José Maldonado

Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants.

Objectives: The aim of the study was to examine the effects of a follow-on formula containing Lactobacillus fermentum CECT5716 (L fermentum) on the incidence of infections in infants between the ages of 6 and 12 months. Patients and Methods: A randomized double-blinded controlled study including infants at the age of 6 months was conducted. Infants were assigned randomly to either follow-on formula supplemented with L fermentum plus galactooligosaccharide (experimental group, EG), or the same formula supplemented with only galactooligosaccharide (control group, CG). The main outcome was the incidence of infections for the 6-month duration of the study. Results: The EG showed a significant 46% reduction in the incidence rate (IR) of gastrointestinal infections (EG: 0.196 ± 0.51, CG: 0.363 ± 0.53, IR ratio 0.54, 95% confidence interval [CI] 0.307–0.950, P = 0.032), 27% reduction in the incidence of upper respiratory tract infections (EG: 0.969 ± 0.96, CG: 1.330 ± 1.23, IR ratio 0.729, 95% CI 0.46–1.38, P = 0.026), and 30% reduction in the total number of infections (EG: 1.464 ± 1.15, CG: 2.077 ± 1.59, IR ratio 0.70, 95% CI 0.46–1.38, P = 0.003), at the end of the study period compared with CG. Conclusions: Administration of a follow-on formula with L fermentum CECT5716 may be useful for the prevention of community-acquired gastrointestinal and upper respiratory infections.

Addition of gangliosides to an adapted milk formula modifies levels of fecal Escherichia coli in preterm newborn infants

Because some gangliosides bind bacteria, we tested the influence of supplementating an adapted milk formula with gangliosides, at a total concentration of 1.43 mg/100 kcal, on the fecal microflora of preterm infants. At all sampling times, feces from infants fed with ganglioside-supplemented formula had significantly lower relative content of Escherichia coli than feces from infants fed with control milk formula: the difference was especially significant at age 7 days postnatal < .001). At age 30 days postnatal, fecal bifidobacterial counts were higher in infants fed with ganglioside-supplemented formula (P < .05). We conclude that gangliosides at concentrations present in human milk significantly modify the fecal flora.

Wholegrain cereals and bread: a duet of the Mediterranean diet for the prevention of chronic diseases.

OBJECTIVE The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Wholegrain cereals are rich in nutrients and many phytochemical compounds, with recognised benefits for health, including dietary fibre, a number of phenolic compounds, lignans, vitamins and minerals and other bioactive components. The aim of the present work is to review the fundamental studies that support the consumption of wholegrain cereals and bread to prevent chronic diseases. DESIGN Descriptive review considering human studies. SETTING AND SUBJECTS Subjects included in randomised intervention trials and cohort studies from different countries published up to 2010. RESULTS Several studies show consistently that subjects who ingest three or more portions of foods per day based on wholegrain cereals have a 20-30 % lower risk of CVD than subjects who ingest low quantities of cereals. This level of protection is not observed with the ingestion of refined cereals, these being even higher than with the intake of fruit and vegetables. Likewise, high intake of wholegrain cereals and their products, such as whole-wheat bread, is associated with a 20-30 % reduction in the risk of type 2 diabetes. Finally, protection against the risk of colorectal cancer and polyps, other cancers of the digestive tract, cancers related to hormones and pancreatic cancer has been associated with the regular consumption of wholegrain cereals and derived products. CONCLUSIONS The regular intake of wholegrain cereals can contribute to reduction of risk factors related to non-communicable chronic diseases.

Coenzyme Q concentration and total antioxidant capacity of human milk at different stages of lactation in mothers of preterm and full-term infants

Coenzyme Q10(CoQ10) in human milk at different stages of maturity in mothers of preterm and full-term infants and its relation to the total antioxidant capacity of milk is described for the first time. Thirty healthy breastfeeding women provided colostrum, transition-milk and mature-milk samples. Coenzyme Q, α-, γ- and δ-tocopherol, fatty acids and the total antioxidant capacity of the milk were analyzed. Coenzyme Q10 was found at higher concentrations for colostrum (0.81 ± 0.06 vs. 0.50 ± 0.05 μmol/l) and transition milk (0.75 ± 0.06 vs. 0.45 ± 0.05 μmol/l) in the full-term vs. the preterm group (similar results were found for total antioxidant capacity). Concentrations of α- and γ-tocopherol were higher in the full-term group and decreased with time. In conclusion, CoQ10 is present in breast milk, with higher concentration in mothers of full-term infants. CoQ10 in breast milk decreases through lactation in mothers delivering full-term infants. Also, CoQ10, α- and γ-tocopherol concentration in human milk directly correlates with the antioxidant capacity of the milk.

Colonization and Impact of Disease and Other Factors on Intestinal Microbiota

The aim of this study was to review the process of microbial colonization and the environmental and host factors that influence colonization and microbial succession. The impact of some diseases on intestinal microbiota composition is also described. Microbial colonization of the gut by maternal vaginal and fecal bacteria begins during and after birth. During the first 2 years of life, specific microbes become established in a process designated microbial succession. Microbial succession in the gastrointestinal tract is influenced by numerous external and internal host-related factors, and by the second year of life, the intestinal microbiota composition is considered identical to that of adults. Nevertheless, intestinal microbiota in both infants and adults remain incompletely characterized and their diversity poorly defined. The main explanation is that many intestinal bacteria that live in an anaerobic environment are difficult or impossible to culture outside the intestine. However, recent advances in molecular biology techniques have initiated the description of new bacteria species. The composition of gut microbiota can be modulated by host, environmental, and bacterial factors, and strong evidence has emerged of substantial modifications during illness or exposure to threatening experiences. It has been postulated that improvements in hygienic measures have led to an increase in allergic diseases (“hygiene hypothesis”). Alterations in gut microbiota and their functions have been widely associated with many chronic and degenerative diseases, including inflammatory bowel disease, colon cancer, and rheumatoid arthritis.

Faecal microbiota and short-chain fatty acid levels in faeces from infants with cow's milk protein allergy.

Background: The present study was designed to compare the faecal microbiota and concentrations of faecal short-chain fatty acid and ammonia between healthy and cow’s milk protein allergic (CMPA) infants. Methods: The population comprised 92 infants aged 2–12 months who were nonallergic (n = 46) or diagnosed as having CMPA (n = 46). Faecal samples were analyzed by fluorescent in situ hybridization and flow cytometry, using a panel of 10 rRNA targeted group- and species-specific oligonucleotide probes. Acetic, propionic, butyric, isocaproic and branched-chain short fatty acids (BCSFA) were measured by gas-liquid chromatography, lactate by enzymatic reaction, and pH and ammonia levels were determined. Results: CMPA infant faeces had significantly higher proportions of the Clostridium coccoides group and Atopobium cluster and a higher sum of the proportions of the different bacterial groups in comparison to healthy infant faeces. Faecal pH and ammonia did not significantly differ between CMPA and healthy infants. Faeces concentrations and percentages of butyric acid and BCSFA were higher in CMPA infants than in healthy infants. Conclusions: The findings clearly set a link between a dysbiosis in gut microbiota composition and the pathogenesis of CMPA. No single species or genus appeared to play an essential role, but dysbiosis led to biomarkers of CMPA among bacterial fermentation products.

Neonatal dietary gangliosides

Gangliosides are glycosphingolipids that are widely distributed in vertebrate tissues and body fluids and which are specially abundant in neural tissues. Milk from different species has a particular ganglioside content and profile. Human milk has a higher content of gangliosides than bovine milk. GD3 and GM3 are the predominant individual gangliosides in bovine milk. In human colostrum GD3 is also the main ganglioside whereas in human mature milk GM3 predominates over the other gangliosides. Human milk also contains GM1 and a number of highly polar gangliosides, which may play an important role in infant physiology. GM1 has been shown to inhibit Escherichia coli and Vibrio cholerae enterotoxins. We have found that a ganglioside-supplemented infant formula modifies the intestinal ecology of preterm newborns, increasing the Bifidobacteria content and lowering that of Escherichia coli. Although the exact mechanism by which dietary gangliosides reduce the fecal content of Escherichia coli is unknown, in vitro experiments suggest that they may act as false intestinal receptors for some strains of this bacteria. Since GD3 and other gangliosides have been involved in mechanisms of lymphocyte activation and differentiation, dietary gangliosides might have a function in intestinal immunity development.

Special formulas in infant nutrition: a review

Special formulas should only be used by medical prescription and for those lactating infants with diagnosed nutritional problems. Lactose-free formulas or those based on soy are the logical choice when the exclusion of lactose from the diet is considered necessary. At present, there is no concensus on the appropriateness of soy formulas for the treatment and prevention of nutritional allergies and current opinion seems to favour hydrolyzed protein formulas. High-degree protein hydrolysate formulas are used to treat lactating infants with an allergy to cow milk proteins or with serious nutritional problems. These formulas are not without risk, as they may contain residual epitopes capable of provoking a severe allergic reaction. Before using these formulas, allergenicity tests should be performed, particularly for highly sensitive infants. The unpleasant taste and high cost of these formulas, in addition to possible nutritional problems, limit their use in the prevention of atopic disease, although their efficacy is well established. Partially protein hydrolysate formulas are only used for preventive purposes and are not suitable for lactating infants with a proven allergy to cow milk. Although these formulas can reduce the incidence or delay the appearance of certain atopic symptoms, they have not been shown to prevent IgE-mediated allergic reactions to cows milk and so their effectiveness is open to question.

Changes in faecal microbiota of infants with cow's milk protein allergy - a Spanish prospective case-control 6-month follow-up study.

Thompson‐Chagoyan OC, Vieites JM, Maldonado J, Edwards C, Gil A. Changes in faecal microbiota of infants with cow’s milk protein allergy – a Spanish prospective case–control 6‐month follow‐up study.
Pediatr Allergy Immunol 2010: 21: e394–e400.
© 2009 John Wiley & Sons A/S

Safety and tolerance of the human milk probiotic strain Lactobacillus salivarius CECT5713 in 6-month-old children.

OBJECTIVE Intestinal microbiota plays an important role in the prevention of certain diseases during the pediatric years. Thus, there is an increasing interest in the addition of probiotics to infant formulas. The aim of this study was to evaluate the safety of a follow-on formula with Lactobacillus salivarius CECT5713 in 6-mo-old children. METHODS The antibiotic susceptibility of L. salivarius CECT5713 was analyzed by a dilution method. A double-blinded, randomized, placebo controlled study was performed. Children (n = 80) were distributed in two groups and consumed the formula supplemented or not with probiotics (2 × 10(6) colony-forming units [cfu]/g) during 6 mo. Fecal samples were collected at enrollment, at 3 mo, and at the end of trial. Clinical and anthropometric evaluations were performed. Depending on the variable, one-way or two-way repeated measures analysis of variance were used for the statistical analysis. RESULTS The antibiotic susceptibility profile of the strain resulted as safe. No adverse effects associated with the consumption of the probiotic formula were reported. In addition, clinical parameters did not differ between groups. Consumption of the probiotic supplemented formula led to an increase in the fecal lactobacilli content (7.6 ± 0.2 versus 7.9 ± 0.1 log cfu/g, P < 0.05). Lactobacillus salivarius CECT5713 was detected in the feces of volunteers from the probiotic group. Probiotic consumption induced a significant increase in the fecal concentration of butyric acid at 6 mo. CONCLUSION Thus, a follow-on formula with L. salivarius CECT5713 is safe and well tolerated in 6-mo-old infants.