Processing Human Milk to Increase Nutrient Density for Preterm Infants

Background: Human milk is the optimal food for newborns. Choices to feed preterm infants in neonatal intensive care units are mother’s milk, donor milk, or formula. Preterm infants have better tolerance for human milk, but the lower caloric density of donor milk might not meet preterm infant growth needs. Preterm infants have higher protein and energy requirements with a limited stomach capacity. Therefore, there is a need for human milk with increased nutrient density. Research Aim: To concentrate donor milk to have a higher caloric and protein density while avoiding side effects of high osmolality by precipitating lactose at low temperatures. Methods: We investigated the results of volume reduction and lactose removal processes on the lactose, protein, osmolality, and viscosity of human milk. Donor milk was obtained from WakeMed Mothers’ Milk Bank. Homogenization and evaporative condensation were applied to samples ( N = 36) before they were stored frozen overnight, followed by refrigerated centrifugation for lactose removal at 0 °C. Supernatants were separated and compared to the composition of controls. Results: A significant reduction of lactose ( SW = -262, p < .0001) and osmolality ( SW = -211.5 p < .01) was achieved in the concentrated milk without a significant protein loss from centrifugation ( SW = -44.5, p = .49). A 30%–40% volume reduction is within the American Academy of Pediatrics recommended osmolality for infant feeding. Conclusion: Concentrating human milk in a milk bank setting for feeding preterm infants might be a simple and low-cost process to achieve a product with higher nutrient density and no non-human components.

Trefoil Factor Family Member 2: From a High-Fat-Induced Gene to a Potential Obesity Therapy Target

Obesity has its epidemiological patterns continuously increasing. With controlling both diet and exercise being the main approaches to manage the energy metabolism balance, a high-fat (HF) diet is of particular importance. Indeed, lipids have a low satiety potential but a high caloric density. Thus, focusing on pharmacologically targetable pathways remains an approach with promising therapeutic potential. Within this context, trefoil factor family member 2 (Tff2) has been characterized as specifically induced by HF diet rather than low-fat diet. TFF2 has also been linked to diverse neurological mechanisms and metabolic patterns suggesting its role in energy balance. The hypothesis is that TFF2 would be a HF diet-induced signal that regulates metabolism with a focus on lipids. Within this review, we put the spotlight on key findings highlighting this line of thought. Importantly, the hypothetical mechanisms pointed highlight TFF2 as an important contributor to obesity development via increasing lipids intestinal absorption and anabolism. Therefore, an outlook for future experimental activities and evaluation of the therapeutic potential of TFF2 inhibition is given. Indeed, its knockdown or downregulation would contribute to an antiobesity phenotype. We believe this work represents an addition to our understanding of the lipidic molecular implications in obesity, which will contribute to develop therapies aiming to manage the lipidic metabolic pathways including the absorption, storage and metabolism via targeting TFF2-related pathways. We briefly discuss important relevant concepts for both basic and clinical researchers.

Dietary energy level, feeder space, and group size on growth performance and carcass characteristics of growing-finishing barrows and gilts

To benefit from feeding low net energy (NE) diets, growing-finishing pigs must be able to increase feed intake to compensate for lower caloric density, but this might be difficult in pens with a high stocking density. Access to the feeder, trough space, and(or) floor area may limit voluntary feed intake. The objective of this study was to clarify the relationships among dietary NE level, feeder space, group size, sex, and interactions in growing-finishing pigs. In a 2 × 2 × 2 × 2 factorial design, 1920 pigs (33 kg) housed in 96 fully-slatted floor pens (6.1 × 2.4 m) with 2 or 3 feeder spaces, and 18 or 22 barrows or gilts per pen, were fed either low (9.2 MJ/kg) or high (9.85 MJ/kg) NE diets over 5 growth phases (Grower 1: day [d] 0 to 20, Grower 2: d 21 to 41, Grower 3: d 42 to 62, Finisher 1: d 63 to 80, Finisher 2: d 81 to slaughter). Pen body weight (BW) and average daily feed disappearance (ADFD) were measured for each growth phase, biweekly from the start of shipping and at slaughter. Warm carcasses were weighed and graded (Destron). For the entire trial, pigs fed low versus (vs.) high NE diets had 0.119 kg/d greater (P &lt; 0.001) ADFD, but 0.556 MJ/d lower (P &lt; 0.050) average daily caloric disappearance (ADCD), and 0.017 kg/kg lower (P &lt; 0.001) gain-to-feed (G:F). Pens with 18 vs. 22 pigs had 0.062 kg/d greater (P &lt; 0.001) ADFD, 0.730 MJ/d greater (P &lt; 0.010) ADCD, and 0.029 kg/d greater (P &lt; 0.001) average daily weight gain (ADWG). Pigs in pens with 3 vs. 2 feeding spaces had 0.051 kg/d greater (P &lt; 0.010) ADFD, 0.511 MJ/d greater (P = 0.050) ADCD but 0.004 kg/kg lower (P &lt; 0.050) G:F. Pigs fed low vs. high NE diets had 0.6 kg lower (P &lt; 0.050) carcass weight and 0.9 mm lower (P &lt; 0.050) loin depth. Pens with 18 vs. 22 pigs took 2.8 days less (P &lt; 0.001) to reach 130 kg slaughter BW. Pens with 18 vs. 22 pigs had a 0.4 %-point decrease (P &lt; 0.050) in dressing percentage. Feeding low vs. high NE diets reduced (P &lt; 0.001) feed cost by Can $21.87/tonne, $3.34/pig, $0.03/kg gain, and increased (P &lt; 0.05) gross income subtracting feed cost (ISFC) by $1.82/pig. Housing 18 vs. 22 pigs per pen increased (P &lt; 0.010) ISFC by $1.98 per pig. Lack of interactions between NE level, feeder space, and group size for ADFD indicate that low NE diets can be fed to pigs even if they have lower than recommended floor area allowance during part of the finishing phase.

Energy Content and Nutrient Profiles of Frequently Consumed Meals in Singapore

Singapore is a multi-ethnic country with a great variety of traditional ethnic cuisines. In this modern society where there is an increasing prevalence of obesity, it is important to know the nutritional content and energy density of our foods. However, there have been little data on the nutritional content of our local foods. The energy density and nutrient content of 45 commonly consumed meals by three ethnic groups in Singapore (Chinese, Malay, and Indian) were assessed in this study. Chinese, Malay, and Indian cuisines had an average energy density of 661, 652, and 723 kJ/100 g, respectively. Moreover, the macronutrient content is different between the different ethnic groups. Compared to Chinese and Malay cuisines, Indian cuisine contained lower protein but higher fat and carbohydrate content (p = 0.03). From the mineral analysis of the ethnic foods, we found out that Chinese cuisines contain significantly higher sodium (average of 238 mg/100 g) than Malay cuisines (p = 0.006) and Indian cuisines (p = 0.03). Knowing the caloric density and nutrition content of local ethnic foods may aid hawkers and government officials in developing healthier options to tackle Singapore’s obesity epidemic.

Effects of Lifestyle Intervention in Tissue-Specific Lipidomic Profile of Formerly Obese Mice

Lipids are highly diverse in their composition, properties and distribution in different biological entities. We aim to establish the lipidomes of several insulin-sensitive tissues and to test their plasticity when divergent feeding regimens and lifestyles are imposed. Here, we report a proton nuclear magnetic resonance (1H-NMR) study of lipid abundance across 4 tissues of C57Bl6J male mice that includes the changes in the lipid profile after every lifestyle intervention. Every tissue analysed presented a specific lipid profile irrespective of interventions. Glycerolipids and fatty acids were most abundant in epididymal white adipose tissue (eWAT) followed by liver, whereas sterol lipids and phosphoglycerolipids were highly enriched in hypothalamus, and gastrocnemius had the lowest content in all lipid species compared to the other tissues. Both when subjected to a high-fat diet (HFD) and after a subsequent lifestyle intervention (INT), the lipidome of hypothalamus showed no changes. Gastrocnemius and liver revealed a pattern of increase in content in many lipid species after HFD followed by a regression to basal levels after INT, while eWAT lipidome was affected mainly by the fat composition of the administered diets and not their caloric density. Thus, the present study demonstrates a unique lipidome for each tissue modulated by caloric intake and dietary composition.

Effect of Feeding Strategies on the Development of Fulminant Necrotizing Enterocolitis

Introduction Necrotizing enterocolitis (NEC) causes significant neonatal morbidity. A subset of infants experience precipitous decline and death from fulminant-NEC (F-NEC). We sought to determine the effect of feeding practices on the development of this more virulent form of NEC. Materials and Methods Premature neonates developing Bell's stage II or III NEC between May 2011 and June 2017 were reviewed. Infants were stratified as having NEC or F-NEC, defined as NEC-totalis or NEC causing rapid decline and death within 72 hours. Risk factors extracted included demographics, gestational age, and weight at NEC diagnosis. Feeding data extracted included age at first feed, caloric density, type of feed (breast milk or formula), and whether full volume feeds were reached. Univariate analysis and multivariate analysis were performed. Results A total of 98 patients were identified, of which 80 were included. In total, 57 patients had NEC and 23 had F-NEC. Reaching full volume feeds was associated with F-NEC on both univariate and multivariate analysis (37.9 vs. 4.5%; odds ratio: 67, 95% confidence interval: 6.606–2041, p = 0.003). Infants developing F-NEC achieved full feeds earlier (22.5 vs. 19.8 days, p = 0.025) on univariate but not multivariate analysis. There was no difference in the rates of NEC and F-NEC among infants receiving breast milk (standard or fortified) or formula (standard or increased caloric density; p = 0.235). Conclusion Among premature neonates with NEC, reaching full volume feedings was associated with a nearly 70-fold increased risk of F-NEC. Assuming it was possible to predict an infant's development of NEC, alternative feeding regimens might reduce the risk of F-NEC in this population.

Cutting Calories: The Preference for Lower Caloric Density Versus Smaller Quantities Among Restrained and Unrestrained Eaters

The marketplace includes many attractive high-calorie indulgent food offerings. Despite their appeal, consumers may often be prompted to consider lower-calorie-package offerings instead (e.g., 100-calorie packs). The question thus arises: What predicts consumers’ preferences between different kinds of lower-calorie offerings? The authors conceptualize two different routes to lower-calorie versions of indulgent foods: a lower-caloric-density version (e.g., baked potato chips) or a smaller-portion-size version (e.g., a smaller bag of potato chips). The authors examine how such versions are differentially preferred and why, focusing on the key role of dietary restraint. The authors show that as dietary restraint increases, the preference for a lower-calorie version created via lower caloric density (vs. a smaller portion size) increases. Differential weights placed on health and fullness goals help explain differing preferences across dietary restraint (as the lower-caloric-density version is perceived as healthier and more filling, albeit less tasty, than the smaller-portion-size version). This framework offers theoretical implications for understanding two routes to cutting calories, practical implications for food marketers, and methodological implications for studying food choices.