Milk, a Glucose Uptake Promoter That's More Than the Sum of Its Parts. Plus: HICA & HMB in Yogurt. How Much EAA in Your Protein? Raw Milk Does not Cure Lactose Intolerance

Milk is one of the few foods that are advertized by celebrities that could actually be good for you (photo from the "Got Milk" campaign)

I hope you are not fed up with milk and dairy, yet, because today's SuppVersity short news have a ton of it. What exactly?

Well, after taking a closer look at the surprisingly high amount of HICA and the comparatively small amount of HMB in yogurt and reviewing the EAA content of six common protein sources, we are going to delve deeper into the latest evidence that shows that milk is much more than the sum of its parts, i.e. milk protein, lactose and fat and conclude on a note on another widely known Internet myth that says that people with lactose intolerance could drink raw milk without a problem.

You can learn more about dairy at the SuppVersity

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There is Good A2 and Bad A1 Dairy, True or False?

Lactulose For Your Gut & Overall Health

Is There a "Fat Advantage" for Dairy Lovers

Dairy, Diabetes, Estrogen, IGF-1, Cancer & More

• 

  Figure 1: Amount of HICA & HMB (in µg/L) in commercial whole milk and yogurt (Ehling. 2014)

  Significant amounts of HMB and specifically HICA in yogurt. We all know that yogurt is among the dairy products with the most evidence of significant health benefits. That yogurt could be a decent muscle builder, on the other hand, would be news.
  
  With ~5 mg of β-hydroxy-β-methylbutyric acid (HMB) and up to 12.5 mg of α-hydroxyisocaproic acid (HICA) yogurt would have what it takes if the values of HMB and HICA Stefan Ehling and Todime M. Reddy measured in regular yogurt were on a per gram, not a per liter basis (Ehling. 2014).
• How much EAA in my protein? Since I have been repeatedly questioned about the essential amino acid content in whey, milk, soy, and egg protein. I have published Table 1 which originally appeared in a 2010 study by Hulmi et al. on Facebook, already.

  

  Table 1: Approximate amino acid composition of popular protein powders (Hulmi. 2010)

  For those of you who are missing out on the daily 12+ SuppVersity Facebook News, because they haven't liked www.facebook.com/SuppVersity, yet. I will now publish it again - as a reference source, if you will.
• Milk a glucose uptake promoter that's more than the sum of its parts. In view of the fact that we have already two dairy related news in today's SuppVersity article, I decided to have another "milky news" in today's SuppVersity short news item. One all the milk-drinkers among the SuppVersity readers will cherish.
  
  Recently, Shirin Panahi and colleagues from the University of Toronto, the Mount Saint Vincent University and the University of Guelph published the results of a randomized, cross-over study that was conducted to prove / disprove the hypothesis that

  "[T]hat regulation of postprandial glycemia after milk consumption occurs through both insulin and insulin-independent actions due to interactions among its macronutrient components and energy content. The objective was to compare the effects of isovolumetric (500ml) beverages of whole milk (3.25% M.F.), each of its macronutrient components (protein, lactose and fat) and their combination (a simulated milk beverage) on postprandial glycemia, glucoregulatory and gastrointestinal hormones and gastric emptying in healthy young men" (Panahi. 2014).

  In the course of the study, the 12 young, male subjects consumed beverages containing 500 ml of whole milk (3.25% M.F.) (control), a simulated milk beverage based on milk macronutrients or milk protein (16g), lactose (24g) and milk fat (16g) in isolation.

  

  Table 2: Nutritional composition of the test meals | ^a Composition of each beverage as provided by
  the manufacturer; ^b amounts given are per 500ml serving. Paracetamol (1.5g), vanilla extract (1.2ml)
  and sucralose (0.02g) were added to all beverages (Panahi. 2014).

  What the researchers found was that both the whole and simulated milk had similar beneficial effects on blood glucose rise after their "meal" (drink), but as it turned out the simulated milk resulted in a significantly higher (41%) glucagon-like peptide-1 (GLP-1) production and lower (43%) ghrelin areas under the curve (AUC) than whole milk (P=.01 and P=.04, respectively).

  

  Figure 2: Glucose, insulin, c-peptite, rate of insulin secretion, GLP-1, PYY, CKK
  and ghrelin levels after the test "meals" expressed relative to the sum of the effects
  of the same amount of milk protein, lactose and fat (Panahi. 2014)

  Now, all that would hardly be newsworthy (at least not for regular SuppVersity readers, if the two samples, i.e. both the whole and simulated milk, didn't lower the glucose (P=.0005) levels more than predicted by the sum of AUCs for their components (see Figure 2)!

  "Adjusted for energy content, milks produced lower glucose and hormone responses than predicted from the sum of their components. The effect of protein/kcal on the AUCs was higher than fat/kcal for insulin, C-peptide, insulin secretion rate, GLP-1, CCK and paracetamol (P < .0001), but similar to lactose except for CCK and paracetamol, which were lower. The response in PYY and ghrelin was similar per unit of energy for each macronutrient" (Panahi. 2014).

  In other words: Milk is way more than the sum of it's parts. In that, the "regulation of postprandial glycemia after milk consumption occurs through both insulin and insulin-independent actions due to interactions among its macronutrient components and energy content to achieve lower postprandial glycemia than predicted from the sum of its components" (Panahi. 2014).

If you haven't read it, already, take a look at my rebuttal to the latest assault on milk | read more

Bottom line: Quite the "milky" short news, right? Well, I guess it may be worth topping off all these good news about dairy products with a bad one. The common "Internet wisdom" that raw milk could offset the problems of people with lactose intolerance is a myth.

According to a 2014 paper by Sarah Mummah et al. who tested this myth in 16 adults with self-reported lactose intolerance and lactose malabsorption confirmed by hydrogen (H2) breath testing, "raw milk fail[s] to reduce lactose malabsorption or lactose intolerance symptoms compared with pasteurized milk among adults positive for lactose malabsorption." (Mummah. 2014) The "raw milk can be consumed by anyone" anecdote does thus belong to the realms of scientifically unwarranted die-hard bro-science | Comment on Facebook!

References:

• Ehling, Stefan, and Todime M. Reddy. "Investigation of the Presence of β-Hydroxy-β-methylbutyric Acid and α-Hydroxyisocaproic Acid in Bovine Whole Milk and Fermented Dairy Products by a Validated Liquid Chromatography–Mass Spectrometry Method." Journal of agricultural and food chemistry 62.7 (2014): 1506-1511.
• Hulmi, Juha J., Christopher M. Lockwood, and Jeffrey R. Stout. "Review Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein." (2010).
• Mummah, Sarah, et al. "Effect of Raw Milk on Lactose Intolerance: A Randomized Controlled Pilot Study." The Annals of Family Medicine 12.2 (2014): 134-141. 
• Panahi, Shirin, et al. "Mechanism of action of whole milk and its components on glycemic control in healthy young men." The Journal of nutritional biochemistry (2014).

Whey and Casein Work Hand in Hand for Protein Anabolism, but Scientists Overlook Fat, When They Reassemble Milk

Image 1: Ex-Mr. Universe, Manohar Aich, turns 100 and swears by milk and other whole foods (NYDaily)

Do you know the good old saying that you often only realize what you had, once you have lost it? A recent study by scientists from the Division of Endocrinology at the Mayo Clinic in Rochester (Soop. 2012) is only the latest instance, in which we (in this particularly case not even scientists, but the food industry) disassembled a natural product, namely milk, in order to maximize its benefits (or our revenues?) only to realize now that the the resulting parts - as good as they may be - are not up to what the whole has had in stock for us.

Whey + casein + lactose = almost milk

In order to quantify the quantity and time course of the total body, splachnic (hepatic) and leg protein flux of whey and casein, Mattias Soop, Vandana Nehra, Gregory C. Henderson, Yves Boirie, G. Charles Ford, and K. Sreekumaran Nair conceived a clever experiment. They used differently labeled whey and casein proteins to determine the individual metabolic fate of the two dairy proteins over 7 hours after their ingestion. To this ends, their 18 healthy subjects (6 men, 12 women) who had been consuming a weight-maintaining diet (20% protein, 50% carbohydrate and 30% fat) for three days before the experiment and had reported to the lab the evening before the actual testing procedure took place, ingested one of the following test meals

• 0.625 g/kg LBM whey + casein + 0.9g/kg LBM lactose, or
• 1.85g/kg LBM lactose

In that, it is important to note that the portion sizes were prepared according to the lean not the total body mass of the study participants and that there were two versions of the first test meals ([13C]WP/[15N]Cas and [15N]WP/[13C]Cas) to make sure that the tracer did not influence the protein kinematics.

Figure 1: Mean rates of appearance (left) and disappearance (right) of radiolabeled phenylalanine via the hepatic vein and portal vein, respectively (Soop. 2012)

The results, you see in figure 1, are actually not really surprising, we all know that whey is the faster of the two protein sources and casein takes longer to digest - what is news though is that this is the first time that we can see their individual contribution to the protein flux in different parts of the body upon co-ingestion.

Surprise?! Lactose is not the working ingredient in milk

Similarly unsurprising as the different amino acid kinematics of whey and casein are is probably that lactose alone did not elevate the protein synthesis in the legs of study participants to a similar level as the ~25g of whey + casein test meal (mixed, mitochondrial and sarcoplasmic FSR were elevated to the same roughly the same degree; data not shown).

Figure 2: Insulin, glucagon and glucose increases (peak at ~60min) after ingestion of the test meals (Soop. 2012)

The pronounced insulin response (figure 2), the scientists observed in response to the test meals could yet actually surprise a few of you, I believe. After all, you hear everywhere that the bad, bad carbohydrates are the sinners who will rise your insulin levels and make you fat and sick - now, despite the fact that lactose obviously is a carbohydrate, the insulin spike which followed the ingestion of the test meals was virtually identical. The only difference being that the lactose only test meal also increased the blood sugar levels, while it the sudden increase in insulin in the protein only group involved a significant increase in glucogon, insulins counterpart that is also released by the pancreas in order to increase gluconeogenesis (in this case obviously from amino acids) and keep the blood sugar levels stable.

Scientists put the pieces back together, yet not without making a fat mistake

Image 2: I wonder if those are the physical consequences of drinking skimmed milk - I mean, David looks like he had a hell lot of glucagon going on, right? ... what? You mean David did not even drink milk, just took the money, no - impossible!

Overall, this study therefore confirms two things we should actually have grasped all-along. Firstly, the combination of whey and casein as it is found in milk has worked to nicely for generations of physical culturists, because it is (if you will) "evolutionary" designed to trigger and sustain protein synthesis. And secondly, milk does contain a hell lot of "sugar", to avoid that the protein-induced surge in insulin leads has to be countered by a similarly pronounced secretion of glucagon, to kickstart gluconeogenesis and stabilize the blood sugar levels.

If you will, you could however argue that nature must have a design flaw in its muscle builder #1, after all the amount of carbs appears to be insufficient to fully negate the release of glucagon; yet while the lactose to protein ratio was 1.44 and thus identical to milk, there was one essential component of milk scientists tend to forget missing: fat! And you know what - an increase in free fatty acids as the one that follows the ingestion of the allegedly bat saturated fats blunts the release of glucagon. What? Yeah, nature is actually pretty smart, you are right!