植物性营养中的低蛋白质含量限制了住院患者的蛋白质过渡:来自观察性研究的结果
M A van Bree1, B C Schouten2, E S Wolters3
1Amsterdam UMC, University of Amsterdam, Nutrition and Dietetics, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Meibergdreef 9, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Endocrinology & Metabolism, Internal Medicine, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM), Meibergdreef 9, Amsterdam, Netherlands.
Clinical nutrition ESPEN
|July 16, 2025
概括
住院患者在植物性饮食中努力满足蛋白质需求. 不足够的蛋白质摄入量和 lysine 缺乏是转向植物性营养以改善全球健康的关键挑战.
科学领域:
- 营养科学 营养科学
- 饮食研究 饮食研究
- 医疗保健 营养 营养
背景情况:
- 荷兰绿色协议可持续医疗保健 (DGD) 准则建议50%的动物蛋白转向植物蛋白,以获得环境和健康的好处.
- 住院患者可能面临的挑战是满足蛋白质和必需氨基酸 (EAA) 需求与植物性饮食由于较低的蛋白质密度和潜在的合成药抵抗力.
- 关于植物性饮食增加对住院患者蛋白质和氨基酸摄入量的影响的数据有限.
研究的目的:
- 评估住院患者的蛋白质和氨基酸摄入量,这些患者主要食用植物性食品,而不是动物性食品.
- 为了评估在饮食过渡期间在大学医院环境中的食的氨基酸评分 (AAS).
- 通过增加植物性食选择,确定实现充足蛋白质摄入量的挑战.
主要方法:
- 一项观察性研究涉及对234名非重症成人患者的直接食物摄入观察 (2023年10月至11月).
- 蛋白质需求量为1.2g/kg体重,调整为BMI.
- 根据蛋白质摄入量 (低,中等,充足) 划分患者;如果蛋白质含量>50%是植物性,那么饮食被归类为主要来自植物的. AAS是按每餐计算的.
主要成果:
- 80%的患者摄入不足的蛋白质.
- 食物中动物和植物蛋白质的总比为69:31.
- 氨酸是主要来自植物的食物中最常见的限制性氨基酸 (AAS <1),而主要来自动物的食物中没有发现限制性氨基酸.
结论:
- 在医院过渡到更多植物性饮食期间,达到足够的蛋白质摄入量 (1.2 g/kg) 是一个重大挑战.
- 主要来自植物的食需要仔细考虑氨基酸概况,特别是素.
- 植物性食中总蛋白质含量较低,是实施住院患者饮食改变的主要障碍.
相关概念视频
01:28Chronic Kidney Disease III: Interprofessional Care
81
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
81
01:21Overview of Protein Metabolism
1.9K
Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
1.9K
01:28Proteins: Dietary Sources and Requirements
645
Consuming animal-based products offers high-quality proteins that contain optimal levels and combinations of essential amino acids, crucial for tissue repair and growth. Foods like eggs, milk, fish, and most meats are a source of complete proteins. Legumes and cereals are abundant in proteins; however, they typically lack a full range of essential amino acids. As a result, they are considered incomplete protein sources. Some plant sources like soybeans, quinoa, and amaranth do contain complete...
645
01:29Factors Affecting Protein-Drug Binding: Patient-Related Factors
116
Protein-drug binding, a pivotal aspect of pharmacokinetics, is subject to considerable variability influenced by an array of patient-related factors. The intricate interplay of age, individual differences, and pathological conditions significantly impact the binding dynamics and subsequent pharmacological effects.
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
116
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
301
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
301
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
318
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
318