Reply to Mazela et al. Comment on "Jankiewicz et al. The Effect of Goat-Milk-Based Infant Formulas on Growth and Safety Parameters: A Systematic Review and Meta-Analysis. Nutrients 2023, 15, 2110".

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Biological Relevance of Goat Milk Oligosaccharides to Infant Health.

Milk is often regarded as the gold standard for the nourishment of all mammalian offspring. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of the life of the infant, followed by a slow introduction of complementary foods to the breastfeeding routine for a period of approximately 2 years, whenever this is possible ( Global Strategy for Infant and Young Child Feeding; WHO, 2003). One of the most abundant components in all mammals' milk, which is associated with important health benefits, is the oligosaccharides. The milk oligosaccharides (MOS) of humans and other mammals differ in terms of their concentration and diversity. Among those, goat milk contains more oligosaccharides (gMOS) than other domesticated dairy animals, as well as a greater range of structures. This review summarizes the biological functions of MOS found in both human and goat milk to identify the possible biological relevance of gMOS in human health and development. Based on the existing literature, seven biological functions of gMOS were identified, namely, MOS action as prebiotics, immune modulators, and pathogen traps; their modulation of intestinal cells; protective effect against necrotizing enterocolitis; improved brain development; and positive effects on stressor exposure. Overall, goat milk is a viable alternate supply of functional MOS that could be employed in a newborn formula.

The Effect of Goat-Milk-Based Infant Formulas on Growth and Safety Parameters: A Systematic Review and Meta-Analysis.

Goat-milk-based infant formulas (GMFs) are now available in several countries, having been approved by authorities. We systematically evaluated the effects of GMF compared with cow-milk-based formula (CMF) on infant growth and safety parameters. The MEDLINE, EMBASE, and Cochrane Library databases were searched (December 2022) for randomized controlled trials (RCTs). The risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (ROB-2). Heterogeneity was quantified by I2. Four RCTs involving a total of 670 infants were identified. All trials revealed some concern in ROB-2. Furthermore, all of the included studies were funded by the industry. Compared with infants fed CMF, those fed GMF showed similar growth in sex- and age-adjusted z-scores for weight (mean difference, MD, 0.21 [95% confidence interval, CI, -0.16 to 0.58], I2 = 56%), length (MD 0.02, [95% CI -0.29 to 0.33], I2 = 24%), and head circumference (MD 0.12, 95% [CI -0.19 to 0.43], I2 = 2%). Stool frequency was similar among the groups. Due to differences in the reporting of stool consistency, no firm conclusion can be drawn. Adverse effects (serious or any) were similar in both groups. These findings provide reassurance that GMFs compared with CMFs are safe and well tolerated.

Effects of a breakfast yoghurt, with additional total whey protein or caseinomacropeptide-depleted alpha-lactalbumin-enriched whey protein, on diet-induced thermogenesis and appetite suppression.

Previous studies have shown effects of high-protein diets, especially whey protein, on energy expenditure and satiety, yet a possible distinction between the effects of whey or alpha-lactalbumin has not been made. The present study assessed the effects of the addition of total whey protein (whey) or caseinomacropeptide-depleted alpha-lactalbumin-enriched whey protein (alpha-lac) to a breakfast yoghurt drink on energy expenditure and appetite suppression in human subjects. A total of eighteen females and seventeen males (aged 20.9 (sd 1.9) years; BMI 23.0 (sd 2.1) kg/m2) participated in an experiment with a randomised, three-arm, cross-over design where diet-induced energy expenditure, respiratory quotient and satiety were measured. Breakfasts were isoenergetic and subject-specific: a normal-protein (NP) breakfast consisting of whole milk (15, 47 and 38 % energy from protein, carbohydrate and fat, respectively), a high-protein (HP) breakfast with additional whey or a HP breakfast containing alpha-lac (41, 47 and 12 % energy from protein, carbohydrate and fat, respectively). Resting energy expenditure did not differ between the three conditions. HP breakfasts (area under the curve: whey, 217.1 (se 10.0) kJ x 4 h; alpha-lac, 234.3 (se 11.6) kJ x 4 h; P < 0.05) increased diet-induced thermogenesis more compared with a NP yoghurt at breakfast (179.7 (se 10.9) kJ x 4 h; P < 0.05). Hunger and desire to eat were significantly more suppressed after alpha-lac (hunger, - 6627 (se 823); desire to eat, - 6750 (se 805) mm visual analogue scale (VAS) x 4 h; P < 0.05) than after the whey HP breakfast (hunger, - 5448 (se 913); desire to eat, - 5070 (se 873) mm VAS x 4 h; P < 0.05). After the HP breakfasts, a positive protein balance occurred (alpha-lac, 0.35 (sd 0.18) MJ/4 h; whey, 0.37 (sd 0.20) MJ/4 h; P < 0.001); after the NP breakfast a positive fat balance occurred (1.03 (sd 0.29) MJ/4 h; P < 0.001). In conclusion, consumption of a breakfast yoghurt drink with added whey or alpha-lac increased energy expenditure, protein balance and decreased fat balance compared with a NP breakfast. The alpha-lac-enriched yoghurt drink suppressed hunger and the desire to eat more than the whey-enriched yoghurt drink.