Repletion of nutritional parameters in surgical patients receiving peptide versus amino acid elemental feedings

Comparative structural, digestion and absorption characterization of three common extruded plant proteins

Extruded plant proteins, also known as textured vegetable proteins (TVPs), serve as vital components in plant-based meat analogue, yet their structural and nutritional characteristics remain elusive. In this study, we examined the impact of high-moisture (HM) and low-moisture (LM) extrusion on the structures, digestion and absorption of three types of plant proteins. Extrusion transformed plant proteins from spherical to fibrous forms, and formed larger aggregate particles. It also led to the disruption of original disulfide bonds and hydrophobic interactions within protein molecules, and the formation of new cross-links. Intriguingly, compared to native plant proteins, TVPs' α-helix/β-sheet values decreased from 0.68 to 0.69 to 0.56-0.65. Extrusion increased the proportion of peptides shorter than 1 kD in digesta of TVPs by 1.44-23.63%. In comparison to unextruded plant proteins, TVPs exhibited lower content of free amino acids in cell transport products. Our findings demonstrated that extrusion can modify protein secondary structure by diminishing the α-helix/β-sheet value, and impact protein tertiary structure by reducing disulfide bonds and hydrophobic interactions, promoting the digestion and absorption of plant proteins. These insights offer valuable scientific backing for the utilization of extruded plant-based proteins, bolstering their role in enhancing the palatability and nutritional profile of plant-based meat substitutes.

Nutritional management of the critically ill neurologic patient

To summarize, the event of severe neurologic injury results in significant metabolic changes. These changes cause increased requirements for protein and nonprotein calories, micronutrients, and small bowel feedings or TPN. Early feeding has been shown to improve survival. Therefore, every effort should be made to provide aggressive nutritional support within the first 72 hours after injury. Specific guidelines are as follows: Provide full-strength, full-rate feedings within 72 hours. Provide enteral nutrients via nasojejunal or percutaneous endoscopic jejunostomy feeding tube if access is available; attempt gastric feedings if not. Provide TPN within 48 hours if enteral access is not available and begin enteral feeding as soon as possible. Provide 2 to 2.3 g protein/kg/d if renal function is normal. Provide 40% to 70% above basal needs as total calories, with 30% to 40% of calories as lipid to minimize hyperglycemia. Provide protein as small peptides to improve tolerance, absorption, utilization, and gut integrity. Provide a lipid source with 50% to 70% medium-chain triglycerides and an omega-6 to omega-3 ratio of 2:1 to 8:1 to minimize negative effects of omega-6 fatty acids and provide an easily absorbed and utilized source of lipid.