Donkey's Milk in the Management of Children with Cow's Milk protein allergy: nutritional and hygienic aspects

Seasonal Variation in Essential Minerals, Trace Elements, and Potentially Toxic Elements in Donkey Milk from Banat and Balkan Breeds in the Zasavica Nature Reserve

Donkey milk is highly valued for its unique nutritional characteristics and hypoallergenic properties. However, limited data exist on its mineral composition and potential contaminants. This study aimed to comprehensively analyze the concentration of selected essential and toxic elements from Banat and Balkan donkey breeds reared under extensive organic conditions (free-range) across different seasons. The focus was on determining the concentrations of essential minerals and trace elements (Ca, P, Na, K, Mg, Zn, Cu, Se), and potentially toxic elements (As, Pb, Hg, Cd). Samples were collected monthly over one year, with nine pooled samples per season. Mineral elements were determined using a validated ICP-MS method. The mineral content ranges (mg/kg) were Ca (588.9-744.4), P (355.6-533.3), Mg (71.1-84.4), K (444.4-711.1), Na (355.6-444.4), with trace elements (mg/kg) including Zn (2.06-2.21), Cu (0.31-0.68), and Se (0.02-0.05). Potentially toxic elements were within safe limits, with the exception that Pb levels exceeded permissible limits in two samples. Statistically significant seasonal variations were observed for Ca, P, K, As, and Cu. Donkey milk from both breeds was rich in minerals and low in contaminants. This research highlights the need for further studies on the nutritional and safety aspects of donkey milk.

Peptidomic profile of human milk as influenced by fortification with different protein sources: An in vitro dynamic digestion simulation

Fortification of human milk (HM) is often necessary to meet the nutritional requirements of preterm infants. The present experiment aimed to establish whether the supplementation of HM with either an experimental donkey milk-derived fortifier containing whole donkey milk proteins, or with a commercial bovine milk-derived fortifier containing hydrolyzed bovine whey proteins, affects peptide release differently during digestion. The experiment was conducted using an in vitro dynamic system designed to simulate the preterm infant's digestion followed by digesta analysis by means of LC-MS-MS. The different fortifiers did not appear to influence the cumulative intensity of HM peptides. Fortification had a differential impact on the release of either donkey or bovine bioactive peptides. Donkey milk peptides showed antioxidant/ACE inhibitory activities, while bovine peptides showed opioid, dipeptil- and propyl endo- peptidase inhibitory and antimicrobial activity. A slight delay in peptide release from human lactoferrin and α-lactalbumin was observed when HM was supplemented with donkey milk-derived fortifier.

Site-Specific N-Glycoprofiling of Immunoglobulin G Subtypes from Donkey Milk

Donkey milk IgG was probed for the site-specific N-glycosylation pattern through RP-UHPLC-MS/MS. The affinity-purified milk IgG was subjected to SDS-PAGE and proteomic analysis, which revealed the presence of subtypes. Multiple N-glycopeptides arising from the predicted donkey IgG1, IgG2, IgG3, IgG5, IgG6, and IgG7 subtypes' heavy-chain constant region were shown to contain glycans at the highly conserved glycosylation site NST in the CH2 domain. Differences in the peptide backbone with the NST site among subtypes generated after trypsin digestion resulted in the evaluation of the subtype-specific glycan pattern. Glycan sequence analysis indicated predominantly biantennary complex types with core fucosylation at the site NST. Interestingly, an additional site NQT in the CH1 domain of the heavy-chain constant region of IgG5 was found to possess mainly sialylated biantennary complex glycans with NeuAc and NeuGc. Structural diversity of glycans was mainly observed in the predicted donkey IgG1, IgG5, and IgG7, whereas IgG2, IgG3, and IgG6 resulted in the glycopeptides that are of low abundance in the analyzed samples. These findings would pave the way for a better understanding of donkey milk functional properties.

Chemical contaminants in donkey milk: A review of literature on sources, routes and pathways of contamination, regulatory framework, health risks, and preventive measures

Donkey milk has garnered increasing attention due to its potential health benefits and nutritional properties, positioning it as a valuable alternative to cow's milk for specific consumer groups, such as individuals with allergies, young children, elderly populations, and those with compromised immune systems. However, the presence of chemical contaminants in donkey milk presents a significant concern for food safety and public health. This review aims to provide an assessment of the types and sources of chemical contaminants in donkey milk, including heavy metals, mycotoxins, pesticides, polychlorinated biphenyls, and antimicrobial and antiparasitic veterinary drugs. Through a comprehensive analysis of available literature, we examine the routes and pathways through which these contaminants enter the milk, their prevalence, and the associated health risks. The review also briefly discusses analytical methods for detecting these contaminants and the existing legislative framework that regulates these contaminants, underscoring its critical role in safeguarding public health and promoting safe consumption of donkey milk products. By identifying gaps in existing research and suggesting areas for further study, this review seeks to contribute to the development of more effective strategies for monitoring and mitigating chemical contamination in donkey milk, ultimately safeguarding consumer health and supporting the sustainable production of this niche dairy product.

Is there sufficient evidence to support the health benefits of including donkey milk in the diet?

Donkey milk has attracted attention due to its distinctive nutritional composition and potential health advantages, particularly because of its whey protein content, which includes lysozyme, α-lactalbumin, lactoferrin, and β-lactoglobulin and vitamin C, among other components. These elements contribute to immunoregulatory, antimicrobial, antioxidant, and anti-inflammatory properties, positioning donkey milk as a possible therapeutic option. In addition, due to the low levels of caseins, the casein-to-whey protein ratio, and the β-lactoglobulin content in donkey milk, it presents an optimal alternative for infant formula for individuals with cow's milk allergies. Moreover, research into donkey milk's potential for cancer prevention, diabetes management, and as a treatment for various diseases is ongoing, thanks to its bioactive peptides and components. Nevertheless, challenges such as its low production yield and the not fully understood mechanisms behind its potential therapeutic role necessitate more thorough investigation. This review consolidates the existing knowledge on the therapeutic possibilities of donkey milk, emphasizing its importance for human health and the need for more detailed studies to confirm its health benefits.

Goat Milk Supplementation Modulates the Mitochondrial Metabolic Flexibility and Orexin-A Levels Influencing the Inflammatory Pattern in Rats

Milk and its derivatives are included in a balanced diet of humans as excellent sources of proteins, vitamins, and essential minerals that are functional nutrients. Knowledge about the nutritional benefits or harms due to milk consumption has been expanding in recent years. We previously explored, in rodent models, the metabolic effects of isoenergetic intake of milk derived from cows, donkeys, or humans, while the impact of goat's milk intake has remained unexplored. The aim of this work was to investigate, in an animal model, the effects of dietary supplementation with goat's milk on energy homeostasis and inflammatory state, focusing on the modulation of mitochondrial functions in most metabolically active organs, such as skeletal muscle and the liver. In addition, we highlighted a link between nutrient intake, substrate metabolism, and the orexinergic system. Our results indicate that goat milk improves mitochondrial oxidative capacity and reduces inflammation and oxidative stress in both organs. Notably, goat milk lowers the circulating levels of Orexin-A, a neuropeptide that plays a crucial role in regulating peripheral energy balance and central nervous system mechanisms. These data provide the first evidence that the anti-inflammatory and antioxidant effects of goat milk are mediated by the modulation of mitochondrial functions and orexinergic signaling.

Impact of processing on the sensitising capacity and cross-reactivity of cow's and camel milk proteins in a Brown Norway rat study

Infant formulas based on hydrolysed cow's milk proteins are used when breastfeeding is not feasible in cow's milk allergic infants. Camel milk has been shown to be well-tolerated by the majority of children with cow's milk allergy (CMA) and may be a substitute in management of CMA. Here we aimed to evaluate the impact of processing on immunogenicity, sensitising, antibody-binding and cross-reactive capacity of cow's and camel milk. Cow's and camel milk were processed by means of enzyme hydrolysis or heat treatment. Brown Norway rats were immunised with PBS, non-processed, enzyme hydrolysed or heat-treated cow's or camel milk. In vivo tests were performed for evaluation of clinical signs. Blood and faecal samples were analysed for levels and specificity of antibody responses. Cow's and camel milk showed similar sensitising capacity. Processing decreased the sensitising capacity of cow's milk, yet only enzyme hydrolysis but not heat treatment decreased the sensitising capacity of camel milk. Processing affected the specificity of antibodies raised in the rats, though the effect differed between cow's and camel milk. The study showed a low cross-reactivity between cow's and camel milk, which was decreased with processing, suggesting that processing of camel milk may improve its usefulness in CMA management.

Isolation of 60 strains from fermented milk of mares and donkeys in Algeria and identification by 16S rRNA sequencing of lactobacilli: Assessment of probiotic skills of important strains and aromatic productivity power

Background and Aim

Donkey and mare milk have high nutritional and functional values, but their lactic acid bacteria (LAB) content remains poorly studied and undervalued in the Algerian dairy industry. This study aimed to isolate and select LAB strains that produce antimicrobial substances during fermentation and to characterize the probiotic profiles of each extracted strain to indicate their potential for antioxidant and proteolytic activity.

Materials and Methods

This study focuses on isolating and identifying lactic acid bacterial strains from 10 Equid-fermented milk samples collected in two regions of El Bayed Wilaya (Algeria). Identification of LAB strains was obtained by 16S rRNA sequencing. The probiotic properties of important strains and their aromatic productivity power are assessed. To evaluate their antibacterial activity against Listeria monocytogenes, Staphylococcus aureus, Chryseobacterium joostei, Pseudomonas aeruginosa, and Escherichia coli, we selected 21 strains. Different induction methods have been used to amplify the antibacterial effects against these pathogenic strains.

Results

Among a total of 60 identified strains, 31 had a probiotic profile, and most were catalase-negative. Aromatic productivity power was observed in eight strains: Lactiplantibacillus plantarum, Lactobacillus casei, Lactobacillus paracasei, Weissella confusa, Weissella cibaria, Leuconostoc mesenteroides, Leuconostoc lactis, and Lactobacillus sp1.

Conclusion

Our results provide insight into the considerable diversity of LAB present in fermented donkey and mare milk. To meet the expectations of the Algerian dairy industry, it is important that the probiotic skills of the nine selected strains are met. In addition, a significant number of these strains may have important probiotic activity and biotechnological potential.

Study on the suitability of life cycle assessment for the estimation of donkey milk environmental impact

In the last decades, western Countries increased their interest in innovative products like donkey milk and other activities carried out with donkeys (onotherapy, onotourism). Donkey milk is considered a high-added-value food and is very similar to human breast milk. It is also used as an ingredient in cosmetics. The growing public interest suggests the need for a pilot study on the sustainability of donkey milk production, according to Life Cycle Assessment (LCA) criteria. Milk was used as the Declared Functional Unit (DFU) and two different models were described, a Real Scenario Model (RSM, i.e. a farm with its declared milk yield), and an Increased Milk Production Model (IMPM, i.e., the same farm with theoretically increased milk yield). Allocation was applied both in RSM and IMPM; thus, different values of impact categories, i.e., Global Warming Potential (GWP, kg CO2 equivalents), Acidification Potential (ACP, g SO2 equivalents) and Eutrophication Potential (EUP, g PO43-) were observed. GWP improved after mass allocation and showed the lowest equivalents in IMPM, compared to economic and reference allocation criterion (P < 0.05). In RSM, allocations affected GWP in a different way: the smaller size of the DFU resulted in the largest estimation of CO2 equivalents (P < 0.05) for reference allocation, whereas the mass allocation estimates were lower than with economic allocation (P < 0.05). ACP and EUP followed the same trends. No differences were found in IMPM results across the three allocation methods used. Moreover, mass allocation values recorded in RSM did not significantly differ from IMPM. ACP and EUP of RSM improved after economic allocation, although they were less sustainable (P < 0.05) than all IMPM values and RSM equivalents after mass allocation (P < 0.05). As expected, the theoretical model with increased milk yield improved the sustainability of the system. Both scenarios were affected by allocation criteria. In RSM, the economic and mass allocations described a representative scenario where donkey meat contributed to subtracting equivalents from milk (the main product). The present paper is a pilot study estimating for the first time the environmental impact of donkey milk production, with the aim to stimulate further research.

Milk somatic cell DNA isolation and characterization of κ-casein gene in Halari donkey milk

Halari donkey breed is one of the indigenous breeds of India and its population is rapidly decreasing. The Jenny milk is more similar to human milk, exhibits a wide range of probiotic diversity and hypo-allergenicity, especially among infants suffering from cow and buffalo milk protein allergy. Some studies indicated low levels of κ-casein fraction of casein protein in donkey milk. The k-casein gene was not amplified from the DNA derived from the milk somatic cells of Halari donkeys. The Halari donkey milk has low somatic cells count. We report the first isolation of DNA from milk somatic cells of Halari donkeys with subsequent characterization of k-casein gene. Through our work, we showed that the milk somatic cells can be used as a non-invasive source for DNA isolation towards molecular studies. It also proved the presence of k-casein gene in Halari donkey milk by its amplification from isolated DNA.

Soy, Rice and Oat Drinks: Investigating Chemical and Biological Safety in Plant-Based Milk Alternatives

During the last decades, plant-based milk has become very appreciated by consumers, becoming a staple ingredient, especially for alternative breakfasts. Milk contains lactose, which is a sugar hydrolysed by the lactase enzyme. Lactose intolerance and lactose malabsorption are very common food intolerances among individuals. However, a lot of consumers consider themselves as lactose intolerant on the basis of self-reported intolerance and start to avoid dairy products, ignoring that plant-based milk alternatives are not nutritionally comparable to animal milk, especially in terms of protein intake. The aim of this study is to grow folder knowledge of the security of plant-based drinks, helping competent authorities to issue a risk assessment and to apply national plans about consumer safety. Results show that proper sanitary practices, such as pasteurization, are necessary in plant-based milk alternatives as well as in dairy milk. Chemical analysis has highlighted that there are no pesticide risks for consumers.

Milk from Halari Donkey Breed: Nutritional Analysis, Vitamins, Minerals, and Amino Acids Profiling

This current research set out to characterize Halari donkey milk by investigating its nutritional constituents, including its proximate analysis, water activity, titratable acidity, energy, and microbiological analysis. A comprehensive profiling of vitamins, minerals, and amino acids was also carried out. It was found that the composition of Halari donkey milk was consistent with previously published donkey milk literature and was comparable to that of human milk. Halari donkey milk has low 0.86 ± 0.04% fat content, 2.03 ± 0.03% protein content, 0.51 ± 0.05% ash content, and high 5.75 ± 0.15% lactose content making it sweet and palatable. The energy content of Halari donkey milk was 40.39 ± 0.31 kcal/100 g, and the water activity ranged from 0.973 to 0.975. Titratable acidity was 0.03 ± 0.01%. Halari donkey milk can be considered acceptable and microbiologically safe, having low total plate count and yeast and mould counts. Mineral testing revealed that Halari donkey milk included significant amounts of magnesium, sodium, calcium, potassium, phosphorus, and zinc. The concentration of different vitamins and amino acids such as isoleucine and valine also contribute to the nutritional value of Halari donkey milk.

Donkey Milk: An Overview of its Chemical Composition and Main Nutritional Properties or Human Health Benefit Properties

The donkey milk has a remarkable similarity to human milk, in addition to its valuable nutritional composition and content of numerous immune factors. The donkey milk is the subject of research worldwide, and data from the literature suggest significant differences with respect to the contents of individual components. However, some basic characteristics of donkey milk have been established: low contents of fat and cholesterol, total proteins and casein and high contents of lactose, whey proteins, calcium, selenium, and Vitamin D3. The donkey milk is rich in various protective proteins (α-lactalbumin, lysozyme, lactoferrin, lactoperoxidase, and immunoglobulins), and shows strong antioxidant, antibacterial, antiviral, antifungal, hypoglycemic, antiparasitic, and antitumor activity. Donkey milk can be considered functional food, having in mind that its fatty-acid profile and content of essential fatty acids are beneficial for cardiac health. The total fat content in donkey milk is low compared to human milk, and for this reason it is necessary to enrich donkey milk with other fat in order to provide enough calories in a diet for children. Commercialization of donkey milk and dairy products is still limited due to low production levels, that is lack of products on the market, and lack of product information. Considering the research data from the literature, there is a need for human clinical trials in order to obtain a stronger evidence of the therapeutic properties of donkey milk.

Structural and Functional Dynamics of the Ovary and Uterus during the Estrous Cycle in Donkeys in the Eastern Caribbean

Eight non-bred, non-pregnant, regularly cycling Caribbean jennies were examined daily via transrectal ultrasound to define the ovarian and uterine dynamics during four consecutive estrous cycles. Blood samples were collected every other day for progesterone analysis. The mean (±SD) overall inter-ovulatory interval across all donkeys and cycles was 22.93 ± 1.99 days. The maximum follicular diameter was 34.6 ± 2.9 mm. A two-wave pattern was evident in 97% (30/31) of the cycles. The emergence of the future dominant follicle and the largest subordinate follicle of the major primary wave coincided on Day 5.7 ± 3.6 post-ovulation, whereas the secondary wave emerged on Day 19.8 ± 2.9 during estrus of the previous cycle or early diestrus. The secondary wave was often minor (93%, 28/30 cycles). Follicular deviation occurred 8.2 ± 1.4 days before the subsequent ovulation. Luteal volume increased for the first four days after ovulation and reached a maximum volume of 8.5 ± 2.7 mm3 at Day 5.4 ± 0.4, before gradually regressing after Day 15. Serum progesterone concentration increased from Day 1 after ovulation, peaking at 27.0 ± 9.6 ng/mL between 7 and 10 days after ovulation. Progesterone concentration dropped precipitously around Day 15 after ovulation and was below 2 ng/mL around Day 17 ± 2. A day effect (p < 0.0001) was observed for corpus luteum’s volume, progesterone concentration, and uterine tone, but not for endometrial edema (p > 0.05). This study helps to clarify and define normal estrous characteristics of jennies in the Eastern Caribbean.

Comparison of Milk Odd- and Branched-Chain Fatty Acids among Human, Dairy Species and Artificial Substitutes

The aim of the study was to compare odd and branched-chain fatty acids (OBCFA) of milk from sheep, goat, cow, buffalo, donkey, human, and formula milk. Ruminant, monogastric, and human milks have different concentrations of these fatty acids (FA). To highlight the differences on OBCFA, a total of 282 individual milk samples were analyzed by gas chromatography. The OBCFA were found higher in ruminant than non-ruminant milks (p < 0.05). Among ruminants, sheep milk had the highest OBCFA (4.5 g/100 g of total FAME), whereases the lowest values were found in formula milk (0.18 g/100 g of total FAME). Regarding individual linear odd-chain FA (linear-OCFA), C11:0 was found higher in donkey milk than others, while sheep and buffalo milks had the greatest concentration of C15:0. Among BCFA, the iso-BCFA were higher than anteiso-BCFA in all considered milks. The isoC17:0 showed the highest concentration in all milks except for donkey and buffalo, which showed higher concentration of isoC16:0 than others. In conclusion, ruminant milks are different in terms of these FA compared to human milk and its substitutes. However, the greatest differences were found with formula milk, suggesting that this product needs the implementation of these FA to be more similar to human milk composition.

Distribution of selected trace elements in the major fractions of donkey milk

The aim of this study was to evaluate the concentrations of Zn, Cu, Mn, Se, Mo, Co, Li, B, Ti, Cr, Rb, Sr, Cd, and Pb in donkey milk and their distribution in major milk fractions (i.e., fat, casein, whey proteins, and aqueous phase). Individual milk samples were provided by 16 clinically healthy lactating donkeys. Subsequent centrifugation, ultracentrifugation, and ultrafiltration were carried out to remove fat, casein, and whey proteins to obtain skim milk, a supernatant whey fraction, and the aqueous phase of milk, respectively. Concentrations of the elements were measured in whole milk and fractions by inductively coupled plasma-mass spectrometry, and the concentrations associated with fat, casein, and whey proteins were then calculated. The effect of removal of fat, casein, and whey proteins was determined by repeated-measures ANOVA. The fat fraction of donkey milk carried a small (∼4.5% to 13.5%) but significant proportion of Mo, Co, Ti, Cr, and Sr. The casein fraction in donkey milk carried almost all milk Zn, a majority of Cu and Mn, and most of Mo, Ti, and Sr. Relevant proportions, between 20% and 36%, of Se, Co, and Cr were also associated with caseins. The majority of Se, Co, Li, B, Cr, and Rb, and relevant proportions of Mn, Mo, Ti, and Sr were found in soluble form (ultracentrifuged samples) and distributed between whey proteins and the aqueous phase of milk (ultrafiltered samples). Whey proteins in donkey milk carried the majority of milk Se and Co. All Li and B was present in the aqueous phase of milk, which also contained most Rb and Cr, and 17% to 42% of Mn, Se, Mo, Co, Ti, and Sr.

Cow's milk allergy

PURPOSE OF REVIEW

To highlight the most recent insights on cow's milk allergy (CMA), its treatment, and management.

RECENT FINDINGS

CMA is one of the most common food allergies among children. Burdened by the risk for fatal reaction, CMA may imply also a severe impairment of health-related quality of life at individual and family level as well as well as individual and societal costs. The updated Diagnosis and Rationale for Action against Cow's Milk Allergy series is going to provide a series of manuscripts that will offer a comprehensive state-of-the-art specifically on CMA, including international evidence-based recommendations. The current results from randomized clinical trials highlight that oral immunotherapy may be effective by itself in providing desensitization. Preliminary data suggest that biologicals such as omalizumab may be able to increase the threshold of reactivity to milk or several foods (if multiple food allergies) without requiring allergen exposure. Breastfeeding is the first choice for infants with CMA. Extensively hydrolyzed formula and amino-acid formula are valid alternatives and may be particularly helpful when eliminating multiple foods, with severe complex gastrointestinal food allergies, eosinophilic esophagitis, severe eczema, or symptoms while exclusively breastfeeding. Heed is needed to ensure the formula is nutritionally sufficient. Due to a high degree of cross-reactivity with cow's milk proteins and risk for allergic reactions, goats' milk or other mammals' milk should not be used.

SUMMARY

The adoption and implementation of evidence-based recommendations may guide a proper diagnostics and management and awaited advances in knowledge will allow the development of a personalized treatment tailored on the specific CMA patient's profile.

Mammary gland physiology and farm management of dairy mares and jennies

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The equid udder has a lower storage capacity than the ruminant udder.

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Milking frequency is one of the most important factors affecting milk yield.

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Foals can be partly artificially suckled during lactation.

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Mechanical milking has been used in equids but our understanding of machine milking remains poor.

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Automated milking systems for equids represent a great challenge for the future.

Equid milk is arousing increasing interest in consumers and researchers because of its similarity in composition to human milk. The low and different protein content makes equid milk it suitable for children with cow milk protein allergy. Both horse and milk production, in many farms, still follow a characteristic and traditional method of separating the foal from the mother to allow milking procedures. This separation lasts at least 2 to 3 h before milking, a time in which the foal remains fasting. This operation is repeated several times a day, as the equid udder has little collection capacity, and milking frequency is one of the most important parameters to increase milk production; it must be emptied often. New partial artificially suckling techniques have been developed that allow the foal to be separated from its mother for many hours without starving. Furthermore, mechanical milking has been introduced in equid milk production, although in-depth knowledge is lacking on milking parameters and how these aspects affect milk production and udder health. Moreover, in some farms, new milking parlors for Equidae have been developed, ensuring that stress is minimized and production and animal welfare are ensured. It is important to develop and apply technologies for equid milk production, evaluating potential effects on welfare, health, and milk production. This represents the broadest perspective and the greatest challenge because of the need to understand management best practices, thinking to the possibility to introduce as soon as possible automatic milking systems that could ensure a good milking frequency.

Characterisation of Zamorano-Leonese Donkey Milk as an Alternative Sustainably Produced Protein Food

The Zamorano-Leonese donkey is the local breed of the Castilla y León region of Spain and is a protected endangered species. The best way to preserve it is to explore viable alternatives such as milk production. Unlike other donkey breeds, this one has not been previously characterised. The aim of this work is the complete nutritional characterisation of its milk for human consumption, either directly or as an ingredient, to meet the new consumer expectations of sustainability and health concerns. This breed did not differ from others in terms of amino acid and protein profile. Its low concentration of β-lactoglobulin may be correlated to a low allergenicity. The presence of lactozyme and lactoferrin, which are potent antimicrobials, stand out among the proteins. This milk presented a higher content of unsaturated fatty acids, being oleic fatty acid the main one. Zamorano-Leonese donkey milk did have a higher content of vitamin C, riboflavin, folic acid and vitamin E than the other donkey breeds. It also had a high concentration of vitamin D despite its low-fat content. However, its mineral concentration was lower than other donkey breeds in line with its lower ash content. In terms of micronutrients, it had a high amount of zinc and selenium. Based on these results we can conclude that donkey milk is a food and/or ingredient with beneficial effects on cardiovascular health and the proper functioning of the immune system, as well as being a good source of protein. Therefore, donkey milk from this local species from Spain is a food and/or ingredient with beneficial nutritional properties and sustainable from an environmental point of view.

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

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

The Indicators of Clinical and Subclinical Mastitis in Equine Milk

Simple Summary

Mastitis, the inflammation of the mammary gland, is a major problem in a mare’s perinatal period, negatively affecting both the health of the mare and newborn foal and the quality of milk produced on dairy equine farms. The detection of mastitis is therefore one of the important goals in the equine breeding and dairy industry. This study aimed to determine the somatic cell count (SCC), the percentage of the immune cells, the electrical conductivity (ECM), and bacteriological index (BII) in milk collected from mares with (CM) and without (NCM) clinical symptoms of mastitis. The increase in examined indicators is suspected to be a subclinical mastitis indicator, therefore the study aimed to separate two subgroups, mares with (SM) and without (NSM) subclinical symptoms of mastitis. In milk from NCM mares the values of SCC, immune cells, and ECM increased immediately after birth and weaning, whereas during the rest of the lactation period their values were at a low level. Similarly, in milk from CM mares, the values of examined indicators were high and comparable to the weaning time. An increase in the level of examined indicators may become an early indication of subclinical mastitis.

Abstract

The somatic cell count in milk (SCC) and electrical conductivity of milk (ECM) are indicators of the health status of the mammary gland. Among somatic cells, mainly polymorphonuclear neutrophils (PMN), macrophages (MAC), and lymphocytes (LYM) are rated. This study aimed to determine the SCC, PMN, MAC, LYM, ECM, and bacteriological index (BII) in milk collected from mares with (CM) and without (NCM) clinical symptoms of mastitis concerning mares with (SM) and without (NSM) subclinical mastitis. Milk samples were collected from 27 mares divided into NCM (n = 12) and CM (n = 15) groups. In samples, SCC quantification, cytological examinations, ECM measurement, and bacteriological examination were performed. In NCM mares, the values of SCC, PMN, MAC, LYM, and ECM were higher in initial than in consecutive examined days after birth until weaning. After weaning the proportion of SCC, PMN, MAC, LYM, ECM, and BII increased and did not differ with the average values in CM mares. These equine milk indicators may reflect an early symptom of subclinical mastitis and in the future may be used in the early detection of mastitis or as a tool of assessment of the health status of the mammary gland in the dairy equine farm.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - I - Plan and definitions

Since the World Allergy Organization (WAO) Diagnosis and Rationale against Cow's Milk Allergy (DRACMA) Guidelines were published 10 years ago, new evidence has accumulated about the diagnosis, therapy, and specific immunotherapy for cow's milk allergy (CMA). For this reason, WAO has felt the need to update the guidelines. We introduce here this update. The new DRACMA guidelines aim to comprehensively address the guidance on diagnosis and therapy of both IgE non-IgE-mediated forms of cow's milk allergy in children and adults. They will be divided into 18 chapters, each of which will be dedicated to an aspect. The focus will be on the meta-analyzes and recommendations that will be expressed for the 3 most relevant clinical aspects: (a) the diagnostic identification of the condition; (b) the choice of the replacement formula in case of CMA in infancy when the mother is not able to breastfeed, and (c) the use of specific immunotherapy for cow's milk protein allergy.

Effects of the Physiological Status and Diet on Blood Metabolic Parameters in Amiata Dairy Donkeys

Simple Summary

This study investigated the physiological responses of donkeys feeding two different diets during maintenance, pregnancy and lactation. To investigate how the metabolic state influences dairy production, we also assessed the relationships between the blood metabolic profile and milk quality. We found that pregnancy and the first months of lactation led to lower feed intake and increases in blood non-esterified fatty acids (NEFAs), which was linked to the difficulty that the jennies have in meeting the higher energy needs. The intake of the concentrate in the diet was associated with the increase in blood glucose, both during maintenance and lactation. Higher NEFA were related to lower de novo synthesized milk fatty acids, whereas higher plasma B-HBA were related to higher somatic cell count. This paper contributes to the knowledge of physiological responses of jennies during milk production phases and provides information for donkey milk producers.

Abstract

Body weight changes and blood metabolic parameters in jennies feeding two different diets and in three physiological statuses were investigated (maintenance vs. pregnancy; maintenance vs. lactation). The relationships between blood metabolic profile and milk quality were also evaluated. Fourteen jennies were allocated to two groups (1: pregnant/lactating; 2: non-pregnant, non–lactating). Pregnant jennies and maintenance jennies (during the first 10-week measurement period) fed a diet consisted of ad libitum grass hay (diet 1); lactating jennies and maintenance jennies (during the last 10-week measurement period) fed ad libitum grass hay plus 2 kg/head/day of concentrate (diet 2). Blood sampling was performed on the jennies of both groups; individual milk samples were also collected during the first 70 days in milk. Higher blood NEFA (p < 0.05) were found in pregnant compared to maintenance jennies (diet 1) (68 vs. 37 μmol/L). Lactating jennies showed higher (p < 0.01) average blood NEFA (268 vs. 26 μmol/L) and glucose (66 vs. 55 mg/dL) compared to the maintenance (diet 2). Blood glucose was positively correlated to milk fat (p < 0.05), while negative significant correlations between de novo milk fatty acids and NEFAs were observed. Positive correlations between plasma B-HBA and somatic cell count (p < 0.01) were also found.

An Overview on Nutritional Aspects of Plant-Based Beverages Used as Substitutes for Cow's Milk

The presence of milk in meals and products consumed daily is common and at the same time the adoption of a milk-free diet increases due to milk allergy, lactose intolerance, vegan diets, and others. Therefore, there is an increasing demand for plant-based beverages, which present variable and, sometimes, unknown nutritional characteristics. This study sought to compare the nutritional aspects of plant-based beverages used as substitutes for cow’s milk described in scientific studies. Therefore, we used a review of the scientific literature on PubMed, Google Scholar, Scopus, Web of Science, Google Patents, Embase, and ScienceDirect databases. The inclusion criteria were scientific studies referring to plant-based beverage used as an alternative to cow’s milk; published in the English language; present data on the serving size, ingredients, and nutritional composition, containing at least data on energy and macronutrients of plant-based beverages. Ingredients and data on energy, macronutrients, and, if available, dietary fiber and some micronutrients of plant-based beverages were collected. Data were obtained from 122 beverages of 22 different matrices, with soy being the most used (27.87%, n = 34). The variation in the amount of nutrients found was 6–183 Kcal/100 mL for energy value; 0.00–22.29 g/100 mL for carbohydrate; 0.06–12.43 g/100 mL for protein; 0.00–19.00 g/100 mL for lipid; 0.00–4.40 g/100 mL for dietary fiber; 0.00–1252.94 mg/100 mL for calcium; 0.04–1.40 mg/100 mL for iron; 0.84–10,178.60 mg/100 mL for magnesium; 0.00–343.43 mg/100 mL for sodium. Salt was the most commonly found added ingredient in plant-based beverages. Some beverages have reached certain amounts of cow’s milk nutrients. However, studies have pointed out differences in their qualities/types. Thus, attention is needed when replacing milk with these alternatives.

Nutritional Properties of Camelids and Equids Fresh and Fermented Milk

Milk is considered a complete food because all of the nutrients important to fulfill a newborn’s daily requirements are present, including vitamins and minerals, ensuring the correct growth rate. A large amount of global milk production is represented by cow, goat, and sheep milks; these species produce about 87% of the milk available all over the world. However, the milk obtained by minor dairy animal species is a basic food and an important family business in several parts of the world. Milk nutritional properties from a wide range of minor dairy animal species have not been totally determined. Hot temperatures and the lack of water and feed in some arid and semi-arid areas negatively affect dairy cows; in these countries, milk supply for local nomadic populations is provided by camels and dromedaries. The nutritional quality in the milk obtained from South American camelids has still not been completely investigated, the possibility of creating an economic resource for the people living in the Andean highlands must be evaluated. Both mare and donkey milks show a chemical composition very similar to human milk, and they represent a good replacer of cows’ milk for infants nutrition, especially for children affected by cow milk proteins allergy. In this review, differences and similarities in the quality parameters of milk from minor dairy animals, such as camelids and equids, have been compared.

Cyathostomin fecal egg count and milk quality in dairy donkeys

This study was performed to assess the possible relationship between gastrointestinal strongylid infections and milk quantity and quality in donkeys used for milk production. Individual fecal and milk samples were collected from 16 multiparous lactating jennies of Amiatina breed at their 6th month of lactation. Statistical analysis was carried out between strongylid eggs per gram of faeces (EPG) and milk parameters. All animals were found to shed cyathostomin eggs, with EPG ranging from 150 to 1900. A higher milk production was observed in animals showing an EPG< 250, but this result was statistically not significant. Conversely, significant higher concentrations of milk urea and pH values, and lower concentrations of milk lactose, were observed in jennies with an EPG >1000. In conclusion, results from this study suggest that cyathostomin EPG values > 1000 may affect milk quality in dairy donkeys. Considering the novelty of these findings, more data needs to be collected to determine EPG thresholds to be used as a good marker for parasite infections influencing milk performance and quality in donkeys.

Current Knowledge on Functionality and Potential Therapeutic Uses of Donkey Milk

Simple Summary

This paper examines scientific evidence on the positive effects of donkey milk consumption on human health and its possible therapeutic applications. The most investigated clinical use of donkey milk is in feeding infants with food allergies, in whom donkey milk is well tolerated in the 82.6–98.5% of cases. Donkey milk has shown several beneficial properties, including immunomodulatory activity, antioxidant and detoxifying effects, modulation of the intestinal microbiota, and lowering of blood sugar and triglycerides, which have been tested almost exclusively in experimental animals. Inhibitory actions on microorganisms have been also observed in vitro studies. This literature review highlights the need for new clinical trials to collect stronger evidence about the positive effects observed in experimental models which could lead to new therapeutic applications of donkey milk in humans.

Abstract

The increase of knowledge on the composition of donkey milk has revealed marked similarities to human milk, which led to a growing number of investigations focused on testing the potential effects of donkey milk in vitro and in vivo. This paper examines the scientific evidence regarding the beneficial effects of donkey milk on human health. Most clinical studies report a tolerability of donkey milk in 82.6–98.5% of infants with cow milk protein allergies. The average protein content of donkey milk is about 18 g/L. Caseins, which are main allergenic components of milk, are less represented compared to cow milk (56% of the total protein in donkey vs. 80% in cow milk). Donkey milk is well accepted by children due to its high concentration of lactose (about 60 g/L). Immunomodulatory properties have been reported in one study in humans and in several animal models. Donkey milk also seems to modulate the intestinal microbiota, enhance antioxidant defense mechanisms and detoxifying enzymes activities, reduce hyperglycemia and normalize dyslipidemia. Donkey milk has lower calorie and fat content compared with other milks used in human nutrition (fat ranges from 0.20% to 1.7%) and a more favourable fatty acid profile, being low in saturated fatty acids (3.02 g/L) and high in alpha-linolenic acid (about 7.25 g/100 g of fat). Until now, the beneficial properties of donkey milk have been mostly related to whey proteins, among which β-lactoglobulin is the most represented (6.06 g/L), followed by α-lactalbumin (about 2 g/L) and lysozyme (1.07 g/L). So far, the health functionality of donkey milk has been tested almost exclusively on animal models. Furthermore, in vitro studies have described inhibitory action against bacteria, viruses, and fungi. From the literature review emerges the need for new randomized clinical trials on humans to provide stronger evidence of the potential beneficial health effects of donkey milk, which could lead to new applications as an adjuvant in the treatment of cardiometabolic diseases, malnutrition, and aging.

Vitamins in Human and Donkey Milk: Functional and Nutritional Role

BACKGROUND

Whole milk is a good source of all the nutrients, and it also contains a sufficient number of vitamins to permit regular the growth of the neonate. Dairy cow milk can create allergy in infants less than 12 months old because of the high caseins and β-lactoglobulin content. In these circumstances, donkey milk can represent a good replacement for dairy cows' milk in children affected by Cow Milk Protein Allergy (CMPA) because of its close chemical composition with human milk, mainly due to its low protein and low mineral content. Milk vitamin content is highly variable among mammalian species and it is strictly correlated with the vitamin status and the diet administered to the mother. Fat-soluble vitamins content in donkey milk is, on average, lower compared to ruminants' milk, while vitamin C content determined in donkey milk is higher compared to dairy cows' milk, showing a great similarity with human milk. In donkey milk, the content of vitamins of the B-complex such as thiamine, riboflavin, niacin, pyridoxine, and folic acid is higher compared to human milk. The use of donkey milk as a new functional food must be further evaluated in interdisciplinary clinical trials in which pediatricians, dietitians, and food scientists must be involved to deepen the knowledge about the positive health impact of donkey milk in different sensitive people, especially children and the elderly.

Best practices, challenges and innovations in pediatrics in 2019

This paper runs through key progresses in epidemiology, pathomechanisms and therapy of various diseases in children that were issued in the Italian Journal of Pediatrics at the end of last year. Novel research and documents that explore areas such as allergy, critical care, endocrinology, gastroenterology, infectious diseases, neonatology, neurology, nutrition, and respiratory tract illnesses in children have been reported. These observations will help to control childhood illnesses.

A preliminary investigation into the unsaponifiable fraction of donkey milk: Sterols of animal origin, phytosterols, and tocopherols

We investigated the main sterols, phytosterols, and the α- and γ-tocopherol content in donkey milk during the first 2 mo of lactation. Cholesterol was the main sterol in milk (mean ± standard deviation = 0.97 ± 0.443 g/100 g of fat). Lanosterol was the main minor sterol of animal origin, followed by desmosterol (0.003 ± 0.001 and 0.001 ± 0.001 g/100 g of fat, respectively). Of the phytosterols, β-sitosterol was the main sterol of vegetal origin in donkey milk (0.005 ± 0.002 g/100 g of fat), but lower levels of campesterol, brassicasterol, and stigmasterol were also recorded. Mean levels of α- and γ-tocopherol were 0.01 ± 0.007 and 0.003 ± 0.001 g/100 g of fat, respectively. We observed no significant changes in sterol or tocopherol content during the first 2 mo of lactation. The presence of lanosterol in donkey milk is of particular interest, because lanosterol is a potential drug and has important physiological effects. The presence of phytosterols, which are considered nutraceutical molecules, enhances the nutritional quality of donkey milk fat for consumers.

Insights on Health and Food Applications of Equus asinus (Donkey) Milk Bioactive Proteins and Peptides-An Overview

Due to its similarity with human milk and its low allergenic properties, donkey milk has long been used as an alternative for infants and patients with cow's milk protein allergy (CMPA). In addition, this milk is attracting growing interest in human nutrition because of presumed health benefits. It has antioxidant, antimicrobial, antitumoral, antiproliferative and antidiabetic activity. In addition, it stimulates the immune system, regulates the gastrointestinal flora, and prevents inflammatory diseases. Although all donkey milk components can contribute to functional and nutritional effects, it is generally accepted that the whey protein fraction plays a significant role. This review aims to highlight the active proteins and peptides of donkey milk in comparison with other types of milk, emphasizing their properties and their roles in different fields of health and food applications.

Distribution of calcium, phosphorus, sulfur, magnesium, potassium, and sodium in major fractions of donkey milk

The aim of this study was to evaluate the concentrations of Ca, P, S, Mg, K, and Na, and their distribution in major fractions of donkey milk (i.e., fat, casein, whey proteins, and aqueous phase). Individual milk samples were collected by mechanical milking from 16 clinically healthy lactating donkeys. Milk yield per milking was recorded and milk gross composition, casein content, and pH were determined. Whole milk samples were centrifuged to separate fat and to obtain skim milk. Skim milk samples were ultracentrifuged to separate a sedimentable casein pellet and to obtain a supernatant whey (soluble) fraction, which was then ultrafiltered to obtain the aqueous phase of donkey milk. Whole milk and the processed samples were analyzed for the aforementioned elements by inductively coupled plasma-mass spectrometry. The concentration of elements associated with fat, casein, and whey proteins was then calculated. All the Na was present in the aqueous phase. The fat fraction in donkey milk carried very little or none of the investigated elements. The majority of Ca (62.9%) and P (53.1%) was associated with casein, and the rest of these elements was mostly present in the aqueous phase. The majority of Mg was present in the aqueous phase, but a relevant part (32.6%) was associated with the casein fraction. No K was associated with casein. On a molar basis, the ratio of colloidal Ca and P to casein (mmol/g of casein) was more than double the values reported in literature for cow milk. The correlation coefficient was negative between milk pH and P in the ultracentrifuged (r = -0.81) and ultrafiltered (aqueous) fraction (r = -0.66). Milk pH correlated positively with colloidal Ca (r = 0.59) and with the ratio of colloidal Ca to casein (mmol/g of casein; r = 0.68). Colloidal Ca and P were positively correlated (r = 0.64). These data suggest that the high ratio of colloidal Ca and P to donkey casein micelles is due to a larger amount of colloidal calcium phosphate bound to casein micelles compared with literature data on cow milk. The percentage of elements associated with whey proteins was less than 5% for Ca, P, and K, but Mg reached approximately 9% of total Mg. The majority of S (63.6%) was associated with whey proteins, and only one-fourth of this element was associated with casein, indicating a higher content of sulfur-containing amino acids in donkey whey proteins than in casein.

Donkey Feeding During Maintenance, Pregnancy, and Lactation: Effects on Body Weight, Milk Production, and Foal Growth

We evaluated the daily intake in donkeys during maintenance, late pregnancy, and early lactation. The growth curves of the foals in the first eight weeks of life and the milk production in lactating jennies were also investigated. Donkeys were separated into two groups: seven pregnant jennies (group 1: pregnant/lactating) and seven nonpregnant, nonlactating jennies (group 2). The groups were fed two different diets each. The feeding period for group 1 covered eight weeks before parturition and eight weeks postpartum. Group 2 was managed during the same time period (16 weeks). Diet 1 consisted of ad libitum hay, which was fed to group 1 during late pregnancy and to group 2 from weeks 1-8. Diet 2 consisted of the same ad libitum hay supplemented with 2 kg/head/day of concentrate, which was fed to group 1 during lactation and to group 2 from weeks 9-16. The daily dry matter intake (diet 1) was 2.56 kg/100 kg of body weight (BW) for nonpregnant jennies and 31% lower in the pregnant donkeys. In the lactating jennies, the total dry matter intake was similar to the nonpregnant group fed diet 2. The nonpregnant jennies lost 1.9% of their initial BW when fed diet 1, whereas they gained 8.4% of their initial BW when fed with diet 2. A weight loss was also found in the lactating donkeys. The foals more than doubled in their birth weight within two months.

Equine Milk Production and Valorization of Marginal Areas-A Review

The equine dairy chain is renewing the interest toward horse and donkey breeding for the production of milk with potential health promoting properties. The dairy equine chain for human consumption could contribute to the rural eco-sustainable development for the micro-economies of those areas threatened by marginalization. As a part of the whole equine industry, and its possible impact in the modern and future society, the main traits of the equine dairy enterprise are reviewed with a special focus on management of animals and milk. Equine milk compositional and nutritional peculiarities are described as also related to milk hygiene and health issues. Scientific and technical aspects of the feeding management are considered in the frame of the emerging dairy equine enterprise, where pasture is an essential element that allows to match production goals for horses and donkeys, biodiversity preservation, as well as landscape safeguard.