1.
Effect of Targeted vs. Standard Fortification of Breast Milk on Growth and Development of Preterm Infants (≤32 Weeks): Results from an Interrupted Randomized Controlled Trial.
Seliga-Siwecka, J, Fiałkowska, J, Chmielewska, A
Nutrients. 2023;15(3)
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Preterm birth results in a high risk of mortality and is a cause of several morbidities, including extrauterine growth restriction. Despite numerous proven benefits, the concentration of some nutrients in human milk may be too low to meet the high nutritional needs of premature infants. Thus, to ensure optimal growth and development, human milk fortification is recommended for all very low birth weight babies. The primary aim of this study was to determine whether tailored compared to the standard fortification of enteral nutrition improved weight gain velocity in preterm infants born at ≤32 weeks of gestation. This study is a randomised observer- and patient-blinded controlled multicentre superiority trial, with two parallel groups with a 1:1 allocation ratio. Due to shortage of staff, two out of three centres failed to randomise patients. Patients were assigned to standard or tailored enteral nutrition fortification groups. Results show that there is no statistically significant difference in the velocity of weight gain during the supplementation period in infants born before 32 weeks of gestation who received targeted fortification compared to those who received standard fortification. Changes in length and head circumference did not differ between the groups. Authors conclude that targeted milk modification is a strategy that may allow for the optimisation of growth in premature infants; however, feasibility and poor tolerance of feeds may be important obstacles in introducing this strategy to neonatal intensive care unit clinical practice.
Abstract
Human milk is recommended for very low birth weight infants. Their nutritional needs are high, and the fortification of human milk is a standard procedure to optimize growth. Targeted fortification accounts for the variability in human milk composition. It has been a promising alternative to standard fixed-dose fortification, potentially improving short-term growth. In this trial, preterm infants (≤32 weeks of gestation) were randomized to receive human milk after standard fortification (HMF, Nutricia) or tailored fortification with modular components of proteins (Bebilon Bialko, Nutricia), carbohydrates (Polycal, Nutricia), and lipids (Calogen, Nutricia). The intervention started when preterms reached 80 mL/kg/day enteral feeds. Of the target number of 220 newborns, 39 were randomized. The trial was interrupted due to serious intolerance in five cases. There was no significant difference in velocity of weight gain during the supplementation period (primary outcome) in the tailored vs. standard fortification group: 27.01 ± 10.19 g/d vs. 25.84 ± 13.45 g/d, p = 0.0776. Length and head circumference were not significantly different between the groups. We found the feasibility of targeted fortification to be limited in neonatal intensive care unit practice. The trial was registered at clinicaltrials.gov NCT:03775785.
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Effect of Casein Hydrolysate on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Zhou, S, Xu, T, Zhang, X, Luo, J, An, P, Luo, Y
Nutrients. 2022;14(19)
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Casein makes up around 80% of the protein in cow’s milk. Hydrolysed casein has been partially broken down, making it easier to digest. It has various biological functions including, anti-inflammatory, antioxidant, and antihypertensive activities which could be beneficial for cardiovascular health. This systematic review and meta-analysis aimed to summarise the effects of casein hydrolysate supplementation on cardiovascular risk factors. 26 randomised control trials (RCTs) were included in the analysis. Casein hydrolysate significantly reduced systolic and diastolic blood pressure compared with control diets, but had no effect on total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides or fasting blood glucose. The authors concluded that their findings support the consumption of casein hydrolysate in the population at risk for the prevention of cardiovascular disease.
Abstract
Casein hydrolysate has various biological functional activities, especially prominent are angiotensin I-converting enzyme inhibitory activities. Increasing evidence has reported the prominent hypotensive effect of casein hydrolysate. However, the effects of casein hydrolysate on cardiovascular risk factors remain unclear and require more comprehensive and detailed studies. Here, we conducted a systematic review and meta-analysis on eligible randomized controlled trials (RCTs) to summarize the effects of casein hydrolysate supplementation on blood pressure, blood lipids, and blood glucose. In the pooled analyses, casein hydrolysate significantly reduced systolic blood pressure by 3.20 mmHg (-4.53 to -1.87 mmHg) and diastolic blood pressure by 1.50 mmHg (-2.31 to -0.69 mmHg). Supplementation of casein hydrolysate displayed no effect on total cholesterol (-0.07 mmol/L; -0.17 to 0.03 mmol/L), low-density lipoprotein cholesterol (-0.04 mmol/L; -0.15 to 0.08 mmol/L), high-density lipoprotein cholesterol (-0.01 mmol/L; -0.06 to 0.03 mmol/L), triglycerides (-0.05 mmol/L, -0.14 to 0.05 mmol/L), or fasting blood glucose (-0.01 mmol/L; -0.10 to 0.09 mmol/L) compared with the placebo diets. Collectively, this study indicated that supplementation of casein hydrolysate displayed decreasing effect on blood pressure without affecting blood lipids or glycemic status.
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Effect of Lactoferrin Supplementation on Inflammation, Immune Function, and Prevention of Respiratory Tract Infections in Humans: A Systematic Review and Meta-analysis.
Berthon, BS, Williams, LM, Williams, EJ, Wood, LG
Advances in nutrition (Bethesda, Md.). 2022;13(5):1799-1819
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Human and bovine milk contains Lactoferrin, an iron-binding glycoprotein that may modulate immune function and has antimicrobial and antioxidant properties. In this systematic review and meta-analysis, 25 heterogeneous studies were included to evaluate the efficacy of lactoferrin supplementation on systemic inflammation, immune function, and respiratory tract infections in children and adults with various inflammatory conditions. Supplementation with Lactoferrin reduced only a few inflammatory markers, and beneficial effects were observed in less than half of the studies included. However, a beneficial effect was observed when the intervention was continued for at least three months, and dosages, such as 35 mg/d to 833 mg/d in infants, and 400 mg/d to 600 mg/d in adults, were also found to be beneficial. By modulating the immune system, lactoferrin supplementation reduces respiratory tract infections in children and infants. Based on the findings of this study, healthcare professionals may be able to understand the beneficial effects of Lactoferrin supplementation on immune modulation, inflammation reduction, and respiratory tract infections when supplemented as a combination with other supplements or as Lactoferrin alone. However, it is necessary to conduct further robust research to confirm the clinical effectiveness of Lactoferrin supplementation since the current research is limited in number and heterogeneous in nature.
Abstract
Lactoferrin (Lf) is a glycoprotein present in human and bovine milk with antimicrobial and immune-modulating properties. This review aimed to examine the evidence for the effect of Lf supplementation on inflammation, immune function, and respiratory tract infections (RTIs) in humans. Online databases were searched up to December 2020 to identify relevant, English-language articles that examined the effect of Lf supplementation in human subjects of all ages, on either inflammation, immune cell populations or activity, or the incidence, duration, or severity of respiratory illness or RTIs. Twenty-five studies (n = 20 studies in adults) were included, of which 8 of 13 studies (61%) in adults reported a decrease in at least 1 systemic inflammatory biomarker. Immune function improved in 6 of 8 studies (75%) in adults, with changes in immune cell populations in 2 of 6 studies (33%), and changes in immune cell activity in 2 of 5 studies (40%). RTI outcomes were reduced in 6 of 10 studies (60%) (n = 5 in adults, n = 5 in children), with decreased incidence in 3 of 9 studies (33%), and either decreased frequency (2/4, 50%) or duration (3/6, 50%) in 50% of studies. In adults, Lf reduced IL-6 [mean difference (MD): -24.9 pg/mL; 95% CI: -41.64, -8.08 pg/mL], but not C-reactive protein (CRP) [standardized mean difference: -0.09; 95% CI: -0.82, 0.65], or NK cell cytotoxicity [MD: 4.84%; 95% CI: -3.93, 13.60%]. RTI incidence was reduced in infants and children (OR: 0.78; 95% CI: 0.61, 0.98) but not in adults (OR: 1.00; 95% CI: 0.76, 1.32). Clinical studies on Lf supplementation are limited, although findings show 200 mg Lf/d reduces systemic inflammation, while formulas containing 35-833 mg Lf/d may reduce RTI incidence in infants and children, suggesting improved immune function. Future research is required to determine optimal supplementation strategies and populations most likely to benefit from Lf supplementation. This trial was registered at PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232186) as CRD42021232186.
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Beverage consumption patterns among 4-19 y old children in 2009-14 NHANES show that the milk and 100% juice pattern is associated with better diets.
Maillot, M, Rehm, CD, Vieux, F, Rose, CM, Drewnowski, A
Nutrition journal. 2018;17(1):54
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Recommendations for milk and/or fruit juice consumption in children’s diets has remained inconclusive. The aim of this study was to assess whether patterns in beverage consumption among children and adolescents can influence food choices and overall diet quality. Beverage consumption patterns of 8119 children and adolescents were analysed based on data from the National Health and Nutrition Examination Survey (NHANES). Beverage patterns were defined as milk pattern, juice pattern, milk and juice or other caloric beverages. This analysis found that while children rarely limit their drinking choices to a single beverage, those who primarily consumed milk, juice or a combination of the two were associated with better dietary choices. Based on this study, the authors conclude that promotion of milk and juice consumption, compared to other caloric beverages, may be an effective way to improve overall diet quality in children and adolescents.
Abstract
BACKGROUND Patterns of beverage consumption among children and adolescents can be indicative of food choices and total diet quality. METHODS Analyses of beverage consumption patterns among 8119 children aged 4-19 y were based on the first 24-h recall of the National Health and Nutrition Examination Survey (2009-14 NHANES). Four pre-defined beverage patterns were: 1) milk pattern; 2) 100% juice pattern; 3) milk and 100% juice pattern; and 4) other caloric beverages. Food- and nutrient-based diet quality measures included the Healthy Eating Index 2010. RESULTS Most children drank other caloric beverages, as opposed to milk (17.8%), 100% juice (5.6%), or milk and 100% juice (13.5%). Drinkers of milk and 100% juice had diets that did not differ from each other in total calories, total and added sugars, fiber, or vitamin E. Milk drinkers consumed more dairy and had higher intakes of calcium, potassium, vitamin A and vitamin D as compared to all other patterns. Juice drinkers consumed more total fruit, same amounts of whole fruit, and had higher intakes of vitamin C as compared to the other consumption patterns. Drinkers of both milk and 100% juice had the highest HEI 2010 scores of all the consumption patterns. CONCLUSIONS Beverage consumption patterns built around milk and/or 100% juice were relatively uncommon. Promoting the drinking of milk and 100% juice, in preference to other caloric beverages, may be an effective strategy to improve children's diet quality. Restricting milk and 100% juice consumption may encourage the selection of other caloric beverages.