New alternatives to holder pasteurization in processing donor milk in human milk banks.

Infectious and toxicological risks are the main potential hazards that operators of Human Milk Banks (HMBs) encounter and must eliminate. HMBs are trying to implement procedures that allow to manage and sanitize human milk without altering significantly its nutritional and biologically protective components, obtaining a product characterized by a valid balance between safety and biological quality. The history of human milk processing is linked to the origins of HMBs themselves. And although other forms of sterilization were used originally, pasteurization soon became the recognized most effective means for sanitizing milk: all the milk that arrives at the HMB must be pasteurized. Holder pasteurization (HoP) is the most used methodology, and it is performed using low temperature and long time (+62.5°C for 30 min). With HoP some bioactive milk components are lost to varying degrees, but many other precious bioactive compounds are completely or partially preserved. To improve the quality of human milk processed by HMBs, maintaining in the meantime the same microbiological safety offered by HoP, new technologies are under evaluation. At present, High-Temperature Short-Time pasteurization (HTST) and High-Pressure Processing are the most studied methodologies. HTST is already utilized in some HMBs for daily practical activity and for research purposes. They seem to be superior to HoP for a better preservation of some nutritional and biologically protective components. Freeze-drying or lyophilization may have advantages for room temperature storage and transportation. The aim of this study is to evaluate the advancement regarding the processing of DHM with a literature search from 2019 to 2022. The effects of the new technologies on safety and quality of human milk are presented and discussed. The new technologies should assure microbiological safety of the final product at least at the same level as optimized HoP, with an improved preservation of the nutritional and bioactive components of raw human milk.

Clinical Impact of Supplementation with Pasteurized Donor Human Milk by High-Temperature Short-Time Method versus Holder Method in Extremely Low Birth Weight Infants: A Multicentre Randomized Controlled Trial.

Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother's own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods-41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64-1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis.

Psychometric Evaluation of the Powe Fatalism Inventory (PFI).

Background and Purpose: Powe conceptually defined "cancer fatalism" and developed the Powe Fatalism Inventory (PFI) to operationalize cancer fatalism. Researchers report disparate underlying factor structures, and sparse evidence supports the validity and reliability of the PFI. Therefore, the purpose of this study was to examine the psychometric properties of the PFI. Specifically, we aimed to examine its (a) underlying dimensions, (b) internal consistency, and (c) construct validity. Methods: We recruited 400 post-menopausal women, 50-64 years old, for a study on mammographic breast density. Women completed the 15-item PFI and the 8-item Champion Breast Cancer Fear Scale (CBCFS). We conducted item analyses and exploratory factor analysis and evaluated different factor structures. We estimated internal consistency and conducted Pearson correlations between PFI and CBCFS scores to examine construct validity. Results: We found a two-factor solution. Factor 1, Predetermination, had an eigenvalue of 5.2 and explained 43% of the variance with factor loadings ranging from -0.59 to -0.83. Factor 2, Pessimism, had an eigenvalue of 4.5 and explained 15.2% of the variance with factor loadings ranging from 0.63 to 0.77. Both factors together explained 58.2% of the variance. There were no cross-loading items and no item loadings below 0.4. The two subscales both had alphas of .89. Cancer fatalism scores were positively related to fear scores (r =317, p < .001, 95% CI: .222, .406). Conclusion: Using PFI responses from postmenopausal women, we determined that the two-factor solution was the most parsimonious yet theoretically sound factor structure underlying the 15 items of the PFI. The subscales Predetermination (Factor 1; six items) and Pessimism (Factor 2; nine items) were internally consistent with the evidence of the construct validity.

Association between meal intake behavior and blood pressure in Spanish adults / Asociación entre conductas relacionadas con la ingesta de alimentos y tensión arterial en adultos españoles

Introduction and objectives: Eating frequency has been suggested to modify blood pressure. Yet, the results are inconclusive, possibly because eating frequency, particularly meal intake behavior (MIB), does not differentiate between meals and snacks. Hence, the aim of this study was to examine the association between more specific MIBs, like the consumption of the three main meals, the intake of forenoon and afternoon meals and snacking between the regular meals, and systolic/diastolic blood pressure (SBP/DBP). Methods: This cross-sectional study includes 1,314 Spanish adults aged 20-79 years. Data collection occurred during cardiovascular health day events organized in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Linear regression analysis was performed to assess the independent association between the mentioned MIBs and SBP/DBP, controlling for several confounders in multiples models. Results: After adjusting for sex, age and individual risk factors, having an afternoon meal was associated with lower SBP (ß -3.91, 95% CI [-6.33, -1.49]) and DBP (ß -2.35, 95% CI [-3.76, -0.94]). This association was attenuated when introducing dietary intake and waist circumference in the predictive models (SBP: ß -2.83, 95% CI [-5.25, -0.40]; DBP: ß -1.67, 95% CI [-3.04, -0.31]), although it still remained significant. None of the other investigated MIBs showed any associations with SBP/DBP. Conclusions: This study suggests that SBP/DBP might be reduced by the intake of an afternoon meal. However, population-based prospective studies are needed in order to confirm the consequences of the investigated associations on health (AU)

Introducción y objetivos: evidencias sugieren que el número de ingestas alimentarias modifican la presión arterial. Sin embargo, los resultados encontrados no son concluyentes, probablemente debido a que esta conducta relacionada con la ingesta de alimentos (CRIA) no diferencia entre comidas y snacks. Este estudio examina la asociación entre CRIA más específicas como la realización de las tres comidas principales, de la media mañana, de la merienda y picar entre las comidas regulares, y la tensión arterial sistólica y diastólica (TAS y TAD). Métodos: es un estudio transversal, en el cual fueron incluidos 1.314 españoles (20-79 años). Los datos fueron recogidos en las Jornadas de Salud Cardiovascular en Madrid, Las Palmas, Sevilla y Valencia, durante el año 2008. Se aplicaron análisis de regresión lineal, controlando el efecto de diversos factores de confusión en múltiples modelos. Resultados: después de ajustar por sexo, edad y factores de riesgo individual, tomar la merienda se asoció directamente a menor TAS (ß -3,91, 95% CI [-6,33, -1,49]) y TAD (ß -2,35, 95% CI [-3,76, -0,94]). La introducción del consumo alimentario y la circunferencia de cintura en los modelos predictivos atenuó esta asociación (TAS: ß -2,83, 95% CI [-5,25, -0,40]; TAD: ß -1,67, 95% CI [-3,04, -0,31]). Ninguna de las otras CRIA investigadas mostró asociaciones con TAS y TAD. Conclusiones: el estudio sugiere que tanto la TAS como la TAD podrían verse reducidas mediante la ingesta de la merienda, aunque se requieren estudios adicionales para confirmar y profundizar en las consecuencias sobre la salud de las asociaciones investigadas (AU)

¿Cómo se asocian las conductas de consumo de alimentos con la ingesta de frutas y verduras en adultos españoles? / How are meal intake behaviours associated with the consumption of fruit and vegetables among Spanish adults?

Introducción: A pesar de la evidencia de que la ingesta de frutas y verduras es recomendable para la salud, el consumo de ambos grupos de alimentos no es adecuado en España. Objetivo: Identificar conductas de consumo de alimentos (CCA) que se asocien a un consumo recomendado de frutas (CRF) y verduras (CRV). Métodos: Durante las “Jornadas de Prevención en Salud” realizadas en cuatro ciudades de España en 2008, se recogieron datos de 1501 individuos (20-79 años) sobre distintas CCA como el número de comidas realizadas durante el día, comer algo a media mañana y en la merienda y comer entre las cinco comidas principales, así como sobre el consumo diario de raciones de frutas y verduras. Un consumo recomendado fue definido cuando se ingirieron más de una fruta y verdura al día, utilizándolos como variables dependientes en los análisis de regresión logística. Resultado: Tomar más de tres comidas diarias (OR 2.5; IC 95% 1.9-3.2), merendar (OR 2.0; IC 95% 1.5-2.6) y comer a media mañana (OR 1.7; IC 95% 1.3-2.3) se asocian con un CRF. Las probabilidades de un CRV aumenta con más de tres comidas diarias (OR 1.3; IC 95% 1.1-1.6) y comer a media mañana (OR 1.7; IC 95% 1.4-2.1). Las CCA estudiadas se asocian a un CRF y CRV, independientemente del sexo, edad y otros hábitos de vida. Conclusión: De forma que, incentivar la realización de más ingestas diarias, incluyendo consumos a media mañana y en la merienda, deberían ser promovidos en las acciones destinadas a la mejora del estado nutricional de la población española (AU)

Introduction: Despite the evidence that the intake of fruits and vegetables is a healthy habit, the consumption of both food groups is insufficient in Spain. Objective: The study aims to indentify meal intake behaviour (MIB) potentially associated with the recommended consumption of fruits (RCF) and vegetables (RCV). Methods: During the Cardiovascular Health events “Jornadas de Prevención en Salud” in four Spanish cities, we assessed MIB like the daily meal frequency, the intake of forenoon and afternoon meal and snacking between the five main meals, as well as information about the daily rations of fruit and vegetables, from 1501 Spanish adults aged 20-79 years. A recommended consumption was defined when more than one ration of fruit and vegetable were consumed per day and used as dependent variables in logistic regression. Results: Having more than three meals (OR 2.5; IC 95% 1.9-3.2), a forenoon meal (OR 1.7; IC 95% 1.3- 2.3) as well as having an afternoon meal (OR 2.0; IC 95% 1.5-2.6) were associated with the RCF. The probability of a RCV increased with the consumption of more than three meals per day (OR 1.3; IC 95% 1.1- 1.6) and having a forenoon meal (OR 1.7; IC 95% 1.4- 2.1). Our results were independent of sex, age and other lifestyle factors. Conclusion Therefore, the consumption of more than three meals, including a forenoon meal and an afternoon meal should be promoted to improve the nutritional status of the Spanish population (AU)