MILK Symposium review: The importance of milk and dairy foods in the diets of infants, adolescents, pregnant women, adults, and the elderly

Using integrated transcriptomics and metabolomics to explore the effects of infant formula on the growth and development of small intestinal organoids

Infant formulas are designed to provide sufficient energy and the necessary nutrients to support the growth and development of newborns. Currently, research on the functions of formula milk powder focuses on clinical research and cell experiments, and there were many cell experiments that investigated the effect of infant formulas on cellular growth. However, most of the cells used are tumor cell lines, which are unable to simulate the real digestion process of an infant. In this study, we innovatively proposed a method that integrates human small intestinal organoids (SIOs) with transcriptomics and metabolomics analysis. We induced directed differentiation of human embryonic stem cells into SIOs and simulated the intestinal environment of newborns with them. Then, three kinds of 1-stage infant formulas from the same brand were introduced to simulate the digestion, absorption, and metabolism of the infant intestine. The nutritional value of each formula milk powder was examined by multi-omics sequencing methods, including transcriptomics and metabolomics analysis. Results showed that there were significant alterations in gene expression and metabolites in the three groups of SIOs after absorbing different infant formulas. By analyzing transcriptome and metabolome data, combined with GO, KEGG, and GSEA analysis, we demonstrated the ability of SIOs to model the different aspects of the developing process of the intestine and discovered the correlation between formula components and their effects, including Lactobacillus lactis and lactoferrin. The study reveals the effect and mechanisms of formula milk powder on the growth and development of infant intestines and the formation of immune function. Furthermore, our method can help to construct a multi-level assessment model, detect the effects of nutrients, and evaluate the interactions between nutrients, which is helpful for future research and development of infant powders.

Animal board invited review: Dietary transition from animal to plant-derived foods: Are there risks to health?

Animal-derived foods (ADFs) are a very varied group of foods, but many are nutrient rich and contain higher quality protein than provided by plant-derived foods such that a simple replacement of ADF protein is likely to lead to a reduction in overall protein quality. In addition, many ADFs are richer in some nutrients than plant-based foods (e.g. Fe, Ca) and these often have a higher bioavailability. ADFs also provide nutrients that plants cannot supply (e.g. vitamin B12) and some provide beneficial health functionality (e.g. hypotensive) which is not explained by traditional nutrition. However, there remains a good health reason to increase the proportion of plant-derived food in many diets to increase the intake of dietary fibre which is often consumed at very sub-optimal levels. It seems logical that the increased plant-derived foods should replace the ADFs that have the least benefit, the greatest risk to health and the highest environmental impact. Processed meat fits these characteristics and should be an initial target for replacement with plant-based based protein-rich foods that additionally provide the necessary nutrients and have high-quality dietary fibre. Processed meat covers a wide range of products including several traditional foods (e.g. sausages) which will make decisions on food replacement challenging. There is therefore an urgent need for research to better define the relative health risks associated with the range of processed meat-based foods. The aim of this review is to examine the evidence on the benefits and risks of this dietary transition including the absolute necessity to consider initial nutrient status before the replacement of ADFs is considered.

The Assessment of the Nutritional Status among the Young-Old and Old-Old Population with Alimentary-Dependent Diseases

Background and Objectives: Unhealthy nutrition can contribute to the development or progression of various alimentary-dependent diseases, including obesity, type 2 diabetes mellitus, metabolic syndrome, anaemia, and arterial hypertension. Young-old and old-old individuals often have diets deficient in essential vitamins, minerals, and macronutrients, characterized by high consumption of carbohydrate-rich foods and insufficient intake of plant-based products like vegetables and fruits. This study aims to identify key parameters of nutritional status among the young-old (aged 60-74 years) and old-old (aged 75-90 years) populations in central Kazakhstan, particularly in relation to specific alimentary-dependent diseases. Materials and Methods: The study involved 300 participants aged 60-90 years. The study incorporated a dietary questionnaire, food consumption records (such as 24 h recalls), and measurements of anthropometric indicators including weight and skinfold measurements. Results: Residents in the surveyed regions typically consumed food 3-4 times daily, with breakfast, lunch, and dinner being eaten at consistent times. A significant proportion of individuals, especially older adults, followed this meal schedule. About one-third ate before bedtime, and more than half believed they adhere to a specific diet. The mean BMI for men aged 60-74 years was 28.3 (95% CI: 20.1-43.2) and, for those aged 75-90 years, it was 29.0 (95% CI: 22.1-40.8). Caloric intake among individuals aged 60-74 was higher compared to those aged 75-90, with males consuming an average of 2372.7 kcal and females consuming 2236.78 kcal versus 2101.5 kcal for males and 2099.9 kcal for females in the older age group. Conclusions: The dietary patterns observed among old-old individuals were marked by excessive calorie intakes and imbalances in macronutrient composition, with a predominant emphasis on high-carbohydrate foods at the expense of essential nutrients like proteins, fats, and key vitamins (such as C, E, B vitamins) and minerals (such as potassium, calcium, and iron).

Assessing the Health Risk and Trophic Transfer of Lead and Cadmium in Dairy Farming Systems in the Mantaro Catchment, Central Andes of Peru

This study investigated lead (Pb) and cadmium (Cd) transfer in three dairy farming areas in the Mantaro river headwaters in the central Peruvian Andes and at varying distances from the mining complex at La Oroya. At each of these sites, the transfer of trace metals from the soil to raw milk was estimated, and a hazard assessment for lead and cadmium was carried out in scenarios of minimum, average, and maximum milk consumption in a Peruvian population aged 2-85. Pb and Cd were quantified by flame atomic absorption spectrometry. Significantly, the concentrations of lead and cadmium were found to exceed the maximum limits recommended by the World Health Organization, with a positive geospatial trend correlated with the distance from mining activity. Both Pb and Cd were found to be transferred through the soil-pasture-milk pathway, with the primary source of Cd being phosphate-based fertilizers used in pasture improvement. Pb was found to be the most significant contributor to the Hazard Index (HI) with those under 19 years of age and over 60 recording an HI of >1, with infants being the most vulnerable group due to their greater milk consumption in relation to their body weight. A marginal increase in contamination was observed in the dry season, indicating the need for studies to be expanded over several annual cycles.

Snack Provision Practice in Long-Term Care Hospitals and Facilities in Korea

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

The role of dairy food intake for improving health among black Americans across the life continuum: A summary of the evidence

Decades of health data show major health disparities occurring at every life stage between Black and White Americans. These disparities include greater mortality rates among Black mothers and their offspring, higher levels of malnutrition and obesity among Black children and adolescents, and a higher burden of chronic disease and lower life expectancy for Black adults. Although nutrition is only one of many factors that influence human health and well-being across the life continuum, a growing body of research continues to demonstrate that consuming a healthy dietary pattern is one of the most dominant factors associated with increased longevity, improved mental health, improved immunity, and decreased risk for obesity and chronic disease. Unfortunately, large percentages of Black Americans tend to consume inadequate amounts of several essential nutrients such as vitamin A, vitamin D, calcium, and magnesium; and simultaneously consume excessive amounts of fast foods and sugar-sweetened beverages to a greater degree than other racial/ethnic groups. Therefore, strategies that can help improve dietary patterns for Black Americans could make up a major public health opportunity for reducing nutrition-related diseases and health disparities across the life course. A key intervention strategy to improve diet quality among Black Americans is to focus on increasing the intake of nutrient-rich dairy foods, which are significantly underconsumed by most Black Americans. Compared to other food group, dairy foods are some of the most accessible and affordable sources of essential nutrients like vitamin A, D, and B12, calcium, magnesium, potassium, selenium, and zinc in the food supply, as well as being some of the primary sources of several health-promoting bioactive compounds, including polar lipids, bioactive proteins and peptides, oligosaccharides, and live and active cultures in fermented products. Given the complex relationships that many Black Americans have with dairy foods, due to issues with lactose intolerance, and/or negative perceptions about the health effects of dairy foods, there is still a need to examine the role that dairy foods play in the health and well-being of Black Americans of all ages and life stages. Therefore, the National Medical Association and its partners have produced multiple reports on the value of including adequate dairy in the diet of Black Americans. This present summary paper and its associated series of evidence reviews provide an examination of an immense amount of research focused on dairy intake and health outcomes, with an emphasis on evidence-based strategies for improving the health of Black Americans. Overall, the findings and conclusions from this body of research continue to indicate that higher dairy intake is associated with reduced risk for many of the most commonly occurring deficiencies and diseases impacting each life stage, and that Black Americans would receive significantly greater health benefits by increasing their daily dairy intake levels to meet the national recommendations than they would from continuing to fall short of these recommendations. However, these recommendations must be considered with appropriate context and nuance as the intake of different dairy products can have different impacts on health outcomes. For instance, vitamin D fortified dairy products and fermented dairy products like yogurt - which are low in lactose and rich in live and active cultures - tend to show the greatest benefits for improved health. Importantly, there are significant limitations to these research findings for Black Americans, especially as they relate to reproductive and child health, since most of the research on dairy intake and health has failed to include adequate representation of Black populations or to sufficiently address the role of dairy intake during the most vulnerable life stages, such as pregancy, lactation, fetal development, early childhood, and older age. This population and these life stages require considerably more research and policy attention if health equity is ever to be achieved for Black Americans. Sharing and applying the learnings from this summary paper and its associated series of evidence reviews will help inform and empower nutrition and health practitioners to provide more evidence-based dietary recommendations for improving the health and well-being of Black Americans across the life course.

Concentration of heavy metals in pasteurized and sterilized milk and health risk assessment across the globe: A systematic review

OBJECTIVE

Although milk and dairy products are almost complete food, they can contain toxic heavy elements with potential hazards for consumers. This review aims to provide a comprehensive report on the occurrence, concentration, and health risks of selected heavy metals in pasteurized and sterilized milk recorded worldwide.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to develop this systematic review. Databases included the Web of Knowledge, Scopus, Scientific Information Database, Google Scholar, and PubMed from inception until January 2023. Keywords related to the terms "Heavy metals", "Arsenic" and "Pasteurized and sterilized milk" and "Risk Assessment" were used. The potential health risks to human health from milk daily consumption were estimated using extracted data on heavy metals concentration based on metal estimated daily intake, target hazard quotient, and carcinogenic risk.

RESULTS

A total of 48 potentially relevant articles with data on 981 milk samples were included in the systematic review. Atomic Absorption Spectroscopy, atomic absorption spectroscopy, inductively coupled plasma-mass spectrometry, and inductively coupled plasma-optical emission spectrometry were the most common valid methods to measure heavy metals in milk samples. Following the initial evaluation, Cu, Cd, Zn, and Pb were the most contaminants, which exceeded the maximum permissible criteria in 94%, 67%, 62%, and 46% of the milk samples tested. Relying on target hazard quotient and carcinogenic risk results, milk consumers in 33(68.75%) and 7 (14.5%) studies were exposed to moderate to high levels of carcinogenic and non-carcinogenic risk, respectively. The highest level of risk is due to the consumption of pasteurized and sterilized milk detected in Pakistan, Brazil, Egypt, Slovakia, and Turkey.

CONCLUSION

The elevated levels of heavy metals in milk samples, especially Pb and Cd is a public health concern; therefore, maximum control and strict regulations must be adopted to decrease heavy metals contaminants in the dairy industry. Further studies are required to develop safe milk processing and handling methods for the decontamination of heavy metals in milk and its products.

Almli V. Basic taste sensitivity, eating behaviour, food propensity and BMI of preadolescent children: How are they related?

Background

Taste sensitivity has been reported to influence children's eating behaviour and contribute to their food preferences and intake. This study aimed to investigate the associations between taste sensitivity, eating behaviour, food frequency and BMI (Body Mass Index) in preadolescents.

Methods

Preadolescents' taste sensitivity was measured by detection threshold of sweetness (sucrose), sourness (citric acid), saltiness (sodium chloride), bitterness (caffeine, quinine), and umami (monosodium glutamate). In addition, the Child Eating Behaviour Questionnaire (CEBQ), the Food Propensity Questionnaire (FPQ) measuring food frequency, and the children's body weight and height were completed by the parents. A total of 69 child-parent dyads participated (preadolescents mean age =10.9 years).

Results

Taste sensitivity to caffeine bitterness was significantly associated with eating behaviour in food responsiveness, emotional overeating, and desire to drink. The preadolescents who were less sensitive to caffeine bitterness had higher food responsiveness scores. Those who were less sensitive to caffeine bitterness and to sweetness had higher emotional overeating scores. In addition, preadolescents who were less sensitive to sourness and bitterness of both caffeine and quinine demonstrated to have higher scores in desire to drink. There was no association between taste sensitivity and FPQ, but significant differences were observed across preadolescents' BMI for FPQ of dairy food items, indicating higher consumption of low-fat milk in the overweight/obese compared to the underweight/normal-weight subjects. There was no significant difference in taste sensitivity according to BMI. Preadolescents' eating behaviour differed across BMI, demonstrating a positive association between BMI and food approach, and a negative association between BMI and food avoidance.

Conclusions

This study contributes to the preliminary understanding of the relationships between taste sensitivity and eating behaviour in preadolescents. The results may be used to develop effective strategies to promote healthy eating practices by considering taste sensitivity in preadolescents.

Cow's Milk: A Benefit for Human Health? Omics Tools and Precision Nutrition for Lactose Intolerance Management

Cow's milk (CM) is a healthy food consumed worldwide by individuals of all ages. Unfortunately, "lactase-deficient" individuals cannot digest milk's main carbohydrate, lactose, depriving themselves of highly beneficial milk proteins like casein, lactoalbumin, and lactoglobulin due to lactose intolerance (LI), while other individuals develop allergies specifically against these proteins (CMPA). The management of these conditions differs, and an inappropriate diagnosis or treatment may have significant implications for the patients, especially if they are infants or very young children, resulting in unnecessary dietary restrictions or avoidable adverse reactions. Omics technologies play a pivotal role in elucidating the intricate interactions between nutrients and the human body, spanning from genetic factors to the microbiota profile and metabolites. This comprehensive approach enables the precise delineation and identification of distinct cohorts of individuals with specific dietary requirements, so that tailored nutrition strategies can be developed. This is what is called personalized nutrition or precision nutrition (PN), the area of nutrition that focuses on the effects of nutrients on the genome, proteome, and metabolome, promoting well-being and health, preventing diseases, reducing chronic disease incidence, and increasing life expectancy. Here, we report the opinion of the scientific community proposing to replace the "one size fits all" approach with tailor-made nutrition programs, designed by integrating nutrigenomic data together with clinical parameters and microbiota profiles, taking into account the individual lactose tolerance threshold and needs in terms of specific nutrients intake. This customized approach could help LI patients to improve their quality of life, overcoming depression or anxiety often resulting from the individual perception of this condition as different from a normal state.

The effects of residual energy intake on nutrient use, methane emissions and microbial composition in dairy cows

For sustainable food production selection and breeding of feed efficient animals is crucial. The objective of this study was to evaluate whether multiparous dairy cows, ranked during their first lactation based on residual energy intake (REI) as efficient (low; L-REI) or inefficient (high; H-REI), differ in terms of nutrient use efficiency, methane emissions, rumen fermentation, and gut microbiota composition. Six L-REI and 6 H-REI cows were offered two diets with either a low or high proportion of concentrates (30 vs. 50% of DM) on two consecutive periods of 21 d. Gas exchanges, milk yield, feces and urine excretions were measured in open-circuit respiratory chambers. The results indicated that L-REI cows had higher methane yields (22.6 vs. 20.4 g/kg DM intake) and derived more energy (energy balance - 36.6 vs. - 16.9 MJ/d) and protein (N balance - 6.6 vs. 18.8 g/d) from the tissues to support similar milk yields compared to H-REI cows. Nutrient intake and digestibility were not affected by REI, and there were no interactions between REI and diet. Milk yield, milk production efficiency, and milk composition were not affected by REI except for milk urea concentration that was higher for L-REI cows (14.1 vs. 10.8 mg/100 ml). The rumen and fecal microbiota community structure and function were associated with both the diet and REI, but the diet effect was more pronounced. The current study identified several physiological mechanisms underlying the differences between high and low REI cows, but further studies are needed to distinguish the quantitative role of each mechanism.

Lipidomic Characterization of Whey Concentrates Rich in Milk Fat Globule Membranes and Extracellular Vesicles

Lipids from milk fat globule membranes (MFGMs) and extracellular vesicles (EVs) are considered beneficial for cognitive development and human health. Milk-derived whey concentrates rich in these lipids are therefore used as ingredients in infant formulas to mimic human milk and in medical nutrition products to improve the metabolic fitness of adults and elderly people. In spite of this, there is no consensus resource detailing the multitude of lipid molecules in whey concentrates. To bridge this knowledge gap, we report a comprehensive and quantitative lipidomic resource of different whey concentrates. In-depth lipidomic analysis of acid, sweet, and buttermilk whey concentrates identified 5714 lipid molecules belonging to 23 lipid classes. The data show that the buttermilk whey concentrate has the highest level of fat globule-derived triacylglycerols and that the acid and sweet whey concentrates have the highest proportions of MFGM- and EV-derived membrane lipids. Interestingly, the acid whey concentrate has a higher level of cholesterol whereas sweet whey concentrate has higher levels of lactosylceramides. Altogether, we report a detailed lipid molecular compendium of whey concentrates and lay the groundwork for using in-depth lipidomic technology to profile the nutritional value of milk products and functional foods containing dairy-based concentrates.

Prevalence and Antimicrobial Resistance of Escherichia coli O157:H7 and Salmonella, and the Prevalence of Staphylococcus aureus in Dairy Cattle and Camels under Pastoral Production System

Escherichia coli O157:H7, Salmonella and Staphylococcus aureus are common foodborne pathogens. We determined the prevalence of E. coli O157:H7 and Salmonella in feces and milk and the prevalence of S. aureus in milk from dairy cattle and camels in the Borana pastoral community in the Southern Oromia Region of Ethiopia. Paired individual cow composite (pooled from all quarters in equal proportions) milk and fecal samples were collected from cows (n = 154) and camels (n = 158). Samples were cultured on bacterial isolation and identification media. E. coli O157:H7 and Salmonella isolates were further tested for susceptibility against nine antimicrobial drugs. Different risk factors associated with hygienic milking practices were recorded and analyzed for their influence on the prevalence of these bacteria in milk and feces. The prevalence of E. coli O157:H7 and Salmonella in feces were 3.9% and 8.4%, respectively, in cows, and 0.6% and 2.5%, respectively, in camels. E. coli O157:H7 and Salmonella were detected in the composite milk samples of 2.6% and 3.9% of the cows, respectively, and 0% and 1.3% of the camels, respectively. S. aureus was detected in composite milk samples of 33.4% of the cows and 41.7% of the camels. All E. coli O157:H7 (n = 11) and Salmonella (n = 25) isolates from both animal species and sample types were resistant to at least one antimicrobial drug. Multidrug resistance was observed in 70% (7/10) of the E. coli O157:H7 fecal and milk isolates from cows and 33.3% (2/6) of the Salmonella fecal and milk isolates from camels. The prevalence of these bacteria in feces and milk was not affected by risk factors associated with milking practices. Given the very close contact between herders and their animals and the limited availability of water for hand washing and udder cleaning, these bacteria are most likely present in all niches in the community. Improving community awareness of the need to boil milk before consumption is a realistic public health approach to reducing the risk of these bacteria.

Vegetarian diets and diets which restrict animal-source foods during childhood in high-income countries

Increasing numbers of populations in the West are restricting their intake of meat and other animal products for reasons relating to health or ethics; in many countries, these restrictions are already common for cultural, religious, or socio-economic reasons. By following their parent's diet, children are exposed in parallel. This narrative review aims at assessing current data regarding vegetarian diets in children from birth to 18 years of age, which include, by increasing degree of restriction, flexitarian, lacto-ovo-vegetarian, lacto-vegetarian, pescatarian, vegan and macrobiotic diets. The 202 references include 45 studies in children. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Of particular concern are vitamin B12, iron, zinc, calcium, n-3 long-chain polyunsaturated fatty acids, and protein and energy intake, especially in pregnant and nursing women, infants and young children. Providing an adequate lacto-ovo-vegetarian diet is relatively easy, whereas the maintenance of more restrictive diets may be challenging. The benefits and risks of vegetarian diets in adults are relatively well documented, but data for children are scarce. Vegan and macrobiotic diets should be discouraged in pregnant and lactating mothers as well as in young children, who, otherwise, should pay careful attention to ensuring nutritional adequacy, blood testing and appropriate supplementation. The health consequences of a chosen diet should be discussed with parents and adolescents to ensure the best possible adherence to advice and prescriptions. There is a need for well conducted studies in children but also for better knowledge of nutrition in healthcare professionals.Abbreviations: ALA: α-linolenic acid; ARA: arachidonic acid; ASF: animal source foods; BMC: bone mineral content; BMD: bone mineral density; DHA: docosahexaenoic acid; DRV: dietary reference value; EPA: eicosapentaenoic acid; FLD: flexitarian diet; LA: linoleic acid; LC-PUFA: long-chain polyunsaturated fatty acids; LOVD: lacto-ovo-vegetarian diet; LVD: lacto-vegetarian diet; MAD: macrobiotic diet; OMD: omnivorous diet; PSF: plant-source foods; SFA: saturated fatty acids; VGD: vegetarian diets; VND: vegan diet.

Lead, Cadmium, and Arsenic in Raw Cow's Milk in a Central Andean Area and Risks for the Peruvian Populations

Milk and its derivatives are basic foods in Peru, especially for children. The Junín region, in the central Andes, is one of the leading dairy basins. However, the safety of milk is affected by mining-metallurgical activities, wastewater dumping, organic residues, and inappropriate use of organophosphate fertilizers in agriculture whose contaminants reach the food chain, putting human health at risk. The purpose of this study was to evaluate the bioaccumulation of lead (Pb), cadmium (Cd), and arsenic (As) in milk produced on a representative farm in central Peru, which uses phosphorous agrochemicals and is adjacent to a small mineral concentrator and a municipal solid waste dump, and to evaluate the potential risk for the Peruvian population of 2-85 years considering three levels of daily intake by age, which constitutes the innovative contribution of the study. These three elements were quantified by flame atomic absorption spectrometry following standardized procedures. The mean contents of Pb (0.062 mg/kg), Cd (0.014 mg/kg), and As (0.030 mg/kg) in milk exceeded the maximum limits allowed by international standards. At all ages, the target quotient hazard followed a descending order of As > Pb > Cd, being > 1 in the case of As. The hazard index was >1 for children under 7, 9, and 11 years of age in the scenarios of low, medium, and high milk intake. The information is valid for formulating policies to prevent adverse health effects and develop standards and awareness programs, monitoring, and control of heavy metals in milk in Peru.

Evaluation of the adulteration of camel milk by non-camel milk using multispectral image, fluorescence and infrared spectroscopy

In the present study, the focus was to evaluate the potential of three spectroscopic techniques (Middle Infrared -MIR-, fluorescence, and multispectral imaging -MSI-) to check the level of adulteration in camel milk with goat, cow, and ewe milks. Camel milk was adulterated with goat, ewe, and cow milks, respectively, at 6 different levels viz. 0.5, 1, 2, 5, 10, and 15%. After preprocessing the data with standard normal variate (SNV), multiplicative scattering correction (MSC), and normalization (area under spectrum = 1), partial least squares regression (PLSR) and partial least squares discriminant analysis (PLSDA) were used to predict the adulteration level and their belonging group, respectively. The PLSR and PLSDA models, validated using external data, highlighted that fluorescence spectroscopy was the most accurate technique giving a Rp² ranging between 0.63 and 0.96 and an accuracy ranging between 67 and 83%. However, no technique has allowed the construction of robust PLSR and PLSDA models for the simultaneous prediction of contamination of camel milk by the three milks.

Plant-Based Dairy Alternatives-A Future Direction to the Milky Way

One significant food group that is part of our daily diet is the dairy group, and both research and industry are actively involved to meet the increasing requirement for plant-based dairy alternatives (PBDAs). The production tendency of PBDAs is growing with a predictable rate of over 18.5% in 2023 from 7.4% at the moment. A multitude of sources can be used for development such as cereals, pseudocereals, legumes, nuts, and seeds to obtain food products such as vegetal milk, cheese, cream, yogurt, butter, and different sweets, such as ice cream, which have nearly similar nutritional profiles to those of animal-origin products. Increased interest in PBDAs is manifested in groups with special dietary needs (e.g., lactose intolerant individuals, pregnant women, newborns, and the elderly) or with pathologies such as metabolic syndromes, dermatological diseases, and arthritis. In spite of the vast range of production perspectives, certain industrial challenges arise during development, such as processing and preservation technologies. This paper aims at providing an overview of the currently available PBDAs based on recent studies selected from the electronic databases PubMed, Web of Science Core Collection, and Scopus. We found 148 publications regarding PBDAs in correlation with their nutritional and technological aspects, together with the implications in terms of health. Therefore, this review focuses on the relationship between plant-based alternatives for dairy products and the human diet, from the raw material to the final products, including the industrial processes and health-related concerns.

Preparation of synbiotic milk powder and its effect on calcium absorption and the bone microstructure in calcium deficient mice

Calcium deficiency can lead to osteoporosis. Adequate calcium intake can improve calcium deficiency and prevent osteoporosis. Milk powder is the best source of dietary calcium supplements. Probiotics and prebiotics are considered to be beneficial substances for promoting calcium absorption. In this study, synbiotic milk powder (SMP) was prepared by combining the three, and its calcium supplementation effect and osteogenic activity were evaluated in calcium deficient mice. Through prebiotic screening experiments in vitro, after adding 1.2% iso-malto-oligosaccharide, the number of viable bacteria and the calcium enrichment of Lactobacillus plantarum JJBYG12 increased by 8.15% and 94.53% compared with those of the control group. Long-term calcium deficiency led to a significant reduction in calcium absorption and bone calcium content in mice, accompanied by structural deterioration of bone trabeculae. SMP significantly improved apparent calcium absorption, increased serum calcium and phosphorus levels, and decreased ALP activity and CTX-1 levels. In the meantime, the bone mineral density increased significantly, and the number of bone trabeculae and the proliferation and differentiation of osteoblasts also increased. SMP has good dietary calcium supplementation capacity and bone remodeling ability without significant side effects on major organs. These findings provide insights into using SMP as a dietary calcium source to improve bone health.

Sustainability of dairy systems through the lenses of the sustainable development goals

In this paper, we propose to view the sustainability of dairy farming as nested within the sustainability of agriculture, a subset of the sustainability of food systems, which in turn could be construed as a subset of the national commitments of a country to achieve the Sustainable Development Goals (SDGs). Disciplinary, multidisciplinary, and interdisciplinary research are essential to study bio-physical system components and their interactions. However, when dairy farming is viewed as nested within broader societal systems, the inclusion of human elements calls for transdisciplinary research. Few of the 17 SDGs are left untouched by the livestock sector. Research should aim at identifying relevant farm-level metrics that are in alignment with any of the 231 indicators supporting the SDGs. We used two examples to illustrate the approach. In the first, SDG 13 (Climate Action) is used as a reminder that despite the current emphasis on reducing milk carbon footprint (kg CO2-e/kg milk), the contribution of the sector to Climate Action depends on reducing its annual emission (kg CO2-e/year; indicator 13.2.2). In the second example, indicator 2.4.1 (land use for sustainable agriculture) of SDG 2 (Zero Hunger) is used to illustrate the potential tradeoffs between Milk N/Intake N as a metric of nitrogen use efficiency at the cow level and metrics such as the input:output ratio of human-edible protein (Milk N/Intake of human-edible N) that prioritize the use of human-inedible feed in dairy rations as a way to enhance efficiency and circularity at the food system level.

Variation in macrominerals and trace elements in cows' retail milk and implications for consumers nutrition

Based on previous farm-level studies, this study hypothesised that production system (conventional, CON; organic, ORG; channel island, CHA) and season would cause variation in the concentrations of macrominerals and trace elements in retail milk. On average, milk retained its status as an excellent source of Ca, P, I, and Mo across different demographics, and a very good source of K, Mg, and Zn for children. Compared with CON and ORG, CHA milk contained higher concentrations of Ca, Mg, P, Cu, Mn, and Zn; and lower concentrations of K and I. Macrominerals did not show a clear seasonal pattern but trace elements were all at lower concentrations during the typical grazing season. Variation in mineral concentrations can have implications to Ca and P supply in children, and I and Zn supply across different consumer demographics; while the seasonal variation was more pronounced than that associated with production system.

Determination of nutritional health indexes of fresh bovine milk using near infrared spectroscopy

Bovine milk is one of the most complete foods that exist. During the last decades, milk FA have shown to improve human health due to the reduction in risk of cardiovascular disease and related pathologies. The aim of this study was to evaluate the feasibility of near infrared spectroscopy (NIRS) reflectance analysis to predict the nutritional value, fatty acid (FA) composition, and health index of fresh milk from dairy cows of pastoral systems. The prediction of Atherogenicity and Thrombogenicity indexes, along with other FA ratios in fresh milk samples by NIRS were precise and accurate. In addition, the calibration model obtained by NIRS provides an opportunity for the routine quantification of milk’s healthy FA such as omega-3 and conjugated linoleic acid (CLA), with applications in the dairy industry for food labeling, and at the farm level for management of the dairy cow’s diet.

Lead and Cadmium Bioaccumulation in Fresh Cow's Milk in an Intermediate Area of the Central Andes of Peru and Risk to Human Health

The dairy basin of the Mantaro River located in the centre of Peru faces serious anthropogenic disturbances as it receives emissions and discharges from the metallurgical mining activity located in the headwaters of the basin and milk contaminated with lead (Pb) and cadmium (Cd) endangers the environmental and human health, especially children. To measure the concentrations of Pb and Cd in milk and the dangers of their consumption in the Peruvian population, 40 milk samples were collected and quantified by atomic absorption spectrometry. The mean concentration of Pb in milk was 15 ± 2.6 µg/kg, which represented 75% of the Maximum Limit (ML), and that of Cd was 505 ± 123 µg/kg, which exceeded the ML by more than 194 times. The estimated weekly intake of Pb for people aged 2−85 years was below the Provisional Tolerable Weekly Intake (PTWI) references, determining risk coefficients (CRD) < 1. Weekly Cd intake was much higher than the PTWIs and CRDs were between 14 and 34, indicating that consumers would experience carcinogenic health effects, with children being at higher risk than adults, therefore, milk from the area is not safe for consumption. Cd would be transferred mainly through the soil (water)-grass-milk pathway, due to its presence in irrigation water and in fertilizers that contain Cd. The main pathway for Pb entry would be air-soil (water)-milk grass, from the fine particles emitted into the air by the mining-metallurgical activity, developed approximately 90 km from the study area.

Aflatoxin M1 in milk does not contribute substantially to global liver cancer incidence

BACKGROUND

For 60 y, it has been known that aflatoxin B1 (AFB1), a mycotoxin produced by Aspergillus fungi in certain food and feed crops, causes hepatocellular carcinoma (liver cancer; HCC) in humans. The annual global burden of AFB1-related HCC has been estimated. However, much less is known about the potential carcinogenic impact of a metabolite of AFB1 called aflatoxin M1 (AFM1), which is secreted in milk when dairy animals consume AFB1-contaminated feed. The cancer risk of AFM1 to humans from milk consumption has not yet been evaluated.

OBJECTIVES

We sought to estimate the global risk of AFM1-related liver cancer through liquid milk consumption, accounting for possible synergies between AFM1 and chronic infection with hepatitis B virus (HBV) in increasing cancer risk.

METHODS

We conducted a quantitative cancer risk assessment by analyzing extensive datasets of national population sizes, dairy consumption patterns, AFM1 concentrations in milk in 40 nations, and chronic HBV prevalence. Two separate cancer risk assessments were conducted: assuming a possible synergy between AFM1 and HBV in increasing cancer risk in a manner similar to that of AFB1 and HBV, and assuming no such synergy.

RESULTS

If there is no synergy between AFM1 and HBV, AFM1 may contribute ∼0.001% of total annual HCC cases globally. If there is synergy between AFM1 and HBV infection, AFM1 may contribute ∼0.003% of all HCC cases worldwide. In each case, the total expected AFM1-attributable cancer cases are ∼13-32 worldwide.

CONCLUSION

AFM1 exposure through liquid milk consumption does not substantially increase liver cancer risk in humans. Policymakers should consider this low risk against the nutritional benefits of milk consumption, particularly to children, in a current global situation of milk being discarded because of AFM1 concentrations exceeding regulatory standards.

Development of a High-Throughput Screening Analysis for 195 Pesticides in Raw Milk by Modified QuEChERS Sample Preparation and Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry

This study aimed to develop a simple, high-throughput method based on modified QuEChERS (quick, easy, cheap, effective, rugged, and safe) followed by liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q-TOF/MS) for the rapid determination of multi-class pesticide residues in raw milk. With acidified acetonitrile as the extraction solvent, the raw milk samples were pretreated with the modified QuEChERS method, including extraction, salting-out, freezing, and clean-up processes. The target pesticides were acquired in a positive ion electrospray ionization mode and an All ions MS/MS mode. The developed method was validated, and good performing characteristics were achieved. The screening detection limits (SDL) and limits of quantitation (LOQ) for all the pesticides ranged within 0.1–20 and 0.1–50 μg/kg, respectively. The recoveries of all analytes ranged from 70.0% to 120.0% at three spiked levels (1 × LOQ, 2 × LOQ, and 10 × LOQ), with relative standard deviations less than 20.0%. The coefficient of determination was greater than 0.99 within the calibration linearity range for the detected 195 pesticides. The method proved the simple, rapid, high throughput screening and quantitative analysis of pesticide residues in raw milk.

Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: cross-sectional analyses of the Canadian Community Health Survey 2015 Public Use Microdata File

Dietary recommendations to reduce sugars consumption may influence choices of sugars-containing foods and affect the intake of key micronutrients. We compared intakes of nutrients and food sources stratified by quintiles of total sugars in Canadian children (2-8 y) and adolescents (9-13 y, 14-18 y) using 24-hour dietary recalls from the 2015 Canadian Community Health Survey-Nutrition. Energy intakes did not differ across quintiles of sugars intake. Those with lower sugars intakes (Q1/Q3) generally had higher protein, fat, sodium, niacin, folate, and zinc and lower vitamin C compared with those with the highest sugars intakes (Q5). Q1 also had lower potassium but higher saturated fat compared with Q5. Further, Q1 generally had higher protein, fats, and niacin compared with Q3, while children in Q3 had higher potassium and riboflavin and older adolescents had higher calcium and fibre. Q5 had highest intakes of multiple sugar-containing food categories (e.g., fruit, confectionary, milks, cakes/pies/pastries), with higher sugars-sweetened beverages in adolescents. Q3 had higher fruit, milks, and fruit juice compared with Q1 and lower sugars/syrups/preserves, confectionary, and fruit juices compared with Q5. Certain nutrient-dense food sources of sugars (fruit, milks) may help increase key nutrients (potassium, calcium, fibre) in older adolescents with low sugars intakes. However, in those with the highest sugars intakes, nutrient-poor foods may displace nutrient-dense foods. Novelty: Canadian children and adolescents with lower sugars intake have better intakes of some nutrients. Energy intakes did not differ across sugars intake. Older adolescents with mean intakes of total sugars had better intakes of some key nutrients (potassium, calcium, fibre).

Adherence to the United States Department of Agriculture Dietary Recommendations Pre- and During the Coronavirus Disease-19 Pandemic Among Pregnant Women in Arab Countries

During pregnancy, woman’s diet is one of the most preeminent factors affecting mother and child’s health. Prior to the coronavirus disease-19 (COVID-19) pandemic, inadequate maternal diet and low adherence to dietary guidelines was reported among pregnant women in the Arab countries. Nowadays, COVID-19 infection during pregnancy is widely discussed among literature. However, there is limited data on the health impacts of the COVID-19 pandemic on non-infected pregnant women. This substantially larger group also suffered significant lifestyle changes during the lockdown period. The aim of the study is to characterize dietary patterns, intake and adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Arab pregnant women. Using a specially designed questionnaire and using the snowball sampling method, the survey was carried out among a convenient sample of 1,939 pregnant women from five Arab countries. Our study found an increment in the consumption of cereals, fruits, vegetables, dairy products, meats, and nuts that occurred during the pandemic compared to the preceding period. Despite this noticeable increase during the pandemic, the Arab pregnant women in this study had significantly lower adherence to the USDA pregnancy guidelines. The daily consumption of almost all food groups was lower than the USDA’s daily recommendations, except for fruits intake, which was higher than the daily standard. Demonstrated poor adherence to prenatal USDA dietary guidelines by Arab pregnant women can lead to numerous deficiencies and health risks among their offspring. In conclusion, our study showed that before and during the COVID-19 pandemic, poor adherence to dietary recommendations occurred in a considerable number of Arab pregnant women. The findings emphasize the need for nutritional education and intervention during prenatal visits.

Development and single laboratory validation of a targeted liquid chromatography-triple quadrupole mass spectrometry-based method for the determination of insulin like growth factor-1 in different types of milk samples

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Bovine insulin growth factor 1 (IGF-1) was estimated in different cow milk samples.

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In house validation of a LC-MS/MS IGF-1 investigation method in milks obtained by different technological treatments.

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Development of a sample treatment for the extraction of IGF-1 from different types of cow milk.

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IGF-1 level in cow’s milk was not dependent form milk technological processing.

A simple and reliable targeted liquid chromatography-electrospray-tandem mass spectrometry (LC-MS/MS) method was developed and validated through the selection of two biomarker peptides for the identification and determination of bovine insulin like growth factor-1 (IGF-1) in milk samples. Two urea-based sample extraction procedures were tested. The validation results provided detection limits at the 1–5 ng IGF-1/mL level as a function of the milk matrix, precision ranged from 3 to 8% and the method accuracy in the different milk matrices was assured. Finally, IGF-1 was measured in milk samples obtained by treatment with eleven different technological processes: IGF-1 concentrations were spread over a wide range from 11.2 ± 0.3 ng/mL to 346 ± 8 ng/mL with a median of 57.0 ± 0.2 ng/mL. The highest amount of IGF-1 was found in fresh whole milk samples and no significant correlation was found between the total milk protein content and the IGF-1 concentration level.

Effect of Reversal of Whey-Protein to Casein Ratio of Cow Milk, on Insulin, Incretin, and Amino Acid Responses in Humans

SCOPE

Milk-proteins, besides lactose, stimulate insulin and incretin secretion. Although whey-proteins (WP) are more efficient than casein (Cas) in hormone secretion, the effects of reversal of the (WP/Cas) ratio in whole-milk are poorly known.

METHODS AND RESULTS

Healthy volunteers received two different cow-milk drinks, at identical lactose (0.36 g × kg-1 BW) and total-protein (0.18 g × kg1 BW) loads, but at reversed WP/Cas ratio. One is cow-whole milk with a ≈20/80 [WP/Cas] ratio, the other an experimental cow-milk with a ≈70/30 [WP/Cas] ratio ([↑WP↓Cas]-milk). Both milk-types induced the same mild hyperglycemic response. Following [↑WP↓Cas]-milk, the [20'-90'] insulin incremental area (iAUC) (+ ≈44%, p < 0.035), and the [20'-120'] C-peptide iAUC (+ ≈47%, p < 0.015) are greater than those with cow-milk. Similarly, following [↑WP↓Cas]-milk, the GLP-1 [20'-90'] iAUC (+96%, p < 0.025), and the GIP [30'-60'] iAUC (+140%, p < 0.006), were greater than those with cow-milk. Plasma total and branched-chain amino acids are also greater following the [↑WP↓Cas] than cow-milk.

CONCLUSIONS

Reversal of the (WP/Cas) ratio in cow-milk enhanced the insulin response, an effect possibly mediated by incretins and/or amino acids(s). These data may be useful in designing specific milk formulas with different effects on insulin and incretin response(s).

Consumer Choice for Milk and Dairy in Romania: Does Income Really Have an Influence?

Milk and dairy are basic food products and their importance in healthy human development is well known. However, this does not mean that the consumers’ requests for these products are not evolving and fitting into the new context of sustainable development. By conducting a quantitative analysis on 847 answers regarding milk and dairy consumption offered by Romanian consumers, the objective of this study is to reveal what are the main factors of influence for respondents when choosing a milk or dairy product, and to see if these factors are evolving towards including sustainability-related aspects. The results point out that while price and store availability are still present as choice criteria, new aspects that might be related to a sustainable behavior, such as ecologic certification, country of origin or traditional products, are considered by the respondents when purchasing milk and dairy. However, this depends on the level of income; higher incomes allow respondents to consider new criteria.

Identification and in silico characterization of structural and functional impacts of genetic variants in milk protein genes in the Zebu breeds Guzerat and Gyr

Whole genome sequencing of bovine breeds has allowed identification of genetic variants in milk protein genes. However, functional repercussion of such variants at a molecular level has seldom been investigated. Here, the results of a multistep Bioinformatic analysis for functional characterization of recently identified genetic variants in Brazilian Gyr and Guzerat breeds is described, including predicted effects on the following: (i) evolutionary conserved nucleotide positions/regions; (ii) protein function, stability, and interactions; (iii) splicing, branching, and miRNA binding sites; (iv) promoters and transcription factor binding sites; and (v) collocation with QTL. Seventy-one genetic variants were identified in the caseins (CSN1S1, CSN2, CSN1S2, and CSN3), LALBA, LGB, and LTF genes. Eleven potentially regulatory variants and two missense mutations were identified. LALBA Ile60Val was predicted to affect protein stability and flexibility, by reducing the number the disulfide bonds established. LTF Thr546Asn is predicted to generate steric clashes, which could mildly affect iron coordination. In addition, LALBA Ile60Val and LTF Thr546Asn affect exonic splicing enhancers and silencers. Consequently, both mutations have the potential of affecting immune response at individual level, not only in the mammary gland. Although laborious, this multistep procedure for classifying variants allowed the identification of potentially functional variants for milk protein genes.

Food Systems Transformation for Child Health and Well-Being: The Essential Role of Dairy

Malnutrition, in all its forms, during the critical stages of child growth and development can have lifelong impacts on health and well-being. While most forms of malnutrition can be prevented with simple dietary interventions, both undernutrition and overnutrition remain persistent and burdensome challenges for large portions of the global population, especially for young children who are dependent on others for nourishment. In addition to dietary factors, children's health also faces the growing challenges of climate change, environmental degradation, pollution, and infectious disease. Food production and consumption practices both sit at the nexus of these issues, and both must be significantly transformed if we are to achieve the 2030 Sustainable Development Goals. Food sources (i.e., animal-source foods vs. plant-source foods), food production practices, the effects of food processing, the impacts of a more globalized food system, and food loss and waste have all been receiving growing attention in health and sustainability research and policy discussions. Much of this work points to recommendations to reduce resource-intensive animal-source foods, heavily processed foods, and foods associated with excessive waste and pollution, while simultaneously increasing plant-source options. However, some of these recommendations require a little more nuance when considered in the context of issues such as global child health. All types of foods can play significant roles in providing essential nutrition for children across the globe, and for improving the well-being and livelihoods of their families and communities. Dairy foods provide a prime example of this need for nuance, as both dairy production practices and consumption patterns vary greatly throughout the world, as do their impacts on child health and food system sustainability. The objective of this narrative review is to highlight the role of dairy in supporting child health in the context of food system sustainability. When considering child health within this context it is recommended to take a holistic approach that considers all four domains of sustainability (health, economics, society, and the environment) to better weigh trade-offs, optimize outcomes, and avoid unintended consequences. To ensure that children have access to nutritious and safe foods within sustainable food systems, special consideration of their needs must be included within the broader food systems transformation narrative.

Identification of the Potential Role of the Rumen Microbiome in Milk Protein and Fat Synthesis in Dairy Cows Using Metagenomic Sequencing

Simple Summary

The rumen is the main digestive and absorption organ of dairy cows. It contains abundant microorganisms and can effectively use human-indigestible plant mass. Therefore, we used metagenomics to explore the role of rumen microbes in the regulation of milk protein and fat in dairy cows. This study showed that Prevotella species and Neocallimastix californiae in the rumen of cows are related to the synthesis of milk components due to their important functions in carbohydrate, amino acid, pyruvate, insulin, and lipid metabolism and transportation metabolic pathways.

Abstract

The rumen contains abundant microorganisms that aid in the digestion of lignocellulosic feed and are associated with host phenotype traits. Cows with extremely high milk protein and fat percentages (HPF; n = 3) and low milk protein and fat percentages (LPF; n = 3) were selected from 4000 lactating Holstein cows under the same nutritional and management conditions. We found that the total concentration of volatile fatty acids, acetate, butyrate, and propionate in the rumen fluid was significantly higher in the HPF group than in the LPF group. Moreover, we identified 38 most abundant species displaying differential richness between the two groups, in which Prevotella accounted for 68.8% of the species, with the highest abundance in the HPF group. Functional annotation based on the Kyoto Encyclopedia of Gene and Genome (KEGG), evolutionary genealogy of genes: Non-supervised Orthologous Groups (eggNOG), and Carbohydrate-Active enzymes (CAZy) databases showed that the significantly more abundant species in the HPF group are enriched in carbohydrate, amino acid, pyruvate, insulin, and lipid metabolism and transportation. Furthermore, Spearman’s rank correlation analysis revealed that specific microbial taxa (mainly the Prevotella species and Neocallimastix californiae) are positively correlated with total volatile fatty acids (VFA). Collectively, we found that the HPF group was enriched with several Prevotella species related to the total VFA, acetate, and amino acid synthesis. Thereby, these fulfilled the host’s needs for energy, fat, and rumen microbial protein, which can be used for increased biosynthesis of milk fat and milk protein. Our findings provide novel information for elucidation of the regulatory mechanism of the rumen in the formation of milk composition.

Field Monitoring of Aflatoxins in Feed and Milk of High-Yielding Dairy Cows under Two Feeding Systems

Aflatoxin M1 (AFM1) is a hydroxylated metabolite of aflatoxin B1 (AFB1) that can be excreted in milk of cows after consuming contaminated feed. The aim of this study consisted of a field monitoring to assess the contamination levels of AFB1 in 60 feed samples from two feeding systems for high-yielding dairy cows and of AFM1 in the corresponding raw milk samples. The aflatoxins were analyzed by in-house validated methods based on high-performance liquid chromatography (HPLC) with fluorescence detection. AFB1 was detected in 55% of feed samples (mean 0.61 μg/kg, with 2 samples exceeding the European Union (EU) maximum level set at 5 μg/kg), with greater incidence and concentration in compound feed than in unifeed rations (p < 0.05). AFM1 was detected in 38.3% milk samples (mean 12.6 ng/kg, with 5 samples exceeding the EU maximum level set at 50 ng/kg), with a higher occurrence in milk of cows fed compound feed, as well as in spring milk compared to that produced in winter. The overall transfer ratio of aflatoxins from feed to milk was 3.22%, being higher in cows fed with compound feed and in spring milkings. In a selection of positive matched samples (n = 22), the ratio AFM1/AFB1 exceeded the European Food Safety Authority (EFSA) estimated 6% threshold for high-yielding dairy cows.

The Role of Fetal, Infant, and Childhood Nutrition in the Timing of Sexual Maturation

Puberty is a crucial developmental stage in the life span, necessary to achieve reproductive and somatic maturity. Timing of puberty is modulated by and responds to central neurotransmitters, hormones, and environmental factors leading to hypothalamic-pituitary-gonadal axis maturation. The connection between hormones and nutrition during critical periods of growth, like fetal life or infancy, is fundamental for metabolic adaptation response and pubertal development control and prediction. Since birth weight is an important indicator of growth estimation during fetal life, restricted prenatal growth, such as intrauterine growth restriction (IUGR) and small for gestational age (SGA), may impact endocrine system, affecting pubertal development. Successively, lactation along with early life optimal nutrition during infancy and childhood may be important in order to set up timing of sexual maturation and provide successful reproduction at a later time. Sexual maturation and healthy growth are also influenced by nutrition requirements and diet composition. Early nutritional surveillance and monitoring of pubertal development is recommended in all children, particularly in those at risk, such as the ones born SGA and/or IUGR, as well as in the case of sudden weight gain during infancy. Adequate macro and micronutrient intake is essential for healthy growth and sexual maturity.

MILK Symposium Introduction: Dairy production in developing countries

In low- and middle-income countries (LMICs), dairy production is highly valued, and demand for milk is projected to continue to increase markedly over the next few decades. This presents a tremendous opportunity to improve the nutrition, health, incomes, and livelihoods of millions of people with the high-quality protein and bioavailable micronutrients in dairy products. However, low dairy consumption levels, due to low affordability, accessibility, and availability, still typify several LMICs. This is caused by inadequate feeding, management, and genetics; poor transport, cooling, and processing infrastructure; unconducive policy environments; and sociocultural and demographic factors. Strategies to address some of these factors were presented at the MILK Symposium hosted by the Feed the Future Innovation Lab for Livestock Systems during the 2019 American Dairy Science Association Annual Meeting. The papers presented are full manuscripts in this Special Issue of the Journal of Dairy Science. They address the importance of dairy products for human health, strategies to address feed, management, health, and food safety challenges in dairy production systems, and sustainability of dairy production in LMICs. They collectively show how strategic interventions can lead to marked improvements in dairy production in developing countries. These will ultimately contribute to meeting the growing global demand for milk and to achievement of the United Nations Sustainable Development Goals.