An write-up of Associate Professor Felizardo Gatcheco, Paediatric Gastroenterologist / Clinical Epidemiologist

Previous evidence has suggested that components of the human milk fat globule membrane (MFGM) provide immunological benefits in the developing infant. Recent research indicates that supplementation with bovine MFGM may confer anti-infective and immunomodulatory factors to infant formula.

Milk fat globule membrane fractions are complex and contain many different (glycosylated) lipid components, including cholesterol, and also glycoproteins and enzymes (4-6).

Reduction of incidence of common infant infections

Milk fat globules and immune health 3

Supplementation of infant formula with MFGM may potentially reduce the incidence of common infant infections (2, 7-9)  Infants fed with MFGM-supplemented formula had a significantly reduced incidence of acute otitis media (p=0.034) compared with infants receiving standard formula (Figure 1). In a double-blind, randomized controlled study, 160 infants were fed formula supplemented with bovine MFGM or standard formula from <2 months until 6 months of age. (2) Parents of infants receiving MFGM supplemented formula reported significantly less antipyretics use than those receiving standard formula. Serum concentrations of immunoglobulins against pneumococci were also significantly lower in the MGFM supplemented group than in those receiving the standard formula, suggesting that immune modulation may be part of the protective effect.

Figure 1. Cumulative incidence of acute otitis media in infants fed formula supplemented with bovine MFGM

Milk fat globules and immune health

Source: Timby et al (2015)

The incidence of diarrhoea may be reduced with MFGM supplementation, according to data from a large (n=550) randomized study. Infants fed an MFGM-enriched formula showed a reduction of incidence of diarrhoea and bloody diarrhoea compared to the control group. (7) Another large trial (n=450) conducted in India found that infants fed a formula supplemented with gangliosides experienced a shorter duration of rota virus diarrhoea than the control group (2.3 vs. 3.8 days; p=0.03) (8). However, the incidence of rotavirus diarrhoea during the study period was lower than expected making the study underpowered. The researchers concluded that further studies against a background of higher seasonal prevalence were needed to assess efficacy of ganglioside-supplemented formula complex milk lipids to reduce the incidence of rotavirus diarrhoea.

FrieslandCampina -Story of milk 1The INPULSE study investigated if MFGM-enriched milk would reduce the incidence of  gastrointestinal and other infections in 182 preschool children (9). The primary endpoints of the study were the number of days with fever, diarrhoea, coughing (assuming infection-related causes) or constipation. The children who consumed phospholipid-enriched chocolate milk for 4 months were reported to have fewer febrile episodes than the children just fed chocolate formula milk. The protective effect from the occurrence of short febrile episodes was apparent after 6 weeks of regular consumption. The results of the INPULSE study also suggested involvement of an immunological effect of MFGM supplementation, although it was not clear whether the effect was associated with the lipid or the protein fraction of the MFGM preparation, or possibly both. (9)

Conclusion

Studies indicate that MFGM may exhibit beneficial anti-infective properties, reducing the incidence of acute otitis media and possibly diarrhoea. However, further clinical studies are required to fully elucidate the role of MFGM in infections and immunity and to determine which of the many compounds present in MFGM are critical for this bioactivity.

References

  1. Rueda, R. (2007). The role of dietary gangliosides on immunity and the prevention of infection. British Journal of Nutrition, 2007; 98:S68-S73.
  2. Timby, N. et al (2015). Infections in infants fed formula supplemented with bovine milk fat globule membranes. Journal of Pediatric Gastroenterology and Nutrition, 2015; 60:384-389.
  3. Hernell, O. et al (2016). Clinical Benefits of Milk Fat Globule Membranes for Infants and Children. The Journal of Pediatrics, 2016; 173:S60-S65.
  4. Verardo, V. et al (2017). Recent Advances in Phospholipids from Colostrum, Milk and Dairy By-Products. International Journal of Molecular Sciences, 2017;18:173.
  5. Hettinga, K. et al (2011). The host defense proteome of human and bovine milk. PLoS One 2011;6:e19433.
  6. Singh H, Gallier S. Food Hydrocoll 2016;In Press.
  7. Zavaleta, N. et al (2011). Efficacy of an MFGM-enriched complementary food in diarrhea, anemia, and micronutrient status in infants. Journal of Pediatric Gastroenterology and Nutrition, 2011;53:561-568.
  8. Poppitt, S.D. et al (2014). Bovine complex milk lipid containing gangliosides for prevention of rotavirus infection and diarrhoea in northern Indian infants. Journal of Pediatric Gastroenterology and Nutrition, 2014;59:167-171.
  9. Veereman-Wauters G. et al (2012). Milk fat globule membrane (INPULSE) enriched formula milk decreases febrile episodes and may improve behavioral regulation in young children. Nutrition, 2012;28:749–752