Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
  • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23C—DAIRY PRODUCTS, e.g. MILK, BUTTER OR CHEESE; MILK OR CHEESE SUBSTITUTES; MAKING OR TREATMENT THEREOF
  • A23C21/00—Whey; Whey preparations
  • A23C21/04—Whey; Whey preparations containing non-milk components as source of fats or proteins
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
  • A61K38/1703—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates
  • A61K38/1709—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans from vertebrates from mammals
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23C—DAIRY PRODUCTS, e.g. MILK, BUTTER OR CHEESE; MILK OR CHEESE SUBSTITUTES; MAKING OR TREATMENT THEREOF
  • A23C21/00—Whey; Whey preparations
  • A23C21/06—Mixtures of whey with milk products or milk components
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23D—EDIBLE OILS OR FATS, e.g. MARGARINES, SHORTENINGS OR COOKING OILS
  • A23D9/00—Other edible oils or fats, e.g. shortenings or cooking oils
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23J—PROTEIN COMPOSITIONS FOR FOODSTUFFS; WORKING-UP PROTEINS FOR FOODSTUFFS; PHOSPHATIDE COMPOSITIONS FOR FOODSTUFFS
  • A23J3/00—Working-up of proteins for foodstuffs
  • A23J3/04—Animal proteins
  • A23J3/08—Dairy proteins
  • A23J3/10—Casein
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23J—PROTEIN COMPOSITIONS FOR FOODSTUFFS; WORKING-UP PROTEINS FOR FOODSTUFFS; PHOSPHATIDE COMPOSITIONS FOR FOODSTUFFS
  • A23J3/00—Working-up of proteins for foodstuffs
  • A23J3/14—Vegetable proteins
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • 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
  • A23L33/18—Peptides; Protein hydrolysates
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • 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 OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • 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
  • A23L33/19—Dairy proteins
• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • 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
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/01—Hydrolysed proteins; Derivatives thereof
  • A61K38/012—Hydrolysed proteins; Derivatives thereof from animals
  • A61K38/018—Hydrolysed proteins; Derivatives thereof from animals from milk
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/168—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from plants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/46—Ingredients of undetermined constitution or reaction products thereof, e.g. skin, bone, milk, cotton fibre, eggshell, oxgall or plant extracts
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
  • A61K35/20—Milk; Whey; Colostrum

Definitions

• This invention is in the field of protein-containing nutritional compositions.
• this invention concerns the coagulation of such compositions in the upper gastrointestinal tract, more in particular in the stomach.
• This invention aims to modulate the digestive coagulation of proteins and peptic digestion, by adjusting the production process of nutritional compositions comprising proteins and lipids.
• Coagulation of proteins in the upper gastro-intestinal tract, in particular in the stomach, is hypothesized to delay gastric emptying. This can result in upper gastrointestinal complications like reflux, gastrointestinal discomfort, aspiration pneumonia, but also to confer satiety and the feeling of having a full stomach when this is not intended yet.
• Nutritional compositions that mainly contain caseins are desired for their nutritional value, but these compositions in particular tend to coagulate under the acidic conditions encountered in the stomach.
• One manner of providing digestion support to subjects in need thereof is to administer nutrition that results in lower coagulation levels in the stomach.
• the possibility to reduce digestive coagulation is preferred for those subjects suffering from upper gastrointestinal-related conditions such as intestinal discomfort, reflux, aspiration pneumonia, high gastric residual volume (GRV), vomiting, nausea, bloating, and delayed gastric emptying.
• facilitating digestibility is desired when aiming to promote digestive comfort, reduce gastrointestinal cramping or colics.
• a certain level of coagulation of nutritional compositions within the stomach can be desirable. Therefore, having the ability to influence gastric coagulation levels can be desirable.
• Nutritional compositions containing casein, in particular sodium caseinate, vegetable proteins, such as soy and/or pea protein, and a lipid source are known.
• enteral formulations comprising 40-95 weight% of caseinate and 5 -60 weight% of a stabilizing protein, selected from the group of whey protein and one or more vegetable proteins selected from the group of soy, corn, potato, rice and pea, the most preferred vegetable protein being soy protein.
• a stabilizing protein selected from the group of whey protein and one or more vegetable proteins selected from the group of soy, corn, potato, rice and pea, the most preferred vegetable protein being soy protein.
• the document is concerned with the reduction of creaming in enteral formulae and is silent with respect to coagulation properties of the composition.
• EP 1 972 346 discloses a pea- based protein mixture comprising 50 weight% caseinate, 25 weight% whey proteins and 25 weight% pea protein. The document is silent with respect to coagulation properties of the composition.
• WO2010/131952 Another example is WO2010/131952, wherein a method for reducing digestive coagulation of proteins is disclosed.
• a method for reducing digestive coagulation of proteins is disclosed.
• combining casein and anti-coagulating proteins in nutritional compositions reduces gastric coagulation effects.
• the document makes no suggestions on how to further reduce gastric coagulation of coagulation proteins in a nutritional composition comprising a lipid source.
• gastric coagulation of a given protein composition that contains a casein and a lipid can be modulated by adjusting the production process of the nutritional composition. For instance, it was observed that reduction in coagulation was much more than was expected based on the ratio of casein and anti-coagulating proteins that were included, together with a lipid, in the composition.
• digestive coagulating of the protein fraction of a nutritional composition further comprising a lipid can be influenced to achieve desirably low coagulation levels.
• the present invention therefore relates to a process of producing a composition, preferably a nutritional composition, comprising at least one lipid and a mixture of two different proteins, of which at least one is a casein and at least one is an anti-coagulating protein, comprising the steps of:
• said mixture comprises an effective amount of anti-coagulating protein such that coagulation of said casein is reduced in the stomach of a subject.
• said mixture preferably has a weight ratio of said casein to said anti- coagulating protein of any value between 20:1 and 1:3.
• this mixture is part of a nutritional composition further comprising said lipid.
• At least said second liquid component comprises said lipid, preferably during heat-sterilization.
• the invention relates to a process of producing a composition comprising a lipid and a mixture of casein and anti-coagulating proteins, preferably in a weight ratio of between 20:1 and 1:3, for reducing or preferably preventing coagulation in the upper gastrointestinal tract.
• the process of the invention includes step a) which involves heat-sterilizing said first liquid component which comprises said casein in an amount of at least 85 wt% of the total protein content of the first component, preferably a casein, and includes step b) which involves heat-sterilizing said second liquid component which comprises said anti-coagulating protein, preferably pea, soy or whey protein or a combination thereof, followed by mixing of the two components, wherein the first and/or second liquid component comprises lipid, such that a composition is obtained which comprises lipid and a mixture of casein and anti-coagulating proteins in a weight ratio which is between 20: 1 and 1:3.
• Preferred caseins used in the process of the invention comprise (or preferably consist of) micellar casein and/or caseinate proteins.
• Preferred anti- coagulating proteins comprise (or preferably consist of) leguminous proteins (especially pea and/or soy) and/or whey proteins.
• the process of the present invention can be performed such that a composition is obtained which comprises a mixture of caseins, preferably micellar casein and/or caseinate, and anti- coagulating protein, preferably pea, soy or whey protein or a combination thereof, having a weight ratio of casein to anti-coagulating proteins ranging between 20:1 and 1:3, preferably between 19:1 and 1:2, more preferably between 16:1 and 1:1, most preferably between 10:1 and 1:1.
• Preferred lipids include compounds containing fatty acids, such as free fatty acids, esters, monoglycerides, diglycerides, triglycerides, and phospholipids as defined below.
• the fatty acids comprise saturated fatty acids, mono-unsaturated fatty acids and poly-unsaturated fatty acids, preferably including a-linolenic acid .
• the lipids may comprise fish oil, vegetable oil and/or animal fats, more preferably fish oil and/or vegetable oil such as palm oil, canola oil and sunflower oil.
• Preferred fish oils include long-chain omega-3 fatty acids, such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA).
• the process of the invention may further comprise a drying step to obtain a dry composition, e.g. in the form of a powder.
• a drying step it may be included after heat-sterilizing the first and/or second liquid components of steps a) and b) but before the mixing thereof in step c), such that mixing is performed with at least the dried heat-sterilized first component and the dried heat-sterilized second component, wherein the first and/or second component comprises a lipid.
• such a drying step is performed after the heat-sterilized first liquid component is mixed with the heat-sterilized second liquid component in step c), such that mixing in step c) is performed with a liquid mixture of heat-sterilized casein and anti-coagulating proteins and lipids which is subsequently dried, for instance to obtain a powder.
• step c) as mentioned herein comprises the mixing of a heat- sterilized first liquid component with a heat-sterilized second liquid component, wherein either or both comprises a lipid, to obtain a mixture of lipids and casein and anti-coagulating proteins in liquid form.
• the second liquid component comprises the lipid.
• compositions obtainable by the process of the present invention.
• Said composition comprises a lipid and at least two different proteins, of which at least one is a casein, preferably comprising or consisting of a casein, and of which at least one is an anti-coagulating protein, preferably comprising or consisting of pea, soy or whey protein or a combination thereof.
• Said composition preferably comprises a lipid and a mixture of casein to anti-coagulating proteins having a weight ratio which ranges between 20:1 and 1:3.
• the process of the invention is performed such that casein and anti- coagulating protein are separately heat-sterilized, i.e. without having been mixed with each other before the heat-sterilization steps.
• the composition obtainable by the process of the invention which comprises a lipid and said mixture of casein and anti-coagulating proteins is characterized by having reduced coagulation properties when ingested.
• said mixture of anti-coagulating and caseins according to the present invention constitutes, in liquid form, between 1 and 20% (w/v), preferably between 2 and 15% (w/v), more preferably between 4 and 12% (w/v), most preferably between 5 and 10% (w/v) of the composition.
• said composition is a liquid nutritional composition suitable for enteral feeding.
• said lipid comprises between 1 and 30 wt% of the composition obtainable according to the invention, more preferably between 3 and 20 wt%, most preferably between 4 and 15 wt%.
• Yet another aspect of the invention relates to the use of a composition obtainable by the process according to the invention for treating a person or patient experiencing gastric problems related to coagulation in the upper gastrointestinal tract, in particular the stomach, by administering the composition obtainable by the process of the present invention to said person.
• Another aspect of the present invention is concerned with a method of providing relief of gastric problems by administering or providing the composition obtainable by the process according to the present invention to a person.
• Consumption of the composition serves to lower coagulate particle size and/or reduce the number of coagulate particles in the stomach of said person or patient. This is expected to improve peptic digestion and gastric emptying of the stomach content of said person or patient.
• the invention further relates to the use of a composition obtainable by the process according to the present invention in the reduction or preferably prevention of coagulation in the upper gastrointestinal tract, in particular the stomach, of the person or patient.
• the invention also relates to the manufacturing of a composition according to the present invention, which composition has improved properties with respect to reduction or preferably prevention of coagulation in the stomach of a person or patient.
• the invention also relates to the use of the composition according to the present invention in the manufacture of a nutritional composition, which composition has improved properties with respect to reduction or preferably prevention of coagulation in the stomach of a person or patient.
• kits-of-parts comprising a first holder containing a heat-treated casein obtainable by step a) and a second holder containing a heat-treated anti-coagulating protein obtainable by step b), wherein said first and/or said second holder further comprises at least one lipid.
• Said first holder either comprises said casein in liquid form or in dry form, either or both further comprising said lipid.
• said second holder comprises said anti-coagulating protein in either liquid or dry form, optionally further comprising said lipid.
• at least said second holder comprises said lipid.
• This invention aims to reduce the digestive coagulation of proteins through the provision of an improved production process of providing compositions comprising lipid and protein; preferably such a composition is a nutritional composition.
• the present invention therefore relates to a process of producing a
• composition comprising at least one lipid and a mixture of two different proteins, of which at least one is a casein and at least one is an anti-coagulating protein, comprising the steps of:
• said mixture has a weight ratio of said casein to said anti-coagulating protein of between 20: 1 and 1:3.
• said mixture of casein and anti-coagulating proteins and said lipid is part of a nutritional composition.
• the casein is present in an amount of at least 50%, most preferably between 60 and 90 wt% of the total protein of the composition obtainable by the method of the invention.
• the mixing according to step c) of casein with anti- coagulating protein results in the provision of a mixture of casein (preferably micellar casein and/or caseinate) and anti-coagulating protein (preferably pea, soy or whey protein or a combination of 2 or 3 thereof) having a weight ratio of casein to anti-coagulating protein which is between 20: 1 and 1:3.
• said heat-sterilization steps a) and b) of the process of the invention are performed such that the first liquid component and the second liquid component are not mixed with each other during heating steps a) and b).
• said first and second liquid component are not mixed with each other during heating steps a) and b).
• components are typically heat-sterilized in separate holders, containers or any other suitable means.
• said first liquid component comprises less than 15 wt% anti-coagulating protein, preferably less than 10 wt%, more preferably less than 8 wt% or most preferably less than about 5 wt% based on the total protein content of the first component.
• said anti-coagulating protein comprises or consist of pea, whey, soy and/or any combination thereof.
• the second liquid component is substantially free of casein.
• the phrase "substantially free of” is meant to be understood as that the second liquid component of step b) may comprise only a small amount of casein, such as preferably 4 wt% or less (or less than 3%, 2%, 1.5%, 1%, 0.5% or even less than 0.1%) relative to the total amount of protein present in the second liquid component.
• the second liquid component comprises less than 30 wt.%, preferably less than 15 wt% more preferably less than 8 wt% or most preferably less than about 5 wt% of casein based on the total protein content of the second component, and most preferably is essentially free of casein.
• the heat-sterilized liquid components used in steps a) and b) are preferably aqueous solutions, emulsions or dispersions containing said proteins in a concentration of between 0,1 and 20 wt% (w/v) [i.e. 1-200 g/1), preferably 1-20 wt%, more preferably 2-15 wt%, most preferably 4-12 wt% or even 5-10 wt%.
• the pH thereof is in the range of 5-9, more preferably 6-8.
• the amounts of anti-coagulating and caseins used in steps a) and b) are preferably selected such that the resulting mixture is characterized by a weight ratio of casein to anti-coagulating of between 20: 1 and 1:3, preferably 19:1 and 1:2, more preferably 16:1 to 1:1, most preferably 10:1 to 1:1.
• the amount of casein in the first liquid component is between 0.5 and 19 wt%, preferably 1-14 wt%, more preferably 2-11 wt%, most preferably 3-9 wt%, whereas the amount of anti-coagulating protein in the second liquid component is between 0.05-10 wt%, preferably 0.1-8 wt%, more preferably 0.2-6 wt%, most preferably 0.3-5 wt%.
• Other values can be calculated on the basis of the preferred mixture of casein and anti-coagulating proteins and the amount thereof as used in the composition.
• mixing step c) is performed with heat-sterilized casein and anti-coagulating proteins which have not been in contact with each other prior to said mixing in the process of the invention.
• Said mixing in step c) preferably involves mixing of two liquid
• the mixing in step c) preferably comprises mixing of dry first and second components to obtain a dry composition, such as a powder.
• the dry first component comprising the casein is mixed with said liquid second component comprising said anti- coagulating protein, or a liquid first component is mixed with a dry second component.
• Said lipid is included in the first and/or the second liquid component, preferably at least or only in said second liquid component.
• Preferred lipids include compounds containing fatty acids, such as free fatty acids, their esters, monoglycerides, diglycerides,
• triglycerides and phosphatides of mono-and diglycerides (phospholipids).
• the lipids comprises triglycerides.
• the fatty acids comprise saturated fatty acids, mono- unsaturated fatty acids and poly-unsaturated fatty acids.
• the lipids may comprise fish oil, vegetable oil and/or animal fats, more preferably fish oil and/or vegetable oil such as palm oil, canola oil and sunflower oil.
• Preferred fish oils include long- chain omega-3 fatty acids, such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA).
• the lipids comprise between 5 and 35 wt.% of polyunsaturated fatty acids, comprising between 0.5 and 10 wt.% of alpha-linolenic acid (ALA).
• ALA alpha-linolenic acid
• said lipid comprises between 1 and 30 wt% (w/v) of the composition in liquid form obtainable according to the invention, more preferably between 3 and 20 wt%, most preferably between 4 and 15 wt%.
• heat-sterilization of the first and second liquid components in step a) and b) is performed with any suitable method, such as retort sterilization, ultra-high temperature (UHT) treatment or direct- steam injection (DSI).
• UHT ultra-high temperature
• DSI direct- steam injection
• Heat-sterilization comprises heating to a temperature of at least 80°C, preferably at least 100°C, most preferably at least 110°C.
• Preferably said temperature is applied for a sufficient period to accomplish sterilisation, e.g. at least 1 minute, in particular at least 5 minutes at 100°C, or shorter or longer depending on the temperature.
• Heat-sterilization of the first and/or second liquid components in step a) and/or b) of the process of the present invention can be preceded or followed by a homogenization step. Homogenization of said liquid components may be accomplished by the skilled person using methods known to him, such as shaking, stirring, inverting or vortexing of the liquid components at a suitable temperature for a suitable period of time such that a homogenized liquid is obtained.
• the heat-sterilization of said first and/or second liquid components comprises heat-sterilization of homogenized first and/or homogenized second liquid components, which are subsequently mixed in step c).
• the first and/or second liquid components are first heat-sterilized according to step a) and/or b), followed by a homogenizing step of said liquid components, after which step c) is performed.
• the first and/or second liquid components are first heat- sterilized according to step a) and/or b), followed by mixing according to step c), after which the composition is subjected to a homogenizing step of said liquid components.
• at least one drying step is included.
• such a drying step takes place before the mixing in step c), such that the heated first liquid component and the heated second liquid component are dried, e.g. to obtain a powder, which components are subsequently mixed or dry blended.
• step c) comprises mixing of dry or dried first and second component to obtain a dry mixture thereof.
• This powder is thus a mixture of at least one lipid and separately heat-sterilized and dried casein and anti-coagulating proteins, which mixture has a dry weight ratio of said casein to said anti-coagulating protein of between 20:1 and 1:3.
• the drying step of the process of the invention is included after the mixing in step c), wherein said mixture of at least one lipid and first and second liquid components form is dried, e.g. to obtain a powder.
• This powder is thus a dried mixture of said lipid and separately heat-sterilized casein and anti- coagulating proteins which mixture has a dry weight ratio of said casein to said anti-coagulating protein of between 20:1 and 1:3.
• a pre- drying step resulting in partially dried mixtures may precede mixing step c), and a post-drying step may follow resulting in a powder.
• step c) the mixing in step c) is performed under sterile conditions.
• the process of the invention further comprises a step d), subsequent to step c), wherein the liquid product is aseptically filled into a holder.
• a suitable time period such as at least 9 months.
• further food components are added prior to, during or after performing any of the steps a), b) and/or c).
• Such further food components can be added to the heat-sterilized first and/or heat- sterilized second liquid components and subsequently mixed or added after the mixing of first and second components in step c), preferably followed by a homogenization step.
• said further food components are added in food- grade quality (meaning they are sterilized, pasteurized or filtrated) which obviates having to subject the composition to any further processing steps that could reduce the quality, shelf-life or stability et cetera of the composition.
• the further food components typically comprise conventional food ingredients or constituents, such as digestible carbohydrates, fibres, vitamins, minerals, single amino acids, dipeptides, tripeptides and oligopeptides.
• the further food components are selected from at least 1 wt%, preferably at least 4 wt%, up to e.g. 20 wt% of digestible carbohydrates and at least 0.1 wt%, preferably at least 0.5 wt.% of dietary fibres, up to e.g. 3 wt% based on the total weight of the first and/or second liquid component.
• the further food components are selected from at least 1 wt%, preferably at least 10 wt%, up to e.g. 250 wt% of digestible carbohydrates and at least 0.1 wt%, preferably at least 1 wt.%, up to e.g. 25 wt% of dietary fibres, relative to the total weight of the mixture of proteins as obtained after step c).
• a further protein such as defined herein below, is added to the process of the invention.
• the amount of said further protein is lower than the level of casein. More preferably, the amount of said further protein is lower than both the level of casein and anti-coagulating protein.
• said further protein may be heat-sterilized together with the casein in step a), or together with the anti-coagulating protein in step b), or with both.
• the further protein if present at all, may be separately heat- sterilized and added in step c) as a third component.
• Such a further protein serves a different purpose as influencing the coagulating status of the said mixture, for example, and if needed, to provide a source of amino acids which is
• the invention also pertains to a heat-sterilized mixture of at least one lipid, casein and anti-coagulating proteins as a product obtainable by the process of the invention.
• said mixture is comprised by a composition, in particular a nutritional composition.
• said mixture has a weight ratio of casein (preferably comprising or consisting of micellar casein or caseinate or a combination thereof) to anti-coagulating protein (preferably comprising or consisting of pea, soy, whey protein or a combination thereof) of between 20:1 and 1:3, or any ratio in between as mentioned herein.
• said composition is in liquid form (as an aqueous solution, emulsion or dispersion), however, it can also be advantageous to have said composition in dry form, e.g. in the form of a powder.
• the composition comprising said mixture, in particular a nutritional composition is preferably heat-treated, in particular sterilized or pasteurized, or (ultra) filtrated.
• the pH thereof preferably is in the range of 5-9, more preferably 6-8.
• the heat-sterilization of the liquid components in steps a) and b) is the final heat-treatment or sterilization step before the composition is aseptically filled in at least one holder.
• the mixture of anti-coagulating and caseins constitutes, in liquid form, between 1 and 20% (w/v), preferably between 2 and 15% (w/v), more preferably between 4 and 12% (w/v), most preferably between 5 and 10% (w/v) of the composition, with or without further food components, preferably with further food components.
• said composition is a nutritional composition, most preferably said composition is a liquid enteral nutritional composition.
• the at least one lipid in the composition obtainable by the method of the present invention is preferably an oil and/or fat, and includes compounds comprising fatty acids as defined above.
• the lipid may comprise saturated fatty acids, mono unsaturated fatty acids (MUFA), poly unsaturated fatty acids (PUFA), long-chain polyunsaturated fatty acids (lcPUFA) such as EPA and DHA, and may be provided by fish oil, vegetable oil and/or animal fats, more preferably fish oil and/or vegetable oil such as palm oil, canola oil and sunflower oil.
• said lipid (preferably an oil and/or a fat) comprises between 1 and 30 wt% (w/v) of the composition obtainable according to the invention in liquid form, more preferably between 3 and 20 wt%, most preferably between 5 and 15 wt%.
• the contribution of the mixture of the anti-coagulating and caseins as a percentage of total weight of the composition depends on the presence of further food components as mentioned herein.
• the mixture of anti-coagulating and caseins can be used in a wide variety of food compositions, such as, but not limited to, enteral feeds, tube feeds, sip feeds or medical food, or used as an intermediate product for the manufacture of such feeds or food.
• the amount of the mixture of anti-coagulating and casein constitutes between 10 and 90 wt% based on the total dry weight of the composition.
• the amount of the mixture of anti-coagulating and caseins varies between 8 and 90 wt%, 9 and 80 wt%, 10 and 70 wt%, 12 and 60 wt%, 13 and 50 wt%, 14 and 40 wt%, 15 and 30 wt% based on the total dry weight of the composition.
• the amount of lipid in the first and/or second holder(s) constitutes between 10 and 90 wt% based on the total dry weight of the composition of the total of the two holders. More preferably, this amount is between 10 and 80 wt%, 15 and 70 wt%, 18 and 60 wt%, 20 and 50 wt%, 25 and 40 wt% based on the total dry weight of the composition.
• the weight ratio between total lipid and total protein in the total composition is between 1:9 and 9:1, more preferably between 4:1 and 1:4, most preferably between 3:1 and 1:2.5.
• the mixture according to the present invention is part of a composition which comprises further food components.
• further food components are preferably present in food-grade quality, meaning they are heat- treated (e.g. pasteurized or sterilized) and/or (ultra) filtrated.
• the further food components typically comprise conventional food ingredients or constituents, such as digestible carbohydrates, fibres, vitamins minerals, single amino acids, dipeptides, tripeptides and oligopeptides.
• the further food components are selected from at least 1 wt% digestible carbohydrates and at least 0.1 wt% dietary fibres, relative to the total weight of said mixture of casein and anti-coagulating proteins comprised by said composition.
• the relative amounts of proteins, digestible carbohydrates and fibres comprised by the composition according to the invention may vary according to the specific use and on whether it is a complete food or a food supplement.
• the protein portion thereof, in particular comprising said mixture according to the invention in terms of energy (4 kcal/g) can e.g. be between 8 and 90 en.%.
• said protein portion is preferably 8-40 en.%, more preferably 12-32 en.%, most preferably betweenl5 and 25 en.%.
• the lipid portion thereof in terms of energy (9 kcal/g) can e.g. be between 10 en.% and 92 en%.
• lipid portion is preferably 10-60 en.%, more preferably 15-50 en.%, most preferably between 20 and 40 en.%.
• a further protein such as defined herein below, is encompassed by the mixture of at least one fat lipid, casein and anti-coagulating comprising nutritional composition.
• the amount of said further protein in said composition is lower than the level of casein. More preferably, the amount of said further protein in said composition is lower than both the level of casein and anti-coagulating protein.
• the invention furthermore relates to a kit-of-parts, said kit-of-parts comprising a first holder containing a heat-sterilized casein obtainable by step a) and a second holder containing a heat-sterilized anti-coagulating protein obtainable by step b), wherein at least one lipid is present in the first and/or second holder.
• the heat-sterilized first component and/or heat- sterilized second component is/are in a dry form, preferably as a powder. It will be clear that to obtain the composition in a dry form, the process of the invention comprises a drying step as mentioned herein.
• the heat-sterilized first component and/or heat-sterilized second component are in liquid form.
• the content of the first holder and the content of the second holder can be mixed such that a mixture is obtained which comprises at least one lipid and has a weight ratio of casein (preferably comprising or consisting of micellar casein and/or caseinate) to anti-coagulating protein (preferably comprising or consisting of pea, soy, whey protein or a combination thereof) of between 20: 1 and 1:3, preferably between 19:1 and 1:2, more preferably 16:1 to 1:1, most preferably 10: 1 to 1:1.
• the contents of the first and second holder of said kit-of-parts are obtainable by performing steps a) and b) of the process according to the invention.
• the first holder containing the heat-sterilized casein obtainable by step a) comprises said casein in an amount of at least 85 wt% of the total protein content of the first component.
• the second holder containing heat-treated anti-coagulating protein obtainable by step b) is preferably substantially free of casein.
• the contents of the first holder, as well as the contents of the second holder are sterile.
• said first and/or said second holder comprises at least 1 wt% carbohydrates and/or 0.1 wt% dietary fibers. Vitamins and/or minerals can also be included in the first and/or second holder.
• the content of the first and/or second holderfs) is in liquid form, the total protein content thereof is between 1 and 20% (w/v), preferably between 2 and 15% (w/v), more preferably between 4 and 12% (w/v), most preferably between 5 and 10% (w/v).
• the amount of lipid in the first and/or second holder(s) preferably is between 1 and 30 wt% (w/v), more preferably between 3 and 20 wt%, most preferably between 5 and 15 wt%.
• the amount of the mixture of anti-coagulating and casein constitutes between 10 and 90 wt% based on the total dry weight of the composition of the total of the two holders. More preferably, the amount of the mixture of anti-coagulating and caseins varies between 10 and 80 wt%, 10 and 70 wt%, 12 and 60 wt%, 13 and 50 wt%, 14 and 40 wt%, 15 and 30 wt% based on the total dry weight of the composition. Preferably, the amount of lipid in the first and/or second holder(s) constitutes between 10 and 90 wt% based on the total dry weight of the
• composition of the total of the two holders More preferably, this amount is between 10 and 80 wt%, 15 and 70 wt%, 18 and 60 wt%, 20 and 50 wt%, 25 and 40 wt% based on the total dry weight of the composition.
• the first and/or second holder of the kit-of- parts comprise(s) further food components.
• Such further food components are preferably present in food-grade quality, meaning they are heat-treated (e.g.
• the further food components typically comprise conventional food ingredients or constituents, such as digestible carbohydrates, fibres, vitamins minerals, single amino acids, dipeptides, tripeptides and oligopeptides.
• the further food components are selected from at least 1 wt% digestible carbohydrates and at least 0.1 wt% dietary fibres, relative to the total weight of said mixture of casein and anti-coagulating proteins comprised by said composition.
• a further protein such as defined below, is encompassed by first and/or second holder of the kit-of-parts.
• the amount of said further protein in said first and/or second holder is lower than the level of casein. More preferably, the amount of said further protein in said first and/or second holder is lower than both the level of casein and anti-coagulating protein.
• the casein preferably is micellar casein and/or a caseinate.
• a casein is thus to be construed as including casein, caseinate, micellar casein, sodium caseinate, calcium caseinate, potassium caseinate and magnesium caseinate.
• said casein is an intact casein, e.g. intact casein and/or intact caseinate.
• intact casein in particular means non-hydrolysed casein, i.e. having a degree of hydrolysis of less than 2%.
• a 6 wt% (w/v) protein solution with 5.8 wt% (w/v) of canola oil as a lipid source is incubated in the presence of artificial human saliva and artificial human gastric juice as defined below under
• physiologically suitable conditions i.e. at 37°C under continuous stirring for 100 minutes
• pH such that the neutral starting pH of the protein solution (preferably a pH of 6) is reduced to a final pH of 2, after which the coagulate is size-fractioned and wet weight of the different fractions is determined.
• the wet weights of the different fractions represent a measure for the degree of coagulation.
• the artificial human gastric juice as meant herein is a physiologically representative aqueous solution having 50 mM NaCl, 15 mM KCl, 1 mM CaCl 2 .H 2 0, 15 mM NaHCOs, 0.014% (w/v) pepsin (e.g. porcine stomach, Sigma p7012), 0.019 % (w/v) lipase [Rhizopus oryzae, DF 15K Amano Pharmaceutical Co, Ltd Nagoya), at a pH of 4.0, of which 45 ml is used in the Gastric Digestion Test.
• the artificial human saliva as meant herein is a physiologically representative aqueous solution having 100 mM NaCl, 30 mM KCl, 2 mM CaCl 2 .H 2 0, 0.065% (w/v) amylase (Sigma A 6211) having a pH of 6.3.
• the composition is divided in four fractions of different particle sizes using a sieve. These four fractions are characterized as a) having a particle size of 0.25 mm or less, b) a particle size of between 0.25 and 1 mm, c) a particle size of between 1 and 2 mm and d) a particle size of larger than 2 mm.
• a) having a particle size of 0.25 mm or less b) a particle size of between 0.25 and 1 mm
• Especially coagulates having a size larger than 1 mm, or larger than 2 mm are believed to play a role in delay of gastric emptying. However, reducing the amount of total coagulate, meaning herein all particles with a size larger than 0.25 mm, is believed to facilitate peptic digestion.
• the amount of the individual wet weight fractions is determined by weighing each individual sieve with coagulate on it and subtracting
• the mixture of at least one lipid, casein and anti-coagulating proteins obtainable by the method of the present invention has reduced coagulation properties under the prevailing conditions of the upper gastrointestinal tract, in particular the acidic conditions of the stomach, compared to the same mixture which is obtained by first mixing and subsequently heat-sterilizing both proteins and the at least one lipid.
• the reduction on coagulation of casein in the stomach means that the addition of an anti-coagulating protein to a casein in the presence of at least one lipid yields a synergistic effect on reduction of coagulation beyond what is expected arithmetically.
• Anti-coagulation thus means herein that a protein has the effect of reducing the coagulation of the casein with which it is combined in the presence of at least one lipid.
• This reduction effect on coagulation can be further characterized by the use of the herein described physiologically relevant Gastric Digestion Test.
• the anti-coagulating protein is characterized according to this digestion test, and qualifies as a protein which, when subjected to the method according to the present invention, reduces the size of coagulate particles in a synergistic manner.
• the average size of coagulate particles of coagulating protein with a diameter of 0.25 mm or more in a detectable manner, compared to a processing method wherein the anti-coagulating protein is not absent during heat-sterilization.
• this reduction in the amount of particles with a size of 0.25 mm or more is at least 10 wt%.
• the anti-coagulating protein reduces the amount of coagulate with particles of 1 mm or more in a detectable manner or by at least 10 wt%.
• the reducing effect on coagulation is preferably determined using the Gastric Digestion Test with a 6% (w/v) solution of sodium caseinate and pea as anti- coagulating protein in the presence of 5.8% (w/v) canola oil as lipid source.
• a weight ratio of 70:30 or 60:40 of sodium caseinate to anti-coagulating protein is used.
• Anti-coagulating proteins are preferably selected such so as to provide an amino acid profile commensurate to the nutritional requirements of humans.
• the anti-coagulating protein is selected to comply with the WHO amino acid profile recommendations for complete nutrition (see: WHO technical report series no. 935 -Protein and amino acid requirements in human nutrition: report of a joint FAO/WHO/UNU expert consultation, 2007).
• Anti-coagulating proteins for example are selected from non-dairy proteins, preferably from vegetal and/or microbial proteins and combinations thereof.
• “vegetal” relates to protein from plant origin, such as, for instance originating from vegetables such as carrot, pea, chickpea, green pea, cowpea, field pea, kidney bean, lupine, rice, soy, lentil, canola, hemp, zein, maize, corn, barley, flax, linseed, and wheat.
• Equivalent wording may be used, such as “vegetable”, or "plant-derived”.
• the vegetal protein is derived from leguminous plants [Fabaceae family).
• Microbial proteins in particular comprise fungal or algal proteins.
• the anti-coagulating protein is whey protein or a non-dairy protein.
• the non-dairy protein is selected from the group consisting of vegetal proteins, fungal proteins and algal proteins.
• Preferred vegetal proteins include proteins obtained from cereals, legumes, brassicaceae, crucifers, solanaceae, fabaceae, carrot, hemp or linseed.
• Fungal proteins include proteins obtained from mushrooms or yeast.
• the anti-coagulating or vegetal protein is a legume (peas, beans) protein of the Fabaceae family, such as pea or soy protein, most preferably a pea protein as further defined below.
• the anti-coagulating proteins used in the composition of the invention are preferably intact, i.e. non-hydrolysed.
• hydrolysed dairy or milk protein in particular hydrolysed casein
• the anti-coagulating protein is selected from hydrolysed dairy protein, hydrolysed milk protein, hydrolysed whey protein, hydrolysed casein, hydrolysed caseinate, or combinations thereof.
• Hydrolysed herein means the hydrolysed protein has been subjected to a hydrolysis step, in particular with a degree of hydrolysis of at least 2%, more in particular between 3 and 30%. Such hydrolysed proteins are readily available and commercialized as such on the market.
• a further protein is a protein which is a non-casein, and not considered an anti-coagulating protein based on the definition which is derived from the Gastric Digestion Test described herein.
• a protein may be present in the compositions according to the invention as a further protein at a level which does not exceed 50% of the total weight of casein and anti-coagulating proteins, preferably less than 25% thereof.
• Such a further protein may be added in the process of the invention to the components in step a) and/or b), or mixed as a third component in step c).
• such further proteins are added separate from the caseins, i.e. after step a) of the process of the invention, and more preferably also separate from the anti-coagulating proteins, i.e. after step b).
• pea protein preferably intact pea protein
• pea protein is included in said mixture in an effective amount such that coagulation of said casein is reduced in the stomach of a subject.
• Pea protein can be used effectively as anti-coagulating protein according to the process of the invention and composition obtainable thereby in a wide range of casein to anti-coagulating protein weight ratios as indicated, such as 20:1 and 1:3 or between 10:1 and 1:1, or between 4:1 and 1:1, or between 3:1 and 1:1, or between 10:1 and 1.5:1, or between 4:1 and 1.5:1, or between 3:1 and 1.5:1.
• Whey protein is preferably included in said mixture in an effective amount such that coagulation of said casein is reduced in the stomach of a subject, preferably between 20:1 and 1:3. More preferably, whey protein is included in relatively small amounts (e.g. between 10:1 and 1:1, or between 4:1 and 1:1, or between 3:1 and 1:1, or between 10:1 and 1.5:1, or between 4:1 and 1.5:1, or between 3:1 and 1.5:1) which already suffice to obtain a pronounced reduction in gastric coagulation.
• the anti-coagulating protein consists of pea and/or whey.
• Pea protein is relatively inexpensive (on average, pea protein may cost about half the price of caseinates) and as it is added to the nutritional composition it increases the protein content while keeping costs quite low. Pea protein is generally tolerated well by most people, it is lactose-free and is not a common allergen. Pea protein is quite high in cysteine content and can therefore
• pea protein is quite high in arginine compared to casein, which is required for muscle metabolism and which facilitates the intake of body mass while reducing body fat; and it is quite high in lysine, when compared to the other vegetable proteins derived from cereals / grains, which is needed to build protein muscle and assist in the maintenance of lean body mass.
• pea sources are readily available to the skilled person, for example, from Roquette (Lestrem, France) which markets a pea isolate obtained from yellow pea [Pisum sativum), and from Cosucra Groupe Warcoing (Warcoing, Belgium).
• Other pea protein sources may originate from green pea (Pisum sativum), cowpea (Vigna unguiculata), chickpea (Cicer arietinum), and field pea (Pisum arvense).
• the pea protein is substantially in intact form or non-hydrolysed. In another embodiment according to the invention, the pea protein is fermented pea protein or is pea protein hydrolysate.
• non-hydrolysed protein is equivalent to an "intact" protein, meaning that the protein has not been subjected to a hydrolysis process.
• minor amounts of hydrolysed proteins may be present in the source of non-hydrolysed proteins.
• minor should be understood as an amount of 10 weight% or less.
• the term “about” should be interpreted as a deviation of plus or minus 10 % of the given value.
• soy protein preferably intact soy protein
• soy protein is another preferred anti-coagulating protein.
• soy protein is included in said mixture in an effective amount such that coagulation of said casein is reduced in the stomach of a subject.
• Soy protein can be used in the process of the invention and included in the composition obtainable thereby in a wide range of the ratios as indicated herein, ranging between 20:1 and 1:3.
• the preferred ratio of casein to soy protein is such that moderate levels (e.g. between 10:1 and 1:1, or between 4:1 and 1: 1, or between 3:1 and 1:1, or between 10:1 and 1.5: 1, or between 4:1 and 1.5:1, or between 3:1 and 1.5:1) of soy protein provide the most pronounced anti-coagulating effect.
• the anti- coagulating protein consists of soy, or consists of a combination with pea and/or whey.
• Soy protein is a vegetable protein that contains the essential amino acids in a relatively high proportion for human health.
• Soy sources are readily available to the skilled person, for example, from The Solae Company (St. Louis, MO, USA).
• the soy protein is substantially in intact form or non-hydrolysed.
• the soy protein is fermented soy protein, or soy protein hydrolysate. Mixture of casein and anti-coagulating protein
• this weight ratio is between 19: 1 and 1:2, 18:1 and 1:1.5, 17: 1 and 1:1.25, 16:1 and 1:1, 15:1 and 1:1, 14: 1 and 1:1, 13:1 and 1: 1, 12:1 and 1:1, 11:1 and 1:1, 10:1 and 1:1, 9:1 and 1:1, 8:1 and 1:1, 7:1 and 1:1, 6:1 and 1:1, 5:1 and 1:1, 4: 1 and 1:1, 3:1 and 1:1, 2:1 and 1:1.
• the upper limit of this range of said casein, in particular micellar casein or caseinate, to said anti-coagulating protein [e.g. pea, soy or whey protein or a combination thereof), expressed as weight ratio, in said mixture is 20: 1, 19:1, 18:1, 17:1, 16:1, 15:1, 14:1, 13: 1, 12:1, 10: 1, 9: 1, 8:1, 7:1, 6: 1, 5:1, 4:1, 3:1, or 2:1.
• the lower limit of this range of said casein [e.g. micellar casein or a caseinate) to said anti-coagulating protein e.g.
• pea, soy or whey protein or a combination thereof), expressed as a weight ratio, in said mixture is 1:3, preferably 1:2, more preferably 1:1.5, even more preferably 1: 1, or 1.2:1, or 1.5:1, or, 1.8:1, or 2: 1, or 2.2:1, or 2.5:1, or 2.8:1 or 3:1.
• the weight ratio of said casein [e.g. micellar casein or a caseinate) to said anti-coagulating protein e.g.
• pea, soy or whey protein or a combination thereof) in said mixture is about 20: 1, or about 19:1, or about 18:1, or about 17:1, or about 16:1, or about 15:1, or about 14:1, or about 13:1, or about 12:1, or about 10: 1, or about 9:1, or about 8:1, or about 7:1, or about 6:1, or about 5:1, or about 4:1, or about 3:1 or about 2: 1 or about 1:1, or about 1:1.5, or about 1:2. It is within the capabilities of the skilled person to establish what exact ratio is preferred to reduce the gastric coagulation properties of a given casein by selecting an amount and type of anti-coagulating protein using the Gastric Digestion Test as meant herein.
• the ratio of casein, in particular micellar casein or caseinate, to anti-coagulating protein [e.g. leguminous or whey protein or a combination thereof) of said mixture is between 95:5 and 25:75, expressed as wt% casein to wt% anti-coagulating protein in the mixture obtained in step c). More preferably, this ratio is between 90: 10 and 33:67, 85:15 and 40:60, 70:30 and 50:50 or between 60:40 and 50:50.
• the composition obtainable by the process of the invention is a liquid composition which comprises said mixture of casein and anti-coagulating protein obtainable by step c) and at least one lipid.
• the amount of the protein mixture obtainable by step c) as included in the liquid composition comprises between 1 and 20% (w/v) of said liquid
• the amount of the protein mixture as obtainable by step c) of the invention comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20% (w/v) of said liquid composition.
• the protein content of the liquid composition 6% (w/v).
• Tube feeding is given to provide nutrition to patients which cannot obtain nutrition by swallowing, 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
• enteral feeding comprising all of the abovementioned tube feeding systems
• enteral nutrition used in the feeding by nutritional supplements and/or a by a feeding tube
• Use of such enteral nutrition may be temporary for the treatment of acute conditions, or lifelong in the case of chronic disabilities. In the latter case, it is primordial that the enteral nutrition is designed for long-term administration containing all necessary components.
• upper gastrointestinal complications such as, e.g. gastrointestinal reflux, intestinal discomfort, reflux, aspiration pneumonia, high gastric residual volume, vomiting, nausea, bloating, digestive discomfort, gastrointestinal cramping, colics, coagulation in the upper gastrointestinal tract and/or delayed gastric emptying, especially in vulnerable people, such as hospitalized patients.
• said composition comprising at least one lipid and said mixture of the invention is a nutritional composition which is
• said administering involves oral administration, by eating or drinking, preferably enterally by tube feeding, of the composition with the mixture of the present invention.
• the invention concerns the use of anti-coagulating protein in the manufacture of a nutritional composition that further comprises casein, for the reduction, prevention or treatment of upper gastrointestinal conditions or complications selected from the group of reflux, aspiration pneumonia, high gastric residual volume (GRV), vomiting, nausea, bloating, and delayed gastric emptying.
• casein for the reduction, prevention or treatment of upper gastrointestinal conditions or complications selected from the group of reflux, aspiration pneumonia, high gastric residual volume (GRV), vomiting, nausea, bloating, and delayed gastric emptying.
• the invention concerns the use of anti-coagulating proteins, preferably one or more leguminous proteins, or whey protein or a combination thereof, in the manufacture of a nutritional composition that further comprises casein, preferably micellar casein or a caseinate, for use in preventing or reducing of coagulation in the stomach of said casein.
• casein preferably micellar casein or a caseinate
• the invention concerns the use of anti-coagulating proteins, preferably leguminous protein or a combination thereof, in the manufacture of a nutritional composition that further comprises casein, preferably micellar casein or a caseinate, and at least one lipid for the reduction, prevention or treatment of upper gastrointestinal complications such as, e.g. gastrointestinal reflux, intestinal discomfort, reflux, aspiration pneumonia, high gastric residual volume, vomiting, nausea, bloating, digestive discomfort, gastrointestinal cramping, colics, coagulation in the upper gastrointestinal tract and/or delayed gastric emptying, especially in vulnerable people, such as hospitalized patients.
• casein preferably micellar casein or a caseinate
• at least one lipid for the reduction, prevention or treatment of upper gastrointestinal complications such as, e.g. gastrointestinal reflux, intestinal discomfort, reflux, aspiration pneumonia, high gastric residual volume, vomiting, nausea, bloating, digestive discomfort, gastrointestinal cramping, colics, coagulation in the upper gastrointestinal tract and/or delayed gastric emptying, especially in vulnerable people, such
• the nutritional composition is an infant formula, a follow-on formula and/or a toddler formula.
• the nutritional composition is in a suitable form for administration to a baby, an infant and/or a toddler.
• the nutritional composition is to promote digestive comfort, reduce gastrointestinal cramping and/or reduce colics.
• the mixture of the invention and the at least one lipid comprised by a (nutritional) composition can be used to partially or fully replace, or supplement, the typical daily intake by a person of caseins which are produced by conventional methods, i.e. methods not including the combination of separately heat-sterilizing casein and anti-coagulating proteins in steps a) and b), with the mixing thereof in step c) according to the present invention.
• the amount of the at least one lipid and the protein mixture of the invention included in the diet of a person experiencing gastric problems related to coagulation in the upper gastrointestinal tract, in particular the stomach, is such that coagulation- related problems experienced by that person are reduced or preferably prevented.
• the composition according to the invention comprising said protein mixture and at least one lipid preferably has the form of a complete food, i.e. it can meet all nutritional needs of the user.
• the composition is preferably in the form of a liquid, more preferably a liquid enteral composition according to the invention, and as such preferably contains 1000 to 2500 kcal per daily dosage.
• 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 composition according to the invention of 1.0 kcal/ml.
• the composition is adapted for tube feeding.
• a complete food composition of the invention may, in addition to the protein mixture of the invention comprising at least one casein and at least one anti-coagulating protein, contain further proteins sources, it is preferred that the proteins mixture of the invention is the only protein source.
• the protein mixture of the invention preferably contributes to between 5 and 40 en.%, more preferably between 8 and 32 en.%, most preferably between 15 and 25 en.% of the complete food.
• the daily dosage of the protein mixture of the invention is preferably between 3 kcal and 10 kcal per kg bodyweight, more preferably between 4 and 8 kcal per kg bodyweight, or preferably between 0.75 and 2.5 g protein mixture, preferably between 1 and 2 g per patient per day, as part of a complete food.
• the composition is packaged, stored and provided in a container such as plastic bag or a pouch or the like.
• a container such as plastic bag or a pouch or the like.
• a variety of such containers is known, for example 500 ml, 1000 ml, and 1500 ml containers are known in the art. It should be noted that any suitable container can be used to package, store and provide the nutritional composition according to the invention.
• 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 composition is in the form of a powder, accompanied with instructions to dissolve or reconstitute in an aqueous composition or water to arrive at the liquid enteral composition according to the present invention.
• the present liquid enteral composition may thus be obtained by dissolving or reconstituting a powder, preferably in an aqueous composition, in particular water.
• Figure 1 shows the absolute wet weight of coagulates between 0.25 mm and 1 mm (lower part, black bars), between 1mm and 2 mm (middle part, open bars) and larger than 2 mm (upper part, grey bars), after 100 minutes of gastric digestion of protein mixtures of sodium caseinate with pea protein and canola oil as lipid source.
• Na-cas:pea 60:40 ratio; heat-sterilized as a single protein mixture, 2: same ratio, casein and pea mixed after separate heat-sterilization.
• canola oil sodium caseinate with a protein content of 88 wt%
• pea protein with a protein content of 78 wt% were used as starting materials for obtaining the solutions as prepared.
• Dispersion 1 was obtained by mixing sodium caseinate and pea protein (weight ratio of 60:40 sodium caseinate to pea protein) and canola oil.
• Dispersion 2a contained only sodium caseinate, dispersion 2b contained pea protein and canola oil.
• the pH was then adjusted using potassium hydroxide to reach pH 8.0. After pH adjustment, the three different mixtures were heated for 30 seconds at 85°C, which was followed by a homogenisation step.
• the sterilized dispersion 1 was subsequently used in the Gastric Digestion
• Dispersions 2a and 2b were mixed after sterilization to obtain a 60:40 sodium caseinate to pea protein ratio and subsequently subjected to the Gastric Digestion Test.
• each sample was poured over metal sieves to yield fractions with particle sizes of a) larger than 2 mm, b) below 2 mm and above 1 mm, c) below 1 mm and above 0.25 mm and d) below the limit of 0.25 mm.
• the wet weight fractions were determined by weighing each individual respective sieve with coagulate on it and subtracting the weight of each sieve. Control results
• pea protein which was sterilized in a single solution together with sodium caseinate in a 60:40 weight ratio and canola oil gave a total amount of coagulate of about 45 wt% based on wet weight (FIG 1, sample 1).
• the coagulate amounts of each individualized fraction and total coagulate wet weight were significantly reduced (FIG 1, sample 2).

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