Increase of Human Milk Fat Inducing Nutritional Ketosis in Exclusively Breastfed Infant, Brought About by Treating the Mother With Ketogenic Dietary Therapy

Introduction: Medicalized Ketogenic Therapy is commonly used to treat refractory epilepsy. Patients have varying degrees of seizure or symptom relief, responding at individual levels of ketone production. Typically, initiating the therapy necessitates the discontinuation of breastfeeding. Our case study mother was keen to continue breastfeeding if possible. We were able to achieve this by placing the healthy mother on a ketogenic diet and altering the composition of the mother’s own milk. Main Lactation Issue: Pediatric Medicalized Ketogenic Therapy is delivered through a ketogenic diet consisting of up to 90% fat, measuring of ingredients to 0.1 g matching a food prescription of fat, protein, and carbohydrate. We placed the mother on a less stringent ketogenic diet achieving 61% fat and measured both infant and mother’s blood sugar levels and ketones. The hypothesis was that changes would occur in the mother’s own milk fat content, and/or ketones would be passed directly to the infant. If therapeutic levels of ketones were reached in the infant and a reduction in seizures observed, breastfeeding could continue. Management Overview: Over 3 months we achieved a calorific increase of the mother’s mature milk by an additional 134%. The infant was successfully put into nutritional ketosis and visible seizures eliminated. Conclusion: Medicalized Ketogenic Therapy can be safely used to treat seizures of breastfeeding infants diagnosed with epilepsy, through management of the mother on a ketogenic diet. Significantly increasing the mature mothers own milk fat component could have implications for other areas, including faltering growth.

Processing and Palm Oil-Based Food Product Development Opportunities In Indonesia

<p><em></em>Palm oil is produced from the mesocarp part of the oil palm fruit (Elaeis guineensis Jacq.), contains balanced saturated fatty acids (47.8-55.2%) and unsaturated fatty acids (43.1-53.8%), and is semi-solid at room temperature with a melting point of 33.0-39.0 °C. About 80%, palm oil is applied to food products. In food products, palm oil needs to be purified through a refining process to remove free fatty acids, water, and impurities. Palm oil can be fractionated based on differences in melting points to produce palm olein fraction and palm stearin fraction with yields of about 70- 80% and 20-30%, respectively. Food products produced from palm oil and its fractions include cooking oil, vanaspati, shortening, margarine, cocoa butter equivalent, and human milk fat substitute. These food products are produced by modifying the physicochemical characteristics of palm oil and its fractions through blending, hydrogenation, and interesterification processes. The challenge for the palm oil industry in the future is to produce products that are low in contaminants such as 3- monochloropropane-1,2-diol and glycidyl esters, trans-fat free, and products that have high functional and nutritional value, such as structured lipids. Improving the quality and developing diversification of palm oil-based food products will encourage the sustainability of the palm oil industry in Indonesia.</p><p>Keywords: Palm oil, processing, palm oil, food product</p><p> </p><p><strong>Abstrak</strong></p><p><strong>PENGOLAHAN DAN PELUANG PENGEMBANGAN PRODUK PANGAN BERBASIS MINYAK SAWIT DI INDONESI</strong>A</p><p>Minyak sawit dihasilkan dari bagian mesokarp buah tanaman kelapa sawit (Elaeis guineensis Jacq.), mengandung asam lemak jenuh (47,8-55,2%) dan asam lemak tak jenuh (43.1-53,8%) seimbang, dan berbentuk semi padat pada suhu ruang dengan titik leleh sebesar 33,0-39,0°C. Sekitar 80%, minyak sawit diaplikasikan untuk produk pangan. Pada produk pangan, minyak sawit perlu dimurnikan melalui proses rafinasi untuk menghilangkan asam lemak bebas, air dan kotoran. Minyak sawit dapat difraksinasi berdasarkan perbedaan titik leleh untuk menghasilkan fraksi olein sawit dan fraksi stearin sawit dengan rendemen masing-masing sekitar 70- 80% dan 20-30%. Produk pangan yang dapat dihasilkan dari minyak sawit dan fraksi-fraksinya meliputi minyak goreng, vanaspati, shortening, margarin, cocoa butter equivalent dan human milk fat substitute. Produk-produk pangan tersebut dihasilkan dengan memodifikasi karakteristik sifat fisikokimia minyak sawit dan fraksi-fraksinya melalui proses pencampuran (blending), hidrogenasi, dan interesterifikasi. Tantangan industri minyak sawit ke depan adalah menghasilkan produk rendah kontaminan seperti 3-monokloropropana-1,2-diol dan glisidil ester, bebas lemak trans, dan produk yang memiliki nilai fungsional dan nutrisi tinggi seperti lipida terstruktur. Dengan dilakukannya peningkatan kualitas dan pengembangan diversifikasi produk pangan berbasis minyak sawit akan mendorong keberlanjutan industri kelapa sawit di Indonesia.</p><p>Kata kunci: Kelapa sawit, pengolahan, minyak sawit, produk pangan</p>

Production of human milk fat substitute by engineered strains of Yarrowia lipolytica

Human milk fat has a distinctive stereoisomeric structure where palmitic acid is esterified to the middle (sn-2) position on the glycerol backbone of the triacylglycerol and unsaturated fatty acids to the outer (sn-1/3) positions. This configuration allows for more efficient nutrient absorption in the infant gut. However, the fat used in most infant formulas originates from plants, which tend only to esterify palmitic acid to the sn-1/3 positions. Oleaginous yeasts provide an alternative source of lipids for human nutrition. However, these yeasts also exclude palmitic acid from the sn-2 position of their triacylglycerol. Here we show that Yarrowia lipolytica can be engineered to produce triacylglycerol with more than 60% of the palmitic acid in the sn-2 position, by expression of a lysophosphatidic acid phosphatase with palmitoyl-Coenzyme A specificity, such as LPAAT2 from Chlamydomonas reinhardtii. The engineered Y. lipolytica strains can be cultured on glycerol, glucose, palm oil or a mixture of substrates, under nitrogen limited condition, to produce triacylglycerol with a fatty acid composition that resembles human milk fat, in terms of the major molecular species; palmitic, oleic and linoleic acids. Culture on palm oil or a mixture of glucose and palm oil produced the highest lipid titre in shake flask culture and a triacylglycerol composition that is most similar with human milk fat. Our data show that an oleaginous yeast can be engineered to produce a human milk fat substitute (β-palmitate), that could potentially be used as an ingredient in infant formulas.

Enzymatic Synthesis of Human Milk Fat Substitute - A Review on Technological Approaches

Human milk fat substitute (HMFS) is a structured lipid designed to resemble human milk fat. It contains 60-70 % palmitic acid at the sn-2 position and unsaturated fatty acids at the sn-1,3 positions in triacylglycerol structures. HMFS is synthesized by the enzymatic interesterification of vegetable oils, animal fats, or blend of oils. The efficiency of HMFS synthesis can be enhanced through the selection of appropriate substrates, enzymes, and reaction methods. This review focuses on the synthesis of HMFS by lipase-catalyzed interesterification. This work provides a detailed overview of biocatalysts, substrates, synthesis methods, factors influencing the synthesis, and purification process of HMFS. Major challenges and future research in the synthesis of HMFS are also discussed. This review can be used as an information for developing future strategies in producing HMFS.