Effect of the route of nutrient administration on whole-body protein kinetics in man

Jeevanandam, Malayappa; Lowry, Stephen F.; Brennan, Murray F.

doi:10.1016/0026-0495(87)90134-x

Cited by 22 publications

(2 citation statements)

References 31 publications

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“…Duffy and Pencharz (I), using the "N-glycine method in postsurgical neonates, showed protein turnover, synthesis, and breakdown to be 40% lower during parenteral compared with enteral feeding. Jeevanandam (2) demonstrated similar reductions in protein kinetics in normal adults using the same technique. In a study examining proteindepleted rats, Maiz et al (30) measured decreased rates of protein breakdown using a constant infusion of 1-14c-leucine during parenteral compared with enteral feeding.…”

Section: Discussionmentioning

confidence: 71%

“…Previous studies carried out in both premature infants and adults demonstrated significant reductions in protein turnover during parenteral compared with enteral feeding (1)(2)(3). However, in these studies, protein kinetic measurements were made during parenteral nutrition after a prolonged period in which enteral feeding was withheld, thus raising the possibility that the observed differences in protein kinetics resulted from an adaptation to the unused gastrointestinal tract (1)(2)(3). Alternatively, lower rates of protein turnover may be a direct effect of parenteral substrate.…”

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confidence: 99%

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Effect of Enteral Versus Parenteral Feeding on Leucine Kinetics and Fuel Utilization in Premature Newborns

et al. 1994

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To determine whether the route of nutrient delivery affects whole-body protein kinetics and fuel utilization, eight premature newborns were studied during both a 4-h period of enteral intake and a 4-h period of parenteral nutrition. The kinetics of the essential amino acid leucine were measured using a constant tracer infusion of 1-"Cleucine, and fuel utilization and energy expenditure were assessed by respiratory calorimetry. All leucine kinetic parameters were similar during enteral or parenteral nutri- enteral versus 196 * 50 parenteral). In addition, overall Parenteral feeding is used extensively in the clinical care of premature newborns. It is often used before beginning enteral nutrition as well as during times when a change in clinical status necessitates interrupting enteral feedings. In addition, parenteral nutrition is used to supplement the early stages of enteral feeding, when total nutritional requirements are not met by enteral feedings alone. Parenteral feeding is thus widely regarded as an appropriate substitute for enteral intake in premature newborns, at least for brief periods of time. However, it is unclear whether the metabolic effects of short-term parenteral nutrition mirror those of enteral feeding in premature infants. For example, it is not certain whether carbohydrate and fat are similarly utilized for oxidative metabolism if given by the parenteral or enteral route. It is also unclear whether overall protein metabolism is rates of energy expenditure (-52 kcal/kg/d) and pattern of fuel utilization (-70% carbohydrate, 13% fat, 17% protein) were unaltered by the route of feeding. Thus, as reflected by leucine kinetics, overall rates of protein turnover, synthesis, oxidation, and breakdown as well as energy expenditure and fuel utilization are similar when nutrition is provided to premature newborns by either the enteral or parenteral route. These results suggest that short-term provision of parenteral nutrition may be able to substitute appropriately for enteral intake, at least with regard to the utilization of one essential amino acid and the overall pattern of fuel utilization. (Pediatr Res 36: [429][430][431][432][433][434][435] 1994)

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Section: Discussionmentioning

confidence: 71%

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confidence: 99%