Requerimientos energéticos y proteicos estimados por calorimetría indirecta y nitrógeno urinario en pacientes con quemadura o pancreatitis aguda / Energy and protein requirements estimated by indirect calorimetry and urine urea nitrogen in burn and acute pancreatitis patients

The pathological states of burn injuries and acute pancreatitis are associated with hypermetabolic and hypercatabolic states. The objective of the study was to determine energy and protein requirements in these conditions. A transversal analytical study was applied to 18 patients: 10 with mild burn injuries in <5% body surface and 8 with acute pancreatitis. Anthropometric measurements were taken (weight, height, BMI, skin folds), as well as resting metabolic rate through indirect calorimetry (RMR IC), protein catabolism using 24-hour urine urea nitrogen (UUN), and trauma factor (RMR IC/BMR Harris-Benedict equation). The sample was made up of 72.2% men and27.8% women. The study of burn and acute pancreatitis patients was carried out on the average 16.1 ± 13.0 SD and 8.8 ± 2.0 SD days after the onset of the disease, respectively. There were no statistically significant differences in RMR IC since mean energy requirements were 24.4 kcal/kg/d and 23.2 kcal/kg/d in patients with burns and acute pancreatitis, respectively, for both sexes (p>0.05). Total energy expenditure (TEE) was not significant (p>0.05). Acute pancreatitis and burn patients showed mild catabolism and their protein requirement was 1,19 g/ kg/d (p>0.05). The trauma factor in acute pancreatitis patients was 0,91 (p>0.05). In conclusion, patient energy requirement was lower than reported or recommended values in both pathologies under study, whereas protein requirement was lower in burn patients.

Los estados patológicos de quemadura y pancreatitis aguda, se asocian a estados híper metabólicos e híper catabólicos. El objetivo de este estudio fue determinar los requerimientos energéticos y proteicos mediante un estudio analítico transversal en 18 pacientes: 10 con quemadura menores al 5% de la superficie corporal quemada y 8 con pancreatitis aguda. Se determinó el peso, la talla, el IMC, los pliegues cutáneos, la tasa metabólica en reposo por calorimetría indirecta (TMR CI), el catabolismo proteico mediante nitrógeno ureico (NUU) orina de 24 horas, factor trauma (TMR CI/TMB fórmula Harris Benedict). La muestra estuvo representada en 72,2 % por hombres y 27,8% por mujeres. El estudio en pacientes quemados o con pancreatitis aguda se realizó en promedio a los 16,1 ± 13,04 DS y 8,8 ± 2,0 DS días posteriores al inicio de la enfermedad, respectivamente. No mostró diferencias estadísticamente significativas en TMR CI, resultando un requerimiento energético promedio de 24,4 kcal/Kg/día y 23,2 kcal/Kg/día, en pacientes con quemadura y pancreatitis aguda, respectivamente, en ambos géneros (p>0,05); tampoco en el gasto energético total (GET) (p>0,05). Los pacientes con pancreatitis aguda o quemadura presentaron un catabolismo leve y su requerimiento proteico fue 1,19 g/Kg/día (p>0,05). En los pacientes con pancreatitis aguda el factor trauma fue 0. 91 (p>0,05). En conclusión, en ambas patologías estudiadas el requerimiento energético de los pacientes fue inferior a lo reportado, respecto al requerimiento proteico, siendo menor en el paciente quemado.

Protein requirements in healthy adults: a meta-analysis of nitrogen balance studies / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The goal of this study was to analyze protein requirements in healthy adults through a meta-analysis of nitrogen balance studies.</p><p><b>METHODS</b>A comprehensive search for nitrogen balance studies of healthy adults published up to October 2012 was performed, each study were reviewed, and data were abstracted. The studies were first evaluated for heterogeneity. The average protein requirements were analyzed by using the individual data of each included studies. Study site climate, age, sex, and dietary protein source were compared.</p><p><b>RESULTS</b>Data for 348 subjects were gathered from 28 nitrogen balance studies. The natural logarithm of requirement for 348 individuals had a normal distribution with a mean of 4.66. The estimated average requirement was the exponentiation of the mean of the log requirement, 105.64 mg N/kg•d. No significant differences between adult age, source of dietary protein were observed. But there was significant difference between sex and the climate of the study site (P<0.05).</p><p><b>CONCLUSION</b>The estimated average requirement and recommended nutrient intake of the healthy adult population was 105.64 mg N/kg•d (0.66 g high quality protein/kg•d) and 132.05 mg N/kg•d (0.83 g high quality protein/kg•d), respectively.</p>

Evaluation of the protein requirement in Chinese young adults using the indicator amino acid oxidation technique / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To accurately calculate the protein requirements in Chinese young adults using the indicator amino acid oxidation technique.</p><p><b>METHODS</b>Nine women and ten men received a restricted daily level of protein intake (0.75, 0.82, 0.89, 0.97, and 1.05 g/kg), along with L-[1-13C]-leucine. Subjects' protein requirement was determined by a biphasic linear regression crossover analysis of F13CO2 data. In doing so, a breakpoint at the minimal rate of appearance of 13CO2 expiration specific to each level of dietary protein was identified. This trial was registered with the Chinese clinical trial registry as ChiCTR-ONC-11001407.</p><p><b>RESULTS</b>The Estimated Average Requirement (EAR) and the Recommended Nutrient Intake (RNI) of protein for healthy Chinese young adults were determined to be 0.87 and 0.98 g/(kg•d), respectively, based on the indicator amino acid oxidation technique.</p><p><b>CONCLUSION</b>The EAR and RNI of mixed protein are 5% and 16% that are lower than the current proposed EAR and RNI (0.92 and 1.16 g/(kg•d), respectively), as determined by the nitrogen balance method. The respective EAR and RNI recommendations of 0.87 and 0.98 g/(kg•d) of mixed protein are estimated to be reasonable and suitable for Chinese young adults.</p>

Optimum dietary protein requirement for Amazonian Tambaqui, Colossoma macropomum Cuvier, 1818, fed fish meal free diets / Exigência protéica de juvenis de tambaqui, Colossoma macropomum Cuvier, 1818, alimentados com rações livres de farinha de peixe

Fish meal free diets were formulated to contain graded protein levels as 25% (diet 1), 30% (diet 2), 35% (diet 3) and 40% (diet 4). The diets were fed to tambaqui juveniles (Colossoma macropomum) (46.4 ± 6.3g) in randomly designed recirculating systems for 60 days, to determine the optimum protein requirement for the fish. The final weight of the fish, weight gain (28.1, 28.5, 32.2, 28.0g) and specific growth rate increased (P>0.05) consistently with increasing dietary protein up to treatment with 35% protein diet and then showed a declining trend. Feed intake followed the same trend resulting in best feed efficiency (62.5%) in fish fed diet with 35% protein. Similarly, the protein intake increased significantly with increasing dietary protein levels and reduced after the fish fed with 35% protein; while protein efficiency ratio (2.28, 1.99, 1.87, 1.74) decreased with increasing dietary protein levels. Carcass ash and protein had linear relationship with dietary protein levels while the lipid showed a decreasing trend. Ammonia content (0.68, 0.73, 0.81, 1.21 mg L-1) of the experimental waters also increased (P<0.05) with increasing protein levels while pH, dissolved oxygen and temperature remained fairly constant without any clear pattern of inclination. Broken-line estimation of the weight gain indicated 30% protein as the optimum requirement for the fish.

Foram formuladas quatro dietas sem a inclusão de farinha de peixes contendo os níveis crescentes de proteína de 25% (dieta 1), 30% (dieta 2), 35% (dieta 3) e 40% (dieta 4). As dietas foram fornecidas a juvenis de tambaqui (Colossoma macropomum) (46.4 ± 6.3g) distribuídos ao acaso em um sistema de recirculação durante 60 dias, para determinar o requerimento protéico ótimo para o peixe nesta faixa etária. O peso final dos peixes, o ganho de peso (28.1, 28.5, 32.2, 28.0g) e a taxa de crescimento específico tiveram um aumento não significativo (P>0,05) conforme aumentou o nível protéico das rações até o nível de 35% proteína e então uma tendência ao declínio. O consumo de alimento seguiu a mesma tendência resultando em melhor eficiência alimentar (62.5%) para os peixes alimentados com a dieta contendo 35% de proteína. Similarmente, o consume de proteína aumentou significativamente com o aumento crescente dos níveis protéicos dietários e reduziu após os peixes serem alimentados com a dieta com 35% de proteína, enquanto a taxa de eficiência protéica (2.28, 1.99, 1.87, 1.74) diminuiu com o aumento dos níveis protéicos dietários. A cinza e a proteína da carcaça apresentaram uma relação linear com os níveis protéicos dietários enquanto o lipídio mostrou uma tendência decrescente. O aumento do conteúdo da amônia (0.68, 0.73, 0.81, 1.21 mg L-1) da água dos tanques experimentais com a elevação dos níveis de proteína não foi significativo (P>0,05) enquanto o pH, oxigênio dissolvido e a temperatura permaneceram claramente constantes sem qualquer padrão claro de inclinação. O "ponto de virada" da curva de ganho de peso indicou 30% como o nível protéico ótimo para esta espécie de peixe, nesta fase de crescimento, nas condições deste experimento.