2.A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants
Yvan VANDENPLAS ; Zakiudin MUNASIR ; Badriul HEGAR ; Dewi KUMARAWATI ; Ahmad SURYAWAN ; Muzal KADIM ; Julistio Tb DJAIS ; Ray Wagiu BASROWI ; Deni KRISNAMURTI
Korean Journal of Pediatrics 2019;62(5):149-154
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
Breast Feeding
;
Critical Period (Psychology)
;
Epidemiologic Studies
;
Food Hypersensitivity
;
Humans
;
Hypersensitivity
;
Infant Formula
;
Infant
;
Milk
;
Milk Hypersensitivity
;
Whey
;
World Health Organization
3.A Synbiotic Infant Formula with High Magnesium Content Improves Constipation and Quality of Life
Ioannis XINIAS ; Antonis ANALITIS ; Antigoni MAVROUDI ; Ioannis ROILIDES ; Maria LYKOGEORGOU ; Varvara DELIVORIA ; Vasilis MILINGOS ; Mayra MYLONOPOULOU ; Yvan VANDENPLAS
Pediatric Gastroenterology, Hepatology & Nutrition 2018;21(1):28-33
PURPOSE: To evaluate the efficacy of synbiotic formula with partial whey hydrolysate and high magnesium content in infants presenting with functional constipation. METHODS: Sixty-five infants with functional constipation were included. Forty infants were treated during one month with parental reassurance and the intervention formula and were compared to a control group of 25 infants treated with parental reassurance only. Parents completed a quality of life (QoL) questionnaire at baseline and during the last week of the study. RESULTS: At inclusion, stool characteristics and QoL were similar in both groups. The control group was slightly older than the intervention group (7.5±3.9 vs. 6.2±3.6 weeks). At onset, stool composition was “hard and tight” (Bristol stool scale 1 and 2) in all infants. After one month, stool composition remained unchanged in the control group except in two infants that developed “creamy” stools (Bristol stool scale type 3 and 4). In the intervention group, stools remained “hard and tight” in 27.5%, and became “creamy” in 47.5%, “loose” (Bristol stool scale type 5) in 22.5% and “watery” (Bristol stool type 6 and 7) in 2.5%. The benefit of the intervention formula was estimated to be “very important” in 70%. The median scores for QoL improved significantly in the intervention group for all parameters and for one in the control group. CONCLUSION: The intervention formula significantly improved functional constipation resulting in a better QoL of the parents and infants.
Constipation
;
Humans
;
Infant Formula
;
Infant
;
Magnesium
;
Parents
;
Prebiotics
;
Quality of Life
;
Synbiotics
;
Whey
4.Effect of Nutrient Preload and Food Order on Glucose, Insulin, and Gut Hormones.
Journal of Korean Diabetes 2018;19(4):193-199
Postprandial hyperglycemia is associated with the risk of diabetes mellitus, cardiovascular disease, and mortality. Nutrition therapy is an important component of the management of postprandial hyperglycemia. Postprandial glucose levels are determined by several factors, such as the quantity and composition of nutrients, gastric emptying rates, secretion of incretin hormones, insulin secretion, glucose uptake by peripheral tissues, and endogenous glucose production. Nutrient preload and food order (or meal sequence) are dietary approaches targeting these factors. Nutrient preload reduces postprandial glucose excursion by enhancing insulin secretion, augmenting the secretion of glucagonlike peptide-1, and delaying gastric emptying. Carbohydrates-last food order improves glycemic control, increases the secretion of glucagon-like peptide-1, and decreases insulin requirements. Therefore, both nutrient preload and manipulation of food order can be an effective, safe, and feasible strategy for treating hyperglycemia in individuals with diabetes mellitus.
Carbohydrates
;
Cardiovascular Diseases
;
Diabetes Mellitus
;
Gastric Emptying
;
Gastrointestinal Hormones
;
Glucagon-Like Peptide 1
;
Glucose*
;
Hyperglycemia
;
Incretins
;
Insulin*
;
Meals
;
Mortality
;
Nutrition Therapy
;
Whey Proteins
5.The effect of Whey Protein Supplementation on duration of Mechanical Ventilation: A pilot study
Kristine Mae Vega-Alava ; Rosa Allyn G. Sy
Philippine Journal of Internal Medicine 2018;56(2):71-76
Introduction:
It is important to wean mechanically-ventilated patients as early as possible to avoid complications such as ventilator-associated pneumonia. Supplementing the diet with additional protein may help to stimulate muscle protein synthesis which may enhance respiratory muscle function and ventilator drive. This study aims to determine the effect of whey protein supplementation on the duration of mechanical ventilation in intensive care unit patients of Ospital ng Makati.
Methods:
We enrolled forty eligible patients in this openlabel randomized controlled trial and were assigned into two groups: Group A (N=20): patients were given enteral feeding using commercial formula with added whey protein, given as one serving every eight hours (equivalent to 18 g of additional protein per day) and Group B (N=20): patients were given enteral feeding using commercial formula alone. Weaning was started as soon as the patient fulfilled the criteria of spontaneous breathing trial and was considered successful if the patient maintained these criteria for 48 hours after extubation.
Results:
Our study’s results showed that the mechanically intubated patients in Group A have lesser ventilatordependent days with an average of 5.4 days as compared to those in Group B with an average of 7.45 days (p=0.00). Patients in Group A were also noted to have statistically significant higher increase in serum albumin, mid-arm circumference and triceps skin fold from baseline. Twentyfive percent of patients in Group B developed ventilator acquired pneumonia and none in Group A. No mortality was noted in both groups.
Conclusion
Whey protein supplementation in mechanically ventilated patients can be recommended to facilitate early weaning because of its effect on early muscle protein synthesis leading to improvement of lung function and ventilator drive. It can also help in preventing malnutrition and nosocomial infections during critical illness. With all these benefits of whey protein, its use can potentially lead to shorter duration of mechanical ventilation and hospital stay which can also mean less cost of care delivery.
Whey Proteins
;
Weaning
;
Respiration, Artificial
;
Intensive Care Units
;
Randomized Controlled Trial
6.Innovative Dietary Intervention Answers to Baby Colic.
Ioannis XINIAS ; A ANALITIS ; Antigoni MAVROUDI ; Ioannis ROILIDES ; Maria LYKOGEORGOU ; Varvara DELIVORIA ; Vasilis MILINGOS ; Mayra MYLONOPOULOU ; Yvan VANDENPLAS
Pediatric Gastroenterology, Hepatology & Nutrition 2017;20(2):100-106
PURPOSE: The purpose of this paper is to evaluate the efficacy of a lactose- reduced synbiotic partial whey hydrolysate in formula fed infants presenting with colic and the impact of this dietary intervention in mean crying time and quality of life. METHODS: Forty infants with infantile colic were treated during one month with parental reassurance and the intervention formula (partial whey hydrolysate, reduced lactose, Bifidobacterium lactis BB12 and galacto-oligosaccharides) and were compared to a control group of 20 infants with infantile colic treated with parental reassurance and a standard infant formula. Parents completed a quality of life (QoL) questionnaire assessing the burden of infantile colic. Wilcoxon test, t-test and Mann-Whitney test were used to compare QoL scores before and after intervention as well as between the intervention and control group. RESULTS: At inclusion, duration of crying did not differ between both groups. Crying duration decreased with 2.7 hours (from 3.2 to 0.5 hours) in the intervention group while duration of crying decreased only with 1.2 hours in the control group (p<0.001). Stool composition became looser in the intervention group, but defecation frequency did not change. The median scores of the QoL questionnaire improved significantly in the intervention group for all parameters. In the control group, parameters improved significantly also but not for the parent-child and social interaction. The score changes were significantly greater in the intervention than in the control group. CONCLUSION: The intervention formula (partial whey hydrolysate, synbiotic, reduced lactose) significantly reduced the duration of crying and improved QoL of the parents and infants.
Bifidobacterium
;
Colic*
;
Crying
;
Defecation
;
Humans
;
Infant
;
Infant Formula
;
Interpersonal Relations
;
Lactose
;
Parents
;
Prebiotics
;
Probiotics
;
Quality of Life
;
Synbiotics
;
Whey
7.Development and properties of hypoallergenic infant formula.
Woel Kyu HA ; Jeongmin LEE ; Kyu Earn KIM
Allergy, Asthma & Respiratory Disease 2017;5(2):63-72
Milk proteins are composed of casein, further classified into αS1-casein, αS2-casein, β-casein, and κ-casein, and whey protein, which is separated into α-lacatalbumin, β-lactoglobulin, serum albumin, and some minor proteins, such as lactoferrin and immunoglobulin. To reduce the allergenicity of protein, heat treatment and enzymatic protein hydrolysis by endopeptidase are necessarily required. Additionally, membrane technology should be applied to produce a protein hydrolyzate, which has consistent molecular weight of peptide and low in free amino acid without allergenic peptide or protein. Extensive casein hydrolyzate and whey protein hydrolyzate are used for protein source of mainly extensively hydrolyzed protein formula (eHF) intended for the treatment of cow's milk allergy. Also, partially hydrolyzed formula (pHF) is developed, which is using a single protein source e.g., whey protein hydrolyzate. The allergenicity of infant formula can be determined according to molecular weight profile and antigenicity reduction compared to intact protein. More than 90% peptides are present in eHF have a molecular weight of <3,000 Da. Peptide molecular weight profiles of pHF range mainly between 3,000 and 10,000 Da, but have a small percentage of >10,000 Da. Generally, antigenicity reduction in eHF and pHF is 10-6 and 10-3, respectively. Even if protein hydrolyzate is manufactured under strict quality control, there is still a risk of cross contamination of allergenic milk components through environmental conditions and the shared manufacturing process. Thus, quality assessment of protein hydrolyzate formula must be performed routinely.
Caseins
;
Hot Temperature
;
Humans
;
Hydrolysis
;
Immunoglobulins
;
Infant Formula*
;
Infant*
;
Lactoferrin
;
Membranes
;
Milk
;
Milk Hypersensitivity
;
Milk Proteins
;
Molecular Weight
;
Peptides
;
Quality Control
;
Serum Albumin
;
Whey Proteins
8.Anti-bacterial effects of enzymatically-isolated sialic acid from glycomacropeptide in a Helicobacter pylori-infected murine model.
Hye Ji NOH ; Hong Bum KOH ; Hee Kyoung KIM ; Hyang Hyun CHO ; Jeongmin LEE
Nutrition Research and Practice 2017;11(1):11-16
BACKGROUND/OBJECTIVES: Helicobacter pylori (H. pylori) colonization of the stomach mucosa and duodenum is the major cause of acute and chronic gastroduodenal pathology in humans. Efforts to find effective anti-bacterial strategies against H. pylori for the non-antibiotic control of H. pylori infection are urgently required. In this study, we used whey to prepare glycomacropeptide (GMP), from which sialic acid (G-SA) was enzymatically isolated. We investigated the anti-bacterial effects of G-SA against H. pylori in vitro and in an H. pylori-infected murine model. MATERIALS/METHODS: The anti-bacterial activity of G-SA was measured in vitro using the macrodilution method, and interleukin-8 (IL-8) production was measured in H. pylori and AGS cell co-cultures by ELISA. For in vivo study, G-SA 5 g/kg body weight (bw)/day and H. pylori were administered to mice three times over one week. After one week, G-SA 5 g/kg bw/day alone was administered every day for one week. Tumor necrosis factor-α (TNF-α), IL-1β, IL-6, and IL-10 levels were measured by ELISA to determine the anti-inflammatory effects of G-SA. In addition, real-time PCR was performed to measure the genetic expression of cytotoxin-associated gene A (cagA). RESULTS: G-SA inhibited the growth of H. pylori and suppressed IL-8 production in H. pylori and in AGS cell co-cultures in vitro. In the in vivo assay, administration of G-SA reduced levels of IL-1β and IL-6 pro-inflammatory cytokines whereas IL-10 level increased. Also, G-SA suppressed the expression of cagA in the stomach of H. pylori-infected mice. CONCLUSION: G-SA possesses anti-H. pylori activity as well as an anti-H. pylori-induced gastric inflammatory effect in an experimental H. pylori-infected murine model. G-SA has potential as an alternative to antibiotics for the prevention of H. pylori infection and H. pylori-induced gastric disease prevention.
Animals
;
Anti-Bacterial Agents
;
Body Weight
;
Coculture Techniques
;
Colon
;
Cytokines
;
Duodenum
;
Enzyme-Linked Immunosorbent Assay
;
Helicobacter pylori
;
Helicobacter*
;
Humans
;
In Vitro Techniques
;
Interleukin-10
;
Interleukin-6
;
Interleukin-8
;
Methods
;
Mice
;
Mucous Membrane
;
N-Acetylneuraminic Acid*
;
Necrosis
;
Pathology
;
Real-Time Polymerase Chain Reaction
;
Stomach
;
Stomach Diseases
;
Whey
9.Anti-Helicobacter pylori activity of crude N-acetylneuraminic acid isolated from glycomacropeptide of whey.
Dong Jae KIM ; Min Jung KANG ; Jin A CHOI ; Dae Seung NA ; Jin Beom KIM ; Chun Soo NA ; Jong Hwan PARK
Laboratory Animal Research 2016;32(2):99-104
Helicobacter pylori colonizes the gastric mucosa of about half of the world's population, causing chronic gastritis and gastric cancer. An increasing emergence of antibiotic-resistant H. pylori arouses demand on alternative non-antibiotic-based therapies. In this study, we freshly prepared crude N-acetylneuraminic acid obtained from glycomacropeptide (G-NANA) of whey through a neuraminidase-mediated reaction and evaluated its antibacterial ability against H. pylori and H. felis. Overnight cultures of the H. pylori were diluted with fresh media and different concentrations (1-150 mg/mL) of crude G-NANA were added directly to the culture tube. Bacterial growth was evaluated by measuring the optical density of the culture medium and the number of viable bacteria was determined by a direct count of the colony forming units (CFU) on agar plates. For the in vivo study, mice were orally infected with 100 µL (5×108 cfu/mL) of H. felis four times at a day's interval, accompanied by a daily administration of crude G-NANA or vehicle. A day after the last infection, the mice were daily administered the crude G-NANA (0, 75, and 300 mg/mL) for 10 days and euthanized. Their stomachs were collected and bacterial colonization was determined by quantitative real-time PCR. Crude G-NANA inhibited H. pylori's growth and reduced the number of viable bacteria in a dose-dependent manner. Furthermore, crude G-NANA inhibited bacterial colonization in the mice. These results showed that crude G-NANA has antibacterial activity against Helicobacter and demonstrated its therapeutic potential for the prevention of chronic gastritis and gastric carcinogenesis induced by Helicobacter infection in humans.
Agar
;
Animals
;
Bacteria
;
Carcinogenesis
;
Cats
;
Colon
;
Felis
;
Gastric Mucosa
;
Gastritis
;
Helicobacter
;
Helicobacter Infections
;
Helicobacter pylori
;
Humans
;
Mice
;
N-Acetylneuraminic Acid*
;
Real-Time Polymerase Chain Reaction
;
Stem Cells
;
Stomach
;
Stomach Neoplasms
;
Whey*
10.Effect of the whey basic protein on bone mineral density.
Bing DU ; Wei-zhong CHAI ; Xiao-ming LIN
Chinese Journal of Preventive Medicine 2007;41(2):96-100
OBJECTIVETo examine the effects of the whey basic protein on bone metabolism of Sprague-Dawley (SD) rats and healthy mid-aged women.
METHODSForty-four female SD rats were randomized by weight into four groups of eleven rats each and fed 10 mg x kg BW(-1) x d(-1), 20 mg x kg BW(-1) x d(-1), 30 mg x kg BW(-1) x d(-1) of whey basic protein and control diet was given respectively by intragastrically injection for 90 days. Bone mineral density of femur was measured by dual-energy X-ray absorptiometry in vitro. Sixty-three health women [(37.9 +/- 4.3) years old] were randomly assigned to treatment with placebo, 30 mg whey basic protein per day or 60 mg whey basic protein per day for 24 weeks. The bone mineral density (BMD) of the lumbar vertebrae L2-LA, femoral neck and right calcaneus of each subject were measured by dual-energy X-ray absorptiometry (DXA) at 0 and the 24th week of treatment. Serum bone specific alkaline phosphatase and N-telopeptide (NTX) were measured at 0 and the 14th week.
RESULTSThe mean BMD value of the distal end of the femur in 10 mg x kg BW(-1) x d(-1) whey basic protein group was significantly higher than that of the control group at the end of the trail. But after treatment by doses of whey basic protein used in the study, there were no differences between the control group and others groups on bone mineral density in the human trail.
CONCLUSIONWhey basic protein should enhance the bone mineral density of the rats' femur and no obvious effect was detected in the human trail.
Adult ; Animals ; Bone Density ; drug effects ; Female ; Food, Formulated ; Humans ; Lactalbumin ; pharmacology ; Milk ; Milk Proteins ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Whey Proteins


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