Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial
Holder pasteurization has been reported to modify human milk composition and structure by inactivating bile salt-stimulated lipase (BSSL) and partially denaturing some of its proteins, potentially affecting its subsequent digestion. We sought to determine the impact of human milk pasteurization on g...
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| Veröffentlicht in: | The American journal of clinical nutrition 2017-02, Vol.105 (2), p.379-390 |
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| creator | de Oliveira, Samira C Bellanger, Amandine Ménard, Olivia Pladys, Patrick Le Gouar, Yann Dirson, Emelyne Kroell, Florian Dupont, Didier Deglaire, Amélie Bourlieu, Claire |
| description | Holder pasteurization has been reported to modify human milk composition and structure by inactivating bile salt-stimulated lipase (BSSL) and partially denaturing some of its proteins, potentially affecting its subsequent digestion.
We sought to determine the impact of human milk pasteurization on gastric digestion (particularly for proteins and lipids) in preterm infants who were fed their mothers' own milk either raw or pasteurized.
In a randomized controlled trial, 12 hospitalized tube-fed preterm infants were their own control group in comparing the gastric digestion of raw human milk (RHM) with pasteurized human milk (PHM). Over a 6-d sequence, gastric aspirates were collected 2 times/d before and after RHM or PHM ingestion. The impact of milk pasteurization digestive kinetics and disintegration was tested with the use of a general linear mixed model.
Despite inactivating BSSL, instantaneous lipolysis was not affected by pasteurization (mean ± SD at 90 min: 12.6% ± 4.7%; P > 0.05). Lipolysis occurred in milk before digestion and was higher for PHM than for RHM (mean ± SD: 3.2% ± 0.6% and 2.2% ± 0.8%, respectively; P < 0.001). Pasteurization enhanced the proteolysis of lactoferrin (P < 0.01) and reduced that of α-lactalbumin (only at 90 min) (P < 0.05). Strong emulsion destabilization was observed, with smaller aggregates and a higher specific surface for PHM (P < 0.05). Pasteurization did not affect gastric emptying (∼30-min half time) or pH (mean ± SD: 4.4 ± 0.8) at 90 min.
Overall, pasteurization had no impact on the gastric digestion of lipids and some proteins from human milk but did affect lactoferrin and α-lactalbumin proteolysis and emulsion disintegration. Freeze-thawing and pasteurization increased the milk lipolysis before digestion but did not affect gastric lipolysis. Possible consequences on intestinal digestion and associated nutritional outcomes were not considered in this study. This trial was registered at clinicaltrials.gov as NCT02112331. |
| doi_str_mv | 10.3945/ajcn.116.142539 |
| format | Article |
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We sought to determine the impact of human milk pasteurization on gastric digestion (particularly for proteins and lipids) in preterm infants who were fed their mothers' own milk either raw or pasteurized.
In a randomized controlled trial, 12 hospitalized tube-fed preterm infants were their own control group in comparing the gastric digestion of raw human milk (RHM) with pasteurized human milk (PHM). Over a 6-d sequence, gastric aspirates were collected 2 times/d before and after RHM or PHM ingestion. The impact of milk pasteurization digestive kinetics and disintegration was tested with the use of a general linear mixed model.
Despite inactivating BSSL, instantaneous lipolysis was not affected by pasteurization (mean ± SD at 90 min: 12.6% ± 4.7%; P > 0.05). Lipolysis occurred in milk before digestion and was higher for PHM than for RHM (mean ± SD: 3.2% ± 0.6% and 2.2% ± 0.8%, respectively; P < 0.001). Pasteurization enhanced the proteolysis of lactoferrin (P < 0.01) and reduced that of α-lactalbumin (only at 90 min) (P < 0.05). Strong emulsion destabilization was observed, with smaller aggregates and a higher specific surface for PHM (P < 0.05). Pasteurization did not affect gastric emptying (∼30-min half time) or pH (mean ± SD: 4.4 ± 0.8) at 90 min.
Overall, pasteurization had no impact on the gastric digestion of lipids and some proteins from human milk but did affect lactoferrin and α-lactalbumin proteolysis and emulsion disintegration. Freeze-thawing and pasteurization increased the milk lipolysis before digestion but did not affect gastric lipolysis. Possible consequences on intestinal digestion and associated nutritional outcomes were not considered in this study. This trial was registered at clinicaltrials.gov as NCT02112331.</description><identifier>ISSN: 0002-9165</identifier><identifier>ISSN: 1938-3207</identifier><identifier>EISSN: 1938-3207</identifier><identifier>DOI: 10.3945/ajcn.116.142539</identifier><identifier>PMID: 28052887</identifier><language>eng</language><publisher>United States: American Society for Clinical Nutrition, Inc</publisher><subject>bile ; breast milk ; carboxylic ester hydrolases ; Caseins - blood ; Clinical trials ; Dietary Carbohydrates - analysis ; Dietary Fats - analysis ; Dietary Proteins - analysis ; Digestion ; Digestive system ; Emulsions ; Fatty Acids - analysis ; Food and Nutrition ; Food engineering ; Gastric Emptying ; Gastric Mucosa - metabolism ; Humans ; Hydrogen-Ion Concentration ; Impact analysis ; Infant ; Infant Nutritional Physiological Phenomena ; Infant, Premature ; Infants ; Ingestion ; intestines ; lactalbumin ; Lactalbumin - blood ; lactoferrin ; Lactoferrin - blood ; Life Sciences ; Lipids ; Lipolysis ; Milk ; Milk Proteins - chemistry ; Milk, Human - chemistry ; mothers ; Pasteurization ; Premature birth ; Proteolysis ; randomized clinical trials ; raw milk ; Serum Albumin - metabolism ; statistical models ; Sterol Esterase - antagonists & inhibitors ; Sterol Esterase - metabolism ; Thawing</subject><ispartof>The American journal of clinical nutrition, 2017-02, Vol.105 (2), p.379-390</ispartof><rights>2017 American Society for Nutrition.</rights><rights>Copyright American Society for Clinical Nutrition, Inc. Feb 1, 2017</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-5073a6ce7629b8fc67e2b7f98b694af40bd069e60ace3f1e10a3a2467aa7eb63</citedby><cites>FETCH-LOGICAL-c466t-5073a6ce7629b8fc67e2b7f98b694af40bd069e60ace3f1e10a3a2467aa7eb63</cites><orcidid>0000-0001-5497-9224 ; 0000-0001-5304-6561 ; 0000-0001-8366-116X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28052887$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-01437014$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>de Oliveira, Samira C</creatorcontrib><creatorcontrib>Bellanger, Amandine</creatorcontrib><creatorcontrib>Ménard, Olivia</creatorcontrib><creatorcontrib>Pladys, Patrick</creatorcontrib><creatorcontrib>Le Gouar, Yann</creatorcontrib><creatorcontrib>Dirson, Emelyne</creatorcontrib><creatorcontrib>Kroell, Florian</creatorcontrib><creatorcontrib>Dupont, Didier</creatorcontrib><creatorcontrib>Deglaire, Amélie</creatorcontrib><creatorcontrib>Bourlieu, Claire</creatorcontrib><title>Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial</title><title>The American journal of clinical nutrition</title><addtitle>Am J Clin Nutr</addtitle><description>Holder pasteurization has been reported to modify human milk composition and structure by inactivating bile salt-stimulated lipase (BSSL) and partially denaturing some of its proteins, potentially affecting its subsequent digestion.
We sought to determine the impact of human milk pasteurization on gastric digestion (particularly for proteins and lipids) in preterm infants who were fed their mothers' own milk either raw or pasteurized.
In a randomized controlled trial, 12 hospitalized tube-fed preterm infants were their own control group in comparing the gastric digestion of raw human milk (RHM) with pasteurized human milk (PHM). Over a 6-d sequence, gastric aspirates were collected 2 times/d before and after RHM or PHM ingestion. The impact of milk pasteurization digestive kinetics and disintegration was tested with the use of a general linear mixed model.
Despite inactivating BSSL, instantaneous lipolysis was not affected by pasteurization (mean ± SD at 90 min: 12.6% ± 4.7%; P > 0.05). Lipolysis occurred in milk before digestion and was higher for PHM than for RHM (mean ± SD: 3.2% ± 0.6% and 2.2% ± 0.8%, respectively; P < 0.001). Pasteurization enhanced the proteolysis of lactoferrin (P < 0.01) and reduced that of α-lactalbumin (only at 90 min) (P < 0.05). Strong emulsion destabilization was observed, with smaller aggregates and a higher specific surface for PHM (P < 0.05). Pasteurization did not affect gastric emptying (∼30-min half time) or pH (mean ± SD: 4.4 ± 0.8) at 90 min.
Overall, pasteurization had no impact on the gastric digestion of lipids and some proteins from human milk but did affect lactoferrin and α-lactalbumin proteolysis and emulsion disintegration. Freeze-thawing and pasteurization increased the milk lipolysis before digestion but did not affect gastric lipolysis. Possible consequences on intestinal digestion and associated nutritional outcomes were not considered in this study. This trial was registered at clinicaltrials.gov as NCT02112331.</description><subject>bile</subject><subject>breast milk</subject><subject>carboxylic ester hydrolases</subject><subject>Caseins - blood</subject><subject>Clinical trials</subject><subject>Dietary Carbohydrates - analysis</subject><subject>Dietary Fats - analysis</subject><subject>Dietary Proteins - analysis</subject><subject>Digestion</subject><subject>Digestive system</subject><subject>Emulsions</subject><subject>Fatty Acids - analysis</subject><subject>Food and Nutrition</subject><subject>Food engineering</subject><subject>Gastric Emptying</subject><subject>Gastric Mucosa - metabolism</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Impact analysis</subject><subject>Infant</subject><subject>Infant Nutritional Physiological Phenomena</subject><subject>Infant, Premature</subject><subject>Infants</subject><subject>Ingestion</subject><subject>intestines</subject><subject>lactalbumin</subject><subject>Lactalbumin - blood</subject><subject>lactoferrin</subject><subject>Lactoferrin - blood</subject><subject>Life Sciences</subject><subject>Lipids</subject><subject>Lipolysis</subject><subject>Milk</subject><subject>Milk Proteins - chemistry</subject><subject>Milk, Human - chemistry</subject><subject>mothers</subject><subject>Pasteurization</subject><subject>Premature birth</subject><subject>Proteolysis</subject><subject>randomized clinical trials</subject><subject>raw milk</subject><subject>Serum Albumin - metabolism</subject><subject>statistical models</subject><subject>Sterol Esterase - antagonists & inhibitors</subject><subject>Sterol Esterase - metabolism</subject><subject>Thawing</subject><issn>0002-9165</issn><issn>1938-3207</issn><issn>1938-3207</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkk1v1DAQhi0EokvhzA1Z4lIO2foj_uJWVYVWWolL79bEcVoviR3spBL99XjZ0gMXkEae0atnRhrPi9B7SrbctOIc9i5uKZVb2jLBzQu0oYbrhjOiXqINIYQ1hkpxgt6UsieEslbL1-iEaSKY1mqD9jfTDG7BacD36wQRT2H8jmcoi19zeIQlpIhr3FUlB4f7cOfLbzFEPGe_-DzVcoC4lM8YcIbYpyk8-h67FJecxrGWtRXGt-jVAGPx757yKbr9cnV7ed3svn29ubzYNa6VcmkEURyk80oy0-nBSeVZpwajO2laGFrS9UQaLwk4zwfqKQEOrJUKQPlO8lP06Tj2HkY75zBB_mkTBHt9sbMHjdCWq_o80MqeHdk5px9rXcxOoTg_jhB9WotlVEkuKOf6nyjVWhuhieH_gQqhtKz3qujHv9B9WnOs31MpKQkTgrNKnR8pl1Mp2Q_Pe1FiDz6wBx_Y6gN79EHt-PA0d-0m3z_zfw7PfwFaca3R</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>de Oliveira, Samira C</creator><creator>Bellanger, Amandine</creator><creator>Ménard, Olivia</creator><creator>Pladys, Patrick</creator><creator>Le Gouar, Yann</creator><creator>Dirson, Emelyne</creator><creator>Kroell, Florian</creator><creator>Dupont, Didier</creator><creator>Deglaire, Amélie</creator><creator>Bourlieu, Claire</creator><general>American Society for Clinical Nutrition, Inc</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T7</scope><scope>7TS</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>7U7</scope><scope>7S9</scope><scope>L.6</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-5497-9224</orcidid><orcidid>https://orcid.org/0000-0001-5304-6561</orcidid><orcidid>https://orcid.org/0000-0001-8366-116X</orcidid></search><sort><creationdate>20170201</creationdate><title>Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial</title><author>de Oliveira, Samira C ; Bellanger, Amandine ; Ménard, Olivia ; Pladys, Patrick ; Le Gouar, Yann ; Dirson, Emelyne ; Kroell, Florian ; Dupont, Didier ; Deglaire, Amélie ; Bourlieu, Claire</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-5073a6ce7629b8fc67e2b7f98b694af40bd069e60ace3f1e10a3a2467aa7eb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>bile</topic><topic>breast milk</topic><topic>carboxylic ester hydrolases</topic><topic>Caseins - blood</topic><topic>Clinical trials</topic><topic>Dietary Carbohydrates - analysis</topic><topic>Dietary Fats - analysis</topic><topic>Dietary Proteins - analysis</topic><topic>Digestion</topic><topic>Digestive system</topic><topic>Emulsions</topic><topic>Fatty Acids - analysis</topic><topic>Food and Nutrition</topic><topic>Food engineering</topic><topic>Gastric Emptying</topic><topic>Gastric Mucosa - metabolism</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Impact analysis</topic><topic>Infant</topic><topic>Infant Nutritional Physiological Phenomena</topic><topic>Infant, Premature</topic><topic>Infants</topic><topic>Ingestion</topic><topic>intestines</topic><topic>lactalbumin</topic><topic>Lactalbumin - blood</topic><topic>lactoferrin</topic><topic>Lactoferrin - blood</topic><topic>Life Sciences</topic><topic>Lipids</topic><topic>Lipolysis</topic><topic>Milk</topic><topic>Milk Proteins - chemistry</topic><topic>Milk, Human - chemistry</topic><topic>mothers</topic><topic>Pasteurization</topic><topic>Premature birth</topic><topic>Proteolysis</topic><topic>randomized clinical trials</topic><topic>raw milk</topic><topic>Serum Albumin - metabolism</topic><topic>statistical models</topic><topic>Sterol Esterase - antagonists & inhibitors</topic><topic>Sterol Esterase - metabolism</topic><topic>Thawing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Oliveira, Samira C</creatorcontrib><creatorcontrib>Bellanger, Amandine</creatorcontrib><creatorcontrib>Ménard, Olivia</creatorcontrib><creatorcontrib>Pladys, Patrick</creatorcontrib><creatorcontrib>Le Gouar, Yann</creatorcontrib><creatorcontrib>Dirson, Emelyne</creatorcontrib><creatorcontrib>Kroell, Florian</creatorcontrib><creatorcontrib>Dupont, Didier</creatorcontrib><creatorcontrib>Deglaire, Amélie</creatorcontrib><creatorcontrib>Bourlieu, Claire</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Toxicology Abstracts</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>The American journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Oliveira, Samira C</au><au>Bellanger, Amandine</au><au>Ménard, Olivia</au><au>Pladys, Patrick</au><au>Le Gouar, Yann</au><au>Dirson, Emelyne</au><au>Kroell, Florian</au><au>Dupont, Didier</au><au>Deglaire, Amélie</au><au>Bourlieu, Claire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial</atitle><jtitle>The American journal of clinical nutrition</jtitle><addtitle>Am J Clin Nutr</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>105</volume><issue>2</issue><spage>379</spage><epage>390</epage><pages>379-390</pages><issn>0002-9165</issn><issn>1938-3207</issn><eissn>1938-3207</eissn><abstract>Holder pasteurization has been reported to modify human milk composition and structure by inactivating bile salt-stimulated lipase (BSSL) and partially denaturing some of its proteins, potentially affecting its subsequent digestion.
We sought to determine the impact of human milk pasteurization on gastric digestion (particularly for proteins and lipids) in preterm infants who were fed their mothers' own milk either raw or pasteurized.
In a randomized controlled trial, 12 hospitalized tube-fed preterm infants were their own control group in comparing the gastric digestion of raw human milk (RHM) with pasteurized human milk (PHM). Over a 6-d sequence, gastric aspirates were collected 2 times/d before and after RHM or PHM ingestion. The impact of milk pasteurization digestive kinetics and disintegration was tested with the use of a general linear mixed model.
Despite inactivating BSSL, instantaneous lipolysis was not affected by pasteurization (mean ± SD at 90 min: 12.6% ± 4.7%; P > 0.05). Lipolysis occurred in milk before digestion and was higher for PHM than for RHM (mean ± SD: 3.2% ± 0.6% and 2.2% ± 0.8%, respectively; P < 0.001). Pasteurization enhanced the proteolysis of lactoferrin (P < 0.01) and reduced that of α-lactalbumin (only at 90 min) (P < 0.05). Strong emulsion destabilization was observed, with smaller aggregates and a higher specific surface for PHM (P < 0.05). Pasteurization did not affect gastric emptying (∼30-min half time) or pH (mean ± SD: 4.4 ± 0.8) at 90 min.
Overall, pasteurization had no impact on the gastric digestion of lipids and some proteins from human milk but did affect lactoferrin and α-lactalbumin proteolysis and emulsion disintegration. Freeze-thawing and pasteurization increased the milk lipolysis before digestion but did not affect gastric lipolysis. Possible consequences on intestinal digestion and associated nutritional outcomes were not considered in this study. This trial was registered at clinicaltrials.gov as NCT02112331.</abstract><cop>United States</cop><pub>American Society for Clinical Nutrition, Inc</pub><pmid>28052887</pmid><doi>10.3945/ajcn.116.142539</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-5497-9224</orcidid><orcidid>https://orcid.org/0000-0001-5304-6561</orcidid><orcidid>https://orcid.org/0000-0001-8366-116X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | bile breast milk carboxylic ester hydrolases Caseins - blood Clinical trials Dietary Carbohydrates - analysis Dietary Fats - analysis Dietary Proteins - analysis Digestion Digestive system Emulsions Fatty Acids - analysis Food and Nutrition Food engineering Gastric Emptying Gastric Mucosa - metabolism Humans Hydrogen-Ion Concentration Impact analysis Infant Infant Nutritional Physiological Phenomena Infant, Premature Infants Ingestion intestines lactalbumin Lactalbumin - blood lactoferrin Lactoferrin - blood Life Sciences Lipids Lipolysis Milk Milk Proteins - chemistry Milk, Human - chemistry mothers Pasteurization Premature birth Proteolysis randomized clinical trials raw milk Serum Albumin - metabolism statistical models Sterol Esterase - antagonists & inhibitors Sterol Esterase - metabolism Thawing |
| title | Impact of human milk pasteurization on gastric digestion in preterm infants: a randomized controlled trial |
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