Heat Treatment of Bovine Milk Impacts Gastric Emptying and Nutrient Appearance

Milk structural assemblies (e.g., casein micelles) occur naturally and can be altered during processing, and this may influence the milk’s nutritional properties. Heat treatment of dairy ensures microbiological safety and extends shelf-life. Both pasteurisation and ultra-high temperature (UHT) processing are known to alter natural structural assemblies, but despite widespread use, only four human studies have addressed how heat treatment affects nutrient delivery. In vitro, animal, and human models have all shown more rapid nutrient release or appearance from UHT vs. pasteurised milk, with altered gastric emptying rate proposed as a mechanism. We hypothesised that differences in bovine milk structural assemblies arising from different processing methods would speed up gastric emptying and nutrient delivery following consumption of UHT relative to pasteurised milk. A randomised double-blind crossover trial assessed gastric emptying rate (using magnetic resonance imaging measuring gastric content volume) over 3 h and plasma amino acid appearance (using ultra-performance liquid chromatography) over 5 h following 500 mL of each milk in healthy women (n = 20). Gastric electrical activity was measured using body surface gastric mapping, and abdominal distension using stretch sensors. The time to empty 25% of the stomach contents was greater following UHT vs. pasteurised milk (45 ± 4 vs. 33 ± 4 min p < 0.05). While gastric content remained greater for longer following UHT milk, the incremental area under the curve of plasma essential amino acids was greater than pasteurised milk (55324 ± 3809 vs. 36598 ± 5673 μmol·min·L−1 p < 0.05). The greater amino acid appearance following UHT milk aligns with more rapid release of proteins from the gastric curd observed in vitro, yet the greater gastric content volume implies gastric content composition (e.g., solid vs. liquid) is an important determinant of nutrient release. Dairy processing using different heat treatments, which induced structural modifications, impacted gastric emptying and plasma amino acid appearance, with implications for appetite regulation and nutrient utilisation for metabolism.