Impact of homogenization of pasteurized human milk on gastric digestion in the preterm infant: A randomized controlled trial

Autor: Amélie Deglaire, Olivia Ménard, Yann Le Gouar, Florence Rousseau, Emelyne Dirson, Claire Bourlieu, Amandine Bellanger, Samira de Oliveira, Didier Dupont, Frédéric Carrière, Gwénaële Henry, Patrick Pladys
Přispěvatelé: Science et Technologie du Lait et de l'Oeuf (STLO), Institut National de la Recherche Agronomique (INRA)-AGROCAMPUS OUEST, Pediatrics Department, Centre Hospitalier Universitaire [Rennes], Faculty of Medicine, Université de Rennes (UR), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Pediatrics, Faculty of medicine, University of Rennes, Enzymologie interfaciale et de physiologie de la lipolyse (EIPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Ingénierie des Agro-polymères et Technologies Émergentes (UMR IATE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université de Montpellier (UM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), French National Institute for Agricultural Research, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Institut National de la Recherche Agronomique (INRA), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
allegation nutritionnelle
Endocrinology
Diabetes and Metabolism
pasteurisation
human health
Gastroenterology
law.invention
0302 clinical medicine
Randomized controlled trial
law
[SDV.IDA]Life Sciences [q-bio]/Food engineering
Ingestion
Infant Nutritional Physiological Phenomena
ComputingMilieux_MISCELLANEOUS
2. Zero hunger
Nutrition and Dietetics
enfant prématuré
Stomach
human milk
santé humaine
premature infant
medicine.anatomical_structure
Treatment Outcome
Ultrasonic Waves
Preterm infant
Holder pasteurization
Pasteurization
Digestion
Female
France
medicine.symptom
Infant
Premature
medicine.medical_specialty
Homogenization (chemistry)
03 medical and health sciences
030225 pediatrics
Internal medicine
medicine
Lipolysis
Humans
lait humain
pasteurizing
Homogenization
030109 nutrition & dietetics
Milk
Human
business.industry
Infant
Newborn
Stomach emptying
Endocrinology
Blood chemistry
homogénéisation thermique
Gastric Mucosa
business
Weight gain
[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Zdroj: Clinical Nutrition
Clinical Nutrition, 2017, 20, pp.1-11. ⟨10.1016/j.clnesp.2017.05.001⟩
Clinical Nutrition, Elsevier, 2017, 20, pp.1-11. ⟨10.1016/j.clnesp.2017.05.001⟩
ISSN: 2405-4577
0261-5614
1532-1983
DOI: 10.1016/j.clnesp.2017.05.001⟩
Popis: International audience; Background & aims: It has been suggested that homogenization of Holder-pasteurized human milk (PHM) could improve fat absorption and weight gain in preterm infants, but the impact on the PHM digestive kinetics has never been studied. Our objective was to determine the impact of PHM homogenization on gastric digestion in preterm infants. Methods: In a randomized controlled trial, eight hospitalized tube-fed preterm infants were their own control to compare the gastric digestion of PHM and of homogenized PHM (PHHM). PHM was obtained from donors and, for half of it, was homogenized by ultrasonication. Over a six-day sequence, gastric aspirates were collected twice a day, before and 35, 60 or 90 min after the start of PHM or PHHM ingestion. The impact of homogenization on PHM digestive kinetics and disintegration was tested using a general linear mixed model. Results were expressed as means ± SD. Results: Homogenization leaded to a six-fold increase in the specific surface (P < 0.01) of lipid droplets. The types of aggregates formed during digestion were different between PHM and PHHM, but the lipid fraction kept its initial structure all over the gastric digestion (native globules in PHM vs. blend of droplets in PHHM). Homogenization increased the gastric lipolysis level (P < 0.01), particularly at 35 and 60 min (22 and 24% higher for PHHM, respectively). Homogenization enhanced the proteolysis of serum albumin (P < 0.05) and reduced the meal emptying rate (P < 0.001, half-time estimated at 30 min for PHM and 38 min for PHHM). The postprandial gastric pH was not affected (4.7 ± 0.9 at 90 min). Conclusions: Homogenization of PHM increased the gastric lipolysis level. This could be a potential strategy to improve fat absorption, and thus growth and development in infants fed with PHM; however, its gastrointestinal tolerance needs to be investigated further. This trial was registered at clinicaltrials.gov as NCT02112331.
Databáze: OpenAIRE
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