JP5160569B2 - Nutritional composition that can adjust the amount of energy, the amount of water and the amount converted to salt - Google Patents
Nutritional composition that can adjust the amount of energy, the amount of water and the amount converted to salt Download PDFInfo
- Publication number
- JP5160569B2 JP5160569B2 JP2009550844A JP2009550844A JP5160569B2 JP 5160569 B2 JP5160569 B2 JP 5160569B2 JP 2009550844 A JP2009550844 A JP 2009550844A JP 2009550844 A JP2009550844 A JP 2009550844A JP 5160569 B2 JP5160569 B2 JP 5160569B2
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- water
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Classifications
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- A—HUMAN NECESSITIES
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Description
本発明は、エネルギー量、水分量および食塩換算量を調整できる、経腸栄養法に用いる栄養組成物に関する。 The present invention relates to a nutritional composition used for enteral nutrition that can adjust the amount of energy, the amount of water, and the amount converted into salt.
栄養療法は、消化器機能が低下している、患者、乳幼児、高齢者および要介護者などにおいて、食事摂取が不十分もしくは不可能な場合の栄養素補給のために用いられており、なかでも経腸栄養療法は、経静脈栄養法より安全かつ低コストな栄養療法として広く用いられている。これは、中心静脈栄養法では、消化管を経由しないことから、糖代謝異常等の代謝性合併症、消化管粘膜の萎縮等の消化器合併症およびカテーテルに起因する感染症などの問題があるためである。そのため、近年、消化器が機能していれば、中心静脈栄養法ではなく経腸栄養法を選択するという原則が確立しつつある。 Nutrition therapy is used by patients, infants, the elderly and care recipients who have impaired digestive function to provide nutrients when food intake is inadequate or impossible. Intestinal nutrition therapy is widely used as a safer and less expensive nutrition therapy than parenteral nutrition. This is because the central parenteral nutrition method does not go through the digestive tract, causing metabolic complications such as abnormal sugar metabolism, digestive tract complications such as atrophy of the digestive tract mucosa, and catheter-related infections. Because. Therefore, in recent years, the principle of selecting enteral nutrition rather than central parenteral nutrition is being established if the digestive system is functioning.
上記のとおり、経腸栄養法は安全かつ低コストな栄養療法として、多くの患者、乳幼児、高齢者および要介護者などに幅広く用いられており、食品または医薬品として各種の経腸栄養法用の流動性栄養組成物(以下、「流動食」ともいう)が市販されている。また、種々の栄養成分を配合した流動食が提案されている。流動食の配合例が開示されている代表的な特許文献を以下に例示する。 As mentioned above, enteral nutrition is a safe and low-cost nutritional therapy widely used by many patients, infants, the elderly and care recipients, and is used as a food or medicine for various enteral nutrition. A fluid nutrition composition (hereinafter also referred to as “liquid food”) is commercially available. Moreover, the liquid food which mix | blended various nutrient components is proposed. The typical patent document in which the formulation example of a liquid food is disclosed is illustrated below.
ここで、従来の市販されている経腸栄養法用の流動食や上記特許文献の流動食は、主にエネルギー量や各種栄養成分の濃度の観点から配合を設計しているため、摂取する人の状態に応じて、一食分のエネルギー量、水分量、およびナトリウム量を塩化ナトリウム(食塩)量に換算した食塩換算量などを調節する必要があり、通常は、市販の流動食のエネルギー量を基準にして、水およびナトリウムなどの含量を計算し、不足分を流動食に添加して調整した後に投与する必要があった。 Here, conventional liquid foods for enteral nutrition and liquid foods in the above-mentioned patent documents are designed mainly from the viewpoint of the amount of energy and the concentration of various nutritional components. It is necessary to adjust the amount of energy for one serving, the amount of water, and the amount of sodium converted to sodium chloride (salt) amount according to the state of the meal. It was necessary to calculate the contents of water, sodium, and the like as a standard, and add the deficiency to the liquid food to adjust it before administration.
このとき、とくに病院などの医療機関、保育施設や介護施設などの福祉施設においては、流動食を摂取する人は、患者、乳幼児、高齢者および要介護者など多様であり、その人毎の必要なエネルギー量、水分量および食塩換算量は異なっている。さらに、同じカテゴリーの人の間、例えば、同じ疾患の患者の間でも、それぞれの人が必要とするエネルギー量、水分量および食塩換算量は異なっている。 At this time, especially in medical institutions such as hospitals, welfare facilities such as childcare facilities and nursing care facilities, there are a wide variety of people who take liquid food, including patients, infants, the elderly, and people requiring care, and each person needs it. The amount of energy, the amount of water, and the amount converted into salt are different. Furthermore, the amount of energy, the amount of water, and the amount of salt converted by each person are different among people in the same category, for example, between patients with the same disease.
しかし、従来の市販されている経腸栄養法用の流動食では、ある種の疾患の患者、乳幼児、高齢者、要介護者などを夫々一括りにして、標準となるエネルギー量および栄養成分の濃度になるように配合されたものが市販されているのが現状である。
そのため、患者などの多様な人の状態に応じて、市販の流動食に、水や塩化ナトリウムなどを添加して調整することになるため、その人毎の必要量に合わせた水や塩化ナトリウムなどの添加作業が必要となり、臨床現場などにおける作業は極めて煩雑となっている。However, in the conventional liquid food for enteral nutrition, patients with certain diseases, infants, elderly people, care recipients, etc., each of which has a standard amount of energy and nutritional components. The present condition is that what was mix | blended so that it might become a density | concentration is marketed.
Therefore, according to the condition of various people such as patients, water and sodium chloride etc. will be adjusted by adding water and sodium chloride to commercially available liquid food, so water and sodium chloride etc. according to the required amount for each person Therefore, the work at the clinical site etc. is extremely complicated.
例えば、一般に臨床現場などにおいては、水分の添加は、流動食の容器に湯冷ましを直接加えて混合する方法や、流動食の容器とは別の容器に流動食と湯冷ましを入れて混合する方法などにより行われており、また、塩化ナトリウムの添加は、湯冷ましに塩化ナトリウムを溶かした後に、この溶液を流動食に加えて混合する方法や、溶液をシリンジで経管栄養チューブへ投与する方法などにより行われている。そして、介護や看護に携わる人は、これらの作業を1日に3回、しかも例え同一人物に対する同一処方の流動食であっても食事毎に行う必要があり、作業者は同じ作業を繰り返し行うという、極めて非効率な現状がある。 For example, generally in clinical settings, the addition of water is performed by directly adding hot water to a liquid food container and mixing, or by mixing liquid food and hot water in a container separate from the liquid food container, etc. In addition, sodium chloride is added by dissolving the sodium chloride in water and then adding this solution to a liquid food and mixing it, or administering the solution to a tube feeding tube with a syringe, etc. Has been done. And those who are engaged in nursing care or nursing need to perform these operations three times a day, and even for liquid foods of the same prescription for the same person for each meal, the operator repeats the same work There is a very inefficient current situation.
また、従来の市販されている経腸栄養法用の流動食では、上記のとおりエネルギー量や各栄養成分の濃度の観点から配合を設計しており、水分量や食塩換算量が端数であるため、計算がしづらく計算を間違える可能性も生じる。
さらに、一般に流動食の投与は、連続して数時間行われるものであり、上記の水および塩化ナトリウムの添加作業により一度開封された流動食は、微生物などによる汚染の可能性があり衛生的な問題も生じる。In addition, in the conventional commercially available liquid food for enteral nutrition method, the formulation is designed from the viewpoint of the amount of energy and the concentration of each nutritional component as described above, and the amount of water and salt equivalent is fractional. There is also a possibility that the calculation is difficult to make and is wrong.
Furthermore, in general, liquid food is administered for several hours continuously, and the liquid food once opened by the above-described operation of adding water and sodium chloride may be contaminated by microorganisms and is hygienic. Problems also arise.
したがって、このような状況下では、介護や看護に携わる人の日常業務の中において、市販の流動食の水分量や食塩換算量などを調整するための作業負担は少なくないという問題が、潜在的に存在しているといえる。また、流動食の汚染の可能性も大きな問題となり得る。 Therefore, under such circumstances, there is a potential problem that the work burden for adjusting the amount of water and salt equivalent of commercially available liquid food is not small in the daily work of people engaged in nursing care and nursing. It can be said that it exists. The possibility of contamination of liquid food can also be a major problem.
本発明者は、このような意外にも、これまで看過されてきた問題にあえて着目し、患者などの多様な人の状態に応じた最適なエネルギー量、水分量および食塩換算量などを有する流動食を、簡便かつ迅速に調製できる手段を開発することにより、流動食に水および塩化ナトリウムなどを添加する作業を省略でき、かつ調製時の汚染の問題を解消できる手段を提供することを目的とする。 The present inventor unexpectedly pays attention to problems that have been overlooked so far, and has the optimum energy amount, water amount, salt conversion amount, etc. according to the conditions of various people such as patients. The purpose of the present invention is to provide means that can eliminate the work of adding water, sodium chloride, etc. to a liquid food, and can solve the problem of contamination during preparation, by developing means that can prepare food easily and quickly. To do.
本発明によれば、エネルギー源となる栄養素、水およびナトリウムを含み、互いに略同一の成分であるが、エネルギー源となる栄養素、水およびナトリウムから選ばれる1種以上の成分の含量が異なる2種以上の栄養組成物を予め調製して準備し、多様な人の状態に応じた処方に合わせて前記栄養組成物を2種以上で組み合わせることにより、組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量を、同時に簡便かつ迅速に調整できることを見出し、さらに研究を進めた結果、本発明を完成するに至った。 According to the present invention, two kinds of nutrients, water and sodium that are energy sources are substantially the same as each other, but have different contents of one or more ingredients selected from nutrients, water, and sodium that are energy sources. Prepare and prepare the above nutritional composition in advance, and combine the nutritional composition in combination of two or more according to the prescription according to various human conditions. As a result of further research, the present inventors have completed the present invention.
すなわち本発明は、他の1種以上の栄養組成物と組み合わせることにより、組み合わせ後のエネルギー量、水分量および食塩換算量を調整するための、エネルギー源となる栄養素、水およびナトリウムの3成分を含む経腸栄養法に用いる栄養組成物であって、該栄養組成物と組み合わされる他の全ての栄養組成物と略同一の成分を含み、前記3成分から選ばれる1以上の成分が前記組み合わされる1種以上の栄養組成物中の当該成分とその含量において異なり、かつ、エネルギー量が5kcalの整数倍、水分量が50mlの整数倍および食塩換算量が0.5gの整数倍である、前記栄養組成物に関する。 That is, the present invention combines three components of nutrients, water, and sodium, which are energy sources, for adjusting the energy amount, water amount, and salt equivalent amount after combination by combining with one or more other nutritional compositions. A nutritional composition used for enteral nutrition, comprising substantially the same ingredients as all other nutritional compositions combined with the nutritional composition, wherein one or more ingredients selected from the three ingredients are combined The amount of energy is an integral multiple of 5 kcal, the amount of water is an integral multiple of 50 ml, and the amount in terms of salt is an integral multiple of 0.5 g. It relates to the nutritional composition.
さらに本発明は、栄養組成物のエネルギー量が200〜500kcalであり、水分量が200〜700mlであり、食塩換算量が0.5〜3.5gである、前記栄養組成物に関する。
また本発明は、栄養組成物のエネルギー量、水分量および食塩換算量が、夫々、300kcal、300mlおよび1.0g、300kcal、400mlおよび1.5g、300kcal、500mlおよび2.0g、400kcal、400mlおよび1.5g、400kcal、500mlおよび2.0g、または400kcal、600mlおよび2.5gである、前記栄養組成物に関する。
Furthermore, this invention relates to the said nutritional composition whose energy amount of a nutritional composition is 200-500 kcal, the amount of moisture is 200-700 ml, and salt conversion amount is 0.5-3.5 g.
The present invention also provides the nutritional amount of energy, water content and salt equivalent amount of 300 kcal, 300 ml and 1.0 g, 300 kcal, 400 ml and 1.5 g, 300 kcal, 500 ml and 2.0 g, 400 kcal, 400 ml and It relates to said nutritional composition which is 1.5 g, 400 kcal, 500 ml and 2.0 g, or 400 kcal, 600 ml and 2.5 g.
さらに本発明は、エネルギー源となる栄養素が、脂質、タンパク質、炭水化物、およびそれらの加水分解物からなる群より選ばれる1種以上である、前記栄養組成物に関する。
また本発明は、含量を調整する成分として、さらにビタミンおよび/またはナトリウム以外のミネラルを含む、前記栄養組成物に関する。Furthermore, this invention relates to the said nutrition composition whose nutrient as an energy source is 1 or more types chosen from the group which consists of lipid, protein, carbohydrate, and those hydrolysates.
Moreover, this invention relates to the said nutrition composition which contains minerals other than a vitamin and / or sodium as a component which adjusts content.
また本発明者は、従来の栄養組成物は、水分量に対するエネルギー量が1.0kcal/mlを超えるように配合設計されており、身体活動レベルの低い寝たきりの高齢者などが必要とする水分量とエネルギー量のバランスとは異なることに着目して、寝たきりの高齢者などの身体活動レベルに適合した、最適な水分量とエネルギー量のバランスを有する栄養組成物の発明を同時に開発した。
したがって本発明は、栄養組成物の水分量に対するエネルギー量が、0.5〜1.0kcal/mlである、前記栄養組成物にも関する。In addition, the present inventor has formulated and designed the conventional nutritional composition so that the amount of energy relative to the amount of water exceeds 1.0 kcal / ml, and the amount of water required by bedridden elderly people with low physical activity levels. At the same time, we developed an invention of a nutritional composition that has the optimal balance between the amount of water and the amount of energy suitable for the physical activity level of bedridden elderly people.
Therefore, this invention relates also to the said nutrition composition whose energy amount with respect to the moisture content of a nutrition composition is 0.5-1.0 kcal / ml.
さらに本発明者は、従来の栄養組成物は、エネルギー量に対する食塩換算量が0.25g/100kcal未満となるように配合設計されており、身体活動レベルの低い寝たきりの高齢者などが必要とするエネルギー量と食塩換算量のバランスとは異なることに着目して、寝たきりの高齢者などの身体活動レベルに適合した、最適なエネルギー量と食塩換算量のバランスを有する栄養組成物の発明を同時に開発した。
したがって本発明は、栄養組成物のエネルギー量に対する食塩換算量が、0.25〜1.0g/100kcalである、前記栄養組成物にも関する。
さらにまた本発明は、流動食である、前記栄養組成物に関する。
Furthermore, the present inventor has formulated and designed the conventional nutritional composition so that the amount of salt converted to the amount of energy is less than 0.25 g / 100 kcal, which is necessary for bedridden elderly people with low physical activity levels, etc. Focusing on the fact that the balance between the amount of energy and the amount converted into salt is different, and simultaneously developed the invention of a nutritional composition that has the optimum balance between the amount of energy and the amount converted into salt that is suitable for the physical activity level of the bedridden elderly did.
Therefore, this invention relates also to the said nutrition composition whose salt conversion amount with respect to the energy amount of a nutrition composition is 0.25-1.0g / 100kcal.
Furthermore, this invention relates to the said nutrition composition which is a liquid food.
また本発明者は、前記栄養組成物を密閉型の容器入りとすることにより、外気との接触を最小限にして患者に投与することを可能とし、栄養組成物の汚染の可能性をさらに減少できることに着目して、密閉式の容器に入れた容器入り栄養組成物の発明を同時に完成した。
したがって本発明は、前記栄養組成物を、密閉式の容器に入れた、容器入り栄養組成物であって、容器が、流出用および/または混合用の細口部を1つまたは2つ以上備えた、前記容器入り栄養組成物にも関する。
In addition, the present inventor can administer the nutritional composition to a patient with minimal contact with the outside air by placing the nutritional composition in a sealed container, further reducing the possibility of contamination of the nutritional composition. Focusing on what can be done, the invention of the nutritional composition in a container in a sealed container was completed at the same time.
Accordingly, the present invention is a nutritional composition containing a container in which the nutritional composition is placed in a hermetically sealed container, wherein the container is provided with one or more narrow mouth portions for outflow and / or mixing. It also relates to the nutritive composition in the container .
また本発明は、前記容器入り栄養組成物を2種以上で含む、容器入り栄養組成物のキットに関する。
さらに本発明は、エネルギー源となる栄養素、水およびナトリウムの3成分を含む経腸栄養法に用いる栄養組成物を、他の1種以上の栄養組成物と組み合わせることにより、組み合わせ後のエネルギー量、水分量および食塩換算量を調整する方法であって、
調整される栄養組成物が、組み合わされる他の全ての栄養組成物と略同一の成分を含み、前記3成分から選ばれる1以上の成分が前記組み合わされる1種以上の栄養組成物中の当該成分とその含量において異なり、かつ、調整される栄養組成物および組み合わされる他の全ての栄養組成物のエネルギー量が5kcalの整数倍、水分量が50mlの整数倍および食塩換算量が0.5gの整数倍である、前記方法に関する。
Moreover, this invention relates to the kit of the nutrition composition in a container containing the said nutrition composition in a container by 2 or more types.
Furthermore, the present invention combines a nutritional composition used for enteral nutrition containing three components of nutrients, water and sodium, which are energy sources, with one or more other nutritional composition, A method of adjusting the amount of moisture and the amount converted to salt,
The nutritional composition to be adjusted contains substantially the same ingredients as all other nutritional compositions to be combined, and one or more ingredients selected from the three ingredients are included in the one or more nutritional compositions to be combined. And the content of the nutritional composition to be adjusted and all other nutritional compositions to be combined are an integral multiple of 5 kcal, an integral multiple of 50 ml of water, and a salt equivalent of 0.5 g Is an integral multiple of the method.
本発明によれば、エネルギー源となる栄養素、水およびナトリウムを含み、互いに略同一の成分を含むが、エネルギー源となる栄養素、水およびナトリウムから選ばれる1種以上の成分の含量が異なる栄養組成物を、2種以上で組み合わせることにより、組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量などを自由に配合設計して同時に調整することができるため、多様な人の状態に応じた処方に合わせて、水やナトリウムなどの一日の必要量を計算して栄養組成物に添加する作業を無くして省力化することができる。さらに栄養組成物の調製時の汚染の可能性を大幅に低減することができる。 According to the present invention, a nutrient composition containing nutrients, water, and sodium as energy sources, including substantially the same components as each other, but having different contents of at least one component selected from nutrients, water, and sodium as energy sources By combining two or more kinds of foods, it is possible to freely design and adjust the energy amount, water content, salt equivalent amount, etc. of the nutritional composition after combination, so that it can be adjusted according to the conditions of various people According to the prescription, it is possible to save labor by eliminating the work of calculating the daily required amount of water and sodium and adding it to the nutritional composition. Furthermore, the possibility of contamination during preparation of the nutritional composition can be greatly reduced.
本発明において、栄養組成物とは、経腸栄養法に用いる栄養組成物であり、食品または医薬品である。
ここで、経腸栄養法には、栄養補給を口から行う経口摂取法と、チューブを用いて投与する経管栄養法とを含み、典型的には経管栄養法である。さらに経管栄養法には、経口法、経鼻法および経瘻法を含む。In the present invention, the nutritional composition is a nutritional composition used for enteral nutrition, and is a food or a medicine.
Here, the enteral nutrition method includes an oral intake method in which nutrition is supplied from the mouth and a tube feeding method in which administration is performed using a tube, and is typically a tube feeding method. Further, tube feeding includes oral, nasal and vaginal methods.
本発明の栄養組成物の性状は、液体、流動体、ゼリー状またはペースト状などであり、典型的には液体または流動体である。なお、栄養組成物を濃縮または乾燥して粉末状または固体などにし、使用時に水などを加えて液体または流動体などにする使用形態でもよい。
また、栄養組成物の分類は、成分栄養剤、消化態流動食もしくは消化態栄養剤、半消化態流動食もしくは半消化態栄養剤、または天然濃厚流動食などであり、典型的には消化態流動食もしくは消化態栄養剤、または半消化態流動食もしくは半消化態栄養剤である。The nutritional composition of the present invention is in the form of a liquid, fluid, jelly or paste, and is typically a liquid or fluid. In addition, the use form which concentrates or dries the nutritional composition to powder or solid and adds water at the time of use to make liquid or fluid may be used.
The classification of the nutritional composition includes ingredient nutrients, digested liquid foods or digestive nutrients, semi-digested liquid foods or semi-digested nutrients, natural concentrated liquid foods, etc. Liquid diet or digestive nutrient, or semi-digested fluid or semi-digestible nutrient.
本発明において、組み合わせるとは、本発明の栄養組成物の単体を、単体同士で組み合わせること、ならびに単体で組み合わせて混合した栄養組成物の一部を、単体および/または単体で組み合わせて混合した栄養組成物の一部に組み合わせることを意味する。
本発明の栄養組成物を2種以上で組み合わせることより、エネルギー量、水分量および食塩換算量を調整した栄養組成物は、組み合わせる各栄養組成物の単体を一食分として投与してもよく、また2種以上の栄養組成物の単体を互いに混合した後に、該混合した栄養組成物の全部または一部を一食分として投与してもよい。In the present invention, the term “combination” refers to the combination of the nutritional composition of the present invention as a single substance, and the nutritional composition obtained by combining and mixing a part of the nutritional composition as a single substance and / or as a simple substance. It is meant to be combined with a part of the composition.
By combining two or more of the nutritional compositions of the present invention, the nutritional composition in which the amount of energy, the amount of water and the amount in terms of salt are adjusted may be administered as a single serving of each nutritional composition to be combined, After the two or more kinds of nutritional compositions are mixed with each other, all or part of the mixed nutritional composition may be administered as a serving.
本発明において、組み合わされる他の1種以上の栄養組成物が、互いに略同一の成分を含むとは、組み合わされる2種以上の栄養組成物が、互いに同一の成分を含むこと、または互いに同一の組み合わせることにより含量を調整する成分を含み、さらに互いに異なる他の成分を含むことを意味する。 In the present invention, the other one or more nutritional compositions to be combined contain substantially the same ingredients as each other means that the two or more nutritional compositions to be combined contain the same ingredients or the same as each other. It includes ingredients that adjust the content by combining them, and further includes other ingredients that are different from each other.
組み合わされる他の1種以上の栄養組成物の数は、組み合わせ後の栄養組成物が多様な処方に対応できることの観点から、例えば、1〜5つであり、計算が容易であることおよび調製の作業負担を考慮して、好ましくは1〜4つであり、より好ましくは1〜3つである。 The number of other one or more nutritional compositions to be combined is, for example, 1 to 5 from the viewpoint that the combined nutritional composition can be used for various prescriptions. , Preferably 1 to 4, more preferably 1 to 3.
本発明の栄養組成物において、そのエネルギー量は、組み合わせ後の栄養組成物のエネルギー量が多様な処方に対応できること、およびエネルギー量の計算が容易であることの観点から、好ましくは5kcal、10kcal、25kcal、50kcalまたは100kcalの整数倍であり、品種数を少なくする観点から、より好ましくは25kcal、50kcalまたは100kcalの整数倍であり、とくに好ましくは50kcalまたは100kcalの整数倍である。 In the nutritional composition of the present invention, the amount of energy is preferably 5 kcal, 10 kcal, from the viewpoint that the energy amount of the nutritional composition after combination can correspond to various prescriptions and the calculation of the energy amount is easy. It is an integer multiple of 25 kcal, 50 kcal, or 100 kcal, and from the viewpoint of reducing the number of varieties, it is more preferably an integer multiple of 25 kcal, 50 kcal, or 100 kcal, and particularly preferably an integer multiple of 50 kcal or 100 kcal.
本発明の栄養組成物において、その水分量は、同様に組み合わせ後の栄養組成物の水分量が多様な処方に対応できること、および水分量の計算が容易であることの観点から、好ましくは5ml、10ml、25ml、50mlまたは100mlの整数倍であり、品種数を少なくする観点から、より好ましくは25ml、50mlまたは100mlの整数倍であり、とくに好ましくは50mlまたは100mlの整数倍である。 In the nutritional composition of the present invention, the water content is preferably 5 ml from the viewpoint that the water content of the nutritional composition after combination can correspond to various formulations and the calculation of the water content is easy. It is an integer multiple of 10 ml, 25 ml, 50 ml or 100 ml. From the viewpoint of reducing the number of varieties, it is more preferably an integer multiple of 25 ml, 50 ml or 100 ml, and particularly preferably an integer multiple of 50 ml or 100 ml.
本発明の栄養組成物において、食塩換算量とは、栄養組成物に含まれるナトリウム量を塩化ナトリウム(食塩)量に換算した数値である。
本発明の栄養組成物において、その食塩換算量は、同様に組み合わせ後の栄養組成物の食塩換算量が多様な処方に対応できること、および食塩換算量の計算が容易であることの観点から、好ましくは0.25g、0.5g、1.0gまたは2.5gの整数倍であり、品種数を少なくする観点から、より好ましくは0.25g、0.5gまたは1.0gの整数倍であり、とくに好ましくは0.5gまたは1.0gの整数倍である。In the nutritional composition of the present invention, the amount in terms of salt is a numerical value obtained by converting the amount of sodium contained in the nutritional composition into the amount of sodium chloride (salt).
In the nutritional composition of the present invention, the salt equivalent amount is preferably from the viewpoint that the salt equivalent amount of the nutritional composition after combination can correspond to various prescriptions and the calculation of the salt equivalent amount is easy. Is an integer multiple of 0.25 g, 0.5 g, 1.0 g, or 2.5 g, and more preferably an integer multiple of 0.25 g, 0.5 g, or 1.0 g from the viewpoint of reducing the number of varieties. Particularly preferred is an integer multiple of 0.5 g or 1.0 g.
本発明の栄養組成物において、エネルギー量、水分量および食塩換算量の配合は、組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量が多様な処方に対応できること、計算が容易であることおよび品種数を減らす観点から、好ましくはエネルギー量、水分量および食塩換算量が、夫々、100kcal〜600kcal、100ml〜800mlおよび0.25g〜4.5gの範囲であり、より好ましくは200kcal〜500kcal、200ml〜700mlおよび0.5g〜3.5gの範囲であり、とくに好ましくは300kcal〜400kcal、300ml〜600mlおよび0.5g〜2.5gの範囲である。 In the nutritional composition of the present invention, the amount of energy, the amount of water and the amount converted into salt can be combined with various formulas for the energy amount, the amount of water and the amount converted into salt after the combination, and calculation is easy. From the viewpoint of reducing the number of varieties and the number of varieties, the amount of energy, the amount of water and the amount converted to salt are preferably in the range of 100 kcal to 600 kcal, 100 ml to 800 ml and 0.25 g to 4.5 g, more preferably 200 kcal to 500 kcal, respectively. , 200 ml to 700 ml and 0.5 g to 3.5 g, particularly preferably 300 kcal to 400 kcal, 300 ml to 600 ml and 0.5 g to 2.5 g.
本発明の栄養組成物において、エネルギー量、水分量および食塩換算量の具体的な配合例としては、同様に組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量が多様な処方に対応できること、計算が容易であることおよび品種数を減らす観点から、例えば、エネルギー量、水分量および食塩換算量が、夫々、300kcal、300mlおよび0.5g、300kcal、300mlおよび1.0g、300kcal、400mlおよび1.0g、300kcal、400mlおよび1.5g、300kcal、500mlおよび1.5g、300kcal、500mlおよび2.0g、400kcal、400mlおよび1.0g、400kcal、400mlおよび1.5g、400kcal、500mlおよび1.5g、400kcal、500mlおよび2.0g、400kcal、600mlおよび2.0g、または400kcal、600mlおよび2.5gである栄養組成物などがあげられ、好ましくは、エネルギー量、水分量および食塩換算量が、夫々、300kcal、300mlおよび1.0g、300kcal、400mlおよび1.5g、300kcal、500mlおよび2.0g、400kcal、400mlおよび1.5g、400kcal、500mlおよび2.0g、または400kcal、600mlおよび2.5gである栄養組成物などがあげられる。 In the nutritional composition of the present invention, as specific examples of the amount of energy, the amount of water and the amount converted into salt, the energy amount, the amount of water and the amount converted into salt in the combined nutritional composition are also compatible with various formulations. From the viewpoint of being able to be calculated, easy to calculate, and reducing the number of varieties, for example, the amount of energy, the amount of water, and the amount in terms of salt are 300 kcal, 300 ml and 0.5 g, 300 kcal, 300 ml and 1.0 g, 300 kcal, 400 ml, respectively. And 1.0 g, 300 kcal, 400 ml and 1.5 g, 300 kcal, 500 ml and 1.5 g, 300 kcal, 500 ml and 2.0 g, 400 kcal, 400 ml and 1.0 g, 400 kcal, 400 ml and 1.5 g, 400 kcal, 500 ml and 1 .5 , 400 kcal, 500 ml and 2.0 g, 400 kcal, 600 ml and 2.0 g, or 400 kcal, 600 ml and 2.5 g of a nutritional composition, etc. 300 kcal, 300 ml and 1.0 g, 300 kcal, 400 ml and 1.5 g, 300 kcal, 500 ml and 2.0 g, 400 kcal, 400 ml and 1.5 g, 400 kcal, 500 ml and 2.0 g, or 400 kcal, 600 ml and 2.5 g There are certain nutritional compositions.
実際の臨床現場などにおける経腸栄養法の処方は多様であり、処方のエネルギー量、水分量および食塩換算量の範囲は必ずしも明確ではないが、一般的には、エネルギー量が600〜2000kcalの範囲であり、水分量が600〜2000mlの範囲であり、食塩換算量が3〜12gの範囲であるため、上記のとおり配合された栄養組成物を2種以上で組み合わせることにより、実際の臨床現場などにおいて求められる大部分の処方に対応することできる。 There are various prescriptions for enteral nutrition in actual clinical settings and the range of energy amount, water amount and salt equivalent amount of the prescription is not necessarily clear, but generally the energy amount is in the range of 600 to 2000 kcal. Since the amount of water is in the range of 600 to 2000 ml and the amount in terms of salt is in the range of 3 to 12 g, by combining two or more nutritional compositions formulated as described above, the actual clinical site etc. Can handle most of the prescriptions required in
本発明において、含量を調整する成分としては、エネルギー源となる栄養素、水、ナトリウム、ビタミン、ナトリウム以外のミネラルおよび食物繊維などがあげられ、典型的には、エネルギー源となる栄養素、水およびナトリウムである。エネルギー源となる栄養素としては、脂質、タンパク質、炭水化物およびそれらの加水分解物などがあげられる。これらの成分の詳細は後述する。 In the present invention, the ingredients for adjusting the content include nutrients serving as energy sources, water, sodium, vitamins, minerals other than sodium, and dietary fiber, and typically nutrients serving as energy sources, water, and sodium. It is. Examples of nutrients that serve as energy sources include lipids, proteins, carbohydrates, and hydrolysates thereof. Details of these components will be described later.
本発明の栄養組成物において、栄養組成物の水分量に対するエネルギー量は、本発明の栄養組成物が投与される患者などの身体活動レベルを考慮して、好ましくは0.5〜1.0kcal/mlであり、より好ましく0.5〜0.9kcal/mlであり、とくに好ましくは0.5〜0.8kcal/mlである。経腸栄養法が適用される寝たきりの高齢者などでは、身体活動レベルが低いため、栄養組成物の水分量に対するエネルギー量を低くする必要があり、0.5〜1.0kcal/mlの範囲であれば、水分摂取不足による脱水状態や尿量減少に起因する尿路感染症などの問題を防止することができる。 In the nutritional composition of the present invention, the amount of energy relative to the moisture content of the nutritional composition is preferably 0.5 to 1.0 kcal / in consideration of the level of physical activity such as the patient to whom the nutritional composition of the present invention is administered. ml, more preferably 0.5 to 0.9 kcal / ml, and particularly preferably 0.5 to 0.8 kcal / ml. In bedridden elderly people to whom enteral nutrition is applied, since the level of physical activity is low, it is necessary to reduce the amount of energy relative to the water content of the nutritional composition, and in the range of 0.5 to 1.0 kcal / ml If so, problems such as dehydration due to insufficient water intake and urinary tract infections due to a decrease in urine volume can be prevented.
本発明の栄養組成物において、栄養組成物のエネルギー量に対する食塩換算量は、本発明の栄養組成物が投与される患者などの必要な熱量を考慮して、好ましくは0.25〜1.0g/100kcalであり、より好ましくは0.35〜1.0g/100kcalであり、とくに好ましくは0.45〜1.0g/100kcalである。経腸栄養法が適用される寝たきりの高齢者などでは、必要な熱量が少ないため、エネルギー量に対する食塩換算量を高くする必要があり、0.25〜1.0g/100kcalの範囲であれば、尿濃縮能による低ナトリウム血症などの問題を防止することができる。 In the nutritional composition of the present invention, the amount of salt converted with respect to the amount of energy of the nutritional composition is preferably 0.25 to 1.0 g in consideration of the necessary calorie of the patient to whom the nutritional composition of the present invention is administered. / 100 kcal, more preferably 0.35 to 1.0 g / 100 kcal, and particularly preferably 0.45 to 1.0 g / 100 kcal. For bedridden elderly people to whom enteral nutrition is applied, because the amount of heat required is small, it is necessary to increase the amount of salt converted to the amount of energy, and if it is in the range of 0.25 to 1.0 g / 100 kcal, Problems such as hyponatremia due to urine concentration ability can be prevented.
本発明において、密閉式容器とは、内容物である栄養組成物と外界とを遮断するための密閉された容器(クローズドパック)を意味し、容器の形態としては、典型的にはパック、レトルトパウチ、ソフトバッグ、定形の容器および缶などがあげられ、好ましくはパック、レトルトパウチ、ソフトバッグ、定形の容器などである。容器の材質としては、典型的には紙、プラスチック、ガラスおよび金属などがあげられ、好ましくは紙、プラスチックおよび金属などである。 In the present invention, the hermetically sealed container means a hermetically sealed container (closed pack) for shutting off the nutritional composition as the contents and the outside world, and the form of the container is typically a pack or a retort. Examples include pouches, soft bags, regular containers and cans, and packs, retort pouches, soft bags, regular containers and the like are preferable. Typical examples of the material of the container include paper, plastic, glass and metal, and preferably paper, plastic and metal.
また容器は、流出用および/または混合用の細口部を1つまたは2つ以上で備えていてもよく、該細口部は、使用前にはシールされており、使用時に栄養組成物を投与するチューブまたは他の栄養組成物の容器の細口部などに、直接に接続できる機構を備えていてもよい。
本発明の栄養組成物を充填する容器を、上記の密閉式容器とすることにより、栄養組成物の患者への投与、栄養組成物同士への他のタンパク質、ビタミン、ミネラルなどの成分の添加、および栄養組成物同士の混合などを、開封せずに、または最小限の細口部のみを開封することにより行うことが可能となり、外気との接触を最小限に抑えて汚染を防止することができる。Further, the container may be provided with one or two or more narrow mouth portions for spilling and / or mixing, and the narrow mouth portion is sealed before use, and a nutritional composition is administered at the time of use. You may provide the mechanism which can be directly connected to the narrow mouth part of the tube or the container of another nutrition composition.
By making the container filled with the nutritional composition of the present invention into the above-described sealed container, administration of the nutritional composition to a patient, addition of other proteins, vitamins, minerals and other ingredients to the nutritional composition, In addition, it is possible to perform mixing between nutritional compositions without opening or by opening only the minimum narrow mouth part, and it is possible to prevent contamination by minimizing contact with the outside air .
本発明において、栄養組成物のキットとは、本発明の容器入り栄養組成物を2種以上で含む、経腸栄養法に用いるための栄養組成物のキットを意味し、容器入り栄養組成物を2種以上の他に、経管栄養法用のチューブ、活栓、シリンジおよび接続用のアダプタなどを含んでもよい。
キットに含まれる2種以上の容器入り栄養組成物は、臨床現場などにおいて求められる大部分の処方に適切に対応することできるように、特定の配合の容器入り栄養組成物を2種以上で組み合わせた容器入り栄養組成物の一群としてもよく、該容器入り栄養組成物の一群を複数セット含んでもよい。In the present invention, the nutritional composition kit means a nutritional composition kit for use in enteral nutrition, comprising two or more nutritional compositions in a container of the present invention. In addition to two or more kinds, a tube for tube feeding, a stopcock, a syringe, a connection adapter, and the like may be included.
Two or more kinds of nutritional compositions in containers included in the kit can be combined with two or more kinds of nutritional compositions in containers of a specific formulation so that they can appropriately respond to most prescriptions required in clinical settings. A group of nutritional compositions contained in a container may be included, and a plurality of groups of nutritional compositions contained in the container may be included.
また、キットに含まれる容器入り栄養組成物の品種数は、組み合わせ後の容器入り栄養組成物が多様な処方に対応できることなどの観点から、例えば、1〜18種類であり、計算が容易であることおよび品種数を少なくする観点などから、好ましくは1〜12種類であり、より好ましくは1〜6種類である。 Moreover, the number of varieties of the nutrition composition contained in the container included in the kit is, for example, 1 to 18 kinds from the viewpoint that the nutrition composition contained in the container after combination can cope with various prescriptions, and is easy to calculate. From the viewpoint of reducing the number of varieties and the like, the number is preferably 1 to 12, more preferably 1 to 6.
容器入り栄養組成物の一群の具体例としては、例えば、エネルギー量、水分量および食塩換算量の配合が、夫々、(A)300kcal、300mlおよび1.0g、(B)300kcal、400mlおよび1.5g、ならびに(C)300kcal、500mlおよび2.0gである3種類の容器入り栄養組成物を一群としたもの、(D)400kcal、400mlおよび1.5g、(E)400kcal、500mlおよび2.0g、ならびに(F)400kcal、600mlおよび2.5gである3種類の容器入り栄養組成物を一群としたもの、該(A)〜(F)の6種類の容器入り栄養組成物を一群としたもの、(A’)300kcal、300mlおよび0.5g、(B’)300kcal、400mlおよび1.0g、ならびに(C’)300kcal、500mlおよび1.5gである3種類の容器入り栄養組成物を一群としたもの、(D’)400kcal、400mlおよび1.0g、(E’)400kcal、500mlおよび1.5g、ならびに(F’)400kcal、600mlおよび2.0gである3種類の容器入り栄養組成物を一群としたもの、該(A’)〜(F’)の6種類の容器入り栄養組成物を一群としたもの、ならびに該(A)〜(F)および該(A’)〜(F’)の12種類の容器入り栄養組成物を一群としたものなどがあげられる。 As a specific example of a group of nutritional compositions in a container, for example, the blending of energy amount, moisture amount and salt equivalent amount is (A) 300 kcal, 300 ml and 1.0 g, and (B) 300 kcal, 400 ml and 1. 5 g and (C) 300 kcal, 500 ml and 2.0 g of three nutritional compositions in containers, (D) 400 kcal, 400 ml and 1.5 g, (E) 400 kcal, 500 ml and 2.0 g And (F) 400 kcal, 600 ml and 2.5 g of the three nutritional compositions in a container, and (A) to (F) of the six nutritional compositions in a group. (A ′) 300 kcal, 300 ml and 0.5 g, (B ′) 300 kcal, 400 ml and 1.0 g, (D ') 400 kcal, 400 ml and 1.0 g, (E') 400 kcal, 500 ml and 1. g. (C ') 300 kcal, 500 ml and 1.5 g. 5 g, and (F ′) 400 kcal, 600 ml and 2.0 g of a nutritional composition in a container as a group, and (A ′) to (F ′) 6 kinds of nutritional compositions in a container. Examples include a group, and a group of 12 kinds of nutritional compositions in containers (A) to (F) and (A ′) to (F ′).
本発明の栄養組成物に配合する、前記のナトリウム、脂質、タンパク質、炭水化物、ビタミンおよびミネラルなどは、食品および飲料ならびに医薬品の分野において、通常に用いられているものであれば特に限定されないが、厚生労働省に、食品および医薬品の原材料および添加剤として認可されているものを用いることが好ましい。また、各栄養素の配合量は、例えば厚生労働省策定の「日本人の食事摂取基準(2005年版)」に従って決定することができる。本発明の栄養組成物に配合する各栄養素の具体例を以下に示す。 The sodium, lipid, protein, carbohydrate, vitamin, mineral and the like to be blended in the nutritional composition of the present invention are not particularly limited as long as they are usually used in the field of food and beverages and pharmaceuticals, It is preferable to use those approved by the Ministry of Health, Labor and Welfare as raw materials and additives for foods and pharmaceuticals. The amount of each nutrient can be determined in accordance with, for example, “Japanese dietary intake standards (2005 version)” formulated by the Ministry of Health, Labor and Welfare. The specific example of each nutrient mix | blended with the nutrition composition of this invention is shown below.
本発明の栄養組成物のナトリウム供給源としては、酢酸ナトリウム、塩化ナトリウム、クエン酸ナトリウム、水酸化ナトリウム、炭酸ナトリウム、炭酸水素ナトリウム、リン酸水素一ナトリウム、リン酸水素二ナトリウム、メタリン酸ナトリウム、ピロリン酸ナトリウムおよびトリポリリン酸ナトリウムなどがあげられ、好ましくは塩化ナトリウムおよびクエン酸ナトリウムなどがあげられる。また、これらのナトリウム供給源を1種以上で用いてもよい。
また、本発明の栄養組成物に用いる水は、純水、精製水およびイオン交換水などがあげられる。Sodium sources of the nutritional composition of the present invention include sodium acetate, sodium chloride, sodium citrate, sodium hydroxide, sodium carbonate, sodium bicarbonate, monosodium hydrogen phosphate, disodium hydrogen phosphate, sodium metaphosphate, Examples thereof include sodium pyrophosphate and sodium tripolyphosphate, preferably sodium chloride and sodium citrate. Moreover, you may use these sodium supply sources by 1 or more types.
Examples of the water used in the nutritional composition of the present invention include pure water, purified water, and ion exchange water.
本発明の栄養組成物に配合する脂質としては、大豆油、パーム油、パーム分別油およびオリーブ油などの植物性油脂、乳脂肪、豚脂および魚油などの動物性油脂、ならびにオレイン酸、リンノレン酸およびγ-リノレン酸などの遊離脂肪酸などがあげられ、好ましくは、大豆油およびパーム油などがあげられる。また、これらの脂質を1種以上で用いてもよい。脂質の配合量は、好ましくは0〜4%の範囲であり、より好ましくは2.2〜3.3%の範囲であり、健常な日本人の平均的な摂取量の観点から、好ましくは栄養組成物の全エネルギー量の0〜30%の範囲であり、より好ましくは20〜25%の範囲である。 Lipids to be blended in the nutritional composition of the present invention include vegetable oils such as soybean oil, palm oil, palm fractionation oil and olive oil, animal fats such as milk fat, pork fat and fish oil, and oleic acid, linolenic acid and Examples include free fatty acids such as γ-linolenic acid, preferably soybean oil and palm oil. One or more of these lipids may be used. The amount of lipid blended is preferably in the range of 0 to 4%, more preferably in the range of 2.2 to 3.3%. From the viewpoint of the average intake of healthy Japanese, It is in the range of 0 to 30% of the total energy amount of the composition, and more preferably in the range of 20 to 25%.
本発明の栄養組成物に配合するタンパク質としては、大豆タンパク質などの植物性タンパク質、カゼインおよびホエイタンパク質などの動物性タンパク質などがあげられ、好ましくは、大豆タンパク質、カゼインおよびホエイタンパク質などがあげられる。また、これらのタンパク質の加水分解物などを用いてもよく、これらのタンパク質およびその加水分解物などを1種以上で用いてもよい。タンパク質の配合量は、好ましくは2〜10%の範囲であり、より好ましくは3〜6.5%の範囲であり、健常な日本人の平均的な摂取量の観点から、好ましくは栄養組成物の全エネルギー量の12〜40%の範囲であり、より好ましくは16〜25%の範囲である。 Examples of the protein to be blended in the nutritional composition of the present invention include plant proteins such as soybean protein, animal proteins such as casein and whey protein, and preferably soybean protein, casein and whey protein. In addition, hydrolysates of these proteins may be used, and one or more of these proteins and hydrolysates thereof may be used. The amount of protein blended is preferably in the range of 2 to 10%, more preferably in the range of 3 to 6.5%. From the viewpoint of the average intake of healthy Japanese, preferably the nutritional composition Is in the range of 12 to 40% of the total energy amount, and more preferably in the range of 16 to 25%.
本発明の栄養組成物に配合する炭水化物としては、デキストリン、ショ糖、乳糖およびオリゴ糖などがあげられ、好ましくは、デキストリン、ショ糖およびパラチノースなどがあげられる。また、これらの炭水化物の加水分解物などを用いてもよく、これらの炭水化物および加水分解物などを1種以上で用いてもよい。炭水化物の配合量は、好ましくは5〜20%の範囲であり、より好ましくは10〜15%の範囲であり、健常な日本人の平均的な摂取量の観点から、好ましくは栄養組成物の全エネルギー量の20〜80%の範囲であり、より好ましくは40〜60%の範囲である。 Examples of the carbohydrate to be blended in the nutritional composition of the present invention include dextrin, sucrose, lactose and oligosaccharide, preferably dextrin, sucrose and palatinose. Moreover, you may use the hydrolyzate etc. of these carbohydrates, and you may use these carbohydrates, hydrolyzate, etc. by 1 or more types. The amount of the carbohydrate is preferably in the range of 5 to 20%, more preferably in the range of 10 to 15%. From the viewpoint of the average intake of healthy Japanese, preferably the total amount of the nutritional composition It is in the range of 20 to 80% of the energy amount, and more preferably in the range of 40 to 60%.
本発明の栄養組成物に配合するビタミンとしては、ビタミンA、ビタミンD、ビタミンE、ビタミンB1、ビタミンB2、ナイアシン、ビタミンB6、葉酸、ビタミンB12、パントテン酸およびビタミンCなどがあげられ、好ましくはビタミンB1、ビタミンB2、ナイアシン、ビタミンB6、葉酸、ビタミンB12、パントテン酸およびビタミンCなどがあげられる。また、これらのビタミンを1種以上で用いてもよい。Vitamins to be blended in the nutritional composition of the present invention include vitamin A, vitamin D, vitamin E, vitamin B 1 , vitamin B 2 , niacin, vitamin B 6 , folic acid, vitamin B 12 , pantothenic acid and vitamin C. Preferably, vitamin B 1 , vitamin B 2 , niacin, vitamin B 6 , folic acid, vitamin B 12 , pantothenic acid, vitamin C and the like can be mentioned. Moreover, you may use 1 or more types of these vitamins.
本発明の栄養組成物に配合するナトリウム以外のミネラルとしては、カルシウム、鉄、リン、マグネシウム、カリウム、銅および亜鉛などがあげられ、好ましくはカルシウム、リン、マグネシウム、カリウムなどがあげられる。また、これらのミネラルを1種以上で用いてもよい。 Examples of minerals other than sodium blended in the nutritional composition of the present invention include calcium, iron, phosphorus, magnesium, potassium, copper and zinc, and preferably calcium, phosphorus, magnesium, potassium and the like. Moreover, you may use these minerals by 1 or more types.
また、本発明の栄養組成物は、食物繊維を含んでもよく、水溶性食物繊維としては、難消化性デキストリンおよび還元難消化性デキストリンなどがあげられ、また、非水溶性食物繊維としては、セルロースなどがあげられる。さらに、本発明の栄養組成物は、各種香料、甘味料および他の添加物などを含むことができる。 In addition, the nutritional composition of the present invention may contain dietary fiber. Examples of water-soluble dietary fiber include indigestible dextrin and reduced indigestible dextrin, and examples of water-insoluble dietary fiber include cellulose. Etc. Furthermore, the nutritional composition of the present invention can contain various flavors, sweeteners and other additives.
本発明の栄養組成物のpHは、風味面や物性面の観点から、好ましくはpH3〜11の範囲であり、より好ましくは4〜10の範囲であり、さらに好ましくは5〜9の範囲であり、実質的に7であってもよい。またpHを調整するために、クエン酸などのpH調整剤を含んでもよい。 The pH of the nutritional composition of the present invention is preferably in the range of pH 3-11, more preferably in the range of 4-10, and still more preferably in the range of 5-9, from the viewpoint of flavor and physical properties. , Substantially seven. Moreover, in order to adjust pH, you may include pH adjusters, such as a citric acid.
また、本発明の栄養組成物の浸透圧は、高浸透圧による下痢、腹痛など消化器症状の防止の観点から、好ましくは200〜800mOsm/Lの範囲であり、より好ましくは300〜750mOsm/Lの範囲である。 The osmotic pressure of the nutritional composition of the present invention is preferably in the range of 200 to 800 mOsm / L, more preferably 300 to 750 mOsm / L, from the viewpoint of preventing digestive symptoms such as diarrhea and abdominal pain due to high osmotic pressure. Range.
さらに、本発明の栄養組成物が液体または流動体の場合には、その粘度は、経管栄養法に用いる観点から、好ましくは室温測定において3〜40mPa・sの範囲であり、より好ましくは5〜20mPa・sの範囲である。 Furthermore, when the nutritional composition of the present invention is a liquid or a fluid, the viscosity thereof is preferably in the range of 3 to 40 mPa · s in room temperature measurement, more preferably 5 from the viewpoint of use in tube feeding. It is in the range of ˜20 mPa · s.
本発明の栄養組成物は、当該分野において公知の常法に従って調製することができる。例えば、各成分を秤量し、水に加えて十分に混合した後、乳化させ、該栄養組成物を予め加熱滅菌した後、無菌的に容器に充填する方法(例えば、UHT滅菌法とアセプティック包装法を併用した方法)、または該栄養組成物を容器に充填した後、容器とともに加熱滅菌する方法(例えば、オートクレーブ法)などがあげられる。 The nutritional composition of the present invention can be prepared according to conventional methods known in the art. For example, each component is weighed, mixed well with water, and then emulsified, and the nutritional composition is preliminarily heat sterilized and then aseptically filled into a container (for example, UHT sterilization method and aseptic packaging method) Or a method in which the nutritional composition is filled in a container and then sterilized by heating with the container (for example, an autoclave method).
以下、本発明について実施例に基づいて更に詳細に説明を加えるが、本発明はこれらの実施例に限定されるものではなく、本発明の技術的思想を逸脱しない範囲で種々の変更が可能である。 Hereinafter, the present invention will be described in more detail based on examples, but the present invention is not limited to these examples, and various modifications can be made without departing from the technical idea of the present invention. is there.
[実施例1]
エネルギー量が300kcalであり、水分量および食塩換算量が、夫々、Aタイプは300mlおよび1.0g、Bタイプは400mlおよび1.5g、Cタイプは500mlおよび2.0gとなるように、各原材料の配合を設計した。各成分を、約60℃の純水に投入して混合した後、混合液をホモミキサーに投入し、約5000rpm、10分間で粗乳化を行った。ついで、90℃に加温して5分間で静置した後、高圧乳化機にて精乳化(20kgf/cm2)を行った。得られた乳化液を約20℃に冷却し、ビタミン、ミネラルおよび香料を添加後、メスアップを行い、A〜Cタイプの流動性栄養組成物を得た。互いに組み合わせるA〜Cタイプの栄養組成物の配合例を、実施例1の配合例として下記表1に示す。[Example 1]
Each raw material so that the amount of energy is 300 kcal, and the amount of water and salt equivalent are 300 ml and 1.0 g for A type, 400 ml and 1.5 g for B type, and 500 ml and 2.0 g for C type, respectively. The formulation of was designed. Each component was put into pure water at about 60 ° C. and mixed, and then the mixed solution was put into a homomixer and roughly emulsified at about 5000 rpm for 10 minutes. Subsequently, after heating to 90 degreeC and leaving still for 5 minutes, fine emulsification (20 kgf / cm < 2 >) was performed with the high pressure emulsifier. The obtained emulsified liquid was cooled to about 20 ° C., vitamins, minerals, and fragrances were added, and the volume was increased to obtain AC type fluid nutritional compositions. Table 1 below shows formulation examples of the A to C type nutritional compositions combined with each other as formulation examples of Example 1.
また、互いに組み合わせる上記A〜Cタイプの栄養組成物の原料組成例を、実施例1の原料組成例として下記表2に示す。 Moreover, the raw material composition example of said AC type nutrient composition combined with each other is shown in the following Table 2 as a raw material composition example of Example 1.
[実施例2]
エネルギー量が400kcalであり、水分量および食塩換算量が、夫々、Dタイプは400mlおよび1.5g、Eタイプは500mlおよび2.0g、Fタイプは600mlおよび2.5gとなるように、各原材料の配合を設計した。前記A〜Cタイプと同様に調製して、D〜Fタイプの流動性栄養組成物を得た。互いに組み合わせるD〜Fタイプの栄養組成物の配合例を、実施例2の配合例として下記表3に示す。[Example 2]
Each raw material so that the amount of energy is 400 kcal, the amount of water and the amount of salt converted are 400 ml and 1.5 g for D type, 500 ml and 2.0 g for E type, and 600 ml and 2.5 g for F type, respectively. The formulation of was designed. It prepared similarly to the said AC type, and obtained the fluid nutrition composition of the DF type. Formulation examples of the DF type nutritional compositions combined with each other are shown in Table 3 below as formulation examples of Example 2.
また、互いに組み合わせる上記D〜Fタイプの栄養組成物の原料組成例を、実施例2の原料組成例として下記表4に示す。 Moreover, the raw material composition example of the said DF type nutrient composition combined mutually is shown in following Table 4 as a raw material composition example of Example 2. FIG.
品質の確認の一例として、上記Fタイプの栄養組成物を、経腸栄養法用の接続口を備えた密閉型のプラスチック容器に充填した後に、レトルト殺菌(予備加熱80℃、殺菌121℃、9分30秒間)して容器入り栄養組成物を調製した。該栄養組成物の物性値を下記表5に示す。なお、表中の製品規格値(基準値)は、一般的な経腸栄養法用の流動性栄養組成物に求められる製品規格値である。 As an example of quality confirmation, after filling the above-mentioned F type nutrition composition into a sealed plastic container having a connection port for enteral nutrition, retort sterilization (preheating 80 ° C., sterilization 121 ° C., 9 Min. For 30 seconds) to prepare a nutritive composition in a container. The physical properties of the nutritional composition are shown in Table 5 below. In addition, the product specification value (reference value) in a table | surface is a product specification value calculated | required by the fluid nutrition composition for general enteral nutrition.
上記Fタイプの容器入り栄養組成物の各物性値は、製品規格値を満たしており、長期の保存でも顕著な増粘、沈殿形成および脂肪分離などの変化は認められなかった。 Each physical property value of the F-type nutrition composition in the container satisfied the product specification value, and no significant changes such as thickening, precipitation formation and fat separation were observed even after long-term storage.
前記A〜Fタイプの栄養組成物を2種以上で組み合わせることにより、組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量を最適に調整して、臨床現場において求められる、患者などの症例に合わせた多様な栄養組成物の処方に、迅速かつ柔軟に対応することができた。従来品(単位エネルギー量:1kcal/ml)の栄養組成物を使用した投与方法を比較例1〜6とし、前記A〜Fタイプの栄養組成物を2種以上組み合わせた投与方法を実施例3〜8とした。比較結果を下記表6に示す。 By combining two or more types of the A to F type nutritional compositions, the energy amount, water content and salt equivalent amount of the nutritional composition after the combination are optimally adjusted, such as patients required in clinical settings We were able to respond quickly and flexibly to the formulation of various nutritional compositions tailored to the case. The administration method using the nutritional composition of the conventional product (unit energy amount: 1 kcal / ml) is referred to as Comparative Examples 1 to 6, and the administration method in which two or more of the A to F type nutritional compositions are combined is described in Example 3 It was set to 8. The comparison results are shown in Table 6 below.
上記表6の結果より、比較例1〜6の投与方法では、患者の処方に合わせた栄養組成物の一食分当たりの投与量に対して、水および塩化ナトリウムの添加作業を1日に3回行い、水分量および食塩換算量を調整する必要があることが分かる。また、実際の臨床現場においては、一般的には作業負担を考慮して、エネルギー量は100kcal、水分量は100ml、食塩換算量は0.5または1g単位で管理されており、従来品の水分量および食塩換算量が端数であるため、患者の処方の要求量と投与量の間に誤差が生じていることが分かる。
一方、実施例3〜8の投与方法では、前記A〜Fタイプの栄養組成物を2種以上で組み合わせることにより、患者の処方に完全に適合した栄養組成物を、簡便かつ迅速に調製できることが分かる。From the results of Table 6 above, in the administration methods of Comparative Examples 1 to 6, water and sodium chloride were added three times a day with respect to the dose per serving of the nutritional composition according to the patient's prescription. It is understood that it is necessary to adjust the amount of water and the amount converted into salt. In actual clinical settings, the amount of energy is generally 100 kcal, the amount of water is 100 ml, and the salt equivalent is 0.5 or 1 g in consideration of the work load. Since the amount and the salt equivalent are fractions, it can be seen that there is an error between the required amount of the patient's prescription and the dose.
On the other hand, in the administration methods of Examples 3 to 8, it is possible to easily and quickly prepare a nutritional composition perfectly adapted to the patient's prescription by combining two or more of the A to F type nutritional compositions. I understand.
次に、前記A〜Fタイプの栄養組成物を組み合わせて、エネルギー量、水分量および食塩換算量を調整した投与パターンの一例を下記表7に示す。 Next, Table 7 below shows an example of an administration pattern in which the nutritional compositions of the A to F types are combined to adjust the amount of energy, the amount of water, and the amount converted into salt.
上記表7の結果より、前記A〜Fタイプの6種類の栄養組成物を組み合わせる投与パターンにより、エネルギー量が800〜1200kcal、水分量が800〜1800ml、食塩換算量が3.0〜7.5gまでの極めて広い範囲に調整できることが分かる。
実際の臨床現場における患者などの処方は多様であり、処方のエネルギー量、水分量および食塩換算量の範囲は必ずしも明確ではないが、一般的には、エネルギー量が600〜2000kcalの範囲であり、水分量が600〜2000mlの範囲であり、食塩換算量が3〜12gの範囲であるため、前記A〜Fタイプの配合の栄養組成物を2種以上で組み合わせることにより、実際の臨床現場において求められる大部分の処方に対応できることが分かる。From the results of Table 7 above, the energy amount is 800 to 1200 kcal, the water amount is 800 to 1800 ml, and the salt equivalent amount is 3.0 to 7.5 g depending on the administration pattern combining the six types of nutritional compositions of types A to F. It can be seen that it can be adjusted to a very wide range.
There are various prescriptions such as patients in actual clinical settings, and the range of energy amount, water amount and salt equivalent amount of the prescription is not necessarily clear, but generally the energy amount is in the range of 600 to 2000 kcal, Since the amount of water is in the range of 600 to 2000 ml and the amount in terms of salt is in the range of 3 to 12 g, it is obtained in an actual clinical field by combining two or more nutritional compositions of the A to F types. It can be seen that most prescriptions can be handled.
本発明によれば、エネルギー源となる栄養素、水およびナトリウムを含み、互いに略同一の成分であるが該成分の含量が異なる2種以上の栄養組成物を予め調製して準備し、これを2種以上で組み合わせることにより、組み合わせ後の栄養組成物のエネルギー量、水分量および食塩換算量などを自由に配合設計して同時に調整することができるため、患者などの処方に合わせて、水やナトリウムなどの一日の必要量を計算して栄養組成物に添加する作業を無くして省力化することができ、かつ栄養組成物の調製時の汚染の可能性を大幅に低減することができるため、とくに病院などの医療機関、保育施設や介護施設などの福祉施設などにおいて有用である。 According to the present invention, two or more kinds of nutritional compositions containing nutrients, water and sodium as energy sources and having substantially the same components but different contents are prepared in advance. By combining more than one species, the energy content, water content and salt equivalent amount of the nutritional composition after combination can be freely designed and adjusted at the same time, so water and sodium can be adjusted according to the patient's prescription. It is possible to save labor by eliminating the work of calculating the daily required amount and adding it to the nutritional composition, and greatly reduce the possibility of contamination during preparation of the nutritional composition, This is particularly useful in medical institutions such as hospitals, welfare facilities such as childcare facilities and nursing care facilities.
Claims (11)
調整される栄養組成物が、組み合わされる他の全ての栄養組成物と略同一の成分を含み、前記3成分から選ばれる1以上の成分が前記組み合わされる1種以上の栄養組成物中の当該成分とその含量において異なり、かつ、調整される栄養組成物および組み合わされる他の全ての栄養組成物のエネルギー量が5kcalの整数倍、水分量が50mlの整数倍および食塩換算量が0.5gの整数倍である、前記方法。By combining the nutritional composition used for enteral nutrition, which contains nutrients that are energy sources, water and sodium, with one or more other nutritional compositions, the amount of energy, water content and salt converted after combination A method of adjusting the amount,
The nutritional composition to be adjusted contains substantially the same ingredients as all other nutritional compositions to be combined, and one or more ingredients selected from the three ingredients are included in the one or more nutritional compositions to be combined. And the content of the nutritional composition to be adjusted and all other nutritional compositions to be combined are an integral multiple of 5 kcal, an integral multiple of 50 ml of water, and a salt equivalent of 0.5 g The method, which is an integer multiple of.
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US8840950B2 (en) * | 2010-05-26 | 2014-09-23 | Jacqueline M. Hibbert | Compositions of nutrition supplementation for nutritional deficiencies and method of use therefore |
JP6449648B2 (en) * | 2012-06-28 | 2019-01-09 | 株式会社明治 | Nutritional composition |
JP6084092B2 (en) * | 2013-03-28 | 2017-02-22 | テルモ株式会社 | Thorough nutritional composition |
JP6306943B2 (en) * | 2014-05-30 | 2018-04-04 | 株式会社明治 | Container for nutritional composition |
JP6754698B2 (en) * | 2014-12-26 | 2020-09-16 | 株式会社明治 | Replenisher containing dietary fiber |
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