乳脂肪球对婴幼儿健康的临床意义

doi:10.11852/zgetbjzz2024-1399

摘要/Abstract

摘要： 母乳是最适合婴儿消化、代谢能力,满足婴儿全面营养需求的天然食物。对母乳成分的高度关注和研究,促进了婴儿配方奶粉的改进。母乳脂肪球的结构被认为是母乳生态系统中的重要部分。临床试验表明,含有模拟母乳脂肪球结构的新型配方奶粉具有良好的安全性和耐受性,新型配方奶粉喂养儿的体质量指数发展轨迹更贴近于母乳喂养婴儿;在粪便样本中的平均粪便脂肪含量、磷和钙的含量以及脂肪酸的总和优于传统配方奶粉,并调节婴儿肠道菌群;通过促进ω-3长链多不饱和脂肪酸吸收促进婴儿认知发育。

关键词: 母乳, 配方奶粉, 乳脂肪球, 生长发育, 婴儿

Abstract: Breast milk is the natural food best suited to infants′ digestive and metabolic capabilities, fulfilling their comprehensive nutritional needs. Heightened attention and research on the components of breast milk have facilitated improvements in infant formula. The structure of breast milk fat globules is recognized as an important part of the breast milk biosystem. Clinical trials indicate that novel formulas containing structures mimicking breast milk fat globules exhibit safety and well tolerance, with body mass index development trajectories closer to those of breastfed infants. These formulas surpass traditional infant formulas in terms of average fecal fat content, phosphorus and calcium levels, and total fatty acids in stool samples, while also modulating infant gut microbiota. They promote infant cognitive development by enhancing the absorption of ω-3 long-chain polyunsaturated fatty acids.

Key words: breast milk, formula milk, milk fat globule, growth and development, infants

中图分类号:

R174.4

韦伟, 汪之顼, 王兴国, 毛萌. 乳脂肪球对婴幼儿健康的临床意义[J]. 中国儿童保健杂志, 2025, 33(2): 132-135.

WEI Wei, WANG Zhixu, WANG Xingguo, MAO Meng. Clinical significance of milk fat globules for infant health[J]. Chinese Journal of Child Health Care, 2025, 33(2): 132-135.

参考文献

[1] Dowben RM, Bunner JR, Philpott DE. Studies on milk fat globule membranes[J]. BBA Biomembranes, 1967, 135(1): 1-10.
[2] Heid HW, Keenan TW. Intracellular origin and secretion of milk fat globules[J]. Eur J Cell Biol, 2005, 84(2): 245-258.
[3] Wei W, Li D, Jiang C, et al. Phospholipid composition and fat globule structure II: Comparison of mammalian milk from five different species[J]. Food Chem, 2022, 388: 132939.
[4] Lopez C, Madec MN, Jimenez-Flores R. Lipid rafts in the bovine milk fat globule membrane revealed by the lateral segregation of phospholipids and heterogeneous distribution of glycoproteins[J]. Food Chem, 2010, 120(1): 22-33.
[5] Wei W, Yang J, Yang D, et al. Phospholipid composition and fat globule structure I: Comparison of human milk fat from different gestational ages, lactation stages, and infant formulas[J]. J Agr Food Chem, 2019, 67(50): 13922-13928.
[6] Gallier S, Vocking K, Post JA, et al. A novel infant milk formula concept: Mimicking the human milk fat globule structure[J]. Colloid Surface B, 2015, 136: 329-339.
[7] Pontzer H, Yamada Y, Sagayama H, et al. Daily energy expenditure through the human life course[J]. Science, 2021, 373(6556): 808-812.
[8] Ko CW, Qu J, Black DD, et al. Regulation of intestinal lipid metabolism: Current concepts and relevance to disease[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(3): 169-183.
[9] Cheong LZ, Jiang C, He X, et al. Lipid profiling, particle size determination, and in vitro simulated gastrointestinal lipolysis of mature human milk and infant formula[J]. J Agr Food Chem, 2018, 66(45): 12042-12050.
[10] Liu L, Zhang X, Liu Y, et al. Simulated in vitro infant gastrointestinal digestion of infant formulas containing different fat sources and human milk: Differences in lipid profiling and free fatty acid release[J]. J Agr Food Chem, 2021, 69(24): 6799-809.
[11] Infantes-Garcia MR, Verkempinck SHE, Del Castillo-Santaella T, et al. In vitro gastric lipid digestion of emulsions with mixed emulsifiers: Correlation between lipolysis kinetics and interfacial characteristics[J]. Food Hydrocoll, 2022, 128: 107576.
[12] Zhao P, Yang X, Li D, et al. Development of in vitro digestion simulation of gastrointestinal tract to evaluate lipolysis and proteolysis: Comparison of infant model digestion of breast milk and adult model digestion of cow milk[J]. Food Hydrocoll, 2023, 142: 108859.
[13] Yuan T, Geng Z, Dai X, et al. Triacylglycerol containing medium-chain fatty acids: 12 comparison of human milk and infant formulas on lipolysis during in vitro digestion[J]. J Agr Food Chem, 2020, 68(14): 4187-4195.
[14] Wei W, Yang X, Zhao P, et al. Structural changes and triacylglycerol lipolysis products of milk formula with large phospholipid-coated lipid droplets during in vitro digestion: Comparison with human milk and commercial standard formulas[J]. Food Hydrocoll, 2024, 151: 109831.
[15] de Oliveira SC, Bellanger A, Ménard O, et al. Impact of human milk pasteurization on gastric digestion in preterm infants: A randomized controlled trial[J]. Am J Clin Nutr, 2017, 105(2): 379-390.
[16] Pan Y, Liu L, Tian S, et al. Comparative analysis of interfacial composition and structure of fat globules in human milk and infant formulas[J]. Food Hydrocoll, 2022, 124: 107290.
[17] Hou Y, Shen P, Wang R, et al. Mechanism of fat globule size and surface composition regulating in vitro dynamic digestion, absorption and transport of structured emulsions[J]. Food Hydrocoll, 2023, 142.
[18] Breij LM, Abrahamse-Berkeveld M, Vandenplas Y, et al. An infant formula with large, milk phospholipid-coated lipid droplets containing a mixture of dairy and vegetable lipids supports adequate growth and is well tolerated in healthy, term infants[J]. Am J Clin Nutr, 2019, 109(3): 586-596.
[19] van de Heijning BJM, Schoen S, Abrahamse-Berkeveld M, et al. A concept formula with large, milk phospholipid-coated lipid droplets enriched with milk fat decreases palmitic acid and calcium levels in stools of healthy, term infants[J]. Eur J Lipid Sci Tech, 2022, 124(12): 2200018.
[20] Cianci D, Tims S, Roeselers G, et al. Multi-part strategy for testing differential taxa abundance in sequencing data: A simulation study with an application to a microbiome study[J]. J Microbiol Methods, 2023, 212: 106810.
[21] Lackey KA, Fehrenkamp BD, Pace RM, et al. Breastfeeding beyond 12 months: Is there evidence for health impacts?[J]. Annu Rev Nutr, 2021, 41(2021): 283-308.
[22] Abrahamse-Berkeveld M, Jespers SNJ, Khoo PC, et al. Infant milk formula with large, milk phospholipid-coated lipid droplets enriched in dairy lipids affects body mass index trajectories and blood pressure at school age: Follow-up of a randomized controlled trial[J]. Am J Clin Nutr, 2024, 119(1): 87-99.
[23] Oosting A, Kegler D, Wopereis HJ, et al. Size and phospholipid coating of lipid droplets in the diet of young mice modify body fat accumulation in adulthood[J]. Pediatr Res, 2012, 72(4): 362-369.
[24] Teller IC, Hoyer-Kuhn H, Brönneke H, et al. Complex lipid globules in early-life nutrition improve long-term metabolic phenotype in intrauterine growth-restricted rats[J]. Br J Nutr, 2018, 120(7): 763-776.
[25] Baars A, Oosting A, Engels E, et al. Milk fat globule membrane coating of large lipid droplets in the diet of young mice prevents body fat accumulation in adulthood[J]. Br J Nutr, 2016, 115(11): 1930-1937.
[26] Oosting A, van Vlies N, Kegler D, et al. Effect of dietary lipid structure in early postnatal life on mouse adipose tissue development and function in adulthood[J]. Br J Nutr, 2014, 111(2): 215-226.
[27] Kodde A, van der Beek EM, Phielix E, et al. Supramolecular structure of dietary fat in early life modulates expression of markers for mitochondrial content and capacity inadipose tissue of adult mice[J]. Nutr Metab, 2017, 14: 37.
[28] Ronda OA, van de Heijning BJ, Martini I, et al. Effects of an early life diet containing large phospholipid-coated lipid globules on hepatic lipid metabolism in mice[J]. Scic Rep, 2020, 10(1): 16128.
[29] Ronda O, van de Heijning BJM, Martini IA, et al. An early-life diet containing large phospholipid-coated lipid globules programmes later-life postabsorptive lipid trafficking in high-fat diet- but not in low-fat diet-fed mice[J]. Br J Nutr, 2021, 125(9): 961-971.
[30] Ruigrok SR, Abbink MR, Geertsema J, et al. Effects of early-life stress, postnatal diet modulation and long-term western-style diet on peripheral and central inflammatory markers[J]. Nutrients, 2021, 13(2): 288.
[31] Jelenik T, Kodde A, Pesta D, et al. Dietary lipid droplet structure in postnatal life improves hepatic energy and lipid metabolism in a mouse model for postnatal programming[J]. Pharmacol Res, 2022, 179: 106193.
[32] Schipper L, Bartke N, Marintcheva-Petrova M, et al. Infant formula containing large, milk phospholipid-coated lipid droplets and dairy lipids affects cognitive performance at school age[J]. Front Nutr, 2023, 10: 1215199.
[33] Schipper L, van Dijk G, Broersen LM, et al. A postnatal diet containing phospholipids, processed to yield large, phospholipid-coated lipid droplets, affects specific cognitive behaviors in healthy male mice[J]. J Nutr, 2016, 146(6): 1155-1161.
[34] van Heijningen S, Karapetsas G, van der Beek EM, et al. Early life exposure to a diet with a supramolecular lipid structure close to that of mammalian milk improves early life growth, skeletal development, and later life neurocognitive function in individually and socially housed male C57BL/6J mice[J]. Front Neurosci, 2022, 16: 838711.
[35] Oosting A, Harvey L, Ringler S, et al. Beyond ingredients: Supramolecular structure of lipid droplets in infant formula affects metabolic and brain function in mouse models[J]. PLoS One, 2023, 18(8): e0282816.