efficiency of digestion (%)
5% lost in faeces
%EE used by gut and liver
35% of EE
% of glucose used by gut and intestines
10%
% of glucose used by the gut and intestines in preterm infants
33%
European Food Safety Authority recommends that ?%
of calories should be contributed by linoleic acid and
?% by α-linolenic acid
4% of calories should be contributed by linoleic acid and
0.5% by α-linolenic acid
PN Phosphides
Higher in 10% than in 30%
TG is broken down by an enzyme called?
lipoprotein lipase
How to measure lipids peroxidation ?
MDA
How to reduce lipids peroxidation?
vitamin E
Lowering carbohydrates intake
Disadvantages of lipids
“fat overload syndrome” – activation of platelets
and immune system
• Cholestasis
• Fat is increased slowly in PN due to intolerance
• Excessive triglyceride and or free fatty acid levels
deleterious and need to be monitored
High levels of phytosterols from parenteral nutrition may lead to
increase hepatic lipogenesis and bile acid synthesis, leading to fatty liver and cholestasis and PNAC
acute phase proteins are particularly high in
sulphur amino acids
% of leucine utilised by intestine and liver
24-50
% of lysine utilised by intestine and liver
20
% of glutamine utilised by intestine and liver
up to 50
Egg protein is high in
Relatively high in phenylalanine
How much of each amino acid should be given parenterally?
Reference profile for premature infants
umbilical cord
antioxidant enzymes
intracellular
extracellular
chemical antioxidants
• fat soluble
• water soluble
• non-specific antioxidants e.g. amino acids, proteins
intra- and extracellular superoxide dismutases
- CuZn-SOD (lung extracellular fluids and plasma) (cystolic)
- Mn-SOD (mitochondria)
- superoxide O2- -> H2O2 hydroxides
Catalases
- Peroxisomes
- contains Fe+3 at active site
- active at high H2O2 concentration
glutathione peroxidase
- Mitochondria H2O2 -> water
- Lipids peroxides
anti-oxidant roles of micronutrients in PN
• iron (catalase)
• copper (superoxide dismutase)
• zinc (superoxide dismutase)
• manganese (superoxide dismutase)
• selenium (glutathione peroxidase)