Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, United States.
Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, United States.
Adv Nutr. 2024 Jun;15(6):100229. doi: 10.1016/j.advnut.2024.100229. Epub 2024 May 30.
Donor human milk (DHM) is an essential source of nutrition among high-risk infants (e.g., premature and low-birth weight). Holder pasteurization, a common step in DHM processing, is known to partially alter the composition of DHM; however, the impact on fat composition is historically inconsistent.
This scoping review aimed to broadly review the literature on the impact of Holder pasteurization on the fat content in DHM, with a focus on preanalytical sample mixing.
A systematic search of original, peer-reviewed research articles was conducted on 11 July, 2022. Articles were included if they compared matched raw (control) and Holder-pasteurized human milk samples and measured total lipids, cholesterol, and individual classes of fatty acids. Article review and selection was conducted by 2 independent reviewers.
The search yielded 26 original, peer-reviewed research articles published between 1978 and 2022. Overall methodology varied considerably between studies. When study methods described any mixing for collecting raw milk, 1 (17%) of the 6 of studies reported a small change in total fat concentration following pasteurization (<5%). Alternatively, among studies that did not describe methods for mixing raw milk to ensure a representative sample, 10 (56%) of the 18 reported a significant change (≥± 5%) in total fat concentration, with changes ranging from -28.6% to +19.4%.
This review suggests that inconsistent findings regarding the impact of Holder pasteurization on fat may be related to study methodologies, particularly preanalytical sample mixing. More research considering the role of preanalytical handling procedures and methodologies is necessary to help clarify the impact of Holder pasteurization on human milk composition.
捐赠人母乳（DHM）是高危婴儿（如早产儿和低出生体重儿）的重要营养来源。Holder 巴氏消毒法是 DHM 处理中的常见步骤，已知它会部分改变 DHM 的成分；然而，其对脂肪成分的影响在历史上并不一致。
本范围综述旨在广泛回顾关于 Holder 巴氏消毒对 DHM 中脂肪含量影响的文献，重点关注预分析样品混合。
于 2022 年 7 月 11 日对原始的同行评审研究文章进行了系统搜索。如果文章比较了匹配的原始（对照）和 Holder 巴氏消毒的人乳样本，并测量了总脂质、胆固醇和脂肪酸的各个类别，则将其纳入。文章审查和选择由 2 名独立审查员进行。
搜索结果产生了 26 篇发表于 1978 年至 2022 年之间的原始同行评审研究文章。研究之间的总体方法差异很大。当研究方法描述了采集原始奶的任何混合方法时，6 项研究中有 1 项（17%）报告巴氏消毒后总脂肪浓度有较小变化（<5%）。相反，在未描述混合原始奶以确保代表性样本的方法的研究中，18 项研究中有 10 项（56%）报告总脂肪浓度有显著变化（≥±5%），变化范围从-28.6%到+19.4%。
本综述表明，关于 Holder 巴氏消毒对脂肪影响的不一致发现可能与研究方法有关，特别是预分析样品混合。需要更多考虑预分析处理程序和方法的作用的研究来帮助阐明 Holder 巴氏消毒对人乳成分的影响。
