Search Results (151)

This review aimed to be comprehensive and to critically analyze the factors that may affect the macronutrient and energy content of breast milk. Systematic reviews were prioritized, even though other types of literature reviews on the subject, as well as studies not included in these reviews, were included. Reported factors that potentially affect the macronutrient and energy content of breast milk comprise: maternal factors, such as age, nutritional status, dietary intake, smoking habits, lactation stage, circadian rhythmicity, and the use of galactagogues; obstetrical factors, such as parity, preterm delivery, multiple pregnancies, labor and delivery, and pregnancy morbidities including intrauterine growth restriction, hypertensive disorders, and gestational diabetes mellitus; and newborn factors, including sexual dimorphism, and anthropometry at birth. Some factors underwent a less robust assessment, while others underwent a more in-depth analysis. For example, the milk from overweight and obese mothers has been reported to be richer in energy and fat. A progressive decrease in protein content and an increase in fat content was described over time during lactation. The milk from mothers with hypertensive disorders may have a higher protein content. Higher protein and energy content has been found in early milk from mothers who delivered prematurely. Full article

Background/Objectives: Lactating mothers have increased nutritional requirements, but nutritional adequacy is difficult to achieve. Additionally, human milk (HM) composition depends on maternal diet. However, the nutritional intake and status of mothers with hospitalized very preterm infants (MHVPIs) (<32 weeks of gestational age) have rarely been assessed. Hence, the aim of the present study was to determine the intake of macronutrients, micronutrients, and lipids, as well as the nutritional status of MHVPIs. The results were compared with a group of HM donors (HMDs), and associations with HM composition were evaluated using multiple linear regression. Methods: For dietary assessment, a 5-day dietary record including supplement intake was completed by 15 MHVPIs and 110 HMDs. Vitamins and fatty acids (FA) were determined in plasma and erythrocytes; minerals and methylmalonic acid were determined in urine; and macronutrients, vitamins, minerals, and the lipid profile were determined in HM. Results: Considering dietary reference intakes, the dietary evaluation of MHVPIs revealed a high percentage of inadequate nutrient intake in relation to total energy, as well as for iodine and vitamins B8, B9, C, D, and E. A high protein intake was observed. The percentage of energy from carbohydrates was low, whereas the percentage of energy from fat was high. However, the diet of MHVPIs did not differ substantially from the diet of HMDs. Associations were observed between the study groups (MHVPI vs. HMD) and the HM concentration of protein, several micronutrients, and fatty acids independent from intake and status. Conclusions: Deficient nutrient intakes did not appear to be exclusively related to MHVPI but rather seemed to be widespread in both study groups. However, for preterm infants, an insufficient supply of nutrients is critical and should be addressed in order to improve preterm infant’s outcomes. Furthermore, we provided additional insights into the exploration of HM by relating its composition to prematurity. Full article

Background/Objectives: Preterm infants are at high risk of extrauterine growth restriction and suboptimal neurological development due to cumulative nutrient deficits. Standard fortification (SF) of human milk does not account for individual macronutrient variability, potentially leading to inadequate intake. Target fortification (TFO) adjusts supplementation based on the measured macronutrient content, aimed at providing macronutrient intake aligned with ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) recommendations and optimize growth and development. This study aims to evaluate the effects of TFO compared to SF on growth, body composition, and neurological outcomes at 18 months corrected age. Methods: In this double-blind, randomized controlled trial, preterm infants (<30 weeks gestation) received either SF or TFO for at least three weeks. Macronutrient levels in breast milk were analyzed three times per week, with modular adjustments in the TFO group. Growth parameters, body composition at 36 weeks postmenstrual age, and Bayley Scales of Infant and Toddler Development III (BSID-III) scores at 18 months corrected age were assessed (n = 69). Results: TFO significantly increased protein, fat, and carbohydrate intake compared to SF, leading to higher weight gain (2514 ± 289 g vs. 2283 ± 332 g, p < 0.01) and growth velocity (21.7 ± 2.3 g/kg/d vs. 19.2 ± 2.2 g/kg/d, p < 0.001). In infants whose mother’s milk had low protein levels, fat-free mass was significantly higher with TFO compared to SF. BSID-III scores were higher in the TFO group across cognitive, language, and motor domains, with significant improvements in expressive language scores in infants whose mother’s milk had high protein levels (p < 0.05). The number of preterm infants with a motor BSID-III score of ≤70 was significantly lower in the TFO group compared to the SF group (0 vs. 3, p < 0.05). Conclusions: TFO enhanced growth and body composition and may support better neurological outcomes in preterm infants. While most BSID-III differences were not statistically significant, the data suggest that TFO may reduce the risk of developmental delays. Larger, multicenter trials are needed to confirm these findings. Full article

Background: Dietary intake during the first year of life is a key determinant of a child’s growth and development. ORIGINS is a longitudinal birth cohort study investigating factors that contribute to a ‘healthy start to life’ and the prevention of non-communicable diseases. Methods: This descriptive cross-sectional study aims to describe the dietary intakes of one-year-old children participating in ORIGINS and compare these to the Australian Dietary Guidelines and Nutrient Reference Values (NRVs). Between 2020 and 2023, dietary intake data were collected on 779 one-year-old children using a Food Frequency Questionnaire (FFQ). The analysis explored milk intake (breastmilk, infant formula, and cow’s milk), the introduction to solids, macronutrient, micronutrient, and food group intakes. Results: The results indicated that 41.5% were still being breastfed at one year of age, while 58.0% continued to receive formula milk. While the cohort met NRV cut-offs for most micronutrients, iodine intake fell below requirements, and sodium intake exceeded recommendations. Diet quality, based on the food group intake, did not meet recommendations, with children over-consuming fruit and discretionary foods, while under-consuming vegetables and cereals and grains foods. Conclusions: These findings highlight areas for improvement in the dietary intake of one-year-old children. Full article

The function of the immune system is not only dependent on factors like genetics, age, the environment, and exposure to infectious agents and allergens but also on our microbiota and our diet. It has been known for centuries that food can influence health and vulnerability to infection. This is especially true for infants, young children, and the elderly. This review focuses on how nutrition can support immune function from gestation to school-aged children. Immune support begins during pregnancy by the mother’s diet and transfer of nutritional components as well as antibodies to her fetus. After birth, breastfeeding is of crucial importance for immune development as well as for the development of the intestinal microbiota of an infant. If breastfeeding is not possible, early-life formulas are an alternative. These can provide several of the functionalities of breastmilk, as well as the key nutrients a child needs. New foods are introduced during and after weaning, and after this period, children switch to consuming a normal diet. However, due to circumstances, children can be malnourished. This can range from severe protein/energy malnutrition to micronutrient deficiencies and obesity, all of which can affect the function of the immune system. This narrative review describes the immune challenges in early life, explores breastfeeding and early life nutrition, and provides mechanistic insight into the relative contribution of macronutrients, micronutrients and other immunomodulatory food components that can support immune function in early life. Full article

Background: The composition of breast milk is influenced by a variety of factors, including maternal anthropometric characteristics, dietary and lifestyle habits, and lactation and feeding parameters. Emerging evidence also suggests that an infant’s sex may play a role in shaping breast milk composition. Objective: This study aims to investigate the macronutrient composition of early breast milk up to 3 months postpartum, with a particular focus on potential differences related to the infant’s sex. Methods: A total of 102 breast milk samples were collected at four time points across three lactation stages, representing colostrum, transitional, and mature milk, from a cohort consisting of 51 consenting mothers of Mediterranean origin who met the inclusion criteria. The samples were analyzed using mid-infrared spectroscopy to determine their macronutrient composition. Results: Colostrum from mothers of male infants contained approximately 60% higher levels of nitrogenous compounds, crude protein, true protein, and non-protein nitrogen compared to colostrum from mothers of female infants. Transitional milk for female infants contained higher fat, total solids, and energy. No significant differences in macronutrient composition were observed in mature milk between the sexes. For both sexes, colostrum contained more nitrogenous compounds and fewer total solids than mature milk. Male colostrum had lower carbohydrate levels compared to the later stages of lactation, while female samples showed no significant changes. Strong positive correlations between fat and crude protein were found for both sexes during the transitional and mature milk stages. In male colostrum, all macronutrients were interrelated. Conclusions: The observed differences in the composition of colostrum and transitional breast milk for male and female neonates suggest potential sex-specific nutritional adaptations during early lactation. These findings may have implications for personalized infant nutrition strategies in cases where breast feeding is hampered, as well as for understanding early neonatal adaptations. Full article

Background: More and more women are following a vegan and vegetarian diet. For some, the use of a vegan diet during lactation is controversial. Purpose: The aim of the study was to comparatively analyze the concentration of selected hormones, micro- and macronutrients, vitamins, and the basic composition and antioxidant status of the milk of vegan women, compared to the milk of omnivorous women. Methods: The study included 17 breastfeeding vegan women and 27 omnivorous women. The basic composition of human milk was analyzed using the MIRIS HMATM analyzer (Uppsala, Sweden) The levels of hormones and vitamins were determined by the enzyme-linked immunosorbent method. In order to determine the antioxidant activity and micro- and macroelements, spectrophotometric methods were used. Results: The vegan group was characterized by a lower average age, lower BMI, and lower WHR index compared to the control group. The milk of vegan women showed significantly higher cortisol concentrations and lower iron, vitamin B6, and antioxidant status than the milk of omnivorous women. Conclusions: A vegan diet helps maintain a healthy body weight and is more popular among younger women, under 30 years of age. Higher levels of milk cortisol in vegan women may indicate a high level of anxiety and stress experienced by breastfeeding women, which may have negative consequences not only for breastfeeding mothers but also for the development of their children. Lack of appropriate supplementation in women who do not consume meat and animal products may cause a deficiency of micro- and macroelements in breast milk. Full article

Background: Breast milk confers essential passive immunity to infants, particularly during viral pandemics. This study investigates dynamic changes in SARS-CoV-2-specific antibodies and proteome in the breast milk of mothers infected with either the wild-type or Omicron variants, addressing gaps in longitudinal dynamics and conserved or variant-specific immune responses. Methods: A prospective cohort of 22 lactating mothers infected with Omicron variant (December 2022–January 2023) was analyzed alongside a published dataset of wild-type-infected mothers (January–May 2020). Breast milk samples were collected at eight time points (1, 4, 7, 14, 21, 28, 35, 42 days post-infection) from the Omicron cohort for ELISA quantification of SARS-CoV-2-specific IgA, IgG, and IgM. Proteomic analysis was conducted for both cohorts. Results: Macronutrient composition remained stable throughout the post-infection period. SARS-CoV-2-specific IgA and IgG demonstrated biphasic kinetics, rapidly rising by day 14 (IgA: 0.03 to 0.13 ng/mL; IgG: 0.91 to 37.00 ng/mL) and plateauing through day 42. In contrast, IgM levels remained unchanged. Proteomic profiling identified 135 proteins associated with IgA/IgG dynamics, including variant-specific and conserved proteins. Conclusions: Breast milk maintains nutritional integrity while mounting robust immune responses during SARS-CoV-2 infection. These findings underscore breastfeeding as a safe and protective practice during COVID-19. Full article

Background/Objectives: Endocannabinoids are endogenous bioactive lipids that promote neurodevelopment and positive energy balance. Increased levels of endocannabinoids are associated with obesity, but the effect of maternal obesity on breast milk endocannabinoids across lactation is mostly unknown. Methods: Women from Rio de Janeiro (Brazil) (n = 92) were followed from the third trimester of pregnancy to 119 days postpartum, and milk samples were analyzed in the postpartum days 2–8 (T1), 28–47 (T2), and 88–119 (T3). We assessed the endocannabinoids anandamide (AEA) and 2-arachidonoylglycerol (2-AG) by high-performance liquid chromatography–mass spectrometry, leptin and insulin by immunoassay, and macronutrients by colorimetric assays in milk samples. Results: Milk AEA concentration was higher in T2 compared with T1 or T3, while 2-AG levels were higher in T2 and T3 compared with T1. Milk endocannabinoids were directly correlated with pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and milk triglycerides. Triglyceride and leptin levels were higher in mature milk (T2 and T3) of women with BMI > 25 or excessive GWG. Adjusted linear regression models showed a positive association between excessive GWG and milk 2-AG (β = 1629; 95% CI: 467–2792; p = 0.008). Conclusions: The endocannabinoid levels are higher in mature milk from women with obesity or excessive GWG, which may impact offspring development and metabolism. Full article

The importance of assessing the microbiological safety of food products is beyond doubt, which is also true for milk and dairy products. The goal of this work was to evaluate the changes in the composition of the gas phase in milk based on signals from chemical sensors to predict the quantity of the bacteria in the milk samples. The gas phase in raw milk samples and samples during pasteurization, as well as for a standard (a model aqua solution of macronutrients and minerals), was studied using an array of sensors with polycomposite coatings, including those contaminated with E. coli bacteria. Assessment of microbiological indicators was carried out according to GOST in parallel with the gas-phase analysis. The applicability of the results obtained on model systems was assessed using milk samples, including those containing other types of pathogenic microorganisms (Staphylococcus aureus, Klebsiella spp., etc.). It was found that the obtained models can be used to assess the presence and quantity of E. coli in milk at the pasteurization stage. Full article

Microquantity laboratory procedures (<5 mL) are often used to analyze milk from non-bovid or less common species due to limited available samples and small sample sizes, unlike the large quantities of milk needed for macroquantity (~20 mL) assays standard in the commercial dairy industry. To better understand microquantity milk laboratory analyses, quarter horse (Equus caballus) milk from North Carolina State University (females = 4, n = 43) and California Polytechnic State University (females = 4, n = 42) equine centers was compared to investigate differences in macronutrient composition from 4 to 130 days after parturition. All mares were healthy, but consumed different diets. Major milk macronutrients were measured at the Smithsonian National Zoo and Conservation Biology Institute using a microquantity analysis of ash, crude protein (CP), dry matter (DM), crude fat, sugar, and gross energy. Of the six measured nutrients, only CP and crude fat differed (p < 0.05) by location, while sugar and crude fat had differences among individual mares. Californian mares had greater fat concentration means on a dry matter basis (DMB) than the North Carolinian mares (ANCOVA, p = 0.003). North Carolinian mares had greater CP concentration means than Californian mares. These findings indicate that dietary differences and/or environmental factors may play a role in CP and crude fat milk macronutrient composition within horse breeds. However, despite the differences noted, the microquantity analyses for nutritional means for all eight mares were within macroquantity horses ranges available in the previous literature. The results indicate that micro versus macroassays are comparable and supports clinical and scientific research on milk from species where large sample quantities are difficult to obtain. Full article

Background/Objectives: Dietary patterns are able to capture the complexity of the diet. The present study aimed to compare the nutrient intake across different dietary patterns in Brazilian community-dwelling older adults. Methods: Dietary patterns from 295 (predominantly women, 85%) of Brazilian community-dwelling older adults were identified using principal component analysis, based on a 24 h dietary recall (24HR). The following patterns were identified: the “traditional” pattern (consisting of in natura or minimally processed food); the “modified” pattern (consisting of processed foods, confectionery), and the “snack” pattern (composed of coffee, whole milk, bread, toast, butter, or margarine). Participants were divided into three tertiles according to their scores in each pattern. A comparison of energy and nutrient intake across the tertiles of the three patterns was analyzed using the Kruskal–Wallis rank sum test. Then, the intake of energy and macro and micronutrients were analyzed. Results: Older adults with higher scores for the “traditional” pattern had significantly higher intakes of total energy, all macronutrients, beta-carotene, vitamin C, E and K, thiamine, pyridoxine, and total folate (p < 0.05). Participants with higher scores for the “modified” pattern had significantly higher intakes of total energy, added sugar, total and animal protein, leucine, arginine, monounsaturated fat, cholesterol, niacin, and pyridoxine; the second tertile had lower vitamin A than the first tertile (p < 0.05). Finally, older adults with higher scores for the “snack” pattern had significantly lower intakes of total and insoluble fiber, animal and vegetable proteins, vitamins (A, E, and K), niacin, and pyridoxine (p < 0.05). The “Traditional” pattern exhibited the most appropriate dietary pattern regarding the availability of essential nutrients, resulting in a better quality of habitual intake and outcomes that are related to health promotion and reduction in the risk of non-chronic issues. Conclusions: The results reinforce the importance of public policies that encourage the maintenance of the traditional Brazilian dietary pattern, which is in alignment with Brazilian Dietary Guidelines, especially in the older population. Full article

Encapsulation techniques play a crucial role in enhancing the stability and viability of probiotics in functional foods. This study investigates the efficacy of calcium–alginate encapsulation, combined with hydrocolloids such as carrageenan, agar, and gelatin, in improving the survival of Lactobacillus rhamnosus GG (LGG) and stabilizing the total phenolic content (TPC) in fermented black goji berry beverages. The results revealed that 1.5% alginate encapsulation, combined with 1% carrageenan, agar, or gelatin and 5% calcium, significantly enhanced the LGG viability and increased the TPC content in the fermented black goji berry beads when compared to calcium–alginate encapsulation alone. Fourier Transform Infrared Spectroscopy (FTIR) confirmed the successful incorporation and interaction of hydrocolloids within the encapsulation matrix. Among the formulations, calcium–alginate–gelatin beads exhibited the highest LGG survival rates after simulated gastric and intestinal digestion. Notably, calcium–alginate beads containing carrageenan preserved LGG viability during simulated gastric and intestinal conditions when co-digested with all tested milk types (high carbohydrate, high protein, and high fat). Co-ingestion with these milk types further improved TPC retention in all bead formulations, as the macronutrients in milk provided protective effects, stabilizing the encapsulated polyphenols and minimizing their degradation during simulated gastric and intestinal digestion. This study highlights the potential of calcium–alginate encapsulation, integrated with hydrocolloids such as carrageenan, agar, or gelatin, to improve probiotic viability and polyphenol stability, offering promising applications for enhancing the functional properties of non-dairy fermented beverages. Full article

Breastfeeding is the best way to provide newborns with crucial nutrients and produce a unique bond between mother and child. Breast milk is rich in nutritious and non-nutritive bioactive components, such as immune cells, cytokines, chemokines, immunoglobulins, hormones, fatty acids, and other constituents. Maternal effects during gestation and lactation can alter these components, influencing offspring outcomes. Chronic inflammatory maternal conditions, such as obesity, diabetes, and hypertension, impact breast milk composition. Breast milk from obese mothers exhibits changes in fat content, cytokine levels, and hormonal concentrations, potentially affecting infant growth and health. Similarly, diabetes alters the composition of breast milk, impacting immune factors and metabolic markers. Other pro-inflammatory conditions, such as dyslipidemia and metabolic syndrome, have been barely studied. Thus, maternal obesity, diabetes, and altered tension parameters have been described as modifying the composition of breast milk in its macronutrients and other important biomolecules, likely affecting the offspring’s weight. This review emphasizes the impact of chronic inflammatory conditions on breast milk composition and its potential implications for offspring development through the revision of full-access original articles. Full article

Adequate milk production is key for optimal infant growth, yet women often wean due to perceived low milk production (LMP). Maternal adiposity and gestational diabetes mellitus (GDM) are known potential risk factors for LMP and may alter both hormonal and macronutrient composition of human milk. This study aims to investigate the hormonal and macronutrient composition of human milk in relation to LMP, particularly in the context of maternal adiposity and GDM. Human milk samples were collected from 68 women with LMP and 160 women with normal milk production during 1–6 months postpartum. Of the 228 participants with the mean pre-pregnancy BMI of 26.3 ± 6.0 kg/m², 80 (35.1%) had GDM. Concentrations of hormones (estrone, estradiol, progesterone, insulin, leptin, adiponectin) and macronutrients (fat, protein, lactose, glucose) were measured and compared between the two groups. Univariable and multivariable logistic regression analyses were conducted, adjusting for potential confounders such as maternal body mass index (BMI) and GDM, to assess the relationships between hormone and macronutrient concentrations, and milk production. Preliminary analyses indicated that higher concentrations of estrone (p < 0.001), leptin (p = 0.009), insulin (p = 0.002), protein (p = 0.012), and lactose (p = 0.004) were associated with LMP. After adjusting for maternal BMI and GDM in the univariable models, all of these associations remained, and progesterone (p = 0.045) also emerged as positively associated with LMP. In multivariable regression, followed by stepwise model selection, estrone (p < 0.001), protein (p < 0.001) and lactose (p = 0.015) demonstrated the strongest associations with LMP, with maternal BMI also contributing significantly (p = 0.010). The findings suggest that hormone and macronutrient concentrations in human milk may reflect LMP status and provide insights into the underlying biological mechanisms associated with LMP. Full article