Does processing of a powder or in-bottle-sterilized liquid infant formula affect calcium bioavailability?

How processing may affect milk protein digestion and overall physiological outcomes: A systematic review

Dairy is one of the main sources for high quality protein in the human diet. Processing may, however, cause denaturation, aggregation, and chemical modifications of its amino acids, which may impact protein quality. This systematic review covers the effect of milk protein modifications as a result of heating, on protein digestion and its physiological impact. A total of 5363 records were retrieved through the Scopus database of which a total of 102 were included. Although the degree of modification highly depends on the exact processing conditions, heating of milk proteins can modify several amino acids. In vitro and animal studies demonstrate that glycation decreases protein digestibility, and hinders amino acid availability, especially for lysine. Other chemical modifications, including oxidation, racemization, dephosphorylation and cross-linking, are less well studied, but may also impact protein digestion, which may result in decreased amino acid bioavailability and functionality. On the other hand, protein denaturation does not affect overall digestibility, but can facilitate gastric hydrolysis, especially of β-lactoglobulin. Protein denaturation can also alter gastric emptying of the protein, consequently affecting digestive kinetics that can eventually result in different post-prandial plasma amino acid appearance. Apart from processing, the kinetics of protein digestion depend on the matrix in which the protein is heated. Altogether, protein modifications may be considered indicative for processing severity. Controlling dairy processing conditions can thus be a powerful way to preserve protein quality or to steer gastrointestinal digestion kinetics and subsequent release of amino acids. Related physiological consequences mainly point towards amino acid bioavailability and immunological consequences.

Effect of fructo-oligosaccharide supplementation in soya beverage on the intestinal absorption of calcium and iron in newly weaned rats

Studies have shown the positive effects of prebiotics on the intestinal absorption of Ca and Fe. The present study evaluated the effect of fructo-oligosaccharide (FOS) supplementation in soya beverage (SB) on absorption mechanisms of Ca and Fe in recently weaned rats. Male Wistar rats were divided into four groups: lactose-free cows' milk (CM), lactose-free CM with FOS (0·8 g/100 ml) (CMF), SB and soya beverage with FOS (0·8 g/100 ml) (SBF). These rats were euthanised after 1 week of treatment. Organ weight, pH of the caecal content and absorption mechanisms of Ca and Fe were evaluated. The results showed that the weight of the caecal contents increased in the CMF and SBF groups, and the pH of the caecal contents was lower in these groups. The Hb levels of the CMF and SB groups were higher when compared with that of the CM group and lower in relation to the SBF group. The apparent Ca and Fe absorption and apparent Ca retention in the CM group were higher when compared with the SB group, whereas in the CMF group, they were higher in relation to the SBF group. Divalent metal transporter 1 (DMT1) protein expression in the duodenum was higher in the SBF group than in the SB and CMF groups. SB resulted in lower intestinal Ca absorption and higher Hb concentration, despite the lower apparent Fe absorption in relation to CM. Supplementation with FOS provided beneficial effects on Hb and DMT1 protein expression in the duodenum, in addition to improving the absorption process.

Effect of Probiotic, Prebiotic and Synbiotic Follow-up Infant Formulas on Iron Bioavailability in Rats

The effect of functional ingredients-supplemented diets on iron bioavailability and the section of the large intestine involved with this effect was investigated in rats. The diets consisted of seven powder follow-up infant formulas containing probiotics ( Bifidobacterium bifidum and Bifidobacterium longum), prebiotics (galactooligosaccharides (4'-GOS) at 1.2, 5 and 10%) or synbiotics (bifidobacteria and 4'-GOS at 1.2, 5 and 10%) that were administered to weanling rats over 30 days. Iron balancing (mineral apparent absorption and retention ratios) was carried out in three periods of 72h each. Results showed that the administration of any of the test diets increased the apparent iron absorption or retention in any of the periods, however only 10% prebiotic and synbiotic diets significantly (P<0.05) increased apparent iron absorption and retention during the three periods of mineral balancing when compared to the control group. A linear regression study demonstrated that the stimulation of iron absorption took place mainly in the colon portion of the gut, since the parameters iron absorption, crypt depth of proximal colon and pH colon content showed a multiple linear relationship (R2=0.56). We concluded that 10% prebiotic and synbiotic diets were the diets most prone to improving iron bioavailability in the colons of rats.

Effect of Enzyme Amounts Used in Gastrointestinal Digestion Upon Solubility and Caco-2 Cell Uptake Assays of Minerals from Infant Formulas

The effect of enzyme amounts used in gastrointestinal in vitro digestion upon the solubility and Caco-2 cell uptake of calcium, iron and zinc from infant formulas (IFs) was studied. Different amounts of enzymes (g enzyme/g IF), pepsin (0.002 and 0.048), pancreatin (0.0005, 0.002 and 0.01) and bile extract (0.003, 0.125 and 0.0625) were assayed. Mineral soluble contents and mineral uptakes by Caco-2 cells were affected by the enzyme amounts used in digestion. Although the highest mineral solubility (Ca 98.6 vs 46.2%; Fe 98.1 vs 83.9%; Zn 98.4 vs 83%) was obtained when the lowest enzyme (pepsin 0.002 vs 0.048; pancreatin 0.0005 vs 0.01g/g IF) and bile extract (0.003 vs 0.0625g/g IF) amounts were used, under these conditions uptake decreased with respect to that obtained when the highest amounts were used (Ca 0.4 vs 1.8%; Fe 0.3 vs 4.8%; Zn 1.7 vs 37%), that indicated a lack of relationship between solubility and absorption. Interactions among different products resulting from the proteolytic activity of digestive enzymes and minerals can modify the physicochemical forms in which minerals are available for absorption after gastrointestinal digestion.

Multipoint near-infrared spectrometry for real-time monitoring of protein conformational stability in powdered infant formula

Powdered infant formula (PIF) can be the sole source of nutrition for babies and infants. Monitoring conformational changes in protein during manufacture of PIF is critical in order to maintain its nutritional value. This study presents the development of a calibration model for monitoring conformational changes in PIF protein by applying a novel multipoint near-infrared (NIR) spectrometry. NIR spectra were collected for PIF and PIF proteins, casein and whey protein isolate, before and after heat treatment. Results show that principal component analysis showed discrimination between native protein at room temperature and protein conformational changes caused at elevated temperature. Partial least squares regression analysis showed good calibration models with correlation coefficients ranging between 87% and 99% for the prediction of protein quality. This novel multipoint NIR spectrometry could serve as a simple in-line tool to rapidly monitor protein quality during processing stages, contributing to product nutritional value.

Feeding intolerance in preterm infants fed with powdered or liquid formula: a randomized controlled, double-blind, pilot study

Feeding intolerance (FI) is usually defined as "gastric residual volume of more than 50 % of the previous feeding volume, emesis, abdominal distension or both of these symptoms and a decrease, delay or discontinuation of enteral feedings." We aimed to compare the incidence of FI in preterm infants fed with powdered or liquid infant formula, and in a prospective, double-blind, pilot study, 78 preterm infants were randomized to receive powdered or liquid form of the same preterm infant formula. The primary outcomes were the incidence of FI in both groups. The pH of gastric fluids was measured in the fasting and postprandial periods on the seventh day of life, and gastrointestinal complications were recorded during the hospitalization period. The incidence of FI was significantly higher in infants fed with liquid formula (n = 34) when compared with infants fed with powdered formula (n = 44) [9 (26.5 %) vs 2 (4.5 %), p < 0.01, respectively]. The median fasting gastric fluid pH was significantly lower and postprandial gastric fluid pH was significantly higher than in infants fed with powdered formula (2.9 vs 3.4, p < 0.01 and 6.0 vs 5.9, p < 0.05 respectively). Infants fed with liquid formula regained birth weight significantly later than infants fed with powdered formula (9.5 vs 8.0 days, p < 0.01).

CONCLUSION

Although the exact mechanisms are not clear, increased incidence of FI and delayed growth in the first weeks of life in preterm infants fed with liquid formula might be caused by altered gastric acidity or possible disrupted protein bioavailability due to different production and sterilization processes.

Effects of diets supplemented with MRPs from bread crust on the food intake and body weights in rats

Traditionally the effects of dietary Maillard reaction products (MRPs) on food intake and body weight have been described in different studies, but few investigations have been conducted to analyse the main contributors responsible. We studied the effects of long-term consumption of MRPs from bread crust (BC) on rat growth, investigating the efficiency of diet and protein utilization. Different soluble and insoluble fractions of BC were studied to analyse the possible contributors. Additionally, the colour of the faecal material and the amount of fluorescent MRPs in the urine were measured in order to demonstrate MRP excretion. Six groups of rats were fed the following diets for 88 days: control (AIN-93G diet); bread dough (BD) and BC (containing 10% of BD or BC, respectively); low and high molecular weight (LMW-HMW) (containing soluble compounds from BC with <5 kDa and >5 kDa, respectively); insoluble (containing insoluble compounds from BC). Dietary MRPs tended to reduce the food intake and body weight significantly after consumption of more complex compounds (HMW and insoluble). The L*-value in the faeces decreased in animals fed BC and its derivatives, providing evidence of the presence of MRPs. The fluorescence associated with MRP excretion in urine was higher when the LMW diet was consumed, suggesting the easier absorption and clearance of the smaller compounds of BC.

Effects of dietary bread crust Maillard reaction products on calcium and bone metabolism in rats

Maillard reaction products (MRP) consumption has been related with the development of bone degenerative disorders, probably linked to changes in calcium metabolism. We aimed to investigate the effects of MRP intake from bread crust on calcium balance and its distribution, and bone metabolism. During 88 days, rats were fed control diet or diets containing bread crust as source of MRP, or its soluble high molecular weight, soluble low molecular weight or insoluble fractions (bread crust, HMW, LMW and insoluble diets, respectively). In the final week, a calcium balance was performed, then animals were sacrified and some organs removed to analyse calcium levels. A second balance was carried out throughout the experimental period to calculate global calcium retention. Biochemical parameters and bone metabolism markers were measured in serum or urine. Global calcium bioavailability was unmodified by consumption of bread crust or its isolate fractions, corroborating the previously described low affinity of MRP to bind calcium. Despite this, a higher calcium concentration was found in femur due to smaller bones having a lower relative density. The isolate consumption of the fractions altered some bone markers, reflecting a situation of increased bone resorption or higher turnover; this did not take place in the animals fed the bread crust diet. Thus, the bread crust intake does not affect negatively calcium bioavailability and bone metabolism.

Assessing the effects of severe heat treatment of milk on calcium bioavailability: in vitro and in vivo studies

Thermal processing of milk is a common practice. As milk is the main source of dietary calcium, this study aimed to assess the effects of overheating milk on calcium availability. Thus, thermally damaged milk (overheated, OH, milk; 3 cycles of sterilization at 116 °C, 16 min) was compared with UHT milk (150 °C, 6s) in 2 types of assays: in vitro and in vivo (rats). In addition, the greater Maillard reaction rate associated with thermal treatment in OH milk was confirmed by determining specific (furosine) and unspecific markers (CieLab color). A negative effect on calcium solubility was observed after in vitro digestion of OH milk compared with UHT milk. Feeding rats the diet containing OH milk as the protein source led to significantly lower values of apparent calcium absorption and retention than those found among animals fed the UHT milk diet. Whereas reducing the absorption appears to result mainly from the decreased food intake, the negative effect on retention seems to be due to factors derived from milk thermal damage, such as the formation of Maillard reaction products. It was concluded that milk-processing conditions warrant special attention to prevent impaired dietary calcium utilization. This may be especially important in situations where milk and dairy products are the main dietary components, such as in early infancy.

In vitrodetermination of calcium bioavailability of milk, dairy products and infant formulas

In this study, the aim was to determine the in vitro calcium bioavailability of different dairy products and to investigate the effect of dry matter, fat, acidity and calcium content on calcium bioavailability of the products. For this purpose, the dry matter, fat, acidity and calcium content of different kinds of milk, yogurt, cheese and infant formulas were analysed. Then, calcium bioavailability of products was determined by an in vitro method that involves simulating gastrointestinal digestion of the product with pepsin-HCl and pancreatin-biliary salts, and then measuring the fraction of element that dialyses through a membrane of a certain pore size. Each of the product groups was examined statistically and no difference was found among milk, yogurt and infant formula groups in terms of calcium bioavailability. However, there were differences among cheese kinds according to the results of the Duncan test; all cheese kinds were considerably different from each other (P < 0.05). Moreover, it was found that calcium, dry matter, fat content and acidity did not affect the calcium bioavailability (P < 0.05). According to the results of statistical analysis that was applied to all product groups, it was found that the yogurt group was different from the other products and that the acidity affected calcium bioavailability (P < 0.05).

Enteral calcium, phosphate and vitamin D requirements and bone mineralization in preterm infants

With major advances in life-support measures, nutrition has become one of the most debated issues in the care of very low birth-weight (VLBW) infants. Current nutritional recommendations are based on healthy premature infants and designed to provide postnatal nutrient retention during the 'stable-growing' period equivalent to the intrauterine gain of a normal foetus. However, this reference is still a matter of discussion, especially in the field of the mineral requirements. After birth, there are dramatic physiological changes in bone metabolism resulting from various factors: disruption in maternal mineral supply, stimulation of calciotropic hormone secretion, change in hormonal environment and relative reduction in mechanical stress. These events stimulate the remodelling process leading to an increase in endosteal bone resorption and a decrease in bone density. In preterm infants, these adaptation processes modify the mineral requirement, since, by itself, the increased remodelling provides a part of the mineral requirement necessary for postnatal bone growth and turnover. The care of newly born premature infants should not necessarily aim to achieve intrauterine calcium accretion rates.

CONCLUSION

Considering that a calcium retention level ranging from 60 to 90 mg/kg/day assures appropriate mineralization, and decreases the risk of fracture and diminishes the clinical symptoms of osteopenia, an intake of 100 to 160 mg/kg/day of highly bioavailable calcium salts, 60 to 90 mg/kg/day of phosphorus and 800 to 1000 IU of vitamin D per day is recommended.

Maillard reaction indicators in diets usually consumed by adolescent population

Contents of some indicators of the Maillard reaction (MR) in two diets adjusted to the adolescent requirements are compared: the A-diet, usually consumed by the adolescent population containing their preferred foods cooked by the culinary techniques more frequently chosen; and the B-diet, with the same foods, except those industrially processed and with high content of Maillard reaction products (MRP), cooked in softer processes to minimise the MR. Aliquots of a lunch-dinner (LD) and breakfast-afternoon (BA) snack pools separately from both diets were ground and lyophilised. Fluorescence associated to MRP, CIELAB colour parameters, furosine, hydroxymethylfurfural (HMF), carboxymethyllysine (CML) and sugar contents were investigated in the samples. Significant losses of lightness were manifested in A samples compared to the B ones. Fluorescence intensity was significantly higher in the LD and BA samples from the A-diet. Furosine measured in the A-diet was similar to that found in the B-diet. However, HMF content was significantly higher in the A-diet, as well as CML. Data showed significant higher levels of advanced MRP in the usual diet. Thus, MRP intake associated to alimentary pattern in the adolescence population might be studied in order to assess the health implications of the MRP consumption and its possible synergic effect with endogenous advanced glycation endproducts.

Baby Foods: Formulations and Interactions (A Review)

Infant foods have a special place among food products mainly because of nutritional aspects and preparations methods. A great increase of baby foods incomes is predicted in near future. Formulation, handling, and storage of baby foods are important to keep nutritional quality and physicochemical properties of these foods. During storage some reactions and interactions occur which change physicochemical and nutritional properties of baby foods. Lactose crystallization, Maillard reaction, oxidation, and interactions between micronutrients and other components are the most important aspect of preparation and storage of baby foods. These reactions and interactions influence physical properties such as flowability of powder, solubility, and other functional properties. Controlling of storage conditions such as temperature and moisture content and oxygen quantity in headspace of product is required to keep product quality. In this paper the composition and interactions of baby foods between major components and their effect on nutritional quality of baby foods are explained.

Heat Processing in Infant Formulas Induces Changes in Copper Tissue Levels in Suckling and Weanling Rats

AIM

To assess the effects of dehydration, conventional in-bottle sterilization, and ultrahigh-temperature (UHT) sterilization, involved in the production of infant formulas, on the copper bioavailability in rats at two stages.

METHODS

Two-week-old suckling rats were fed a reconstituted powder (P1) and an in-bottle-sterilized liquid infant formula (SC1) in a drinking bottle for 7 days. Weanling rats were fed P1, SC1, another powder (P2), and a liquid UHT formula (UHT2) complemented with a standard rat diet. Intake, body weight, and percentage copper absorption were calculated, and whole-body, serum, liver, skin, and erythrocyte copper concentrations were determined.

RESULTS

Food intake, body weight, and copper intake were reduced in suckling rats consuming SC1, but the percentage copper absorption increased, and whole-body and tissue copper concentrations were unaffected, except for the erythrocyte copper concentration which was significantly higher as compared with pups fed P1. In weanling rats, the only difference observed was the significantly higher liver copper concentration in animals fed the diet containing P1 as compared with the diets containing SC1 and UHT2.

CONCLUSIONS

Consuming the SC1 formula induced high erythrocyte copper levels in suckling rats, whereas the equivalent dehydrated formula (P1) induced elevated liver copper concentrations in weanling rats. This is associated with the different Maillard reaction products resulting from the processing of each infant formula and with the developmental stage of the animals.

Comparative effects of glucose-lysine versus glucose-methionine Maillard reaction products consumption: in vitro and in vivo calcium availability

The influence of glucose-lysine and glucose-methionine Maillard reaction products (MRPs) on calcium availability was studied in rats and in Caco-2 cells. Equimolar glucose/lysine and glucose/methionine mixtures (40% moisture) were heated (150 degrees C, 30 or 90 min) to prepare samples (GL30, GL90, GM30, and GM90, respectively). For 21 days, the rats were fed the AIN-93G diet (control group) or diets containing separately 3% of the heated mixtures (GL30, GL90, GM30, and GM90 groups, respectively). In the last week of the trial, a calcium balance was performed. On day 21, the animals were sacrificed and their livers and femurs removed for analysis of calcium levels. The GL30 and GM30 samples and the corresponding raw mixtures were used for Caco-2 cells experiments. Fecal excretion of calcium decreased and urinary elimination increased in the GM30 and GM90 groups. In accordance, increased calcium transport in Caco-2 cells was found in the presence of the GM30 sample, compared with the raw sample. Bone calcium concentration was lower among the animals consuming MRP diets, compared with the control group. The possible long-term effects of MRP intake on calcium deposition in the bone should be further studied to ascertain the implications on related diseases.

Bioavailability of calcium from milk-based formulas and fruit juices containing milk and cereals estimated by in vitro methods (solubility, dialyzability, and uptake and transport by caco-2 cells)

An adequate calcium intake during the first years of life is needed for normal growth and development and to prevent rickets. The bioavailability of calcium from infant foods (milk-based formulas and fruit juices containing milk and cereals, FMC), the dietary sources of calcium in these stages of life, has been estimated on the basis of simulated gastrointestinal digestion and calcium solubility and dialyzability values and on the efficiency of transport and uptake by Caco-2 cells. The ranking of samples according to calcium bioavailability depends on the use of solubility or dialyzability as criterion. On the basis of the former, the highest value corresponded to adapted formulas and the lowest to fruit juices. However, when using percentage dialysis, the highest value corresponded to fruit juices and the lowest to follow-up formulas. The highest percentages of transport efficiency and uptake by Caco-2 cells corresponded to calcium from the analyzed fruit juices, followed by toddler, follow-up, and adapted formulas.

Iron bioavailability from powdered and in-bottle-sterilized infant formulas in suckling and weanling rats

OBJECTIVE

The Maillard reaction and lactose isomerization may be induced during the manufacture of infant formulas. We studied the effects of dehydration and sterilization on iron bioavailability from an infant formula in suckling and weanling rats.

METHODS

In experiment 1, a previously reconstituted powdered infant formula and an in-bottle-sterilized liquid infant formula from the same manufacturer were fed from drinking bottles to 2-wk-old suckling rat pups for 7 d. In experiment 2, the same formulas were complemented with AIN-76 and fed to weanling rats for 7 d after a 4-d adaptation period. In both experiments, intake, body weight, and fecal and urinary excretions were monitored, and the following iron indexes were calculated: apparent absorption and retention and the coefficients percentage of absorption versus intake, percentage of retention versus absorption, and percentage of retention versus intake.

RESULTS

The liquid infant formula resulted in lower body weights on day 4, particularly among the younger rats that had significantly lower food intakes (P = 0.045). In weanling rats fed powdered and liquid infant formulas, food intake and body weight were not significantly different. The pups showed significantly higher absorption (percentage of absorption versus intake) and retention (percentages of retention versus absorption and retention versus intake) efficiencies than did the weanling rats (P < 0.001 for the three indexes). Hemoglobin values (P = 0.001) and liver iron concentrations (P = 0.009) were significantly higher in the weanling rats than in the pups. In contrast, erythrocyte iron concentrations and hematocrit were higher in the pups (P = 0.016 and 0.053, respectively).

CONCLUSIONS

In rat pups, iron bioavailability is negatively affected by the consumption of in-bottle-sterilized infant formula, possibly as the result of the content of Maillard reaction products, altered proteins, and lactulose. However, when this formula is included in a mixed diet and given to weanling rats, this detrimental effect no longer occurs.

Effect of heat treatment and mineral and vitamin supplementation on the nutritive use of protein and calcium from lentils (Lens culinaris M.) in growing rats

OBJECTIVE

The effects of heat treatment, supplementation of a mineral and vitamin premix, and 4% olive oil on the bioavailability of protein and calcium from Lens culinaris M., var vulgaris, cultivar. magda-20 were studied in growing rats.

METHODS

Nutrition assessment was based on chemical analysis of lentil protein, energy, total and available starch, lipid and calcium composition, and the digestive and metabolic use of nitrogen and calcium by rats. Lentils used for the present study had crude protein and calcium contents of 25.5% and 0.07%, respectively. Heating lentils to 120 degrees C at 1 atm for 30 min decreased trypsin inhibitor activity, phytate, and tannin content by 76%, 8%, and 12%, respectively, but did not improve dietary intake or digestive use of protein compared with untreated raw control lentils.

RESULTS

Mineral, vitamin, and olive oil supplementation of raw or autoclaved lentils significantly improved daily food intake and nutritive use of nitrogen and calcium. The best results were obtained for the rats fed with a diet of raw lentils supplemented with a premix of minerals and vitamins.

CONCLUSIONS

There was a direct correlation between calcium balance and weight gain in animals (r = 0.89) and between the calcium balance and nitrogen balance (r = 0.86).