Milk Fortification with Vitamin A & D: A Need of the Hour in India

Micronutrient deficiency is caused by a diet deficient in important vitamins and minerals, and it continues to be a serious public health issue for many low- and middle-income countries' populations. Vitamin A and D deficiency is extremely common in India, affecting both young children and adults. With 146.3 million tonnes of milk produced annually, India is the world's largest producer, yet only around 9% of the milk is fortified with vitamins and minerals. Milk fortification is one of the treatments for vitamin deficiency. Milk is one of the most nutrient-dense foods available. In India, it is a staple dish that is consumed by people of all age groups. Regular consumption of fortified milk led to an 18% reduction in diarrhoea, a 26% reduction in pneumonia, 7% fewer days with a high fever, and 15% fewer days sick with severe sickness. Out of 416 LLPD produced, about 198.4 LLPD gets fortified currently in India, reaching about 121 million people. There is still a significant gap between production and fortification. Governments must take appropriate steps to improve milk fortification and make India a healthy country.

Human milk-based fortifier is associated with less alteration of milk fat globule size than cow milk-based fortifier

We aimed to evaluate if human milk-based fortifier (HMBF) affects human milk fat globule (MFG) size less than cow milk-based fortifier (CMBF), which may impact overall infant feeding tolerance. Measurements of donated human milk were performed before fortification as well as at 1 hour, 24 hours, and 48 hours after fortification with CMBF or HMBF. MFG size in each sample of fortified milk was measured by laser light scattering. MFG size in the fortified milks increased gradually over time. At 24 and 48 hours after fortification, MFG size in the milk with CMBF was larger than that in the milk with HMBF (4.8 ± 0.5 vs 4.3 ± 0.3 μm, p<0.01, 5.1 ± 0.7 vs 4.5 ± 0.4 μm, p = 0.03, respectively). HMBF is associated with less alteration of MFG size than CMBF. This may have an impact on feeding tolerance of very preterm infants.

Carotenoids in Milk and the Potential for Dairy Based Functional Foods

Carotenoids are a family of over 1100 known natural pigments synthesized by plants, algae, fungi and bacteria. Dietary intake of carotenoids is necessary for mammals as they cannot be synthesized in the body. In cows, the nature of the diet consumed strongly influences the composition of milk produced and this includes carotenoid concentration and profile. Fresh forage is the richest source of carotenoids for cows. The main carotenoids identified in forages are lutein, β-carotene, zeaxanthin and epilutein. Manipulating cow feed via carotenoid supplementation increases the carotenoid content of bovine milk. In humans, carotenoids have anti-oxidant, anti-inflammatory and provitamin A activity. Lutein is a major carotenoid in human milk and the brain tissue of adults and infants. Lutein and zeaxanthin are linked to improved eye health and cognitive function. Traditionally for humans, fruit and vegetables have been the main source of carotenoid intake. Functional foods present an opportunity to incorporate these naturally occurring compounds into milk products for added health benefits, widening the range of dietary sources of carotenoids. We offer an overview of the literature to date on carotenoid-fortified dairy products and infant formula. This review will describe and summarize the key mechanisms by which the carotenoid profile of bovine milk can be manipulated. We present findings on the origin and role of carotenoids in bovine and human milk, outline factors that impact the carotenoid content of milk, evaluate carotenoid-fortified milk products and discuss the associated challenges, such as bioaccessibility and stability.

Development of One-Step Non-Solvent Extraction and Sensitive UHPLC-MS/MS Method for Assessment of N-(n-Butyl) Thiophosphoric Triamide (NBPT) and N-(n-Butyl) Phosphoric Triamide (NBPTo) in Milk

N-(n-butyl) thiophosphoric triamide (NBPT) is a urease inhibitor utilised in urea-based fertilizers. In Ireland, fertilizer treated with NBPT is applied to pasture to mitigate both ammonia and nitrous oxide emissions, but concerns arise as to the potential for residues in milk products. A quick ultrafiltration extraction and ultra-high performance liquid chromatography coupled with mass spectrometry triple quadrupole (UHPLC-MS/MS) quantitation method was developed and validated in this study. The method was applied in the analysis of samples collected from a field study investigating potential transfer of NBPT residues into milk. NBPT and NBPTo residues, were extracted from fortified milk samples and analysed on a UHPLC-MS/MS with recoveries ranging from 74 to 114%. Validation of the UHPLC-MS/MS method at low (0.0020 mg kg−1) and high (0.0250 mg kg−1) concentration levels in line with SANTE/12682/2019 showed overall trueness in the range of 99 to 104% and precision between 1 and 10%, RSD for both compounds. The limit of quantitation (LOQ) was 0.0020 mg kg−1 and other tested parameters (linearity, sensitivity, specificity, matrix effect, robustness, etc.) satisfied acceptance criteria. Stability assessment using spiked samples revealed the compounds were stable in raw and pasteurised milk for 4 weeks at –80 °C storage temperature. Maintaining samples at pH 8.5–9.0 further improved stability. Analysis of 516 milk samples from the field study found that NBPT and NBPTo concentrations were below the LOQ of 0.0020 mg kg−1, thus suggesting very low risk of residues occurring in the milk. The method developed is quick, robust, and sensitive. The method is deemed fit-for-purpose for the simultaneous determination of NBPT and NBPTo in milk.

The role of breast milk fortifier in the post-discharge nutrition of preterm infants

Infants born prematurely are often discharged from hospital before 37 weeks post-menstrual age. While breastfeeding will meet all the nutritional requirements of full-term infants, these preterm infants may need enhanced levels of protein, minerals and possibly energy to ensure optimum growth, bone mineralisation and neurological development. To meet these additional nutrient needs in the neonatal unit, it is currently recommended that multinutrient breast milk fortifier is added to maternal breast milk. There may also be benefits in continuing to provide fortified milk after discharge, potentially including improved growth and preserving breastfeeding, and this is increasingly becoming a recognised practice in some neonatal units. This article presents the discussion and consensus of a multidisciplinary panel of neonatologists, neonatal dietitians, a GP and a neonatal outreach sister. The aim is to develop guidance on providing safe and effective nutritional supplementation for preterm infants after discharge in order to maintain optimal growth. This guidance is aimed at community healthcare staff and is based on the limited evidence available, using shared best practice and expertise.

Effect of Some Strains of Lactic Acid Bacteria and Their Mixture on the Level of Fats and Cholesterol in Albino Rats (Rattus norvegicus) Male with Hypothyroidism Induced Using Carbimazole

Fortified milk containing Lactobacillus plantarum, L. casei, and L. acidophilus isolates and their mixture were used in dosing the male albino rats at an age of 9-12 weeks at an average of 23 g with induced hypothyroidism at a concentration of 0.6 g.kg-1 of carbimazole. Total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) were estimated. The results showed a significant increase in the level of triglycerides (TG), cholesterol and triglycerides. Low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL), with a significant decrease in the level of high-density lipoprotein (HDL) in infected male mice, compared to the control sample, and upon dosing with liquid milk fortified, it returned to its normal level without significant differences from the control group.

Toddler milk perceptions and purchases: the role of Latino ethnicity

Objectives: Toddler milk (i.e. a nutrient-fortified milk-based drink marketed for children 12–36 months old) is increasingly being marketed in the USA despite not being recommended for young children. There is evidence of targeted toddler milk marketing to Latinos in the USA. This study aimed to explore toddler milk perceptions and behaviours among Latino and non-Latino parents. Design: An online survey assessed toddler milk perceptions, behaviours and interpretations of nutrition-related claims. Multivariable logistic and linear regression explored socio-demographic correlates of parent reported past purchases and perceived healthfulness. Setting: Online. Participants: National convenience sample of 1078 US parents of children aged 2–12 years (48 % Latino). Results: About half of parents (51 %) had previously purchased toddler milk and few (11 %) perceived toddler milk as unhealthy. Latino parents were more likely to have purchased toddler milk than non-Latino parents (P < 0·001), but there were no differences in perceived product healthfulness (P = 0·47). Compared to parents born in the USA, parents living in the USA 10 years or less were more likely to have purchased toddler milk (P < 0·001) and perceive toddler milk as healthier (P = 0·002). Open-ended interpretations of claims were primarily positive, suggesting ‘health halo’ effects. Conclusions: Common misperceptions about toddler milk healthfulness suggest stronger labelling regulations are needed. Greater reported purchases by Latino parents and recent immigrants warrant further investigation.

Parental Perceptions and Exposure to Advertising of Toddler Milk: A Pilot Study with Latino Parents

Marketing of toddler milk (i.e., typically sugar-sweetened nutrient-fortified milk-based drinks marketed for children 12–36 months) is an emerging public health problem in the US. The American Academy of Pediatrics recommends against the consumption of toddler milk because it often contains added sugar and can displace nutrient-dense foods. Studies have not examined toddler milk perceptions among Latinos, an important gap given Latino children in the US are at high risk of having poor diet quality, and toddler milk is extensively advertised on Spanish-language TV. This study used an online survey of a convenience sample of 58 Latino parents to examine parents’ experiences with toddler milk, understand their perceptions of the healthfulness and the nutrition-related claims on toddler milk, and describe their exposure to toddler milk advertising. Nearly half (44%) of parents in the sample reported purchasing toddler milk. When asked to provide open-ended interpretations of claims on toddler milk, almost all parents gave positive answers, suggesting potential “health halo” effects of the claims. More than half (56%) of parents reported seeing toddler milk advertisements, most commonly on Spanish-language TV. The misperceptions about toddler milk identified should be explored in further research using larger, more representative samples.