CN108703378A - 一种糖尿病型肠内营养多聚合剂 - Google Patents
一种糖尿病型肠内营养多聚合剂 Download PDFInfo
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Abstract
本发明公开了一种糖尿病型肠内营养多聚合剂，它涉及营养制剂领域。所述的糖尿病型肠内营养多聚合剂具体包括以下重量配比的组分：脂肪粉25‑30份；乳清蛋白30‑35份；麦芽糊精0‑20份；果糖2‑8份；缓释淀粉2‑15份；膳食纤维5‑15份；复合维生素2‑5份；复合矿物质3‑7份；木糖醇5‑10份；苦瓜粉5‑8份；百合粉5‑8份；枣粉2‑5份；黄原胶0.2‑0.8份；香精0.1‑0.4份。本发明是一种营养均衡、低GI值的配方产品，符合现代医学关于糖尿病的营养治疗发展方向，具有广阔的市场前景。
Description
技术领域
本发明涉及的是营养制剂领域，具体涉及一种糖尿病型肠内营养多聚合剂。
背景技术
随着社会老龄化进程，我国糖尿病患者已超过1.3亿，糖耐量降低的患者已超过1.4亿。因此,为糖尿病患者或糖不耐受患者提供一种部分替代或全部替代糖尿病专用型肠内的营养剂刻不容缓。
糖尿病患者由于体内胰岛素分泌绝对或相对不足，容易造成糖、蛋白质、脂肪代谢紊乱和酸碱平衡紊乱，进而引发各种并发症。三大热能营养素的代谢异常，最突出的是糖代谢异常。一方面，糖尿病患者的胰岛素分泌不足，容易造成葡萄糖进入细胞内减少，糖原合成减少，糖酵解减弱，三羧酸循环减弱，磷酸戊糖通路减弱，这些因素共同作用引起葡萄糖的利用减少，血糖升高。另一方面，正常血糖浓度的维持有赖于胰岛素和升高血糖激素的平衡。糖尿病患者由于胰岛素减少，升血糖激素(如胰高血糖素、儿茶酚胺等)相对分泌增加，从而引起糖原分解增多和糖原异生增加，最终导致血糖偏高。
脂肪代谢方面，由于胰岛素缺乏使脂肪合成减少，分解增加，造成血中脂肪酸明显增多，脂肪酸与磷酸甘油结合转化为甘油三酯。所以糖尿病患者血中甘油三酯水平显著增高，脂肪酸经肝的氧化分解大量的乙酰CoA，该物质不能进入三羧酸循环，所以酮体生成增加，胆固醇合成增加。
胰岛素极其重要的作用是促进蛋白质合成，抑制蛋白质分解。糖尿病时，尤其是1型糖尿病患者由于胰岛素分泌不足，引起胰岛素的上述作用减弱，其结果是蛋白质的合成减少而分解增加，机体呈负氮平衡，最终导致患者肌肉萎缩，消瘦乏力，抵抗力降低。
GI值是衡量食物引起餐后血糖反应的有效指标，表示含50g有价值糖类食物和相当量葡萄糖或白面包在一定时间内，通常为2小时，体内血糖应答水平百分比值，餐后血糖应答值常用血糖应答曲线下面积来表示。研究表明，在总能量控制的前提下，提高糖类摄入量（低GI值）不仅可改善糖耐量、降低胆固醇及三酰甘油，还可提高周围组织对胰岛素敏感性。
综上所述，本发明设计了一种糖尿病型肠内营养多聚合剂。
发明内容
针对现有技术上存在的不足，本发明目的是在于提供一种糖尿病型肠内营养多聚合剂，是一种营养均衡、低GI值的配方产品，符合现代医学关于糖尿病的营养治疗发展方向，具有广阔的市场前景。
为了实现上述目的，本发明是通过如下的技术方案来实现：一种糖尿病型肠内营养多聚合剂，包括以下能量配比的营养成分：碳水化合物50%-55%，蛋白质20%-22%，脂肪25%-28%，其中单不饱和脂肪酸供能比为10-20% 。
所述的糖尿病型肠内营养多聚合剂具体包括以下重量配比的组分：脂肪粉25-30份；乳清蛋白30-35份；麦芽糊精0-20份；果糖2-8份；缓释淀粉2-15份；膳食纤维5-15份；复合维生素（维生素A、维生素D、维生素E、维生素K、维生素B1、维生素B2、维生素B6、维生素B12、烟酰胺、泛酸、维生素C、叶酸、生物素、牛磺酸）2-5份；复合矿物质（钠、钾、钙、镁、磷、锌、铁、铜、锰、碘、硒、氯）3-7份；木糖醇5-10份；苦瓜粉5-8份；百合粉5-8份；枣粉2-5份；黄原胶0.2-0.8份；香精0.1-0.4份。
所述的碳水化合物系统由麦芽糊精、果糖、缓释淀粉和膳食纤维四部分组成。
所述的缓释淀粉包括抗性淀粉、木薯淀粉、高直连玉米淀粉、蜡质谷物淀粉中的一种或两种组合。
所述的膳食纤维包含可溶性膳食纤维与不溶性膳食纤维，其中可溶性膳食纤维来源于菊粉、聚葡萄糖、低聚半乳糖、低聚果糖、多聚果糖、棉籽糖、低聚木糖、低聚异麦芽糖中的一种或多种组合；不溶性膳食纤维来源于抗性糊精、大豆纤维、玉米麸纤维、甜菜纤维、小麦纤维、小麦麸纤维、燕麦纤维、苹果纤维中的一种或多种组合种。
所述的水溶性膳食纤维与不溶性膳食纤维的比例为2:1-1:3，更优选的为1:1。
本发明具有以下有益效果：
1. 本发明所提供的肠内营养组合物通过多种原料的合理组合，符合营养指南对患有糖尿病且肾功能正常个体的营养推荐。临床研究结果也显示：经过5d的该种肠内营养治疗，糖尿病患者营养状况均有改善，其中ALB和PB较治疗前浓度明显提高(P <0.05)，而肺部感染、腹腔感染、尿路感染发生率与标准整蛋白制剂相比却明显降低(P<0.05)。本发明所述肠内营养聚合剂在保证患者正常生活的前提下，可以有效纠正已发生的代谢紊乱，减轻胰岛β细胞负荷，从而延缓并减轻糖尿病并发症的发生和发展，进一步提高其生活质量。
2.本发明所提供的肠内营养组合物，选用特殊的碳水化合物配方，既能快速补充人体所需能量；又能缓慢消化分解，减轻胰岛负担。通过合理配比，有效控制产品的血糖生成指数在30-40之间，从而有利于患者胰岛功能的恢复,降低患者餐后血糖。临床研究表明：使用该肠内营养聚合剂治疗后第3天、第5天患者餐后2 h血糖水平明显低于治疗前和对照组（标准整蛋白制剂）三者之间P<0. 05，表明该产品在降低餐后血糖方面具有显著效果。
3.在满足人体能量需求的基础上，本发明以单不饱和脂肪酸部分地替代饱和脂肪酸，能有效纠正糖尿病患者脂代谢异常，减少高胆固醇血症及心血管疾病的发生。
4. 本发明将疾病营养与传统中医理论相结合，在保证基础营养需求的基础上特别添加多种药食同源成分，能够有效改善胰岛素敏感性，提高患者糖耐量，降低空腹血糖水平。
具体实施方式
为使本发明实现的技术手段、创作特征、达成目的与功效易于明白了解，下面结合具体实施方式，进一步阐述本发明。
本具体实施方式采用以下技术方案：一种糖尿病型肠内营养多聚合剂，包括以下能量配比的营养成分：碳水化合物50%-55%，蛋白质20%-22%，脂肪25%-28%，其中单不饱和脂肪酸供能比为10-20% 。
所述的糖尿病型肠内营养多聚合剂具体包括以下重量配比的组分：脂肪粉25-30份；乳清蛋白30-35份；麦芽糊精0-20份；果糖2-8份；缓释淀粉2-15份；膳食纤维5-15份；复合维生素（维生素A、维生素D、维生素E、维生素K、维生素B1、维生素B2、维生素B6、维生素B12、烟酰胺、泛酸、维生素C、叶酸、生物素、牛磺酸）2-5份；复合矿物质（钠、钾、钙、镁、磷、锌、铁、铜、锰、碘、硒、氯）3-7份；木糖醇5-10份；苦瓜粉5-8份；百合粉5-8份；枣粉2-5份；黄原胶0.2-0.8份；香精0.1-0.4份。配方通过多种原料的合理组合，符合ADA及《中国糖尿病医学营养治疗指南（2010）》中对于患有糖尿病患者的营养推荐，可以有效纠正已发生的代谢紊乱，减轻胰岛β细胞负荷，从而延缓并减轻糖尿病并发症的发生和发展，进一步提高患者生活质量。
在碳水化合物来源方面，目前国内已上市的含缓释淀粉的整蛋白型肠内营养多为美国和欧洲进口，成本较高，不利于长期使用；而国产该类肠内营养研究基本空白。本发明针对糖尿病患者的糖代谢特点，结合临床营养推荐及低GI食物的治疗效果，在保证碳水化合物达到推荐比例的基础上特别设计了特殊的碳水化合物系统，以降低产品的GI值。该碳水化合物系统由麦芽糊精、果糖、缓释淀粉和膳食纤维四部分组成。其中，麦芽糊精能迅速分解为葡萄糖，可以快速补充人体所需能量；果糖在体内的代谢由于不受胰岛素的控制，因此其不会引起餐后血糖高峰；而缓释淀粉和膳食纤维组合则可以减缓碳水化合物的消化分解，减轻胰岛负担。本发明通过将四者合理配比，能有效控制产品的血糖生成指数，终产品GI值约为30-40，长期食用具有改善患者血糖控制能力，避免高胰岛素血症和胰岛素抵抗等代谢综合症及微血管并发症发生的功能。
所述的缓释淀粉包括抗性淀粉、木薯淀粉、高直连玉米淀粉、蜡质谷物淀粉中的一种或两种组合。
所述的膳食纤维包含可溶性膳食纤维与不溶性膳食纤维，其中可溶性膳食纤维来源于菊粉、聚葡萄糖、低聚半乳糖、低聚果糖、多聚果糖、棉籽糖、低聚木糖、低聚异麦芽糖中的一种或多种组合；不溶性膳食纤维来源于抗性糊精、大豆纤维、玉米麸纤维、甜菜纤维、小麦纤维、小麦麸纤维、燕麦纤维、苹果纤维中的一种或多种组合种。分析目前市场产品中不难发现其添加的膳食纤维多为水溶性膳食纤维，大多没有考虑膳食纤维的配比。本发明的创造性还在于：在研究膳食纤维合理配比的基础上，结合中国居民饮食中水溶性膳食纤维所占的比例小的特点，调整配方中水溶性膳食纤维与不溶性膳食纤维的比例为2:1-1:3，更优选的为1:1。
在脂肪来源方面，本发明依据ADA对糖尿病饮食治疗的推荐，将富含ω-6脂肪酸的玉米油、大豆油或葵花籽油，富含ω-6脂肪酸的亚麻籽油或紫苏籽油与富含单不饱和脂肪酸（MUFA）的橄榄油或茶籽油复配喷雾，使脂肪粉中脂肪含量达到30%-70%，其中不饱和脂肪酸含量高达80%-90%，单不饱和脂肪酸含量达到50%-80%。与市场上标准整蛋白产品相比，本发明以单不饱和脂肪酸部分地替代饱和脂肪酸，一方面能有效降低患者血糖水平，提高患者糖耐量；另一方面还可以纠正患者脂代谢异常，减少高胆固醇血症及心血管疾病的发生。
在蛋白来源方面，本发明所述肠内营养多聚合剂选用全优质乳清蛋白来源，包括浓缩乳清蛋白、分离乳清蛋白或水解乳清蛋白的一种或多种。其优势在于：第一，乳清蛋白的组成最接近人体氨基酸模式，也是生物利用率最高的蛋白质（乳清蛋白的生物价（104）明显高于乳蛋白（91）、酪蛋白（77）和大豆蛋白（74））；第二，乳清蛋白中免疫球蛋白和乳铁蛋白的免疫活性和抗氧化特性，还可以提高免疫力。
本具体实施方式的原料中还可以以重量计加入木糖醇5-10份。由于木糖醇可以在不依赖胰岛素的情况下通过磷酸戊糖途径生成6一磷酸果糖及3一磷酸甘油醛，从而改善葡萄糖的利用。因此本发明特别添加木糖醇有利于纠正患者血糖控制能力，从而患者血糖波动。
本具体实施方式将疾病营养与传统中医理论相结合，添加了苦瓜粉5-8份、百合粉5-8份、枣粉2-5份。研究发现，苦瓜能够有效增加骨骼肌IRS-1酪氨酸磷酸化，从而改善胰岛素敏感性，提高患者糖耐量，降低空腹血糖水平；百合能够有效促进胰岛β细胞的增殖和分泌胰岛素，从而降低患者血糖水平，而红枣则具有促进淋巴细胞增殖的功能，对抗氧化、抗衰老、提高机体免疫力的作用。因此，本发明在保证基础营养需求的基础上还能够有效改善机体状态，从而有利于患者的康复。
本具体实施方式的糖尿病型肠内营养组合物中添加了不溶性的膳食纤维和矿物质，在冲调过程中容易出现沉淀，不利于营养成分的吸收。为了改善产品的组织状态，提高产品粘度和悬浮稳定性，本发明所述的原料中还以重量计加入了黄原胶0.2-0.8份。通过调整黄原胶的添加量，产品冲调后可以稳定悬浮8小时以上。
实施例1：
一种糖尿病型肠内营养多聚合剂，包括以下重量配比的组分：脂肪粉30份；浓缩乳清蛋白27份；麦芽糊精8.5份；果糖4份；抗性淀粉5份；木薯淀粉2份；菊粉2份；抗性糊精3份；复合维生素2份；复合矿物质4份；木糖醇5份；枣粉2份；苦瓜粉5份；百合粉5份；黄原胶0.3份；香精0.2份。
实施例2：
一种糖尿病型肠内营养多聚合剂，包括以下重量配比的组分：脂肪粉30份；分离乳清蛋白28份；麦芽糊精5.4份；果糖2份；抗性淀粉7份；木薯淀粉5份；小麦纤维1份；抗性糊精2份；菊粉2份；低聚果糖1份；复合维生素4份；复合矿物质4份；木糖醇5份；枣粉2份；苦瓜粉6份；百合粉6份；黄原胶0.3份；香精0.3份。
实施例3：
一种糖尿病型肠内营养多聚合剂，包括以下重量配比的组分：脂肪粉25份；浓缩乳清蛋白15.5份；分离乳清蛋白9.5份；麦芽糊精10.5份；果糖3份；高直链玉米淀粉6份；木薯淀粉3份；低聚果糖1份；低聚异麦芽糖1份；聚葡萄糖1份；苹果纤维2份；抗性糊精1份；复合维生素4份；复合矿物质4份；木糖醇8份；枣粉3份；苦瓜粉8份；百合粉6份；黄原胶0.3份；香精0.2份。
实施例4：
一种糖尿病型肠内营养多聚合剂，包括以下重量配比的组分：脂肪粉25份；浓缩乳清蛋白18.5份；分离乳清蛋白16份；果糖2份；抗性淀粉3份；蜡质谷物淀粉3份；木薯淀粉7份；低聚木糖0.5份；棉籽糖1.5份；燕麦纤维1.5份；抗性糊精1.5份；复合维生素4份；复合矿物质4份；木糖醇5份；枣粉3份；苦瓜粉8份；百合粉8份；黄原胶0.3份；香精0.2份。
以上显示和描述了本发明的基本原理和主要特征和本发明的优点。本行业的技术人员应该了解，本发明不受上述实施例的限制，上述实施例和说明书中描述的只是说明本发明的原理，在不脱离本发明精神和范围的前提下，本发明还会有各种变化和改进，这些变化和改进都落入要求保护的本发明范围内。本发明要求保护范围由所附的权利要求书及其等效物界定。
Claims (6)
1.一种糖尿病型肠内营养多聚合剂，其特征在于，包括以下能量配比的营养成分：碳水化合物50%-55%，蛋白质20%-22%，脂肪25%-28%，其中单不饱和脂肪酸供能比为10-20%。
2.根据权利要求1所述的一种糖尿病型肠内营养多聚合剂，其特征在于，所述的糖尿病型肠内营养多聚合剂具体包括以下重量配比的组分：脂肪粉25-30份；乳清蛋白30-35份；麦芽糊精0-20份；果糖2-8份；缓释淀粉2-15份；膳食纤维5-15份；复合维生素2-5份；复合矿物质3-7份；木糖醇5-10份；苦瓜粉5-8份；百合粉5-8份；枣粉2-5份；黄原胶0.2-0.8份；香精0.1-0.4份。
3.根据权利要求1所述的一种糖尿病型肠内营养多聚合剂，其特征在于，所述的碳水化合物系统由麦芽糊精、果糖、缓释淀粉和膳食纤维四部分组成。
4.根据权利要求2所述的一种糖尿病型肠内营养多聚合剂，其特征在于，所述的缓释淀粉包括抗性淀粉、木薯淀粉、高直连玉米淀粉、蜡质谷物淀粉中的一种或两种组合。
5.根据权利要求2所述的一种糖尿病型肠内营养多聚合剂，其特征在于，所述的膳食纤维包含可溶性膳食纤维与不溶性膳食纤维，其中可溶性膳食纤维来源于菊粉、聚葡萄糖、低聚半乳糖、低聚果糖、多聚果糖、棉籽糖、低聚木糖、低聚异麦芽糖中的一种或多种组合；不溶性膳食纤维来源于抗性糊精、大豆纤维、玉米麸纤维、甜菜纤维、小麦纤维、小麦麸纤维、燕麦纤维、苹果纤维中的一种或多种组合种。
6.根据权利要求5所述的一种糖尿病型肠内营养多聚合剂，其特征在于,所述的水溶性膳食纤维与不溶性膳食纤维的比例1:1。
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