JP2006131611A - Nutritional composition for improving bone metabolism/protein metabolism - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To obtain a nutritional composition for improving bone metabolism/protein metabolism, which can supply nutrients necessary for improving protein metabolism effective for preventing decubital ulcer or bone metabolism effective for preventing or treating osteoporosis, to subjects with low dietary intake, such as elderly weak people confined to beds whose caloric intake is low. <P>SOLUTION: This nutritional composition contains, per 100 kcal, at least 70-150 IU vitamin D, 50-150 mg vitamin C, 350-700 IU vitamin A, 9-1,000 μg vitamin K, 80-120 mg calcium, 1.8-3.5 mg zinc and 3-6 g protein and contains a carbohydrate and a lipid as calorie sources. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a nutritional composition for improving bone metabolism and protein metabolism capable of supplying necessary nutrients to a subject whose food intake is low, such as an elderly frail person.

  As the aging society progresses, when the level of daily activity decreases due to various triggers, it is often accompanied by disuse atrophy, which further reduces the level of activity and falls into a bedridden state requiring care. Coupled with a decrease in the degree of daily activity, a frequent occurrence in the elderly is a decrease in appetite and the accompanying lack of supplemental nutrients.

  In such a case, it is preferable to devise a normal food and replenish the necessary nutrients, but in the current situation, sufficient nutrition cannot be provided when the intake is low.

  By the way, as a nutritional composition intended for elderly people, Patent Document 1 discloses a nutritional composition containing specific lipids and proteins in a certain ratio and further containing vitamins, minerals, trace elements and the like. Yes. This nutritional composition has an effect of improving the intestinal tract function of elderly people with intestinal tract function inferior.

  Patent Document 2 describes a polymeric complete nutritional composition containing proteins, lipids, vitamins, minerals, trace elements and the like so as to meet the nutritional requirements of elderly people.

  Patent Document 3 discloses a multivitamin and multimineral nutritional supplement that is particularly effective for improving the immune response of the elderly and preventing infection.

  However, the nutritional compositions described in these patent documents include various nutrients, particularly vitamins, that are necessary for subjects whose food intake is also low due to a decrease in daily activities such as bedridden elderly people. It is not intended to replenish the required amount of minerals.

  In particular, the development of pressure ulcers in which the skin, muscles, and deep tissue are necrotic when bedridden or close to it is strongly associated with chronic nutritional deterioration. Essential (Non-Patent Document 1). For recovery from pressure ulcers, activation of collagen biosynthesis and protein synthesis necessary for wound healing is important (Non-patent Document 2). On the other hand, the onset of osteoporosis involves a decrease in the function of the bone remodeling system due to the influence of aging (Non-Patent Document 3) and an increase in bone resorption due to changes in hormones after menopause (Non-Patent Document 4). . Furthermore, the enhancement of bone resorption due to immobilization and disuse (Non-patent Document 5) contributes to the decrease in bone strength of elderly people whose living activities have decreased. Therefore, elderly frail people are required to provide nutritional compositions that take into account the above protein metabolism and bone metabolism.

Japanese Patent Laid-Open No. 2003-313142 JP-A 64-67164 JP-A-6-340535 Yoshio Mino, History of Medicine Vol.198, 1108-12, 2001 Eiichiro Miura et al., Treatment Vol.85, 2805-15, 2003 Toshio Matsumoto, History of Medicine Vol.198, 1087-90, 2001 Yutaka Ueno et al., Clinical adult diseases 30, 871-6, 200 Shinjiro Takada, Clinical Calcium, 11, 895-901, 2001

  The present invention is suitable for nutritional management of subjects whose food intake is low, such as bedridden elderly frail people, and protein metabolism necessary for prevention of wounds and prevention of osteoporosis even with low calorie intake It is an object of the present invention to provide a nutritional composition for improving bone metabolism and protein metabolism, which can supply nutrients necessary for improving bone metabolism useful for treatment.

  As a result of various studies to solve the above-mentioned problems, the present inventors have taken the nutritional composition shown below, and are necessary for improving bone metabolism and protein metabolism even with a low calorie intake. The present inventors have found a new fact that nutrients such as vitamins and minerals can be sufficiently supplied, and have completed the present invention.

(1) at least 70 to 150 IU vitamin D per 100 kcal,
Vitamin C 50-150 mg,
Vitamin A 350-700 IU,
Vitamin K 9-1000 μg,
Calcium 80-120 mg,
Zinc 1.8-3.5mg and protein 3-6g
A nutritional composition for improving bone metabolism and protein metabolism, characterized by containing saccharides and lipids as calorie sources.

(2) The nutritional composition for improving bone metabolism and protein metabolism according to (1) above, wherein the lipid has a fatty acid composition in which the weight ratio of ω6 fatty acid / ω3 fatty acid is 2 to 4.
(3) The nutritional composition for improving bone metabolism / protein metabolism according to the above (1) or (2), wherein the lipid contains a medium-chain fatty acid triglyceride.
(4) The bone metabolism / protein metabolism according to any one of (1) to (3) above, further comprising at least one selected from 4 to 25 mg of isoflavone, 50 to 500 mg of glucosamine and 0.1 to 1 g of oligosaccharide. Nutritional composition for improvement.
Such a nutritional composition of the present invention is suitable for use in the nutritional management of subjects who have reduced food intake or are unable to take a normal diet, and bone metabolism and protein metabolism even at low caloric intake. It is suitable for adjusting the calorie intake per day to 800 to 1400 kcal for nutritional management because it can sufficiently supply nutrients such as vitamins and minerals necessary to improve the quality.

  The nutritional composition of the present invention can supplement nutrients such as vitamins and minerals necessary to improve at least bone metabolism and protein metabolism even with low calorie intake. It is optimal for the nutritional management of bedridden elderly people who have fallen, and patients who cannot take regular food.

  The nutritional composition of the present invention contains a predetermined amount of vitamins and minerals in consideration of bone metabolism and protein metabolism, and further contains carbohydrates and lipids as caloric sources in addition to proteins. With regard to vitamins and minerals, the daily required amount can be replenished with at least 800 kcal intake.

  Vitamin D, calcium and vitamin K are useful for the regulation of bone metabolism (Weber P, Nutrition 17, 880-7, 2001: Latest Nutrition, supervised by Shuichi Kimura et al., Kenshisha). Therefore, considering the improvement of bone metabolism, the amount of these nutrients, which is difficult for elderly frail people to take in a sufficient amount from meals, is relatively large or mixed in a high concentration. That is, the nutritional composition of the present invention contains 70 to 150 IU of vitamin D, 80 to 120 mg of calcium and 9 to 1000 μg of vitamin K per 100 kcal. Thereby, it can contribute to prevention and improvement, such as osteoporosis.

  Vitamin C, vitamin A and zinc are useful in the regulation of collagen and protein metabolism (MacKay D et al., Alt Med Rev, Vol. 8, 359-77, 2003). Therefore, many of the above-mentioned nutrients are blended in consideration of these metabolic improvements. That is, the nutritional composition of the present invention contains 50 to 150 mg of vitamin C, 350 to 700 IU of vitamin A and 1.8 to 3.5 mg of zinc (Zn) per 100 kcal. Thereby, it can contribute to prevention of pressure ulcer. Further, copper (Cu) is more preferable for improving protein metabolism, and Zn / Cu is more preferably 10 or more by weight from the viewpoint of absorption of Zn. -64, 2003).

  In addition, the nutritional composition of the present invention contains 3 to 6 g of protein (nitrogen source) per 100 kcal, and enables protein supplementation to patients. In terms of nutrition management, it is more preferable to contain 4.5 to 6 g of protein per 100 kcal. As protein, it is preferable to use milk protein and vegetable protein (soy protein etc.), from the standpoint of prevention of diarrhea occurrence, improvement of stool, pharmacological activity, cardiovascular disease, chronic disease, The milk protein / soy protein weight ratio is more preferably 0/1 to 4/1.

  The lipid has a fatty acid composition in which the weight ratio of ω6 fatty acid / ω3 fatty acid is 2 to 4. Specifically, the fatty acid composition of the lipid is preferably 3 to 20% by weight of ω3 fatty acid and 10 to 40% by weight of ω6 fatty acid.

  As the lipid, a lipid containing an ω3 fatty acid and a lipid containing an ω6 fatty acid are blended. Preferred ω3 fatty acids are α-linolenic acid, eicosapentaenoic acid and docosahexaenoic acid, and the total of ω3 fatty acids contains 3 to 20% by weight in the fatty acid composition. A preferred ω6 fatty acid is linoleic acid. The ω6 fatty acid contains 10 to 40% by weight of the fatty acid composition of the lipid. Examples of oils containing both ω3 fatty acids and ω6 fatty acids include edible oils such as perilla oil, sesame oil, linseed oil, tung oil, fish oil, safflower oil, corn oil, soybean oil, and rapeseed oil. By mixing two or more of these oils, a lipid having the above-mentioned ω6 / ω3 ratio can be obtained. Further, as other lipids, medium chain fatty acid triglycerides (MCT) that can be rapidly digested and absorbed may be used.

  Examples of the saccharide include starch, dextrin, sucrose, glucose, galactose, maltose and the like. In addition, fructose, xylitol, palatinose, sugar alcohol and the like, which are unlikely to cause an increase in blood sugar level, can be partly blended.

  In the present invention, 0.1 to 1 g of oligosaccharide may be blended per 100 kcal. By blending oligosaccharides, the effect of maintaining and improving the intestinal environment can be expected. Examples of oligosaccharides include fructooligosaccharides, dairy oligosaccharides, galactooligosaccharides, lactulose, isomalto-oligosaccharides, panose, gentio-oligosaccharides, xylo-oligosaccharides, chitin oligosaccharides, soybean oligosaccharides, and raffinose. The above components can be blended. Formulation of fructooligosaccharides, dairy oligosaccharides, and galactooligosaccharides is particularly desirable, and these have a mineral absorption promoting function in addition to the above-described effects.

  Furthermore, in this invention, you may mix | blend 0-3g of dietary fiber per 100 kcal. Examples of dietary fiber include cellulose, lignin, indigestible dextrin, indigestible starch, polydextrose, gum arabic, guar gum degradation, water-soluble pectin, glucomannan, galactomannan, carrageenan, alginic acid, wheat bran, soybean fiber, Chitosan, chitin, psyllium and the like can be mentioned, and one or more of these components can be blended.

  The blending amount of lipid and carbohydrate is not particularly limited. For example, when caloric intake per day is set to 800 kcal to 1400 kcal, specifically, the lipid is 120 to 560 kcal and the carbohydrate is 300 to 1000 kcal.

  In the present invention, various nutritional components can be blended in addition to the above active ingredients. Examples of such nutritional components include protein hydrolysates, amino acids, vitamins and minerals other than those described above, and the like. As minerals, organic salts or inorganic salts such as Na, K, Mg, P, Cl, Fe, Cu, Mn, I, Se, Cr, and Mo can be blended in addition to the above Zn and Ca. In addition to the above, fat-soluble vitamins such as vitamin E, and water-soluble vitamins such as vitamins B1, B2, B6, B12, pantothenic acid, niacin, biotin, and folic acid can be added as vitamins. Vitamin K may be vitamin K2. Furthermore, 4-25 mg of isoflavones per 100 kcal of isoflavones that are useful for bone metabolism can be blended. Glucosamine that is useful for joint pain and the like can be blended in an amount of 50 to 500 mg per 100 kcal. Furthermore, 0.1-3 g of citric acid, which is useful for fatigue recovery, can be blended per 100 kcal. Moreover, you may mix | blend catechin or polyphenol as needed.

  The form of the nutritional composition of the present invention is not particularly limited. For example, powders obtained by mixing each nutritional component with powder, liquids obtained by dissolving in water, and liquids are dried. The powder obtained is preferable. In preparing the liquid nutritional composition, if necessary, an emulsifier such as lecithin, glycerin fatty acid ester, sucrose fatty acid ester, sorbitan fatty acid ester, propylene glycol fatty acid ester, stearoyl calcium lactate may be used.

  The nutritional composition obtained in this way is used to replenish a small amount of nutrients to a subject who has a reduced level of daily activity, such as those who are bedridden and who have a reduced appetite. The As the dosage form, it can be administered orally, by tube, or enterally depending on the situation.

  In addition, the present nutritional composition can be used to add a paste (thickener, gelling agent) as needed to give a viscous or jelly-like substance when dysphagia is observed or administration to the gastrostoma is performed. Can also be prepared. Examples of the paste used at that time include, for example, agar, gelatin, carrageenan, gum arabic, guar gum, locust bean gum, tara gum, gellan gum, xanthan gum, curdlan, pullulan, pectin, sodium alginate, carboxymethyl cellulose, and other pastes. The polysaccharide etc. which can be used are mention | raise | lifted and what combined these 1 type, or 2 or more types is used. The blending ratio of these pastes is preferably 5 parts by weight or less with respect to 100 parts by weight of the nutritional composition prepared in a viscous or jelly form.

  The nutritional composition of the present invention varies depending on age, symptoms, etc., but when it is difficult to take a normal meal, 800 kcal to 1400 kcal per day per human adult is administered orally or tube / enterally. It is preferable. It can also be used in combination with a normal meal as a supplement.

  EXAMPLES Hereinafter, although an Example is given and this invention is demonstrated in detail, this invention is not limited only to a following example.

<Manufacture of liquid preparations>
A liquid sterilized nutritional composition having the composition shown in Table 1 and having a calorie of 1000 kcal was prepared according to a conventional method. The nutritional composition shown in Table 1 was made up to 1000 mL with purified water. The ratio of fat calories to total calories is 20%, the ratio of fatty acid composition (ω6 fatty acids / ω3 fatty acids) is 3, the ratio of protein calories is 20%, and the weight ratio of milk protein / soy protein is 4/1. It is.

<Manufacture of liquid preparations>
A sterilized nutritional composition was prepared in the same manner as in Example 1 except that the nutritional composition having the formulation shown in Table 1 was used. The ratio of fat calories to total calories is 24%, the ratio of fatty acid composition (ω6 fatty acids / ω3 fatty acids) is 2, the ratio of protein calories is 22.4%, and the weight ratio of milk protein / soy protein is 1/0. It is.

<Manufacture of liquid preparations>
A sterilized nutritional composition was prepared in the same manner as in Example 1 except that the nutritional composition having the formulation shown in Table 1 was used. The ratio of fat calories to total calories is 20%, the ratio of fatty acid composition (ω6 fatty acids / ω3 fatty acids) is 3.2, the ratio of protein calories is 20%, and the weight ratio of milk protein / soy protein is 4. / 1.

  In Table 1 below, the sum of the amount of casein and the mass of soybean protein exceeds the total protein mass is due to the purity of the protein contained in the added raw materials (casein and soy protein). That is, the total protein mass is a value obtained by calculation in consideration of the purity of the protein contained in these raw materials.

<Bone metabolism test>
SD male rats were divided into 2 groups, 10 rats each, transferred to individual metabolic cages, and acclimated for 3 days. Thereafter, the nutritional composition of Example 3 was used to perform 50% restriction feeding of the required calories. On the seventh day from the start of restricted feeding, tail suspension treatment was performed, and thereafter, restricted feeding was continued under tail suspension conditions. Urine was collected for 3 days from 12 to 14 days after tail suspension treatment, and blood was collected and sacrificed under ether anesthesia on day 15, and the femur was collected. As a comparative example, a sterilized nutritional composition was prepared in the same manner as in Example 1 using a commercially available nutritional composition (concentrated liquid food), and the nutritional composition was subjected to the same restricted feeding as described above. The test was also performed on the given one (Comparative Example 1). Table 2 shows the composition of the nutritional composition prepared in Comparative Example 1.

The collected urine was subjected to measurement of a creatinine correction value (nM / mM Cre) of urinary deoxypyrinodiline (DPD) excretion. The collected blood was subjected to measurement of serum alkaline phosphatase. The collected femur was subjected to measurement of total bone density (mg / cm ³ ) and estimated bone strength (minimum cross-sectional second moment (unit: mgxcm)) using CT for animals.

  The measurement result of the creatinine correction value of urinary DPD excretion is shown in FIG. The creatinine correction value of urinary deoxypyrinodiline (DPD) excretion increases as bone resorption is promoted in the process of bone loss, but as shown in FIG. 1, on the 12th to 14th days after tail suspension treatment. Compared with the group of Comparative Example 1, the value of the group of Example 3 was significantly lower. Moreover, in the measurement of serum alkaline phosphatase reported to be elevated when bone metabolism is abnormal, the group of Comparative Example 1 was 436 ± 60 U / L, whereas the group of Example 3 was 343 ± 59 U / L. The value was low, and a significant difference (p <0.01) was observed. From the test results of bone metabolism markers such as DPD excretion measurement and serum alkaline phosphatase measurement, it can be seen that the nutritional composition of Example 3 has a certain bone metabolism improvement effect.

  The measurement result of the total bone density is shown in FIG. As shown in FIG. 2, the total bone density of Example 3 was significantly higher (p <0.05) than the result of Comparative Example 1. Moreover, the measurement result of a bone strength estimated value (minimum cross-section second moment) is shown in FIG. As shown in FIG. 3, compared to the result of Comparative Example 1, the value of the minimum cross-sectional second moment of Example 3 was significantly higher (p <0.05). From these results, it can be seen that the nutritional composition of Example 3 has an effect of improving bone density and bone strength.

<Pressure prevention test>
The SD male rats were divided into 10 groups of 2 groups, and the nutritional composition of Example 3 or the nutritional composition of Comparative Example 1 (corresponding to 50% of the necessary calorie intake) was restricted in an individual breeding cage. Reared for 2 weeks. After 2 weeks of breeding, the ischemic treatment for 4 hours was performed on the skin on the back of the rat using a magnet. Thereafter, the ulcers on the back of the rat were observed 2 days, 4 days, 8 days and 11 days after the ischemic treatment while continuing the above restricted feeding. The observation results were evaluated according to the following 6-step criteria of 0 to 5 according to the size of the ulcer site and the state of necrosis.
(Evaluation criteria)
0: No occurrence of ulcer 1: A change suspected of necrosis is observed in a part of the subcutaneous part.
2: A skin defect having a diameter of 3 mm or less is observed, or a change in which necrosis is suspected is observed in the entire ischemic subcutaneous region.
3: A skin defect having a diameter of 3 mm or less is observed, or hardening due to necrosis of the ischemic skin is observed.
4: A skin defect with a diameter of 5 mm or more is seen, or the skin of the ischemic area changes to a scab shape. 5: A skin defect with a diameter of 5 mm or more is seen, and the ulcer part reaches the subcutaneous fat part.

  As shown in FIG. 4, after the ischemic treatment, skin ulcers deteriorated over time, and in both groups, there was no difference in scores after 2 days of ischemic treatment. However, after 4 days after the ischemic treatment, in the process where the ulcers became more serious, the score of the group of Example 3 tended to be lower than that of the group of Comparative Example 1.

It is a graph which shows the measurement result of the amount of urinary DPD excretion in the bone metabolism test conducted in the example of the present invention. It is a graph which shows the measurement result of the total bone density in the bone metabolism test done in the Example of this invention. It is a graph which shows the measurement result of the bone strength (minimum cross-section second moment) in the bone metabolism test performed in the Example of this invention. It is a graph which shows the result of having observed the onset situation of the ulcer of a rat back in the pressure ulcer prevention test conducted in the Example of this invention.

Claims (6)

At least 70 to 150 IU of vitamin D per 100 kcal,
Vitamin C 50-150 mg,
Vitamin A 350-700 IU,
Vitamin K 9-1000 μg,
Calcium 80-120 mg,
Zinc 1.8-3.5mg and protein 3-6g
A nutritional composition for improving bone metabolism and protein metabolism, characterized by containing saccharides and lipids as calorie sources.   The nutritional composition for improving bone metabolism and protein metabolism according to claim 1, wherein the lipid has a fatty acid composition in which the weight ratio of ω6 fatty acid / ω3 fatty acid is 2-4.   The nutritional composition for improving bone metabolism / protein metabolism according to claim 1 or 2, wherein the lipid contains medium-chain fatty acid triglyceride.   The nutrition for improving bone metabolism / protein metabolism according to any one of claims 1 to 3, further comprising at least one selected from isoflavone 4 to 25 mg, glucosamine 50 to 500 mg, and oligosaccharide 0.1 to 1 g per 100 kcal. Composition.   The nutritional composition for improving bone metabolism / protein metabolism according to any one of claims 1 to 4, for use in nutritional management of subjects who have reduced food intake or are unable to take normal food. The nutritional composition for improving bone metabolism and protein metabolism according to any one of claims 1 to 5, for adjusting the daily calorie intake to 800 to 1400 kcal for nutritional management.

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