Casein addition to a whey-based formula has limited effects on gut function in preterm pigs

Area of Science:

• Neonatal nutrition
• Gastroenterology
• Pediatric research

Background:

• Preterm infants face increased risks of necrotizing enterocolitis (NEC).
• Nutritional strategies are crucial for improving outcomes in preterm neonates.
• The role of different milk protein fractions in preterm gut development requires further investigation.

Purpose of the Study:

• To compare the efficacy of a whey-casein-based formula versus a whey-only formula in preterm pigs.
• To evaluate the impact of these formulas on intestinal sugar absorption and NEC development.
• To assess the effects on gut microbiota and short-chain fatty acid (SCFA) levels.

Main Methods:

• Utilized a preterm pig model (92% gestation) with induced enteral feeding.
• Administered parenteral nutrition followed by enteral formulas (whey vs. whey-casein).
• Assessed in vivo and ex vivo sugar absorption, NEC lesion severity, digestive enzymes, microbiota, and SCFA concentrations.

Main Results:

• Galactose absorption was significantly higher in the whey-casein group at 6 hours post-enteral feeding initiation.
• No significant differences were observed in NEC lesion severity between the diet groups.
• Ex vivo glucose uptake, digestive enzymes, microbiota profiles, and SCFA concentrations did not differ between groups.

Conclusions:

• Casein may offer a transient benefit in stimulating intestinal sugar absorption in preterm neonates.
• Whey-casein-based formulas show limited impact on gut structure, microbiota, and NEC development compared to whey-only formulas in this model.
• Further research is needed to optimize preterm infant formulas for NEC prevention and gut health.