Dairy Foods: A Matrix for Human Health and Precision Nutrition—Effect of processing infant milk formula on protein digestion and gut barrier health (in vitro and preclinical)

The infant gut is immature and permeable with high gastric pH, low protease activities, and underdeveloped intestinal architecture. Protein digestion in the upper gastrointestinal tract of infants is slow and incomplete. During manufacture, infant milk formula (IMF) is typically heat-treated so it is safe for human consumption. This heat treatment causes denaturation and aggregation of milk proteins, and formation of undesirable Maillard reaction products. The aim of this review is to critically summarize the in vitro and preclinical data available on the effect of IMF thermal processing on protein digestion and gut barrier physiology in the immature infant gut. Recent research efforts have focused on reducing thermal loads during IMF manufacturing by sourcing ingredients with low thermal loads, by reducing temperatures during IMF processing itself, and by seeking alternative processing technologies. This review also aims to evaluate whether these thermal reductions have a knock-on effect on protein digestion and gut barrier health in the infant. The ultimate aim is to create a safe next-generation IMF product that more closely mimics human breast milk in its protein digestion kinetics and its ability to promote gut barrier maturity in the infant.