Effect of high-protein peptide-based formula compared with isocaloric isonitrogenous polymeric formula in critically ill surgical patient

BACKGROUND Malnutrition is common in critically ill patients,and it is associated with an increased risk of complications.Early enteral nutrition with adequate caloric and protein intake is critical nevertheless it is difficult to achieve.Peptide-based formulas have been shown to be beneficial in patients with feeding intolerance.However,there are limited studies showing the efficacy and safety of high-protein peptide-based formula in critically ill surgical patients.AIM To determine the effects of a high-protein peptide formulation on gastrointestinal tolerance,nutritional status,biochemical changes,and adverse events in patients in the surgery intensive care unit(SICU)compared to an isocaloric isonitrogenous standard polymeric formulation.METHODS This study was a multi-center double-blind,randomized controlled trial.We enrolled adult patients in the surgical intensive care unit,age≥15 years and expected to receive enteral feeding for at least 5-14 d post-operation.They were randomly assigned to receive either the high-protein peptide-based formula or the isocaloric isonitrogenous standard formula for 14 d.Gastric residual volume(GRV),nutritional status,body composition and biochemical parameters were assessed at baseline and on days 3,5,7,9,11,and 14.RESULTS A total of 19 patients were enrolled,9 patients in the peptide-based formula group and 10 patients in the standard formula group.During the study period,there were no differences of the average GRV,body weight,body composition,nutritional status and biochemical parameters in the patients receiving peptide-based formula,compared to the standard regimen.However,participants in the standard formula lost their body weight,body mass index(BMI)and skeletal muscle mass significantly.While body weight,BMI and muscle mass were maintained in the peptide-based formula,from baseline to day 14.Moreover,the participants in the peptide-based formula tended to reach their caloric target faster than the standard formula.CONCLUSION The study emphasizes the importance of early nutritional support in the SICU and showed the efficacy and safety of a high-protein,peptide-based formula in meeting caloric and protein intake targets while maintaining body weight and muscle mass.

Production of whey protein hydrolyzates and its incorporation into milk

Whey proteins provide an excellent source of low-molecular-weight bioactive peptides with important functional properties and bioactivities like antihypertensive,opioid,and antimicrobial effects.Presence of peptide molecules with lower molecular weight has a great role in food for health promotion.In this investigation,the release of low-molecular-weight peptides from whey protein concentrate was attempted by using enzymatic digestion.The hydrolyzate was then incorporated into milk to obtain enriched milk(EM)with low-molecular-weight peptides.Based on sensory analysis of EM,electrophoretic and RP-HPLC studies,hydrolyzates of 10%protein(degree of hydrolysis 5%;enzyme/substrate E/S,1:50)were finally incorporated into milk at 20%(v/v)to develop an acceptable product enriched with low-molecular-weight peptides.EM had higher protein content,viscosity and emulsifying properties than control milk with 3%fat.It is recommended that EM should not be sterilized as it results in coagulation,but can be safely pasteurized and spray dried without any undesirable effects.Maximum ACE-inhibition activity was obtained in hydrolyzate,followed by EM.This study is expected to boost the opportunity for the dairy industry to venture further into the nutraceutical dairy market.