WO1998054985A1 - Produit et procede d'apport de glutamine - Google Patents

Produit et procede d'apport de glutamine Download PDF

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Publication number
WO1998054985A1
WO1998054985A1 PCT/EP1998/002798 EP9802798W WO9854985A1 WO 1998054985 A1 WO1998054985 A1 WO 1998054985A1 EP 9802798 W EP9802798 W EP 9802798W WO 9854985 A1 WO9854985 A1 WO 9854985A1
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WO
WIPO (PCT)
Prior art keywords
protein
source
glutamine
product
cereal
Prior art date
Application number
PCT/EP1998/002798
Other languages
English (en)
Inventor
Susan L. Trimbo
Christian Melin
Julio Boza
Original Assignee
Societe Des Produits Nestle S.A.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Societe Des Produits Nestle S.A. filed Critical Societe Des Produits Nestle S.A.
Priority to AU77647/98A priority Critical patent/AU7764798A/en
Priority to EP98925589A priority patent/EP1123013A1/fr
Publication of WO1998054985A1 publication Critical patent/WO1998054985A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/17—Amino acids, peptides or proteins
    • A23L33/185—Vegetable proteins
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/17—Amino acids, peptides or proteins
    • A23L33/175—Amino acids

Definitions

  • This invention relates generally to the treatment and nutritional support of patients. More specifically, this invention relates to nutritional products and treatments designed to provide supplemental glutamine to persons in need thereof.
  • the amino acid glutamine has many important functions in the body. For example, glutamine acts as the primary vehicle for transfer of amino nitrogen from skeletal muscle to visceral organs, as a fuel for the rapidly dividing cells of the gastrointestinal tract and immune system, and as a substrate that permits the kidneys to excrete acid loads and protect the body against acidosis. Further, there is increasing evidence that glutamine is essential to the proper functioning of host defence mechanisms and wound healing.
  • glutamine is traditionally classified as non-essential amino acid. The reason is that the body is generally able to synthesise sufficient glutamine for its needs from glutamate and glutamic acid. Also, glutamine is the most abundant amino acid in the blood and free amino acid pool of the body. However, this is only true in periods of good health and does not apply to pre- term babies. During periods of illness, the metabolic rate of glutamine increases and the body is not able to synthesise sufficient glutamine to meet its needs. This is particularly true during episodes of stress such as sepsis, injury, burns, inflammation, diarrhoea and surgery. During episodes of stress, there is a marked increase in glutamine consumption by the gastrointestinal tract, immune cells, inflammatory tissue and the kidney.
  • glutamine supplemented diets have been shown to regenerate muco- proteins and intestinal epithelium, support gut barrier function, shorten hospital stay, improve immune function, and enhance patient survival (Stehle et al; 1989; Lancet, 1:231-3; Hammerqvist et al; 1989; Ann. Surg. ; 209:455-461 ; Li et al; 1995; J. Parenter. Enteral Nutr., 18, 303-307 and Gianotti et al; 1995; J. Parenter. Enteral Nutr., 19, 69-74). Therefore glutamine is now considered to be a conditionally essential amino acid for critically ill and other stressed patients (Lacey et al; 1990; Nutrition Review, 48:297-309).
  • gluten or gluten hydrolysates as a protein source for nutritional compositions.
  • Gluten is particularly rich in glutamine and is hence a good source of glutamine.
  • the use of gluten or a gluten hydrolysate offers the advantage of providing the glutamine in a form which is stable and relatively soluble.
  • gluten is potentially allergenic and this has severely limited its use in nutritional formulas. This problem may be ameliorated to some extent by using a gluten hydrolysate instead of gluten and a nutritional composition based on gluten hydrolysate is commercially available under the trade name Nutricomp® Immun. However, although the risk from allergenic reaction is much reduced, it has not been removed entirely.
  • a yet further approach has been to supplement nutritional formulas with synthetic dipeptides such as L-alanyl-L-glutamine or L-glycyl-L-glutamine. These dipeptides are stable in solution and have been shown to be an effective form of glutamine supplementation. However, synthetic peptides of this nature may significantly increase the cost of the nutritional formulas.
  • This invention provides a nutritional product for delivering supplemental glutamine to a person or animal in need thereof. Accordingly, in one aspect, this invention provides an enterally administrable, nutritional product for delivering glutamine to a person in need thereof, the product comprising a protein source which includes a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • cereal proteins provide an excellent source of glutamine in a form which is stable and readily absorbed. Also, these cereal protein provide very little or no risk of inducing allergenic reactions since they contain little or no gluten. Further, the protein source has a good amino acid profile and excellent overall nutritional value. Another advantage is that the nutritional product contains a protein source which is less expensive than casein and whey.
  • the protein source includes about 30% to about 95% by weight of at least one of the cereal proteins; for example about 50% to about 90% by weight. More preferably, the remaining about 70% to about 5% by weight of the protein source comprises casein, whey, or free amino acids, or a mixture thereof. It is especially preferred for the protein source to include a source of lysine; for example in the form of free amino acids.
  • the protein source comprises from about 15% to about 35% of the total calories of the nutritional product.
  • the nutritional product may include a carbohydrate source.
  • the carbohydrate source may comprise about 35% to about 60% of the total calories of the nutritional product.
  • the nutritional product may also include a lipid source.
  • the lipid source preferably comprises about 20% to about 40% of the total calories of the nutritional product.
  • the nutritional product is provided in a liquid form for enteral feeding.
  • the nutrition product is in ready-to-drink liquid form.
  • this invention provides a nutritional product for delivering glutamine to a person in need thereof, the product comprising a protein source which includes a cereal protein selected from oat bran protein, sorghum protein and millet protein, or mixtures thereof; and a source of lysine.
  • this invention provides a method for delivering glutamine to a person or animal.
  • the method includes a step of administering to a the person or animal a therapeutically effective amount of a nutritional product comprising a protein source which includes a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • this invention provides a method of increasing plasma glutamine levels in a human or animal, the method comprising enterally administering to the human or animal an effective amount of a nutritional composition having a protein source which includes a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • the human or animal is a stressed patient, a pre-term baby, or an athlete.
  • stressed patients are patients who are critically ill, or who are suffering from sepsis, injury, burns, or inflammation, or patients recovering from surgery.
  • this invention provides a method of improving the immune function of a stressed patient or athlete by providing glutamine to the patient, the method comprising administering to the patient or athlete an effective amount of a nutritional composition having a protein source which includes a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • this invention provides a method of providing glutamine to patients suffering from injured or diseased intestines or to maintain the physiological functions of the intestine, the method comprising enterally administering to the patient an effective amount of a nutritional composition having a protein source which includes a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • this invention provides the use of a cereal protein selected from oat protein, sorghum protein and millet protein, or mixtures thereof, in the preparation of an enterally administrable, nutritional composition for providing glutamine to a human or animal.
  • This invention relates to the provision of glutamine to humans and animals.
  • Glutamine is an important nutrient because it promotes regeneration of mucoproteins and the intestinal epithelium.
  • glutamine is an important supplement for patients suffering from intestinal injury or disease, immune disorders, or any of a wide variety of diseases affecting the connective and supporting tissues.
  • free glutamine or synthetic glutamine containing peptides is not feasible due to the high cost and low stability of these compounds.
  • cereal proteins selected from oat protein, sorghum protein and millet protein are rich in glutamine and, when properly prepared, can serve as both a protein source and glutamine source in a nutritional product.
  • oat protein has a glutamine content of about 16 to about 20 g/100 g amino acids
  • sorghum protein has a glutamine content of about 16 g/100 g amino acids
  • millet protein has a glutamine content of about 19 g/100 g amino acids.
  • these proteins contain very little gluten and hence have a low risk of inducing gluten- related, allergenic reactions. In other words, these proteins provide an excellent source of dietary glutamine.
  • the protein may be added in whole or hydrolysed form. Further, peptide mixtures may also be fractionated by chromato graphic methods to produce glutamine rich peptide segments which can be added to enteral diets and clinical foods. Also, selected fractions of the cereal proteins are even richer in glutamine than the proteins themselves and provide an excellent source of glutamine. For example, oat bran concentrates are very rich in glutamine.
  • the protein source preferably provides approximately 15% to 30% of the total calories of the nutritional product. Further, preferably approximately 50% to 90% by weight of the protein source is selected from oat protein, sorghum protein and millet protein, or mixtures thereof.
  • the remaining approximately 50% to 10% of the protein source may be another suitable protein, such as casein, whey, soy or mixtures thereof, or may comprise free amino acids or salts thereof.
  • the remaining protein source is enriched in lysine; either in the form of lysine-rich proteins or peptides or as a free amino acid.
  • lysine in the form of a free amino acid, or salt thereof provides up to about 4% by weight of the protein source.
  • the protein source preferably has well balanced amino acid profile which fulfils the recommendations of the FAO/WHO expert committee for the essential amino acid requirements for children > 2 years of age.
  • protein source provides approximately 25% of the caloric content of the nutritional product.
  • the cereal protein preferably comprises approximately 85% to 90% by weight of the protein source.
  • whey or casein comprises about 5% to about 10% by weight of the protein source.
  • the carbohydrate source preferably provides approximately 35% to 60% of the total calories of the nutritional product. In a preferred embodiment, carbohydrate source provides approximately 45% of the caloric content.
  • carbohydrates may be used including maltodextrin, com starch, com syrup solids or sucrose, and mixtures thereof.
  • corn syrup solids comprise approximately 62% of the carbohydrate source and sucrose comprises approximately 38% of the carbohydrate source.
  • the carbohydrate source is lactose free.
  • the lipid source may provide approximately 20% to 40% of the total caloric content of the nutritional composition. In a preferred embodiment, the lipid content comprises approximately 30% of the total caloric content of the nutritional composition.
  • the lipid source may include a mixture of medium chain triglycerides (MCT) and long chain triglycerides (LCT).
  • MCT medium chain triglycerides
  • LCT long chain triglycerides
  • the lipid source may include at about 20% to about 80% by weight of medium chain triglycerides.
  • medium chain triglycerides may make up about 70% by weight of the lipid source.
  • Suitable sources of long chain triglycerides are canola oil, olive oil, soy oil, milk fat, com oil, residual milk fat, and soy lecithin, or mixtures thereof.
  • coconut oil is a suitable source of medium chain triglycerides.
  • the lipid source has an ⁇ -6: ⁇ -3 ratio ranging from about 4: 1 to about 15 : 1.
  • the ⁇ -6 to ⁇ -3 ratio is approximately 5: 1.
  • the ratio of calories to grams of nitrogen (CAL/gN) is preferably approximately 91 : 1.
  • the lipid source is provided by a combination of com oil (14%) by weight), canola oil (30% by weight), coconut oil (50% by weight), soy lecithin (6% by weight) and residual milk fat (less than 1% by weight).
  • the nutritional product preferably includes a specialised vitamin and mineral profile.
  • the product may include a source of vitamins and minerals including approximately 75% to about 250% of the recommended daily allowance per 1000 Kcal of the product administered.
  • the nutritional product may be administered either enterally or parenterally. Suitable enterally administered forms are soluble powders, liquid concentrates, or ready-to use liquid formulations.
  • the nutritional product is a ready-to-use liquid formulation.
  • Such a formulation may be tube-fed to a patient or fed by having the patient drink the formulation.
  • the caloric density of the formulation is approximately 1.0 Kcal per ml.
  • Various flavours, fibres and other additives may also be present.
  • the nutritional product may also be in the form of common foodstuffs; for example yoghurts, soups, pastas, porridges, breakfast cereals, convenience foods such as muesli bars, and the like.
  • the composition may be in the form of dried or canned pet food.
  • the nutritional product may be produced as is conventional; for example, for formulas, the nutritional product may be prepared by blending together the protein source, the carbohydrate source, and the lipid source. If used, the emulsifiers may be included in the blend. The vitamins and minerals may be added at this point but are usually added later to avoid thermal degradation. Any lipophilic vitamins, emulsifiers and the like may be dissolved into the lipid source prior to blending. Water, preferably water which has been subjected to reverse osmosis, may then be mixed in to form a liquid mixture. The temperature of the water is conveniently about 50°C to about 80°C to aid dispersal of the ingredients. Commercially available liquefiers may be used to form the liquid mixture.
  • the liquid mixture may then be thermally treated to reduce bacterial loads.
  • the liquid mixture may be rapidly heated to a temperature in the range of about 80°C to about 110°C for about 5 seconds to about 5 minutes. This may be carried out by steam injection or by heat exchanger; for example a plate heat exchanger.
  • the liquid mixture may then be cooled to about 60°C to about 85°C; for example by flash cooling.
  • the liquid mixture is then homogenised; for example in two stages at about 7 MPa to about 40 MPa in the first stage and about 2 MPa to about 14 MPa in the second stage.
  • the homogenised mixture may then be further cooled to add any heat sensitive components; such as vitamins and minerals.
  • the pH and solids content of the homogenised mixture is conveniently standardised at this point. If it is desired to produce a powdered nutritional product, the homogenised mixture is transferred to a suitable drying apparatus such as a spray drier or freeze drier and converted to powder.
  • the powder should have a moisture content of less than about 5% by weight.
  • the homogenised mixture is preferably aseptically filled into suitable containers.
  • Aseptic filling of the containers may be carried out by preheating the homogenised mixture (for example to about 75 to 85°C) and then injecting steam into the homogenised mixture to raise the temperature to about 140 to 160°C; for example at about 150°C.
  • the homogenised mixture may then be cooled, for example by flash cooling, to a temperature of about 75 to 85°C.
  • the homogenised mixture may then be homogenised, further cooled to about room temperature and filled into containers. Suitable apparatus for carrying out aseptic filling of this nature is commercially available.
  • the nutritional product may be used as a nutritional support.
  • the nutritional product may be used to provide nutrition and glutamine to animals and humans.
  • the nutrition product may be used to provide nutrition and glutamine to stressed patients; for example for patients who are critically ill, or who are suffering from sepsis, injury, bums, or inflammation, or patients recovering from surgery.
  • the nutritional product may be used to provide glutamine to patients suffering from injured or diseased intestines or to maintain the physiological functions of the intestine.
  • the nutritional product may be used to raise plasma glutamine levels in humans and animals.
  • the nutritional product may also be used to provide glutamine to athletes after intense exercise or to pre-term babies.
  • the nutritional product is intended primarily for patients who require supplemental glutamine, it may also be used as a source of nutrition for people who are not suffering from any illness or condition.
  • the nutritional product may form the sole source of nutrition or form a supplement to other nutritional sources; including parenterally administered nutrition.
  • the amount of the nutritional product required to be fed to an ill patient will vary depending upon factors such as the patient's condition, the patient's body weight, the age of the patient, and whether the nutritional product is the sole source of nutrition. However the required amount may be readily set by a medical practitioner.
  • sufficient of the nutritional product is administered to provide the patient with about 1 g protein to about 4.0 g protein per kg of body weight per day.
  • an adult critically ill patient may be administered about 1.5 g protein to about 2.0 g protein per kg of body weight per day
  • a pre-term infant may be administered about 2.0 g protein to about 4.0 g protein per kg of body weight per day
  • a infant may be administered about 2.0 g protein to about 3.0 g protein per kg of body weight per day.
  • sufficient of the nutritional product is preferably administered to provide the patient with about lOg to about 25 g of glutamine per day.
  • the nutritional product may be taken in multiple doses, for example 2 to 5 times, to make up the required daily amount or may taken in a single dose.
  • the nutritional product also provides a source of glutamic acid.
  • an example of a suitable nutritional product is as follows:
  • a suitable product that may be utilised as an enteral diet or a liquid diet taken orally is as follows:
  • Another suitable product is as follows:
  • Another suitable product is as follows:
  • Another suitable product is as follows:

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  • Life Sciences & Earth Sciences (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Mycology (AREA)
  • Health & Medical Sciences (AREA)
  • Nutrition Science (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Food Science & Technology (AREA)
  • Polymers & Plastics (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

L'invention concerne un produit nutritionnel et un procédé pour apporter de la glutamine à un patient. Ce produit nutritionnel comporte une source protéique qui comprend une protéine de céréale. Cette protéine peut être une protéine de l'avoine, une protéine du sorgho ou une protéine du millet. Ce produit nutritionnel comprend aussi une source d'hydrate de carbone et une source de lipides.
PCT/EP1998/002798 1997-06-02 1998-05-06 Produit et procede d'apport de glutamine WO1998054985A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU77647/98A AU7764798A (en) 1997-06-02 1998-05-06 Product and method for providing glutamine
EP98925589A EP1123013A1 (fr) 1997-06-02 1998-05-06 Produit et procede d'apport de glutamine

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US4825097P 1997-06-02 1997-06-02
US60/048,250 1997-06-02

Publications (1)

Publication Number Publication Date
WO1998054985A1 true WO1998054985A1 (fr) 1998-12-10

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1998/002798 WO1998054985A1 (fr) 1997-06-02 1998-05-06 Produit et procede d'apport de glutamine

Country Status (3)

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EP (1) EP1123013A1 (fr)
AU (1) AU7764798A (fr)
WO (1) WO1998054985A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8067471B2 (en) 2000-04-12 2011-11-29 Nestec S.A. Composition comprising free amino acids
US8178487B2 (en) 1998-03-31 2012-05-15 Nestec S.A. Method for providing glutamine
US10201513B2 (en) 2016-12-19 2019-02-12 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US10596136B2 (en) 2018-06-20 2020-03-24 Axcella Health Inc. Compositions and methods for the treatment of fat infiltration in muscle
US10660870B2 (en) 2017-08-14 2020-05-26 Axcella Health Inc. Compositions and methods for the treatment of liver diseases and disorders associated with one or both of hyperammonemia or muscle wasting

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1991003543A1 (fr) * 1989-09-11 1991-03-21 Clovis Grain Processing, Limited Procede de co-production d'ethanol et d'un produit alimentaire ameliore destine a l'homme, tire de grains de cereales
WO1994021141A1 (fr) * 1993-03-23 1994-09-29 Kansas State University Research Foundation Enrichissement de regimes proteiques au moyen de dipeptides et de tripeptides
EP0705542A1 (fr) * 1994-09-21 1996-04-10 Sandoz Nutrition Ltd. Composition diététique destinée à des adolescents
DE29711429U1 (de) * 1997-04-24 1997-11-06 Reichenauer Feil Andrea Getränkezubereitung und daraus herstellbares Getränk

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1991003543A1 (fr) * 1989-09-11 1991-03-21 Clovis Grain Processing, Limited Procede de co-production d'ethanol et d'un produit alimentaire ameliore destine a l'homme, tire de grains de cereales
WO1994021141A1 (fr) * 1993-03-23 1994-09-29 Kansas State University Research Foundation Enrichissement de regimes proteiques au moyen de dipeptides et de tripeptides
EP0705542A1 (fr) * 1994-09-21 1996-04-10 Sandoz Nutrition Ltd. Composition diététique destinée à des adolescents
DE29711429U1 (de) * 1997-04-24 1997-11-06 Reichenauer Feil Andrea Getränkezubereitung und daraus herstellbares Getränk

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8178487B2 (en) 1998-03-31 2012-05-15 Nestec S.A. Method for providing glutamine
US8383680B2 (en) 2000-04-12 2013-02-26 Nestec S.A. Composition comprising free amino acids
US8067471B2 (en) 2000-04-12 2011-11-29 Nestec S.A. Composition comprising free amino acids
US10201513B2 (en) 2016-12-19 2019-02-12 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US10238617B2 (en) 2016-12-19 2019-03-26 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US10471034B2 (en) 2016-12-19 2019-11-12 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US11602511B2 (en) 2016-12-19 2023-03-14 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US11129804B2 (en) 2016-12-19 2021-09-28 Axcella Health Inc. Amino acid compositions and methods for the treatment of liver diseases
US11571404B2 (en) 2017-08-14 2023-02-07 Axcella Health Inc. Compositions and methods for the treatment of liver diseases and disorders associated with one or both of hyperammonemia or muscle wasting
US10660870B2 (en) 2017-08-14 2020-05-26 Axcella Health Inc. Compositions and methods for the treatment of liver diseases and disorders associated with one or both of hyperammonemia or muscle wasting
US10682325B2 (en) 2017-08-14 2020-06-16 Axcella Health Inc. Compositions and methods for the treatment of liver diseases and disorders associated with one or both of hyperammonemia or muscle wasting
US10596136B2 (en) 2018-06-20 2020-03-24 Axcella Health Inc. Compositions and methods for the treatment of fat infiltration in muscle
US10973793B2 (en) 2018-06-20 2021-04-13 Axcella Health Inc. Compositions and methods for the treatment of fat infiltration in muscle
US11833127B2 (en) 2018-06-20 2023-12-05 Axcella Health Inc. Compositions and methods for the treatment of fat infiltration in muscle

Also Published As

Publication number Publication date
EP1123013A1 (fr) 2001-08-16
AU7764798A (en) 1998-12-21

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