Amino acid intolerance during prolonged total parenteral nutrition reversed by molybdate therapy

Abumrad, Naji N.; Schneider, Albert J.; Steel, Dinah; Rogers, Lydia

doi:10.1093/ajcn/34.11.2551

Cited by 189 publications

(52 citation statements)

References 20 publications

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“…Only one human case of likely dietary molybdenum deficiency has been reported in an adult patient on TPN because of short-bowel syndrome (Abumrad et al, 1981). A UL for molybdenum for children one to three years old was set at 100 µg/day (SCF, 2000c).…”

Section: Health Consequencesmentioning

confidence: 99%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

281

124

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel's opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant's metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded. There is scientific consensus that breast milk is the preferred food for all healthy infants and provides an adequate supply of all nutrients to support growth and development (with the exception of vitamin K during the first weeks of life and of vitamin D). Whereas the composition of infant formula remains stable over time, breast milk composition changes continuously and therefore infant formula cannot imitate breast milk. © EuropeanAll formulae intended for infants must be safe and suitable to meet the nutritional requirements and promote growth and development of infants born at term when used as a sole source of nutrition during the first months of life, and when used as the principal liquid element in a progressively diversified diet after the introduction of appropriate complementary feeding. Nutrients and substances should be added to formulae for infants only in amounts that serve a nutritional or other benefit. The addition in amounts higher than those serving a benefit or the inclusion of unnecessary substances in formulae may put a burden on the infant's metabolism and/or on other physiological functions, as substances which are not used or stored have to be excreted.The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first half of the first year of life in its previous opinion and an average amount of daily energy intake from formula during this period (500 kcal/day). These minimum amounts should be understood as target values which cover the nutritional needs of virtually all infants born at term for optimal growth and devel...

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Section: Health Consequencesmentioning

confidence: 99%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

281

124

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“…1,2) In Dietary Reference Intakes for Japanese in (DRI-J 2005, the recommended dietary allowances of Mo and Cr for adults were set at 20 to 25 mg/d and 25 to 40 mg/d respectively. 3) Information on the secretion of trace elements in human milk is needed in order to estimate intake by breast-fed infants and, to establish the recommended intake for infants.…”

mentioning

confidence: 99%

Molybdenum and Chromium Concentrations in Breast Milk from Japanese Women

Yoshida

Takada

Hirose

et al. 2008

Bioscience, Biotechnology, and Biochemistry

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Molybdenum (Mo) and chromium (Cr) in 79 Japanese breast milk samples were measured by inductively coupled plasma-mass spectrometry. For Mo, 51 samples (64.6%) showed less than 5 ng/ml and only 12 samples (15.2%) showed more than 10 ng/ml. The range and median were <0:1 to 25.91 and 3.18 ng/ml respectively. For Cr, 38 samples (48.1%) showed less than 1 ng/ml, 20 samples (25.3%) showed 1 to 2 ng/ml, and only six samples (7.6%) showed more than 5 ng/ml. The range and median were <0:1 to 18.67 and 1.00 ng/ml respectively.Key words: molybdenum; chromium; breast milk; dietary reference intake; inductively coupled plasma-mass spectrometry Mo and Cr are essential trace elements in human nutrition, and deficiencies of them have been observed in patients with long-term total parenteral nutrition. 1,2) In Dietary Reference Intakes for Japanese in (DRI-J 2005, the recommended dietary allowances of Mo and Cr for adults were set at 20 to 25 mg/d and 25 to 40 mg/d respectively. 3) Information on the secretion of trace elements in human milk is needed in order to estimate intake by breast-fed infants and, to establish the recommended intake for infants. In fact, adequate intake (AI) levels of several trace elements for infants (0 to 5 months) were set on the basis of the concentrations of those trace elements in breast milk of Japanese women in DRI-J 2005, 3) but, AI levels for Mo and Cr were not set in DRI-J 2005 because there was no available information on the concentration of these two trace elements in breast milk from Japanese women. In the present study, we measured Mo and Cr concentrations of breast milk samples from 79 Japanese women by inductively coupled plasma-mass spectrometry (ICPMS), and attempted to estimate AI levels for these two trace elements in Japanese infants.The study was reviewed and approved by the Ethics Committee of the University of Shiga Prefecture, and it followed the Declaration of Helsinki. Seventy-nine healthy Japanese mothers who were breast-feeding exclusively and not taking vitamin or mineral supplements were recruited in several midwife clinics in Hokkaido, Chiba, Kanagawa, Kyoto, Hiroshima, and Nagasaki Prefectures in Japan from March 2005 to December 2006. The numbers of subjects recruited in the various prefectures were as follows: Hokkaido, 12; Chiba, 10; Kanagawa, 15; Kyoto, 30; Hiroshima, 2; and Nagasaki, 10. All the subjects had given birth to infants at term (gestational age 38 to 41 weeks). The mothers were 32:0 AE 4:1 years old (mean AE SD), with a range of 19 to 39 years. There were no health problems in their babies.Breast milk was obtained from the subjects at an intermediate time during breast-feeding, placed in a nylon bag (Kaneson, Osaka, Japan) or a polypropylene centrifuge tube (Sumitomo Bakelite, Tokyo, Japan) and stored in a freezer at À20 C until analysis. The postpartum day on which the sample was collected was 95:5 AE 46:8 d (mean AE SD) with a range of 5 to 191 d.Two to 5 milliliters of breast milk was transferred to a ceramic melting pot (32 Â 24 mm), dried at ...

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“…This information, in turn, has improved the understanding of the role of these nutrients in human nutrition irrespective of the route of nutrient administration. Trace minerals that had not been recognized previously as essential but have been recognized in patients receiving only parenteral nutrients include Cr (Jeejeebhoy et al 1977), Se (Kien & Ganther, 1983), and Mo (Abumrad et al 1981). The development of neurological abnormalities in a child who had received long-term parenteral nutrition without a source of a-linolenic acid (18 : 3n-3) has established this fatty acid as a second essential fatty acid (Holman et al 1982).…”

Section: Defining Parenteral Micronutrient Requirementsmentioning

confidence: 99%

Biochemical homeostasis and body growth are reliable end points in clinical nutrition trials

Heird

2005

Proc. Nutr. Soc.

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Studies of biochemical homeostasis and/or body growth have been included as outcome variables in most nutrition trials in paediatric patients. Moreover, these outcome variables have provided important insights into the nutrient requirements of infants and children, and continue to do so. Examples of the value of such studies in improving parenteral nutrition, in defining essential fatty acid metabolism and requirements of infants and in defining the protein and energy needs of low-birth-weight infants are discussed. Data from such studies have helped to define the mechanism of metabolic acidosis and hyperammonaemia associated with the use of early crystalline amino acid mixture and, hence, how to prevent these disorders. Such studies have allowed the development of parenteral amino acid mixtures that circumvent grossly abnormal plasma concentrations of most amino acids and appear to be utilized more efficiently. These studies have also helped define micronutrient requirements, including requirements for several such nutrients that had not been previously recognized as essential (e.g. Cr, Se, Mo, α-linolenic acid). Studies of body growth have been particularly valuable in defining the nutritional requirements of low-birth-weight infants. Finally, studies of metabolic homeostasis coupled with more sophisticated metabolic studies have provided considerable insight into the metabolism of the essential fatty acids, linoleic acid (18:2n-6) and α-linolenic acid (18:3n-3). Although such studies have not defined the amount of the longer-chain PUFA synthesized from each of these essential fatty acids, i.e. arachidonic acid (20:4n-6) and DHA (22:6n-3), they have shown that the rates of conversion are extremely variable from infant to infant, suggesting a possible explanation of why some studies show developmental advantages from intake of these fatty acids while others do not.

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Amino acid intolerance during prolonged total parenteral nutrition reversed by molybdate therapy

Cited by 189 publications

References 20 publications

Scientific Opinion on the essential composition of infant and follow-on formulae

Scientific Opinion on the essential composition of infant and follow-on formulae

Molybdenum and Chromium Concentrations in Breast Milk from Japanese Women

Biochemical homeostasis and body growth are reliable end points in clinical nutrition trials

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