Neither Incretin or Amino Acid Responses, nor Casein Content, Account for the Equal Insulin Response Following Iso-Lactose Loads of Natural Human and Cow Milk in Healthy Young Adults

Human milk contains <50% less protein (casein) than cow milk, but is equally effective in insulin secretion despite lower postingestion hyperaminoacidemia. Such potency of human milk might be modulated either by incretins (glucagon-like polypeptide-1,GLP-1); glucose-inhibitory-polypeptide, GIP), and/or by milk casein content. Healthy volunteers of both sexes were fed iso-lactose loads of two low-protein milks, i.e., human [Hum] (n = 8) and casein-deprived cow milk (Cow [↓Cas]) (n = 10), as well as loads of two high-protein milks, i.e., cow (n = 7), and casein-added human-milk (Hum [↑Cas]) (n = 7). Plasma glucose, insulin, C-peptide, incretins and amino acid concentrations were measured for 240′. All milks induced the same transient hyperglycemia. The early [20′−30′] insulin and C-peptide responses were comparable among all milk types apart from the low-protein (Cow [↓Cas]) milk, where they were reduced by <50% (p < 0.05 vs. others). When comparing the two high-protein milks, GLP-1 and GIP [5’−20’] responses with the (Hum [↑Cas]) milk were lower (by ≈2−3 fold, p < 0.007 and p < 0.03 respectively) than those with cow milk, whereas incretin secretion was substantially similar. Plasma amino acid increments largely reflected the milk protein content. Thus, neither casein milk content, nor incretin or amino acid concentrations, can account for the specific potency of human milk on insulin secretion, which remains as yet unresolved.

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

Scope

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

Methods and Results

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

Conclusions

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