Academic literature on the topic 'Milk protein supplementation'

Purpose The purpose of the study was to evaluate the acute effect of milk proteins supplementation, compared to another nitrogen compound on muscle protein synthesis. Design/methodology/approach The search was conducted on MEDLINE® (via PUBMED®), Cochrane and Embase databases, using the terms “whey proteins,” “caseins,” “milk proteins,” “protein biosynthesis,” “human” and its related entry terms. The selected outcome was fractional synthetic rate (FSR) before (0) and 3 h after consumption of milk proteins, compared to supplementation with other protein sources or isolated amino acids. Findings The results were expressed as mean difference (MD) of absolute values between treatments with confidence interval (CI) of 95 per cent. Of the 1,913 identified studies, 4 were included, with a total of 74 participants. Milk proteins generated a greater FSR (MD 0.03 per cent/h, CI 95 per cent 0.02-0.04; p < 0.00001), compared to control group. Acute consumption of milk proteins promotes higher increase in FSR than other protein sources or isolated amino acids. Originality/value This paper is a systematic review of the effects of milk proteins supplementation, which is considered an important subject because of its large consumption among athletes and physical exercise practitioners.

We investigated the influence of human milk protein and medium-chain triglyceride supplementations of human milk feedings on the growth of very low birth weight infants during their first weeks of life. A group of 44 preterm infants with birth weights of less than 1,520 g and a mean gestational age of 30.3 weeks was randomly divided into four groups to receive plain human milk or human milk supplemented with human milk protein (0.9 g/dL), with medium-chain triglycerides (1 g/dL), or with both. The medium-chain triglyceride oil supplementation did not influence the growth of these infants. The infants given supplementary protein gained weight faster during weeks 4 to 6 than those without (18.5 ± 0.7 v 15.1 ± 0.6 g/kg/d; mean ± SEM; P = .001). After 4 weeks of age the infants given supplementary protein had a mean weight gain equal to the mean intra-uterine rate, in contrast to the infants of the other groups, who grew more slowly until age 6 weeks. Furthermore, we found a correlation between serum albumin concentration and weight gain during the seventh week of life (P = .018). The length growth velocity for the infants with protein supplementation was 0.99 ± 0.06 cm/wk (mean ± SEM) and for those without 0.83 ± 0.05 cm/wk (P = .043). There was no difference in growth of head circumference between the groups. We conclude that human milk protein supplementation improves the growth of small premature infants fed human milk, and that the protein concentration of bank milk is insufficient for their adequate growth.

Two experiments (mid- and late lactation) were conducted to test whether methionine (Met) limited milk production in Friesian cows fed sole diets of fresh perennial ryegrass–white clover pasture. In mid-lactation (exp. 1), 26 cows were assigned to one of three treatments: ruminally protected oral DL-Met (15 g d−1), continuous intrajugular infusion of L-Met (15 g d–1) and control. Twelve animals from exp. 1 were used during late lactation (exp. 2) and distributed in two experimental groups: ruminally protected oral DL-Met (15 g d−1) and control. Dry matter, metabolizable energy, crude protein and Met intakes, milk yield and composition and blood Met, cysteine and urea were measured. Oral and intravenous Met supplementation increased blood Met concentration by 50–90% compared with controls. Met supplementation did not alter the concentration of milk fat, protein or lactose in either experiment. Met supplementation had no significant effects on yields of fat, lactose, casein, whey proteins or non-protein nitrogen during mid-lactation. In late lactation, Met supplementation did not affect milk protein composition or yield of milk components, with exception of a decrease (P < 0.05) in the yield of β -casein. Intravenous Met supplementation increased (P < 0.05) the efficiency of conversion of pasture N to milk protein in mid-lactation. Key words: Dairy cows, methionine, ruminally protected methionine, milk protein, casein, fresh pasture diets

Breast milk does not meet the nutritional needs of preterm infants, necessitating fortification. Breast milk is particularly variable in protein content, hence standardized (fixed dosage) supplementation results in inadequate supply. This was a secondary analysis of 589 breast milk protein content measurements of 51 mothers determined by mid-infrared spectroscopy during a clinical trial of higher versus lower protein supplementation in very low birth weight infants. Mothers (and breast milk samples) were divided into a test (41 mothers) and a validation cohort (10 mothers). In the test cohort, the decrease in protein content by day of lactation was modeled resulting in the breast milk-equation (BME)). In the validation cohort, five supplementation strategies to optimize protein supply were compared: standardized supplementation (adding 1.0 g (S1) or 1.42 g protein/100 mL (S2)) was compared with ‘adapted’ supplementation, considering variation in protein content (protein content according to Gidrewicz and Fenton (A1), to BME (A2) and to BME with adjustments at days 12 and 26 (A3)). S1 and S2 achieved 5% and 24% of adequate protein supply, while the corresponding values for A1–A3 were 89%, 96% and 95%. Adapted protein supplementation based on calculated breast milk protein content is easy, non-invasive, inexpensive and improves protein supply compared to standardized supplementation.

Date pits (DP) are discarded as agricultural waste by-products and used in animals’ supplementation. Data on multi-nutrient milk analysis is still less published to understand the effects of supplementation. Therefore, this research was done to evaluate the effect of DP powder (DPP) cultivars as supplementation on milk yield and quality to lactating Saanen-Boer crossed bred goats for a 12-week trial and to analyse the parameters using chemometrics. The analyses include milk yield, crude protein, fat, lactose and total phenolic content (TPC). The goats (n=24) were grouped into 12 designated cubicles and goats fed with normal daily rations, served as control. Several doses of DPP supplementations were administered against the control. Milk yield was significantly (p < 0.05) affected by DPP cultivars and doses. Significant (p < 0.05) increase in milk yield was registered for goats fed with A20 (59.52%) and M30 (28.24%), respectively compared to control. However, the crude protein (2.71 – 4.33%), fat (2.69 – 5.55%), lactose (4.52 – 9.66 mM) and TPC (0.14 – 0.42 mg/g) of the milk were not affected (p > 0.05) by the cultivar and dose. 3D PCA of the significant highest milk yield (A20 and M30) compared to the control focusing on combination of milk yield, crude protein, fat and TPC was obviously clustered. Hence, milk quality analyses via a multi-nutrient chemometric approach could be a comprehensive method in determining milk as food for food security and sustainability.

This review evaluated the effects of milk-based protein supplementation on resistance training (RT)-induced gains in lean body mass or fat free mass (LBM/FFM) and muscle strength for older adults. A systematic search of PubMed, Scopus and EBSCOhost/SPORTDiscus was conducted. Eligibility criteria: Randomized controlled trials comparing all types of milk-based protein supplements with control supplements for the training older adults at mean age ≥ 60 y. Twenty studies were included in the qualitative synthesis, whilst seventeen studies were included in the quantitative synthesis. A dose of 10–15 g of milk protein supplementation was sufficient to augment RT-induced LBM/FFM. Intriguingly, four out of five studies show negative effect of whey protein supplementation at the same dose range (or even higher) compared with control supplementation (−0.49 kg, 95% CI: −0.69, −0.29, I2 = 14%, Z = 4.82, p < 0.001). For milk-based protein supplementation, RT-induced improvements in muscle strength were observed only when the protein doses ≥22 g (+0.66 kg, 95% CI: 0.07, 1.25, I2 = 0%, Z = 2.18, p = 0.03). Conclusion: Milk protein is superior to whey protein in enhancing RT-induced LBM/FFM gains for older adults. Optimal daily protein intake can dilute the protein supplementation effect.

As the preference of consumers for casein products has increased, the protein content of milk from dairy cows is drawing more attention. Protein synthesis in the milk of dairy cows requires a proper supply of dietary protein. High protein supplementation may help to produce more milk protein, but residues in feces and urine cause environmental pollution and increase production costs. As such, previous studies have focused on protein supplements and amino acid (AA) supply. This review concerns AA nutrition for enhancing milk protein in dairy cows, and mainly focuses on three AAs: methionine, lysine, and histidine. AA supplementation for promoting protein synthesis is related to the mammalian target of rapamycin (mTOR) complex and its downstream pathways. Each AA has different stimulating effects on the mTOR translation initiation pathway, and thus manifests different milk protein yields. This review will expand our understanding of AA nutrition and the involved pathways in relation to the synthesis of milk protein in dairy cows.

SummaryMammary gland protein metabolism, determined by an arteriovenous difference technique, was monitored in four Holstein-Friesian dairy cows in response to supplemental dietary protein (provided as rumen-protected soyabean meal) during late lactation (weeks 24–30). Each cow was offered two isoenergetic diets composed of grass silage (170 g crude protein/kg dry matter) plus either a low (108 g/kg) or medium (151 g/kg) crude protein concentrate in a single crossover design involving two 21 d periods. On day 21, arteriovenous measurements across the mammary gland were made during a 13 h continuous i.v. infusion of [1-13C]leucine and with frequent (2 hourly) milk sampling during the final 6 h. Although total milk yield was slightly increased (+1 kg/d) by protein supplementation, milk protein yield was not significantly affected. Whole body protein flux (protein synthesis plus oxidation) was not significantly affected by supplementation. Total mammary gland protein synthesis (milk plus non-milk protein) was also not affected by supplementation but on both diets gland synthesis was always greater (by 20–59%) than milk protein output. The fractional oxidation rate of leucine by the mammary gland was significantly increased by protein supplementation (0·047 v. 0·136). Although the enrichment of leucine in secreted milk protein continued to increase, the final value (at 13 h) was 0·94 of the arterial plasma free leucine plateau value (not significantly different), suggesting almost exclusive use of plasma free leucine for milk protein synthesis. Based on current feeding schemes for dairy cattle, a fixed proportion (0·65–0·75) of the additional protein intake (+490 g/d) should have been partitioned into milk protein. Instead, leucine oxidation by the mammary gland was increased. Whether oxidation of other amino acids was also enhanced is unknown but if amino acid oxidation and the ‘additional’ non-milk protein synthesis occurring in the gland are not crucial to milk synthesis, then by reducing such activities improvements in the efficiency of converting absorbed amino acid into milk protein can be achieved.

Freeze storage and pasteurization of human milk are common treatments in milk banks. Thermal treatment changes the quality of milk for preterm infants? nutrition, and the aim of this paper was to examine the nutritional profile and antioxidant potential of preterm human milk after storage and pasteurization, and also after supplementation with fortifier. The effects of storage processes were estimated on mature preterm milk of 30 breastfeeding women. Total proteins, lipids and lactose were determined after thermal processing and supplementation of mature preterm milk with fortifier. The antioxidant capacity was determined using the ferric reducing antioxidant potential method and lipid peroxidation inhibition assay. Protein concentration decreased after frozen storage and pasteurization (p<0.05). Pasteurization further reduced the lipid concentration after freezing. The ferric reducing antioxidant potential decreased after thermal treatments (p<0.05). Supplementation of mature milk with fortifier increased the concentration of proteins, lipids and lactose. Our findings demonstrated that storage and pasteurization processes affect the basic nutritional composition and antioxidant capacity of preterm human milk. In order to ensure adequate nutrition for preterm infants with preterm human milk, supplementation, especially with high concentrations of proteins and lipids, is necessary after thermal treatments.

This research was aimed to determine the impact of balanced energy and protein supplementation with high rumen undegraded protein (HRUP) to milk production and quality in early lactating dairy cows. Twelve early lactating Friesian Holstein cows were divided into two groups (control and HRUP). Both control and HRUP group were fed on a basal diet (forage to concentrate ratio was 60:40; DM basis), with rumen undegraded protein (RUP) levels were 27.47% and 32.78% for control and HRUP, respectively. The experimental diets were given to animals twice daily, morning and afternoon. Water was given by ad libitum. The observed parameters were nutrient intake, quantity and quality of milk production . Data were examined using t-test. Results showed that feed intake, milk production and 4% FCM, milk fat and lactose concentrations, and milk solid non-fat and total solid concentrations were not differed significantly between control and HRUP groups. However, milk protein concentration and production were differed (P

Les équilibres en calcium (Ca) entre la phase soluble et la phase colloïdale ont été étudiés dans des systèmes lactés (laits de vache, de soja Hydrolysé ou Non-Hydrolysé). La supplémentation en Ca (CaCl2, CC, 25 mmoles.kg-1) a été suivie d’un cycle de pH (pHmin 5,5 ou 3,5). Le pH, la concentration en calcium ionisé (Ca2+), la turbidité et la viscosité apparente ont été reliés aux variations de la phase protéique. La concentration en Ca2+, initialement négligeable dans le lait de soja, augmente avec l’addition en Ca, ainsi qu’avec l’acidification et diminue lors de l’alcalinisation. Pour le lait de vache non supplémenté, le cycle de pH à 5,5 n’est réversible ni sur les variations en Ca2+, ni sur les variations de la phase protéique, contrairement au lait de vache supplémenté en Ca. Ceci pourrait être dû à la capture préalable en Ca, entraînant un renforcement des micelles de caséines. Pour des cycles de pH à 5,5, l’agrégation induite par l’acidification est partiellement ou complètement réversible lors de l’alcalinisation pour les laits de soja NH et H, mais l’agrégation induite par le Ca est irréversible. Quelque soit le système, des phénomènes sont irréversibles lors de cycle de pH à 3,5. Les interactions Ca-protéines (de vache ou de soja) étudiées par CTI montrent des signaux endothermiques similaires, probablement dû au relargage de molécules d’eau. La liaison du Ca pourrait être décrite comme un échange H+/Ca2+ étant donné les force électrostatiques impliquées. Les sites de fixation du Ca on été identifiés par IR-TF. L’énergie d’absorption diminue dans les région amides I et II et dans la région carboxylate lors de l’addition de Ca
Ca equilibrium between soluble and colloidal phases was studied in milky systems (milk, Non Hydrolysed, NH, or Hydrolysed, H, soy milks). Calcium chloride supplementation (CC, 25 mmoles.kg-1) was followed by pH cycle (pHmin 5.5 or 3.5). pH, Ca2+, turbidity and apparent viscosity were recorded in situ. Ca equilibria were related to protein phase variations. Contrarily to milk, Ca2+ concentration was initially negligible in soy milks. Yet, whatever the milky system, Ca2+ increased upon CC addition and with acidification, and decreased during alkalinization. For reference milk, pH cycle to 5.5 was reversible neither on Ca2+ variations nor on protein phase contrarily to CC-milk. This could be due to the previous capture of Ca during supplementation, involving casein micelles reinforcement through Ca-protein interactions. For pH cycle to 5.5, acid-induced aggregation was partially and completely reversible upon alkalinization for NH and H-soy milks, respectively. Once CC addition, Ca-induced aggregation was irreversible and pH cycle had minor effects. Whatever the system, the irreversibility of phenomena was observed for pH cycle to 3.5. Ca-(milk or soy) protein interactions studied by ITC showed similar endothermic signals, probably due to the water release occurring upon interaction. Ca binding should rather be described as H+/Ca2+ exchange with respect to the electrostatic forces involved. Finally, Ca-binding sites were identified with FTIR spectroscopy. A decrease of the absorption energy in the amide I and II region and in the carboxylate region occurred upon CC-addition, with higher variations in soy milks

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Capes
Energy is the most limiting nutrient to dairy cows at pasture, especially at tropical pastures. However when energy supplementation is offered, other nutrients may become limiting, as the protein under forms of Rumen Degradable Protein (RDP) or Rumen Undegradable Protein (RUP). The objective of this study was evaluate the effects of supplementation with energetic or energetic-proteic concentrate with protein sources of high or low rumen degradability to high producing Jersey cows grazing tropical grasses. Thirty Jersey cows (DIM 58.2 ± 44.4, milk yield 21.0± 4.4 kg and body weight 345.5 ± 32.1 kg at the beginning of the experiment) were assigned to one of three continuous treatments in a 12-wk trial (1 for adaptation and 11 experimental) from October to December, which consisted of three concentrate supplements: energetic, 14% of crude protein (CP), energy-protein 20% of CP with high RDP and a energy-protein 20% of CP with high RUP, offered at 7 kg/ cow/ day,, twice after milking. Concentrates were composed by ground corn, soybean hulls, solvent soybean meal or treated soybean meal (Soypass BR®), minerals and vitamins. The cows grazed a fertilized pasture with predominance of giant-missionary grass (Axonopus catharinensis), under intermittent stocking. Milk yield was taken daily, milk composition and body condition score (BCS), were taken weekly. Body weight was taken at begin and end of experiment. After experimental period, the cows received the same management and feed supply by 11 weeks for evaluation of carryover effects. The milk yield increased at 2 kg/cow/day, as the fat, protein and lactose yields were greater for cows receiving RUP supplementation. Live weight gain and dry matter intake also were increased by RUP supplementation. At post experimental period, the cows that had received RUP produced more milk and protein. Supplementation of RUP to cows at tropical pasture increased the milk, milk components yield and weight gain, with carryover effects along lactation. Supplementation with RDP did not increase milk or milk components yield when compared with energy supplementation
A energia é o nutriente mais limitante para vacas leiteiras em pastagens, especialmente em pastagens tropicais, no entanto quando é oferecida suplementação energética outros nutrientes podem se tornar limitantes como a proteína sob as formas de Proteína Degradável no Rúmen (PDR) ou Proteína Não Degradável no Rúmen (PNDR). O objetivo deste estudo foi avaliar os efeitos da suplementação concentrada energética ou energético-proteica com fontes de proteína de alta ou baixa degradabilidade ruminal para vacas Jersey de alta produção mantidas em pastagem tropical. Trinta vacas Jersey (DEL 58.2 ± 44.4, produção de leite 21.0± 4.4 kg e peso vivo 345.5 ± 32.1 kg no início do experimento) foram alocadas em um dos três tratamentos contínuos em um experimento de 12 semanas (1 para adaptação e 11 experimentais) de outubro a dezembro que consistiram de três suplementos concentrados: energético com 14% de Proteína Bruta (PB), energético-proteico com 20% de PB com alta PDR e energético-proteico com 20% de PB com alta PNDR, oferecidos na taxa de 7 kg/vaca/dia em duas vezes após as ordenhas. Os concentrados foram compostos por milho moído, casca de soja, farelo de soja ou farelo de soja tratado (Soypass BR®), minerais e vitaminas. As vacas foram mantidas em uma pastagem fertilizada com predominância de missioneira gigante (Axonopus catharinensis), sob lotação intermitente. A produção de leite foi medida diariamente, a composição do leite e o escore de condição corporal (ECC) foram avaliados semanalmente. O peso vivo foi mensurado no início e final do período experimental. Após o período experimental, as vacas receberam o mesmo manejo e alimentação por 11 semanas para avaliação de efeitos residuais dos tratamentos. A produção de leite aumentou em 2 kg/vaca/dia, e também as produções diárias de gordura, proteína e lactose foram maiores para as vacas recebendo suplementação com PNDR. O peso vivo e o consumo de matéria seca foram aumentados pela suplementação com PNDR. No período pós-experimental, as vacas que tinham recebido PNDR produziram mais leite e proteína. A suplementação com PNDR para vacas em pastagem tropical aumentou a produção de leite, de componentes do leite e o ganho de peso das vacas, com efeitos residuais ao longo da lactação. A suplementação com PDR não aumentou a produção de leite ou de componentes quando comparado com a suplementação energética

Tese de Mestrado em Nutrição Clínica apresentada à Faculdade de Ciências de Nutrição e Alimentação da Universidade do Porto
Abstract: Background The aetiology of weight loss in Alzheimer Disease (AD), has not yet been definitively established. Although appears multifactorial, a decline in food intake may be a contributor. Nutritional supplements are often prescribed, especially to prevention for weight loss, but it has not been demonstrated that a short-term nutritional supplementation has impact in AD-patients nutritional status. Objectives The aim of this study was (1) to evaluate the effect of short-term administration of a high protein, energy-dense Oral liquid Supplement (OS) in patients with mild AD who were malnourished, on nutritional status and in body composition, cognitive function and functional ability; (2) to assess the long-term effect of this intervention after discontinuation of the OS. Methods and Measurements A 21 days prospective randomized nonblinded controlled trial was conducted in a Geriatric Unit of a Psychiatric Hospital. From an initial group of Thirty five patients, twenty were randomly assigned to the Treatment Group (TG) n=20 and Fifteen to the Control Group (CG) n=15. During the study period, the TG received during 21 consecutive days, once a day a 200 mL high protein energy-dense OS, which provided 400kcal from a mixture of protein (18% of energy), fat (17.4% of energy), and carbohydrate (42.8% of energy) plus dietetic advice. Patients in the CG received the same dietetic advice as the TG, but no OS. The nutritional status, body composition, functional status and cognitive function were determined at baseline, 21 days (after intervention) and at 90 days of follow-up. The Mini Nutritional Assessment (MNA), anthropometric measurements, bioelectrical impedance analysis and serum biomarkers (albumin, total-protein, total-cholesterol, vitamin-B12 and folic acid) levels were obtained. Cognitive function was evaluated using the Mini Mental Status Examination (MMSE) tool and the Clock-Drawing Test (CDT). (...)

Tese de Mestrado em Nutrição Clínica apresentada à Faculdade de Ciências de Nutrição e Alimentação da Universidade do Porto
Abstract: Background The aetiology of weight loss in Alzheimer Disease (AD), has not yet been definitively established. Although appears multifactorial, a decline in food intake may be a contributor. Nutritional supplements are often prescribed, especially to prevention for weight loss, but it has not been demonstrated that a short-term nutritional supplementation has impact in AD-patients nutritional status. Objectives The aim of this study was (1) to evaluate the effect of short-term administration of a high protein, energy-dense Oral liquid Supplement (OS) in patients with mild AD who were malnourished, on nutritional status and in body composition, cognitive function and functional ability; (2) to assess the long-term effect of this intervention after discontinuation of the OS. Methods and Measurements A 21 days prospective randomized nonblinded controlled trial was conducted in a Geriatric Unit of a Psychiatric Hospital. From an initial group of Thirty five patients, twenty were randomly assigned to the Treatment Group (TG) n=20 and Fifteen to the Control Group (CG) n=15. During the study period, the TG received during 21 consecutive days, once a day a 200 mL high protein energy-dense OS, which provided 400kcal from a mixture of protein (18% of energy), fat (17.4% of energy), and carbohydrate (42.8% of energy) plus dietetic advice. Patients in the CG received the same dietetic advice as the TG, but no OS. The nutritional status, body composition, functional status and cognitive function were determined at baseline, 21 days (after intervention) and at 90 days of follow-up. The Mini Nutritional Assessment (MNA), anthropometric measurements, bioelectrical impedance analysis and serum biomarkers (albumin, total-protein, total-cholesterol, vitamin-B12 and folic acid) levels were obtained. Cognitive function was evaluated using the Mini Mental Status Examination (MMSE) tool and the Clock-Drawing Test (CDT). (...)

Orientador: Jaime Amaya-Farfan
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos
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Resumo: A Esclerose Lateral Amiotrófica (ELA) é uma doença progressiva neurodegenerativa que envolve, neurônios motores do córtex cerebral, cérebro e medula espinhal. Em aproximadamente 50% dos pacientes, a doença afeta inicialmente os braços. Em 25%, a doença afeta as pernas e, em 25%, o início da doença é bulbar. Ocorre desnutrição em 16%- 50% dos pacientes com ELA, principalmente pela disfunção da deglutição. Para 50% dos casos, a ELA é comumente fatal dentro de 3-4 anos a partir da ocorrência de pneumonia. Muitas complicações nutricionais que acontecem com o paciente com ELA, geralmente se devem à viscosidade da dieta. Os líquidos de baixa viscosidade dificultam a deglutição de pacientes que apresentam controle laríngeo reduzido. O objetivo do presente trabalho foi diagnosticar o estado nutricional, bem como avaliar o efeito da suplementação com isolado protéico do soro de leite aglomerado com polissacarídeo no estado nutricional e condições gerais de pacientes com ELA. A investigação da ingestão alimentar se deu por meio da avaliação do consumo alimentar, qualitativo e quantitativo, de pacientes com ELA. Aplicou-se o questionário de freqüência de consumo alimentar e o recordatório de 24 horas. Todos os pacientes apresentaram inadequação para energia, fibras, cálcio e vitamina E. Considerando-se a predominância topográfica do comprometimento muscular na doença, foram observadas diferenças significativas entre pacientes predominantemente bulbares e de predomínio apendicular. Nos pacientes com maior envolvimento apendicular (GA) houve maior ingestão energética (p=0,02), de gordura saturada (p=0,03), monoinsaturada (p=0,04) e polinsaturada (p=0,001), além de colesterol (p=0,001) e fibras (p=0,001). Nos pacientes com predominância bulbar (GB) houve dificuldade no manejo da consistência da dieta. A partir daí, foram elaborados suplementos a base de proteínas do soro de leite e polissacarídeo. O aglomerado contendo 70% de isolado protéico do soro de leite e 30% de amido modificado (70%WPI:30%AM) na concentração de 28g em 250mL em todos os sistemas avaliados, suco de laranja e leite integral, exibiu viscosidade entre 2122,66 e 5110,60 centipoises, além de maior nota, nos testes sensoriais, 6,97 (± 0,15), quando comparado aos outros produtos, não diferindo (p=0,681) do espessante comercial, que obteve nota 6,91 (± 0,38). Baseando-se nestes resultados, sugeriu-se a utilização do aglomerado 70%WPI:30%AM para terapia nutricional de pacientes com ELA. Previamente à administração do suplemento, em função dos poucos dados sobre as técnicas de avaliação nutricional em ELA, foram correlacionados os indicadores mais comuns na avaliação nutricional, funcional e respiratória dos pacientes. No GA, observou-se correlação entre: Pressão inspiratória máxima (Pimax) e expiratória máxima (Pemax) (r=-0,76); Pemax e oximetria de pulso (r=0,58); Pimax e porcentagem de perda de peso (%PP) (r=0,59); e entre Pimax, escore total e subescala respiratória (ALSFRS) com %PP (r=0,59). No GB, houve correlação entre Pemáx e IMC (r=0,97). Em ambos GA e GB, observaram-se correlação entre índice de massa corporal (IMC) e as variáveis: massa (kg), gordura (%), circunferência braquial e punho (cm), pregas cutâneas tricipital, subescapular e supra-ilíaca (mm), circunferência muscular do braço (cm), área muscular e gordurosa do braço (mm2). Definidas as técnicas de avaliação, 16 pacientes foram divididos em dois grupos: suplementado (70%WPI:30%AM) e controle (maltodextrina) e submetidos a avaliação nutricional, respiratória e funcional durante 4 meses. No grupo suplementado verificou-se melhora do estado nutricional geral, aumento do peso e Índice de Massa Corporal-IMC, circunferência e área muscular do braço (CMB e AMB), albumina, linfócitos e leucócitos, diminuindo os marcadores do catabolismo muscular, creatina quinase, aspartato-aminotransferase e alanina-amino-transferase. No grupo controle, observou-se diminuição do peso, IMC, CMB e AMB e aumento da área gordurosa do braço, sem alterações significativas nos parâmetros bioquímicos. O presente estudo mostrou que o suplemento 70%WPI:30%AM melhorou o estado nutricional e condições gerais pacientes com ELA, podendo ser utilizado na prática clínica
Abstract: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder that involves, motor neurons in the cerebral cortex, brainstem, and spinal cord. In approximately 50% of the patients, the disease first affects the arms, in 25% the legs and in 25% the onset is bulbar. Malnutrition occurs in 16%-50% of patients with ALS, mainly for swallowing difficulty. For 50% of the cases, ALS is frequently fatal inside of 3-4 years from the pneumonia occurrence. Many of the nutritional complications that occur with ALS sufferers are due to the low viscosity of the diet. Fluid liquids are difficult to swallow by patients with reduced deglutition control. The objective of the present work was to diagnosis the nutricional state as well as evaluating the effect of the supplementation with milk whey protein isolate agglomerated with modified starch in the nutricional state and general conditions of patients with ALS. The investigation of the alimentary intake was evaluate quantitatively and qualitatively food intake in patients with ALS. We employed the frequency questionnaire and the 24h-diet history. All patients presented inadequate energy, fibers, calcium and vitamin E intake. Taking into account predominantly affected muscle groups, we found significant differences between patients with bulbar or appendicular onset. Patients with appendicular ALS had higher intake of energy (p=0.02), saturated fat (p=0.03), monounsaturated fat (p=0.04), polyunsaturated fat (p=0.001), as well as cholesterol (p=0.001) and fibers (p=0.001). In the patients with predominance to bulbar (GB) had difficulty in the handling of the consistency of the diet. From there, supplements had been elaborated from protein base of whey milk and modified starch. The agglomerate contend 70% whey protein isolate and 30% modified starch (70%WPI:30%MS), in all the systems evaluated, at a concentration of 112g/L showed a viscosity between 2,122 and 5,110cP. In the sensory tests, the 70%WPI:30%MS in orange juice obtained the highest score, 6.97 (± 0.15), in relation to the other agglomerates, not differing (p=0.681) from the commercial thickener, 6.91 (p=0.380). Based on these results, the agglomerate 70%WPI:30%MS was suggested for use in the nutritional therapy of patients with ALS. Previously the administration of the supplement, in function of the few data on the techniques of nutricional evaluation in ALS, had been correlated the pointers most common in the nutricional, functional and respiratory evaluation of the patients. Among the GA type significant correlation was observed between maximal inspiratory (MIP) and expiratory (MEP) pressure (r=-0.76), MEP and pulse oxymetry (r=0.58), MIP and percent weight loss (%WL; r=0.59), and between MIP, total and subscale respiratory scores (ALSFRS-R) with %WL. With regard to the GB, correlation was found between MEP and BMI (r=0.97). In both GA and GB correlations were noticed between the BMI and the variables mass (kg), fat (%), arm and fist circumference (cm), and tricipital, subscapular and supra-iliac skinfolds (mm), as well as the arm muscle circumference (cm) and fatty arm muscular area (mm2). After defined the evaluation techniques, 16 patients were randomized to two groups, treatment (70%WPI:30%MS) and placebo (maltodextrin). They underwent prospective nutritional, respiratory and functional assessment for 4 months. Patients in the treatment group presented weight gain, increased BMI, increased arm muscle area and circumference, higher albumin, white blood cell and total lymphocyte counts, and reduced markers of skeletal muscle turnover (creatine-kinase, aspartate transferase and alanine transferase). In the placebo group, biochemical measures did not change, but weight and BMI declined. Our results indicate that the agglomerate 70%WPI:30%MS may be useful in the nutritional therapy of patients with ALS
Doutorado
Nutrição Experimental e Aplicada à Tecnologia de Alimentos
Doutor em Alimentos e Nutrição

Les équilibres en calcium (Ca) entre la phase soluble et la phase colloïdale ont été étudiés dans des systèmes lactés (laits de vache, de soja Hydrolysé ou Non-Hydrolysé). La supplémentation en Ca (CaCl2, CC, 25 mmoles.kg-1) a été suivie d’un cycle de pH (pHmin 5,5 ou 3,5). Le pH, la concentration en calcium ionisé (Ca2+), la turbidité et la viscosité apparente ont été reliés aux variations de la phase protéique. La concentration en Ca2+, initialement négligeable dans le lait de soja, augmente avec l’addition en Ca, ainsi qu’avec l’acidification et diminue lors de l’alcalinisation. Pour le lait de vache non supplémenté, le cycle de pH à 5,5 n’est réversible ni sur les variations en Ca2+, ni sur les variations de la phase protéique, contrairement au lait de vache supplémenté en Ca. Ceci pourrait être dû à la capture préalable en Ca, entraînant un renforcement des micelles de caséines. Pour des cycles de pH à 5,5, l’agrégation induite par l’acidification est partiellement ou complètement réversible lors de l’alcalinisation pour les laits de soja NH et H, mais l’agrégation induite par le Ca est irréversible. Quelque soit le système, des phénomènes sont irréversibles lors de cycle de pH à 3,5. Les interactions Ca-protéines (de vache ou de soja) étudiées par CTI montrent des signaux endothermiques similaires, probablement dû au relargage de molécules d’eau. La liaison du Ca pourrait être décrite comme un échange H+/Ca2+ étant donné les force électrostatiques impliquées. Les sites de fixation du Ca on été identifiés par IR-TF. L’énergie d’absorption diminue dans les région amides I et II et dans la région carboxylate lors de l’addition de Ca
Ca equilibrium between soluble and colloidal phases was studied in milky systems (milk, Non Hydrolysed, NH, or Hydrolysed, H, soy milks). Calcium chloride supplementation (CC, 25 mmoles.kg-1) was followed by pH cycle (pHmin 5.5 or 3.5). pH, Ca2+, turbidity and apparent viscosity were recorded in situ. Ca equilibria were related to protein phase variations. Contrarily to milk, Ca2+ concentration was initially negligible in soy milks. Yet, whatever the milky system, Ca2+ increased upon CC addition and with acidification, and decreased during alkalinization. For reference milk, pH cycle to 5.5 was reversible neither on Ca2+ variations nor on protein phase contrarily to CC-milk. This could be due to the previous capture of Ca during supplementation, involving casein micelles reinforcement through Ca-protein interactions. For pH cycle to 5.5, acid-induced aggregation was partially and completely reversible upon alkalinization for NH and H-soy milks, respectively. Once CC addition, Ca-induced aggregation was irreversible and pH cycle had minor effects. Whatever the system, the irreversibility of phenomena was observed for pH cycle to 3.5. Ca-(milk or soy) protein interactions studied by ITC showed similar endothermic signals, probably due to the water release occurring upon interaction. Ca binding should rather be described as H+/Ca2+ exchange with respect to the electrostatic forces involved. Finally, Ca-binding sites were identified with FTIR spectroscopy. A decrease of the absorption energy in the amide I and II region and in the carboxylate region occurred upon CC-addition, with higher variations in soy milks

This book presents strategies for feeding energy and protein supplements to pasture-fed dairy cows and examines the potential economic benefits. Effective supplementary feeding of concentrates is critical to the success of all dairy farms. This book is a substantially revised edition of 'Feeding Concentrates: Supplements for Dairy Cows' DRDC 1993. It focuses on feeding concentrates to pasture fed cows to achieve high milk production per cow per hectare, and will assist farmers to decide which supplements give the best results in their particular situation. The benefits that arise from supplementary feeding include higher stocking rates, promotion of growth in heifers and young cows; better body condition score and increased lactation length when pasture is less available; improved pasture use; reduced cost per tonne of pasture eaten; flexibility to increase milk production when milk prices are high; and increased milk protein content when the energy content in pasture is low. This edition has thoroughly reviewed the issues and clearly documents the results of research particularly for grains supplementation. The summaries and recommendations in each chapter will be particularly helpful to dairy farmers in making best management decisions relating to concentrate feeding.

Both colostrum and milk quality and quantity can influence piglet survival and growth, especially in a highly prolific sow. The Danish Landrace × Yorkshire crossbred was selected for high prolificacy and challenged to provide enough colostrum and milk of high quality to all piglets. This chapter reviewed the mechanism of colostrum and milk production, basic information of colostrum, and milk quality (immunoglobulin, fat, protein, lactose, etc.) and quantity. The importance of colostrum and milk in modern sows on piglet performance and survival was addressed. Since the sow immunoglobulin cannot pass epitheliochorial placenta in the sow to the piglet’s bloodstream. Therefore, colostrum is a crucial role in piglet survival and growth. However, the amount of colostrum and milk production in hyperprolific sow still improve from high litter size. The knowledge about the factors influencing colostrum and milk quality and quantity, such as parity number, piglet, the environment in hyperprolific sows, may support veterinarians and farmers in the commercial swine farms for increasing pig production. Moreover, the technique to improve colostrum and milk quality and quantity were explained, such as feed supplementation in gestating and lactating sows.

The ability to change milk composition via cow diet can lead to increases in the yield and functional properties of dairy products. Inducing such changes via diet can lead to more rapid and reversible changes to milk composition than other contributing factors . However, some components are more readily changed than others. Milk fat, for example, is readily altered by changing the forage:concentrate ratio or by feeding oilseeds containing high levels of polyunsaturated fatty acids. Such changes can improve the yields, functional properties and perceived healthiness of butter and other products. Similarly, the mineral composition can be altered by supplementation, which has implications for product functionality and human health. Unfortunately alterations of the amount and type of milk protein are difficult to achieve via dietary manipulation. Maintaining an adequate supply of metabolisable energy to ensure maximum protein concentrations is probably the only reliable strategy in this regard.

This chapter describes historic steps in feeding techniques and knowledge about the nutritional needs of premature infants. Devices to overcome weak sucking and swallowing were developed from 1851 to 1920: tube feeding by gavage, medicine droppers and pipettes, feeding bottles with air inlet, and beaked spoons for nasal feeding. Indwelling nasogastric tubes were in use from 1951. For alleged safety concerns, postnatal feeding was postponed until a week of starvation was reached in the 1950s and studies showed an association with neurological handicaps. The premature infant’s elevated need for energy, protein, and minerals has been known since 1919. However, nutritional practice lagged behind theoretical knowledge. Concentrated formula was developed in the 1940s, parenteral supplementation in the 1960s, and human milk fortifiers in the 1970s. In the 1990s, necrotizing enterocolitis was found to be more frequent in infants fed formula than in those fed human milk. Recently, probiotics were shown to reduce the risk of necrotizing enterocolitis. Compared to other aspects of neonatal medicine, there is little evidence on how to feed preterm infants.

A 40-year-old man sought care for a 3-year history of tingling in his cheeks and face, with progressive urinary urgency. He had a 1-year history of progressive binocular diplopia and ataxia. On examination, he had decreased vibration sensation in his toes and a mild broad-based gait. Magnetic resonance imaging of the brain indicated mild fluid-attenuated inversion recovery abnormality with punctate postgadolinium enhancement, primarily in the pons. Spinal fluid analysis showed 2 white blood cells/µL with 95% lymphocytes, protein value of 32 mg/dL, 0 unique oligoclonal bands, and normal immunoglobulin G index. Pontine biopsy showed a polyclonal lymphocytic infiltrate, with a small polyclonal B-cell infiltrate. The patient was treated with intravenous methylprednisolone. His symptoms markedly improved, and repeated brain magnetic resonance imaging showed resolution of the enhancing lesions. Six months later he had progressive ataxia and pseudobulbar affect. Repeated brain magnetic resonance imaging showed a recurrence of the punctate enhancing lesions in the pons. A diagnosis of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids was made. The patient was treated with weekly intravenous methylprednisolone, oral methotrexate, and folic acid supplementation. After 6 weeks, the methylprednisolone infusion interval was lengthened. Serial magnetic resonance imaging for 16 years after the original disease presentation showed no recurrence of enhancing brain lesions. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids is an inflammatory brainstem disorder of unknown cause. It presents with a progressive pontocerebellar dysfunction associated with punctate enhancing lesions centered on the pons and cerebellum.