Lönnerdal Bo
Nestle Nutr Inst Workshop Ser. 2016;86:97-107. doi: 10.1159/000442729. Epub 2016 Jun 23.
Breastfeeding has been associated with many benefits, both in the short and in the long term. Infants being breastfed generally have less illness and have better cognitive development at 1 year of age than formula-fed infants. Later in life, they have a lower risk of obesity, diabetes and cardiovascular disease. Several components in breast milk may be responsible for these different outcomes, but bioactive proteins/peptides likely play a major role. Some proteins in breast milk are comparatively resistant towards digestion and may therefore exert their functions in the gastrointestinal tract in intact form or as larger fragments. Other milk proteins may be partially digested in the upper small intestine and the resulting peptides may exert functions in the lower small intestine. Lactoferrin, lysozyme and secretory IgA have been found intact in the stool of breastfed infants and are therefore examples of proteins that are resistant against proteolytic degradation in the gut. Together, these proteins serve protective roles against infection and support immune function in the immature infant. α-lactalbumin, β-casein, κ-casein and osteopontin are examples of proteins that are partially digested in the upper small intestine, and the resulting peptides influence functions in the gut. Such functions include stimulation of immune function, mineral and trace element absorption and defense against infection.
母乳喂养无论在短期还是长期都有诸多益处。与配方奶喂养的婴儿相比,母乳喂养的婴儿通常患病较少,且在1岁时认知发育更好。在其日后的生活中,他们患肥胖症、糖尿病和心血管疾病的风险较低。母乳中的几种成分可能是这些不同结果的原因,但生物活性蛋白质/肽可能起主要作用。母乳中的一些蛋白质对消化相对具有抗性,因此可能以完整形式或作为较大片段在胃肠道中发挥其功能。其他乳蛋白可能在上段小肠中被部分消化,产生的肽可能在小肠下段发挥作用。乳铁蛋白、溶菌酶和分泌型免疫球蛋白A在母乳喂养婴儿的粪便中被完整发现,因此是在肠道中抗蛋白水解降解的蛋白质实例。这些蛋白质共同起到抗感染的保护作用,并支持未成熟婴儿的免疫功能。α-乳白蛋白、β-酪蛋白、κ-酪蛋白和骨桥蛋白是在上段小肠中被部分消化的蛋白质实例,产生的肽会影响肠道功能。这些功能包括刺激免疫功能、矿物质和微量元素吸收以及抗感染。