The Swedish medical birth register during five decades: documentation of the content and quality of the register.

Pregnancy-related factors are important for short- and long-term health in mothers and offspring. The nationwide population-based Swedish Medical Birth Register (MBR) was established in 1973. The present study describes the content and quality of the MBR, using original MBR data, Swedish-language and international publications based on the MBR.The MBR includes around 98% of all births in Sweden. From 1982 onwards, the MBR is based on prospectively recorded information in standardized antenatal, obstetric, and neonatal records. When the mother and infant are discharged from hospital, this information is forwarded to the MBR, which is updated annually. Maternal data include information from first antenatal visit on self-reported obstetric history, infertility, diseases, medication use, cohabitation status, smoking and snuff use, self-reported height and measured weight, allowing calculation of body mass index. Birth and neonatal data include date and time of birth, mode of delivery, singleton or multiple birth, gestational age, stillbirth, birth weight, birth length, head circumference, infant sex, Apgar scores, and maternal and infant diagnoses/procedures, including neonatal care. The overall quality of the MBR is very high, owing to the semi-automated data extraction from the standardized regional electronic health records, Sweden's universal access to antenatal care, and the possibility to compare mothers and offspring to the Total Population Register in order to identify missing records. Through the unique personal identity numbers of mothers and live-born offspring, the MBR can be linked to other health registers. The Swedish MBR contains high-quality pregnancy-related information on more than 5 million births during five decades.

Protein efficiency in intensive dairy production: a Swedish example.

BACKGROUND: Animal agriculture has been criticised in terms of its sustainability from several perspectives. Ruminants such as dairy cows can transform inedible, low-quality protein in roughage and by-products from the food industry into the high-quality protein found in milk and meat. Evaluation of the protein conversion efficiency of dairy production from a sustainability and resource perspective must be based on the proportion of the animal feed edible to humans. A relevant metric is thus edible feed protein conversion ratio (eFPCR), i.e. human-edible protein output in cow's milk per unit human-edible protein input in feed. In this study, eFPCR was calculated for five regionally adapted and realistic feed rations fed to Swedish dairy cows producing different annual milk yields typical for high-yielding, intensive dairy production. RESULTS: All scenarios except one showed a protein efficiency ratio of >1 for human-edible protein. Thus, depending on the composition of their diet, most Swedish dairy cows can convert human-inedible protein into edible, high-value protein. However, higher milk yield led to a decrease in eFPCR, regardless of diet. CONCLUSION: Dairy cows in high-yielding, intensive production systems such as those used in Sweden have the capacity to convert low-value inedible protein into high-value edible protein. However, a minor part of the dairy cow diet is edible for humans and this fraction must be minimised to justify dairy production. These results are in line with previous findings on protein conversion efficiency and add scientific input to the debate on sustainable food systems and sustainable diets. © 2017 Society of Chemical Industry.

Effect of shortening or omitting the dry period of Holstein-Friesian cows on casein composition of milk.

The aim of this study was to evaluate the effect of shortening or omitting the dry period of dairy cows on milk casein composition. For this study, we analyzed milk samples of 90 cows with a dry period of 0, 30, or 60d and either a glucogenic or a lipogenic ration in early lactation. Milk was sampled at 6 and 2wk prepartum and at 2, 6, and 12wk postpartum. Milk was analyzed for casein (CN) composition by capillary zone electrophoresis, and isoforms of κ-CN were measured by reversed phase-HPLC. Shortening the dry period from 60 to 30d reduced the αS1-CN fraction by 3.8% and increased the αS2-CN fraction by 5.5%. In milk from cows with a 0-d dry period, the glycosylated κ-CN fraction in late lactation increased from 8 to 12% between 6 and 2wk prepartum. After calving, the glycosylated κ-CN fraction in milk was higher for cows with a 0-d dry period (6.7%) compared with cows with a 60-d dry period (5.2%). The glycosylated κ-CN fraction at 2wk postpartum was negatively correlated with milk yield, suggesting that glycosylation was related to reduced productivity of mammary epithelial cells. In early lactation, the ß-CN fraction was reduced in milk of cows with a 0-d dry period. A lowered ß-CN fraction was associated with high somatic cell count and greater parity, indicating that it was the result of proteolytic activity. In conclusion, casein composition changes that result from shortening the dry period from 60 to 30d are not expected to affect processing characteristics of milk. Applying a 0-d dry period may affect processability of milk because of a higher glycosylated κ-CN fraction, and possibly because of higher proteolytic activity compared with a 60-d dry period.

Potential role of milk fat globule membrane in modulating plasma lipoproteins, gene expression, and cholesterol metabolism in humans: a randomized study.

BACKGROUND: Butter is rich in saturated fat [saturated fatty acids (SFAs)] and can increase plasma low density lipoprotein (LDL) cholesterol, which is a major risk factor for cardiovascular disease. However, compared with other dairy foods, butter is low in milk fat globule membrane (MFGM) content, which encloses the fat. We hypothesized that different dairy foods may have distinct effects on plasma lipids because of a varying content of MFGM. OBJECTIVE: We aimed to investigate whether the effects of milk fat on plasma lipids and cardiometabolic risk markers are modulated by the MFGM content. DESIGN: The study was an 8-wk, single-blind, randomized, controlled isocaloric trial with 2 parallel groups including overweight men and women (n = 57 randomly assigned). For the intervention, subjects consumed 40 g milk fat/d as either whipping cream (MFGM diet) or butter oil (control diet). Intervention foods were matched for total fat, protein, carbohydrates, and calcium. Subjects were discouraged from consuming any other dairy products during the study. Plasma markers of cholesterol absorption and hepatic cholesterol metabolism were assessed together with global gene-expression analyses in peripheral blood mononuclear cells. RESULTS: As expected, the control diet increased plasma lipids, whereas the MFGM diet did not [total cholesterol (±SD): +0.30 ± 0.49 compared with -0.04 ± 0.49 mmol/L, respectively (P = 0.024); LDL cholesterol: +0.36 ± 0.50 compared with +0.04 ± 0.36 mmol/L, respectively (P = 0.024); apolipoprotein B:apolipoprotein A-I ratio: +0.03 ± 0.09 compared with -0.05 ± 0.10 mmol/L, respectively (P = 0.007); and non-HDL cholesterol: +0.24 ± 0.49 compared with -0.14 ± 0.51 mmol/L, respectively (P = 0.013)]. HDL-cholesterol, triglyceride, sitosterol, lathosterol, campesterol, and proprotein convertase subtilisin/kexin type 9 plasma concentrations and fatty acid compositions did not differ between groups. Nineteen genes were differentially regulated between groups, and these genes were mostly correlated with lipid changes. CONCLUSIONS: In contrast to milk fat without MFGM, milk fat enclosed by MFGM does not impair the lipoprotein profile. The mechanism is not clear although suppressed gene expression by MFGM correlated inversely with plasma lipids. The food matrix should be considered when evaluating cardiovascular aspects of different dairy foods. This trial was registered at clinicaltrials.gov as NCT01767077.

Genomic selection in relation to bovine milk composition and processability.

Genomic selection is a new technology in which selection decisions are based on direct genomic values (DGVs) or genomic enhanced breeding values (GEBVs). The objective of this study was to evaluate the relations between DGVs and several milk traits important for both the nutritional value and processability of milk. This is a new approach and can be used to increase the knowledge on how genomic selection can be used in practice. Morning milk samples from Swedish Holstein cows were analyzed for milk composition and technological properties. DGVs were received for each cow for milk, protein and fat yield, milk index, udder health, Nordic total merit and a quota was calculated between fat and milk yield as well as protein and milk yield. The results show that linear correlations exist (P<0·10) between the studied DGVs and contents and yields of parameters in the protein (P=0·002-0·097), fat (P=0·024-0·055) and mineral profiles (P=0·001-0·099) as well as for cheese characteristics (P=0·004-0·065), thus making it possible to obtain detailed information on milk traits that are not registered in the milk recording scheme. Hence, genomic selection will be an efficient tool for breeding and dairy industry to select cows early in life for targeted milk production.

Effect of polymorphisms in the leptin, leptin receptor and acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1) genes and genetic polymorphism of milk proteins on bovine milk composition.

The relations between cow genetics and milk composition have gained a lot of attention during the past years, however, generally only a few compositional traits have been examined. The aim of this study was to determine if polymorphisms in the leptin (LEP), leptin receptor (LEPR) and acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1) genes as well as genetic polymorphism of ß-casein (ß-CN), κ-CN and ß-lactoglobulin (ß-LG) impact several bovine milk composition traits. Individual milk samples from the Swedish Red and Swedish Holstein breeds were analyzed for components in the protein, lipid, carbohydrate and mineral profiles. Cow alleles were determined on the following SNP: A1457G, A252T, A59V and C963T on the LEP gene, T945M on the LEPR gene and Nt984+8(A-G) on the DGAT1 gene. Additionally, genetic variants of ß-CN, κ-CN and ß-LG were determined. For both the breeds, the same tendency of minor allele frequency was found for all SNPs and protein genes, except on LEPA1457G and LEPC963T. This study indicated significant (P<0·05) associations between the studied SNPs and several compositional parameters. Protein content was influenced by LEPA1457G (G>A) and LEPC963T (T>C), whereas total Ca, ionic Ca concentration and milk pH were affected by LEPA1457G, LEPA59V, LEPC963T and LEPRT945M. However, yields of milk, protein, CN, lactose, total Ca and P were mainly affected by ß-CN (A2>A1) and κ-CN (A>B>E). ß-LG was mainly associated with whey protein yield and ionic Ca concentration (A>B). Thus, this study shows possibilities of using these polymorphisms as markers within genetic selection programs to improve and adjust several compositional parameters.

Nutrient density of beverages in relation to climate impact.

The food chain contributes to a substantial part of greenhouse gas (GHG) emissions and growing evidence points to the urgent need to reduce GHGs emissions worldwide. Among suggestions were proposals to alter food consumption patterns by replacing animal foods with more plant-based foods. However, the nutritional dimensions of changing consumption patterns to lower GHG emissions still remains relatively unexplored. This study is the first to estimate the composite nutrient density, expressed as percentage of Nordic Nutrition Recommendations (NNR) for 21 essential nutrients, in relation to cost in GHG emissions of the production from a life cycle perspective, expressed in grams of CO(2)-equivalents, using an index called the Nutrient Density to Climate Impact (NDCI) index. The NDCI index was calculated for milk, soft drink, orange juice, beer, wine, bottled carbonated water, soy drink, and oat drink. Due to low-nutrient density, the NDCI index was 0 for carbonated water, soft drink, and beer and below 0.1 for red wine and oat drink. The NDCI index was similar for orange juice (0.28) and soy drink (0.25). Due to a very high-nutrient density, the NDCI index for milk was substantially higher (0.54) than for the other beverages. Future discussion on how changes in food consumption patterns might help avert climate change need to take both GHG emission and nutrient density of foods and beverages into account.

Revealing the size, conformation, and shape of casein micelles and aggregates with asymmetrical flow field-flow fractionation and multiangle light scattering.

Casein (CN) micelles are naturally occurring colloidal protein aggregates present in a dispersed state in milk. In this paper we aim to obtain a detailed description of physicochemical properties of CN micelles over the entire size distribution using asymmetrical flow field-flow fractionation (AsFlFFF) connected to multiangle light scattering (MALS) and refractive index (RI) detection. Conclusions are drawn on the colloidal level regarding shape and conformation by comparison with models of colloidal particles. By using AsFlFFF-MALS-RI, it is concluded that the CN micelles are highly polydisperse with an average rms radius and hydrodynamic radius of 177 and 116 nm, respectively. The results show that the majority of CN micelles have a spherical shape, whereas a low concentration exists of larger and elongated aggregates. By comparison with models of aggregates of colloidal particles, the aggregates are shown to be anisotropic, e.g., aggregating linearly (threadlike) or in a sheet, rather than forming randomly spherical clusters. The results show that the characterization of colloidal dispersions with AsFlFFF-MALS-RI and the comparison with theoretical models are of a general character and, thus, of fundamental importance for colloidal dispersions.

Relationship between somatic cell count, polymorphonuclear leucocyte count and quality parameters in bovine bulk tank milk.

The somatic cell count (SCC) in bovine bulk tank milk is presently used as an indicator of raw milk quality, reflecting the udder health status of the herd. During mastitis, SCC increases, mostly owing to an influx of polymorphonuclear leucocytes (PMN) from blood into milk, with a concomitant change in milk composition. Bulk tank milk samples were categorized according to their SCC, as well as polymorphonuclear leucocyte count (PMNC), to study relationships between SCC, PMNC and various raw milk quality traits, i.e. contents of total protein, whey protein, casein, fat and lactose, casein number, proteolysis and rheological properties. The proportion of PMN, obtained by direct microscopy, was significantly higher in samples with high SCC compared with low SCC samples. SCC and PMNC were strongly correlated, yielding a correlation coefficient of 0.85. High SCC samples had lower lactose and casein contents, lower casein number and more proteolysis than low SCC samples. Samples with high PMNC had a lower casein number than low PMNC samples. Samples with high and low SCC or PMNC did not differ in respect to rheological properties. Our results do not indicate that PMNC is a better biomarker than SCC for raw bulk tank milk quality, as previously proposed.

Lactoferrin and cancer disease prevention.

Lactoferrin (LF) is an iron-binding glycoprotein that is composed of the transferrin family and is predominantly found in the products of the exocrine glands located in the gateways of the digestive, respiratory, and reproductive systems, suggesting a role in the non-specific defence against invading pathogens. Additionally, several physiological roles have been attributed to LF, namely regulation of iron homeostasis, host defence against infection and inflammation, regulation of cellular growth, and differentiation and protection against cancer development and metastasis. These findings have suggested LF's great potential therapeutic use in cancer disease prevention and/or treatment, namely as a chemopreventive agent. This review looks at the recent advances in understanding the mechanisms underlying the multifunctional roles of LF and future perspectives on its potential therapeutic applications.

Fatty acids in bovine milk fat.

Milk fat contains approximately 400 different fatty acid, which make it the most complex of all natural fats. The milk fatty acids are derived almost equally from two sources, the feed and the microbial activity in the rumen of the cow and the lipids in bovine milk are mainly present in globules as an oil-in-water emulsion. Almost 70% of the fat in Swedish milk is saturated of which around 11% comprises short-chain fatty acids, almost half of which is butyric acid. Approximately 25% of the fatty acids in milk are mono-unsaturated and 2.3% are poly-unsaturated with omega-6/omega-3 ratio around 2.3. Approximately 2.7% are trans fatty acids.

Identification of peptides in milk as a result of proteolysis at different levels of somatic cell counts using LC MALDI MS/MS detection.

The somatic cell count (SCC) in milk is associated with increasing proteolytic degradation of caseins and it has been suggested that enzymes derived from somatic cells contribute to a lower yield and poorer quality of cheese. It is essential to increase the knowledge on naturally occurring milk proteinase activities to better understand how to improve the technological quality of milk. The aim of this work was to identify peptides actually present in milk as a result of proteolysis at different levels of SCC and to assign these peptides to potential responsible proteases where possible. Peptide fractions were prepared from acid whey by ultrafiltration at a molecular cut-off value of 10 000 Da. The peptides were separated using capillary reversed phase high performance liquid chromatography (RP-HPLC) and identified by matrix-assisted laser desorption/ionization-time of flight tandem mass spectrometry (MALDI-TOF MS/MS). Peptides identified ranged in mass from 1023 to 2000 Da, and originated from alphaS1-, alphaS2- or beta-casein. Possible responsible proteases that could be suggested when examining the peptide cleavage sites included plasmin, cathepsin B, D and leukocyte elastase. The results indicated that plasmin was primarily responsible for the observed proteolysis in milk at low cell count, whereas the cathepsins and elastase became implicated at elevated cell count. Specificity and activity of cathepsins and elastase has earlier mainly been studied in model systems, whereas less is known about their activities in milk itself. This is also the first indication of involvement of elastase in milk proteolysis through the unequivocal determination of cleavage sites.

The role of osteopontin in tumor progression and metastasis in breast cancer.

The use of cancer biomarkers to anticipate the outlines of disease has been an emerging issue, especially as cancer treatment has made such positive steps in the last few years. Progress in the development of consistent malignancy markers is imminent because advances in genomics and bioinformatics have allowed the examination of immense amounts of data. Osteopontin is a phosphorylated glycoprotein secreted by activated macrophages, leukocytes, and activated T lymphocytes, and is present in extracellular fluids, at sites of inflammation, and in the extracellular matrix of mineralized tissues. Several physiologic roles have been attributed to osteopontin, i.e., in inflammation and immune function, in mineralized tissues, in vascular tissue, and in kidney. Osteopontin interacts with a variety of cell surface receptors, including several integrins and CD44. Binding of osteopontin to these cell surface receptors stimulates cell adhesion, migration, and specific signaling functions. Overexpression of osteopontin has been found in a variety of cancers, including breast cancer, lung cancer, colorectal cancer, stomach cancer, ovarian cancer, and melanoma. Moreover, osteopontin is present in elevated levels in the blood and plasma of some patients with metastatic cancers. Therefore, suppression of the action of osteopontin may confer significant therapeutic activity, and several strategies for bringing about this suppression have been identified. This review looks at the recent advances in understanding the possible mechanisms by which osteopontin may contribute functionally to malignancy, particularly in breast cancer. Furthermore, the measurement of osteopontin in the blood or tumors of patients with cancer, as a way of providing valuable prognostic information, will be discussed based on emerging clinical data.