JP2004051494A - Enteral nutrient preparation - Google Patents

Enteral nutrient preparation Download PDF

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JP2004051494A
JP2004051494A JP2002207643A JP2002207643A JP2004051494A JP 2004051494 A JP2004051494 A JP 2004051494A JP 2002207643 A JP2002207643 A JP 2002207643A JP 2002207643 A JP2002207643 A JP 2002207643A JP 2004051494 A JP2004051494 A JP 2004051494A
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component
energy
liquid enteral
nutritional supplement
amino acid
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JP4328065B2 (en
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Keiichi Minami
南 圭一
Ryoichi Unno
海野 良一
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NOF Corp
Sanwa Kagaku Kenkyusho Co Ltd
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NOF Corp
Sanwa Kagaku Kenkyusho Co Ltd
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  • Medicinal Preparation (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
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Abstract

<P>PROBLEM TO BE SOLVED: To provide an enteral nutrient preparation expectable of an improvement in protein metabolism, immune capacity, intestinal mucous functions, etc., by administration thereof to patients during surgical stress, patients suffering from serious infectious diseases, etc. <P>SOLUTION: The liquid enteral nutrient preparation comprises the following ingredients A, B, C, D and E as principal ingredients and has 300-600 mOsm/kg osmotic pressure and 100 amino acid score.The ingredient A contains a protein, a glutamine-containing peptide and an amino acid and is a nitrogen source ingredient of10-40% energy% based on the whole energy source. The ingredient B is a lipid of 10-40 energy% based on the whole energy source. The ingredient C is a glucide of 40-80 energy% based on the whole energy source. The ingredient D is an emulsifying agent. The ingredient E is water. <P>COPYRIGHT: (C)2004,JPO

Description

【0001】
【発明の属する技術分野】
本発明は、経腸栄養剤に関するもので、特に、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等が期待でき、外科侵襲時の患者や重症感染症患者等に投与するのに好適な液状経腸栄養剤及び経腸栄養組成物に関する。
【0002】
【従来の技術】
従来から、患者の手術前後の栄養補給方法としては、経口または経管による経腸栄養剤投与、あるいは中心静脈栄養投与等の方法が採用されている。中心静脈栄養投与では胃腸を使用しないことから、生理的な面や消化管粘膜の萎縮の問題があり、近年は、経口および経鼻を含む経腸で栄養剤を投与する方法が注目されてきている。これらの経腸栄養剤の投与により、蛋白質、脂質、糖質、ビタミン、微量元素を含むミネラル等の栄養剤を患者に摂取せしめて、疾病の治療の改善に大きく寄与している。更に最近では、医薬に依存している疾病の治療と同様の効果を経腸栄養剤に担わせるために、治療効果が期待できる有効成分を積極的に加える栄養剤の処方が検討されている。具体的には、例えばグルタミンは、外科侵襲時の患者や重症感染症患者等に投与することにより、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等が期待できるものとして挙げられる。グルタミンは、非必須アミノ酸として分類されるが、疾病時には摂取が必要であると認められたため、条件付必須アミノ酸として分類されるようになった。
ただし、遊離グルタミンは、水に溶解した際や加熱した際にピログルタミン酸へと変換され、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等の生理機能を失ってしまうことが知られており、遊離グルタミンは液状中心静脈栄養剤あるいは液状経腸栄養剤には利用できなかった。
【0003】
しかし、近年、水に溶解し、更に加熱殺菌してもピログルタミン酸へと変換しないグルタミン供給源として、グルタミン含有ペプチドが注目を集め、液状経腸栄養剤への利用の可能性が、(1)特開平10−139681号公報、(2)特開2002−119250号公報、(3)特開平9−121809号公報に開示されている。すなわち、(1)には、免疫学的な賦活、蛋白質系の賦活をさせて、感染症の予防、創傷の早期治癒等を目的とした、L−アルギニン及びグルタミン含有ペプチドを含有する水性乳化栄養組成物が開示されており、(2)には、N末端ピログルタミン酸含量が遊離ピログルタミン酸換算で5質量%以下のグルタミン含有ペプチドを含有することを特徴とする栄養組成物が開示されており、(3)には、即座に使用可能な溶液100mlあたり蛋白質成分が0.5ないし3.0gのグルタミンに富む蛋白加水分解物からなる調製剤について開示されている。
【0004】
一方、必須アミノ酸とは、健全な成長や体重の保持等、健康な肉体を維持する上で、外界より摂取しなければならないアミノ酸を指し、動物の種類によって多少異なるが、成人では、ロイシン、イソロイシン、バリン、スレオニン、リジン、メチオニン、フェニルアラニン、トリプトファンを指す。栄養組成物の蛋白質の栄養価は、含有する必須アミノ酸のうち所要量に対して最も不足する制限アミノ酸によって大きく左右され、栄養組成物の蛋白質の評価は、1985年にFAO/WHO/UNUが定めた必須アミノ酸のみから構成されるアミノ酸評点パターンを指標とし、アミノ酸スコアにて算出される。一般的に、経腸栄養剤における主な窒素源であるカゼインや総合乳蛋白等の乳由来の蛋白質および/または蛋白加水分解物のアミノ酸スコアは100であるが、グルタミンを多く含む小麦やコーン由来の蛋白質および/または蛋白加水分解物のアミノ酸スコアは約30である。このことから、窒素源としてカゼインや総合乳蛋白等の乳由来の蛋白質および/または蛋白加水分解物と共にグルタミンおよび/またはグルタミン含有ペプチドを含有する経腸栄養剤のアミノ酸スコアは、100未満となることが予測される。アミノ酸スコアが100未満の経腸栄養剤を外科侵襲時の患者や重症感染症患者等に投与した場合、必須アミノ酸が不足し、栄養失調状態に陥ることは容易に推測できる。そのため、グルタミンの効果として期待される蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等の効果は充分には望めないことになる。すなわち、前記(1)、(2)、(3)の従来技術では、アミノ酸スコアが100に満たないため、グルタミンの効果が充分発揮されないという問題がある。
【0005】
また、一般的に液状経腸栄養剤は水相と油相が混在した乳化系をとっている。その乳化系の安定性は種々の乳化剤によって付与されるが、乳化状態が不良な場合は、油脂分離、凝集物発生等の経腸栄養剤として用いるのに不具合な現象が生じる。蛋白分解物であるペプチドや遊離アミノ酸等のように低分子の素材を多く用いると、乳化系を不良の状態にする傾向が強く、乳化剤の使用は必須であり、その選択には、充分な配慮が必要である。
【0006】
したがって、前記のようにグルタミン含有ペプチドを含み、グルタミンの効果である蛋白質代謝の改善等が見込まれ、食味が良く、体に負担の少ない浸透圧でアミノ酸スコアが100となる液状経腸栄養剤が望まれていた。
しかしながら、蛋白質および/またはグルタミン含有ペプチドのような蛋白分解物、脂質、糖質、乳化剤を主成分として含み、食味が良く、且つ浸透圧が300〜600mOsm/kgで、アミノ酸スコアが100となる乳化安定性に優れた液状経腸栄養剤は、これまでに知られていない。
【0007】
【発明が解決しようとする課題】
本発明の目的は、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等が期待でき、外科侵襲時の患者や重症感染症患者等に投与するのに好適な液状経腸栄養剤又は経腸栄養組成物を提供することにある。
【0008】
【課題を解決するための手段】
本発明者らは、上記従来の問題点に鑑み鋭意検討した結果、外科侵襲時の患者や重症感染症患者等に液状経腸栄養剤を投与することによって、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等が期待できるグルタミン含有量をグルタミン含有ペプチドにて供給し、それによりアミノ酸スコアが100未満となる問題を制限アミノ酸となりうるアミノ酸を遊離アミノ酸にて補うことによって回避し、更にこれによって生じた乳化の不安定化要因と苦味を、適切な乳化剤と糖質の添加により解決することによって、本発明を完成するに至った。すなわち、本発明は次の〔1〕〜〔8〕である。
〔1〕下記のA成分、B成分、C成分、D成分およびE成分を主成分として含み、且つ浸透圧が300〜600mOsm/kgで、アミノ酸スコアが100となることを特徴とする液状経腸栄養剤。
A成分:全エネルギー源に対して10〜40エネルギー%の窒素源成分であり、蛋白質、グルタミン含有ペプチド、およびアミノ酸を含む、
B成分:全エネルギー源に対して10〜40エネルギー%の脂質、
C成分:全エネルギー源に対して40〜80エネルギー%の糖質、
D成分:乳化剤、
E成分:水。
〔2〕A成分中に含まれる蛋白質が、カゼイネート、乳蛋白および大豆蛋白からなる群より選ばれる1種または2種以上であり、A成分中に含まれるアミノ酸が、必須アミノ酸から選ばれる1種または2種以上である、前記〔1〕に記載の液状経腸栄養剤。
〔3〕必須アミノ酸が、スレオニン、メチオニン及びトリプトファンである、前記〔2〕に記載の液状経腸栄養剤。
〔4〕C成分の糖質が、主として、デキストリン、オリゴ糖、蔗糖および果糖からなる群から選ばれる1種または2種以上である、前記〔1〕〜〔3〕のいずれかに記載の液状経腸栄養剤。
〔5〕D成分の乳化剤が、全液の0.01〜1質量%である、前記〔1〕〜〔4〕のいずれかに記載の液状経腸栄養剤。
〔6〕D成分の乳化剤が、ポリまたはモノグリセリン脂肪酸エステル、ソルビタン脂肪酸エステル、プロピレングリコール脂肪酸エステル、ショ糖脂肪酸エステル、有機酸モノグリセライドおよびレシチンの群から選ばれる1種または2種以上である、前記〔1〕〜〔5〕のいずれかに記載の液状経腸栄養剤。
〔7〕総カロリーが80〜200kcal/100mlである、前記〔1〕〜〔6〕のいずれかに記載の液状経腸栄養剤。
〔8〕下記のA成分、B成分、C成分及びD成分を主成分として含み、総カロリーが80〜200kcal/100mlとなるように水に溶解又は懸濁した時の浸透圧が300〜600mOsm/kgで、アミノ酸スコアが100となることを特徴とする経腸栄養組成物。
A成分:全エネルギー源に対して10〜40エネルギー%の窒素源成分であり、蛋白質、グルタミン含有ペプチド、およびアミノ酸を含む、
B成分:全エネルギー源に対して10〜40エネルギー%の脂質、
C成分:全エネルギー源に対して40〜80エネルギー%の糖質、
D成分:乳化剤。
【0009】
【発明の実施の形態】
本発明の経腸栄養剤は、基本的には、グルタミン含有ペプチド、蛋白質、アミノ酸、脂質、糖質、乳化剤及び水を含有する液状経腸栄養剤であるが、水を除いた組成物として提供することもできる。水を除いた組成物として提供された場合は、使用時に水を添加して溶解又は懸濁した後に使用するものである。
以下、本発明の経腸栄養剤について詳細に説明するが、主として水を添加調製後の液状経腸栄養剤について説明する。水を除いた組成物については、これらの説明から、水を除いて考えればよい。尚、質量%とは、特に断りのない場合は、液状経腸栄養剤全液の質量に対するw/w%である。
【0010】
本発明で使用する窒素源成分(A成分)としては、グルタミン含有ペプチド(a1)、蛋白質(a2)、およびアミノ酸(a3)が必須成分として挙げられる。a1のグルタミン含有ペプチドとは、N末端ピログルタミン酸含量が遊離ピログルタミン酸換算で5質量%以下のグルタミン含有ペプチドである。a2の蛋白質としては、カゼイネート(カゼインナトリウム等のカゼイン塩)、乳蛋白、大豆蛋白等の蛋白質が挙げられ、これらを組み合わせて使用することもできる。a3のアミノ酸としては、L−ロイシン、L−イソロイシン、L−バリン、L−スレオニン、L−リジン、L−メチオニン、L−フェニルアラニン、L−トリプトファン等の必須アミノ酸が挙げられ、これらを組み合わせて使用することができるが、必須アミノ酸の中でも、L−スレオニン、L−メチオニン及びL−トリプトファンの3つのアミノ酸を組み合わせて使用するのが好ましい。特に、蛋白質(a2)として、カゼイネート、乳蛋白といった乳由来の蛋白質を使用する場合は、アミノ酸(a3)としては、前記L−スレオニン、L−メチオニン及びL−トリプトファンの3つのアミノ酸の組み合わせが好適である。また、アミノ酸として非必須アミノ酸を含んでいてもよい。窒素源成分(A成分)としては、必要に応じて、グルタミン含有ペプチド以外の蛋白分解物(a4)を含有させてもよい。a4のグルタミン含有ペプチド以外の蛋白分解物としては、カゼインペプチド、乳蛋白ペプチド、大豆蛋白ペプチドが挙げられる。
これらの窒素源成分、即ち、グルタミン含有ペプチド(a1)、蛋白質(a2)、およびアミノ酸(a3)等を、アミノ酸スコアが100になるよう、且つ全エネルギー源に対して10〜40エネルギー%を供給するように配合する。本発明で必要とするグルタミン含有ペプチド(a1)のアミノ酸スコアは30と低いので、一般的に蛋白質(a2)としては、アミノ酸スコアが高い動物由来の蛋白質を組み合わせるのが好ましく、特にカゼイネート、乳蛋白といった乳由来の蛋白質を組み合わせることが好ましい。前記グルタミン含有ペプチド(a1)と蛋白質(a2)の組み合わせの組成物には制限アミノ酸が生じ、アミノ酸スコアが100未満となるので、制限アミノ酸となるアミノ酸を遊離アミノ酸にて補うことによって、使用する窒素源のアミノ酸スコアを100へと高めることができる。ここで、グルタミン含有ペプチド(a1)の添加量は、その効果発現の観点からは多い方が好ましいが、アミノ酸スコアを100に維持するという観点からは、多過ぎることは好ましくない。これらの2つの観点から判断すると、グルタミン含有ペプチド(a1)の添加量は1〜5質量%が適当であり、更に好ましくは1.3〜3質量%で、中でも1.5〜2.5質量%が最も好ましいと考えられる。アミノ酸(a3)の添加量としては、調製した液状経腸栄養剤の食味、液の性状の観点から、全遊離アミノ酸の合計量として、0.01〜0.2質量%が好ましい。L−スレオニン、L−メチオニン及びL−トリプトファンを添加する場合、各々の添加量は、0.005〜0.05質量%であることが好ましく、特に、L−スレオニンが0.01質量%、L−メチオニンが0.02質量%、L−トリプトファンが0.02質量%であることがより好適である。
【0011】
本発明で使用するB成分の脂質としては、大豆油、ヤシ油、パーム油、サフラワー油、コーン油、ナタネ油、中鎖脂肪、シソ油、魚油等が挙げられ、また、本発明の効果を損なわない範囲内において、遊離脂肪酸も使用することができる。脂質はエネルギー源として、また生体内機能成分として極めて重要な栄養素であるが、その反面、糖質と比べて消化吸収されにくく、多量に摂取すると下痢や腹部の膨満の原因になることを考慮すると、脂質として、全エネルギー源に対して10〜40エネルギー%を供給し、特に20〜30エネルギー%を供給することが好ましい。脂質の構成成分として脂肪酸があり、飽和脂肪酸、単価不飽和脂肪酸、多価不飽和脂肪酸からなるが、そのうち多価不飽和脂肪酸の生体内機能に、近年注目が集まっている。多価不飽和脂肪酸は、α−リノレン酸等のω3系多価不飽和脂肪酸とリノール酸等のω6系多価不飽和脂肪酸等からなり、これらを摂取した生体内において、ω3系多価不飽和脂肪酸とω6系多価不飽和脂肪酸は別々の経路で代謝され、これら2種の代謝系で変換された産物は異なった生体内機能を有し、互いが複雑に影響し合うことで生体調節機能を司っていると言われている。飽和脂肪酸の供給源として、消化・吸収に優れたヤシ油や中鎖脂肪が例として挙げられ、単価不飽和脂肪酸および多価不飽和脂肪酸の供給源として、大豆油、サフラワー油、コーン油、ナタネ油、シソ油、魚油等が挙げられ、多価不飽和脂肪酸のうちω3系脂肪酸の供給源となる脂質はシソ油や魚油が例として挙げられ、ω6系脂肪酸の供給源となる脂質は大豆油、サフラワー油、コーン油、ナタネ油が例として挙げられる。これらの脂質は目的に応じて1種単独であるいは2種以上を組み合わせて使用することができるが、飽和脂肪酸、単価不飽和脂肪酸、多価不飽和脂肪酸およびω3系多価不飽和脂肪酸とω6系多価不飽和脂肪酸のバランスを考慮すると、2種以上を組み合わせて使用することが好ましい。
【0012】
本発明で使用するC成分の糖質としては、デキストリン、オリゴ糖、蔗糖、果糖等が挙げられ、これらの糖質は1種単独であるいは2種以上を組み合わせて使用することができ、更に別の糖質を組み合わせて使用することもできる。糖質は、全エネルギー源に対して40〜80エネルギー%を供給するが、血糖の恒常性を保持するとともに、蛋白質、脂質、他の不可欠な栄養素を適切に摂取するためには、55〜75エネルギー%を供給することが好ましい。食味を良くし、且つ高浸透圧による下痢を引き起すことのないよう、液状経腸栄養剤の浸透圧を300〜600mOsm/kgとするためには、分子量の異なる2種以上の糖質を組み合わせて使用することが好ましい。また、アミノ酸の苦みは、果糖等の高甘味度の糖質を使用することによって、効果的に改善することができる。さらに液状経腸栄養剤を経管投与する場合、低粘度であることが必要であるため、この観点からは、低分子量の糖質が有利である。これらのことを全て考慮すると、糖質としては、分子量が異なる数種のデキストリンと果糖の組み合わせが好ましいと考えられる。
【0013】
本発明で使用するD成分の乳化剤としては、ポリまたはモノグリセリン脂肪酸エステル、ソルビタン脂肪酸エステル、プロピレングリコール脂肪酸エステル、ショ糖脂肪酸エステル、有機酸モノグリセライド、レシチン等が挙げられる。これらの乳化剤は1種単独であるいは2種以上を組み合わせて使用することができるが、乳化系の保存安定性、食味への影響等を考慮すると、有機酸モノグリセライドが好ましく、有機酸モノグリセライドを2種以上組み合わせて使用することが好ましい。中でも、特に、コハク酸モノグリセライドとクエン酸モノグリセライドの組み合わせが好ましく、その添加比率はコハク酸モノグリセライド:クエン酸モノグリセライド=3:2〜2:3が好適である。
乳化剤は、全液中に0.01〜1質量%含有させるのが好ましく、更に好ましくは、0.3〜0.8質量%含有させる。乳化剤は、0.01質量%未満であると分離を起こし、1質量%を超えて配合すると、調製した液状経腸栄養剤の保存安定性が悪くなる。
なお、これら乳化剤を含有する経腸栄養剤について脂質含量を分析した場合、乳化剤の添加量のほとんどが脂質分として検出される。
【0014】
本発明の経腸栄養剤を液状とするために、E成分の水を用いる。水としては、純水、精製水、イオン交換水等、通常の加工食品に使用されるものが挙げられる。
本発明の経腸栄養剤は、液状経腸栄養剤とした場合に、総カロリーが80〜200kcal/100mlとなるように前記水を用いて調製することが好ましい。同時に浸透圧が300〜600mOsm/kgとなるように調製することが好ましい。また、経管投与を行う場合は、低粘度であることが必要であり、30cp以下となるように調製することが好ましい。なお、100kcal/100mlの液状経腸栄養剤を調製する場合の水の添加量は、60〜90質量%程度である。
【0015】
また、本発明の経腸栄養剤には、前記成分の他に、ミネラル類、ビタミン類を配合することが好ましく、その配合率は、例えば第六次改定日本人の栄養所要量(第1出版社発行)に記載の摂取量(目標摂取量)を参考にすることができる。
本発明の経腸栄養剤には、その他にも、食物繊維、香料、pH調整剤等を配合することができる。
【0016】
次に、本発明の経腸栄養剤の製造方法の一例について記す。
本発明の経腸栄養剤は、約60℃の温水に、グルタミン含有ペプチドをはじめとする蛋白質および/または蛋白分解物、脂質、糖質、乳化剤、更に必要に応じて、ミネラル類、ビタミン類、食物繊維、香料、pH調整剤を加えて溶解又は懸濁し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パック等への充填を経て得ることができる。また、使用時に、前記含有成分に約60℃の温水を加えて溶解又は懸濁して調製してもよい。
【0017】
本発明の経腸栄養剤は、患者に対して、経口投与法または経管投与法にて、経腸投与することができる。経管投与法としては、経鼻胃管法や経鼻腸管法といった経鼻法、胃瘻管法や腸瘻管法といった瘻管法等を使用することができる。特に、本発明の経腸栄養剤は、外科侵襲時の患者や重傷感染症患者等への投与に好適である。
【0018】
【発明の効果】
本発明品を外科侵襲時の患者や重症感染症患者等に投与することによって、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等が期待できる。
【0019】
【実施例】
以下、具体例に基づいて、本発明を詳細に説明する。
[実施例1]
表1および表2に示すように、約60℃の温水に、3質量%のカゼインナトリウム、2質量%の乳蛋白、1.5質量%のグルタミン含有ペプチド、0.02質量%L−メチオニン、0.01質量%のL−スレオニン、0.02質量%のL−トリプトファン、1.4質量%のナタネ油、0.6質量%の中鎖脂肪、0.08質量%の魚油、0.39質量%のコハク酸モノグリセライド、0.26質量%のクエン酸モノグリセライド、9質量%のDE11のデキストリン、3.0質量%のDE25のデキストリン、1.5質量%の果糖、0.1質量%のクエン酸ナトリウム、0.2質量%のクエン酸カリウム、0.1質量%のメタリン酸ナトリウム、0.05質量%の塩化カリウム、0.1質量%の硫酸マグネシウム、0.01質量%のクエン酸鉄ナトリウム、0.04質量%のビタミンC、0.02質量%のビタミンE、0.002質量%のナイアシン、0.0009質量%のパントテン酸、0.0006質量%のβ−カロチン、0.0006質量%のビタミンA、0.0003質量%のビタミンB、0.0003質量%のビタミンB、0.0002質量%のビタミンB、0.0000003質量%のビタミンB12、0.0001質量%のビタミンD、0.000005質量%の葉酸、0.000003質量%のビタミンK、0.6質量%のグアーガム分解物、0.1質量%のパイナップル風香料、0.07質量%の水酸化ナトリウムを撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。
【0020】
この実施例1の液状経腸栄養剤を用いて、後述の試験法の分析項目について評価を行った。
実施例1で得た液状経腸栄養剤は、表1に示すように、100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlだった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。また、乳化安定性をはじめとする、液状経腸栄養剤として使用するための適性を評価する上で重要な指標となる項目について分析した結果、浸透圧は480mOsm/kg、粘度10cp、平均粒径は0.18μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は488mOsm/kg、粘度10cp、平均粒径は0.18μm、pHは6.5で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。
これらの評価により、実施例1の液状経腸栄養剤は、食味がよく、且つ乳化安定性をはじめとする液状経腸栄養剤として使用するための適性に優れていることが確認できた。そのため、習慣的な投与が可能となり、外科侵襲時の患者や重症感染症患者等に投与することによって、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善が期待される。
【0021】
[試験法]
(1)蛋白質含量;ケルダール法による窒素の分析値より算出
(2)グルタミン含量;アミド態窒素法、アミノ酸自動分析法を組み合わせて算出
(3)アミノ酸スコア;アミノ酸自動分析法と高速液体クロマトグラフ法にて、アミノ組成分析を行い、1985年にFAO/WHO/UNUが定めたアミノ酸評点パターンを指標として算出
(4)脂質含量;レーゼゴットリーブ法
(5)総カロリー;栄養表示基準によるエネルギー換算係数を用いて算出。エネルギー換算係数は、蛋白質:4、脂質:9、糖質:4
(6)糖質含量;栄養表示基準に基づいて算出。100−(水分含量(%)+蛋白質含量(%)+脂質含量(%)+灰分含量(%)+食物繊維含量(%))
(7)浸透圧;氷点降下法
(8)粘度;液温20℃に調整後、B型粘度計にて測定
(9)平均粒径;超遠心式粒度分布測定装置にて測定
(10)pH;液温20℃に調整後、pHメーターにて測定
(11)液の性状;油脂分離あるいは凝集物の発生の有無およびその程度を以下の評価基準で目視にて評価
◎:良好である、
○:液状経腸栄養剤の機能として特に問題はないが、僅かに不均一性が認められる、
△:分離した油脂、あるいは凝集物の発生が僅かに認められる、
×:著しく油脂が分離し、あるいは全体的に液状を保っていない。
(12)食味;20名の被験者によって官能検査を行い、各被験者が10点満点で評価した得点の合計値によって評価。評価基準は次のとおり。
◎:170〜200点、
○:140〜169点、
△:110〜139点、
×:〜109点。
(13)保存試験;紙パックのまま30℃で180日間保存した後、上記(7)〜(12)の分析項目を評価した。
【0022】
[実施例2]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、実施例2で得た液状経腸栄養剤は、100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は472mOsm/kg、粘度10cp、平均粒径は0.21μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は493mOsm/kg、粘度12cp、平均粒径は0.24μm、pHは6.5で、目視で観察したところ、油脂の分離が僅かに確認され、食味はフルーツオレ様で美味だったが、実施例1よりも劣る結果となった。
なお、実施例2は栄養組成が実施例1と同様であるが、保存試験での液の性状および食味の点で実施例1よりも劣っていた。
【0023】
[実施例3]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、実施例3で得た液状経腸栄養剤は、100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は479mOsm/kg、粘度10cp、平均粒径は0.20μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は495mOsm/kg、粘度12cp、平均粒径は0.26μm、pHは6.5で、目視で観察したところ、液状ではあるが不均一な部分が確認され、食味はフルーツオレ様で美味だったが、実施例1よりも劣る結果となった。
なお、実施例3は栄養組成が実施例1と同様であるが、保存試験での液の性状および食味の点で実施例1よりも劣っていた。
【0024】
[実施例4]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、実施例4の液状経腸栄養剤は100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は499mOsm/kg、粘度10cp、平均粒径は0.28μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は512mOsm/kg、粘度18cp、平均粒径は0.77μm、pHは6.5で、目視で観察したところ、液面の一部に油脂の分離が認められ、また食味がやや劣化していた。
なお、実施例4は栄養組成が実施例1と同様であるが、保存試験での液の性状および食味の点で実施例1よりも劣っていた。
【0025】
[実施例5]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、実施例5の液状経腸栄養剤は100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は493mOsm/kg、粘度10cp、平均粒径は0.26μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は507mOsm/kg、粘度14cp、平均粒径は0.58μm、pHは6.5で、目視で観察したところ、僅かに凝集物が見られ、また食味がやや劣化していた。
なお、実施例5は栄養組成が実施例1と同様であるが、保存試験での液の性状および食味の点で実施例1よりも劣っていた。
【0026】
[実施例6]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、実施例6の液状経腸栄養剤は100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は461mOsm/kg、粘度7cp、平均粒径は0.18μm、pHは6.1で、目視で観察したところ、油脂の分離、凝集物等の発生はなかった。しかし、食味については僅かに酸味を感じた。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、液状を保っていなかったため、保存試験後の浸透圧、粘度、平均粒径、pHは実施できなかった。また、食味については食感が悪く、また強く酸味を感じた。
なお、実施例6は栄養組成が実施例1と同様であるが、保存試験での液の性状および食味の点で問題があり、調製後早期に使用する必要があることがわかり、実施例6は製品化には適さないと判断した。
【0027】
[比較例1]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。この液状経腸栄養剤について、試験法の分析項目について評価を行った。
その結果、比較例1の液状経腸栄養剤は100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.2g/100ml、アミノ酸スコアは100、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は472mOsm/kg、粘度9cp、平均粒径は0.19μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は480mOsm/kg、粘度10cp、平均粒径は0.19μm、pHは6.5で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で、美味だった。
これらの評価により、比較例1は食味がよく、且つ乳化安定性をはじめとする液状経腸栄養剤としての適性に優れていることが確認できた。しかし、グルタミン含有ペプチドを含有していないため、外科侵襲時の患者や重症感染症患者等に投与しても、蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善は期待できない。
【0028】
[比較例2]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、比較例2の液状経腸栄養剤は100ml当たり100kcalで、蛋白質含量は5.5g/100ml、グルタミン含量は0.75g/100ml、アミノ酸スコアは70、脂質含量は2.6g/100ml、糖質含量は13.7g/100mlであった。また、A成分としては22エネルギー%、B成分としては23エネルギー%、C成分としては55エネルギー%であった。浸透圧は476mOsm/kg、粘度9cp、平均粒径は0.19μm、pHは6.7で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。紙パックに入ったこの液状経腸栄養剤を30℃の条件下で180日間保存した結果、浸透圧は483mOsm/kg、粘度10cp、平均粒径は0.19μm、pHは6.5で、目視で観察したところ、油脂の分離、凝集物等の発生はなく良好で、食味はフルーツオレ様で美味だった。
しかし、比較例2は、アミノ酸スコアが70のため必須アミノ酸が不足し、投与された患者が栄養失調状態に陥る可能性があり、グルタミンの効果として期待される蛋白質代謝の改善、免疫能力の改善、腸管粘膜機能の改善等の効果はあまり期待できない。
【0029】
[比較例3]
表1および表2に示す成分を約60℃の温水に撹拌溶解し、高圧均質機を用いて50MPaで乳化し、UHT殺菌処理、紙パックへの充填を経て、液状経腸栄養剤を得た。得られた液状経腸栄養剤について、試験法の分析項目について評価を行った。結果を表1に示す。
その結果、比較例3の液状経腸栄養剤を調製した直後に、著しい油脂の分離が起こり、食味も著しく油脂の存在が感じられ、明らかに乳化不良な状態だったため、経腸栄養剤として不適であると判断した。
【0030】
以上の組成および結果を表1および表2に示す。
【0031】
【表1】

Figure 2004051494
【0032】
【表2】
Figure 2004051494
[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an enteral nutritional supplement, and is particularly expected to improve protein metabolism, improve immunity, and improve intestinal mucosal function, and can be administered to patients at the time of surgical invasion or patients with severe infections. It relates to suitable liquid enteral nutritional supplements and enteral nutritional compositions.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, as a method of supplementing nutrition before and after a patient's operation, a method such as oral or tube administration of an enteral nutrient or central parenteral nutrition has been adopted. Since central vein nutrition does not use the gastrointestinal tract, there are problems of physiological aspects and atrophy of the gastrointestinal mucosa, and in recent years, methods of administering nutritional preparations orally and enterally, including nasal, have been attracting attention. I have. The administration of these enteral nutritional supplements allows patients to take nutritional supplements such as proteins, lipids, carbohydrates, vitamins, and minerals containing trace elements, which greatly contributes to the improvement of disease treatment. More recently, in order to make the enteral nutrition have the same effect as the treatment of diseases dependent on medicines, the formulation of a nutrient that actively adds an active ingredient that can be expected to have a therapeutic effect has been studied. Specifically, for example, glutamine can be expected to improve protein metabolism, improve immunity, improve intestinal mucosal function, and the like by being administered to patients at the time of surgical invasion and patients with severe infections. Glutamine is classified as a non-essential amino acid, but has been classified as a conditionally essential amino acid because it was recognized that ingestion was necessary in the case of disease.
However, it is known that free glutamine is converted to pyroglutamic acid when dissolved in water or when heated, resulting in loss of physiological functions such as improvement of protein metabolism, improvement of immunity, and improvement of intestinal mucosal function. Free glutamine was not available for liquid parenteral nutrition or liquid enteral nutrition.
[0003]
However, in recent years, glutamine-containing peptides have attracted attention as a glutamine supply source that is not converted to pyroglutamic acid even when dissolved in water and further sterilized by heating. These are disclosed in JP-A-10-139681, (2) JP-A-2002-119250, and (3) JP-A-9-121809. That is, (1) includes an aqueous emulsion nutrition containing L-arginine and a glutamine-containing peptide for the purpose of immunological activation and protein activation to prevent infectious diseases and to heal wounds at an early stage. A composition is disclosed, and (2) discloses a nutritional composition characterized by containing a glutamine-containing peptide having an N-terminal pyroglutamic acid content of 5% by mass or less in terms of free pyroglutamic acid, (3) discloses a preparation which comprises a protein hydrolyzate rich in glutamine with a protein component of 0.5 to 3.0 g per 100 ml of ready-to-use solution.
[0004]
Essential amino acids, on the other hand, refer to amino acids that must be taken from the outside world in order to maintain a healthy body, such as healthy growth and weight retention, and vary slightly depending on the type of animal, but in adults, leucine and isoleucine , Valine, threonine, lysine, methionine, phenylalanine, tryptophan. The nutritional value of the protein in the nutritional composition is greatly influenced by the most restricted amino acid in the essential amino acid contained in the nutritional composition. The evaluation of the protein in the nutritional composition was determined by FAO / WHO / UNU in 1985. The amino acid score is calculated using the amino acid score pattern composed of only essential amino acids as an index. Generally, milk-derived proteins and / or protein hydrolysates such as casein and total milk protein, which are the main nitrogen sources in enteral nutrition, have an amino acid score of 100, but have a high glutamine-rich wheat or corn origin. The protein and / or protein hydrolyzate has an amino acid score of about 30. From this, the amino acid score of an enteral nutritional supplement containing glutamine and / or a glutamine-containing peptide together with milk-derived proteins and / or protein hydrolysates such as casein and total milk protein as a nitrogen source is less than 100. Is predicted. When an enteral nutrient having an amino acid score of less than 100 is administered to a patient at the time of surgical invasion, a patient with severe infection, or the like, it is easily presumed that essential amino acids are deficient and a malnutrition state occurs. Therefore, effects such as improvement of protein metabolism, improvement of immunity, and improvement of intestinal mucosal function, which are expected as effects of glutamine, cannot be sufficiently expected. That is, the conventional techniques (1), (2) and (3) have a problem that the amino acid score is less than 100, so that the effect of glutamine is not sufficiently exerted.
[0005]
In general, liquid enteral nutrients take an emulsified system in which an aqueous phase and an oil phase are mixed. The stability of the emulsified system is imparted by various emulsifiers, but when the emulsified state is poor, phenomena unsuitable for use as an enteral nutritional agent such as separation of fats and oils and generation of aggregates occur. If many low-molecular materials such as peptides and free amino acids are used as proteolysates, the emulsification system tends to be in a poor state, and the use of an emulsifier is indispensable. is necessary.
[0006]
Therefore, as described above, a liquid enteral nutritional supplement containing a glutamine-containing peptide, which is expected to improve protein metabolism, which is an effect of glutamine, has a good taste, and has an amino acid score of 100 at an osmotic pressure with little burden on the body. Was desired.
However, emulsification which contains protein degradation products such as proteins and / or glutamine-containing peptides, lipids, carbohydrates and emulsifiers as main components, has good taste, has an osmotic pressure of 300 to 600 mOsm / kg, and has an amino acid score of 100 Liquid enteral nutrients with excellent stability have not been known so far.
[0007]
[Problems to be solved by the invention]
An object of the present invention is to improve protein metabolism, improve immunity, and improve intestinal mucosal function, etc., and are suitable for administration to patients at the time of surgical invasion or severe infectious diseases, etc. It is to provide an enteral nutrition composition.
[0008]
[Means for Solving the Problems]
The present inventors have conducted intensive studies in view of the above conventional problems, and as a result, by administering a liquid enteral nutritional supplement to a patient at the time of surgical invasion or a patient with a severe infectious disease, the protein metabolism has been improved, and the immune ability has been improved. By providing a glutamine-containing peptide that can be expected to improve intestinal mucosal function and the like by a glutamine-containing peptide, thereby avoiding the problem of an amino acid score of less than 100 by supplementing an amino acid that can be a limiting amino acid with a free amino acid, The present invention has been completed by solving the destabilizing factor and bitterness of the resulting emulsification by adding an appropriate emulsifier and carbohydrate. That is, the present invention provides the following [1] to [8].
[1] A liquid enteral containing the following components A, B, C, D, and E as main components, and having an osmotic pressure of 300 to 600 mOsm / kg and an amino acid score of 100. Nutrition.
A component: a nitrogen source component of 10 to 40% by energy based on the total energy source, including proteins, glutamine-containing peptides, and amino acids;
B component: lipid of 10 to 40 energy% with respect to all energy sources,
C component: 40-80 energy% saccharide with respect to all energy sources,
D component: emulsifier,
E component: water.
[2] The protein contained in the component A is one or more selected from the group consisting of caseinate, milk protein and soybean protein, and the amino acid contained in the component A is one selected from essential amino acids. Or the liquid enteral nutritional supplement according to the above [1], which is two or more kinds.
[3] The liquid enteral nutrient according to [2], wherein the essential amino acids are threonine, methionine, and tryptophan.
[4] The liquid according to any one of [1] to [3], wherein the carbohydrate of the C component is one or more kinds mainly selected from the group consisting of dextrin, oligosaccharide, sucrose, and fructose. Enteral nutrition.
[5] The liquid enteral nutritional preparation according to any of [1] to [4], wherein the emulsifier of the D component is 0.01 to 1% by mass of the whole liquid.
[6] The emulsifier of component D is one or more selected from the group consisting of poly or monoglycerin fatty acid ester, sorbitan fatty acid ester, propylene glycol fatty acid ester, sucrose fatty acid ester, organic acid monoglyceride and lecithin. The liquid enteral nutritional supplement according to any one of [1] to [5].
[7] The liquid enteral nutritional supplement according to any one of [1] to [6] above, wherein the total calorie is 80 to 200 kcal / 100 ml.
[8] Contains the following components A, B, C, and D as main components, and has an osmotic pressure of 300 to 600 mOsm / when dissolved or suspended in water so that the total calories are 80 to 200 kcal / 100 ml. An enteral nutrition composition having an amino acid score of 100 in kg.
A component: a nitrogen source component of 10 to 40% by energy based on the total energy source, including proteins, glutamine-containing peptides, and amino acids;
B component: lipid of 10 to 40 energy% with respect to all energy sources,
C component: 40-80 energy% saccharide with respect to all energy sources,
D component: emulsifier.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
The enteral nutritional supplement of the present invention is basically a liquid enteral nutritional supplement containing glutamine-containing peptides, proteins, amino acids, lipids, carbohydrates, emulsifiers and water, but is provided as a composition excluding water. You can also. When provided as a composition excluding water, it is used after dissolving or suspending by adding water at the time of use.
Hereinafter, the enteral nutritional supplement of the present invention will be described in detail, but mainly the liquid enteral nutritional supplement after adding and preparing water will be described. The composition excluding water may be considered from these descriptions, excluding water. In addition, the mass% is w / w% with respect to the mass of the liquid enteral nutrient solution unless otherwise specified.
[0010]
Examples of the nitrogen source component (A component) used in the present invention include glutamine-containing peptide (a1), protein (a2), and amino acid (a3) as essential components. The glutamine-containing peptide a1 is a glutamine-containing peptide having an N-terminal pyroglutamic acid content of 5% by mass or less in terms of free pyroglutamic acid. Examples of the protein a2 include protein such as caseinate (caseinate such as sodium caseinate), milk protein, and soybean protein, and these can be used in combination. Examples of the amino acid a3 include essential amino acids such as L-leucine, L-isoleucine, L-valine, L-threonine, L-lysine, L-methionine, L-phenylalanine, L-tryptophan and the like. However, among the essential amino acids, it is preferable to use a combination of three amino acids, L-threonine, L-methionine and L-tryptophan. In particular, when a milk-derived protein such as caseinate or milk protein is used as the protein (a2), a combination of the three amino acids L-threonine, L-methionine and L-tryptophan is preferable as the amino acid (a3). It is. Further, non-essential amino acids may be included as amino acids. As the nitrogen source component (A component), a protein hydrolyzate (a4) other than the glutamine-containing peptide may be contained as necessary. Proteolytic products other than the glutamine-containing peptide of a4 include casein peptides, milk protein peptides, and soy protein peptides.
These nitrogen source components, that is, glutamine-containing peptide (a1), protein (a2), amino acid (a3), etc., are supplied with an amino acid score of 100 and 10 to 40 energy% with respect to all energy sources. To be blended. Since the amino acid score of the glutamine-containing peptide (a1) required in the present invention is as low as 30, it is generally preferable to use a protein derived from an animal having a high amino acid score as the protein (a2), especially caseinate and milk protein. It is preferable to combine such milk-derived proteins. In the composition of the combination of the glutamine-containing peptide (a1) and the protein (a2), restricted amino acids are generated, and the amino acid score is less than 100. The source amino acid score can be increased to 100. Here, the addition amount of the glutamine-containing peptide (a1) is preferably large from the viewpoint of the manifestation of the effect, but is preferably not too large from the viewpoint of maintaining the amino acid score at 100. Judging from these two viewpoints, the addition amount of the glutamine-containing peptide (a1) is suitably 1 to 5% by mass, more preferably 1.3 to 3% by mass, and particularly preferably 1.5 to 2.5% by mass. % Is considered most preferred. The amount of the amino acid (a3) to be added is preferably 0.01 to 0.2% by mass as the total amount of all free amino acids from the viewpoint of the taste of the prepared liquid enteral nutrient and the properties of the liquid. When L-threonine, L-methionine and L-tryptophan are added, the amount of each is preferably 0.005 to 0.05% by mass, particularly 0.01% by mass of L-threonine and 0.01% by mass of L-threonine. More preferably, methionine is 0.02% by mass and L-tryptophan is 0.02% by mass.
[0011]
Examples of the lipid of the B component used in the present invention include soybean oil, coconut oil, palm oil, safflower oil, corn oil, rapeseed oil, medium chain fat, perilla oil, fish oil, and the like, and the effects of the present invention. Free fatty acids can also be used as long as they do not impair. Lipids are extremely important nutrients as energy sources and functional components in the body, but on the other hand, they are not easily digested and absorbed compared to carbohydrates, and when taken in large quantities, they can cause diarrhea and bloating in the abdomen. As the lipid, 10 to 40% by energy is supplied to all the energy sources, and it is particularly preferable to supply 20 to 30% by energy. Fatty acids are constituents of lipids, and are composed of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids. Among them, the functions of polyunsaturated fatty acids in vivo have been attracting attention in recent years. The polyunsaturated fatty acids are composed of ω3 polyunsaturated fatty acids such as α-linolenic acid and ω6 polyunsaturated fatty acids such as linoleic acid. Fatty acids and ω6 polyunsaturated fatty acids are metabolized by different pathways, and the products converted by these two metabolic systems have different in vivo functions, and exert a bioregulatory function by affecting each other in a complex manner. Is said to govern Examples of the source of the saturated fatty acid include coconut oil and medium-chain fat excellent in digestion and absorption. As the source of the monounsaturated fatty acid and the polyunsaturated fatty acid, soybean oil, safflower oil, corn oil, Rapeseed oil, perilla oil, fish oil, etc. are listed. Among the polyunsaturated fatty acids, lipids serving as a source of ω3 fatty acids include perilla oil and fish oil, and lipids serving as a source of ω6 fatty acids are large. Examples include soybean oil, safflower oil, corn oil, and rapeseed oil. These lipids can be used alone or in combination of two or more depending on the purpose. Saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids and ω3 polyunsaturated fatty acids and ω6 Considering the balance of polyunsaturated fatty acids, it is preferable to use two or more kinds in combination.
[0012]
Examples of the saccharide of the C component used in the present invention include dextrin, oligosaccharide, sucrose, fructose, and the like. These saccharides can be used alone or in combination of two or more. Can be used in combination. Carbohydrates supply 40-80 energy% of total energy sources, but maintain blood glucose homeostasis and 55-75 energy for proper intake of proteins, lipids and other essential nutrients. Preferably, energy% is supplied. In order to increase the osmotic pressure of the liquid enteral nutritional agent to 300 to 600 mOsm / kg so as to improve the taste and not to cause diarrhea due to the high osmotic pressure, a combination of two or more kinds of carbohydrates having different molecular weights is used. It is preferable to use them. In addition, the bitterness of amino acids can be effectively improved by using a sugar having a high degree of sweetness such as fructose. Further, when a liquid enteral nutrient is administered by tube, it is necessary to have a low viscosity, and from this viewpoint, a low molecular weight saccharide is advantageous. Considering all of these, it is considered that a combination of several types of dextrin and fructose having different molecular weights is preferable as the saccharide.
[0013]
Examples of the emulsifier of component D used in the present invention include poly- or monoglycerin fatty acid ester, sorbitan fatty acid ester, propylene glycol fatty acid ester, sucrose fatty acid ester, organic acid monoglyceride, lecithin and the like. These emulsifiers can be used alone or in combination of two or more. However, in consideration of the storage stability of the emulsified system, the effect on taste, etc., organic acid monoglycerides are preferable, and two types of organic acid monoglycerides are used. It is preferable to use them in combination. Among them, a combination of succinic acid monoglyceride and citric acid monoglyceride is particularly preferable, and the addition ratio is preferably succinic acid monoglyceride: citrate monoglyceride = 3: 2 to 2: 3.
The emulsifier is preferably contained in the whole liquid in an amount of 0.01 to 1% by mass, more preferably 0.3 to 0.8% by mass. If the emulsifier is less than 0.01% by mass, separation occurs, and if it is more than 1% by mass, the storage stability of the prepared liquid enteral nutrient becomes poor.
When the enteral nutritional supplement containing these emulsifiers is analyzed for lipid content, most of the added amount of the emulsifier is detected as a lipid content.
[0014]
In order to make the enteral nutritional supplement of the present invention liquid, water of the E component is used. Examples of the water include pure water, purified water, ion-exchanged water, and the like used for ordinary processed foods.
The enteral nutrition of the present invention is preferably prepared using the water so that the total calorie is 80 to 200 kcal / 100 ml when used as a liquid enteral nutrition. At the same time, it is preferable to adjust the osmotic pressure to be 300 to 600 mOsm / kg. In addition, in the case of performing tube administration, it is necessary to have a low viscosity, and it is preferable to adjust the viscosity to 30 cp or less. The amount of water added when preparing a 100 kcal / 100 ml liquid enteral nutritional supplement is about 60 to 90% by mass.
[0015]
In addition, the enteral nutritional supplement of the present invention preferably contains minerals and vitamins in addition to the above-mentioned components. The compounding ratio is determined, for example, by the nutritional requirements of the sixth revised Japanese (First Publication). (Published by the company) can be referred to.
The enteral nutritional supplement of the present invention may further contain dietary fiber, flavor, pH adjuster and the like.
[0016]
Next, an example of the method for producing the enteral nutritional supplement of the present invention will be described.
The enteral nutritional composition of the present invention is prepared by adding proteins and / or proteolysates such as glutamine-containing peptides, lipids, carbohydrates, emulsifiers, and, if necessary, minerals, vitamins, Dietary fiber, flavor, and a pH adjuster are added to dissolve or suspend, emulsify at 50 MPa using a high-pressure homogenizer, and can be obtained through UHT sterilization treatment and filling in a paper pack or the like. Further, at the time of use, it may be prepared by adding hot water of about 60 ° C. to the above-mentioned components to dissolve or suspend them.
[0017]
The enteral nutritional supplement of the present invention can be enterally administered to a patient by an oral administration method or a tube administration method. As a tube administration method, a nasal method such as a nasogastric tube method or a naso-intestinal tube method, a fistula tube method such as a gastrostomy tube method and an enterostomy tube method, and the like can be used. In particular, the enteral nutritional supplement of the present invention is suitable for administration to patients at the time of surgical invasion, patients with severe infectious diseases, and the like.
[0018]
【The invention's effect】
By administering the product of the present invention to a patient at the time of surgical invasion, a patient with severe infection, etc., improvement of protein metabolism, improvement of immunity, improvement of intestinal mucosal function and the like can be expected.
[0019]
【Example】
Hereinafter, the present invention will be described in detail based on specific examples.
[Example 1]
As shown in Tables 1 and 2, 3% by mass of sodium caseinate, 2% by mass of milk protein, 1.5% by mass of glutamine-containing peptide, 0.02% by mass of L-methionine were added to warm water of about 60 ° C. 0.01 wt% L-threonine, 0.02 wt% L-tryptophan, 1.4 wt% rapeseed oil, 0.6 wt% medium chain fat, 0.08 wt% fish oil, 0.39 wt% Wt% succinic monoglyceride, 0.26 wt% citrate monoglyceride, 9 wt% DE11 dextrin, 3.0 wt% DE25 dextrin, 1.5 wt% fructose, 0.1 wt% citrate Sodium acid, 0.2% by weight potassium citrate, 0.1% by weight sodium metaphosphate, 0.05% by weight potassium chloride, 0.1% by weight magnesium sulfate, 0.01% by weight iron citrate Thorium, 0.04 wt% vitamin C, 0.02 wt% vitamin E, 0.002 wt% niacin, 0.0009 wt% pantothenic acid, 0.0006 wt% β-carotene, 0.0006 wt% Mass% vitamin A, 0.0003 mass% vitamin B 6 0.0003% by mass of vitamin B 2 0.0002% by mass of vitamin B 1 , 0.0000003% by mass of vitamin B 12 0.0001% by weight of vitamin D, 0.000005% by weight of folic acid, 0.000003% by weight of vitamin K, 0.6% by weight of guar gum decomposed product, 0.1% by weight of pineapple flavor, 0.07% Sodium hydroxide of mass% was stirred and dissolved, and emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement.
[0020]
The liquid enteral nutritional supplement of Example 1 was used to evaluate the analysis items of the test method described below.
As shown in Table 1, the liquid enteral nutritional supplement obtained in Example 1 was 100 kcal per 100 ml, had a protein content of 5.5 g / 100 ml, a glutamine content of 0.75 g / 100 ml, an amino acid score of 100, and a lipid content. Was 2.6 g / 100 ml and the saccharide content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. In addition, as a result of analyzing items that are important indices for evaluating suitability for use as a liquid enteral nutrient including emulsification stability, the osmotic pressure was 480 mOsm / kg, the viscosity was 10 cp, and the average particle size was Was 0.18 μm, and the pH was 6.7. The mixture was visually observed. As a result, no separation of oils and fats, no generation of aggregates, etc. was observed, and the taste was fruit-like and delicious. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 488 mOsm / kg, the viscosity was 10 cp, the average particle size was 0.18 μm, and the pH was 6.5. As a result, no separation of oils and fats, no generation of aggregates, etc. was observed, and the taste was fruit-like and delicious.
From these evaluations, it was confirmed that the liquid enteral nutritional product of Example 1 had good taste and excellent suitability for use as a liquid enteral nutritional product including emulsion stability. Therefore, habitual administration becomes possible, and by administering to patients at the time of surgical invasion, patients with severe infections, etc., it is expected to improve protein metabolism, improve immunity, and improve intestinal mucosal function.
[0021]
[Test method]
(1) Protein content; calculated from the analytical value of nitrogen by the Kjeldahl method
(2) Glutamine content; calculated by combining the amide nitrogen method and the automatic amino acid analysis method
(3) Amino acid score: Amino acid composition analysis is performed by the automatic amino acid analysis method and the high performance liquid chromatography method, and the amino acid score pattern determined by FAO / WHO / UNU in 1985 is calculated as an index.
(4) Lipid content; Reese Gottlieb method
(5) Total calories; calculated using energy conversion coefficients based on nutrition labeling standards. Energy conversion factors are: protein: 4, lipid: 9, carbohydrate: 4
(6) Carbohydrate content; calculated based on nutrition labeling standards. 100- (moisture content (%) + protein content (%) + lipid content (%) + ash content (%) + dietary fiber content (%))
(7) Osmotic pressure; freezing point depression method
(8) Viscosity: Measured with a B-type viscometer after adjusting the liquid temperature to 20 ° C
(9) Average particle size; measured with an ultracentrifugal particle size distribution analyzer
(10) pH: Adjusted to a liquid temperature of 20 ° C and measured with a pH meter
(11) Properties of the liquid; the presence or absence of oil and fat separation or generation of aggregates and the degree thereof are visually evaluated according to the following evaluation criteria.
: Good,
:: There is no particular problem with the function of the liquid enteral nutritional supplement, but slight heterogeneity is observed.
Δ: generation of separated fats and oils or agglomerates is slightly observed.
X: The fats and oils were remarkably separated or the liquid was not entirely maintained.
(12) Taste: A sensory test was conducted by 20 subjects, and each subject was evaluated based on a total score obtained from a maximum of 10 points. The evaluation criteria are as follows.
◎: 170 to 200 points
○: 140 to 169 points,
△: 110-139 points,
×: ~ 109 points.
(13) Storage test: The paper pack was stored at 30 ° C. for 180 days, and then the analysis items (7) to (12) were evaluated.
[0022]
[Example 2]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutritional supplement obtained in Example 2 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 100, and the lipid content was 2.6 g. / 100 ml, and the sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure is 472 mOsm / kg, the viscosity is 10 cp, the average particle diameter is 0.21 μm, and the pH is 6.7. It was delicious. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 493 mOsm / kg, the viscosity was 12 cp, the average particle diameter was 0.24 μm, and the pH was 6.5. As a result, the separation of oils and fats was slightly confirmed, and the taste was fruit-ole-like and delicious, but the result was inferior to that of Example 1.
Example 2 had the same nutritional composition as Example 1, but was inferior to Example 1 in the properties and taste of the solution in the storage test.
[0023]
[Example 3]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutritional supplement obtained in Example 3 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 100, and the lipid content was 2.6 g. / 100 ml, and the sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure is 479 mOsm / kg, the viscosity is 10 cp, the average particle diameter is 0.20 μm, and the pH is 6.7. It was delicious. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 495 mOsm / kg, the viscosity was 12 cp, the average particle size was 0.26 μm, the pH was 6.5, and As a result, a non-uniform part was observed although it was in a liquid state, and the taste was fruit-ole-like and delicious, but the result was inferior to that of Example 1.
Example 3 had the same nutritional composition as that of Example 1, but was inferior to Example 1 in the properties and taste of the solution in the storage test.
[0024]
[Example 4]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutritional supplement of Example 4 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 100, the lipid content was 2.6 g / 100 ml, The sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure is 499 mOsm / kg, the viscosity is 10 cp, the average particle size is 0.28 μm, and the pH is 6.7. When observed by visual observation, it is good with no separation of oils and fats and no generation of aggregates. It was delicious. As a result of storing this liquid enteral nutrient in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 512 mOsm / kg, the viscosity was 18 cp, the average particle size was 0.77 μm, the pH was 6.5, and As a result, the separation of oils and fats was observed at a part of the liquid surface, and the taste was slightly deteriorated.
Example 4 had the same nutritional composition as Example 1, but was inferior to Example 1 in the properties and taste of the solution in the storage test.
[0025]
[Example 5]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutrient of Example 5 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 100, the lipid content was 2.6 g / 100 ml, The sugar content was 13.7 g / 100 ml. The A component was 22 energy%, the B component was 23 energy%, and the C component was 55 energy%. The osmotic pressure is 493 mOsm / kg, the viscosity is 10 cp, the average particle size is 0.26 μm, and the pH is 6.7. When visually observed, no separation of oils and fats, no generation of aggregates, etc. was observed. It was delicious. As a result of storing this liquid enteral nutrient in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 507 mOsm / kg, the viscosity was 14 cp, the average particle size was 0.58 μm, and the pH was 6.5. As a result, a slight aggregate was observed, and the taste was slightly deteriorated.
Example 5 had the same nutritional composition as Example 1, but was inferior to Example 1 in the properties and taste of the solution in the storage test.
[0026]
[Example 6]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutritional supplement of Example 6 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 100, and the lipid content was 2.6 g / 100 ml. The sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure was 461 mOsm / kg, the viscosity was 7 cp, the average particle size was 0.18 μm, and the pH was 6.1. When observed visually, no separation of oils and fats and no generation of aggregates were found. However, the taste was slightly sour. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the liquid was not kept in a liquid state, so that the osmotic pressure, viscosity, average particle size and pH after the storage test could not be carried out. . Further, the palatability was poor and the taste was strongly sour.
In addition, although the nutritional composition of Example 6 was the same as that of Example 1, there was a problem in the properties and taste of the solution in the preservation test, and it was found that it was necessary to use the solution early after preparation. Determined that it was not suitable for commercialization.
[0027]
[Comparative Example 1]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . With respect to this liquid enteral nutritional supplement, the analysis items of the test method were evaluated.
As a result, the liquid enteral nutritional supplement of Comparative Example 1 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.2 g / 100 ml, the amino acid score was 100, the lipid content was 2.6 g / 100 ml, The sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure is 472 mOsm / kg, the viscosity is 9 cp, the average particle diameter is 0.19 μm, and the pH is 6.7. It was delicious. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 480 mOsm / kg, the viscosity was 10 cp, the average particle diameter was 0.19 μm, the pH was 6.5, and As a result, no separation of oils and fats and no generation of agglomerates were observed, and the taste was fruit-ole-like and delicious.
From these evaluations, it was confirmed that Comparative Example 1 had good taste and excellent suitability as a liquid enteral nutritional agent including emulsion stability. However, since it does not contain a glutamine-containing peptide, it cannot be expected to improve protein metabolism, improve immunity, and improve intestinal mucosal function even when administered to patients at the time of surgical invasion or patients with severe infection.
[0028]
[Comparative Example 2]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, the liquid enteral nutritional supplement of Comparative Example 2 was 100 kcal per 100 ml, the protein content was 5.5 g / 100 ml, the glutamine content was 0.75 g / 100 ml, the amino acid score was 70, the lipid content was 2.6 g / 100 ml, The sugar content was 13.7 g / 100 ml. The component A was 22 energy%, the component B was 23 energy%, and the component C was 55 energy%. The osmotic pressure is 476 mOsm / kg, the viscosity is 9 cp, the average particle diameter is 0.19 μm, and the pH is 6.7. It was delicious. As a result of storing this liquid enteral nutritional supplement in a paper pack under the condition of 30 ° C. for 180 days, the osmotic pressure was 483 mOsm / kg, the viscosity was 10 cp, the average particle diameter was 0.19 μm, the pH was 6.5, and As a result, no separation of oils and fats and no generation of agglomerates were observed, and the taste was fruit-ole-like and delicious.
However, in Comparative Example 2, the amino acid score was 70, the essential amino acids were deficient because of the amino acid score, and the administered patient might fall into a malnutrition state. However, effects such as improvement of intestinal mucosal function cannot be expected very much.
[0029]
[Comparative Example 3]
The components shown in Tables 1 and 2 were stirred and dissolved in warm water of about 60 ° C., emulsified at 50 MPa using a high-pressure homogenizer, and subjected to UHT sterilization treatment and filling in a paper pack to obtain a liquid enteral nutritional supplement. . The obtained liquid enteral nutrient was evaluated for analysis items in the test method. Table 1 shows the results.
As a result, immediately after preparing the liquid enteral nutritional supplement of Comparative Example 3, remarkable separation of fats and oils occurred, the taste was noticeable, and the presence of the fats and oils was noticed. Was determined to be.
[0030]
Tables 1 and 2 show the above compositions and results.
[0031]
[Table 1]
Figure 2004051494
[0032]
[Table 2]
Figure 2004051494

Claims (8)

下記のA成分、B成分、C成分、D成分およびE成分を主成分として含み、且つ浸透圧が300〜600mOsm/kgで、アミノ酸スコアが100となることを特徴とする液状経腸栄養剤。
A成分:全エネルギー源に対して10〜40エネルギー%の窒素源成分であり、蛋白質、グルタミン含有ペプチド、およびアミノ酸を含む、
B成分:全エネルギー源に対して10〜40エネルギー%の脂質、
C成分:全エネルギー源に対して40〜80エネルギー%の糖質、
D成分:乳化剤、
E成分:水。
A liquid enteral nutritional supplement comprising the following A component, B component, C component, D component and E component as main components, and has an osmotic pressure of 300 to 600 mOsm / kg and an amino acid score of 100.
A component: a nitrogen source component of 10 to 40% by energy based on the total energy source, including proteins, glutamine-containing peptides, and amino acids;
B component: lipid of 10 to 40 energy% with respect to all energy sources,
C component: 40-80 energy% saccharide with respect to all energy sources,
D component: emulsifier,
E component: water.
A成分中に含まれる蛋白質が、カゼイネート、乳蛋白および大豆蛋白からなる群より選ばれる1種または2種以上であり、A成分中に含まれるアミノ酸が、必須アミノ酸から選ばれる1種または2種以上である、請求項1に記載の液状経腸栄養剤。The protein contained in the component A is one or more selected from the group consisting of caseinate, milk protein and soy protein, and the amino acid contained in the component A is one or two selected from essential amino acids. The liquid enteral nutritional supplement according to claim 1, which is the above. 必須アミノ酸が、スレオニン、メチオニン及びトリプトファンである、請求項2に記載の液状経腸栄養剤。The liquid enteral nutritional product according to claim 2, wherein the essential amino acids are threonine, methionine, and tryptophan. C成分の糖質が、主として、デキストリン、オリゴ糖、蔗糖および果糖からなる群から選ばれる1種または2種以上である、請求項1〜3のいずれか1項に記載の液状経腸栄養剤。The liquid enteral nutritional supplement according to any one of claims 1 to 3, wherein the carbohydrate of the C component is mainly one or more selected from the group consisting of dextrin, oligosaccharide, sucrose and fructose. . D成分の乳化剤が、全液の0.01〜1質量%である、請求項1〜4のいずれか1項に記載の液状経腸栄養剤。The liquid enteral nutritional supplement according to any one of claims 1 to 4, wherein the emulsifier of the D component is 0.01 to 1% by mass of the whole liquid. D成分の乳化剤が、ポリまたはモノグリセリン脂肪酸エステル、ソルビタン脂肪酸エステル、プロピレングリコール脂肪酸エステル、ショ糖脂肪酸エステル、有機酸モノグリセライドおよびレシチンの群から選ばれる1種または2種以上である、請求項1〜5のいずれか1項に記載の液状経腸栄養剤。The emulsifier of component D is one or more selected from the group consisting of poly- or monoglycerin fatty acid ester, sorbitan fatty acid ester, propylene glycol fatty acid ester, sucrose fatty acid ester, organic acid monoglyceride and lecithin. 6. The liquid enteral nutritional supplement according to any one of items 5 to 5. 総カロリーが80〜200kcal/100mlである、請求項1〜6のいずれか1項に記載の液状経腸栄養剤。The liquid enteral nutrition according to any one of claims 1 to 6, wherein the total calorie is 80 to 200 kcal / 100 ml. 下記のA成分、B成分、C成分及びD成分を主成分として含み、総カロリーが80〜200kcal/100mlとなるように水に溶解又は懸濁した時の浸透圧が300〜600mOsm/kgで、アミノ酸スコアが100となることを特徴とする経腸栄養組成物。
A成分:全エネルギー源に対して10〜40エネルギー%の窒素源成分であり、蛋白質、グルタミン含有ペプチド、およびアミノ酸を含む、
B成分:全エネルギー源に対して10〜40エネルギー%の脂質、
C成分:全エネルギー源に対して40〜80エネルギー%の糖質、
D成分:乳化剤。
It contains the following A component, B component, C component and D component as main components, and has an osmotic pressure of 300 to 600 mOsm / kg when dissolved or suspended in water so that the total calories become 80 to 200 kcal / 100 ml. An enteral nutrition composition having an amino acid score of 100.
A component: a nitrogen source component of 10 to 40% by energy based on the total energy source, including proteins, glutamine-containing peptides, and amino acids;
B component: lipid of 10 to 40 energy% with respect to all energy sources,
C component: 40-80 energy% saccharide with respect to all energy sources,
D component: emulsifier.
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