CN101522056A - 老年人的长期喂养 - Google Patents
老年人的长期喂养 Download PDFInfo
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- CN101522056A CN101522056A CNA2007800376342A CN200780037634A CN101522056A CN 101522056 A CN101522056 A CN 101522056A CN A2007800376342 A CNA2007800376342 A CN A2007800376342A CN 200780037634 A CN200780037634 A CN 200780037634A CN 101522056 A CN101522056 A CN 101522056A
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Abstract
本发明提供了为需要长期和管饲营养的患者提供相同营养的方法。更具体而言，本发明提供了为老年患者提供长期营养的方法和组合物。
Description
发明背景
本申请涉及营养。更具体而言，本发明涉及临床营养。
由于多种疾病、创伤、和并发症，患者可能无法通过口摄取食物，例如进食来获得必需的营养。因此，经肠内或肠胃外提供临床营养已广为人知。已开发了多种不同制剂来提供此类临床营养。
甚至就典型的肠内营养产品而言，这些产品设计为短期使用，通常为10到24天。在此方面，产品通常提供基本营养成分以向具有急性病状的患者在他们住院期间提供必需营养。虽然这些产品适合这种短期使用，但却不曾必要地将它们设计用于患者的长期喂养。随着医学进步，导致预期寿命增长并且疾病治疗变得更好，许多个体可以从为提供长期肠内营养而设计的产品中受益。
发明概述
本发明提供向需要长期管饲营养的患者提供长期管饲营养的方法。更具体而言，本发明提供为老年患者提供长期管饲营养的方法和组合物。
为此，在实施方案中，本发明提供为老年患者提供管饲营养的方法，所述方法包括步骤：经导管长期施用营养产品至少每天一次，所述营养产品包含：按产品热焓计包含14％至20％的蛋白质来源；按产品热焓计包含10％至50％的糖类来源；按产品热焓计包含30％至45％的脂类来源；每升产品中提供10至25克的膳食纤维来源；和每100千卡产品8.0至18.0微克铬。
根据所述方法，在实施方案中，按重量计脂类可包含40到60％的单不饱和脂肪(MUFA)。在实施方案中，所述产品每100千卡包含不超过1.1克的饱和脂肪酸(SFA)，且按脂类重量计所述产品包含0.4％至2.0％的二十碳五烯酸(EPA)。蛋白质来源可选自酪蛋白、乳清和大豆。糖类可选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。
根据所述方法，产品可包含其它成分。例如，每100千卡所述产品可包含至少：30mg胆碱；4.0mg牛磺酸；和/或3.0mg肉碱。此外，每100千卡所述产品可包含至少：0.1mg β-胡萝卜素；0.2mg番茄红素；和/或0.05mg叶黄素。
在所述方法的实施方案中，能量密度为0.8至1.3千卡/ml。如需要，所述产品包含益生元，并提供可溶性及不溶性纤维。按重量计至少25％的纤维是可溶性的。
在另一个实施方案中，本发明提供了为老年患者提供营养的方法，所述方法包括步骤：经导管长期施用组合物至少每天一次，所述组合物包含：蛋白质来源；脂肪来源；由糖类来源提供的不超过44％的组合物能量；包含按重量计至少25％可溶性纤维的膳食纤维来源；每100千卡产品至少8.0微克铬；维生素D；和钙。
在所述方法的实施方案中，每100千卡中维生素D包含至少0.5微克且每100千卡中钙包含至少35mg。
在所述方法的实施方案中，所述蛋白质来源选自酪蛋白、乳清和大豆且所述糖类选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。
更进一步，根据本发明，提供用于提供长期管饲营养的组合物，所述组合物包含：按产品热焓计包含14％至20％的蛋白质来源；按产品热焓计包含10％至50％的糖类来源；按产品热焓计包含30％至45％的脂类来源；每升产品中提供10至25克且包含可溶性及不溶性纤维的膳食纤维来源，其中按重量计至少25％的纤维是可溶性的；每100千卡产品中8.0至18.0微克铬。
对产品的许多变更和添加是可能的。例如，脂类可包含按重量计40％至60％的单不饱和脂肪，每100千卡不超过1.1克饱和脂肪酸，和按脂类重量计0.4％至2.0％的二十碳五烯酸。所述蛋白质来源可选自酪蛋白、乳清和大豆且所述糖类可选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。在实施方案中，每100千卡所述产品包含至少：30mg胆碱；4.0mg牛磺酸；和3.0mg肉碱。在另一个实施方案中，每100千卡所述产品包含至少：0.1mgβ-胡萝卜素；0.2mg番茄红素；和0.05mg叶黄素。
本发明的优点在于提供改善的肠内营养产品。
此外，本发明的优点在于提供用于提供肠内营养的改良方法。
此外，本发明的优点在于提供用于为老年患者提供长期管饲营养的组合物。
此外，本发明的优点在于提供为老年患者提供长期管饲营养的方法。
此处描述了额外的特征和优点，并在以下详细描述中将是显而易见的。
发明详述
本发明涉及临床营养。更具体而言，本发明涉及为老年患者提供长期管饲营养。如此处所用，术语“长期”指超过一个月(30天)。如此处所用，术语“管饲”指经喂食导管为患者提供产品，所述喂食导管与患者消化道的一部分接合，例如，鼻饲导管或经皮内镜胃造瘘术导管。申请人因此提交标题为“提供长期营养的方法”的专利申请，所述申请公开了多种长期肠内营养配方和基于以上的商业方法，其公开内容特此引入作为参考。
长期管饲营养产品优选设计用于老年患者。如此处所用，术语“老年患者”指不能通过正常饮食摄取营养但代谢正常(即未患代谢疾病)的65岁或65岁以上的成年患者。这类患者先前可能曾经历过头部或颈部癌症手术而消化道不完整或不能吞咽，可能颈部曾受到损伤而使得他或她不能吞咽或因例如中风引起的神经学损伤而不能吞咽，或可能患有如阿尔茨海默氏病、帕金森病、吞咽咽困难或CVA疾病。如此处所用，术语“正常饮食”指通过进食(即使用一个人的嘴，不使用任何喂养导管或肠胃外给养)摄取至少基本上全部营养。
在本发明的组合物中，已进行尝试来优化喂食制剂的老年患者体内的血糖应答。高血糖的重复性发作是老年人肠道喂养的主要困难。这对于在余生中可能需要长期管饲营养的老年患者而言尤为严重。高血糖可以加重被认为与许多衰老症状相关的慢性低水平炎症。例如，高血糖的反复发作可能与血管内皮的炎症相关，导致血管缩窄。这可导致心血管疾病和与此相关的问题。类似地，尿体积会增加，导致无机物的过量损失和肾脏相应的负荷。
因此，根据本发明，在至少一个实施方案中，所述制剂能够通过维持血糖稳态来维持长期管饲营养的老年患者的代谢状态。为此，设计所述组合物来降低胰岛素抗性和/或调节葡萄糖反应。在实施方案中，设计所述制剂来长期提供每天1500ml必需的营养。
优选地，所述组合物提供供应14％至20％产品总热焓的蛋白质来源。可使用任何高品质蛋白质来源，或其混合物，以提供平衡的必需氨基酸谱。实例包括酪蛋白、乳清和大豆蛋白质。蛋白质可为完整蛋白质或部分水解的蛋白质。如需要可添加游离氨基酸。优选地，按重量计至少50％的蛋白质是乳清蛋白质。在实施方案中，利用60％乳清蛋白质和40％大豆蛋白质的混合物。
优选地，糖类来源提供10％至50％的产品总热焓。在优选的实施方案中，它提供少于45％的总热焓。选择所述糖类成分来优选提供低血糖应答。合适的糖类为果糖、糖醇如山梨醇和木糖醇、淀粉、糊精、麦芽糖糊精和其混合物。
优选地，脂类来源提供30％至45％的总热焓，其中按所述脂类重量计40％至60％为单不饱和脂肪酸(MUFA)。可使用膳食脂类的任何合适混合物如饱和脂肪酸(SFA)、MUFA、多不饱和脂肪酸(PUFA)和中链甘油三酯(MCT)。优选地，所述饱和脂肪酸不超过1.1g/100千卡。优选地，按所述脂类重量计0.4％至2％为二十碳五烯酸。
可向产品中添加额外的物质。例如，每100千卡胆碱可以以至少30mg的水平存在，牛磺酸以至少5.0mg的水平存在，且肉碱以至少3.0mg的水平存在。关于植物营养物，其每100千卡可按如下量存在：至少0.1mgβ-胡萝卜素、至少0.2mg番茄红素、和至少0.05mg叶黄素。在实施方案中，产品的能量密度介于0.8至1.3千卡/ml间。
根据本发明的配方，通过提供降低的糖类摄入，和添加果糖、纤维和铬，配方有助于维持血糖稳态。此外，该配方能够处理在患者群中葡萄糖不耐受的盛行。
在发明的实施方案中使用果糖。果糖运进细胞而无需任何胰岛素介入。因此，它是代替葡萄糖的极好的能量来源。此外，果糖促进葡萄糖的肝脏利用。这两种机制帮助避免过度的餐后高血糖。
由于铬激活葡萄糖的氧化，因此在组合物中使用铬是有益的。它限制对葡萄糖的不耐受并降低对胰岛素的需要。
使用改良纤维调节葡萄糖的吸收。这限制血糖峰值。此外，维生素D摄入量是高的，以便维持骨量储备。
如上指出，本发明提供为长期使用而优化和/或改良的方法及产品。在实施方案中，为在医院环境之外的患者提供这些产品。例如，可在疗养院、外部患者护理中心、或甚至患者家中提供所述产品。优选地，将营养产品包装于塑料袋中。多种此类袋子是公知的，例如，500ml、1000ml和1500ml袋子是本领域已知的。然而，应指出任何合适的容器均可用于容纳该营养产品。在实施方案中，设计产品用于以每天1500ml提供必需营养，尽管本领域技术人员将理解该水平的变化是可能的。
在实施方案中，专门设计营养产品使得它们可提供完整的长期营养，并尝试提供与进食正常膳食的人摄入的相同的大量营养物和微量营养物。因此在实施方案中，配方模拟此处所指的每天5/8。如此处所用，术语“每天5/8”指政府对消费者每天进食5至8份水果和蔬菜的指导方针。因此，在实施方案中设计产品使得在可能程度上它们通过提供在水果和蔬菜中发现的微量营养物和植物营养物来尝试模拟不需要管饲产品的个体优选摄入的正常饮食。在实施方案中，本发明提供基于尝试模拟每天5/8设计长期肠内营养产品的方法。通过提供此类营养产品，可维持患者的抗氧化状态及代谢状态。目标是在可能程度上使这些患者处于与进食均衡膳食的相同年龄的完全健康个体相当的状态。
已发现植物营养物提供如下特征：抗氧化、抗炎症、解毒、抗癌、预防动脉粥样硬化、缓解代谢综合征并预防骨质损失。为获得必需的植物营养物，本发明的组合物可包含一种或多种类胡萝卜素如番茄红素(番茄)、B-胡萝卜素(胡萝卜、菠菜、番茄)、叶黄素(菠菜)、B-隐黄素、维生素如混合的生育酚(油和坚果)和维生素C(橙子)；和多酚类如儿茶素(绿茶)。
优选地，产品包含必需营养组分以在长期基础上为患者提供完全营养。在这方面，所述产品包含：蛋白质、糖类、脂肪、维生素和矿物质以及其它可能的成分。在实施方案中，所述产品基本上(如果不是完全地)满足至少某些政府要求。如此处使用，“政府要求”指来自以下政府中任何一个的任何建议：美国，通常为USRDA；德国，通常为德国RDA；和法国，通常为法国RDA。在实施方案中，所述营养产品满足或超过政府要求中的至少一种。
通过实施例并且非限定，现在给出本发明的实施例。
实施例1-老年人产品
实施例2-老年人产品
根据本发明的实施方案，可在需要时至少每天一次长期向不能进食正常饮食的老年患者提供实施例1或2的制剂。
应理解对此处描述的目前优选实施方案的多种改变和修饰对于本领域技术人员将是显而易见的。可在不背离本主题的精神和范围及不减少其预期优点的情况下进行此类改变和修饰。因此旨在通过附带的权利要求涵盖此类改变和修饰。
Claims (30)
1.向老年患者提供管饲营养的方法，所述方法包括步骤：通过导管每天一次向老年患者长期施用营养产品，所述营养产品包含：按所述产品热焓计包含14％至20％的蛋白质来源；按所述产品热焓计包含10％至50％的糖类来源；按所述产品热焓计包含30％至45％的脂类来源；每升所述产品中提供10至25克的膳食纤维来源；和每100千卡所述产品中8.0至18.0微克铬。
2.权利要求1的方法，其中所述脂类包含按重量计40％至60％的单不饱和脂肪。
3.权利要求1的方法，其中按重量计至少25％的所述纤维是可溶性的。
4.权利要求1的方法，其中所述蛋白质来源选自酪蛋白、乳清和大豆。
5.权利要求1的方法，其中所述糖类选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。
6.权利要求1的方法，其中所述产品每100千卡包含不超过1.1克饱和脂肪酸。
7.权利要求1的方法，其中所述产品包含按脂类重量计0.4％至2.0％的二十碳五烯酸。
8.权利要求1的方法，其中所述产品每100千卡包含至少：
30mg胆碱；
5.0mg牛磺酸；和
3.0mg肉碱。
9.权利要求1的方法，其中所述产品每100千卡包含下列的至少一种或多种：
0.1mg β-胡萝卜素；
0.2mg番茄红素；和
0.05mg叶黄素。
10.权利要求1的方法，其中所述能量密度为0.8至1.3千卡/ml。
11.权利要求1的方法，其中所述膳食纤维来源提供可溶性和不溶性纤维。
12.权利要求1的方法，其中所述产品包含益生元。
13.向老年患者提供营养的方法，所述方法包括步骤：至少每天一次通过导管长期施用组合物，所述组合物包含：蛋白质来源；脂肪来源；通过糖类来源提供的不超过所述组合物44％的能量；包含按重量计至少25％可溶性纤维的膳食纤维来源；每100千卡产品至少8.0微克铬；维生素D；和钙。
14.权利要求13的方法，其中每100千卡包含至少0.5微克维生素D。
15.权利要求13的方法，其中每100千卡包含至少35mg钙。
16.权利要求13的方法，其中所述蛋白质来源选自酪蛋白、乳清和大豆。
17.权利要求13的方法，其中所述糖类选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。
18.权利要求13的方法，其中所述产品每100千卡包含不超过1.1克饱和脂肪酸。
19.权利要求13的方法，其中所述产品每100千卡包含至少：
30mg胆碱；
5.0mg牛磺酸；和
3.0mg肉碱。
20.权利要求13的方法，其中所述产品每100千卡包含至少：
0.1mg β-胡萝卜素；
0.2mg番茄红素；和
0.05mg叶黄素。
21.权利要求13的方法，其中所述能量密度为0.8至1.3千卡/ml。
22.用于提供长期管饲营养的组合物，所述组合物包含：按所述产品热焓计包含14％至20％的蛋白质来源；按所述产品热焓计包含10％至50％的糖类来源；按所述产品热焓计包含30％至45％的脂类来源；每升所述产品提供10至25克的膳食纤维来源，且包含可溶性及不溶性纤维，其中按所述纤维重量计至少25％是可溶性的；每100千卡所述产品中8.0至18.0微克铬；所述产品包含足够的矿物质和维生素以满足政府规定。
23.权利要求22的产品，其中所述脂类包含按重量计40％至60％的单不饱和脂肪。
24.权利要求22的产品，其中所述蛋白质来源选自酪蛋白、乳清和大豆。
25.权利要求22的产品，其中所述糖类选自果糖、糖醇、淀粉、糊精和麦芽糖糊精。
26.权利要求22的产品，其每100千卡包含不超过1.1克饱和脂肪酸。
27.权利要求22的产品，其包含按所述脂类重量计0.4％至2.0％的二十碳五烯酸。
28.权利要求22的产品，其每100千卡包含至少：
30mg胆碱；
5.0mg牛磺酸；和
3.0mg肉碱。
29.权利要求22的产品，其每100千卡包含至少：
0.1mg β-胡萝卜素；
0.2mg番茄红素；和
0.05mg叶黄素。
30.权利要求22的产品，其中所述能量密度为0.8至1.3千卡/ml。
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| CN102753027A (zh) * | 2009-12-07 | 2012-10-24 | N·V·努特里奇亚 | 平衡脂肪组合物及其在适合肠饲的液体营养组合物中的用途 |
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| CN111838321A (zh) * | 2020-08-18 | 2020-10-30 | 青岛大学 | 一种含叶黄素和益生元的老年营养包及其制备方法 |
Also Published As
| Publication number | Publication date |
|---|---|
| US20130296234A1 (en) | 2013-11-07 |
| CO6160277A2 (es) | 2010-05-20 |
| EP2081449A2 (en) | 2009-07-29 |
| RU2406411C1 (ru) | 2010-12-20 |
| CL2007003018A1 (es) | 2009-01-23 |
| JP2010513226A (ja) | 2010-04-30 |
| CA2664139A1 (en) | 2008-04-24 |
| JP2013166767A (ja) | 2013-08-29 |
| MY148276A (en) | 2013-03-29 |
| WO2008046865A2 (en) | 2008-04-24 |
| CA2664139C (en) | 2013-08-13 |
| WO2008046865A3 (en) | 2008-12-11 |
| AU2007312284B2 (en) | 2011-03-03 |
| JP6096571B2 (ja) | 2017-03-15 |
| CN103494196A (zh) | 2014-01-08 |
| ZA200903406B (en) | 2010-07-28 |
| BRPI0717410A2 (pt) | 2013-11-12 |
| AU2007312284A1 (en) | 2008-04-24 |
| IL197475A0 (en) | 2009-12-24 |
| MX2009003239A (es) | 2009-04-08 |
| US20100094246A1 (en) | 2010-04-15 |
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