Branched chain amino acids and other amino acids
Milk is especially rich in essential amino acids and branched chain amino acids. There is evidence that these amino acids have unique roles in human metabolism; in addition to provide substrates for protein synthesis, suppress protein catabolism and serve as substrates for gluconeogenesis, they also trigger muscle protein synthesis and promote protein synthesis [105,106]. Essential amino acids are shown to be more important than non-essential amino acids in muscle protein synthesis [107], and the branched chain amino acid leucine in particular triggers muscle protein synthesis which is sensed by the insulin-signalling pathway [106]. The stimulated insulin secretion caused by milk, is suggested to be caused by milk proteins, and as shown by Nilsson et al. [97] a mixture of leucine, isoleucine, valine, lysine and threonine resulted in glycemic and insulinemic response resembling the response seen after ingestion of whey. A combination of milk with a meal with high glycaemic load (rapidly digested and absorbed carbohydrates) may stimulate insulin release and reduce the postprandial blood glucose concentration [108]. A reduction in postprandial blood glucose is favourable, and it is epidemiological evidence suggesting that milk may lower risk of diseases related to insulin resistance syndrome [109].
Taurine
The concentration of taurine is high in breast milk (about 18 mg/l) and in colostrum from cow, but in regular bovine milk it is not high; about 1 mg/l [110]. Goat milk is however very rich in taurine: 46–91 mg/l [110]. Taurine is an essential amino acid for preterm neonates, and specific groups of individuals are at risk for taurine deficiency and may benefit from supplementation, e.g. patients requiring long-term parenteral nutrition (including premature and newborn infants); diabetes patients, those with chronic hepatic, heart or renal failure [111,112]. It is suggested that during parenteral nutrition, supplementation of 50 mg taurine per kg body weight may be required [113].
Taurine is the most abundant intracellular amino acid in humans. It may be synthesized in the body from methionine and cysteine, but in healthy individuals the diet is the usual source of taurine. It is implicated in numerous biological and physiological functions: bile acid conjugation and cholestasis prevention, antiarrhythmic/inotropic/chronotropic effects, central nervous system neuromodulation, retinal development and function, endocrine/metabolic effects and antioxidant/anti-inflammatory properties [111]. Taurine has been shown to have endothelial protective effects [114], it may function principally as a negative feedback regulator, helping to dampen immunological reactions before they cause too much damage to host tissues or to the leukocytes themselves [115], and it is shown to be analgesic [112,116].
Glutathione (GSH)
Fresh milk may be a good source of glutathione, a tripeptide of the sulphur amino acid cysteine, plus glycine and glutamic acid. In the organism glutathione has the role as an antioxidant. Glutathione can be oxidized forming GSSG (oxidized glutathione), and in this reaction it may remove reactive oxygenspecies (ROS), thereby regulating the level of ROS in the cells. Glutathione participates in regulation of insulin production in the pancreatic cells, as ROS inhibit expression of the pro insulin gene. Glutathione appears to have different important roles in leukocytes, as a growth factor, as an anti-apoptotic factor in leukocytes and to regulate the pattern of cytokine secretion [117]. GSH, moreover, is also central for antioxidative defence in the lungs, which may be very important in connection with lower respiratory infections including influenza [118].