Weber E, Ehrlein H J
Institute of Physiology, University of Hohenheim, Stuttgart, Germany.
Am J Clin Nutr. 1999 Mar;69(3):556-63. doi: 10.1093/ajcn/69.3.556.
Commercial enteral diets differ widely in nutrient composition. It is unknown whether the nutrient composition of the diets influences intestinal absorption.
The objective of this study was to investigate the effects of different enteral diets providing 60% of energy as carbohydrate, protein, or fat or 33.3% of energy from each nutrient on intestinal absorption in mini pigs.
Kinetics of nutrient absorption were determined by perfusing a 150-cm jejunal segment. The kinetics of absorption were used to determine optimal relations between the absorption and recovery of each nutrient. From these data, the optimal nutrient composition of the diets providing complete absorption of the macronutrients in the shortest intestinal length was evaluated. Absorption of nutrients was further determined after oral administration of 4 corresponding meals.
With all enteral diets, the absorption of nutrients displayed saturation kinetics. Absorption rates of carbohydrate were significantly larger than those of fat and protein. Consequently, the amounts of nutrients remaining unabsorbed per unit length of jejunum differed among the macronutrients. After administration of various test meals, the length of the small intestine required for complete absorption of the nutrients depended on the composition of the meals. The shortest intestinal length for complete absorption was needed for a diet providing 48% of energy as carbohydrate, 23% as protein, and 29% as fat. This composition closely matched the nutritional requirements.
The nutrient composition of diets can optimize intestinal absorption. This may be especially important in patients with malabsorption or short-bowel syndrome.
市售肠内营养制剂的营养成分差异很大。目前尚不清楚这些制剂的营养成分是否会影响肠道吸收。
本研究旨在探讨分别以碳水化合物、蛋白质或脂肪提供60%能量,或每种营养素提供33.3%能量的不同肠内营养制剂对小型猪肠道吸收的影响。
通过灌注150厘米长的空肠段来测定营养物质的吸收动力学。利用吸收动力学来确定每种营养素吸收与恢复之间的最佳关系。根据这些数据,评估在最短肠道长度下实现宏量营养素完全吸收的最佳营养制剂组成。口服4种相应餐食后进一步测定营养物质的吸收情况。
所有肠内营养制剂的营养物质吸收均呈现饱和动力学。碳水化合物的吸收速率显著高于脂肪和蛋白质。因此,空肠单位长度上未吸收的营养物质数量在宏量营养素之间存在差异。给予各种测试餐食后,营养物质完全吸收所需的小肠长度取决于餐食的组成。能量48%来自碳水化合物、23%来自蛋白质、29%来自脂肪的饮食实现完全吸收所需的小肠长度最短。这种组成与营养需求密切匹配。
营养制剂的营养成分可优化肠道吸收。这在吸收不良或短肠综合征患者中可能尤为重要。