Decreased levels or impaired function of protein S, a vitamin K-dependant physiological anticoagulant, leads to decreased degradation of factor Va and factor VIIIa and an increased propensity to venous thrombosis.

Types

There are three types of hereditary protein S deficiency:

Type I - decreased protein S activity: low levels of free protein S, normal levels of bound protein S
Type IIa - decreased protein S activity: low levels of free protein S, low levels of bound protein S
Type IIb - decreased protein S activity: normal levels of free protein S, normal levels of bound protein S

Decreased activity is present in an acquired form in vitamin K deficiency or treatment with warfarin. This generally also impairs the coagulation system itself (factors II, VII, IX and X), and therefore predisposes to bleeding rather than thrombosis. Protein S levels are also lower in pregnancy and liver disease.

Protein S deficiency is the underlying cause of a small proportion of cases of disseminated intravascular coagulation (DIC), deep venous thrombosis (DVT) and pulmonary embolism (PE).

Hereditary PSD is an autosomal dominant condition, resulting in a 50 precent chance of passing the disease to offspring. Less than half of those diagnosed with PSD will experience thrombosis, and those who do usually are affected only from the age of the late teens onwards. A positive blood test can lead to the loss of health insurance benefits and/or employment, and the social downsides need to be balanced against the actual medical benefit of accurate diagnosis. Screening of young children is usually deferred because early testing is often inaccurate, and it is better to wait until they are old enough to decide for themselves whether they want to be tested.

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Developing dairy beverages: high-protein diets, nutritional needs offer new opportunities to the recombined milk protein market - Ingredient Technology
From Dairy Foods, 2/1/04 by Eric Bastian

Devotees of high-protein diets such as Atkins, South Beach and the Zone are driving increasingly sophisticated beverage applications for whey protein ingredients. Increased demand for protein by consumers who want to be physically fit, lose weight or follow a high-protein diet, plus an overall rise in the interest in healthful ready-to-drink (RTD) beverage alternatives, has led to innovations in the dairy protein-based product sector. Additionally, the push for higher levels of calcium in the diet has opened up potential markets for milk calcium, more appropriately called milk minerals.

Efforts to push whey protein and milk minerals benefit from mounting scientific evidence linking high-protein, low-carbohydrate diets with weight loss, as well as milk mineral's contributions to reducing osteoporosis and obesity. Research shows that high-protein diets allow weight loss while maintaining bone and muscle mass. Milk minerals can help those following such diets (or those who simply don't care to drink traditional fluid milk products) avoid osteoporosis and other mineral deficiency conditions by offering the complete mineral package of a traditional dairy product for dairy and non-dairy beverage and food applications.

Whey proteins in the form of whey protein concentrate (WPC) and whey protein isolate (WPI) dry beverage mixes available at health food emporiums have long been considered by body builders to be essential tools for increasing muscle mass. Fitness and healthful lifestyle buffs now have alternatives in the RTD protein beverage and high-protein energy bar segments. The RTD nutritional beverage market is expanding from specialty health food stores to mainstream supermarkets. A flat market for high-margin powdered protein supplement mixes is more than offset by the growth of high-protein, low-carbohydrate RTD beverages.

Beverage companies of all types are entering the high-protein market, in which dairy proteins are highly sought after for all types of formulations. As technology and nutritional research develops, opportunities to use new dairy and food ingredients emerge. In fact, high-protein RTD nutritional beverages are currently found at a variety of acidity levels, from neutral (pH=6-7), mid-range (pH=4-5) and low (pH<3.5). Neutral-acid beverages typically have a turbid, milky appearance, such as found in a smoothie. These types of RTD beverages are ideal for traditional casein-based milk protein concentrate (MPC). Though clear protein beverages in this pH range are under development, none are currently on the market.

The mid-range pH in the RTD beverage category faces the challenge of heat-sensitivity, particularly in whey protein beverages with high mineral content. Consumer research shows a preference for less acidic beverages, but technical hurdles including heat sensitivity, create a dearth of dairy protein-based RTD products in the pH 4-5 range. Such products require careful formulation and processing to avoid either precipitation or gelation. Research is under way to stabilize whey proteins' heat sensitivity for future innovation.

The majority of whey protein-fortified RTD beverages have a low pH. The segment easily incorporates WPCs and WPIs, particularly in heat-treated or mineral-fortified products with up to 10% protein. Recent trends toward protein supplementation are driving use of WPC 80% and WPI 90%, particularly in the sports nutrition segment. The buffering ability of protein requires additional acid, which does cause products to have a more tart flavor profile.

Beverage processors seeking high protein while limiting carbohydrates also want formula flexibility. Such formulations aim to restrict lipids or fat material in the product to offer sweetening and flavoring flexibility. WPCs start on the low-end at 35% protein with 50% lactose and go up to 85% protein; fat content rises in correlation with protein content. Meanwhile, WPI contains less than 0.5% fat and is the solution for RTD protein products that can carry the added cost. One such RTD product offers 45g protein, 2g carbohydrates and 0g fat, with ingredients including water, protein blend (WPI and lactoferrin), acids, flavors and colors.

Beyond protein, balanced mineral nutrition is required for overall health. New research shows bone brittleness can be caused by a lack of critical trace minerals found in milk and milk mineral powder, but not when common calcium fortifiers containing only calcium are added to products such as orange juice.

Milk minerals containing calcium, potassium, magnesium, zinc and other minerals are becoming more readily available. Such powders readily dissolve at pH 3.5, which offers application potential in the acidic segment of the sports drink category. Milk calcium is additionally suspended in neutral pH beverages, and remains stable during ultra temperature (UHT) processing.

Many consumers trying to push proteins or increase mineral intake do not even consider ingredients in the RTD beverage segment to be dairy-based. Instead they view such offerings individually as fruit smoothies or nutritional supplement beverages. The result? Opportunities abound to increase consumer dairy intake via the marketing of dairy powder products for recombining in RTD nutritional beverage categories.

THIS INGREDIENT TECHNOLOGY FOCUS ARTICLE WAS WRITTEN BY ERIC BASTIAN, DIR. OF RESEARCH AND DEVELOPMENT FOR MONROE, WIS.-BASED GLANBIA NUTRITIONALS INC. HE WILL PRESENT FURTHER DETAILS ON DEVELOPING DAIRY-BASED BEVERAGES AND ENERGY BARS TO MEET HEALTH AND NUTRITIONAL NEEDS DURING THE FOURTH INTERNATIONAL SYMPOSIUM ON RECOMBINED MILK AND MILK PRODUCTS. THE RECOMBINING SYMPOSIUM PROGRAM, "NEW CHALLENGES, NEW IDEAS," WILL BE HELD AT THE MOON PALACE RESORT IN CANCUN, MEXICO, MAY 9-12, 2004. EDUCATIONAL OPPORTUNITIES AT THE EVENT ARE DESIGNED TO ADDRESS THE TECHNICAL AND MARKETING CHALLENGES AND OPPORTUNITIES IN THE RECOMBINED MILK INGREDIENT MARKET. THE SYMPOSIUM IS ORGANIZED BY THE U.S. DAIRY EXPORT COUNCIL (USDEC) UNDER THE AUSPICES OF THE INTERNATIONAL DAIRY FEDERATION. FOR MORE INFORMATION, CONTACT USDEC AT 703/528-3049 OR VISIT WWW.MILKRECOMBINE04.COM.

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