WO2011071376A1 - Composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide appropriée à une alimentation entérale - Google Patents

Composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide appropriée à une alimentation entérale Download PDF

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Publication number
WO2011071376A1
WO2011071376A1 PCT/NL2010/050825 NL2010050825W WO2011071376A1 WO 2011071376 A1 WO2011071376 A1 WO 2011071376A1 NL 2010050825 W NL2010050825 W NL 2010050825W WO 2011071376 A1 WO2011071376 A1 WO 2011071376A1
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Prior art keywords
acid
fat composition
composition according
dha
epa
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PCT/NL2010/050825
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English (en)
Inventor
Rogier Daniël VAN ANHOLT
Zandrie Hofman
Wynette Hermina Agnes Kiers
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N.V. Nutricia
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Application filed by N.V. Nutricia filed Critical N.V. Nutricia
Priority to BR112012013541-4A priority Critical patent/BR112012013541B1/pt
Priority to PL10798405T priority patent/PL2509431T3/pl
Priority to RU2012128503/13A priority patent/RU2546865C2/ru
Priority to US13/514,275 priority patent/US9044043B2/en
Priority to EP10798405.6A priority patent/EP2509431B1/fr
Priority to CN201080063293.8A priority patent/CN102753027B/zh
Priority to ES10798405.6T priority patent/ES2464045T3/es
Priority to MX2012006463A priority patent/MX2012006463A/es
Publication of WO2011071376A1 publication Critical patent/WO2011071376A1/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
    • A23L33/40—Complete food formulations for specific consumer groups or specific purposes, e.g. infant formula
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23D—EDIBLE OILS OR FATS, e.g. MARGARINES, SHORTENINGS, COOKING OILS
    • A23D7/00—Edible oil or fat compositions containing an aqueous phase, e.g. margarines
    • A23D7/003—Compositions other than spreads
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23D—EDIBLE OILS OR FATS, e.g. MARGARINES, SHORTENINGS, COOKING OILS
    • A23D9/00—Other edible oils or fats, e.g. shortenings, cooking oils
    • 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
    • A23L33/115—Fatty acids or derivatives thereof; Fats or oils
    • A23L33/12—Fatty acids or derivatives thereof
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs

Definitions

  • Tube feeding is provided primarily using a device such as a nasogastric feeding tube or a naso-jejunal feeding tube, or by using a percutaneous endoscopic gastrostomy (PEG) or PEG - jejuno-feeding system.
  • a device such as a nasogastric feeding tube or a naso-jejunal feeding tube, or by using a percutaneous endoscopic gastrostomy (PEG) or PEG - jejuno-feeding system.
  • PEG percutaneous endoscopic gastrostomy
  • such balanced fat composition should comprise at least specific amounts of linoleic acid (LA, 18:2n-6), alpha- linolenic acid (ALA, 18:3n-3), docosahexaenoic acid (DHA, 22:6n-3), eicosapen- taenoic acid (EPA, 20:5n-3), at least one medium chain fatty acid (MCFA, e.g. 8:0 and/or 10:0), and at least one mono-unsaturated fatty acid (MUFA, e.g. 16: 1, 18: 1, 20: 1, 22: 1 and/or 24: 1). More in particular, the balanced fat composition contains lower amounts of LA than found in the prior art, in particular in commercial products available from, for example, Abbott, Fresenius, Nestle, and Nutricia.
  • LA linoleic acid
  • ALA alpha- linolenic acid
  • DHA docosahexaenoic acid
  • EPA eicosapen
  • EP 1 964 554 Al discloses a balanced fat composition suit- able for an enteral nutritional composition with a specific lipid profile, to be used in enteral nutrition products.
  • the fat composition differs from our invention in the fact that is comprises 17.2 to 22.8 weight% (target value 19.95 weight%) of LA and 1.7 to 2.4 weight% of ALA (target value 2.28 weight%).
  • WO 2008/046871 A2 discloses long term tube nutrition for specific patient populations, such as elderly.
  • the fat composition disclosed in the examples differs from our invention in several ways (either lower or higher in LA, no EPA and DHA, or higher in EPA and DHA, and lower in ALA, in comparison with the composi- tion according to the present invention).
  • ⁇ -3 poly-unsaturated fatty acids alpha- lino lenic acid ALA, 18:3n-3
  • docosahexaenoic acid DHA, 22:6n-3
  • MCFA medium-chain fatty acid
  • ARA, EPA, DHA fatty acids
  • EPA, DHA fatty acids
  • LCPs long-chain PUFAs
  • ARA belonging to the omega-6 LCPUFAs
  • EPA and DHA belonging to the omega-3 LCPUFAs.
  • the composition of a diet largely determines the incorporation of these fatty acids into various cells and tissues in a complex way.
  • the fatty acids either derived from the diet or synthesised from precursors, compete on various levels for the same enzymes that determine the incorporation into tissues and/or conversion into bio- logically active metabolites: for enzymes that determine (1) incorporation into phospholipids and tissues, (2) the release from membranes and other stores, (3) the conversion into other fatty acids, and (4) the conversion into various metabolites (eicosanoids, resolvins).
  • enzymes that determine (1) incorporation into phospholipids and tissues, (2) the release from membranes and other stores, (3) the conversion into other fatty acids, and (4) the conversion into various metabolites (eicosanoids, resolvins).
  • eicosanoids and resolvins are involved in a wide variety of physio- logical and immunological processes, regulate the release of a range of hormones and have an effect on nervous system function.
  • Table 1 gives a Schematic representation of the metabolism of fatty acids in humans that starts with the two essential fatty acids linoleic acid and a-linolenic acid from dietary (plant) sources. From these fatty acids all other important fatty acids can (theo- retically) be derived by enzymatic conversion: desaturation enzymes ( ⁇ 5, ⁇ 6) insert new double bounds between carbon atoms and the enzyme elongase adds carbon atoms to the carbon chain.
  • MCFA medium-chain fatty acids
  • MUFA mono-unsaturated fatty acid
  • oleic acid (18: ln-9)
  • Table 2 The combined national and international recommendations from 13 national and international organizations for the intake of different types of fat. Recommendation values are expressed as percentages of the daily caloric food intake ; daily intake calculated for 2 caloric diets, when these products are consumed as a full dietary replacement (complete nutrition).
  • the wording "balanced”, “better balanced” and the like is used to indicate that the fat composition according to the invention is a better solution to the recommendations for a healthy and balanced fat intake than the existing, commercially available fat compositions. 1. Inclusion of a source of EPA and/or DHA
  • EPA and DHA Increasing the consumption of fish oil, high in the omega-3 fatty acids EPA and DHA, has an effect on a range of physiological and immunological processes, including membrane fluidity and functioning and signal transduction pathways. Most impor- tantly, increasing the intake of EPA and DHA reduces the production of proinflammatory mediators such as cytokines, interleukins and tumor necrosis factor (TNF).
  • proinflammatory mediators such as cytokines, interleukins and tumor necrosis factor (TNF).
  • n-3 PUFA A large number of interventions with elevated intakes of n-3 PUFA have been published with the objective to reduce symptoms of (and sometimes to treat) diseases related to chronic inflammation, including rheumatoid arthritis, asthma, cancer-associated cachexia, and inflammatory bowel disease.
  • diseases related to chronic inflammation including rheumatoid arthritis, asthma, cancer-associated cachexia, and inflammatory bowel disease.
  • Other diseases that have been found to be influenced by consumption of fish oil fatty acids are, among others, cardiovascular diseases (CVD), macular degeneration, osteoporosis, depression, schizophrenia, Attention Deficit/Hyperactivity Disorder (ADHD), eating disorders, cancer, burns, and skin disorders (Calder 2006).
  • CVD cardiovascular diseases
  • ADHD Attention Deficit/Hyperactivity Disorder
  • eating disorders cancer, burns, and skin disorders
  • composition and purity of the available fish oils vary considerably. Not only are these oils different in the total amount of EPA and DHA, but also the ratio of EPA to DHA is subject to variation (see Table 3).
  • EPA and DHA have different functions in the human body; beneficial effects of EPA are principally contributed to the competitive inhibition of eicosanoid synthesis from ARA, attributes of DHA are often linked to membrane functioning. Despite these differences in functionality, many intervention studies provide very little information on the exact intake of these fatty acids, not in the least because these levels can be difficult to determine in the diet.
  • EPA and DHA can also be provided as purified ethyl-esters.
  • Dietary LCPUFAs can also be administered in the form of phospholipids, for example derived from eggs. While some studies reported a superior intestinal absorption of omega-3 LCPUFAs from phospholipids compared to triglycerides (Carnielli et al. 1998), others reported similar appearances of LCPUFAs in the plasma lipid fraction and virtually equal rates of incorporation of ARA and DHA in red blood cells from ei- ther phospholipids or triglycerides in infants (Sala-Vila et al. 2004; Sala-Vila et al. 2006).
  • omega-3 LCPUFA reduces the risk of several diseases, including cardiovascular diseases.
  • an improvement of general health might be expected from a reduction of pro -inflammatory markers, reduced serum triglycerides, and/or a reduction in blood pressure.
  • Recommended intakes of EPA+DHA vary from 0.15 to 0.5 En%. To meet the minimum recommended intake of most organizations, the daily intake of EPA+DHA should be at least 500 mg/day (based on a minimum daily food intake of 1500 kcal/day).
  • the balanced fat composition according to the invention comprises between 3.0 and 6 wt% of a combination consisting of the ⁇ -3 poly-unsaturated fatty acids alpha- linolenic acid (ALA), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), wherein the amount of ALA > 2.5 wt%, more preferably > 2.7 wt%, or preferably ranges between 2.5 and 4.0 wt%, and the combined amount of DHA and EPA ⁇ 2.5 wt%, preferably ⁇ 1.0 wt%.
  • ALA alpha- linolenic acid
  • DHA docosahexaenoic acid
  • EPA eicosapentaenoic acid
  • the ⁇ -3 poly-unsaturated fatty acids may be present as triglycerides, ethyl-esters, phospholipids, sphingo lipids, glyco lipids or other food grade forms.
  • Recommendations for an minimum intake of LA vary from 1 to 4% of the total caloric intake per day : the French organizations AFSSA and CNERNA-CNRS provided the highest recommendation of 4 En% for adults. None of the national committees and health councils have included a safe upper limit for LA consumption. Nevertheless, the level of LA in the fat composition that is currently used in a number of commercial products is several times higher than the intake that is considered to be adequate in order to prevent a deficiency. Reasons to limit the LA content to an amount close to the highest recommended (adequate) intake of 4 En% are discussed in the following section.
  • the conversion of the fatty acids LA and ALA into their respective LCPUFAs is controlled by a complex of metabolic factors and the dietary (fatty acid) composition.
  • increasing the dietary intake of LCPUFAs reduces the conversion of LA and ALA presumably due to product downregulation of the desaturation and elongation enzymatic pathways that are responsible for the conversion of LA and ALA (Brenna 2002).
  • Emken et al. (1994) nicely demonstrated that the conversion of LA as well as ALA into their respective LCPUFAs (ARA, EPA, DHA) was reduced by 40- 54%, when the intake of LA was increased from 15 to 30 g/day in volunteers (Emken et al. 1994).
  • LA intakes corresponded to 4.7 and 9.3 En%, respectively (2800 kcal/day diets), which are in the range of normal dietary intakes and of sip and tube feeds currently on the market.
  • EPA and DHA should be supplied via the diet, which is another argument to include fish oil in the composition according to the invention.
  • LA intakes not only reduce the conversion of LA and ALA into long-chain fatty acids, but LA also competes with ALA, EPA, as well as DHA for incorporation into tissue phospholipids: the ratio between the dietary omega-6 and omega-3 fatty acids has a strong effect on the eventual tissue composition. As a consequence, high levels of LA have a marked effect on the efficiency of fish oil supplementation.
  • intakes of ARA a downstream product of LA
  • LA is the predominant PUFA in a normal (western) diet.
  • the level of LA can be regarded as adequate according to all recommendations.
  • this level of 4 En% should preferably be considered as the maximum level for nutritionally complete products.
  • the ratio ⁇ -6 : ⁇ -3 in the fat composition according to the invention is about 2.5: 1 - 3.5: 1, preferably3 : 1 , wherein the term about means a relative deviation of 10 %.
  • LA linoleic acid
  • the linoleic acid may be present as triglycerides, phospholipids, sphingo lipids, gly co lipids or other food grade forms.
  • LA fatty acid
  • MUFAs i.e. oleic acid
  • available oils that are rich in MUFAs also contain LA, which means that an increase in the MUFA content results in an increase of the LA content as well.
  • the saturated fatty acid content can be increased: the current saturated fatty acid contents of most of the commercial products are well below the recommended upper intakes (see Table 2).
  • increasing the saturated fatty acid content cannot imme- diately be considered a health benefit, as it for instance increases serum cholesterol levels.
  • MCTs medium-chain fatty acids
  • MCTs medium-chain fatty acid esters of glycerol consisting of 3 medium-chain saturated fatty acids (MCFAs) each comprising 6 to 12 carbon atoms.
  • Natural sources of MCFAs are coconut oils and palm kernel oils. When hydro- lyzed, these oils provide concentrated sources of MCFAs with chain lengths of primar- ily 8 (caprylic or octanoic acid) and 10 (capric or decanoic acid) carbon atoms. Hence, in practice, when MCTs or MCFAs are administered, this is often limited to fatty acids with 8- and 10-carbon chains, although (theoretically) MCFAs also include carbon chains of 6 and 12 carbon atoms.
  • the MCFAs according to the invention are preferably selected from MCTs originating from coconut oils and/or palm kernel oils.
  • the chain length of the MCFAs according to the invention is 6, 7, 8, 9, 10, 11 or 12, preferably 8, 9 or 10, most preferably 8 or 10 carbon atoms long, or any mixture thereof.
  • MCFAs are not considered essential and therefore are not considered a necessary part of the normal diet. Although MCFAs are categorized as saturated fats, they have completely different biochemical and physiological properties compared to long-chain saturated fatty acids, which will be explained below.
  • MCFAs absorbed from the small intestine are primarily transported via the portal vein to the liver.
  • dietary long-chain triglycerides are first hydro lyzed in the small intestine to LCFAs and re-esterified in the mucosal cells of the small intestine to long-chain triglyerides. They are then incorporated into chylomicrons and reach the circulation via the lymphatic system (Bach et al. 1996; Snook et al. 1996).
  • MCFAs are not dependent on pancreatic enzymes or bile salts.
  • Particularly patients with malabsorption syndromes and/or pancreatic insufficiency will benefit from a diet rich in MCTs/MCFAs and MCFAs are therefore often used as the preferred fat source for these patients (Marten et al. 2006).
  • Beta-oxidation of fatty acids results in the production of acetyl-CoA that enters the Kreb's cycle to produce energy, but acetyl-CoA can also be converted into to acetoacetate, beta-hydroxybutyrate, and acetone, collectively called ketone bodies.
  • the amount of MCFA or MCT required to reduce the LA content is relatively small: e.g. for a commercial product like Nutrison Standard (NV Nutricia) about 4 En% of MCFAs (C8+C10) is sufficient - together with a modification of other vegetable oil sources - to reduce the LA content from 8.3 to 4 En%>. This would correspond to approximately 10 to 15% of the fat composition as MCFA, or 6-8 g MCFA (C8+C10) per day (1500 kcal/day). At these levels, gastrointestinal discomfort is not likely to occur, as much higher levels have been reported to be well tolerated.
  • the overall PUFA can be lowered by increasing the amount of saturated fat: the total saturated fatty acid content of most of the current commercial products is low ( ⁇ 5 En%) and can be increased within the upper recommended levels (10-12 En%).
  • MCFAs are categorised as saturated fat, these fatty acids are easily digestible and are rapidly oxidized to yield energy, in contrast to long-chain fatty acids that are stored in adipose tissue.
  • the inclusion of MCTs/MCFAs can be used as a healthy way of reducing the LA content of the products (within limits). Only small amounts of MCT/MCFA (10-15% of the fat composition) are required to lower the LA content to the desired level of 4 En%, provided that other vegetable oils are modified as well.
  • the balanced fat composition according to the invention comprises between 10 to 20 wt% preferably 14 to 18 wt%, most preferably 15.7 to 16.2 wt% of medium-chain fatty acids (MCFA).
  • MCFA medium-chain fatty acids
  • Unsaturated fatty acids are sensitive to oxidation, which leads to the production of damaging oxygen radicals and oxidative damage to surrounding molecules and cells. As the sensitivity for oxidation of fatty acids depends on the number of double bonds in the fatty acid carbon chain, mono-unsaturated fatty acids (MUFAs) are less susceptible to oxidation than polyunsaturated fatty acids.
  • MUFAs mono-unsaturated fatty acids
  • the balanced fat composition according to the invention makes it possible to produce a liquid enteral nutritional composition with a long shelf life and with a low viscosity.
  • the invention also pertains to a balanced fat composition according to the invention for use in the manufacture of a liquid nutritional composition, in particular for use as a tube feed, most in particular for long-term tube feeding.
  • the invention relates to a liquid nutritional composition
  • a liquid nutritional composition comprising a fat composition which comprises
  • MCFA medium-chain fatty acid
  • the liquid nutritional composition according to the invention comprises the balanced fat composition according to the invention, which balanced fat composition comprises at least between 30 and 50 En%, preferably between 30 and 40 En% of the total energy of the composition.
  • the liquid enteral nutritional composition according to the invention preferably has the form of a complete food, i.e. it can meet all nutritional needs of the user.
  • the liquid enteral nutritional composition according to the invention preferably contains 1000 to 2500 kcal per daily dosage. Depending on the condition of the patient, a daily dose is about 25 to 35 kcal/kg bodyweight/day. Therefore, a typical daily dose for a 70 kg person contains about 2000 kcal.
  • the complete food can be in the form of multiple dosage units, e.g. from 8 (250 ml/unit) to 2 units (1 1/unit) per day for an energy supply of 2000 kcal/day using a liquid enteral nutritional composition according to the invention of 1.0 kcal/ml.
  • the nutritional composition is adapted for tube feeding.
  • the liquid enteral nutritional composition can also be an oral food supplement, for example to be used in addition to a non-medical food or normal diet.
  • the liquid enteral nutritional composition contains per daily dosage less than 1500 kcal, in particular as a supplement, the liquid enteral nutritional composition contains 500 to 1000 kcal per daily dose.
  • the food supplement can be in the form of multiple dosage units, e.g. from 2 (250 ml/unit) to 10 units (50 ml/unit) per day for an energy supply of 500 kcal/day using a liquid enteral nutritional composition according to the invention of 1.0 kcal/ml.
  • the composition is provided in a ready to use liquid form and does not require reconstitution or mixing prior to use.
  • the composition according to the invention can be tube fed or administered orally.
  • the composition according to the invention can be provided in a can, on spike, and hang bag.
  • a composition may be provided to a person in need thereof in powder form, suitable for reconstitution using an aqueous solution or water such that the composition according to the invention is produced.
  • the present invention is also related to providing long-term tub-fed nutrition to patients in need thereof.
  • long-term means greater than one month (30 days). It is obvious that nutrition, when suitable for long-term nutrition, is also suitable for any other shorter period of nutrition, such as medium-term nutrition (10 to 30 days) and short-term nutrition (between 1 and 10 days).
  • tube nutrition is designed for maintenance patients.
  • maintenance patient refers to an patient, being any human of any age, in particular children, adults and elderly, who is unable to receive nutrition through a normal diet but who is normo-metabolic, i.e. not suffering from a metabolic disorder.
  • normo-metabolic i.e. not suffering from a metabolic disorder.
  • normal diet means to receive at least substantially all nutrition by eating, i.e.
  • enteral nutritional composition according to the invention is provided for maintenance, it is not directed to treatment of any specific dis- order, such as cancer, HIV, diabetes, e.a.
  • Patients are typically stable, normo- metabolic, healthy patients except for the fact that they require enteral nutrition in order to meet the necessary nutritional requirements.
  • these patients may suffer from a variety of disorders including swallowing disorders of a variety of etiologies, particu- larly surgical consequences of ear/nose/throat cancer, and patients suffering from a cerebral vascular accident.
  • omega-6 linoleic acid LA
  • LA omega-6 linoleic acid
  • the highest intake of LA refers to the general consumption in the United States, while the lowest level of LA corresponds to the intake in the Philippines estimated from commodities data for the domestic supply of foods for human consumption.
  • the required intakes of omega-3 LCPUFAs are calculated from an empirical formula that takes into account the competition of the various PUFAs for incorporation into tissues. The graph is based on data from Hibbeln et al. 2006.

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Abstract

Cette invention concerne une composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide, en particulier appropriée à une alimentation par sonde. Cette invention concerne en outre ladite composition nutritionnelle liquide pour apporter une nutrition entérale à des patients le nécessitant, en particulier pour apporter une nutrition entérale complète, en particulier pour apporter une nutrition entérale à long terme. Plus spécifiquement, la composition de graisses équilibrée et la composition nutritionnelle liquide comprenant ladite composition de graisses équilibrée comprennent des quantités spécifiques d'acide linoléique (AL), d'acide alpha-linolénique (AAL), d'acide docosahexaénoïque (ADH), d'acide, eicosapentaénoïque (AEP), d'au moins un acide gras à chaîne moyenne (AGCM), et d'au moins un acide gras mono-insaturé (AGMI). L'invention concerne en outre un procédé pour apporter une nutrition entérale à des patients le nécessitant, comprenant l'administration d'une quantité efficace de ladite composition nutritionnelle liquide comprenant la composition de graisses équilibrée selon l'invention.
PCT/NL2010/050825 2009-12-07 2010-12-07 Composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide appropriée à une alimentation entérale WO2011071376A1 (fr)

Priority Applications (8)

Application Number Priority Date Filing Date Title
BR112012013541-4A BR112012013541B1 (pt) 2009-12-07 2010-12-07 composição de gordura, composição nutricional líquida, e uso da composição nutricional líquida
PL10798405T PL2509431T3 (pl) 2009-12-07 2010-12-07 Zrównoważona kompozycja tłuszczowa i jej zastosowanie w płynnej kompozycji żywieniowej odpowiedniej do żywienia dojelitowego
RU2012128503/13A RU2546865C2 (ru) 2009-12-07 2010-12-07 Сбалансированные жировые композиции и их применение в жидких питательных композициях для энтерального питания
US13/514,275 US9044043B2 (en) 2009-12-07 2010-12-07 Balanced fat composition and use thereof in a liquid nutritional composition suitable for enteral feeding
EP10798405.6A EP2509431B1 (fr) 2009-12-07 2010-12-07 Composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide appropriée à une alimentation entérale
CN201080063293.8A CN102753027B (zh) 2009-12-07 2010-12-07 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
ES10798405.6T ES2464045T3 (es) 2009-12-07 2010-12-07 Composición equilibrada de grasas y uso de la misma en una composición nutricional líquida para alimentación enteral
MX2012006463A MX2012006463A (es) 2009-12-07 2010-12-07 Composicion de grasa balanceada y uso de la misma en una composicion liquida alimenticia adecuada para alimentacion enteral.

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NLPCT/NL2009/050741 2009-12-07
PCT/NL2009/050741 WO2011071365A1 (fr) 2009-12-07 2009-12-07 Composition lipidique équilibrée et son utilisation dans une composition nutritionnelle liquide adaptée à l'alimentation entérale

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PCT/NL2010/050825 WO2011071376A1 (fr) 2009-12-07 2010-12-07 Composition de graisses équilibrée et son utilisation dans une composition nutritionnelle liquide appropriée à une alimentation entérale

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US (1) US9044043B2 (fr)
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CN (1) CN102753027B (fr)
BR (1) BR112012013541B1 (fr)
ES (1) ES2464045T3 (fr)
MX (1) MX2012006463A (fr)
PL (1) PL2509431T3 (fr)
RU (1) RU2546865C2 (fr)
WO (2) WO2011071365A1 (fr)

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US11872201B2 (en) 2018-06-21 2024-01-16 Nuseed Nutritional Us Inc. DHA enriched polyunsaturated fatty acid compositions

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