BLBS102-c26 BLBS102-Simpson March 21, 2012 13:51 Trim: 276mm X 219mm Printer Name: Yet to Come
520 Part 4: MilkNUTRITIONAL AND BIOMEDICAL
PROPERTIES OF EQUID MILKIt is claimed that fresh and fermented equid milk relieve
metabolic and intestinal problems while having a gut-cleansing
effect coupled with ‘repair’ of the intestinal micro-flora. It is
claimed to give relief from stomach ulcers, high blood pressure,
high cholesterol and liver problems and is also recommended
as an aid in the treatment of cancer patients. The recommended
amount of equine milk is 250 mL/d. The most significant use
of equid milk is as a substitute for bovine milk for patients
with cows’ milk protein allergy (CMPA); limited research has
shown that both equine and asinine milks are generally tolerated
well by CMPA patients. The use of equine milk in the produc-
tion of cosmetics is relatively new and includes soaps, creams
and moisturisers (Doreau and Martin-Rosset 2002). At present,
equine milk is available in several forms: frozen milk, frozen
yoghurt-type drink, lyopholised powder, shampoos and various
cosmetic and medicinal creams. Lyopholised equine colostrum
is available and used in the high-value horse industry to feed or-
phaned foals. Marconi and Panfili (1998) suggested that research
is required to identify optimum drying and storage conditions for
powdered equine milk for retention of some of the unique char-
acteristics of raw milk, including high levels of whey proteins,
PUFAs, lysine, tocopherols and vitamin C which are partially de-
stroyed in the preparation of commercial powdered equine milk.
Asinine milk is used to make ice cream and other desserts and
also a fermented milk product. To improve the nutritive value of
asinine milk and increase its overall energy content for human
nutrition, it is frequently supplemented with approximately 4%
medium-chain TGs (Salimei 2011).Cow Milk Protein AllergyEquine and asinine milk, with a composition close to that of
human milk, may be good nutritional sources for the neonate
when breast milk is not available. Bovine milk or bovine milk
products are used traditionally as substitutes for human milk in
infant nutrition but bovine milk is considerably different from
human milk in terms of its macro- and micro-nutrients and the
absorption rates of vitamins and minerals from the two milks
are different, which can be problematic for infants. CMPA is
an IgE-mediated type I allergy, which may be life-threatening,
and is defined as a set of immunologically mediated adverse
reactions which occur following the ingestion of milk, affecting
from 2 to 6% of children in their first year of life. About 50%
of affected children recover after the age of one and 80–90% of
those affected recover by 5 years of age (Caffarelli et al. 2010).
The high frequency of CMPA in infants and children is thought
to be due to an incomplete gut mucosal barrier, increased gut
permeability to large molecules and immature local and systemic
responses which are aided by breast-milk which facilitates gut
maturation and provides passive protection against bacteria and
antigens (Hill 1994).
The difference between bovine milk protein allergy and lac-
tose intolerance is of particular interest and it is an area which
causes much confusion. CMPA is a food allergy, that is an ad-verse immune reaction to a food protein that is normally harm-
less to the non-allergic individual. Lactose intolerance is a non-
allergic food hypersensitivity due to a deficiency of the enzyme
β-galactosidase (lactase), required to hydrolyse lactose. Lactase
deficiency manifests as abdominal symptoms and chronic diar-
rhoea after ingestion of milk (see Bindslev-Jensen 1998, Vesa
et al. 2000). Lactose intolerance is not a disease or malady;
70% of the world’s population is lactose-intolerant. Adverse ef-
fects of lactose intolerance occur at a much higher level of milk
consumption than that which causes milk allergy.
CMPA is important because bovine milk is the first foreign
antigen ingested in large quantities in early infancy. Reviews on
CMPA include: Hill (1994); Hill and Hosking (1996); Taylor
(1986); Høst (1988, 1991); Bindslev-Jensen (1998); Wal (2002,
2004); El-Agamy (2007); Apps and Beattie (2009). Because
β-Lg is absent from human milk, it has commonly been con-
sidered to be the most important cows’ milk allergen (Goldman
et al. 1963, Ghosh et al. 1989) although other whey proteins
(Jarvinen et al. 2001) and caseins (Savilahti and Kuitunen 1992,
Restani et al. 1995) have also been implicated in allergic reac-
tions. In children,β-Lg is the major allergen, whereas casein
appears to be the most allergenic for adults. The resistance of
β-Lg to proteolysis allows the protein to remain intact through
the gastrointestinal tract with the possibility of being absorbed
across the gut mucosa. Ingestedβ-Lg has been detected in hu-
man milk and could be responsible for colic in breast-fed infants
and the sensitisation of infants, predisposing them to allergies
(Jakobsson and Lindberg 1978, Kilshaw and Cant 1984, Stuart
et al. 1984, Jakobsson et al. 1985, Axelsson et al. 1986).
The choice of substitute for cows’ milk in cases of CMPA
depends on two major factors, that is, nutritional adequacy and
allergenicity; cost and taste must also be taken into account.
Many soy or hydrolysate (casein-based, and more recently, whey
protein-based) formulae are available for treatment of CMPA but
they can themselves induce allergic reactions. Heat treatment of
milk may destroy heat-labile proteins, especially BSA and Igs,
and change the antigenic properties of other whey proteins, such
asβ-Lg andα-la, although caseins need severe heat treatment
(121◦C×20 minutes) to reduce sensitising capacity (Hill 1994).
Enzymatic treatment of milk proteins may result in products
with an unacceptable taste due to bitterness arising from the
production of peptides and amino acids and such peptides may,
in fact, be allergenic (Schmidt et al. 1995, Selo et al. 1999, ́
El-Agamy 2007).
Many clinical studies have been carried out on the use of the
milk of different species in infant nutrition, for example goat,
sheep (Restani et al. 2002), camel (El-Agamy 2007), buffalo
(El-Agamy 2007), horse and donkey (Iacono et al. 1992,
Carroccio et al. 2000, El-Agamy et al. 1997, Businco et al. 2000,
Monti et al. 2007). Results on the benefits of such milks are con-
flicting and infants with CMPA may suffer allergic reactions to
buffalo, goat, sheep, donkey or mare milk proteins due to positive
immunological cross-reaction with their counterparts in cows’
milk (El-Agamy 2007). Lara-Villoslada et al. (2005) found that
the balance between casein and whey proteins may be impor-
tant in determining the allergenicity of bovine milk proteins in
humans and that modification of this balance may reduce the