Complex Enterally Tube-Fed Community Patients Display Stable Tolerance, Improved Compliance and Better Achieve Energy and Protein Targets with a High-Energy, High-Protein Peptide-Based Enteral Tube Feed: Results from a Multi-Centre Pilot Study

Abstract Objectives Current guidelines and expert recommendations stress the need to implement enteral feeds with a higher protein-to-energy ratio to meet protein requirements as recommended while avoiding gastrointestinal side effects and energy overfeeding in ICU patients. Materials and methods Prospective tolerability study in 18 critically ill patients with a high protein formula (high protein-to-energy (HP:E) formula = Fresubin® Intensive; HPG) compared to a contemporary matched conventional therapy group (CTG). The primary outcome was GI intolerance defined as ≥300 ml daily gastric residual volume (GRV), vomiting, or diarrhea on days 1 and 2. Secondary outcomes were the percentage of patients reaching their protein target on day 4 and overall protein intake. Results Groups were comparable regarding demographic characteristics, disease severity, organ failures, mechanical ventilation, and NUTRIC score at baseline. Eighteen patients completed the 4-day feeding period. The number of events of GRV of ≥300 ml/day was equal in both groups (33.3%). The incidence of diarrhea and vomiting was low in the HPG (two patients concerned). EN did not need to be discontinued due to intolerance in any group. Seventy-two percent of patients reached protein targets ≥1.3 g/kgBW/d within 4 days after initiation of enteral feeding, which was superior to the CTG (33%). Post-hoc testing showed group differences of protein intake between HPG and CTG were significant at t = 72 h and t = 96 h. Energy targets were met in both groups. Conclusion The HP:E formula containing 33% whey protein hydrolysate is well tolerated in this tolerability study. Due to the HP:E ratio protein targets can be reached faster. Larger randomized trials are needed to confirm preliminary results. Trial registration ClinicalTrials.gov Identifier: NCT02678325. Registered 2 May 2016.

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The effect of nutrition on the reproductive performance of first-litter sows 2. Protein and energy intakes during lactation

Animal Science ◽

10.1017/s0003356100002245 ◽

1984 ◽

Vol 38 (2) ◽

pp. 249-256 ◽

Cited By ~ 47

Author(s):

R. H. King ◽

I. H. Williams

Keyword(s):

Protein Intake ◽

Live Weight ◽

High Energy ◽

Low Energy ◽

High Protein ◽

Weight Losses ◽

Lactation Length ◽

Low Protein ◽

Daily Intakes ◽

Dietary Treatments

A factorial experiment involving high (53·1 to 59·5 MJ) and low (25·4 to 27·1 MJ) daily intakes of digestible energy, and high (550 to 745 g) and low (302 to 318 g) daily intakes of crude protein during lactation, was conducted with 68 first-litter sows. Average lactation length was 32 days, and average backfat changes during lactation were +0·3, −1·4, −7·2 and −5·4 mm for the high energy/high protein, high energy/low protein, low energy/high protein and low energy/low protein combinations, respectively. The corresponding mean live-weight losses during lactation were 3·9, 32·5, 29·8 and 35·8 kg. Within 8 days of weaning, more sows receiving high intakes of both energy and protein during lactation exhibited oestrus (0·88 v. 0·53, x2 = 6·7, P < 0·01) than sows whose energy and/or protein intake throughout lactation had been restricted. Nitrogen balances of sows were determined between 18 and 22 days after farrowing. Sows receiving high intakes of both energy and protein during lactation were in positive nitrogen balance, whereas the nitrogen balances of sows on the other three dietary treatments during lactation were similar to each other but negative. Ovulation rate, subsequent litter size and embryo mortality were not significantly affected by energy or protein intake during lactation.

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Increased protein intake is associated with improved hand grip strength and quality of life in home enterally tube fed adults using a high-energy, high-protein feed

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2019.12.005 ◽

2020 ◽

Vol 35 ◽

pp. 208

Author(s):

B.P. Green ◽

E. Wong ◽

S. Andrews ◽

K. Hampshire-Jones ◽

S. McKinnon ◽

...

Keyword(s):

Quality Of Life ◽

Grip Strength ◽

Protein Intake ◽

High Energy ◽

Hand Grip Strength ◽

High Protein ◽

Hand Grip ◽

Protein Feed

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Dependence of 24 h energy expenditure in man on the composition of the nutrient intake

British Journal Of Nutrition ◽

10.1079/bjn19830066 ◽

1983 ◽

Vol 50 (1) ◽

pp. 1-13 ◽

Cited By ~ 45

Author(s):

M. J. Dauncey ◽

S. A. Bingham

Keyword(s):

Energy Expenditure ◽

Heat Loss ◽

Heat Production ◽

High Glucose ◽

Protein Intake ◽

Nutrient Intake ◽

High Protein ◽

Sensible Heat ◽

High Protein Intake ◽

Adult Humans

1. The influence of the nutrient composition of food on energy expenditure during a 24 h period was investigated in adult volunteers. The maximum probable effect was determined using iso-energetic diets high in either protein or in glucose.2. Two men and four women took part in the study. Their body-weights and body composition were within the normal range. Each subject lived for 28 h in a whole-body calorimeterset at 26°, on two separate occasions. During each session they ate one of the following iso-energetic diets: high-protein–low-carbohydrate or high-glucose–low-protein.Energy expenditure was determined while the subject followed a pre-set pattern of activity. A 24 h collection of urine was made and total nitrogen, creatinine and urea excretions were determined, so that heat production could be corrected for protein metabolism.3. Two independent measures of energy expenditure were made: direct calorimetry was used to obtain heat loss partitioned into its sensible and evaporative components, while indirect calorimetry was used to estimate heat production from oxygen consumption, carbon dioxide production and N excretion. There was good agreement between the two estimates of 24 h energy expenditure: for the twelve sessions in the calorimeter the mean difference between heat production and heat loss was only 0·4 (SEM 0·39)%.4. The results showed that nutrient composition can have a marked influence on 24 h energy expenditure in adult humans. Mean values of 8659 (SEM 230) kJ and 7735 (SEM 250) kJ were obtained for the high-protein and high-glucose diets respectively. This 12% increasein energy expenditure on the high-protein intake was significant (P < 0·001). On the high-glucose intake, total heat loss comprised 22 and 78% evaporative and sensible heat losses respectively. The increase in heat loss onthe high-protein intake was accounted for by a 39% increase in evaporative heat loss and a 7% increase in sensible heat loss.5. It is concluded that the composition of the nutrient intake has a greater influenceon the metabolic rate of adult humans than has been suggested by some groups of workers in recent years.

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Geometric framework reveals that a moderate protein, high carbohydrate intake is optimal for severe burn injury in mice

British Journal Of Nutrition ◽

10.1017/s0007114520000276 ◽

2020 ◽

Vol 123 (9) ◽

pp. 1056-1067

Author(s):

Jonathan J. Hew ◽

Roxanne J. Parungao ◽

Kevin H.-Y. Tsai ◽

Huaikai Shi ◽

Duncan Ma ◽

...

Keyword(s):

Wound Healing ◽

Protein Intake ◽

Burn Injury ◽

High Energy ◽

High Protein ◽

Carbohydrate Intake ◽

Carbohydrate Diet ◽

High Protein Intake ◽

High Carbohydrate ◽

Very High

AbstractNutritional therapy is a cornerstone of burns management. The optimal macronutrient intake for wound healing after burn injury has not been identified, although high-energy, high-protein diets are favoured. The present study aimed to identify the optimal macronutrient intake for burn wound healing. The geometric framework (GF) was used to analyse wound healing after a 10 % total body surface area contact burn in mice ad libitum fed one of the eleven high-energy diets, varying in macronutrient composition with protein (P5−60 %), carbohydrate (C20−75 %) and fat (F20−75 %). In the GF study, the optimal ratio for wound healing was identified as a moderate-protein, high-carbohydrate diet with a protein:carbohydrate:fat (P:C:F) ratio of 1:4:2. High carbohydrate intake was associated with lower mortality, improved body weight and a beneficial pattern of body fat reserves. Protein intake was essential to prevent weight loss and mortality, but a protein intake target of about 7 kJ/d (about 15 % of energy intake) was identified, above which no further benefit was gained. High protein intake was associated with delayed wound healing and increased liver and spleen weight. As the GF study demonstrated that an initial very high protein intake prevented mortality, a very high-protein, moderate-carbohydrate diet (P40:C42:F18) was specifically designed. The dynamic diet study was also designed to combine and validate the benefits of an initial very high protein intake for mortality, and subsequent moderate protein, high carbohydrate intake for optimal wound healing. The dynamic feeding experiment showed switching from an initial very high-protein diet to the optimal moderate-protein, high-carbohydrate diet accelerated wound healing whilst preventing mortality and liver enlargement.

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High-protein diet with renal hyperfiltration is associated with rapid decline rate of renal function: a community-based prospective cohort study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz115 ◽

2019 ◽

Cited By ~ 5

Author(s):

Jong Hyun Jhee ◽

Youn Kyung Kee ◽

Seohyun Park ◽

Hyoungnae Kim ◽

Jung Tak Park ◽

...

Keyword(s):

Renal Function ◽

Protein Intake ◽

High Protein Diet ◽

High Protein ◽

Protein Diet ◽

Rapid Decline ◽

Community Based ◽

Increased Risk ◽

Decline Rate ◽

Egfr Decline

Abstract Background The effect of a high-protein diet with renal hyperfiltration (RHF) on decline of kidney function has rarely been explored. We investigated the association between a high-protein diet, RHF and declining kidney function. Methods A total of 9226 subjects from the Korean Genome and Epidemiology Study, a community-based prospective study (2001–14), were enrolled and classified into quartiles according to daily amount of protein intake based on food frequency questionnaires. RHF was defined as estimated glomerular filtration rate (eGFR) with residuals of >95th percentile after adjustment for age, sex, history of hypertension or diabetes, height and weight. Rapid decline of renal function was defined as decline rate of eGFR >3 mL/min/1.73 m2/year. Results The relative risk of RHF was 3.48-fold higher in the highest than in the lowest protein intake quartile after adjustment for confounding factors [95% confidence interval (CI) 1.39–8.71]. The mean eGFR decline rate was faster as quartiles of protein intake increased. Furthermore, the highest quartile was associated with 1.32-fold increased risk of rapid eGFR decline (95% CI 1.02–1.73). When subjects were divided into two groups with or without RHF, the highest quartile was associated with a rapid decline in renal function only in RHF subjects (odds ratio 3.35; 95% CI 1.07–10.51). The sensitivity analysis using the Korean National Health and Nutrition Examination Survey (2008–15) data with 40 113 subjects showed that higher quartile was associated with increased risk for RHF. Conclusions A high-protein diet increases the risk of RHF and a rapid renal function decline in the general population. These findings suggest that a high-protein diet has a deleterious effect on renal function in the general population.

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303. NUTRIENT INTAKE OF BOS INDICUS HEIFERS DURING EARLY AND MID-GESTATION CAUSES CHANGES TO PLASMA CONCENTRATIONS OF TRIIODOTHYRONINE (T3) AND THYROXINE (T4) OF THEIR PROGENY

Reproduction Fertility and Development ◽

10.1071/srb10abs303 ◽

2010 ◽

Vol 22 (9) ◽

pp. 103

Author(s):

G. C. Micke ◽

T. M. Sullivan ◽

V. E. A. Perry

Keyword(s):

Birth Weight ◽

Protein Intake ◽

Nutrient Intake ◽

Average Daily Gain ◽

Plasma Concentrations ◽

Postnatal Growth ◽

High Protein ◽

Economic Implications ◽

High Protein Diets ◽

Protein Diets

Fetal and postnatal growth are mediated by thyroid hormones (TH). Maternal nutrient intake during gestation can program postnatal TH concentrations. This may have significant economic implications for beef cattle production. We investigated the effect of feeding beef heifers high (H = 240%) and low (L = 70%) levels of recommended daily crude protein intake during the first and second trimesters of gestation in a two-by-two factorial design on progeny (n = 68) plasma concentrations of free and total triiodothyronine (FT3 and TT3) and free and total thyroxine (FT4 and TT4) from birth until weaning at 6 mo of age. Exposure to low compared to high protein diets during the second trimester resulted in increased plasma FT3 concentrations relative to TT3 (P = 0.04) at birth. For male progeny, exposure to low compared to high protein diets during the first trimester resulted in greater plasma FT4 concentrations from birth until weaning (P = 0.02). Also for males from birth until weaning, LH had greater plasma TT3 concentrations than HH (P < 0.01). For female progeny, HH had greater plasma TT3 concentrations relative to TT4 than HL from birth until weaning (P = 0.03). Plasma concentrations of FT3 were positively associated with average daily gain relative to birth weight at 1 (r = 0.41; P < 0.01) and 3 mo FT3 (r = 0.41; P < 0.01). Heifer protein intake during the first and second trimesters of gestation has a permanent effect to progeny plasma TH concentrations and these changes are associated with the postnatal growth pathway. (1) Micke GC, Sullivan TM, Magalhaes RJS, Rolls PJ, Norman ST, Perry VEA. Heifer nutrition during early- and mid-pregnancy alters fetal growth trajectory and birth weight. Anim Reprod Sci. 2010; 117: 1–10.

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Asupan Energi dan Protein Berhubungan dengan Gizi Kurang pada Anak Usia 6-24 Bulan

Amerta Nutrition ◽

10.20473/amnt.v1i2.6234 ◽

2017 ◽

Vol 1 (2) ◽

pp. 124

Author(s):

Dewi Kencono Jati ◽

Triska Susila Nindya

Keyword(s):

Nutritional Status ◽

Energy Intake ◽

Random Sampling ◽

Protein Intake ◽

Nutrient Intake ◽

Measurement Data ◽

Simple Random Sampling ◽

High Energy ◽

Chi Square ◽

Cross Sectional

Background: Children under two years of age are susceptible to nutritional problems. Nutrient intake are needed for optimal growth and mental development. Inadequate energy intake in the long run can lead to protein energy malnutrition.Objectives: The purpose of this study was to analyze the association energy and protein intake with nutritional status of children aged 6 to 24 months. Methods: This research used cross sectional design aprroach. The subjects of this study were 62 children under two years (aged 6-24 months). Selection of sample was using simple random sampling Data was collected through interviews using a structured questionnaire, nutrient intake using 2x24hours recall, and weight measurement. Data was analyzed using Chi-square test. Results: The results showed that majority of the children had inadequate energy intake, adequate protein intake, 24.2% were underweight. There was a correlation between energy intake (p=0.044) and protein intake (p=0.038) with nutritional status WAZ. Conclusion: The conclusion of this study is energy and protein intake contribute to underweight incidences among children aged 6-24 months. Therefore, it could be advised to increase high energy and protein intake for optimum growth.ABSTRAK Latar belakang: Anak dengan usia di bawah dua tahun rentan mengalami masalah gizi. Asupan gizi dibutuhkan untuk pertumbuhan dan perkembangan fisik dan mental. Asupan energi yang tidak mencukupi dalam waktu jangka panjang dapat menyebabkan gizi kurang yang berdampak pada kekurangan energi-protein. Tujuan: Tujuan dari penelitian ini adalah untuk menganalisis hubungan asupan energi dan protein dengan status gizi berdasarkan BB/U pada anak usia 6-24 bulan di wilayah kerja Puskesmas Klampis Ngasem, Surabaya.Metode: Penelitian ini menggunakan desain cross sectional. Subyek dari penelitian ini adalah 62 bayi di bawah dua tahun (baduta) berusia 6-24 bulan yang didapatkan dari metode simple random sampling. Pengumpulan data dilakukan dengan menggunakan kuesioner terstruktur, asupan gizi dengan recall 2x24hrs, dan pengukuran berat badan. Teknik analisis data dilakukan dengan uji statistik Chi-square. Hasil: Hasil penelitian menunjukkan bahwa sebagian besar baduta memiliki asupan energi tidak adekuat, asupan protein adekuat, dan 24,2% mengalami underweight. Terdapat hubungan asupan energi (p=0,044) dan asupan protein (p=0,038) dengan status gizi BB/U.Kesimpulan: Energi dan protein berkontribusi terhadap kejadian underweight pada baduta. Oleh karena itu, disarankan selalu melakukan peningkatan konsumsi pangan dengan memberikan asupan makanan yang mengandung energi dan protein untuk pertumbuhan yang optimal.

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Asupan Energi dan Protein Berhubungan dengan Gizi Kurang pada Anak Usia 6-24 Bulan

Amerta Nutrition ◽

10.20473/amnt.v1i2.2017.124-132 ◽

2017 ◽

Vol 1 (2) ◽

pp. 124 ◽

Cited By ~ 1

Author(s):

Dewi Kencono Jati ◽

Triska Susila Nindya

Keyword(s):

Nutritional Status ◽

Energy Intake ◽

Random Sampling ◽

Protein Intake ◽

Nutrient Intake ◽

Measurement Data ◽

Simple Random Sampling ◽

High Energy ◽

Chi Square ◽

Cross Sectional

Background: Children under two years of age are susceptible to nutritional problems. Nutrient intake are needed for optimal growth and mental development. Inadequate energy intake in the long run can lead to protein energy malnutrition.Objectives: The purpose of this study was to analyze the association energy and protein intake with nutritional status of children aged 6 to 24 months. Methods: This research used cross sectional design aprroach. The subjects of this study were 62 children under two years (aged 6-24 months). Selection of sample was using simple random sampling Data was collected through interviews using a structured questionnaire, nutrient intake using 2x24hours recall, and weight measurement. Data was analyzed using Chi-square test. Results: The results showed that majority of the children had inadequate energy intake, adequate protein intake, 24.2% were underweight. There was a correlation between energy intake (p=0.044) and protein intake (p=0.038) with nutritional status WAZ. Conclusion: The conclusion of this study is energy and protein intake contribute to underweight incidences among children aged 6-24 months. Therefore, it could be advised to increase high energy and protein intake for optimum growth.ABSTRAK Latar belakang: Anak dengan usia di bawah dua tahun rentan mengalami masalah gizi. Asupan gizi dibutuhkan untuk pertumbuhan dan perkembangan fisik dan mental. Asupan energi yang tidak mencukupi dalam waktu jangka panjang dapat menyebabkan gizi kurang yang berdampak pada kekurangan energi-protein. Tujuan: Tujuan dari penelitian ini adalah untuk menganalisis hubungan asupan energi dan protein dengan status gizi berdasarkan BB/U pada anak usia 6-24 bulan di wilayah kerja Puskesmas Klampis Ngasem, Surabaya.Metode: Penelitian ini menggunakan desain cross sectional. Subyek dari penelitian ini adalah 62 bayi di bawah dua tahun (baduta) berusia 6-24 bulan yang didapatkan dari metode simple random sampling. Pengumpulan data dilakukan dengan menggunakan kuesioner terstruktur, asupan gizi dengan recall 2x24hrs, dan pengukuran berat badan. Teknik analisis data dilakukan dengan uji statistik Chi-square. Hasil: Hasil penelitian menunjukkan bahwa sebagian besar baduta memiliki asupan energi tidak adekuat, asupan protein adekuat, dan 24,2% mengalami underweight. Terdapat hubungan asupan energi (p=0,044) dan asupan protein (p=0,038) dengan status gizi BB/U.Kesimpulan: Energi dan protein berkontribusi terhadap kejadian underweight pada baduta. Oleh karena itu, disarankan selalu melakukan peningkatan konsumsi pangan dengan memberikan asupan makanan yang mengandung energi dan protein untuk pertumbuhan yang optimal.

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