Fortified Milk Research Articles

Perception of Rickets Disease Among Parents in Al-Baha Province, Saudi Arabia

IntroductionRickets involves the softening of bones in children and osteopenia with disordered calcification, leading to a higher proportion of osteoid tissue prior to epiphyseal closure in children. Rickets is common in the Middle East, Africa, and Asia. The peak age of prevalence is 3–18 months. Signs include bone tenderness, easy fracture, early bone deformity, delayed closure of fontanelles, and softening of skull bones (craniotabes).ObjectiveThis study assesses knowledge in the AlBaha region about rickets’ clinical presentation, causes, complications, and prevention, as well recommendations to educate the community.MethodsIn this descriptive cross-sectional study, a questionnaire was administered to people in the AlBaha region to assess knowledge related to rickets in children. The sample size was calculated using calculator.net, and the Statistical Package for Social Sciences (SPSS) version 2 was used for analyses with P < 0.05 used for significance.ResultsOf the 692 participants, only 5% reported rickets in their children, but the majority (99%) had heard about rickets. Participants’ knowledge of rickets’ complications was highest for spinal vertebral deformities and lowest for skin deformities. 55% of the participants thought there was no need to stop breast-feeding once rickets is diagnosed, 62% preferred to add fortified milk to the diet, 67% thought that a suitable duration for sunlight exposure is 10 to 15 minutes per day, and 46% thought that sunrise and sunset are suitable times for sun exposure. Preventive measures were believed to depend on having enough exposure to sunlight (77% of participants) and eating vitamin-D rich foods (63%). The majority believed that failure to grow is the most obvious symptom, inadequate milk is the main cause, and exclusive breast-feeding is a major risk factor.ConclusionMost people have heard about rickets, but knowledge about complications and prevention varies.

Reasonableness of Enriching Cow's Milk with Vitamins and Minerals.

Milk is an exceptional nutritional product that has been used for many millennia in human nutrition. Milk is a source of many valuable nutrients, including calcium, vitamin B, an especially significant amount of vitamin B2 and fat-soluble vitamins, such as A, D and E. Milk is an attractive product for fortification as it has a high nutritional density in a small volume and a relatively low price. Research shows positive health effects of drinking milk and consuming dairy products. Even more health benefits can be obtained from consuming fortified dairy products. A literature review, current nutritional recommendations, medical recommendations and an analysis of the market situation all recommend introducing milk enriched with minerals in combination with vitamins to the market. This concept corresponds to the current market demand and may supplement the missing and expected range of fortified milk and the correct number of recipients.

Manufacture of magnesium-fortified Chihuahua cheese

The aim of this study was to manufacture magnesium-fortified Chihuahua cheese and to evaluate the effect of magnesium fortification on quality parameters. Addition of magnesium chloride to milk during pasteurization (5.44, 10.80, 16.40, 22.00, and 25.20 g of MgCl2·6H2O/L of milk) resulted in cheese with increased magnesium content, proportional to the amount of magnesium added (up to 2,957.13 mg of Mg/kg of cheese). As magnesium content increased, coagulation time and moisture content also increased, whereas calcium content decreased. Higher levels of magnesium fortification (16.40 g of MgCl2·6H2O/L of milk or more) induced the development of bitter-acid flavors and softer texture. Addition of 10.80 g of MgCl2·6H2O/L to milk resulted in Chihuahua cheese that meets regulatory standards and possesses physicochemical and sensory characteristics similar to those of nonfortified Chihuahua cheese. Under this milk fortification level, the manufactured cheese is able to provide 148.4 mg of magnesium per day (35% of the recommended daily intake of magnesium for adult males and 46% for adult females) assuming 3 portions (28 g each) are consumed.

Green tea catechin loaded niosomes: formulation and their characterization for food fortification.

The main aim of this study was to deliver green tea catechins with enhanced bioavailability using niosomal system. Catechins-loaded niosomes were prepared using food grade surfactant, Tween 60 and membrane stabilizers namely, lauryl alcohol, cetyl alcohol and cholesterol by thin film hydration technique. Catechins-loaded niosomes exhibited a hydrodynamic diameter of 58.48nm with a narrow size distribution (PDI = 0.13) and zeta potential of - 31.75mV, suggestive for homogeneity and good stability. Niosomes entrapped about 85.82% of catechin and showed sustained release under simulated GI conditions. Morphology of niosomal vesicles were carried out using scanning electron microscopy-energy X-ray dispersion spectroscopy, transmission electron microscopy and atomic force microscopy. Fourier-transform infrared spectroscopy and High-performance liquid chromatography analysis confirmed successful encapsulation of catechins. Antioxidant activity of catechins was retained in the niosomal form. Fortification of milk with catechins loaded niosomes showed no significant changes on sensory, physicochemical properties and exhibited higher antioxidant property.

Preterm birth and human milk proteome: are we ready for individualized fortification?

Preterm birth is one of the most pressing clinical problems in obstetrics and neonatology worldwide. One of the most sophisticated components of human milk is the proteome and a better understanding of it can lead to precision guides for feeding preterm infants. In this review, we will examine recent research focused on the human milk proteome and individualized protein fortification of human milk. In both preterm and term birth, the protein content in mother's own milk dropped rapidly in the early postnatal period. Preterm milk had a higher protein content and contained different protein and endogenous peptide compositions compared with term milk. The peptides in gastrointestinal fluids of preterm infants still need further investigation. Individualized fortification is more superior to standard fortification, but it only focuses on the total protein amount. There is no data concerning the composition and posttranslational modifications of proteins and endogenous peptides with fortification and their longterm effects. Comprehensive identification and characterization of the human milk proteome have led to the targeted breast milk fortification theory of preterm infant feeding and has also been enriched by clinical trials. However, to achieve fortification of key proteins and/or endogenous peptides, as standard clinical practice, requires additional studies. Future research should explore the long-term effect of protein fortification and pay more attention to quality rather than quantity in relation to infant body composition and growth outcomes.

Effects of vitamin D3-fortified low-fat yogurt and milk on serum cytokine levels and anti hsp-27 antibody titer in adults with abdominal obesity: A randomized clinical trial

The purpose of the current study was to evaluate the effects of nano-encapsulated 25(OH)D fortified (1500 IU Nano-encapsulated 25(OH)D dairy products on anti-heat shock protein 27 antibody (anti-Hsp27) titers, pro-oxidant-antioxidant balance (PAB) and cytokines concentration in adults with abdominal obesity. This study was part of SUVINA project and designed as a randomized trial. Middle aged adults (n = 306) recruited among students and staff of Mashhad University of Medical Sciences [Iran]. Subjects were randomly assorted into four groups: a low-fat yogurt fortified with 1500 IU 25(OH)D (n = 76), and unfortified yogurt (n = 77), a low-fat milk fortified with 1500 IU 25(OH)D (n = 76), and unfortified milk (n = 77) were followed up for 10 weeks. A total of 289 subjects completed the study. Body mass index (BMI) and waist circumference were measured before and after the ten weeks of intervention. The following biochemical markers were determined: serum pro-oxidant-antioxidant balance (PAB), 25(OH) D, anti-Hsp27 titers and cytokines concentration, at baseline and at the end of the study. There was a significant difference between serum 25(OH)D concentration and PAB at baseline and the end of intervention with fortified milk and yogurt. After the intervention period, changes between groups of intervention group of both of the milk and yogurt and control group were statistically significant for serum 25(OH)D concentration (p < 0.001) and PAB (p < 0.05). In the group provide with fortified milk, waist circumference was decreased (−2.01 ± 3.85 cm, p < 0.05) and serum 25(OH)D concentration increased significantly (5.02 ± 4.07 ng/ml, p < 0.001). In the group taking the fortified yogurt, serum 25(OH)D status increased by 6.75 ± 3.42 ng/ml (p < 0.001) and PAB decreased by −21.85 ± 48.07 HK (p < 0.05). Our results did not show any significant differences in mean weight between the groups (p > 0.05). Our results showed that after the intervention with 25(OH)D fortified yogurt or milk in obese subjects, serum PAB concentrations decreased and serum 25(OH)D increased significantly. Therefore, fortification of low-fat yogurt and milk with 25(OH)D may be effective in reducing the pro-oxidant anti-oxidant balance with effect thsat are greater than for unfortified dairy products. • The oxidative stress is seen in obese individuals, such as dysregulation in Pro-oxidant-Antioxidant Balance (PAB). • One of the prescibed dietary interventions for fighting against the obesity-induced oxidative stress is the vitamin D supplementation. • Serum PAB concentration was decreased after intervention with vitamin D fortified yogurt in obese subjects.

Impact of Early Fortification in Very Low Birth Weight Infants on the Incidence of Malnutrition During a Trophamine Shortage.

The devastation of pharmaceutical production facilities from Hurricane Maria caused a national shortage of parenteral amino acids in October 2017. Our institution decreased trophamine in very low birth weight (VLBW) infants and initiated human milk fortification at a lower feeding volume to increase enteral protein intake more quickly. The objective of this study was to assess how protein management during the shortage period affected the incidence of malnutrition. This was a retrospective cohort study of infants admitted to 2 neonatal intensive care units from June 1, 2017 to May 31, 2018. Infants between 23 and 32 weeks' gestation were included in this study. The primary outcome was the incidence of malnutrition at 14 days, defined as a z score decline of ≥0.8 SDs, in the pre-shortage period compared with the shortage period. Clinical data regarding adverse effects associated with early fortification and pharmacy costs were recorded. There were 68 infants prior to and 65 during the shortage who met inclusion criteria. There was no difference in malnutrition between the pre-shortage and shortage groups; however, a significant increase in malnutrition was observed in infants who did not receive early fortification during the shortage. No difference in time to full enteral feeds or necrotizing enterocolitis was observed with early fortification. Early fortification in VLBW infants receiving less trophamine during the shortage was not associated with an increase in malnutrition. Restricting trophamine in neonates during the shortage allowed for distribution to other critically ill patients.

Monitoring of Aflatoxin M1 in Various Origins Greek Milk Samples Using Liquid Chromatography Tandem Mass Spectrometry

Aflatoxin M1(AFM1), a major metabolite of Aflatoxin B1(AFB1), has been identified as a potential contaminant in dairy products. Because of its possible carcinogenicity, the legislation limits as set by Commission Regulation (EC) No. 1881/2006 are very strict, namely 0.050 μg kg−1 in milk and 0.025 μg kg−1 in infant formulas. To meet these requirements, a sensitive and accurate method was developed, employing liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Ιmmunoaffinity columns (R-Biopharm) were used for sample purification and preconcentration of the analyte of interest. The quantification of AFM1 was conducted using fortified milk samples, while Aflatoxin B2 (AFB2) was used as an internal standard (IS). The method was validated in terms of linearity, precision, trueness, limits of detection and quantification and uncertainty. The performance criteria for the method were evaluated based on European Commission Regulation (EC) No. 401/2006 and its most recent amendment, as well as the suggested criteria for revision by the EU Reference Laboratory for Mycotoxins and Plant Toxins. The recovery was in the range of 77.9–81.0% for all fortification levels (0.025–0.050–0.075 μg kg−1), with RSDR values (Relative Standard Deviation of intermediate precision) ranging from 6.1% to 12%. The method’s detection and quantification limits were 0.0027 μg kg−1 and 0.0089 μg kg−1, respectively. The occurrence of AFM1 was investigated in 40 samples of different animal origin (cow, goat and sheep milk) provided by Greek producers.

Human Milk Fortification in Very Preterm Infants in China: A Multicenter Survey.

AimTo investigate the use of human milk fortifier (HMF) for very preterm infants (VPIs) and complications and nutritional status of VPIs due to various breast milk enhancement strategies among the Chinese population.MethodsVPIs with birth weight < 1,800 g and wholly or predominantly breastfed were assigned to the following fortification groups: no HMF, early HMF (adding HMF at an enteral volume of ≤ 80 ml·kg−1·day−1), middle HMF (adding HMF at an enteral volume of 80–100 ml·kg−1·day−1), and late HMF (adding HMF at an enteral volume of ≥100 ml·kg−1·day−1). The growth status and complications for various groups were evaluated.ResultsWe enrolled 985 VPIs, of which 847 VPIs (86.0%) received HMF, whereas 138 VPIs (14.0%) did not. The number of VPIs in the early, middle, and late fortification groups were 89 (9.0%), 252 (25.6%), and 506 (51.4%), respectively. The complete fortification of the early, middle, and late fortification groups was achieved in 13.2 ± 11.0, 13.8 ± 11.7, and 12.3 ± 13.0 days, respectively, without significant differences (p > 0.05). The groups did not exhibit significant differences in the incidence of feeding intolerance, necrotizing enterocolitis (Bell stage ≥ 2), late-onset sepsis, and metabolic bone diseases (p > 0.05). The middle fortification groups exhibited the fastest growth velocity and the least dramatic decrease in the Z-score of weight and length, and the lowest incidence of EUGR (35.7%), whereas the “no HMF” groups exhibited the slowest growth velocity and the largest decline in the Z-score, and the highest incidence of EUGR (61.6%).ConclusionsThe usage rate of HMF was relatively low among Chinese VPIs, fortification often occurred in the late feeding stage, and the time to reach complete fortification was long. Adding HMF and different breast milk enhancement strategies did not increase the incidence of feeding intolerance and necrotizing enterocolitis. The enteral volume of 80–100 ml·kg−1·day−1 with HMF addition led to increased growth in the weight and length and lower EUGR incidence, indicating that the addition of HMF at the specific feeding volume might be the best practice for promoting growth.

Ultrasonic Extraction of Bioactive Compounds from Green Soybean Pods and Application in Green Soybean Milk Antioxidants Fortification.

Green soybean (Glycine max L.) pods (GSP) are agro-industrial waste from the production of frozen green soybean and milk. These pods contain natural antioxidants and various bioactive compounds that are still underutilized. Polyphenols and flavonoids in GSP were extracted by ultrasound technique and used in the antioxidant fortification of green soybean milk. The ultrasound extraction that yielded the highest total polyphenol content and antioxidant activities was 50% amplitude for 10 min. Response surface methodology was applied to analyze an optimum ultrasonic-assisted extraction (UAE) condition of these variables. The highest desirability was found to be 50% amplitude with an extraction time of 10.5 min. Under these conditions, the experimental total phenolic content, total flavonoid content, and antioxidant activity were well matched with the predicted values (R2 > 0.70). Fortification of the GSP extracts (1–3% v/v) in green soybean milk resulted in higher levels of bioactive compounds and antioxidant activity in a dose-dependent manner. Procyanidins were found to be the main polyphenols in dried GSP crude extracts, which were present at a concentration of 0.72 ± 0.01 mg/100 g. The addition of GSP extracts obtained by using an ultrasound technique to green soybean milk increased its bioactive compound content, especially procyanidins, as well as its antioxidant activity.

State of the evidence from clinical trials on human milk fortification for preterm infants.

Infants born preterm or low birth weight are at risk for morbidity, mortality and later neuroimpairment. Appropriate early post-natal growth is associated with better outcomes in-hospital and post-discharge. Therefore, nutritional strategies that support growth may improve the long-term health of this population. Mother's milk with donor milk as a supplement are preferred sources of nutrition for these infants but may not always support growth, especially amongst infants born of very low birth weight (<1500g) and or those with a major morbidity. Systematic reviews of randomised controlled trials to date demonstrate that multi-nutrient fortification of human milk improves in-hospital growth of preterm infants although data on long-term neurodevelopment are lacking. Further, individualised approaches to fortification based on milk analysis or the infant's metabolic response may improve growth over standard fortification. The evidence is insufficient to inform the timing of introducing fortifier, routine fortification of feeds post-discharge or routine use of fortifiers made from human instead of bovine milk. Importantly, there is insufficient data to determine if these fortification practices improve relevant clinical or neurodevelopmental outcomes. In sum, there is an urgent need for well-designed clinical trials to assess potential benefits and risks of fortification practices and at what cost.

Effect of human milk enriched with human milk-based fortifier (HMBF) versus bovine milk-based fortifier (BMBF) on growth and morbidity among very low birth weight (VLBW) infants – A randomized controlled trial

Introduction: Survival of preterm neonates increased dramatically with the advancement in neonatology services. These infants have high nutritional demands for optimal growth, and human milk alone is insufficient to meet their needs. Hence, fortification of milk has become the standard of care. Bovine milk-based fortifiers (BMBF) are commonly used, but there exists concern regarding the exposure to cow milk protein. Human milk-based fortifier (HMBF) use offers a theoretical advantage from the immunological and gastrointestinal standpoint. We intend to study the effects of HMBF compared to BMBF on growth and morbidity of preterm neonates. Methodology: It is a single-centre, open-labelled, randomized controlled trial (RCT) enrolling very low birth weight (VLBW) neonates of less than 34 weeks of gestation weighing between 1,000 and 1,500 g. Only human milk was used, and infants were randomized to receive either fortifier after reaching 100 ml/kg/day of enteral feeds. Growth and morbidity of preterm neonates were analysed. Results: A total of 50 infants were enrolled (25 in each arm). Weight gain (21.42 vs. 20.84 g/day, p = 0.77) and growth velocity (16.45 vs. 15.85 g/kg/day, p = 0.57) were similar in both groups with no statistical difference. Sepsis (relative risk [RR] = 0.6), feed intolerance (RR = 0.57), necrotizing enterocolitis (NEC) (RR = 0.33) and duration of hospital stay (33 vs. 36 days) were better in the HMBF group than in the BMBF group. Conclusion: Growth velocity was similar in both groups. However, HMBF was well tolerated by neonates with lesser incidence of feed intolerance, NEC, sepsis, and lesser hospital stay duration than in neonates supplemented with BMBF. Given the fewer number of studies, there is a need for well-powered RCTs with a good sample size to fill the knowledge gap.

PHYTOCHEMISTRY, MEDICINAL AND NUTRITIONAL IMPORTANCE OF ASPARAGUS RACEMOSUS

Plants possess very important phytochemical constituents and are rich in nutritional and medicinal contents. Current studies were performed to review the phytochemistry, nutritional and pharmaceutical value of Asparagus racemosus (shatavari). This plant contains numerous steroidal saponins, steroids, alkaloids, flavonoids, cyclic hydrocarbons, tannins, anthraquinones, polysaccharides, oligospirostanoside, trace minerals, derivatives of dihydrophenanthrene and derivatives of furans and essential oils. A. racemosus has shown neuroprotective, antitussive, immunomodulatory, antidepressant, nootropic, antiamnesic, antiulcer, antiparasitic, antidiabetic, anticancer, aphrodisiac, antibacterial, anti-inflammatory, antidiarrheal, antioxidant, hepatoprotective, hypocholestrimic, antiurolithiatic, anti-sebum and wound healing effects. It has been found effective in improving sperm count and also used to treat blood dysentery, skin problems, kidney stones, dysentery, diarrhoea, epilepsy, general weakness, leucorrhoea, gynecological disorders, lactation issues and teratological disorders. Its root extract is an important ingredient of many useful drug formulations including Abana, Diabecon, EyeCare, Geriforte, Himplasia, Lukol and Renalka. Its roots are rich in many nutrients and can be orally given to diary animals as food supplements to increase the milk production, reproduction capacity and immune system. Shatavari extracts can be used to increase the nutritional value of bakery products and fortification of milk.

ВИКОРИСТАННЯ МОРКВЯНИХ ПОРОШКІВ ДЛЯ ЗБАГАЧЕННЯ МОЛОКА МІНЕРАЛЬНИМИ ЕЛЕМЕНТАМИ

Milk is the main source of protein and a must-have in the daily diet of children. It is recommended to consume milk with added vitamins and minerals. That is why milk fortification is a topical issue. The purpose of the study is to substantiate the expediency of using carrot powders for enriching milk with minerals. Milk quality indicators were determined according to standard methods: organoleptic assessment was carried out according to DSTU 2661: 2010, titrated acidity was determined according to DSTU 8550: 2015. Chemical analysis of powders was carried out by electron microscopy using SEM and EDS detectors. Powders were made from the root crops of Shantane carrots and their skins under laboratory conditions and a technology for enriching A2 milk with them was developed. Analysis of the chemical composition showed that carrot powders from the main part of root crops contain K (27.1%), Ca (6.97%), Cl (5.09%), P (3.82%), Na (3.3%), Fe (1.07%), Mg (0.75%) and S (0.47%). It was found that the addition of carrot root vegetable powder in the amount of 10% had a positive effect on the organoleptic properties of milk without reducing its storage capacity. The fortified milk had a characteristic pasteurized smell, a pleasant creamy color, and a slight carrot flavor. The consistency of the developed product corresponded to that of pasteurized milk. It was found that some mineral substances in carrot peel powders contain more than in the main part of the root crop: K – by 4.28%, Fe – by 0.73%, P – by 0.45%, S – by 0.12%. But the addition of such powders to milk significantly reduces its quality indicators and leads to rapid deterioration of the product. The sample with carrot waste powder had a dirty tint and a characteristic vegetable taste and aroma. The acidity of milk with the addition of powder from carrot skins exceeded the standard value by 4°Т. This technology can be waste-free, in the case of drying the carrot pulp obtained after filtering milk and using it as a food additive. The development of a technology for using dried carrot pulp is a prospect for further research.

Age wise preferences for fortified aloo tikki with soybean

Food fortification process includes addition of nutrients and bioactive components in foods. Fortification used as a tool to prevent malnutrition which is cost-effective, applicable and defensive methodology for malnutrition such as salt fortification, milk fortification and rice fortification in rising countries. Fortification is useful for the people suffering from undernourishment mostly influencing children and generative women. Soybean is single one houseplant which provide complete protein along with many other important nutrients like iron, manganese, copper, molybdenum, potassium and vitamin K, dietary fiber, Isoflavone, fat (63% polyunsaturated fatty acids, 23% monounsaturated fatty acids and 14% saturated fatty acids also provide omega-3 fatty acids), 30% carbohydrates and 38-40% protein (70% protein characterized by the blend of glycinin & β-conglycinin). The present research is intended to evaluate sensory quality and overall consumer acceptability of different blends of fortified aloo tikki with soybean by hedonic rating test. For preparation of different blends, boiled grated aloo was blended with boiled grinded soybean (Control group - 100% potato + 0% soybean, Sample A - 75% Potato + 25% Soybean, Sample B - 50% Potato + 50% Soybean and Sample C - 25% Potato + 75% Soybean). The sensory characteristics like appearance, mouth feel, texture and overall acceptability of fortify aloo tikki were evaluated by 50 panelists (Male 23 and female 27) by using 9-Point hedonic rating test. The results concluded that both age group 18-29 year and 30-40 year gave higher acceptability for sample B which hold equal ratio of soybean and aloo. Appearance of sample A and texture of Sample C were highly preferred by both age groups. Respondents of 18-29 year age group prefer sample A (52%) for mouth feel and respondents of 30-40 year age group prefer sample B (64%).

Prevalence and Associated Factors of Iron Deficiency and Iron Deficiency Anemia Among Under-5 Children: A Systematic Review and Meta-Analysis.

Background. Iron deficiency anemia is a common health problem that affects children under the age of five. Children’s cognitive performance is impaired by iron deficiency, which impacts their psychomotor development. Therefore, the aim of this study was to determine the global prevalence and associated factors of iron deficiency and iron deficiency anemia among under-5 children. Methods. Relevant publications published till March 30, 2021 were identified in databases such as Medline/PubMed, Science Direct, Popline, EMBASE, African Journals Online, Scopus, and Google Scholar. The STATA version 11 software was utilized for the analysis. To determine the level of heterogeneity, I2 test statistics were used. To detect publication bias, funnel plots analysis and the Egger weighted regression test were used. Results. The global pooled prevalence of iron deficiency anemia and iron deficiency was 16.42% (95% CI: 10.82, 22.01) and 17.95% (95% CI: 13.49, 22.41), respectively. Age less than 2 years (OR = 1.26; 95% CI: 1.14, 1.38) and living in a large family size (OR = 1.38; 95% CI: 1.18, 1.58) were associated with iron deficiency anemia. Children born from anemic mother, low birth weight, and do not drink iron fortified milk (OR = 1.20; 95% CI: 1.05, 1.36), (OR = 1.15; 95% CI: 1.01, 1.36) and (OR = 1.28; 95% CI: 1.10, 1.46), respectively were associated factors of iron deficiency in under-5 children. Conclusion. The prevalence of iron deficiency anemia and iron deficiency was significant across the globe, particularly in Asia and Africa. Therefore, regular screening and treatment of iron deficiency and iron deficiency anemia are required especially in high-risk children to reduce their complication.PROSPERO registration number: CRD42021267060

Impact of milk on malnutrition and cognitive skills among school children: Evidence from gift milk initiative from a tribal state of India.

ABSTRACTBackground:The objective of this study was to assess the impact of fortified milk on various aspects of growth and development among school children in a tribal-predominant district of Jharkhand, India.Materials and Methods:A longitudinal study was planned in 16 schools (eight in intervention group and eight in control group) of Latehar district of Jharkhand in India. Out of the total 962 study participants, only 528 study participants were considered in study analysis, who were present both during baseline and endline study after 1 year of milk introduction. The study participants were assessed for nutrition, intelligence quotient, and hemoglobin levels with the help of study tools and instruments.Results:The decrease in malnutrition was more evident in the intervention group during endline assessment, with 95% confidence interval (95% CI; 7.37, 7.42) and 95% CI (10.63, 10.58) for the difference in proportion in the intervention and control groups for stunting and thinness, respectively. This was statistically significant (P < 0.05). Anemia also improved with better cognition in the intervention group, and the difference was statistically significant (P < 0.05).Conclusion:In our study, beneficial effects of milk on malnourished children were evident, particularly in combating stunting and thinness, and it also had a positive impact on cognitive skills in school children.

Comparison between Efficacy of Human Milk Fortification Using Human Milk Fortifier versus Preterm Formula: A Retrospective Single-institutional Experience.

This study sought to evaluate the relative efficacy of expressed breast milk (EBM) fortified using human milk fortifier (HMF) compared to commercial preterm formula (PF) on preterm and very low birth weight (VLBW) infants in a major tertiary healthcare center in Oman. This retrospective cohort study included two cohorts of preterm (< 32 weeks gestation) or VLBW infants (birth weight < 1500 g) treated in the neonatal intensive care unit (NICU). Cohort one included infants who were given PF-fortified EBM between January and December 2016, and cohort two were given newly-introduced HMF-fortified EBM between November 2018 and December 2019. Analysis was performed to compare the cohorts with respect to baseline characteristics, primary outcomes, and secondary outcomes. A total of 103 neonates were included (cohort 1: n = 55, cohort 2: n = 48). There were no significant differences in the growth of the weekly length, the growth of the head circumference, or discharge growth parameters. Compared to PF, HMF was associated with significantly better weight gain velocity (g/kg/day) during the first week (p = 0.009) and second week (p = 0.050) after starting fortification, lower need for other adjunctive forms of fortification (p = 0.035), and lower rates of necrotizing enterocolitis in premature infants or VLBW (p = 0.018). This is likely to be the first study to analyze the relative efficacy of HMF and PF in the Middle East. The results of this study will be helpful in guiding standards of nutritional care in NICUs in Oman.

Milk Fortification with Vitamin A &amp; D: A Need of the Hour in India

Micronutrient deficiency is caused by a diet deficient in important vitamins and minerals, and it continues to be a serious public health issue for many low- and middle-income countries' populations. Vitamin A and D deficiency is extremely common in India, affecting both young children and adults. With 146.3 million tonnes of milk produced annually, India is the world's largest producer, yet only around 9% of the milk is fortified with vitamins and minerals.&#x0D; Milk fortification is one of the treatments for vitamin deficiency. Milk is one of the most nutrient-dense foods available. In India, it is a staple dish that is consumed by people of all age groups. Regular consumption of fortified milk led to an 18% reduction in diarrhoea, a 26% reduction in pneumonia, 7% fewer days with a high fever, and 15% fewer days sick with severe sickness. Out of 416 LLPD produced, about 198.4 LLPD gets fortified currently in India, reaching about 121 million people. There is still a significant gap between production and fortification. Governments must take appropriate steps to improve milk fortification and make India a healthy country.

Human milk-based fortifier is associated with less alteration of milk fat globule size than cow milk-based fortifier.

We aimed to evaluate if human milk-based fortifier (HMBF) affects human milk fat globule (MFG) size less than cow milk-based fortifier (CMBF), which may impact overall infant feeding tolerance. Measurements of donated human milk were performed before fortification as well as at 1 hour, 24 hours, and 48 hours after fortification with CMBF or HMBF. MFG size in each sample of fortified milk was measured by laser light scattering. MFG size in the fortified milks increased gradually over time. At 24 and 48 hours after fortification, MFG size in the milk with CMBF was larger than that in the milk with HMBF (4.8 ± 0.5 vs 4.3 ± 0.3 μm, p<0.01, 5.1 ± 0.7 vs 4.5 ± 0.4 μm, p = 0.03, respectively). HMBF is associated with less alteration of MFG size than CMBF. This may have an impact on feeding tolerance of very preterm infants.