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Yao R, Cools A, Matthijs A, Deyn PPD, Maes D, Janssens GPJ. Peculiarities in the Amino Acid Composition of Sow Colostrum and Milk, and Their Potential Relevance to Piglet Development. Vet Sci 2023; 10:vetsci10040298. [PMID: 37104453 PMCID: PMC10141862 DOI: 10.3390/vetsci10040298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
The composition of mother's milk is considered the ideal diet for neonates. This study investigated how conserved or variable the amino acid profile of sow colostrum and milk is throughout lactation, compared with other studies in sows and other species. Twenty-five sows (parity one to seven) from one farm with gestation lengths of 114 to 116 d were sampled on d 0, 3, and 10 after parturition. The total amino acid profile of the samples was analyzed through ion-exchange chromatography, and the results were displayed as the percentage of total amino acid and compared with literature data. Most of the amino acid concentrations in sow milk decreased significantly (p < 0.05) throughout the lactation period, while the amino acid profile generally showed a conserved pattern, especially from d 3 to d 10, and was rather similar across different studies. Glutamine + glutamate was the most abundant amino acid in milk at all sampling moments, accounting for 14-17% of total amino acids. The proportions of proline, valine, and glycine in sow milk nearly accounted for 11%, 7%, and 6% respectively, and were higher compared to human, cow, and goat milk, while the methionine proportion was less than the other three. Compared to the large variations often reported in macronutrient concentrations, the amino acid profile of sow milk in the present study, as well as in others, seems well conserved across the lactation period. Similarities with characteristic differences were also observed between sow milk and piglet body composition, which might reflect the nutrition requirements of preweaning piglets. This study warrants further research exploring the link between the whole amino acid profile and the particular amino acids for suckling piglets and could facilitate insight for optimizing creep feed.
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Affiliation(s)
- Renjie Yao
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - An Cools
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - Anneleen Matthijs
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - Peter P De Deyn
- Laboratory of Neurochemistry and Behaviour, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Dominiek Maes
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - Geert P J Janssens
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
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2
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Ouyang R, Ding J, Huang Y, Zheng F, Zheng S, Ye Y, Li Q, Wang X, Ma X, Zou Y, Chen R, Zhuo Z, Li Z, Xin Q, Zhou L, Lu X, Ren Z, Liu X, Kovatcheva-Datchary P, Xu G. Maturation of the gut metabolome during the first year of life in humans. Gut Microbes 2023; 15:2231596. [PMID: 37424334 PMCID: PMC10334852 DOI: 10.1080/19490976.2023.2231596] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
The gut microbiota is involved in the production of numerous metabolites that maintain host wellbeing. The assembly of the gut microbiome is highly dynamic, and influenced by many postnatal factors, moreover, little is known about the development of the gut metabolome. We showed that geography has an important influence on the microbiome dynamics in the first year of life based on two independent cohorts from China and Sweden. Major compositional differences since birth were the high relative abundance of Bacteroides in the Swedish cohort and Streptococcus in the Chinese cohort. We analyzed the development of the fecal metabolome in the first year of life in the Chinese cohort. Lipid metabolism, especially acylcarnitines and bile acids, was the most abundant metabolic pathway in the newborn gut. Delivery mode and feeding induced particular differences in the gut metabolome since birth. In contrast to C-section newborns, medium- and long-chain acylcarnitines were abundant at newborn age only in vaginally delivered infants, associated by the presence of bacteria such as Bacteroides vulgatus and Parabacteroides merdae. Our data provide a basis for understanding the maturation of the fecal metabolome and the metabolic role of gut microbiota in infancy.
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Affiliation(s)
- Runze Ouyang
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Juan Ding
- Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Huang
- University of Chinese Academy of Sciences, Beijing, China
| | - Fujian Zheng
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Sijia Zheng
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Yaorui Ye
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Qi Li
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Xiaolin Wang
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Xiao Ma
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuxin Zou
- Department of Pediatrics, Liaocheng People’s Hospital, Liaocheng, China
| | - Rong Chen
- Department of Respiratory Medicine, Dalian Municipal Women and Children’s Medical Center (Group), Dalian, China
| | - Zhihong Zhuo
- Department of Pediatric, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhen Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qi Xin
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Lina Zhou
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Xin Lu
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Zhigang Ren
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyu Liu
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
| | - Petia Kovatcheva-Datchary
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Institute for Molecular Infection Biology, University of Wurzburg, Wurzburg, Germany
- Department of Pediatrics, University of Wurzburg, Wurzburg, Germany
| | - Guowang Xu
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
- University of Chinese Academy of Sciences, Beijing, China
- Liaoning Province Key Laboratory of Metabolomics, Dalian, China
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3
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Moya-Alvarez V, Eussen SRBM, Mank M, Koyembi JCJ, Nyasenu YT, Ngaya G, Mad-Bondo D, Kongoma JB, Stahl B, Sansonetti PJ, Bourdet-Sicard R. Human milk nutritional composition across lactational stages in Central Africa. Front Nutr 2022; 9:1033005. [PMID: 36466422 PMCID: PMC9709887 DOI: 10.3389/fnut.2022.1033005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/27/2022] [Indexed: 03/11/2024] Open
Abstract
The African region encompasses the highest undernutrition burden with the highest neonatal and infant mortality rates globally. Under these circumstances, breastfeeding is one of the most effective ways to ensure child health and development. However, evidence on human milk (HM) composition from African women is scarce. This is of special concern, as we have no reference data from HM composition in the context of food insecurity in Africa. Furthermore, data on the evolution of HM across lactational stages in this setting lack as well. In the MITICA study, we conducted a cohort study among 48 Central-African women and their 50 infants to analyze the emergence of gut dysbiosis in infants and describe the mother-infant transmission of microbiota between birth and 6 months of age. In this context, we assessed nutritional components in HM of 48 lactating women in Central Africa through five sampling times from week 1 after birth until week 25. Unexpectedly, HM-type III (Secretor + and Lewis genes -) was predominant in HM from Central African women, and some nutrients differed significantly among HM-types. While lactose concentration increased across lactation periods, fatty acid concentration did not vary significantly. The overall median level of 16 detected individual human milk oligosaccharides (HMOs; core structures as well as fucosylated and sialylated ones) decreased from 7.3 g/l at week 1 to 3.5 g/l at week 25. The median levels of total amino acids in HM dropped from 12.8 mg/ml at week 1 to 7.4 mg/ml at week 25. In contrast, specific free amino acids increased between months 1 and 3 of lactation, e.g., free glutamic acid, glutamine, aspartic acid, and serine. In conclusion, HM-type distribution and certain nutrients differed from Western mother HM.
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Affiliation(s)
- Violeta Moya-Alvarez
- Unité de Pathogénie Microbienne Moléculaire, INSERM U1202, Department of Cell Biology and Infection, Institut Pasteur, Paris, France
- Epidemiology of Emergent Diseases Unit, Global Health Department, Institut Pasteur, Paris, France
| | - Simone R. B. M. Eussen
- Human Milk Research and Analytical Science, Danone Nutricia Research, Utrecht, Netherlands
| | - Marko Mank
- Human Milk Research and Analytical Science, Danone Nutricia Research, Utrecht, Netherlands
| | | | - Yawo Tufa Nyasenu
- Laboratoire d'Analyses Médicales, Institut Pasteur de Bangui, Bangui, Central African Republic
- Laboratoire de Biologie Moléculaire et d'Immunologie, Université de Lomé, Lomé, Togo
| | - Gilles Ngaya
- Laboratoire de Biologie Moléculaire et d'Immunologie, Université de Lomé, Lomé, Togo
| | - Daniel Mad-Bondo
- Direction du Service de Santé de la Gendarmerie, Sis Camp Henri Izamo, Bangui, Central African Republic
| | - Jean-Bertrand Kongoma
- Direction du Service de Santé de la Gendarmerie, Sis Camp Henri Izamo, Bangui, Central African Republic
| | - Bernd Stahl
- Human Milk Research and Analytical Science, Danone Nutricia Research, Utrecht, Netherlands
- Department of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Philippe J. Sansonetti
- Unité de Pathogénie Microbienne Moléculaire, INSERM U1202, Department of Cell Biology and Infection, Institut Pasteur, Paris, France
- Chaire de Microbiologie et Maladies Infectieuses, Collège de France, Paris, France
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Kortesniemi M, Jafari T, Zhang Y, Yang B. 1H NMR Metabolomics of Chinese Human Milk at Different Stages of Lactation among Secretors and Non-Secretors. Molecules 2022; 27:molecules27175526. [PMID: 36080292 PMCID: PMC9458218 DOI: 10.3390/molecules27175526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Human milk is an intricate, bioactive food promoting infant health. We studied the composition of human milk samples collected over an 8-month lactation using 1H NMR metabolomics. A total of 72 human breast milk samples were collected from ten Chinese mothers at eight different time points. The concentrations of ten human milk oligosaccharides (HMOs), fucose and lactose were quantified. Six of the mothers were classified as Lewis-positive secretors (Se+Le+) and four as Lewis-positive non-secretors (Se−Le+) based on the levels of 2′-fucosyllactose (2′-FL), lacto-N-fucopentaose (LNFP) II, lactodifucotetraose (LDFT) and lacto-N-neotetraose (LNnT). Acetate, citrate, short/medium-chain fatty acids, glutamine and urea showed a time-dependent trend in relation to the stage of lactation. The concentrations of 2′-FL, 3-FL (3-fucosyllactose), 3′-SL (3′-sialyllactose), LDFT, LNFP I, LNFP II, LNFP III, LNnT, LNT (lacto-N-tetraose), and fucose were statistically different between secretors and non-secretors. A temporal difference of approximately 1–2 months between the development of non-secretor and secretor HMO profiles was shown. The results highlighted the importance of long-term breastfeeding, especially among non-secretors.
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Affiliation(s)
- Maaria Kortesniemi
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
- Correspondence: (M.K.); (Y.Z.)
| | - Tahereh Jafari
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, Peking University, Xueyuan Road 38, Haidian District, Beijing 100191, China
- Correspondence: (M.K.); (Y.Z.)
| | - Baoru Yang
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
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5
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Michler E, Hilliger S, Kopka K, Kotzerke J. 11C-Methionine Uptake in the Lactating Human Breast. Clin Nucl Med 2022; 47:e66-e67. [PMID: 34284472 DOI: 10.1097/rlu.0000000000003836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 33-year-old nursing mother who underwent resection of a glioblastoma of the right hemisphere was referred for a 11C-methionine PET/MR scan to exclude cancer recurrence. In whole-body PET imaging, a slight radiotracer uptake could be observed in the mammary glands, reflecting lactation status. In this case report, we initially describe 11C-methionine uptake in the human breast and discuss any consequences arising from this special situation.
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Affiliation(s)
- Enrico Michler
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden
| | - Stephan Hilliger
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden
| | - Klaus Kopka
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Jörg Kotzerke
- From the Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden
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6
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Musaev A, Sadykova S, Anambayeva A, Saizhanova M, Balkanay G, Kolbaev M. Mare's Milk: Composition, Properties, and Application in Medicine. ARCHIVES OF RAZI INSTITUTE 2021; 76:1125-1135. [PMID: 35096348 PMCID: PMC8790991 DOI: 10.22092/ari.2021.355834.1725] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022]
Abstract
Mare's milk is a highly valuable organic substance that has a great potential to replace cow's milk. Consumption of cow's milk causes digestive disorders in some individuals. Immunoglobulin E (IgE)-mediated cow's milk allergy (CMA) is one of the most common food allergies among infants. Therefore, finding a protein substitute with the same nutritional value is a priority. Mare's milk can be a good substitute for cow's milk, especially for those suffering from CMA. Prerequisites for this study were the recent interest in mare's milk, as an ancient relic of the Turkic peoples which contains lots of nutrients. The present study aimed to systematize relevant information on the composition of mare's milk and its application in medicine. Google Scholar, PubMed, Cochrane, Elsevier, CyberLeninka were employed for a comprehensive literature search. The searched keywords for this study were mare's milk, saumal, composition, properties, use in medicine. A total of 77 sources were selected for reviewing the literature. Most sources were in English, except for one of the bottom 40 sources published in the last 10 years. Among the milk of many mammalian species, mare's milk is chemically similar to human milk so it can be used as a substitute. It is also used to feed people with various health conditions, especially in patients at risk, or suffering from tuberculosis, hepatitis C, psoriasis, and various types of immunodeficiency. The present study describes the rich composition, antibacterial and antiviral properties of mare's milk. A review of the literature revealed that mare's milk is an excellent thirst quencher, and has valuable nutrients necessary for the human body which is by no means inferior to human milk.
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Affiliation(s)
- A Musaev
- NJSC“Asfendiyarov Kazakh National Medical, University”, Almaty, Kazakhstan
| | - S Sadykova
- Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - A Anambayeva
- NJSC“Asfendiyarov Kazakh National Medical, University”, Almaty, Kazakhstan
| | - M Saizhanova
- NJSC“Asfendiyarov Kazakh National Medical, University”, Almaty, Kazakhstan
| | - G Balkanay
- NJSC“Asfendiyarov Kazakh National Medical, University”, Almaty, Kazakhstan
| | - M Kolbaev
- NJSC“Asfendiyarov Kazakh National Medical, University”, Almaty, Kazakhstan
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7
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Riederer M, Schweighofer N, Trajanoski S, Stelzer C, Zehentner M, Fuchs-Neuhold B, Kashofer K, Mayr JA, Hörmann-Wallner M, Holasek S, van der Kleyn M. Free threonine in human breast milk is related to infant intestinal microbiota composition. Amino Acids 2021; 54:365-383. [PMID: 34477981 PMCID: PMC8948153 DOI: 10.1007/s00726-021-03057-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Accumulating evidence indicates that free amino acids (FAA) might be bioactive compounds with potential immunomodulatory capabilities. However, the FAA composition in human milk is still poorly characterized with respect to its correlation to maternal serum levels and its physiological significance for the infant. Studies addressing the relation of human milk FAA to the infants' intestinal microbiota are still missing. METHODS As part of a pilot study, maternal serum and breast milk FAA concentrations as well as infant intestinal microbiota (16S rRNA) were determined 2 months after birth. The study cohort consisted of 41 healthy mothers and their term delivered, healthy infants with normal birthweight. The relationship between maternal serum and milk FAA was determined by correlation analyses. Associations between (highly correlated) milk FAA and infant intestinal beta diversity were tested using PERMANOVA, LefSe and multivariate regression models adjusted for common confounders. RESULTS Seven breast milk FAA correlated significantly with serum concentrations. One of these, threonine showed a negative association with abundance of members of the class Gammaproteobacteria (R2adj = 17.1%, p = 0.006; β= - 0.441). In addition, on the level of families and genera, threonine explained 23.2% of variation of the relative abundance of Enterobacteriaceae (R2adj; p = 0.001; β = - 0.504) and 11.1% of variability in the abundance of Escherichia/Shigella (R2adj, p = 0.025; β = - 0.368), when adjusted for confounders. CONCLUSION Our study is the first to suggest potential interactions between breast milk FAA and infant gut microbiota composition during early lactation. The results might be indicative of a potential protective role of threonine against members of the Enterobacteriaceae family in breast-fed infants. Still, results are based on correlation analyses and larger cohorts are needed to support the findings and elucidate possible underlying mechanisms to assess the complex interplay between breast milk FAA and infant intestinal microbiota in detail.
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Affiliation(s)
- Monika Riederer
- Institute of Biomedical Science, University of Applied Sciences JOANNEUM, Graz, Austria.
| | | | - Slave Trajanoski
- Core Facility Computational Bioanalytics, Center for Medical Research (ZMF), Medical University of Graz, Graz, Austria
| | - Claudia Stelzer
- Institute of Biomedical Science, University of Applied Sciences JOANNEUM, Graz, Austria
| | - Miriam Zehentner
- Institute of Biomedical Science, University of Applied Sciences JOANNEUM, Graz, Austria
| | - Bianca Fuchs-Neuhold
- Institute of Dietetics and Nutrition, Health Perception Lab, University of Applied Sciences JOANNEUM, Graz, Austria
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Auenbruggerpl. 2, 8036, Graz, Austria
| | - Johannes A Mayr
- Department of Pediatrics, Salzburger Landeskliniken and Paracelsus Medical University, Salzburg, Austria
| | - Marlies Hörmann-Wallner
- Institute of Dietetics and Nutrition, Health Perception Lab, University of Applied Sciences JOANNEUM, Graz, Austria
| | - Sandra Holasek
- Department of Pathophysiology, Medical University Graz, Graz, Austria
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Zhang X, Zhang M, Lin T, Zhao J, Luo Z, Hou J, Sun B, Chen L. Relationship between traditional maternal diet pattern and breastmilk composition of rural lactating women during the first month postpartum in Shigatse, Tibet. Food Sci Nutr 2021; 9:4185-4198. [PMID: 34401070 PMCID: PMC8358384 DOI: 10.1002/fsn3.2384] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
Maternal nutrition can influence the composition of human breastmilk by altering the components that are sensitive to maternal diet pattern. Traditional Tibetan maternal diet pattern among native rural lactating women possesses distinct characteristics due to its unique geographical environment and dietary habits. This study investigated maternal diet pattern and human breastmilk composition of Tibetan lactating women through different lactation stages during the first month postpartum in Shigatse. The results indicated that Tibetan maternal diet profile was apparently monotonous, mainly sufficient in Zanba, buttered tea, red meat, and fatty soup, yet insufficient in white meat, eggs, leafy vegetables, and fruits, leading to imperfect maternal nutritional intakes with high-level carbohydrates and deficient proteins. Distinctions of maternal diet profiles in various degrees can be discovered upon different lactation stages, which brings multiple influences to the composition of human milk. There was significantly weak-to-medium correlation of protein contents between maternal diet intakes and human milk, while other macronutrients correlated insignificantly. Micronutrient constituents in human milk, involving functional unsaturated fatty acids and free essential amino acids, were also impacted by maternal diet intakes through different lactation stages. These results show that more systematic and profound research is requisite for the clarification and development of Tibetan maternal diet to offer more enhanced and individualized nutritional recommendations for Tibetan lactating women and infants.
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Affiliation(s)
- Xiaomei Zhang
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Advanced Innovation Center for Food Nutrition and Human HealthBeijing Technology & Business UniversityBeijingChina
| | - Minghui Zhang
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Tie Lin
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Junying Zhao
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
| | - Zhang Luo
- Food Science CollegeTibet Agriculture & Animal Husbandry UniversityNyingchi, TibetChina
| | - Juncai Hou
- Key Laboratory of Dairy Science, Ministry of EducationCollege of Food ScienceNortheast Agricultural UniversityHarbinChina
| | - Baoguo Sun
- Beijing Advanced Innovation Center for Food Nutrition and Human HealthBeijing Technology & Business UniversityBeijingChina
| | - Lijun Chen
- National Engineering Center of Dairy for Maternal and Child HealthBeijing Sanyuan Foods Co. Ltd.BeijingChina
- Beijing Engineering Research Center of DairyBeijing Technical Innovation Center of Human Milk ResearchBeijing Sanyuan Foods Co. Ltd.BeijingChina
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9
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van Sadelhoff JHJ, Siziba LP, Buchenauer L, Mank M, Wiertsema SP, Hogenkamp A, Stahl B, Garssen J, Rothenbacher D, Genuneit J. Free and Total Amino Acids in Human Milk in Relation to Maternal and Infant Characteristics and Infant Health Outcomes: The Ulm SPATZ Health Study. Nutrients 2021; 13:nu13062009. [PMID: 34200908 PMCID: PMC8230437 DOI: 10.3390/nu13062009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/25/2022] Open
Abstract
Free amino acids (FAAs) are important regulators of key pathways necessary for growth, development, and immunity. Data on FAAs in human milk (HM) and their roles in infant development are limited. We investigated the levels of FAAs and total amino acids (TAA, i.e., the sum of conjugated amino acids and FAAs) in HM in relation to infant and maternal characteristics and immunological conditions. FAA and TAA levels in HM sampled at 6 weeks (n = 671) and 6 months (n = 441) of lactation were determined using high-performance liquid chromatography. Child growth was ascertained at 4–5 weeks and at 6–7 months of age. Child allergy and lower respiratory tract infections were assessed in the first years of life. Associations of amino acid (AA) levels in HM with child growth and health outcomes were determined by Spearman correlation and modified Poisson regression, respectively. Free glutamine, glutamate, and serine in 6-week HM positively correlated with infant weight gain in the first 4–5 weeks of age. Maternal pre-pregnancy weight and body mass index (BMI) were negatively correlated with free glutamine and asparagine in 6-week and 6-month HM and positively correlated with the sum of TAAs in 6-month HM, but significance was lost following confounder adjustment. Free glutamine was lower in 6-month HM of mothers with an allergy (either active or non-active). No consistent associations were found between FAAs in HM and child health outcomes. However, potential negative associations were observed between specific FAAs and the risk of food allergy. These results suggest that specific FAAs play a role in infant growth. Moreover, these findings warrant further investigations into the relation of FAAs in HM with infant health outcomes and maternal allergy.
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Affiliation(s)
- Joris H. J. van Sadelhoff
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (A.H.); (J.G.)
- Correspondence: ; Tel.: +31-625-699-571
| | - Linda P. Siziba
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.P.S.); (L.B.); (J.G.)
| | - Lisa Buchenauer
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.P.S.); (L.B.); (J.G.)
| | - Marko Mank
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (M.M.); (S.P.W.); (B.S.)
| | - Selma P. Wiertsema
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (M.M.); (S.P.W.); (B.S.)
| | - Astrid Hogenkamp
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (A.H.); (J.G.)
| | - Bernd Stahl
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (M.M.); (S.P.W.); (B.S.)
- Department of Chemical Biology & Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands; (A.H.); (J.G.)
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands; (M.M.); (S.P.W.); (B.S.)
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, 04103 Leipzig, Germany; (L.P.S.); (L.B.); (J.G.)
- Institute of Epidemiology and Medical Biometry, Ulm University, 89079 Ulm, Germany;
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10
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Chen MJ, Pan NX, Wang XQ, Yan HC, Gao CQ. Methionine promotes crop milk protein synthesis through the JAK2-STAT5 signaling during lactation of domestic pigeons (Columba livia). Food Funct 2020; 11:10786-10798. [PMID: 33232416 DOI: 10.1039/d0fo02257h] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Crop milk is the sole source of nutrition that sustains young pigeons (squabs) throughout growth and development. Protein accounts for approximately 55% of the nutrients in crop milk; however, its regulation mechanism remains unclear. In our study, three experiments were conducted to investigate the possible underlying mechanism of crop milk protein synthesis and nutritional interventions. Isobaric tagging for relative and absolute quantification (iTRAQ) analysis found that the Janus activated kinase (JAK)/signal transducers and activators of transcription (STAT) pathway was significantly up-regulated in breeding pigeons during lactation compared to non-breeding pigeons. Moreover, the serum prolactin (PRL) levels increased, and the protein expression of the PRL receptor (PRLR)/JAK2/STAT5 pathway was significantly up-regulated during lactation. The serum PRL, the PRLR/JAK2/STAT5 pathway, the crop milk protein synthesis, and the squab growth performance were inhibited by bromocriptine mesylate injection, a PRL-specific inhibitor. In addition, dietary supplementation with 0.30% dl-methionine or dl-methionine-dl-methionine (especially 0.30% dl-methionine-dl-methionine), significantly increased serum PRL levels and PRLR/JAK2/STAT5 activity, and improved the crop milk protein synthesis. In conclusion, our results demonstrated that the PRL-induced PRLR/JAK2/STAT5 signaling pathway plays a vital regulatory role in crop milk protein synthesis, and 0.30% dl-methionine-dl-methionine is superior to dl-methionine in promoting crop milk protein synthesis.
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Affiliation(s)
- Meng-Jie Chen
- College of Animal Science, South China Agricultural University/Guangdong Provincial Key Laboratory of Animal Nutrition Control/Key Laboratory of Chicken Genetics, Breeding and Reproduction, Ministry of Agriculture, Guangzhou 510642, China.
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11
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Manta-Vogli PD, Schulpis KH, Loukas YL, Dotsikas Y. Birth weight related essential, non-essential and conditionally essential amino acid blood concentrations in 12,000 breastfed full-term infants perinatally. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:571-579. [DOI: 10.1080/00365513.2020.1818280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Penelope D. Manta-Vogli
- Department of Clinical Nutrition & Dietetics, Agia Sofia Children’s Hospital, Athens, Greece
| | | | - Yannis L. Loukas
- Laboratory of Pharmaceutical Analysis, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Dotsikas
- Laboratory of Pharmaceutical Analysis, Department of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
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12
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Wei M, Deng Z, Liu B, Ye W, Fan Y, Liu R, Li J. Investigation of amino acids and minerals in Chinese breast milk. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2020; 100:3920-3931. [PMID: 32329067 DOI: 10.1002/jsfa.10434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/13/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The nutrients in human milk, particularly amino acids and minerals, are important for infant growth and development. Since there are few reports of amino acids and minerals in Chinese breast milk, we conducted this study to establish a representative preliminary database of breast milk nutrients in Chinese breast milk. In this study, we collected breast milk from healthy mothers in seven cities in western, southern and central China. The composition, content and proportion of total amino acids and ten elements (potassium, sodium, calcium, magnesium, iron, zinc, manganese, copper, selenium and phosphorus) in human milk in different lactation stages were investigated. RESULTS In this study, it was found that the content of total essential amino acids (671.47 mg 100 mL-1 ) in Chinese breast milk was higher compared with the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) (574 mg 100 mL-1 ), but the content of leucine (LEU) (129.01 mg 100 mL-1 ) and cysteine (CYS) (20.31 mg 100 mL-1 ) was much lower than that recommended by ESPGHAN. Moreover, it was found that the content of most of these ten elements decreased during lactation, and the content of calcium in Chinese breast milk was lower compared with ESPGHAN. In addition, the content of selenium (7.23-20.55 mg 1000 mL-1 ) in breast milk from the three cities Nanchang, Shanghai and Guangzhou in China was much higher than that recommended by ESPGHAN. CONCLUSIONS In a word, amino acids and minerals in Chinese human milk showed a significant difference from other countries. Human milk meal or infant food should be regulated to meet the requirements of the infant and to maintain the balance of the amino acids and minerals. © 2020 Society of Chemical Industry.
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Affiliation(s)
- Meng Wei
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Zeyuan Deng
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Biao Liu
- Yili Group Milk Powder Division Research and Development, Hohhot, China
| | - Wenhui Ye
- Yili Group Milk Powder Division Research and Development, Hohhot, China
| | - Yawei Fan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Rong Liu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Jing Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
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13
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van Sadelhoff JHJ, Wiertsema SP, Garssen J, Hogenkamp A. Free Amino Acids in Human Milk: A Potential Role for Glutamine and Glutamate in the Protection Against Neonatal Allergies and Infections. Front Immunol 2020; 11:1007. [PMID: 32547547 PMCID: PMC7270293 DOI: 10.3389/fimmu.2020.01007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
Breastfeeding is indicated to support neonatal immune development and to protect against neonatal infections and allergies. Human milk composition is widely studied in relation to these unique abilities, which has led to the identification of various immunomodulating components in human milk, including various bioactive proteins. In addition to proteins, human milk contains free amino acids (FAAs), which have not been well-studied. Of those, the FAAs glutamate and glutamine are by far the most abundant. Levels of these FAAs in human milk sharply increase during the first months of lactation, in contrast to most other FAAs. These unique dynamics are globally consistent, suggesting that their levels in human milk are tightly regulated throughout lactation and, consequently, that they might have specific roles in the developing neonate. Interestingly, free glutamine and glutamate are reported to exhibit immunomodulating capacities, indicating that these FAAs could contribute to neonatal immune development and to the unique protective effects of breastfeeding. This review describes the current understanding of the FAA composition in human milk. Moreover, it provides an overview of the effects of free glutamine and glutamate on immune parameters relevant for allergic sensitization and infections in early life. The data reviewed provide rationale to study the role of free glutamine and glutamate in human milk in the protection against neonatal allergies and infections.
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Affiliation(s)
- Joris H J van Sadelhoff
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | | | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Danone Nutricia Research, Utrecht, Netherlands
| | - Astrid Hogenkamp
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
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14
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Ren Q, Sun H, Zhao M, Xu Y, Xie Q, Jiang S, Zhao X, Zhang W. Longitudinal Changes in Crude Protein and Amino Acids in Human Milk in Chinese Population: A Systematic Review. J Pediatr Gastroenterol Nutr 2020; 70:555-561. [PMID: 31899726 DOI: 10.1097/mpg.0000000000002612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE More than 20% of the world population live in China, which has made significant achievement in human milk research. Part of the data that were published in Chinese were, however, unavailable to non-Chinese speakers. There was also no comprehensive overview of crude protein and amino acid levels in human milk in Chinese population. This systematic review aimed to compile the data on human milk crude protein and amino acid levels in Chinese population. METHODS After searching for and screening original research articles in both English and Chinese, 23 published from 1987 to 2019 were identified (18 in Chinese and 5 in English). The data were pooled into 9 defined lactation stages. RESULTS Crude protein and amino acids (protein bound plus nonprotein bound) concentrations gradually decreased during the first 60 postpartum days and remained relatively static thereafter. The concentrations and dynamic change of crude protein and amino acids were similar to those in other populations. By contrast, the longitudinal changes in free amino acids (nonprotein bound) were less clear due to the limited data available. Several common weaknesses were identified in these studies. CONCLUSIONS Our study represented the most comprehensive overview on crude protein and amino acid concentrations in human milk in Chinese population, and enhanced the knowledge of protein and amino acid intakes and requirements by Chinese infants.
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Affiliation(s)
- Qiqi Ren
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Han Sun
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Mengya Zhao
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Yingwei Xu
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Qinggang Xie
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Shilong Jiang
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
| | - Xuejun Zhao
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing.,Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Zhang
- Research and Development Department, Heilongjiang Feihe Dairy Co., Ltd., Beijing
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Free Amino Acid Content in Human Milk is Associated with Infant Gender and Weight Gain during the First Four Months of Lactation. Nutrients 2019; 11:nu11092239. [PMID: 31533347 PMCID: PMC6770539 DOI: 10.3390/nu11092239] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/20/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background: There is a growing interest regarding the physiological role of free amino acids (FAA) present in human milk (HM). Recent studies show FAA in HM could be influenced by infants’ gender and could have an important role in their growth and development. We studied the concentrations of FAA in HM and potential associations with infants’ gender and their patterns of growth in a cohort of Ecuadorian women. Methods: Human milk samples were collected after approximately eight hours of overnight fast within one week (colostrum), 2 weeks (transition milk), and 2 and/or 4 months (mature milk) after parturition. Free AA were determined by cation-exchange chromatography separation. Results: We observed significantly higher concentrations of Glu 14.40 (1.35, 27.44), Gly 1.82 (0.24, 3.4), Cys 0.36 (0.03, 0.68), and Tyr 0.24 (0.02, 0.46) in HM intended for boys. Free Glu, Gly, Cys, and Tyr concentrations increased with time of lactation. In addition, there were higher concentrations of Glu 28.62 (1.78, 55.46) and Ala 7.16 (1.26, 13.06) in HM for children that presented faster weight gain than for those with slower gain. Conclusions: The present results showed that there are differences in FAA levels in HM intended for male and fast-growing children.
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Osmolality of a fortified human preterm milk: The effect of fortifier dosage, gestational age, lactation stage, and hospital practices. Arch Pediatr 2018; 25:411-415. [PMID: 30241780 DOI: 10.1016/j.arcped.2018.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/20/2018] [Accepted: 08/18/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the dose-dependent effect of human milk fortifier (HMF) on the osmolality of various preterm human milks (PHMs) at different gestational and lactation stages, and with different storage and treatment conditions that are routinely used in neonatal intensive care units (NICUs). STUDY DESIGN Twenty-four mothers who had given birth to their baby before 28 or between 29 and 31 weeks of pregnancy participated in the study after 1-2 weeks or 3-4 weeks breastfeeding after delivery. The study was a prospective, multicenter, comparative, and noninterventional study. Osmolality of fresh or pasteurized human milk stored at 4°C was measured (cryoscopy) at baseline, and 24hours after adding Suppletine® Human Milk fortifier (SHMF) at 3%, 4%, 4.5%, and 5% (w/v). RESULTS PHM without supplementation had an osmolality (mean±SD) of 301±8 mOsm/kgH2O (n=40; 95% CI: [298; 303]). Adding 3-5% SHMF induced a linear increase of osmolality (P<0.001; r2=0.975). With 4% SHMF, the osmolality measure was 443±13mOsm/kg H2O (95% CI: [439-447]). Neither a 24-hour storage at 4°C nor pasteurization induced a modification of osmolality compared to the fresh samples. CONCLUSION Whatever the origin and quality of milk as well as hospital practices, adding up to 4% (w/v) SHMF to PHM increases its nutritional quality and osmolality without exceeding 450mOsm/kgH2O, which is generally recognized as safe.
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Longitudinal Variation of Amino Acid Levels in Human Milk and Their Associations with Infant Gender. Nutrients 2018; 10:nu10091233. [PMID: 30189593 PMCID: PMC6163519 DOI: 10.3390/nu10091233] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 12/16/2022] Open
Abstract
It is discussed that specific amino acids (AAs) have functional roles in early life. Understanding the AA composition in human milk (HM) during lactation assists in specifying these roles. To this end we assessed the levels of free AAs (FAAs), total AAs (free and bound, TAAs) and protein levels in HM in the first 6 months of lactation, and evaluated possible associations with infant gender. HM samples of 25 healthy Dutch mothers participating in the PreventCD study were collected monthly during the first 6 months of lactation. Of the participating mothers, 12 gave birth to a boy and 13 gave birth to a girl. Analyses of the HM samples revealed that levels of free glutamate, glutamine, aspartate, glycine, and serine significantly increased during months 1–3 of lactation, both in absolute sense and relative to TAA levels. Evaluation of gender differences by mixed model analyses revealed an association between female infant gender and higher protein content (p = 0.0465) and TAA content (p = 0.0362) in HM during the first 3 months of lactation. Furthermore, there was a tendency for an association of male infant gender with higher levels of free glutamine (p = 0.0948) in HM during the first 3 months of lactation. These results show that FAA, TAA and protein levels in HM display a time-specific occurrence during lactation. Moreover, although confirmation is necessary in view of the small sample size, this study indicates that the AA composition in HM shows differential effects of the infant’s sex.
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