Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Abstract

The manipulation of dietary fat intake can affect the response to disease, injury, and infection. These effects include enhancement or inhibition of immune function, altered susceptibility to cardiovascular disease, promotion or maintenance of gut integrity, and prevention of total parenteral nutrition-induced hepatic dysfunction. These effects may occur as a result of changes in the fatty acid composition of biomembranes or changes in concentrations of lipid moieties such as prostaglandins or leukotrienes. Those fats that have been shown to affect physiologic function include long-chain, medium-chain, and short-chain fatty acids and omega-3 and omega-6 fatty acids. Currently available enteral and parenteral products used for nutrition support contain widely varied amounts of these different fatty acids. Therefore, the selection of the most appropriate product or nutrition support regimen for an individual patient requires an understanding of the metabolism of these different fat substrates, their therapeutic indications, and the contraindications and controversies that surround their use. This article reviews these issues and also focuses on several alternate lipid sources such as short-chain fatty acids, medium-chain fatty acids, omega-3 fatty acids, and blended and structured lipids.

Kinetics of lipase‐catalysed interesterification of triolein and caprylic acid to produce structured lipids

“…Oleic or caprylic acid chromatographic areas in GC analysis area IS Internal standard chromatographic area in GC analysis A Free fatty acid liberated from a native triglyceride (oleic acid) CA Caprylic acid CA/TO Caprylic acid/triolein ratio (mol mol À1 ) e T Enzyme concentration (g g À1 of catalyst particle) E Enzyme or lipase EA, EM Acyl-enzyme complexes of the native fatty acid (A) and the odd fatty acid (M) F ATe Molar fraction of the native fatty acid (oleic acid) in triglycerides at equilibrium F MT Molar fraction of the medium chain fatty acid (caprylic acid) incorporated in triglycerides F MTe Molar fraction of the medium chain fatty acid (caprylic acid) incorporated in triglycerides at equilibrium F X Response factor of oleic or caprylic acids in GC analysis GA 2 Native triglyceride (triolein) GAM Triglyceride with one molecule of M incorporated GC Gas chromatography GM 2 Structured triglyceride (two molecules of M incorporated) k Kinetic constant for reactions (2) and (3), defined by eqns (19), (20) and (21) (m…”

“…Equilibrium constant for reaction (2), defined by eqn (4) K 2 Equilibrium constant for reaction (3), defined by eqn (4) L Long chain fatty acid LCT Long chain triglycerides m E Amount of enzyme (mg) m 0…”

“…Initial reaction rate, defined by eqn (31) (mol g À1 h À1 ) r 1 Reaction rate for reaction (2), defined by eqn (16) r 2 Reaction rate for reaction (3), defined by eqn (18) …”

Half-elemental Nutrition Mixtures for Enteral Nutrition of Children in Critical Conditions: Features of Usage and Economic Efficiency

“…СЦТ не откладываются в жировой ткани, но быстро мета-болизируются. Именно поэтому среднецепочечные три-глицериды являются наиболее оптимальным источником энергии при повышенных потребностях у целевой группы пациентов [18], а также у больных с жировой мальаб-сорбцией [19].…”

“…Жиры СЦТ, входящие в состав смеси для энтерального питания, являются также оптимальным источником энер-гии для пациентов с жировой мальабсорбцией [17,18].…”