Milk-and-Dairy-Products-in-Human-Nutrition-FAO

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Chapter 5 – Dairy components, products and human health 217 5.3 Dairy products In recent decades, technological advances have supported the development of new dairy-based products. Although processes such as fermentation have been traditionally used, the dairy sector has developed techniques to produce a diverse range of milk-based products and dairy ingredients. 48 It is now possible to remove specific dairy components for consumers with special dietary needs and specific intolerances. For example, lactose can be removed by hydrolysis or by physical means such as ultrafiltration and chromatography. It is also possible to enrich and fortify dairy products with nutrients such as iron, plant sterols and stanols. Broadly, dairy products can be categorized as basic products, such as fermented milk, cheese and yoghurt, and value-added products, such as low-fat and fortified milks (Nagpal et al., 2012). Some of the health implications associated with fermented and fortified dairy products are outlined in the next section. 5.3.1 Fermented dairy products Much has been written on the nutritional and therapeutic properties of fermented dairy products. Milk fermentation is one of the oldest known food preservation techniques, and involves the transformation of liquid milk into a range of valueadded products by growth of micro-organisms in the milk and/or their activities on milk. Micro-organisms that perform the fermentation process may produce beneficial metabolites (biogenic effect) or may themselves interact with the host in a positive manner (the probiotic effect) (Stanton et al., 2005; Roupas, Williams and Margetts, 2009). The probiotic concept 49 was first introduced in the early 1900s by Russian scientist Elie Metchnikoff of the Pasteur Institute, who hypothesized that the presence of lactose-fermenting bacteria in the colon could prolong life (Metchnikoff, 1908; Candy et al., 2008). Fermented milk products have traditionally been associated with a series of health-promoting properties. In Eastern Europe, the fermented dairy product kephir has a long history of purported health benefits (Ribeiro and Ribeiro, 2010). The Maasai, a Nilo-Hamitic tribe living a nomadic life in the East African Rift Valley of Southern Kenya and Northern Tanzania, consume kule naoto, a traditional fermented milk product (Mathara et al., 2004). The Maasai believe that kule naoto offers protection against ailments such as diarrhoea and constipation, but this has yet to be confirmed scientifically (Mathara, 1999). Fermented camel milk has received attention for its potential medicinal qualities, including the treatment of stomach ulcers, liver disorders, constipation and wounds (El-Agamy, 2009). Shubat, a fermented camel milk, is used as a therapeutic agent to treat tuberculosis in India, Libya and Kazakhstan (El-Agamy, 2009, and references therein). Systematic reviews of individual fermented dairy foods at the population level are however, lacking. 48 Liquid milk refers to whole milk, reduced-fat and fat-free milk, while a milk product is “any product obtained by any processing of milk, which may contain food additives, and other ingredients functionally necessary for the processing” (FAO and WHO, 2007). 49 Probiotics are “live micro-organisms, which when administrated in adequate amounts, confer a health benefit on the host” (FAO and WHO, 2001).
218 Milk and dairy products in human nutrition Fermented milk products may be better tolerated by people with lactose intolerance, primarily because they contain less lactose (Panesar, 2011). In particular, yoghurt containing live bacteria may be better tolerated by lactose malabsorbers because of the β-galactosidase in the yoghurt or the presence of bacteria in the yoghurt that produce β-galactosidase in the small intestine. Furthermore, yoghurt takes longer to pass through the digestive system than does milk, thus allowing more effective breakdown of lactose (Buttriss, 1997). Lactic acid bacteria (LAB) in fermented milks can affect food-borne pathogens. In Zimbabwe, LAB cultures isolated from naturally fermented milk (amasi) were shown to inhibit the survival and growth of the human pathogens Escherichia coli and Salmonella enteriditis (Mufandaedza et al., 2006). In a study from Tibet, the bacteriocins produced by the LAB strains from kurut, a fermented milk, showed antimicrobial activity and were resistant to high temperatures (Luo et al., 2011). However, the authors also remarked that “further research is necessary to purify the bacteriocins and study their detailed characters before its application in food fermentation” (Luo et al., 2011). St-Onge, Farnworth and Jones (2000) reported that “existing evidence from animal and human studies suggests a moderate cholesterol-lowering action of fermented dairy products”, while Kiessling, Schneider and Jahreis (2002) demonstrated that daily consumption of fermented milk products for six months increased serum HDL-cholesterol, and improved the LDL/HDL ratio in women. Andrade and Borges (2009) examined the effect of milk fermented with Lactobacillus acidophilus and Bifidobacterium longum on plasma lipids of women with normal or moderately elevated cholesterol in a double-blind, cross-over study. Women with a baseline total cholesterol greater than 190 mg/dl who consumed the fermented milk showed a reduction in LDL-cholesterol. Other studies have explored the relationship between fermented milk consumption and hypertension. Usinger, Ibsen and Jensen (2009) reviewed human intervention studies of the possible antihypertensive effect of fermented milk and concluded that the “results are diverging, and the antihypertensive effect is still debatable”. Usinger, Reimer and Ibsen (2012) concluded that fermented milk has no effect on blood pressure and that the results of the review “do not give notion to the use of fermented milk as treatment for hypertension or as a lifestyle intervention for pre-hypertension nor would it influence population blood pressure”. Sonestedt et al. (2011) examined the association between the intake of milk, cheese, cream and butter and the incidence of CVD in the Swedish Malmo diet and cancer cohort. The milk was separated into fermented (yoghurt and cultured sour milk) and non-fermented milk. The authors reported that the highest intake category of fermented milk was associated with 15 percent (95 percent confidence interval: 5-24 percent; P trend=0.003) decreased incidence of CVD relative to the lowest intake category. However, such correlations from epidemiological studies do not demonstrate cause-effect relationships, hence caution is needed when interpreting epidemiological results. Interestingly, it has been reported that yoghurt consumption can benefit vulnerable populations, including malnourished people and those with human immunodeficiency virus (HIV) (Solis et al., 2002). Consumption of probiotic yoghurt was reported to improve gastrointestinal symptoms, nutritional intake and tolerance to antiretroviral treatment among a sample of people living with HIV in Mwanza,
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MILK dairy products in and human nu
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cover photo credits front: © EADD/
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iv 2.7 Emerging issues and challeng
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vi 5.2 Dairy components 209 5.2.1 M
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viii 9.2 Key trends and emerging is
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x 2.5 Per capita energy intake from
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xii Preface Billions of people arou
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xiv The publication serves a variet
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xvi (Research Assistant Professor,
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xviii Permissions granted by extern
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xx FPCM fat and protein-corrected m
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xxii Contributors Anthony Bennett j
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xxiv from the National University o
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xxvi Award 2010 along with colleagu
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2 Milk and dairy products in human
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11 Chapter 2 Milk availability: Cur
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Chapter 2 - Milk availability: Curr
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Table 2.5 Volume and share of milk
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41 Chapter 3 Milk and dairy product
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Chapter 3 - Milk and dairy product
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Table 3.1 Proximate composition of
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Table 3.2 (continued) Vitamins Ribo
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Table 3.4 Mineral composition in mi
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Table 3.6 (continued) Riboflavin Vi
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103 Chapter 4 Milk and dairy produc
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Chapter 4 - Milk and dairy products
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Table 4.1 Nutrient content of full
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Table 4.2 Contents of selected nutr
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Table 4.4 Summary of recent review
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Table 7.1 (continued) 308 Country/o
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