Milk protein digestion and the gut microbiome influence gastrointestinal discomfort after cow milk consumption in healthy subjects

Tagliamonte, Silvia; Lumaga, Roberta Barone; Filippis, Francesca De; Valentino, Vincenzo; Ferracane, Rosalia; Guerville, Mathilde; Gandolfi, Isabella; Barbara, Giovanni; Ercolini, Danilo; Vitaglione, Paola

doi:10.1016/j.foodres.2023.112953

Cited by 12 publications

(12 citation statements)

References 82 publications

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“…Indeed, a recent study with similar inclusion criteria showed that less efficient digestion of milk proteins, leading to a different pattern of peptides reaching the lower gut which might explain GI problems in healthy people after milk consumption. 63 This may be preceded by a difference in gastric digestion. The possible underlying mechanism for the gastrointestinal symptoms may be the remaining coarser coagulum in the stomach.…”

Section: Discussionmentioning

confidence: 99%

Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk

van Eijnatten,

Camps,

Guerville

et al. 2023

Neurogastroenterology Motil

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BackgroundGastrointestinal symptoms after drinking milk are often attributed to lactose intolerance or cow's milk allergy. However, some individuals without either condition still report gastrointestinal symptoms after drinking milk. This may be caused by gastric emptying (GE) rate or gastric protein coagulation. This study aimed to compare GE rate and protein coagulation after milk consumption between individuals reporting gastrointestinal symptoms and those without symptoms using a novel gastric MRI approach.MethodsThirty women were included in this case–control study, of whom 15 reported gastrointestinal symptoms after drinking milk and 15 were controls. Participants underwent gastric MRI before and up to 90 min after consumption of 250 mL cow's milk. Gastric content volume and image texture of the stomach contents were used to determine GE and changes in the degree of coagulation.Key ResultsGE half‐time did not differ between the groups (gastrointestinal symptom group 66 ± 18 min; control group 61 ± 14 min, p = 0.845). The gastrointestinal symptom group reported symptoms from 30 min onwards and rated pain highest at 90 min. The control group reported no symptoms. Image texture analyses showed a significantly higher percentage of coagulum and lower percentage of liquid in the group in the GI symptom group (MD 11%, 95% CI [3.9, 17], p = 0.003). In vitro data suggests that pH and proteolytic enzyme activity influence the coagulum structure.Conclusions and InferencesGastric milk coagulation and emptied fraction of stomach content may differ between individuals experiencing symptoms after milk consumption, possibly due to differences in pH and proteolytic enzyme activity.

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Section: Discussionmentioning

confidence: 99%

Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk

van Eijnatten,

Camps,

Guerville

et al. 2023

Neurogastroenterology Motil

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“…Analysis of BAPs was performed as reported in Tagliamonte et al 24 Briefly, samples added with internal standard ( 13 C-labelled BCM7, 2.5 μg mL −1 ) clean-up was performed by using Strata C18-E (55 μm, 70 Å) cartridges (50 mg/1 mL) (Phenomenex, USA) and eluted with 1 mL of acetonitrile/water (80 : 20) 0.1% formic acid. Thereafter, eluates were dried under nitrogen and reconstituted in water with 0.1% formic acid prior to LC-HRMS analysis.…”

Section: Methodsmentioning

confidence: 99%

“…An isotope labeled d 3 proline was added as an internal standard. The analysis of amino acids in the samples was performed according to Tagliamonte et al 24 Chromatographic separation was performed on a Synchronis HILIC column (250 × 4.6 mm, 5 μm) (Thermo Fisher Scientific, San Jose, CA, USA). A linear gradient mixture of acetonitrile (A) and 0.1% formic acid in water (B) was used as the mobile phase at a flow rate of 400 μl min −1 at 45 °C.…”

Section: Methodsmentioning

confidence: 99%

“…25 BCMs have been found to prolong gastrointestinal transit time, exert antidiarrheal action, 26 and possibly contribute with other BAPs to milk-related gastro-intestinal discomfort. 24,27,28 Indeed, Tagliamonte et al 24 recently found that the circulating higher relative concentration of BAPs opioid agonists-to-antagonists one hour after consuming milk was concomitant with the onset of gastrointestinal discomfort in a group of subjects suffering from this condition. Therefore, protein digestion and the type and time-concentration of BAPs in the alimentary canal and/or in circulation (beyond the amino acids profile) may be crucial for proteins to elicit some physiological BAP-mediated effects.…”

Section: Introductionmentioning

confidence: 99%

“…22 Milk proteins, including CNs, are an important source of BAPs 23 that are available in circulation after consuming milk as we have recently demonstrated in humans. 24 Among CN-derived BAPs, the opioid β-casomorphins (BCMs) were the most studied. 25 BCMs have been found to prolong gastrointestinal transit time, exert antidiarrheal action, 26 and possibly contribute with other BAPs to milk-related gastro-intestinal discomfort.…”

Section: Introductionmentioning

confidence: 99%

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Casein–phenol interactions occur during digestion and affect bioactive peptide and phenol bioaccessibility

Hamzalioglu,

Tagliamonte,

Gökmen

et al. 2023

Food Funct.

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Relationships between diet and gut microbiome in an Italian and Dutch cohort: does the dietary protein to fiber ratio play a role?

Tagliamonte,

Puhlmann,

De Filippis

et al. 2023

Eur J Nutr

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Purpose To investigate the relationships between the habitual diet, the protein to fiber ratio (P/F), and the gut microbiome in one Italian and one Dutch cohort of healthy subjects consuming an omnivore diet. Methods The Italian cohort included 19 males (M_IT, BMI 25.2 ± 0.72 kg/m2, age 25.4 ± 0.96 years) and 20 females (F_IT, BMI 23.9 ± 0.81 kg/m2, age 23.8 ± 0.54 years); the Dutch cohort included 30 females (F_NL, BMI: 23.9 ± 0.81 kg/m2, age: 23.8 ± 0.54 years). Individual diets were recorded through Food Frequency Questionnaires and analyzed to assess the nutrient composition. Gut microbiome was assessed in fecal samples. Results M_IT consumed higher levels of proteins than F_NL and F_IT, whereas dietary fiber intake did not differ among groups. Data showed that consumption of plant protein to animal protein (PP/AP) and PP to total proteins ratio can determine a differentiation of F_NL more than the absolute amount of dietary fiber. Conversely, the protein to fiber (P/F) and AP to total proteins better characterized M_IT. M_IT harbored the highest abundance of proteolytic microorganisms and the lowest microbial gene richness. Conversely, F_NL had more fiber-degrading microorganisms like Bacteroides thetaiotaomicron, Bacteroides xylanisolvens, Roseburia sp., Coprococcus eutactus and Parabacteroides along with the highest number of genes encoding carbohydrate-active enzymes and gene richness. It was predicted that by each unit decrease in the P/F a 3% increase in gene richness occurred. Conclusion Study findings suggested that dietary P/F, rather than the absolute amount of dietary fiber, could contribute to the shaping of the microbiome towards a more proteolytic or fiber-degrading gut ecosystem. ClinicalTrials.gov Identifier NCT04205045—01-10-2018, retrospectively registered. Dutch Trial Register NTR7531—05-10-2018.

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Milk protein digestion and the gut microbiome influence gastrointestinal discomfort after cow milk consumption in healthy subjects

Cited by 12 publications

References 82 publications

Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk

Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk

Casein–phenol interactions occur during digestion and affect bioactive peptide and phenol bioaccessibility

Relationships between diet and gut microbiome in an Italian and Dutch cohort: does the dietary protein to fiber ratio play a role?

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