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1、Name of chairman佳膳纤维 全营养配方 50:50 乳清蛋白: 酪蛋白 适用于口服营养补充和管饲 水溶性和非水溶性膳食纤维配合保护肠道健康2 作为标准配方, 1 kcal /ml, 应用于标准治疗 可以冲调至 1.5 Kcal/mL, 满足对热量要求较高 或对液体摄入限制的病人 e.g. 烧伤, COPD, 心 衰 可灵活配制不同能量密度, 适应临床要求3蛋白质特点和益处Features特点Benefits益处蛋白质含量为全部热量的 16%, 为 中等程度. (10g/250mL)蛋白质摄入量可被灵活掌握满足病人蛋白质标准需求 1.0g+/kg 可覆盖不同的应激状态的病人50%
2、乳清蛋白50% 酪蛋白乳清蛋白 = 优质蛋白乳清蛋白 = 胃排空快提供易消化和吸收的所有必需氨基酸, 防止瘦 肉组织消耗 降低误吸危险, 减少吸入性肺炎的发生乳清蛋白富含半胱氨酸促进谷胱甘肽生成(强抗氧化剂, 增强免疫)富含高支链氨基酸促进肌肉体积和力量4碳水化合物特点和益处Features特点Benefits益处中等程度的碳水化合物含量占总热量50% 来源- 麦芽糖糊精,玉米糖浆, 蔗糖 , 豌豆淀粉 保持理想的渗透压, 保证病人有好的耐受低蔗糖甜味低, 耐受低生糖指数Low glycemic index51 (vs. bread), 36 (vs. glucose)可用于糖尿病人 临床意义
3、的无乳糖避免对乳糖不耐受的风险5脂肪特点和益处Features特点Benefits益处 占总热量的33% 充分的非蛋白质热量, 理想的必需脂肪酸比例关系 n- 6:n-3 = 4:1调节炎性反应,降低炎性因子的生成 25% of fat as MCT迅速供能6膳食纤维: 特点和益处 Features特点Benefits益处膳食纤维含量 (total 15 g/L)50% 水溶性纤维5g 聚果糖 (FOS)(少量的豌豆纤维)益生作用: 维护肠道菌群, 保护肠道健康, 增强免疫, 降低感染危险.降低腹泻危险帮助改善血糖和血胆固醇控制50% 非水溶性纤维: 豌豆外皮纤维增加粪便良,促进肠蠕动,减少便
4、秘 7膳食纤维: 调节大肠功能非水溶性纤维纤维滞留水份 减少便秘, b通过增加粪便良和滞留水份, 使排便更容易水溶性纤维纤维 调节粪便量, 促进肠通过时间,改善腹泻 佳膳纤维纤维含有两者, 即改善便秘,又可改善腹泻 Bowel Management8膳食纤维: 促双岐杆菌纤维 (益生元) 益生作用” 食物中不被消化的成份, 选择性的刺激在结肠和直肠中有益菌的生长, 保护宿主的健康 益生, 或 促双岐杆菌膳食纤维帮助双岐杆菌P生长, 从而, 控制致病菌INULIN(菊粉)2-60 fructose unitsFOS(低聚果糖)2-9 fructose units“Stay Healthy, Ea
5、t Bug Food”9益生作用的健康效果增加有益细菌的生长 FOS 和 菊粉可明显增加双岐杆菌的活力, 不从心降低大肠中有害菌的数量(Kolida 2002; Gibson 1995; Roberfroid 1998)FOS InulinPromotion of Healthy Intestinal Microbiota10Function of Prebiotics11维生素类和矿物质 1500 毫升100%满足 US RDA 对30余种维生 素和矿物质的要求12佳膳纤维 -适应症:外科术前营养强化(佳膳 可用于肠道准备)术后危重病人脑外伤/手术烧伤整型外科创伤内科调节肠道 (便秘或腹泻)
6、应用抗菌素后, 恢复肠道菌群肿瘤/癌症 吞咽困难神经科l (e.g. 中风, Parkinsons, 神经元疾病, 多 发性硬化症)呼吸科, e.g. COPD老年人长期管饲13佳膳纤维的强项Nutren Fibre strengths:50% 乳清蛋白 : 50% 酪蛋白富含 MCT (25%)低渗透压 (360mOsm/kg H2O)低蔗糖 (22 g/L )低生糖指数 (58 vs white bread, 41 vs glucose)灵活配制不同能量密度的溶液 (1 or 1.5 kcal/ml)水溶性和非水溶性膳食纤维,病人耐受性好 14Nutren Fiber Study Whel
7、an et al. J. Nutr. 135: 18961902, 2005.Aim: to investigate the effect of enteral formulas with and without prebiotic fructooligosaccharides (FOS) and fiber on the fecal microbiota and SCFAs.Study design: 10 healthy subjects consumed both a standard enteral formula and Nutren fiber as a sole source o
8、f nutrition for 14 days in a randomized, double-blind, crossover trial with a 6-wk washout phase.Results: This study demonstrates that standard enteral formula leads to adverse alterations to the fecal microbiota and SCFA concentrations in healthy subjects, and these alterations are partially preven
9、ted by fortification of the formula with FOS and fiber.15NUTREN Fibrevs Ensure FOSNUTREN FibreEnsure FOSNestle advantageCarbohydrates (g/L)126.5 (50% TEI)Low GI = 58 (vs. bread), 41 (vs. glucose)134 (55% TEI)? GILower carbohydrates content and low GI promote better glucose control Protein (g/L)40 (1
10、6% TEI)50% casein: 50% whey37 (15%)sodium and calcium caseinates and soy protein isolateBetter protein profile: whey has high BV and promotes better feeding tolerance and maintain LBMFat (g/L)38 (34% TEI)25% fat as MCT41% fat as MUFA33 (30% TEI)No MCT oil61% fat as MUFAMCT does not affect serum chol
11、esterol level. It is easily digested and absorbed, and also quick source of energy to spare protein Fiber (g/L)15 ( include 5g FOS)50% soluble 50% insoluble10 (FOS/Inulin)? Insoluble fiberA mixed blend of fiber to target total gut health through modulating diarrhea and constipation, microflora balance)Osmolality (mOsm/kg H2O)360466 (?)Lower osmolality for better feeding tolerance and decrease risk of diarrhea Feeding routeOral and tube feedingOral and tube feeding -16Renovation of Nutren Optimum and Nutren Fibre formulation 2009/2010
