Human Milk Lipids

Abstract

Human milk lipids provide the infant with energy and essential vitamins, polyunsaturated fatty acids, and bioactive components. Adding complex lipids and milk fat globule membranes to vegetable oil-based infant formula has the potential to enhance infant development and reduce infections. Cholesterol provision with breastfeeding modulates infant sterol metabolism and may induce long-term benefits. Some 98-99% of milk lipids are comprised by triacylglycerols, whose properties depend on incorporated fatty acids. Attention has been devoted to the roles of the long-chain polyunsaturated fatty acids docosahexaenoic (DHA) and arachidonic (ARA) acids. Recent studies on gene-diet interaction (Mendelian randomization) show that breastfeeding providing DHA and ARA improves cognitive development and reduces asthma risk at school age particularly in those children with a genetically determined lower activity of DHA and ARA synthesis. It appears prudent to follow the biological model of human milk in the design of infant formula as far as feasible, unless conclusive evidence for the suitability and safety of other choices is available. The recent European Union legislative stipulation of a high formula DHA content without required ARA deviates from this concept, and such a novel formula composition has not been adequately evaluated. Great future opportunities arise with significant methodological progress for example in lipidomic analyses and their bioinformatic evaluation, which should enhance understanding of the biology of human milk lipids. Such knowledge might lead to improved dietary advice to lactating mothers as well as to further opportunities to enhance infant formula composition.

Exact determination of optimal nutritional composition for at-risk newborns tolerating enteral intake–breast milk analysis as a routine future standard in neonatal care

“…However, the levels of carbohydrates in Mother 1 decreased progressively. The dynamics of the energy content corresponded with the dynamics of fat since fat content represents 40-50 % of the energy intake (14).…”

“…Total energy intake is proportional to the contents of fat and carbohydrates. Fat and carbohydrate represent almost 90 % of total energy content of breast milk (14).…”

Human milk: composition and health benefits

“…24 Furthermore they are an important source of essential nutrients such as polyunsaturated fatty acids (PUFA), lipid soluble vitamins, complex lipids and bioactive compounds. 25 …”

“…However, persistent changes in dietary supply lead to modification of maternal stores. 25,28 LCPUFAs exert several major biological effects, particularly on membrane functions, eicosaenoid and docosanoid production and related physiological processes, including growth and immune response. Human milk lipids, particularly medium chain monoglycerides, have been found to inactivate several pathogens in vitro, including Group B streptococcus, thus contributing to the protection against invasive infections.…”

International Society for the Study of Fatty Acids and Lipids 2018 Symposium: Arachidonic and Docosahexaenoic Acids in Infant Development

“…Koletzko et al concluded by noting that breastfeeding provides both ARA and DHA [91], which compensates for low LCPUFA synthesis in carriers of some FADS gene polymorphisms. Infants with gene-linked low ARA synthesis consuming formula without additional ARA might be at greater risk of asthma, eczema, or other allergic diseases and possibly suboptimal cognitive development [67,92].…”