Efficient in vitro digestion of lipids and proteins in bovine milk fat globule membrane ingredient (MFGMi) and whey-casein infant formula with added MFGMi.

The relative immaturity of the infant digestive system has the potential to affect the bioavailability of dietary lipids, proteins, and their digested products. We performed a lipidomic analysis of a commercial bovine milk fat globule membrane ingredient (MFGMi) and determined the profile of lipids and proteins in the bioaccessible fraction after in vitro digestion of both the ingredient and whey-casein-based infant formula without and with MFGMi. Test materials were digested using a static 2-phase in vitro model, with conditions simulating those in the infant gut. The extent of digestion and the bioaccessibility of various classes of neutral and polar lipids were monitored by measuring a wide targeted lipid profile using direct infusion-mass spectrometry. Digestion of abundant proteins in the ingredient and whey-casein infant formula containing the ingredient was determined by denaturing PAGE with imaging of Coomassie Brilliant Blue stained bands. Cholesterol esters, diacylglycerides, triacylglycerides, phosphatidylcholines, and phosphatidylethanolamines in MFGMi were hydrolyzed readily during in vitro digestion, which resulted in marked increases in the amounts of free fatty acids and lyso-phospholipids in the bioaccessible fraction. In contrast, sphingomyelins, ceramides, and gangliosides were largely resistant to simulated digestion. Proteins in MFGMi and the infant formulas also were hydrolyzed efficiently. The results suggest that neutral lipids, cholesterol esters, phospholipids, and proteins in MFGMi are digested efficiently during conditions that simulate the prandial lumen of the stomach and small intestine of infants. Also, supplementation of whey-casein-based infant formula with MFGMi did not appear to alter the profiles of lipids and proteins in the bioaccessible fraction after digestion.

Softer More Frequent Stools in Infants With Difficult Stooling Fed Hydrolyzed Protein Formula With Added Prebiotics: Randomized Controlled Trial.

Objective: To evaluate stool consistency in infants with reported hard or infrequent stools fed hydrolyzed protein formula with added prebiotics designed to promote stool softening. Methods: In this multi-center, double-blind, controlled study, eligible infants (28-300 days of age at enrollment) were randomized to: partially hydrolyzed cow's milk protein formula (PHF, 75% carbohydrate as lactose; 12 mg Mg/100 kcal; n = 49) or routine intact protein cow's milk-based infant formula (Control, 92% carbohydrate as lactose; 8 mg Mg/100 kcal; n = 51) over a 14-day period. Both formulas had a prebiotic blend (polydextrose and galactooligosaccharides, 4 g/L; 1:1 ratio). Parent-reported stool consistency (hard = 1 through watery = 5) and other daily outcomes were collected by diary. Endpoint stool consistency (mean score over last 3 days of study feeding) was the primary outcome. Adverse events were recorded. Results: Baseline stool consistency (Control: 1.4 ± 0.1, PHF: 1.4 ± 0.1) and frequency were similar between groups; the majority had hard (n = 61, 64%) or formed (n = 30, 32%) stools. Stool consistency became softer over Day 1-3 (Control: 2.5 ± 0.1, PHF: 2.6 ± 0.1) and remained similar from Day 4 to 6 through study end (post hoc analysis). For PHF vs Control, endpoint stool consistency was significantly softer (3.4 ± 0.1 vs 3.0 ± 0.1; P = 0.019) and frequency significantly higher (1.5 ± 0.1 vs 1.0 ± 0.1; P = 0.002). Crying, fussing, and appearance of pain during stooling decreased from baseline to study end in both groups. Formula intake, infant fussiness and incidence of adverse events were similar between groups. Conclusion: An infant formula designed to promote stool softening was well-tolerated and associated with softer, more frequent stools in infants with reported hard or infrequent stools.

Nutrient Intake Adequacy from Food and Beverage Intake of US Children Aged 1-6 Years from NHANES 2001-2016.

The early years, between the ages of one and six, are a period of rapid physical, social and cognitive growth and a nutritionally adequate diet is an important factor for optimum development. We investigated the micronutrient adequacy and status of young US children aged 1-6 years (n = 9848) using 24-h dietary recall interviews completed by parents and caregivers participating in the National Health and Nutrition Examination Survey (NHANES) 2001-2016. data. The proportion of the sample not meeting the Dietary Reference Intakes (DRI) increased with increasing age and was most pronounced for calcium. Despite adequate iron intake, 7.4% and 2.5% had signs of iron deficiency and anemia based on serum ferritin and hemoglobin levels, with younger children and WIC participants at most risk and Non-Hispanic Black children the least. Vitamin B6 intake was adequate, but 6.4% had serum pyridoxal-5-phosphate deficiency. For vitamin E, 69% had intakes below the estimated average requirement (EAR), yet serum deficiency was only detected in 0.9%. Vitamin D intake was inadequate for 87%, but true deficiency may be overestimated. Mean DHA intake was 24 mg/d, well below expert recommendations of 70-100 mg/day. Iron and vitamin B6 deficiency and inadequate calcium, fiber, choline, potassium and DHA intakes are a concern for a significant percentage of young children. The discrepancy between nutrient intakes and serum deficiency levels needs to be further investigated.

A new liquid human milk fortifier and linear growth in preterm infants.

OBJECTIVES: To evaluate the growth, tolerance, and safety of a new ultraconcentrated liquid human milk fortifier (LHMF) designed to provide optimal nutrients for preterm infants receiving human breast milk in a safe, nonpowder formulation. METHODS: Preterm infants with a body weight ≤ 1250 g fed expressed and/or donor breast milk were randomized to receive a control powder human milk fortifier (HMF) or a new LHMF for 28 days. When added to breast milk, the LHMF provided ∼20% more protein than the control HMF. Weight, length, head circumference, and serum prealbumin, albumin, blood urea nitrogen, electrolytes, and blood gases were measured. The occurrence of sepsis, necrotizing enterocolitis, and serious adverse events were monitored. RESULTS: This multicenter, third party-blinded, randomized controlled, prospective study enrolled 150 infants. Achieved weight and linear growth rate were significantly higher in the LHMF versus control groups (P = .04 and 0.03, respectively). Among infants who adhered closely to the protocol, the LHMF had a significantly higher achieved weight, length, head circumference, and linear growth rate than the control HMF (P = .004, P = .003, P = .04, and P = .01, respectively). There were no differences in measures of feeding tolerance or days to achieve full feeding volumes. Prealbumin, albumin, and blood urea nitrogen were higher in the LHMF group versus the control group (all P < .05). There was no difference in the incidence of confirmed sepsis or necrotizing enterocolitis. CONCLUSIONS: Use of a new LHMF in preterm infants instead of powder HMF is safe. Benefits of LHMF include improvements in growth and avoidance of the use of powder products in the NICU.

Transport and metabolism of equol by Caco-2 human intestinal cells.

Equol is a metabolite of daidzein with greater estrogenic activity and antioxidant capacity than its precursor. Although it is known that equol is produced by the gut microflora, information regarding its transport and metabolism in the intestine is lacking. This study investigated transepithelial transport, bioconversion, and efflux of equol using differentiated cultures of Caco-2 cells to characterize its bioavailability. Uptake was directly proportional to the initial concentration in the apical compartment with maximal intracellular concentrations being reached and 20% of the total added to the apical compartment present in the basolateral compartment as free equol after 1 h. By 4 h, 73% of equol was present as beta-glucuronidase/sulfatase sensitive conjugates with approximately 47 and 26% of initial equol distributed in apical and basolateral compartments, respectively. Free equol in the basolateral compartment appeared to be retrotransported, largely conjugated, and effluxed across the apical membrane. These results suggest that differences in the synthesis and efflux of equol conjugates may contribute to the marked variance in the bioavailability of equol in "producer" phenotype.

Gastrointestinal absorption and metabolism of soy isoflavonoids in ileal-canulated swine.

The relative contribution of the small intestine to absorption and microbial metabolism of ingested isoflavonoids (IFN) was investigated in swine with canulae in distal ilea to facilitate collection of chyme (canula open). Weaned swine were fed a single meal containing ground roasted soybean and corn with canulae open followed by a second test soy diet at 48 h with canulae closed to allow passage of chyme into the large intestine. All remaining feedings were soy-free (corn-casein diet). Ileal effluent and urine were collected for 16 and 48 h, respectively, and analyzed for IFN and microbial metabolites of IFN. IFN in ileal effluent were present entirely as aglycones. IFN equivalents excreted for 24 h after ingesting the soy diet were not significantly different when canulae were open or closed. Urinary IFN aglycone equivalents on day 2 were similar to those on day 1 when canulae remained closed, but less than 10% of that on day 1 when canulae were open for 16 h postfeeding. Urinary concentrations of dihydrodaidzein, dihydrogenistein, O-desmethylangolensin, and equol exceeded IFN aglycone equivalents. These findings suggest extensive preabsorptive conversion of IFN glucosides to aglycones in the small intestine and relatively efficient microbial metabolism of IFN in weaned swine.

Isoflavonoid glucosides are deconjugated and absorbed in the small intestine of human subjects with ileostomies.

BACKGROUND: Although soy isoflavonoids have a number of health-promoting benefits, information concerning the sites of their absorption and metabolism in humans remains limited. Isoflavonoid absorption from the gut requires deconjugation of glucosides to aglycones. OBJECTIVE: The objective was to investigate the role of the small intestine in isoflavonoid absorption and metabolism in humans. DESIGN: Human subjects with fully functional gastrointestinal tracts (n = 6) and ileostomy subjects (n = 6) were fed a single soy meal containing 64.8 mg isoflavonoid aglycone equivalents (95% as glucosides). Metabolism of isoflavonoids in the upper gastrointestinal tract was examined by analyzing ileal effluent from ileostomy subjects, and absorption was assessed indirectly by quantifying isoflavonoids and several metabolites in 24-h urine pools. RESULTS: Chyme contained 36.7% of ingested isoflavonoid aglycone equivalents, primarily (95.8%) as aglycones. Qualitative profiles (x +/- SEM) of isoflavonoid excretion in urine (daidzein > glycitein > genistein) and the quantity of isoflavonoid equivalents were not significantly different between the control (18.4 +/- 2.2 mg) and ileostomy (13.5 +/- 3.2 mg) subjects. Dihydrodaidzein was present in the urine of all subjects, although the amount excreted by ileostomy subjects was less than that excreted by the control subjects. The percentage of producers and mean quantities of dihydrogenistein, equol, and O-desmethylangolensin in the urine of ileostomy subjects also were lower than those of control subjects. CONCLUSIONS: Ileostomy subjects efficiently deglycosylate isoflavonoid glucosides in the small intestine and appear to absorb aglycones with an efficiency comparable with that of control subjects. However, the production of microbial metabolites of isoflavonoids is limited in ileostomy subjects.

Stability and bioaccessibility of isoflavones from soy bread during in vitro digestion.

The impact of simulated digestion on the stability and bioaccessibility of isoflavonoids from soy bread was examined using simulated oral, gastric, and small intestinal digestion. The aqueous (bioaccessible) fraction was isolated from digesta by centrifugation, and samples were analyzed by high-performance liquid chromatography (HPLC). Isoflavonoids were stable during simulated digestion. Partitioning of aglycones, acetylgenistin, and malonylgenistin into the aqueous fraction was significantly (P < 0.01) affected by the concentration of bile present during small intestinal digestion. Omission of bile resulted in nondetectable genistein and <40% of total daidzein, glycitein, and acetylgenistin in the aqueous fraction of digesta. Partitioning of these compounds into the aqueous fraction was increased by physiological concentrations of bile extract. These results suggest that micellarization is required for optimal bioaccessibility of isoflavonoid aglycones. We propose that the bioavailability of isoflavones from foods containing fat and protein may exceed that of supplements due to enhanced bile secretion.