You are on page 1of 21

Whey Protein Review

Therapeutic Applications
of Whey Protein
Keri Marshall, ND, MS

Abstract environment. The components of whey include


Whey, a protein complex derived from milk, is beta-lactoglobulin, alpha-lactalbumin, bovine se-
being touted as a functional food with a number rum albumin, lactoferrin, immunoglobulins, lac-
of health benefits. The biological components toperoxidase enzymes, glycomacropeptides, lac-
of whey, including lactoferrin, beta- tose, and minerals.2 In additional, whey derived
lactoglobulin, alpha-lactalbumin, from buttermilk versus cheese contains the lipid
glycomacropeptide, and immunoglobulins, sphingomyelin.
demonstrate a range of immune-enhancing Several cultures consider fermented foods
properties. In addition, whey has the ability to part of a healthful diet. Historically, whey was
act as an antioxidant, antihypertensive, considered a cure-all used to heal ailments rang-
antitumor, hypolipidemic, antiviral, ing from gastrointestinal complaints to joint and
antibacterial, and chelating agent. The primary ligament problems. Nanna Rognvaldardottir, an
mechanism by which whey is thought to exert Icelandic food expert, describes how whey, called
its effects is by intracellular conversion of the syra by the Icelandic people, is fermented and
amino acid cysteine to glutathione, a potent stored in barrels. Syra is diluted with water and
intracellular antioxidant. A number of clinical ingested or used as a marinade or preservative for
trials have successfully been performed using meat and other food. Syra was the most common
whey in the treatment of cancer, HIV, hepatitis beverage of Icelandic people and is thought to have
B, cardiovascular disease, osteoporosis, and replaced ale, due to lack of grains in the region.3
as an antimicrobial agent. Whey protein has Today, whey is a popular dietary protein
also exhibited benefit in the arena of exercise supplement purported to provide antimicrobial
performance and enhancement. activity, immune modulation, improved muscle
(Altern Med Rev 2004;9(2):136-156) strength and body composition, and to prevent
cardiovascular disease and osteoporosis. Advances
Introduction in processing technology, including ultrafiltration,
In recent years, milk constituents have microfiltration, reverse osmosis, and ion-ex-
become recognized as functional foods, suggest- change, have resulted in development of several
ing their use has a direct and measurable effect on different finished whey products. Whey protein
health outcomes.1 Whey, a by-product of cheese concentrates (ranging from 80-95 percent protein),
and curd manufacturing, was once considered a reduced lactose whey, whey protein isolate, de-
waste product. The discovery of whey as a func- mineralized whey, and hydrolyzed whey are now
tional food with nutritional applications elevated
whey to a co-product in the manufacturing of Keri Marshall, MS, ND – 1996 Master of Science Social
and Preventive Medicine, State University of New York at
cheese.2 Milk contains two primary sources of Buffalo; 2001 graduate, National College of Naturopathic
protein, the caseins and whey. After processing Medicine. Private practice, Sandpoint, Idaho.
Correspondence address: 515 Pine Street, Suite H,
occurs, the caseins are the proteins responsible for Sandpoint, ID 83864
making curds, while whey remains in an aqueous Email: mackaynd@aol.com

Page 136 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

Table 1. Types of Commercially Available Whey Proteins

Product Description Protein Concentration Fat, Lactose, and Mineral Content

Whey Protein Isolate 90-95% Little if any

Whey Protein Concentrate Ranges from 25-89% Some fat, lactose, and minerals
Most commonly available as 80% As protein concentration increases, fat,
lactose, and mineral content decreases.

Hydrolyzed Whey Protein Variable Varies with protein concentration


Hydrolysis used to cleave peptide bonds
Larger proteins become smaller peptide fractions
Reduces allergic potential compared
with non-hydrolyzed

Undenatured Whey Concentrate Variable Some fat, lactose, and minerals


Usually ranges from 25-89% As protein concentration increases, fat,
lactose, and mineral content decreases.
Processed to preserve native protein
structures; typically have higher amounts
of immunoglobulins and lactoferrin

available commercially. Each whey product var- and incubated for 30 minutes. Rennet extract is
ies in the amount of protein, carbohydrates, im- added and the mixture is stirred, resulting in co-
munoglobulins, lactose, minerals, and fat in the agulation of curd.
finished product. These variables are important Rennet is derived from the abomasum
factors in the selection of whey fractions for spe- (fourth stomach) of newly born calves. Chymosin,
cific nutritional applications. Table 1 describes the the active enzyme ingredient of rennet, aids in the
various whey protein products available. coagulation of milk by separating it into curds and
whey. In a newly born calf, chymosin aides in the
Whey Protein Manufacturing digestion and absorption of milk. Adult cows do
not have this enzyme.
Protein from bovine whole milk consists
The liquid whey is drained through a stain-
of approximately 20-percent whey protein. When
less steel screen and the remaining curd is cut and
casein is removed from whole milk, liquid whey
cooked at 30 degrees C. Whey liquid is then fil-
remains, having a protein concentration of about
tered at 45 degrees C and brought to a pH of 3 by
65 percent. The following is a summary of the
adding citric acid. The liquid is filtered to one-
Ohio State University method of manufacturing
fifth its original volume, resulting in whey con-
whey protein powder. Milk is high-temperature,
centrate that is approximately 80-percent protein.
short-time pasteurized (163 degrees F for 30 sec-
This can be additionally micro-filtered to increase
onds) and held overnight at 40 degrees C. The
protein concentration to as high as 95 percent.
following morning the mixture is cooled to 30
degrees C, inoculated with a lactic acid culture,

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 137


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

Table 2. Amino Acid Residues in Bovine versus Human fat and lactose. In addition,
some manufacturers hydro-
Lactoferrin lyze (cleaving peptide bonds
via enzymes or heat) the whey
Bovine Lactoferrin Human Lactoferrin to provide more peptides and
free amino acids in the final
Alanine 67 63
product.4
Proline 30 35 The commercial suc-
cess of whey protein has led
Arginine 39 43
to the development of high
Lysine 54 46 quality whey protein supple-
Asparagine 29 33 ments manufactured as pri-
mary products and not as a by-
Valine 47 48 product of cheese manufactur-
Tryptophan 13 10 ing. Manufacturers take spe-
cial care to preserve the bio-
Cysteine 34 32 logical activity, native protein
Threonine 36 31 structure, and protein-bound-
fats in the finished product.
Isoleucine 15 16 Proteins are processed under
Serine 45 50 low temperatures and not ex-
posed to fluctuating pH
Glutamine 29 27 changes to avoid denaturing
Glutamic acid 40 42 the native structures. In addi-
tion, the source of milk and the
Phenylalanine 27 30 health of the milking cows is
Methionine 4 5 thought to contribute to im-
mune-enhancing activity of
Leucine 65 58 whey products.5,6
Glycine 48 54
Tyrosine 22 21
Biological
Components
Aspartic Acid 36 38
Amino Acid Content
Histidine 9 9 Collectively, whey
Total number of residues 689 691 proteins have all the essential
amino acids and in higher con-
From: Pierce A, Colavizza D, Benaissa M, et al. Molecular cloning and centrations compared to vari-
sequence analysis of bovine lactoferrin. Eur J Biochem 1991;196:177-184. ous vegetable protein sources
such as soy, corn, and wheat
gluten.2 In addition to having
a full spectrum of amino ac-
The final whey protein concentrate is ids, the amino acids found in whey are efficiently
warmed and spray-dried to achieve whey protein absorbed and utilized, relative to free amino acid
powder. Whey protein concentrates can then be solutions.7
put through an ion-exchange process to remove

Page 138 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

Relative to other protein sources, whey breast-feeding, and serves as a child’s first line of
has a high concentration of branched-chain amino immune defense – referred to as “passive
acids (BCAAs) – leucine, isoleucine, and valine. immunity.” IgA is secreted in breast milk and
BCAAs, particularly leucine, are important fac- ultimately transferred to the digestive tract in the
tors in tissue growth and repair. Leucine has been newborn infant, providing better immunity than a
identified as a key amino acid in protein metabo- bottle-fed child.12 Colostrums contain significantly
lism during the translation-initiation pathway of greater concentrations of immunoglobulins than
protein synthesis.8 mature milk. Immunoglobulins reach maximum
Whey proteins are also rich in the sulfur- concentration the first 24-48 hours post-parturition
containing amino acids cysteine and methionine. and decline in a time-dependent manner following
With a high concentration of these amino acids, peak concentration.13
immune function is enhanced through intracellu- Similarly, the whey fraction of milk ap-
lar conversion to glutathione. pears to contain a significant amount of immuno-
globulins, approximately 10-15 percent of total
Lactoferrin whey proteins. An in vitro study demonstrated bo-
Lactoferrin, an iron-binding glycoprotein, vine milk-derived IgG suppresses human lympho-
is a non-enzymatic antioxidant found in the whey cyte proliferative response to T cells at levels as
fraction of milk as well as in colostrums. The low as 0.3 mg/mL of IgG. The authors further con-
lactoferrin component of whey consists of approxi- clude bovine milk IgG typically ranges between
mately 689 amino acid residues, while human 0.6-0.9 mg/mL and is therefore likely to confer
lactoferrin consists of 691 residues. 9 Whey immunity that could be carried to humans.14 Stud-
lactoferrin is composed of a single polypeptide ies show raw milk from non-immunized cows con-
chain with two binding sites for ferric ions. Be- tain specific antibodies to human rotavirus, as well
fore processing, bovine lactoferrin is only 15-20 as antibodies to bacteria such as E. coli, Salmo-
percent saturated with iron. Iron-depleted nella enteriditis, S. typhimurium, and Shigella
lactoferrin, defined as containing less than five- flexneri.15,16
percent iron, is referred to as apolactoferrin. Hu-
man breast milk contains apolactoferrin.10 The beta-Lactoglobulin
concentration of lactoferrin in human milk and beta-Lactoglobulin represents approxi-
colostrums is approximately 2 mg/mL and 7 mg/ mately half of the total protein in bovine whey,
mL, respectively, while in bovine milk and colos- while human milk contains no beta-lactoglobu-
trums it is approximately 0.2 mg/mL and 1.5 mg/ lin. Besides being a source of essential and
mL, respectively.11 Lactoferrin is a dominant com- branched chain amino acids, a retinol-binding pro-
ponent of whey protein in human breast milk; tein has been identified within the beta-lactoglo-
however, the concentration in most commercial bulin structure. This protein, a carrier of small
whey protein powders is only 0.35-2.0 percent of hydrophobic molecules including retinoic acid, has
total proteins. Table 2 illustrates the difference in the potential to modulate lymphatic responses.17
amino acid profiles between bovine and human
lactoferrin. alpha-Lactalbumin
alpha-Lactalbumin is one of the main
Immunoglobulins proteins found in human and bovine milk. It
An immunoglobulin (Ig) is an antibody comprises approximately 20-25 percent of whey
or gamma-globulin. There are five classes of proteins and contains a wide variety of amino
antibodies – IgA, IgD, IgE, IgG, and IgM. IgG acids, including a readily available supply of
constitutes approximately 75 percent of the essential and branched chain amino acids. Purified
antibodies in an adult. IgG is transferred from alpha-lactalbumin is most readily used in infant
mother to child in utero via cord blood and by

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 139


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

Table 3. Components Found in Whey Protein

Whey Components % of Whey Protein Benefits

beta-Lactoglobulin 50-55% Source of essential and branched chain


amino acids

alpha-Lactalbumin 20-25% Primary protein found in human breast milk


Source of essential and branched chain
amino acids

Immunoglobulins 10-15% Primary protein found in colostrum


Immune modulating benefits

Lactoferrin 1-2% Antioxidant


Antibacterial, antiviral , and antifungal
Promotes growth of beneficial bacteria
Naturally occurs in breast milk, tears,
saliva, bile, blood, and mucus

Lactoperoxidase 0.50% Inhibits growth of bacteria

Bovine Serum Albumin 5-10% Source of essential amino acids


Large protein

Glycomacropeptide 10-15% Source of branched chain amino acids


Lacks the aromatic amino acids
phenylalanine, tryptophan, and tyrosine

formula manufacturing, as it has the most Lactoperoxidase


structurally similar protein profile compared to Whey contains many types of enzymes,
breast milk. However, due to cost effective including hydrolases, transferases, lyases, pro-
measures, most dairy-based infant formulas teases, and lipases. Lactoperoxidase, an important
contain ingredients such as demineralized whey enzyme in the whey fraction of milk, is the most
with higher levels of beta-lactoglobulin, making abundant enzyme and the majority of it ends up in
them less similar to human milk. whey following the curding process. Lactoperoxi-
In a murine study, alpha-lactalbumin, in dase accounts for 0.25-0.5 percent of total protein
both the native and hydrolyzed state, enhanced found in whey. It has the ability to catalyze cer-
antibody response to systematic antigen stimula- tain molecules, including the reduction of hydro-
tion.18 The same group proved alpha-lactalbumin gen peroxide.20 This enzyme system catalyzes
has a direct effect on B-lymphocyte function, as peroxidation of thiocyanate and some halides
well as suppressing T cell-dependent and -independent (such as iodine and bromium), which ultimately
responses.19 generates products that inhibit and/or kill a range
of bacterial species.21 During the pasteurization
process, lactoperoxidase is not inactivated, sug-
gesting its stability as a preservative.

Page 140 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

Glycomacropeptide form. Riboflavin, niacinamide, and glutathione re-


Glycomacropeptide (GMP) is also re- ductase are essential cofactors in the reduction of
ferred to as casein macropeptide. GMP is a pro- glutathione.23 As a result of the glutathione/anti-
tein present in whey at 10-15 percent, due to the oxidant component of whey, it is being investi-
action of chymosin on casein during the cheese- gated as an anti-aging agent.24
making process. GMP is only present when As a detoxifying agent, glutathione per-
chymosin is used during processing; therefore, oxidase (GSHPx), which is derived from selenium
cheeses such as cottage cheese not made with and cysteine, is an endogenous antioxidant enzyme
chymosin do not produce GMP in the curding pro- with the ability to convert lipid peroxides into less
cess.22 GMP is high in branched chain amino ac- harmful hydroxy acids. The peroxidases interact
ids and lacks the aromatic amino acids including with hydrogen peroxide to reduce it to water, ne-
phenylalanine, tryptophan, and tyrosine. It is one gating its oxidative potential. Both glutathione
of the few naturally occurring proteins that lacks peroxidase activity and selenium concentrations
phenylalanine, making it safe for individuals with have been shown to decrease as lactation contin-
phenylketonuria (PKU). ues, peaking at approximately one month after

Bovine Serum
Albumin Figure 1. Synthesis of Glutathione from Cysteine, Glutamate,
Bovine serum and Glycine
albumin (BSA) is a
large protein that makes
up approximately 10-15 Step 1 Glutamic acid Step 2 g-Glutamylcysteine
percent of total whey + +
protein. BSA is a source Cysteine Glycine
of essential amino + +
acids, but there is very ATP ATP
little available informa-
g-Glutamylcysteine Glutathione
tion regarding its poten-
synthetase synthetase
tial therapeutic activity.
Table 3 sum-
marizes the compo-
nents found in whey. g-Glutamylcysteine Glutathione
+ +
ADP ADP
Mechanism of + +
Action P P
Whey has po-
tent antioxidant activ-
ity, likely by contribut-
ing cysteine-rich pro-
teins that aid in the synthesis of glutathione (GSH), initiation. Practitioners use whey protein products
as a source of cysteine to increase intracellular
a potent intracellular antioxidant.2 GSH is com-
glutathione levels25,26 and it has been reported that
prised of glycine, glutamate, and cysteine (Figure
1). Cysteine contains a thiol (sulfhydryl) group GSHPx activity in cow’s milk, and presumably
whey, is the same as in human milk.27
that serves as an active reducing agent in prevent-
ing oxidation and tissue damage. As an antioxi-
dant, glutathione is most effective in its reduced

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 141


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

Studies on lactoferrin have demonstrated increasing hydrolysis and slowing entrance to the
its ability to activate natural killer (NK) cells and small intestine. Whey proteins, on the other hand,
neutrophils, induce colony-stimulating factor ac- do not coagulate under acidic conditions. They are
tivity, and enhance macrophage cytotoxicity.28-31 considered to be “fast proteins,” as they reach the
Lactoferrin also appears to have antivi- jejunum quickly after entering the gastrointesti-
ral, antifungal, and antibacterial properties. The nal tract.40 After reaching the small intestine, the
antimicrobial effect is likely more potent in or- hydrolysis of whey is slower than that of casein,
ganisms that require iron to replicate, as lactoferrin allowing for greater absorption over the length of
has the unique ability to chelate iron in a way that the small intestine.
deprives microorganisms of this essential nutri- A study by Arnal et al demonstrates that
ent for growth.32 In additional, lactoferrin has the whey’s rapid absorption patterns are superior for
ability to release the outer membrane of gram- postprandial protein utilization and overall nitro-
negative bacteria, the lipopolysaccharide compo- gen balance in elderly women.41 Most recently, a
nent, thus acting as an antibiotic.33 randomized, single-blind study examining protein
Lactoferrin demonstrates anti-inflamma- satiety found whey protein to exhibit a higher post-
tory properties. A mouse study revealed lactoferrin prandial level of plasma amino acids compared to
had the ability to regulate levels of tumor necro- casein.42
sis factor (TNF) and interleukin 6 (IL-6), thus A study by Troost et al examined the ef-
decreasing inflammation and, ultimately, mortal- fects of an orally administered recombinant hu-
ity.34 man lactoferrin (rhLF) in the digestive tract. The
In addition to the above-mentioned prop- study population consisted of eight female ileo-
erties, alpha-lactalbumin can chelate heavy met- stomy patients who consumed 5 g rhLF and col-
als.35 It reduces oxidative stress because of its iron- lected full ileostomy output for 24 hours. In a 24-
chelating properties.36 hour period, only 4 µg of lactoferrin were excreted.
Whey has been recently touted as a health- The study concluded dietary rhLF does not reach
ful dietary supplement to reduce blood pressure. the colon because it is digested in the stomach and
Antihypertensive peptides have been isolated in small intestine.43 A similar study by the same group
the primary sequence of bovine beta-lactoglobu- was conducted on 12 healthy volunteers. On three
lin.37 These peptides give whey significant angio- separate days, volunteers were instructed to con-
tensin I converting enzyme (ACE) inhibitory ac- sume 4.5 g lactoferrin. After conclusion of the
tivity, which blocks the conversion of angiotensin study, results revealed bovine lactoferrin survived
I to angiotensin II, a highly potent vasoconstric- passage through the stomach, demonstrating the
tor molecule.38 beta-Lactoglobulin has been de- ability of this protein to survive in an acidic envi-
scribed by Nagaoka et al as a cholesterol-lower- ronment.44
ing agent. In animal studies, beta-lactoglobulin
inhibited cholesterol absorption by changing mi- Clinical Indications for Whey
cellar cholesterol solubility in the intestine.39
Cancer
Whey protein concentrates have been re-
Absorption and Digestion of Milk searched extensively in the prevention and treat-
Proteins: Casein versus Whey and ment of cancer. Glutathione stimulation is thought
Lactoferrin to be the primary immune-modulating mechanism.
The physical manifestations of milk in the In a review of whey protein concentrates in the
gut vary, based on the type of milk protein. Whey treatment of cancer, Bounous discusses the anti-
comprises approximately 20 percent of milk pro- tumor and anticarcinogenic potential. The amino
tein, while 80 percent of protein in milk is casein.32 acid precursors to glutathione available in whey
These two proteins possess quite different prop- might: (1) increase glutathione concentration in
erties. Casein proteins form curds in the stomach, relevant tissues, (2) stimulate immunity, and (3)

Page 142 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

detoxify potential carcinogens.45 Other authors breast, one patient with pancreatic cancer, and one
conclude the iron-binding capacity of whey may with liver cancer.59 Patients were given 30 g whey
also contribute to anticancer potential, as iron may protein concentrate (Immunocal) for six months.
act as a mutagenic agent causing oxidative dam- In six patients, blood lymphocyte GSH was el-
age to tissues.46 evated initially, suggesting high tumor GSH lev-
Many animal studies have examined the els. After completion of the study, two of the pa-
effects of whey and its immune-enhancing com- tients showed signs of tumor regression and a re-
ponents, including lactoferrin and beta-lactoglo- turn of lymphocyte GSH levels to normal, while
bulin.47-54 In animal studies where colon cancer was two patients showed signs of tumor stabilization
induced, whey demonstrated significantly lower without normalization of glutathione levels. Three
incidence of tumors, as well as fewer aberrant patients had progression of disease and lympho-
crypts.47,49,52,54 When whey-based protein powders cyte GSH levels increased from initial measure-
were compared to soy-based protein powders, ments. The conflicting results and small size of
similar effects were also observed.48,52 Yoo et al this study indicate the need for a larger clinical
demonstrated lactoferrin has the ability to inhibit trial to investigate the potential of a whey protein
metastasis of primary tumors in mice with can- concentrate singly and as an adjunct to chemo-
cer.50 Bovine serum albumin (10-15 percent of total therapy.
whey protein) has demonstrated inhibition of In a recent clinical trial, 20 patients with
growth in human breast cancer cells in vitro.55 A stage IV malignancies (one bladder, five breast,
hamster study demonstrated fractionated whey has two prostate, one neuroblastoma, one ovarian, one
the ability to prevent and treat 5-fluorouracil che- gastric, three colon, one mesothelioma, two lym-
motherapy-induced oral mucositis.56 This protec- phoma, two non-small cell lung, and one osteosar-
tion is thought to occur via induction of tumor coma) received a combination of 40 g/day non-
growth factor-beta (TGF-β), which reduces basal denatured whey protein concentrate, 50-100 g/day
epithelial cell proliferation. intravenous Transfer Factor Plus® (a supplement
A recent in vitro study by Kent et al dem- containing several immunoactive components), 1-
onstrated that an isolate of whey protein, when 2 g/day oral ascorbic acid, Agaricus blazei tea, a
compared to a casein-based protein, increased glu- multiple vitamin/mineral complex, 500 mg
tathione synthesis and protected human prostate Andrographis paniculata twice daily, and a soy
cells against oxidant-induced cell death.57 An in extract for six months.60 After six months there
vitro study on a human hepatoma cell line was were 16 survivors, all of whom had significantly
conducted using a high lactoferrin whey concen- higher NK function and higher mean hemoglobin
trate (Immunocal®), a baicalein medium, or a com- and hematocrit levels. All patients noted having
bination of the two.58 Baicalein, a potential anti- an improved quality of life during the course of
cancer drug, is a flavonoid extracted from the study. No comparison was made between this
Scutellaria revularis that is thought to have anti- combination therapy and whey protein alone.
tumor activity. Immunocal alone did not have a
significant impact on the hepatoma cell line. How- Hepatitis
ever, when Immunocal was combined with Whey protein supplementation demon-
baicelein, cytotoxicity was enhanced by inducing strates variable effects in patients infected with
a higher rate of apoptosis than in the group treated Hepatitis B or C. Initially it was found that bo-
with baicalein alone. vine lactoferrin prevented hepatitis C virus (HCV)
To date, few clinical trials on whey and infection in vitro in a human hepatocyte line.61
cancer have been conducted. It has been proposed These results prompted further clinical trials.
that GSH concentrations are high in tumor cells, A pilot study was conducted on 11 patients
giving them resistance to chemotherapeutic with chronic HCV. Each patient received either
agents.59 In 1995, a small trial was conducted on 1.8 or 3.6 g bovine lactoferrin daily for eight
five patients with metastatic carcinoma of the

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 143


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

weeks. In patients with low pre-


treatment viral loads of HCV, de-
Table 4. Comparison of Whey Products Immunocal creases in HCV RNA and serum
and Protectamin alanine transaminase were ob-
served. In patients with higher
pretreatment HCV viral loads,
Amino Acid Immunocal (g/100 g) Protectamin (g/100 g) levels did not change signifi-
cantly.62
Aspartic 9.80 10.50
A dose-response trial of
Glutamic 16.37 17.48 45 individuals with HCV was
Serine 3.56 5.58 conducted at doses of 1.8, 3.6,
Glycine 1.64 1.84 and 7.2 g lactoferrin daily for
eight weeks.63 A virological re-
Histidine 2.04 1.73 sponse was observed in only four
Arginine 2.30 2.24 patients, although HCV RNA
Threonine 4.63 6.97 was still detectable. Eight pa-
tients had a virological response
Alanine 4.80 4.87 – a 50 percent or greater decrease
Proline 3.76 6.01 in HCV RNA – eight weeks af-
Tyrosine 3.76 1.97 ter the treatment ended. There
were no significant variations in
Valine 4.53 6.06 dose-dependant responses. This
Methionine 2.13 2.27 trial left many unanswered ques-
Isoleucine 6.41 6.32 tions for future studies regarding
whey supplementation and HCV,
Leucine 12.56 9.96 including optimum dose, dura-
Phenylalanine 4.00 3.15 tion, and the potential effects of
Lysine 10.68 9.19 combining supplementation with
conventional treatments such as
Tryptophan 2.86 1.53 interferon therapy.
Cysteine/Cystine 4.17 2.28 In an open study on 25
patients diagnosed with either
Hepatitis B or C, patients were
Minerals given 12 g whey (Immunocal)
Sodium 0.3 0.1 twice daily for 12 weeks.64 Prior
Potassium 0.5 0.5 to the start of treatment with
whey, patients were given 12 g
Calcium 0.4 0.3
casein protein daily for two
Chloride 0.4 0.1 weeks. Patients were also given
Phosphate 0.3 0.3 casein following Immunocal for
a four-week period. In the 17 pa-
Magnesium 0.3 0.1
tients with HCV, no significant
From: Micke P, Beeh KM, Buhl R. Effects of long-term supplementation with changes were noted. In the group
whey proteins on plasma glutathione levels of HIV-infected patients. Eur J Nutr with hepatitis B virus (HBV),
2002;41:12-18. serum lipid peroxidase levels
decreased, while IL-2 and NK
activity increased. In six of eight
HBV patients serum alanine

Page 144 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

transferase levels were reduced, while plasma glu- Antimicrobial


tathione levels increased in five of the same eight. Plasma levels of lactoferrin have been
This trial shows promise for the use of whey pro- found to be elevated due to release from neutro-
tein in the treatment of HBV. phils during infection, inflammation, tumor de-
velopment, and iron overload.11 Several studies
Human Immunodeficiency Virus have revealed lactoferrin plays a direct role in the
(HIV) body’s defense against pathogens, including find-
Glutathione deficiency is a common prob- ings that individuals more susceptible to infection
lem for individuals infected with HIV. In an effort have lower levels of neutrophil lactoferrin.69,70
to increase cysteine, and ultimately glutathione, Several studies have examined the effects of whey
several studies have been conducted on the use of protein concentrates on the eradication of
whey proteins in HIV-positive individuals.65,66 In Helicobacter pylori.71-73 H. pylori is widely ac-
a study by Micke et al, 30 subjects with HIV were cepted as the causative agent in over 90 percent
randomized to receive a daily dose of 45 g whey of duodenal ulcer cases.74 To date, the most effec-
protein from one of two sources – Protectamin® tive form of eradication of H. pylori is one week
or Immunocal. The two products have different of a triple antibiotic therapy. Due to the expense
amino acid profiles and Immunocal is produced of treatment and concern for antibiotic resistance,
at a lower isolation temperature (<72 degrees C). new treatments are being sought.
After two weeks of oral supplementation, the In an open, randomized, single-center
Protectamin-supplemented group demonstrated study of 150 individuals with diagnosed H. pylori
significantly elevated glutathione levels, while the infection, patients were given antibiotics at vary-
Immunocal group had statistically non-significant ing doses and durations (range 7-10 days) in con-
elevations. Table 4 compares the amino acid pro- junction with 200 mg encapsulated lactoferrin.73
files of the two products. Analysis of the study revealed 100-percent eradi-
The same researchers conducted a subse- cation of H. pylori in the group using the seven-
quent six-month study, using the same dose and day antibiotic course with the addition of
products.65 Similarly, in the Protectamin group glu- lactoferrin. On the other hand, the “classic” seven-
tathione levels increased within a two-week pe- day triple antibiotic group had a success rate of
riod, while levels in the Immunocal group did not. 76.9 percent, while the 10-day treatment group
All participants were then crossed over to receive demonstrated a 70.8-percent success rate.
Protectamin. After six months, all patients had a In a small study, 12 children suffering
significantly increased glutathione level when from chronic pharyngitis were administered a
compared to baseline numbers. combination of 500 mg erythromycin three times
Two small studies have been conducted daily and 100 mg bovine lactoferrin in a gargle.
on HIV-positive women examining exercise, whey All children tested positive for Group A Strepto-
supplementation, and body composition.67,68 In a cocci. After 15 days of treatment, fewer intracel-
2000 study the author notes an increase in body lular Group A Streptococci were found compared
mass composition with whey supplementation, to a group treated with antibiotics alone.75
whereas the 2001 study notes no effect. Both stud- In a concise review, Shah discusses the
ies note an improvement in quality of life with bacteriostatic and bacteriocidal activity lactoferrin
increased exercise and whey protein intake. Treat- exhibits against a number of organisms, includ-
ment groups received 1.0 g/kg daily of ing Escherichia coli, Salmonella typhimurium,
undenatured bovine-derived whey protein powder. Shigella dysenteriae, Listeria monocytogenes,
Bacillus stearothermophilus, Bacillus subtilis, and
Micrococcus luteus.32,76-79 Shah further discusses
that lactoferrin, when in combination with
lysozyme, is a more potent bacteriostatic agent

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 145


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

against Pseudomonas aeruginosa, Listeria signaling molecule for initiation of protein syn-
monocytogenes, and E. coli.32,80 In addition to the thesis.8,89 It has been speculated that the quality of
above-mentioned bacteria, lactoferrin has also a particular protein for enhancing muscle hyper-
demonstrated antifungal activity toward Candida trophy and strength is related to its leucine con-
albicans.81 tent.36 The amino acid profile in dietary proteins
influences their nitrogen utilization, and poor qual-
Cardiovascular Disease ity dietary proteins have been shown to increase
In recent years, studies have linked a high- nitrogen losses and limit protein synthesis.90,91
fat diet to an increased risk of cardiovascular dis- Human studies documenting the benefi-
ease (CVD). Because CVD is linked to a number cial effect of whey protein supplementation on
of other factors, including increased age, genet- muscle size and strength are limited. Burke et al
ics, obesity, sedentary lifestyle, and alcohol intake, demonstrated that men engaged in resistance train-
quality of dietary fat must be taken into consider- ing programs while supplementing with whey pro-
ation. Milk is composed of more than 12 different tein concentrates showed greater improvements
types of fat, including sphingolipids, free sterols, in strength than men using resistance training
cholesterol, and oleic acid.82 Several studies have alone.92 Forty-two men, ages 18-31, familiar with
found milk intake and milk products lower blood weight training, followed the same high volume,
pressure and reduce the risk of hypertension.83-85 heavy load, and free-weight resistance-training
A study was conducted on a group of 20 program for 12 weeks. The participants were di-
healthy adult males to investigate whether a fer- vided into three groups in double-blind fashion:
mented milk supplement with an added whey pro- whey protein (1.2 g/kg body wt/day), a multi-in-
tein concentrate would affect serum lipids and gredient whey protein sports supplement (1.3 g/
blood pressure.86 The fermented milk contained kg body wt/day), or placebo (1.2 g/kg body wt/
both Lactobacillus casei and Streptococcus day of maltodextrin ). At baseline there were no
thermophilus. During the course of eight weeks, significant differences among the groups in lean
volunteers consumed 200 mL of fermented milk tissue mass or strength as determined by four
with whey protein concentrate or a placebo in the measurements, including bench press, squat,
morning and evening. The placebo consisted of a isokinetic knee extension, and isokinetic knee flex-
non-fermented milk product without the addition ion. After 12 weeks men who received whey pro-
of whey protein concentrate. After eight weeks, tein or the multi-ingredient whey protein sports
the fermented-milk group showed significantly supplement in combination with resistance train-
higher HDLs and lower triglycerides and systolic ing showed greater improvements in one of four
blood pressure than did the placebo group. While muscle strength measurements. In addition, whey
total cholesterol and LDL levels were lower in the supplemented groups showed greater improve-
fermented-milk group, the difference was not sta- ments in lean tissue mass over the placebo group.
tistically significant. While this study does not demonstrate whey
protein’s superiority over other protein sources, it
does show improvement in resistance training with
Exercise the addition of protein supplementation.
Whey protein supplements, including pu- Lands et al showed the effect of three
rified alpha-lactalbumin sports drinks, have been months whey protein supplementation (10 g twice
readily utilized in the consumer market because daily) versus the same amount of casein as placebo
of the high protein quality score and high percent- on muscular performance in 18 men.93 At baseline
age of BCAAs.87 Whey proteins can contain up to there were no significant differences in age, height,
26-percent branched chain amino acids,2,88 which weight, percent ideal body weight, whole leg
are efficient substrates for synthesizing new pro- isokinetic cycle testing, peak power, or 30-second
teins. For example, the BCAA leucine acts as a work capacity. Peak power and 30-second work

Page 146 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

capacity improved significantly in the treatment Obesity


group with no change in the placebo group. Body Obesity has reached epidemic proportions
weight remained unchanged in both groups, but in the United States. Low-fat, high-carbohydrate
the supplemented group had a decrease in percent dietary trends are being eschewed in favor of
body fat. higher-protein, lower-carbohydrate diets. For in-
While moderate exercise enhances immu- dividuals eating high-protein diets, whey is an at-
nity,94 intense athletic training has been shown to tractive source of dietary protein. Whey protein
stress the immune system.95-97 Free radical produc- isolates can be as high as 95-percent protein, after
tion and increased inflammatory activity are the removal of fat and lactose, and contain valu-
thought to contribute to impaired immune activ- able minerals and vitamins. Whey has made a sig-
ity in over-trained athletes. In highly trained indi- nificant commercial impact in the weight-loss in-
viduals muscular performance and recovery can dustry for its protein content alone. The essential
be hindered by oxidative stress.98-100 The availabil- and non-essential amino acids in whey act as sub-
ity of glutathione has been shown to reduce oxi- strates for protein synthesis and may improve body
dative stress.101 mass index in individuals participating in exer-
Acting as a cysteine donor, whey has been cise programs.92
shown to raise intracellular GSH levels in vitro.102 Calcium is thought to influence energy
Lands et al proposed enhanced biosynthesis of metabolism because intracellular calcium regu-
intracellular glutathione, shown by an increase of lates adipocyte lipid metabolism and triglyceride
lymphocyte GSH levels in test subjects, is the storage.108 Zemel et al demonstrated a greater ef-
mechanism responsible for the improved muscu- fect of dairy versus nondairy sources of calcium
lar performance observed in their study.93 for improving body composition. Calcium-forti-
Whey’s amino acid profile makes it ideal fied cereal was compared to calcium-fortified ce-
for body composition and to support protein syn- real plus nonfat dried milk for accelerating weight
thesis and muscle growth. Other bioactive com- and fat loss in mice. The addition of nonfat dried
ponents found in whey might benefit additional milk resulted in substantial amplification of these
aspects of health in active people and trained ath- effects. The mechanism responsible for increased
letes by improving immune function and gas- fat loss found with dairy-based calcium versus
trointestinal health and exhibiting anti-inflamma- nondairy calcium has not yet been elucidated. The
tory activity. Whey components, such as IgA, researchers speculate, “this additional activity re-
glutamine, and lactoferrin, can beneficially impact sides in the whey fraction of milk.” 108 The
common complaints among athletes, including bioactive components in whey are thought to act
repeated infections and gastrointestinal distur- synergistically with calcium to attenuate lipogen-
bances. esis, accelerate lipolysis, and effect nutrient parti-
Lower levels of sIgA and glutamine103,104 tioning between adipose tissue and skeletal
have been found after intensive exercise and in muscle.108
over-trained individuals, and have been correlated While there is increasing evidence dairy
with increased frequency of infection.105 In addi- intake and whey protein may play a role in the
tion, glutamine deficiency has been proposed to prevention and/or attenuation of the rising epi-
contribute to gastrointestinal complaints experi- demic of obesity, there is minimal data to suggest
enced by highly trained individuals.106 Free radi- dairy, calcium from dairy, or whey can impact in-
cal damage is thought to delay muscle recovery dividuals with established obesity.
and impair performance.107 Whey prevents free
radical damage through supporting intracellular
glutathione levels and supplying lactoferrin for
additional antioxidant activity.

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 147


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

Infant Formula and Infantile Colic Osteoporosis


Creating a substitute for mother’s milk has Milk has been proposed as a nutritional
proved to be challenging. It is estimated a nursing food that aids in the prevention of osteoporosis
infant ingests about 3 g lactoferrin daily during the due to its bioavailable calcium content.116 Re-
first week of life,109 whereas a calf drinking two li- searchers have begun to examine the different
ters of milk a day ingests about 2 g lactoferrin daily. components of milk to determine if a particular
It is well accepted that nursing infants have a much isolate is responsible for the bone-protective ef-
richer gut flora than do bottle-fed infants, particu- fects. Initially, in vitro and animal studies deter-
larly with Bifidobacteria and Lactobacilli.2 Such flora mined milk basic protein (MBP), a component of
is normally associated with an increased resistance whey, has the ability to stimulate proliferation and
to colonization of the digestive tract with pathogenic differentiation of osteoblastic cells as well as sup-
bacteria.110 In a study by Roberts et al it was deter- press bone resorption.117-119 MBP is prepared from
mined that the addition of lactoferrin to a feeding fractionated whey through cation exchange resin.
formula increased levels of Bifidobacteria in bottle- The total protein concentration of MBP is 98 per-
fed babies. The levels of Bifidobacteria in formula- cent, containing lactoferrin, lactoperoxidase, and
fed babies that were supplemented with lactoferrin other minor components. Several in vivo studies
were not as high as those found in breast-fed babies. on rats determined that both whey protein and frac-
In addition, Bifidobacteria in formula-fed babies took tionated whey protein had the ability to increase
up to three months to develop, while Bifidobacteria femoral bone strength in young ovariectomized
developed more rapidly in nursing infants.111 rats.120-122
In a double-blind, German study, 102 To date three clinical trials have been con-
healthy infants less than two-weeks old were ran- ducted to determine the effects of MBP in bone
domized to receive either a standard cow’s milk for- metabolism.123-125 In a trial by Toba et al 30 healthy
mula or an infant formula containing partially hy- adult men were given a beverage containing 300
drolyzed whey protein.112 Results of this study indi- mg MBP.123 Subjects were instructed to drink one
cate the whey-protein fed infants had significantly beverage daily for 16 days while maintaining a
more Bifidobacteria in their stools, ultimately afford- normal diet. After 16 days, serum calcium and
ing improved gastrointestinal immunity. It has been urinary calcium excretion were unchanged among
observed in previous studies that higher levels of all subjects. Both serum osteocalcin and
Bifidobacteria in the digestive system decrease the procollagen I carboxy-terminal propeptide (PICP)
potential for developing atopic disease for at-risk levels increased after 16 days, indicating increased
infants with family history.113 bone formation. Osteocalcin and PICP are bio-
A randomized, double-blind, placebo-con- chemical markers released from osteoblasts to
trolled study of 43 infants with diagnosed infantile assess bone formation.
colic was conducted to determine whether a A similar study was conducted on a group
hypoallergenic, hydrolyzed whey formula was su- of 33 healthy adult women to assess bone metabo-
perior to a standard cow’s milk formula.114 Infantile lism.124 Women in the study were randomized to
colic is described as at least three hours per day of receive either a placebo or a 40 mg MBP bever-
crying for at least three days a week for a minimum age daily. Baseline left calcaneus bone-mineral
of three weeks.115 Parents kept a 24-hour diary for density tests were performed on all women, and
two weeks during the study. After a one-week quali- were repeated again at the completion of the study.
fication period, infants in the study were random- Results indicated bone mineral density was sig-
ized to receive either whey or cow’s milk formula nificantly increased in the MBP group compared
for one week. A clinically relevant result was ob- to placebo. Biochemical indices also revealed the
served in the whey formula group, with crying time MBP group exhibited a significant decrease in
reduced to less that one hour per day – a one-hour urinary cross-linked N-teleopeptides, indicating an
greater reduction than found in the cow’s milk inhibition of osteoclast-mediated bone resorption.
formula group.

Page 148 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

The authors state 400-800 mL of milk is equiva- Whey provides protein necessary for wound heal-
lent to the 40 mg dose of MBP. More recently, ing. Surgery stresses the body, altering natural
Yamura et al conducted a similar double-blind defenses, leading to various post-surgical compli-
study examining 30 women over a six-month pe- cations. Zimecki et al demonstrated lactoferrin
riod. Results indicate a daily dose of 40 mg per regulated the immune response and provided pro-
day of MBP significantly increases radial bone tective measures in post-surgical patients.132
density.125 Human studies demonstrated whey pro-
tein improved cognitive function and coping abil-
Gastrointestinal Support ity in highly stressed individuals.133,134 A rise in
A small, randomized, double-blind, cross- serotonin is thought to improve adaptation to
over study was conducted on 10 children with stress,135 and the authors proposed the tryptophan
short bowel syndrome to examine the effect of a available in whey provides a substrate to increase
hydrolyzed versus a non-hydrolyzed whey protein brain serotonin levels. The treatment groups for
on growth and development.126 Energy intake, ni- both studies received alpha-lactalbumin-enriched
trogen balance, intestinal permeability, and weight whey protein because it has the highest tryptophan
gain were similar among all children, indicating concentration of whey protein fractions.
the particular form of whey was not an essential Table 5 summarizes the clinical trials us-
component. In children experiencing bowel resec- ing whey.
tion, food introduction and promotion of normal
growth and development is of utmost importance. Conclusion
The increased transit time of whey proteins in the Milk is one of the oldest functional foods
small intestine makes it an ideal protein source available to mammals. From birth, mammals rely
for this small subset of children. on mother’s milk for nutrition and immune pro-
Whey protein has demonstrated a protec- tection. Scientists are beginning to develop an
tive effect on the gastric mucosa. This effect is understanding of the various components of milk,
thought to be related to the sulfhydryl component, including whey, and how they may impact health
particularly cysteine and its link with glutamic acid and disease. Considerable positive research re-
in the production of glutathione.127,128 Several ani- garding whey and its biological components con-
mal studies have demonstrated this protective ef- tinues to be published. It is noteworthy some of
fect.129,130 In a study by Rosaneli et al, rats fed a the research has been funded by commercial dairy
whey protein concentrate showed a 41-percent organizations, although a significant amount of
reduction in ulcerative lesions caused by ethanol clinical data from Asia was not supported by dairy-
ingestion, while a 73-percent reduction rate was aligned interest groups.
observed following repeat doses of whey.129 A To date, no severe adverse reactions have
study by Matsumoto et al demonstrated an iso- been noted following administration of whey pro-
lated alpha-lactalbumin formula had a four-fold tein products, although some patients note minor
effect on reducing ulcerative lesions compared to gastrointestinal disturbances. For individuals with
a whey protein formula containing only 25-per- frank milk allergies, whey products may not be
cent alpha-lactalbumin.130 suitable, although many individuals sensitive to
dairy find that casein is the culprit and they can
Other Uses of Whey Protein tolerate whey. Other dairy-sensitive individuals are
The wide range of essential and non-es- lactose-intolerant. Most whey proteins are pro-
sential amino acids, minerals, fats, and biologi- cessed to remove lactose and finished whey prod-
cally active proteins in whey provide extensive ucts only contain trace amounts. De-lactosed
application in clinical nutrition. Adequate protein whey, produced from crystallizing a majority of
intake is essential for post-surgical wound heal- the lactose out and recovering the remaining whey,
ing and protein depletion delays healing time.131 is appropriate for lactose-intolerant individuals.

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 149


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

Table 5. Summary of Clinical Trials Using Whey Protein

Condition Dose of Whey Protein Study Duration Results

30 g daily 6 months 2 of 5 patients had tumor regression


Results suggested an increase in
glutathione levels
in healthy cells and decreased
Cancer glutathione levels
in cancer cells

40 g daily 6 months 16/20 survivors at 6 months


Stage 4 malignancies Increased NK cell function
Used other natural Increased glutathione
therapies. Increased hemoglobin and hematocrit
Improved quality of life

Hepatitis B 12 g daily 12 weeks Decreased serum lipid peroxidase levels


Increased IL-2 and NK activity
Decreased serum alanine transferase
activity
Increased plasma glutathione levels

HIV 45 g daily 2 weeks and Increased glutathione levels in both


6 months trials

Cardiovascular Risk 200 mL of fermented milk 8 weeks Increased HDL


Factors combined with liquid Decreased triglycerides
whey daily Decreased systolic BP
Decreased total cholesterol

1.2 g/kg 12 weeks Improved lean tissue mass


body weight daily Improvement in one of four muscle
Exercise strength measurements

10 g twice daily 3 months Significant improvements in peak power


Significant increase of 30-second work
capacity
Increased lymphocyte glutathione levels

Infant Formula Standard Cow Formula 12 weeks Increased Bifidobacteria proportion


vs Increased gastrointestinal immunity
Partially Hydrolyzed Decreased potential for developing
Whey Formula atopic diseases
(doses varied)
1 week Decreased incidence of infantile colic

A challenge test with a small portion of a particu- foods will develop. In addition to the isolated
lar whey supplement for an individual with dairy colostrum, lactoferrin, and alpha-lactalbumin
sensitivities would be indicated before beginning products currently available, glycomacropeptide,
therapeutic amounts. lactoperoxidase, whey immunoglobulin, and
As researchers further investigate whey bovine serum albumin isolated products may be
components it can be expected that new functional investigated.

Page 150 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

Currently the variety of whey proteins 7. Daenzer M, Petzke KJ, Bequette BJ, Metges
available allows for tailoring their use for specific CC. Whole-body nitrogen and splanchnic
amino acid metabolism differ in rats fed mixed
clinical indications. Hydrolyzed whey provides
diets containing casein or its corresponding
readily available di- and tri-peptide fractions at- amino acid mixture. J Nutr 2001;131:1965-
tractive to athletes and other individuals desiring 1972.
a quickly absorbed, low allergenicity protein 8. Anthony JC, Anthony TG, Kimball SR,
source. Undenatured whey provides the highest Jefferson LS. Signaling pathways involved in
concentrations of intact native proteins such as translational control of protein synthesis in
lactoferrin and immunoglobulins for immune skeletal muscle by leucine. J Nutr
2001;131:856S-860S.
modulation. This is attractive to practitioners us-
ing whey as a functional food for immune-com- 9. Pierce A, Colavizza D, Benaissa M, et al.
Molecular cloning and sequence analysis of
promised patients and as an antimicrobial agent. bovine lactotransferrin. Eur J Biochem
Glycomacropeptide isolates do not contain the 1991;196:177-184.
amino acids phenylalanine, tryptophan, or ty- 10. Steijns JM, van Hooijdonk AC. Occurrence,
rosine, providing a valuable protein source for structure, biochemical properties and techno-
individuals with PKU. logical characteristics of lactoferrin. Br J Nutr
Because of the wide variety of whey prod- 2000;84:S11-S17.
ucts, practitioners using whey could benefit from 11. Levay PF, Viljoen M. Lactoferrin: a general
obtaining an analysis of whey proteins being rec- review. Haematologica 1995;80:252-267.
ommended to patients. Helpful information for 12. Bonang G, Monintja HE, Sujudi, van der
deciding whether a particular whey protein is ap- Waaij D. Influence of breastmilk on the
development of resistance to intestinal
propriate for individuals includes total protein colonization in infants born at the Atma Jaya
concentration and percent beta-lactoglobulin, al- Hospital, Jakarta. Scand J Infect Dis
pha-lactalbumin, glycomacropeptides, immuno- 2000;32:189-196.
globulins, bovine serum albumin, and lactoferrin. 13. Kelly G. Bovine colostrums: a review of
In addition, the presence of fat, lactose, and min- clinical uses. Altern Med Rev 2003;8:378-394.
erals should be considered. 14. Kulczycki A Jr, MacDermott RP. Bovine IgG
and human immune responses: Con A-induced
mitogenesis of human mononuclear cells is
References suppressed by bovine IgG. Int Arch Allergy
1. Gill HS, Rutherford KJ, Cross ML. Bovine Appl Immunol 1985;77:255-258.
milk: a unique source of immunomodulatory 15. Losso JN, Dhar J, Kummer A, et al. Detection
ingredients for functional foods. In: Buttriss J, of antibody specificity of raw bovine and
Saltmarsh M, eds. Functional Foods II – human milk to bacterial lipopolysaccharides
Claims and Evidence. Cambridge, England: using PCFIA. Food Agric Immunol
Royal Society of Chemistry Press; 2000:82-90. 1993;5:231-239.
2. Walzem RL, Dillard CJ, German JB. Whey 16. Yolken RH, Losonsky GA, Vonderfecht S, et
components: millennia of evolution create al. Antibody to human rotavirus in cow’s milk.
functionalities for mammalian nutrition: what N Engl J Med 1985;312:605-610.
we know and what we may be overlooking.
17. Guimont C, Marchall E, Girardet JM, Linden
Crit Rev Food Sci Nutr 2002;42:353-375.
G. Biologically active factors in bovine milk
3. Rognvaldardottir N. Icelandic Food and and dairy byproducts: influence on cell culture.
Cookery. New York, NY: Hippocrene Books; Crit Rev Food Sci Nutr 1997;37:393-410.
2001.
18. Bounous G, Kongshavn PA. Influence of
4. Marshall D. Current Concepts on Whey dietary proteins on the immune system of
Protein Usage. http://www.cfids-cab-inform/ mice. J Nutr 1982;112:1747-1755.
Optimist/marshall97.html
19. Bounous G, Kongshavn PA. Differential effect
5. http://www.immunepro.com/ of dietary protein type on the B-cell and T-cell
6. http://www.immunocal.com/Product/ immune responses in mice. J Nutr
setting_the_standard.htm 1985;115:1403-1408.

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 151


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

20. Bjorck L. Antibacterial effect of the lactoper- 34. Machnicki M, Zimecki M, Zagulski T.
oxidase system on psychotrophic bacteria in Lactoferrin regulates the release of tumour
milk. J Dairy Res 1978;45:109-118. necrosis factor alpha and interleukin 6 in vivo.
21. Kussendrager KD, van Hooijdonk AC. Int J Exp Pathol 1993;74:433-439.
Lactoperoxidase: physico-chemical properties, 35. Sundberg J, Ersson B, Lonnerdal B, Oskarsson
occurrence, mechanism of action and applica- A. Protein binding of mercury in milk and
tions. Br J Nutr 2000;84:S19-S25. plasma from mice and man – a comparison
22. Brody EP. Biological activities of bovine between methylmercury and inorganic
glycomacropeptide. Br J Nutr 2000;84:S39- mercury. Toxicology 1999;137:169-184.
S46. 36. Ha E, Zemel MB. Functional properties of
23. Marz R. Medical Nutrition from Marz, 2nd ed. whey, whey components, and essential amino
Portland, OR: Omni Press; 2002. acids: mechanisms underlying health benefits
for active people (review). J Nutr Biochem
24. Bounous G, Gervais F, Amer V, et al. The
2003;14:251-258.
influence of dietary whey protein on tissue
glutathione and the diseases of aging. Clin 37. Mullally MM, Meisel H, FitzGerald RJ.
Invest Med 1989;12:343-349. Synthetic peptides corresponding to alpha-
lactalbumin and beta-lactoglobulin sequences
25. Crinnion WJ. Environmental medicine, part 2 with angiotensin-I-converting enzyme inhibi-
– health effects of and protection from tory activity. Biol Chem Hoppe Seyler
ubiquitous airborne solvent exposure. Altern
1996;377:259-260.
Med Rev 2000;5:133-143.
38. Pihlanto-Leppala A, Koskinen P, Piilola K, et
26. Crinnion WJ. Environmental medicine, part 4: al. Angiotensin I-converting enzyme inhibitory
pesticides – biologically persistent and
properties of whey protein digests: concentra-
ubiquitous toxins. Altern Med Rev 2000;5:432- tion and characterization of active peptides. J
447. Dairy Res 2000;67:53-64.
27. Hojo Y. Sequential study on glutathione
39. Nagaoka S. Studies on regulation of choles-
peroxidase and selenium contents of human terol metabolism induced by dietary food
milk. Sci Total Environ 1986;52:83-91. constituents or xenobiotics. J Jpn Soc Nutr
28. Nishiya K, Horwitz DA. Contrasting effects of Food Sci 1996;49:303-313.
lactoferrin on human lymphocyte and mono- 40. Boirie Y, Dangin M, Gachon P, et al. Slow and
cyte natural killer activity and antibody- fast dietary proteins differently modulate
dependent cell-mediated cytotoxicity. J
postprandial protein accretion. Proc Natl Acad
Immunol 1982;129:2519-2523. Sci U S A 1997;94:14930-14935.
29. Gahr M, Speer CP, Damerau B, Sawatzki G. 41. Arnal MA, Mosoni L, Boirie Y, et al. Protein
Influence of lactoferrin on the function of
pulse feeding improves protein retention in
human polymorphonuclear leukocytes and elderly women. Am J Clin Nutr 1999;69:1202-
monocytes. J Leukoc Biol 1991;49:427-433. 1208.
30. Sawatzki G, Rich IN. Lactoferrin stimulates
42. Hall WL, Millward DJ, Long SJ, Morgan LM.
colony stimulating factor production in vitro Casein and whey exert different effects on
and in vivo. Blood Cells 1989;15:371-385. plasma amino acid profiles, gastrointestinal
31. McCormick JA, Markey GM, Morris TC. hormone secretion and appetite. Br J Nutr
Lactoferrin-inducible monocyte cytotoxicity 2003;89:239-248.
for K562 cells and decay of natural killer 43. Troost FJ, Saris WH, Brummer RJ. Orally
lymphocyte cytotoxicity. Clin Exp Immunol
ingested human lactoferrin is digested and
1991;83:154-156. secreted in the upper gastrointestinal tract in
32. Shah NP. Effects of milk-derived bioactives: vivo in women with ileostomies. J Nutr
an overview. Br J Nutr 2000;84:S3-S10. 2002;132:2597-2600.
33. Tomita M, Wakabayashi H, Yamauchi K, et al. 44. Troost FJ, Steijns J, Saris WH, Brummer RJ.
Bovine lactoferrin and lactoferricin derived Gastric digestion of bovine lactoferrin in vivo
from milk: production and applications. in adults. J Nutr 2001;131:2101-2104.
Biochem Cell Biol 2002;80:109-112. 45. Bounous G. Whey protein concentrate (WPC)
and glutathione modulation in cancer treat-
ment. Anticancer Res 2000;20:4785-4792.

Page 152 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

46. Weinberg ED. The role of iron in cancer. Eur J 58. Tsai WY, Chang WH, Chen CH, Lu FJ.
Cancer Prev 1996;5:19-36. Enhancing effect of patented whey protein
47. Sekine K, Watanabe E, Nakamura J, et al. isolate (Immunocal) on cytotoxicity of an
Inhibition of azoxymethane-initiated colon anticancer drug. Nutr Cancer 2000;38:200-
tumor by bovine lactoferrin administration in 208.
F344 rats. Jpn J Cancer Res 1997;88:523-526. 59. Kennedy RS, Konok GP, Bounous G, et al.
48. Smithers GW, McIntosh GH, Regester GO, et The use of a whey protein concentrate in the
al. Anti-cancer effects of dietary whey pro- treatment of patients with metastatic carci-
teins. Proceedings of the Second International noma: a phase I-II clinical trial study. Antican-
Whey Conference 1998;9804:306-309. cer Res 1995;15:2643-2649.
49. Tsuda H, Sekine K, Nakamura J, et al. Inhibi- 60. See D, Mason S, Roshan R. Increased tumor
tion of azoxymethane initiated colon tumor necrosis factor alpha (TNF-alpha) and natural
and aberrant crypt foci development by bovine killer cell (NK) function using an integrative
lactoferrin administration in F344 rats. Adv approach in late stage cancers. Immunol Invest
Exp Med Biol 1998:443:273-284. 2002;31:137-153.
50. Yoo YC, Watanabe S, Watanabe R, et al. 61. Ikeda M, Sugiyama K, Tanaka T, et al.
Bovine lactoferrin and lactoferricin inhibit Lactoferrin markedly inhibits hepatitis C virus
tumor metastasis in mice. Adv Exp Med Biol infection in cultured human hepatocytes.
1998;443:285-291. Biochem Biophys Res Commun 1998;245:549-
553.
51. Tsuda H, Sekine K, Ushida Y, et al. Milk and
dairy products in cancer prevention: focus on 62. Tanaka K, Ikeda M, Nozaki A, et al.
bovine lactoferrin. Mutat Res 2000;462:227- Lactoferrin inhibits hepatitis C virus viremia in
233. patients with chronic hepatitis C: a pilot study.
Jpn J Cancer Res 1999;90:367-371.
52. Hakkak R, Korourian S, Shelnutt SR, et al.
Diets containing whey proteins or soy protein 63. Okada S, Tanaka K, Sato T, et al. Dose-
isolate protect against 7,12- response trial of lactoferrin in patients with
dimethylbenz(a)anthracene-induced mammary chronic hepatitis C. Jpn J Cancer Res
tumors in female rats. Cancer Epidemiol 2002;93:1063-1069.
Biomarkers Prev 2000;9:113-117. 64. Watanabe A, Okada K, Shimizu Y, et al.
53. Hakkak R, Korourian S, Ronis MJ, et al. Nutritional therapy of chronic hepatitis by
Dietary whey protein protects against whey protein (non-heated). J Med
azoxymethane-induced colon tumors in male 2000;31:283-302.
rats. Cancer Epidemiol Biomarkers Prev 65. Micke P, Beeh KM, Buhl R. Effects of long-
2001;10:555-558. term supplementation with whey proteins on
54. Kuhara T, Iigo M, Itoh T, et al. Orally adminis- plasma glutathione levels of HIV-infected
tered lactoferrin exerts an antimetastatic effect patients. Eur J Nutr 2002;41:12-18.
and enhances production of IL-18 in the 66. Micke P, Beeh KM, Schlaak JF, Buhl R. Oral
intestinal epithelium. Nutr Cancer supplementation with whey proteins increases
2000;38:192-199. plasma glutathione levels of HIV-infected
55. Laursen I, Briand P, Lykkesfeldt AE. Serum patients. Eur J Clin Invest 2001;31:171-178.
albumin as a modulator on growth of the 67. Agin D, Kotler DP, Papandreou D, et al.
human breast cancer cell line MCF-7. Antican- Effects of whey protein and resistance exercise
cer Res 1990;10:343-351. on body composition and muscle strength in
56. Clarke J, Butler R, Howarth G, et al. Exposure women with HIV infection. Ann N Y Acad Sci
of oral mucosa to bioactive milk factors 2000;904:607-609.
reduces severity of chemotherapy-induced 68. Agin D, Gallagher D, Wang J, et al. Effects of
mucositis in the hamster. Oral Oncol whey protein and resistance exercise on body
2002;38:478-485. cell mass, muscle strength, and quality of life
57. Kent KD, Harper WJ, Bomser JA. Effect of in women with HIV. AIDS 2001;15:2431-
whey protein isolate on intracellular glu- 2440.
tathione and oxidant-induced cell death in
human prostate epithelial cells. Toxicol In Vitro
2003;17:27-33.

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 153


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

69. Boxer LA, Coates TD, Haak RA, et al. 82. Groziak SM, Miller GD. Natural bioactive
Lactoferrin deficiency associated with altered substances in milk and colostrum: effects on
granulocyte function. N Engl J Med the arterial blood pressure system. Br J Nutr
1982;307:404-410. 2000;84:S119-S125.
70. Breton-Gorius J, Mason DY, Buriot D, et al. 83. Ackley S, Barrett-Conner E, Suarez L. Dairy
Lactoferrin deficiency as a consequence of a products, calcium, and blood pressure. Am J
lack of specific granules in neutrophils from a Clin Nutr 1983;38:457-461.
patient with recurrent infections. Detection by 84. Appel LJ, Moore TJ, Obarzanek E, et al. A
immunoperoxidase staining for lactoferrin and clinical trial of the effects of dietary patterns
cytochemical electron microscopy. Am J on blood pressure. DASH Collaborative
Pathol 1980;99:413-428. Research Group. N Eng J Med 1997;336:1117-
71. Early EM, Hardy H, Forde T, Kane M. 1124.
Bactericidal effect of a whey protein concen- 85. Svetkey LP, Simons-Morton D, Vollmer WM,
trate with anti-Helicobacter pylori activity. J et al. Effects of dietary patterns on blood
Appl Microbiol 2001;90:741-748. pressure: subgroup analysis of the Dietary
72. Di Mario F, Aragona G, Dal Bo N, et al. Use Approaches to Stop Hypertension (DASH)
of bovine lactoferrin for Helicobacter pylori randomized clinical trial. Arch Intern Med
eradication. Dig Liver Dis 2003;35:706-710. 1999;159:285-293.
73. Di Mario F, Aragona G, Bo ND, et al. Use of 86. Kawase M, Hashimoto H, Hosoda M, et al.
lactoferrin for Helicobacter pylori erdication. Effect of administration of fermented milk
Preliminary results. J Clin Gastroenterol containing whey protein concentrate to rats
2003;36:396-398. and healthy men on serum lipids and blood
74. No authors listed. NIH Consensus Conference. pressure. J Dairy Sci 2000;83:255-263.
Helicobacter pylori in peptic ulcer disease. 87. Tawa NE Jr, Goldberg AL. Suppression of
NIH Consensus Development Panel on muscle protein turnover and amino acid
Helicobacter pylori in Peptic Ulcer Disease. degradation by dietary protein deficiency. Am
JAMA 1994;272:65-69. J Physiol 1992;263:E317-E325.
75. Ajello M, Greco R, Giansanti F, et al. Anti- 88. Bos C, Gaudichon C, Tome D. Nutritional and
invasive activity of bovine lactoferrin towards physiological criteria in the assessment of milk
group A Streptococci. Biochem Cell Biol protein quality for humans. J Am Coll Nutr
2002;80:119-124. 2000;19:191S-205S.
76. Batish VK, Chander H, Zumdegeni KC, et al. 89. Kimball SR, Jefferson LS. Control of protein
Antibacterial activity of lactoferrin against synthesis by amino acid availability. Curr
some common food-borne pathogenic organ- Opin Clin Nutr Metab Care 2002;5:63-67.
isms. Aust J Dairy Tech 1988;5:16-18. 90. Tome D, Bos C. Dietary protein and nitrogen
77. Payne KD, Davidson PM, Oliver SP. Influence utilization. J Nutr 2000;130:1868S-1873S.
of bovine lactoferrin on the growth of Listeria 91. Millward DJ, Pacy PJ. Postprandial protein
monocytogenes. J Food Prot 1990;53:468-472. utilization and protein quality assessment in
78. Saito H, Miyakawa H, Tamura Y, et al. Potent man. Clin Sci (Lond) 1995;88:597-606.
bactericidal activity of bovine lactoferrin 92. Burke DG, Chilibeck PD, Davidson KS, et al.
hydrolysate produced by heat treatment at The effect of whey protein supplementation
acidic pH. J Dairy Sci 1991;74:3724-3730. with and without creatine monohydrate
79. Yamauchi K. Biologically functional proteins combined with resistance training on lean
in milk and peptides derived from milk tissue mass and muscle strength. Int J Sport
proteins. Bull Int Dairy Fed 1992;272:51. Nutr Exerc Metab 2001;11:349-364.
80. Suzuki T, Yamauchi K, Kawase K, et al. 93. Lands LC, Grey VL, Smountas AA. Effect of
Collaborative bacteriostatic activity of bovine supplementation with a cysteine donor on
lactoferrin with lysozyme against E. coli. Agric muscular performance. J Appl Physiol
Biol Chem 1989;53:1705-1706. 1999;87:1381-1385.
81. Jones EM, Smart A, Bloomberg G, et al.
Lactoferricin, a new antimicrobial peptide.
J Appl Bacteriol 1994;77:208-214.

Page 154 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Review Whey Protein

94. Davis JM, Murphy EA, Brown AS, et al. 109. Reiter B. The biological significance of the
Effects of moderate exercise and oat beta- non-immunoglobulin protective proteins in
glucan on innate immune function and milk: lysozome, lactoferrin, lactoperoxidase.
susceptibility to respiratory infection. Am J Dev Dairy Chem 1985;3:281-336.
Physiol Regul Integr Comp Physiol 110. Van Hooijdonk AC, Kussendrager KD, Steijns
2004;286:R366-R372. JM. In vivo antimicrobial and antiviral activity
95. Nieman DC. Is infection risk linked to exercise of components in bovine milk and colostrum
workload? Med Sci Sports Exerc involved in non-specific defence. Br J Nutr
2000;32:S406-S411. 2000;84:S127-S134.
96. Mackinnon LT. Chronic exercise training 111. Roberts AK, Chierici R, Sawatzki G, et al.
effects on immune function. Med Sci Sports Supplementation of an adapted formula with
Exerc 2000;32:S369-S376. bovine lactoferrin: 1. Effect on the infant
97. Nieman DC. Exercise and resistance to faecal flora. Acta Paediatr 1992;81:119-124.
infection. Can J Physiol Pharmacol 112. Schmelzle H, Wirth S, Skopnik H, et al.
1998;76:573-580. Randomized double-blind study of the
98. Gohil K, Viguie C, Stanley WC, et al. Blood nutritional efficacy and bifidogenicity of a new
glutathione oxidation during human exercise. infant formula containing partially hydrolyzed
J Appl Physiol 1988;64:115-119. protein, a high beta-palmitic acid level, and
nondigestible oligosaccharides. J Pediatr
99. Sastre J, Asensi M, Gasco E, et al. Exhaustive
Gastroenterol Nutr 2003;36:343-351.
physical exercise causes oxidation of glu-
tathione status in blood: prevention by 113. Kalliomaki M, Kirjavainen P, Eerola E, et al.
antioxidant administration. Am J Physiol Distinct patterns of neonatal gut microflora in
1992;263:R992-R995. infants in whom atopy was and was not
developing. J Allergy Clin Immunol
100. Sen CK, Atalay M, Hanninen O. Exercise- 2001;107:129-134.
induced oxidative stress: glutathione supple-
mentation and deficiency. J Appl Physiol 114. Lucassen PL, Assendelft WJ, Gubbels JW, et
1994;77:2177-2187. al. Infantile colic: crying time reduction with a
whey hydrolysate: a double-blind, randomized,
101. No authors listed. Glutathione, reduced (GSH).
placebo-controlled trial. Pediatrics
Monograph. Altern Med Rev 2001;6:601-607. 2000;106:1349-1354.
102. Bounous G, Gold P. The biological activity of 115. Wessel MA, Cobb JC, Jackson EB, et al.
undenatured dietary whey proteins: role of
Paroxysmal fussing in infancy, sometimes
glutathione. Clin Invest Med 1991;14:296-309. called colic. Pediatrics 1954;14:421-435.
103. Gleeson M. Mucosal immune responses and 116. Silverwood B. Building healthy bones.
risk of respiratory illness in elite athletes.
Paediatr Nurs 2003;15:27-29.
Exerc Immunol Rev 2000;6:5-42.
117. Toba Y, Takada Y, Yamamura J, et al. Milk
104. Castell LM. Can glutamine modify the basic protein: a novel protective function of
apparent immunodepression observed after
milk against osteoporosis. Bone 2000;27:403-
prolonged, exhaustive exercise? Nutrition 408.
2002;18:371-375.
118. Takada Y, Aoe S, Kumegawa M. Whey protein
105. Gleeson M, Lancaster GI, Bishop NC. Nutri-
stimulated the proliferation and differentiation
tional strategies to minimise exercise-induced of osteoblastic MC3T3-E1 cells. Biochem
immunosuppression in athletes. Can J Appl Biophys Res Commun 1996;223:445-449.
Physiol 2001;26:S23-S35.
119. Takada Y, Kobayashi N, Matsuyama H, et al.
106. Pals KL, Chang RT, Ryan AJ, Gisolfi CV. Whey protein suppresses the osteoclast
Effect of running intensity on intestinal mediated bone resorption and osteoclast cell
permeability. J Appl Physiol 1997;82:571-576.
formation. Int Dairy J 1997;7:821-825.
107. Vesovic D, Borjanovic S, Markovic S, 120. Takada Y, Kobayashi N, Kato K, et al. Effects
Vidakovic A. Strenuous exercise and action of of whey protein on calcium and bone metabo-
antioxidant enzymes. Med Lav 2002;93:540-
lism in ovariectomized rats. J Nutr Sci
550. Vitaminol(Tokyo) 1997;43:199-210.
108. Zemel MB. Mechanisms of dairy modulation
of adiposity. J Nutr 2003;133:252S-256S.

Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004 Page 155


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission
Whey Protein Review

121. Takada Y, Matsuyama H, Kato K, et al. Milk 133. Markus CR, Olivier B, de Haan EH. Whey
whey protein enhances the bone breaking force protein rich in alpha-lactalbumin increases the
in ovariectomized rats. Nutr Res ratio of plasma tryptophan to the sum of the
1997;17:1709-1720. other large neutral amino acids and improves
122. Kato K, Toba Y, Matsuyama H. Milk basic cognitive performance in stress-vulnerable
protein enhances the bone strength in ovariec- subjects. Am J Clin Nutr 2002;75:1051-1056.
tomized rats. J Food Biochem 2000;24:467- 134. Markus CR, Olivier B, Panhuysen GE, et al.
476. The bovine protein alpha-lactalbumin in-
123. Toba Y, Takada Y, Matsuoka Y, et al. Milk creases the plasma ratio of tryptophan to the
basic protein promotes bone formation and other large neutral amino acids, and in
suppresses bone resorption in healthy adult vulnerable subjects raises brain serotonin
men. Biosci Biotechnol Biochem activity, reduces cortisol concentration, and
2001;65:1353-1357. improves mood under stress. Am J Clin Nutr
2000;71:1536-1544.
124. Aoe S, Toba Y, Yamamura J, et al. Controlled
trial of the effects of milk basic protein (MBP) 135. Graeff FG, Guimaraes FS, De Andrade TG,
supplementation on bone metabolism in Deakin JF. Role of 5-HT in stress, anxiety, and
healthy adult women. Biosci Biotechnol depression. Pharmacol Biochem Behav
Biochem 2001;65:913-918. 1996;54:129-141.
125. Yamamura J, Aoe S, Toba Y, et al. Milk basic
protein (MBP) increases radial bone mineral
density in healthy adult women. Biosci
Biotechnol Biochem 2002;66:702-704.
126. Ksiazyk J, Piena M, Kierkus J, Lyszkowska M.
Hydrolyzed versus nonhydrolyzed protein diet
in short bowel syndrome in children. J Pediatr
Gastroenterol Nutr 2002;35:615-618.
127. Hiraishi H, Shimada T, Ivey KJ, Terano A.
Role of antioxidant defenses against ethanol-
induced damage in cultured rat gastric epithe-
lial cells. J Pharmacol Exp Ther
1999;289:103-109.
128. Hiraishi H, Terano A, Ota S, et al. Protection
of cultured rat gastric cells against oxidant-
induced damage by exogenous glutathione.
Gastroenterology 1994;106:1199-1207.
129. Rosaneli CF, Bighetti AE, Antonio MA, et al.
Efficacy of a whey protein concentrate on the
inhibition of stomach ulcerative lesions caused
by ethanol ingestion. J Med Food 2002;5:221-
228.
130. Matsumoto H, Shimokawa Y, Ushida Y, et al.
New biological function of bovine alpha-
lactalbumin: protective effect against ethanol-
and stress-induced gastric mucosal injury in
rats. Biosci Biotechnol Biochem 2001;65:1104-
1111.
131. MacKay D, Miller AL. Nutritional support for
wound healing. Altern Med Rev 2003;8:359-
377.
132. Zimecki M, Wlaszczyk A, Wojciechowski R,
et al. Lactoferrin regulates the immune
responses in post-surgical patients. Arch
Immunol Ther Exp (Warsz) 2001;49:325-333.

Page 156 Alternative Medicine Review ◆ Volume 9, Number 2 ◆ 2004


Copyright©2004 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission

You might also like