In this study, hydrostatic high-pressure processing (HHP), a non-thermal pasteurisation method, was used to achieve the microbiological safety of donor human milk. After HHP, no bacteria were detected in human milk processed at 400 MPa for 5 min. Activities of a selection of bioactive components, including lysozyme, xanthine oxidase, lactoperoxidase, immunoglobulin A, lactoferrin, lipoprotein lipase and bile salt-stimulated lipase, did not decrease significantly. This study further investigated the gastrointestinal digestion kinetics of HoP and HHP milk compared with raw human milk, using an in vitro static infant digestion model. After 60 min of 'gastric digestion', the microstructure and protein profile of HHP milk samples were more similar to raw milk samples than HoP milk samples. Overall, HPP showed a better retention in milk nutrients and closer digestion behavior than that of HoP.
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Affiliation(s)
- Jie Zhang
- School of Agriculture and Food Science, The University of Queensland, St Lucia 4072, Australia
| | - Nanju Alice Lee
- School of Chemical Engineering, University of New South Wales, Sydney NSW2052, Australia
| | - John A Duley
- School of Pharmacy, The University of Queensland, St Lucia 4072, Australia
| | - David M Cowley
- Mater Research Institute, The University of Queensland, South Brisbane 4101, Australia
| | - Paul N Shaw
- School of Pharmacy, The University of Queensland, St Lucia 4072, Australia
| | - Nidhi Bansal
- School of Agriculture and Food Science, The University of Queensland, St Lucia 4072, Australia; School of Pharmacy, The University of Queensland, St Lucia 4072, Australia.
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Pitino MA, Unger S, Gill A, McGeer AJ, Doyen A, Pouliot Y, Bazinet RP, Kothari A, Mazzulli T, Stone D, O'Connor DL. High pressure processing inactivates human cytomegalovirus and hepatitis A virus while preserving macronutrients and native lactoferrin in human milk. INNOV FOOD SCI EMERG 2022. [DOI: 10.1016/j.ifset.2021.102891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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24
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Kontopodi E, Stahl B, van Goudoever JB, Boeren S, Timmermans RAH, den Besten HMW, Van Elburg RM, Hettinga K. Effects of High-Pressure Processing, UV-C Irradiation and Thermoultrasonication on Donor Human Milk Safety and Quality. Front Pediatr 2022; 10:828448. [PMID: 35386262 PMCID: PMC8979557 DOI: 10.3389/fped.2022.828448] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
Holder pasteurization (HoP) is the current recommended treatment for donor human milk. Although this method inactivates microbial contaminants, it also negatively affects various milk components. High-pressure processing (HPP, 400, 500, and 600 MPa), ultraviolet-C irradiation (UV-C, 2,430, 3,645, and 4,863 J/L) and thermoultrasonication (TUS, 1,080 and 1,620 kJ/L) were investigated as alternatives to thermal pasteurization (HoP). We assessed the effects of these methods on microbiological safety, and on concentration and functionality of immunoglobulin A, lactoferrin, lysozyme and bile salt-stimulated lipase, with LC-MS/MS-based proteomics and activity assays. HoP, HPP, TUS, and UV-C at 4863 J/L, achieved >5-log10 microbial reduction. Native protein levels and functionality showed the highest reduction following HoP, while no significant reduction was found after less intense HPP and all UV-C treatments. Immunoglobulin A, lactoferrin, and lysozyme contents were also preserved after low intensity TUS, but bile salt-stimulated lipase activity was significantly reduced. This study demonstrated that HPP and UV-C may be considered as suitable alternatives to HoP, since they were able to ensure sufficient microbial inactivation while at the same time better preserving the bioactive components of donor human milk. In summary, our results provide valuable insights regarding the evaluation and selection of suitable processing methods for donor human milk treatment, which may replace HoP in the future.
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Affiliation(s)
- Eva Kontopodi
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Food Quality and Design Group, Wageningen University & Research, Wageningen, Netherlands
| | - Bernd Stahl
- Department of Chemical Biology & Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Danone Nutricia Research, Utrecht, Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University and Research, Wageningen, Netherlands
| | - Rian A H Timmermans
- Wageningen Food & Biobased Research, Wageningen University and Research, Wageningen, Netherlands
| | | | - Ruurd M Van Elburg
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Kasper Hettinga
- Food Quality and Design Group, Wageningen University & Research, Wageningen, Netherlands
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Tyebally Fang M, Chatzixiros E, Grummer-Strawn L, Engmann C, Israel-Ballard K, Mansen K, O'Connor DL, Unger S, Herson M, Weaver G, Biller-Andorno N. Developing global guidance on human milk banking. Bull World Health Organ 2021; 99:892-900. [PMID: 34866685 PMCID: PMC8640695 DOI: 10.2471/blt.21.286943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022] Open
Abstract
Donor human milk is recommended by the World Health Organization both for its advantageous nutritional and biological properties when mother’s own milk is not available and for its recognized support for lactation and breastfeeding when used appropriately. An increasing number of human milk banks are being established around the world, especially in low- and middle-income countries, to facilitate the collection, processing and distribution of donor human milk. In contrast to other medical products of human origin, however, there are no minimum quality, safety and ethical standards for donor human milk and no coordinating global body to inform national policies. We present the key issues impeding progress in human milk banking, including the lack of clear definitions or registries of products; issues around regulation, quality and safety; and ethical concerns about commercialization and potential exploitation of women. Recognizing that progress in human milk banking is limited by a lack of comparable evidence, we recommend further research in this field to fill the knowledge gaps and provide evidence-based guidance. We also highlight the need for optimal support for mothers to provide their own breastmilk and establish breastfeeding as soon as and wherever possible after birth.
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Affiliation(s)
- Mirriam Tyebally Fang
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
| | - Efstratios Chatzixiros
- Department of Health Product Policy and Standards, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | | | - Marisa Herson
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
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Human Milk Growth Factors and Their Role in NEC Prevention: A Narrative Review. Nutrients 2021; 13:nu13113751. [PMID: 34836007 PMCID: PMC8620589 DOI: 10.3390/nu13113751] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 12/25/2022] Open
Abstract
Growing evidence demonstrates human milk's protective effect against necrotizing enterocolitis (NEC). Human milk derives these properties from biologically active compounds that influence intestinal growth, barrier function, microvascular development, and immunological maturation. Among these protective compounds are growth factors that are secreted into milk with relatively high concentrations during the early postnatal period, when newborns are most susceptible to NEC. This paper reviews the current knowledge on human milk growth factors and their mechanisms of action relevant to NEC prevention. It will also discuss the stability of these growth factors with human milk pasteurization and their potential for use as supplements to infant formulas with the goal of preventing NEC.
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27
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Effects of pasteurization, microfiltration, and ultraviolet-c treatments on microorganisms and bioactive proteins in bovine skim milk. FOOD BIOSCI 2021. [DOI: 10.1016/j.fbio.2021.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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28
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Applications of emerging processing technologies for quality and safety enhancement of non-bovine milk and milk products. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.111845] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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High Hydrostatic Pressure Treatment Ensures the Microbiological Safety of Human Milk Including Bacillus cereus and Preservation of Bioactive Proteins Including Lipase and Immuno-Proteins: A Narrative Review. Foods 2021; 10:foods10061327. [PMID: 34207614 PMCID: PMC8230168 DOI: 10.3390/foods10061327] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 11/20/2022] Open
Abstract
Breast milk is the nutritional reference for the child and especially for the preterm infant. Breast milk is better than donated breast milk (DHM), but if breast milk is not available, DHM is distributed by the Human Milk Bank (HMB). Raw Human Milk is better than HMB milk, but it may contain dangerous germs, so it is usually milk pasteurized by a Holder treatment (62.5 °C 30 min). However, Holder does not destroy all germs, and in particular, in 7% to 14%, the spores of Bacillus cereus are found, and it also destroys the microbiota, lipase BSSL and immune proteins. Another technique, High-Temperature Short Time (HTST 72 °C, 5–15 s), has been tried, which is imperfect, does not destroy Bacillus cereus, but degrades the lipase and partially the immune proteins. Therefore, techniques that do not treat by temperature have been proposed. For more than 25 years, high hydrostatic pressure has been tried with pressures from 100 to 800 MPa. Pressures above 400 MPa can alter the immune proteins without destroying the Bacillus cereus. We propose a High Hydrostatic Pressure (HHP) with four pressure cycles ranging from 50–150 MPa to promote Bacillus cereus germination and a 350 MPa Pressure that destroys 106 Bacillus cereus and retains 80–100% of lipase, lysozyme, lactoferrin and 64% of IgAs. Other HHP techniques are being tested. We propose a literature review of these techniques.
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Comparison of the Effect of Holder Pasteurization and High-Pressure Processing on Human Milk Bacterial Load and Bioactive Factors Preservation. J Pediatr Gastroenterol Nutr 2021; 72:756-762. [PMID: 33847290 PMCID: PMC8549451 DOI: 10.1097/mpg.0000000000003065] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This project aims at comparing the impact of Holder pasteurization (HoP) and high-pressure processing (HPP) on bacterial load and retention of immunological components in human milk. METHODS Human milk samples discarded by the Public Mothers' milk bank (Montreal, Canada) for bacterial purpose were pooled (n = 6) and pasteurized either by heating in a water bath (62.5°C, 30 minutes) or by HPP treatment (425 MPa, four cycles of 6 minutes, initial milk temperature of 4°C or 37°C). Bacterial load, lysozyme activity, and levels of immunoglobulins, lactoferrin, lipase, and 26 cytokines were analyzed. Untreated milk samples from same pools served as control. RESULTS HPP treatment of milk allows a similar elimination of bacteria than HoP; bacterial counts were under the detection limit [<3 colony-forming units (CFU)/mL] in 50% of milk pools after HPP treatment, compared to 17% for HoP. With initial heating of samples to 37°C before HPP treatment, inactivation to an extent under the detection limit was reached in 67% of pools. There is no significant difference in IgA, lysozyme, and cytokines concentrations between untreated milk and all treatment methods. While no significant difference was observed in the amount of lipase (P > 0.07) and IgG (P > 0.11) between untreated milk and HPP-treated milk samples, HoP seems to be damaging for these factors (P < 0.04). IgM is well preserved in HPP-4°C samples compared to untreated milk (P = 0.07) whereas a decrease is observed for this immunoglobulin levels in HPP-37°C and HoP samples (P < 0.01). Lactoferrin activity, is well maintained in HPP-37°C milk samples in comparison to untreated milk samples (P = 0.52). A decrease in activity of this molecule is noted for samples treated with HPP at 4°C (P = 0.02) and this decrease is even more pronounced for HoP samples (P = 0.004). CONCLUSIONS HPP is a promising alternative to HoP for treatment of human milk intended to preterm babies. Our results demonstrate that HPP treatment of human milk provides safe milk with less detrimental effects on the biochemically and immunologically active milk components than HoP.
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Shama S, Unger S, Pouliot Y, Doyen A, Suwal S, Pencharz P, Pitino MA, Sergius M, Aufreiter S, Stone D, O'Connor DL. A Human Milk-Based Protein Concentrate Developed for Preterm Infants Retains Bioactive Proteins and Supports Growth of Weanling Rats. J Nutr 2021; 151:840-847. [PMID: 33693847 PMCID: PMC8030702 DOI: 10.1093/jn/nxaa383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/12/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bovine milk-based protein modulars are currently available to nutrient-enrich enteral feedings; however, they have limitations for use in very-low-birth-weight infants. OBJECTIVES Our objectives were to develop a human milk-based protein (HMP) concentrate and to conduct a preclinical assessment of the HMP concentrate in weanling rats. METHODS An HMP concentrate was produced from donor milk using pressure-driven membrane filtration processes and high hydrostatic pressure processing. Protein and lactoferrin concentrations and lysozyme activity were determined by Kjeldahl, HPLC, and turbidimetric assay, respectively. Male Sprague Dawley rats 24 d old (n = 30) were randomly assigned to 1 of 3 isocaloric AIN-93G diets for 4 wk containing 100% casein (control) or with 50% of the casein replaced with the HMP concentrate (treatment) or a bovine whey protein isolate (treatment). Body weight, food intake, fat mass, plasma amino acid profiles, and organ weights were measured. Data were analyzed using linear regression models. RESULTS Raw donor milk contained (mean ± SD) 101 ± 6 g protein/kg and 5 ± 1 g lactoferrin/kg of milk solids. Postprocessing, protein and lactoferrin concentrations were 589 ± 3 g/kg and 29 ± 10 g/kg, respectively. Lysozyme activity was initially 209 ± 4 U/kg and increased to 959 ± 39 U/kg in the HMP concentrate. There were no statistically significant differences in body weight, food intake, fat mass, or plasma amino acid profiles between rats fed diets containing the HMP concentrate and the control diet. Full cecum weights were higher in rats fed the HMP concentrate than in those fed control diets (mean difference: 5.59 g; 95% CI: 4.50, 6.68 g; P < 0.0001), likely reflecting the concentration of human milk oligosaccharides. No differences were found for other organ weights. CONCLUSIONS The HMP concentrate retained important bioactive proteins and supported normal rat growth in the preclinical assessment.
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Affiliation(s)
- Sara Shama
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
- Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Yves Pouliot
- Department of Food Sciences, Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Laval University, Quebec City, Quebec, Canada
| | - Alain Doyen
- Department of Food Sciences, Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Laval University, Quebec City, Quebec, Canada
| | - Shyam Suwal
- Department of Food Sciences, Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Laval University, Quebec City, Quebec, Canada
| | - Paul Pencharz
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Pitino
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mélanie Sergius
- Department of Food Sciences, Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Laval University, Quebec City, Quebec, Canada
| | - Susanne Aufreiter
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Debbie Stone
- Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
- Rogers Hixon Ontario Human Milk Bank, Mount Sinai Hospital, Toronto, Ontario, Canada
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Abstract
This review highlights clinical outcomes of human milk from infancy through adulthood. Human milk outcomes of both preterm and term infants, including critically ill term infants (such as infants with congenital heart disease and those requiring therapeutic hypothermia) are summarized. Several human milk diets are identified to reduce the risk of specific diseases. Emerging research of newly discovered components of human milk are also reviewed. Human milk has significant effects on the gut microbiome, somatic growth, and neurocognitive outcomes. Continued research promises to improve donor human milk and donor milk derived products to achieve better outcomes for infants who do not receive their own mother's milk. The promotion of human milk is well-founded on evidence from the previous half century.
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Affiliation(s)
- Katherine E Chetta
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Medical University of South Carolina, Shawn Jenkins Children's Hospital, 10 McClennan Banks Drive, MSC 915, Charleston, SC 29425, United States.
| | - Elizabeth V Schulz
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Uniformed Services University, United States
| | - Carol L Wagner
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Medical University of South Carolina, Shawn Jenkins Children's Hospital, 10 McClennan Banks Drive, MSC 915, Charleston, SC 29425, United States
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Lipid Composition, Digestion, and Absorption Differences among Neonatal Feeding Strategies: Potential Implications for Intestinal Inflammation in Preterm Infants. Nutrients 2021; 13:nu13020550. [PMID: 33567518 PMCID: PMC7914900 DOI: 10.3390/nu13020550] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
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.
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Escuder-Vieco D, Rodríguez JM, Espinosa-Martos I, Corzo N, Montilla A, García-Serrano A, Calvo MV, Fontecha J, Serrano J, Fernández L, Pallás-Alonso CR. High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition. Life (Basel) 2021; 11:life11020114. [PMID: 33546253 PMCID: PMC7913308 DOI: 10.3390/life11020114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 01/04/2023] Open
Abstract
Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected.
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Affiliation(s)
- Diana Escuder-Vieco
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, 28041 Madrid, Spain
- Correspondence: (D.E.-V.); or (L.F.); Tel.: +34-913-908-811 (D.E.-V.); +34-913-943-745 (L.F.)
| | - Juan M. Rodríguez
- Sección Departamental de Nutrición y Ciencia de los Alimentos (Veterinaria), Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | | | - Nieves Corzo
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), 28049 Madrid, Spain; (N.C.); (A.M.); (A.G.-S.); (M.V.C.); (J.F.)
| | - Antonia Montilla
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), 28049 Madrid, Spain; (N.C.); (A.M.); (A.G.-S.); (M.V.C.); (J.F.)
| | - Alba García-Serrano
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), 28049 Madrid, Spain; (N.C.); (A.M.); (A.G.-S.); (M.V.C.); (J.F.)
| | - M. Visitación Calvo
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), 28049 Madrid, Spain; (N.C.); (A.M.); (A.G.-S.); (M.V.C.); (J.F.)
| | - Javier Fontecha
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), 28049 Madrid, Spain; (N.C.); (A.M.); (A.G.-S.); (M.V.C.); (J.F.)
| | - José Serrano
- Departament de Medicina Experimental, Facultad de Medicina, Universitat de Lleida, 25008 Lleida, Spain;
| | - Leónides Fernández
- Sección Departamental de Farmacia Galénica y Tecnología Alimentaria (Veterinaria), Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: (D.E.-V.); or (L.F.); Tel.: +34-913-908-811 (D.E.-V.); +34-913-943-745 (L.F.)
| | - Carmen Rosa Pallás-Alonso
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, 28041 Madrid, Spain;
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Fernández-Pastor S, Castelló DS, López-Mendoza MC. Stability of the Antimicrobial Capacity of Human Milk Against Cronobacter Sakazakii During Handling. J Hum Lact 2021; 37:139-146. [PMID: 32579054 DOI: 10.1177/0890334420932574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neonatal infections with Cronobacter sakazakii have recently been associated with the consumption of expressed human milk. STUDY AIMS (1) To evaluate whether human milk has antimicrobial capacity against C. sakazakii and (2) to determine the stability of its capacity when it is subjected to various treatments. METHODS The antimicrobial capacity of human milk against C. sakazakii was evaluated using an observational, cross-sectional, comparative design. Mature human milk samples (N = 29) were subjected to different treatments. After incubation at 37°C for 72 hr, samples were compared with fresh milk on the stability of their antimicrobial capacity. Two-way analysis of variance (ANOVA) was performed. RESULTS In fresh milk, counts of C. sakazakii were reduced by 47.26% (SD = 6.74) compared to controls. In treated milk, reductions were: refrigeration at 4°C for 72 hr (M = 33.84, SD = 13.84), freezing at -20°C for 1, 2, and 3 months (M = 40.31, SD = 9.10; M = 35.96, SD = 9.39; M = 26.20, SD = 13.55, respectively), Holder pasteurization (M = 23.56, SD = 15.61), and human milk bank treatment with (M = 14.37, SD = 18.02) and without bovine fortifier (M = 3.70, SD = 23.83). There were significant differences (p < .05) between fresh and treated milk. CONCLUSIONS Human milk has antimicrobial capacity against C. sakazakii. However, its capacity is negatively influenced by common preservation and hygienization methods. Milk should be stored refrigerated for a maximum of 72 hr or frozen for a short period of time.
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Affiliation(s)
- Sandra Fernández-Pastor
- 16731 Department of Animal Production and Food Science and Technology, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
| | | | - M C López-Mendoza
- 16731 Department of Animal Production and Food Science and Technology, University CEU-Cardenal Herrera, CEU Universities, Valencia, Spain
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Castro M, Pitino MA, Bando N, Aufreiter S, Stone D, O'Connor DL, Unger S. Term Infants Fed Exclusively With Donor Milk May Require Vitamin C Supplementation. JPEN J Parenter Enteral Nutr 2021; 45:1785-1787. [PMID: 33433904 DOI: 10.1002/jpen.2073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/04/2020] [Accepted: 01/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND When there is insufficient mother's milk for preterm infants, fortified human donor milk (DM) is the preferred supplement. Recently, there is growing interest in providing DM to term infants. Aside from vitamin D, mother's milk is a complete source of nutrition for term infants. It is unknown whether supplementation of micronutrients is required for term infants exclusively fed DM, particularly for nutrients affected by heat processing, such as vitamin C. The objective of this study was to determine the total vitamin C content in DM and whether it would be adequate for an infant exclusively fed DM. METHODS DM samples (n = 56) were collected at a Canadian milk bank from April to August 2018. Vitamin C concentration was determined by high-performance liquid chromatography. RESULTS DM samples had a vitamin C concentration of 17.7 ± 9.8 mg/L (mean ± SD) and were variable, ranging from 1.9 to 43.2 mg/L. Using these values and assuming an exclusive DM consumption of 780 mL/day, the estimated vitamin C intake would be 13.8 ± 8.6 mg (mean ± SD), falling below the adequate intake of 40 mg/day for infants (0-6 months old). CONCLUSION Vitamin C supplementation is required for all infants if DM is the sole source of nutrition. Future studies should investigate other heat- and light-sensitive nutrients.
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Affiliation(s)
- Marina Castro
- Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Pitino
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Bando
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Susanne Aufreiter
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Debbie Stone
- Rogers Hixon Ontario Human Milk Bank, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Sharon Unger
- Department of Pediatrics, Sinai Health, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Kontopodi E, Boeren S, Stahl B, van Goudoever JB, van Elburg RM, Hettinga K. High-Temperature Short-Time Preserves Human Milk's Bioactive Proteins and Their Function Better Than Pasteurization Techniques With Long Processing Times. Front Pediatr 2021; 9:798609. [PMID: 35127595 PMCID: PMC8811466 DOI: 10.3389/fped.2021.798609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/29/2021] [Indexed: 12/14/2022] Open
Abstract
Donor human milk is generally processed by holder pasteurization (HoP) at 62. 5°C for 30 min. This temperature-time combination is sufficient for eliminating pathogens in donor milk, but also negatively affects several bioactive milk components. Long heating up times may further affect the bioactive properties of pasteurized milk. High-Temperature-Short-Time (HTST), a treatment with shorter processing times (72°C for 15 sec), was investigated as a suitable alternative to HoP. In addition, pasteurization methods that follow the same temperature regime but with varying heating up times were compared. Human milk samples from four different donors were combined into one pool, which was then used to perform all analyses. The effects of these methods on the levels and functionality of immunoglobulin A, lactoferrin, lysozyme and bile salt-stimulated lipase, were evaluated with LC-MS/MS-based proteomics and activity assays, while the pasteurization efficacy was evaluated with an alkaline phosphatase test. HoP, a treatment with long processing times, times, caused the highest reduction in all proteins studied (reduced by 50-98%). Compounds such as lactoferrin and bile salt-stimulated lipase that are more sensitive to heat treatments were better retained with HTST, but their levels and functionality were still significantly lower than those of untreated donor milk (52 and 81% reduction of lactoferrin and bile salt-stimulated lipase activity, respectively). Our findings showed that a treatment with considerably shorter processing times, such as HTST, may reduce the thermal damage caused to the bioactive proteins compared to HoP, without affecting pasteurization efficacy. Since the vast majority of the donor human milk banks that are currently operating on a global level apply HoP to donor milk, our findings may provide relevant information for the optimization of donor milk processing.
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Affiliation(s)
- Eva Kontopodi
- Emma Children's Hospital, Amsterdam UMC, Amsterdam, Netherlands.,Food Quality and Design Group, Wageningen University and Research, Wageningen, Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University, Wageningen, Netherlands
| | - Bernd Stahl
- Department of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Danone Nutricia Research, Utrecht, Netherlands
| | | | | | - Kasper Hettinga
- Food Quality and Design Group, Wageningen University and Research, Wageningen, Netherlands
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Koh J, Victor AF, Howell ML, Yeo JG, Qu Y, Selover B, Waite-Cusic J, Dallas DC. Bile Salt-Stimulated Lipase Activity in Donor Breast Milk Influenced by Pasteurization Techniques. Front Nutr 2020; 7:552362. [PMID: 33282897 PMCID: PMC7689290 DOI: 10.3389/fnut.2020.552362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/26/2020] [Indexed: 11/13/2022] Open
Abstract
Breast milk contains bile salt-stimulated lipase (BSSL), which significantly increases the fat digestion capacity of newborns who have limited pancreatic lipase secretion in the first few months after birth. Problematically, Holder pasteurization used in non-profit milk banks to ensure the microbiological safety of donor milk for infants, particularly preterm infants (<37 weeks gestation age), destroys milk BSSL, thus limiting infant fat absorption capacity. Alternative strategies are needed to ensure the safety of donor milk while preserving BSSL activity. Three alternative pasteurization techniques—high-pressure processing (HPP, 550 MPa, 5 min), gamma cell irradiation (IR, 2.5 Mrads) and UV-C (254 nm, 0–33,000 J/L)—were compared with Holder pasteurization (low-temperature long-time, LTLT, 62.5°C, 30 min) for retention of BSSL activity in donor breast milk. As the time required for donor milk pasteurization by UV-C in published methods was not clear, donor breast milk was spiked with seven common bacterial strains and treated by UV-C for variable time periods and the minimum UV-C dosage required to achieve a 5-log10 reduction of CFU/mL was determined. Eight thousand two hundred fifty J/L of UV-C exposure was sufficient to achieve 5-log10 reduction of each of bacterial targets, including Bacillus and Paenibacillus spores. The retention of BSSL activity was highest after HPP (retaining 62% of the untreated milk BSSL activity), followed by UV-C (16,500 J/L), IR and LTLT (35, 29, and 0.3% retention, respectively). HPP was an effective alternative to pasteurize milk with improved retention of BSSL activity compared to Holder pasteurization. Future work should investigate the effect of alternative pasteurization techniques on the entire array of bioactive components in donor breast milk and how these changes affect preterm infant health outcomes. Implementation of HPP technique at milk banks could improve donor milk-fed infant fat absorption and growth.
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Affiliation(s)
- Jeewon Koh
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Ashley F Victor
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Matthew L Howell
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Jooyoung G Yeo
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Yunyao Qu
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States.,Department of Food Science and Technology, College of Agricultural Sciences, Oregon State University, Corvallis, OR, United States
| | - Brandon Selover
- Department of Food Science and Technology, College of Agricultural Sciences, Oregon State University, Corvallis, OR, United States
| | - Joy Waite-Cusic
- Department of Food Science and Technology, College of Agricultural Sciences, Oregon State University, Corvallis, OR, United States
| | - David C Dallas
- Nutrition Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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Liu Y, Xiong L, Kontopodi E, Boeren S, Zhang L, Zhou P, Hettinga K. Changes in the milk serum proteome after thermal and non-thermal treatment. INNOV FOOD SCI EMERG 2020. [DOI: 10.1016/j.ifset.2020.102544] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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40
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de la Cruz Quiroz R, Chotyakul N, Saraiva JA, Lamela CP, Torres JA. Retention of Ascorbic Acid, Retinol, β-Carotene, and α-Tocopherol in Milk Subjected to Pressure-Assisted Thermal Processing (PATP). FOOD ENGINEERING REVIEWS 2020. [DOI: 10.1007/s12393-020-09242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Malinowska-Pańczyk E. Can high hydrostatic pressure processing be the best way to preserve human milk? Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Hoban R, Khatri S, Patel A, Unger SL. Supplementation of Mother's Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study. Nutrients 2020; 12:nu12020589. [PMID: 32102333 PMCID: PMC7071452 DOI: 10.3390/nu12020589] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mother's own milk (MOM) improves in-hospital outcomes for preterm infants. If unavailable, donor milk (DM) is often substituted. It is unclear if DM vs. formula to supplement MOM is associated with improved in-hospital outcomes in term/late preterm surgical infants with gastroschisis or intestinal atresia. METHODS This retrospective study included infants born ≥33 weeks gestational age (GA) with a birth weight of >1500 g who were admitted to a quaternary neonatal intensive care unit (NICU). Using Chi square and Mann-Whitney u testing, we compared hospital outcomes (length of stay, parenteral nutrition and central line days) before and after a clinical practice change to offer DM instead of formula in this surgical population. RESULTS Baseline characteristics were similar between eras for the 140 infants (median GA 37 weeks). Fewer infants in DM era were receiving formula at discharge (50.0% vs. 31.4%, p = 0.03). In sub-analyses including only small bowel atresia and gastroschisis infants, the median length of stay (35 vs. 25, p < 0.01) and the central line days (28 vs. 20, p < 0.01) were lower in the DM era. CONCLUSION In this retrospective study, offering DM instead of formula was associated with less formula feeding at discharge, and in infants with gastroschisis or small bowel atresia, shorter length of stay and central line days.
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Affiliation(s)
- Rebecca Hoban
- Department of Paediatrics, Division of Neonatology, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (S.K.); (S.L.U.)
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Pediatrics, Division of Neonatology, Rush University Children’s Hospital, Chicago, IL 60612, USA;
- Correspondence: ; Tel.: +1-416-813-6345; Fax: +1-416-813-5245
| | - Supriya Khatri
- Department of Paediatrics, Division of Neonatology, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (S.K.); (S.L.U.)
| | - Aloka Patel
- Department of Pediatrics, Division of Neonatology, Rush University Children’s Hospital, Chicago, IL 60612, USA;
| | - Sharon L. Unger
- Department of Paediatrics, Division of Neonatology, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (S.K.); (S.L.U.)
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Paediatrics, Sinai Health, Toronto, ON M5G 1X5, Canada
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Abstract
Human milk provides not only ideal nutrition for infant development but also immunologic factors to protect from infection and inflammation. For the newborn preterm infant, the natural delivery of milk is not attainable, and instead pumped maternal milk, donor human milk, and human milk fortification are mainstays of clinical care. Current research demonstrates a decreased risk of necrotizing enterocolitis with maternal milk and donor human milk when individually compared to formula and with a complete human milk diet of maternal milk supplemented with donor human milk. The incidence of severe retinopathy of prematurity is decreased with an exclusive human milk diet, and this decrease is more pronounced with human milk-based compared to bovine milk-based human milk fortifier. The incidence of other morbidities such as late-onset sepsis and bronchopulmonary dysplasia is decreased with higher dose of human milk though significant differences are not apparent in exclusive human milk diet studies.
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Affiliation(s)
- Sarah N Taylor
- Yale School of Medicine, PO Box 208064, New Haven, Connecticut, 06520-8064, USA.
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Gan J, Zheng J, Krishnakumar N, Goonatilleke E, Lebrilla CB, Barile D, German JB. Selective Proteolysis of α-Lactalbumin by Endogenous Enzymes of Human Milk at Acidic pH. Mol Nutr Food Res 2019; 63:e1900259. [PMID: 31271254 PMCID: PMC7231428 DOI: 10.1002/mnfr.201900259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/03/2019] [Indexed: 01/01/2023]
Abstract
SCOPE The use of human milk products is increasing for high-risk infants. Human milk contains endogenous enzymes that comprise a dynamic proteolytic system, yet biological properties of these enzymes and their activities in response to variations including pH within infants are unclear. Human milk has a neutral pH around 7, while infant gastric pH varies from 2 to 6 depending on individual conditions. This study is designed to determine the specificity of enzyme-substrate interactions in human milk as a function of pH. METHODS AND RESULTS Endogenous proteolysis is characterized by incubating freshly expressed human milk at physiologically relevant pH ranging from 2 to 7 without the addition of exogenous enzymes. Results show that the effects of pH on endogenous proteolysis in human milk are protein-specific. Further, specific interactions between cathepsin D and α-lactalbumin are confirmed. The endogenous enzyme cathepsin D in human milk cleaves α-lactalbumin as the milk pH shifts from 7 to 3. CONCLUSIONS This study documents that selective proteolysis activated by pH shift is a mechanism for dynamic interactions between human milk and the infant. Controlled proteolysis can guide the use of human milk products based on individual circumstance.
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Affiliation(s)
- Junai Gan
- Department of Food Science and Technology, University of California, Davis, CA, USA
| | - Jingyuan Zheng
- Department of Nutrition, University of California, Davis, CA, USA
| | - Nithya Krishnakumar
- Department of Food Science and Technology, University of California, Davis, CA, USA
| | | | - Carlito B. Lebrilla
- Department of Chemistry, University of California, Davis, CA, USA
- Foods for Health Institute, University of California, Davis, CA, USA
| | - Daniela Barile
- Department of Food Science and Technology, University of California, Davis, CA, USA
- Foods for Health Institute, University of California, Davis, CA, USA
| | - J. Bruce German
- Department of Food Science and Technology, University of California, Davis, CA, USA
- Foods for Health Institute, University of California, Davis, CA, USA
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Lipid Profile, Lipase Bioactivity, and Lipophilic Antioxidant Content in High Pressure Processed Donor Human Milk. Nutrients 2019; 11:nu11091972. [PMID: 31438647 PMCID: PMC6770840 DOI: 10.3390/nu11091972] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/15/2019] [Accepted: 08/17/2019] [Indexed: 12/31/2022] Open
Abstract
Human milk fat plays an essential role as the source of energy and cell function regulator; therefore, the preservation of unique human milk donors’ lipid composition is of fundamental importance. To compare the effects of high pressure processing (HPP) and holder pasteurization on lipidome, human milk was processed at 62.5 °C for 30 min and at five variants of HPP from 450 MPa to 600 MPa, respectively. Lipase activity was estimated with QuantiChrom™ assay. Fatty acid composition was determined with the gas chromatographic technique, and free fatty acids content by titration with 0.1 M KOH. The positional distribution of fatty acid in triacylglycerols was performed. The oxidative induction time was obtained from the pressure differential scanning calorimetry. Carotenoids in human milk were measured by liquid chromatography. Bile salt stimulated lipase was completely eliminated by holder pasteurization, decreased at 600 MPa, and remained intact at 200 + 400 MPa; 450 MPa. The fatty acid composition and structure of human milk fat triacylglycerols were unchanged. The lipids of human milk after holder pasteurization had the lowest content of free fatty acids and the shortest induction time compared with samples after HPP. HPP slightly changed the β-carotene and lycopene levels, whereas the lutein level was decreased by 40.0% up to 60.2%, compared with 15.8% after the holder pasteurization.
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Oxylipin concentration, but not fatty acid composition, is altered in human donor milk pasteurised using both thermal and non-thermal techniques. Br J Nutr 2019; 122:47-55. [PMID: 31006410 DOI: 10.1017/s0007114519000916] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Human donor milk (DM) is Holder pasteurised (62·5°C, 30 min) to ensure its microbiological safety for infant consumption. In low-resource settings, flash heating is used to pasteurise milk. Although there is considerable interest in non-thermal alternatives (high hydrostatic pressure processing (HHP) and UVC irradiation) for pasteurisation, their effect on the fatty acid composition is not well understood. Of particular interest is the effect of pasteurisation on the generation of oxylipins. DM from eight mothers containing bacteria >5 × 107 colony-forming units/l was used. In a paired design, each pool of milk underwent four pasteurisation techniques: Holder; flash heating; UVC (250 nm, 25 min) and HHP (500 MPa, 8 min). Fatty acids were quantified by GC-flame ionisation detection and oxylipins derived from arachidonic acid; 18-carbon PUFA (α-linolenic acid, linoleic acid and γ-linolenic acid) and EPA/DHA were measured by liquid chromatography-tandem MS in aliquots of raw and processed milk. There were no significant changes to the composition of fatty acids following all pasteurisation techniques compared with raw milk. The n-6:n-3 ratio remained constant ranging from 6·4 to 6·6. Several arachidonic acid-derived oxylipins were highest post-UVC and elevated post-HHP compared with raw milk. Several oxylipins derived from 18-carbon PUFA (linoleic and α-linolenic acids) were elevated in UVC-treated milk. EPA/DHA-derived oxylipins were on average, unaffected by pasteurisation. Although some PUFA-derived oxylipins were increased following UVC and HHP, no method affected the fatty acid composition of human DM. Further research is needed to determine if varying levels of oxylipins in human DM as a result of processing can potentially mediate cellular signalling; proliferation and apoptosis, especially important for preterm infant development.
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