BACKGROUND Intestinal mucosal barrier injury and gastrointestinal dysfunction are important causes of sepsis.However,few studies have investigated the effects of enteral underfeeding on gastrointestinal function in se...BACKGROUND Intestinal mucosal barrier injury and gastrointestinal dysfunction are important causes of sepsis.However,few studies have investigated the effects of enteral underfeeding on gastrointestinal function in sepsis.Moreover,no consensus on goal enteral caloric intake has been reached in sepsis.AIM To investigate the effects of different goal caloric requirements of enteral nutrition on the gastrointestinal function and outcomes in the acute phase of sepsis.METHODS Patients were randomly assigned to receive 30%(defined as group A),60%(group B),or 100%(group C)of goal caloric requirements of enteral nutrition in this prospective pilot clinical trial.The acute gastrointestinal injury(AGI)grades,incidence of feeding intolerance(FI),daily caloric intake,nutritional and inflammatory markers,and biomarkers of mucosal barrier function were collected during the first 7 d of enteral feeding.The clinical severity and outcome variables were also recorded.RESULTS A total of 54 septic patients were enrolled.The days to goal calorie of group C(2.55±0.82)were significantly longer than those of group A(3.50±1.51;P=0.046)or B(4.85±1.68;P<0.001).The FI incidence of group C(16.5%)was higher than that of group A(5.0%)or B(8.7%)(P=0.009).No difference in the incidence of FI symptoms was found between groups A and B.The serum levels of barrier function biomarkers of group B were significantly lower than those of group A(P<0.05)on the 7th day of feeding.The prealbumin and IL-6 levels of group A were lower than those of group B(P<0.05)on the 7th day of feeding.No significant differences in the clinical outcome variables or 28-d mortality were found among the three groups.CONCLUSION Early moderate enteral underfeeding(60%of goal requirements)could improve the intestinal barrier function and nutritional and inflammatory status without increasing the incidence of FI symptoms in sepsis.However,further large-scale prospective clinical trials and animal studies are required to test our findings.Moreover,the effects of different protein intake on gastrointestinal function and outcomes should also be investigated in future work.展开更多
In recent years,interest in the larvae of black soldier fly(BSF)(Hermetia illucens)as a sustainable protein resource for livestock feed has increased considerably.However,knowledge on the nutritional and physiological...In recent years,interest in the larvae of black soldier fly(BSF)(Hermetia illucens)as a sustainable protein resource for livestock feed has increased considerably.However,knowledge on the nutritional and physiological aspects of this insect,especially compared to other conventional farmed animals is scarce.This review presents a critical comparison of data on the growth potential and efficiency of the BSF larvae(BSFL)compared to conventional monogastric livestock species.Advantages of BSFL over other monogastric livestock species includes their high growth rate and their ability to convert low-grade organic waste into high-quality protein and fat-rich biomass suitable for use in animal feed.Calculations using literature data suggest that BSFL are more efficient than broilers,pigs and fish in terms of conversion of substrate protein into body mass,but less efficient than broilers and fish in utilization of substrate gross energy to gain body mass.BSFL growth efficiency varies greatly depending on the nutrient quality of their dietary substrates.This might be associated with the function of their gastrointestinal tract,including the activity of digestive enzymes,the substrate particle characteristics,and their intestinal microbial community.The conceived advantage of BSFL having an environmental footprint better than conventional livestock is only true if BSFL is produced on low-grade organic waste and its protein would directly be used for human consumption.Therefore,their potential role as a new species to better close nutrient cycles in agro-ecological systems needs to be reconsidered,and we conclude that BSFL is a complementary livestock species efficiently utilizing organic waste that cannot be utilized by other livestock.In addition,we provide comparative insight into morpho-functional aspects of the gut,characterization of digestive enzymes,gut microbiota and fiber digestion.Finally,current knowledge on the nutritional utilization and requirements of BSFL in terms of macro-and micronutrients is reviewed and found to be rather limited.In addition,the research methods to determine nutritional requirements of conventional livestock are not applicable for BSFL.Thus,there is a great need for research on the nutrient requirements of BSFL.展开更多
基金Supported by National Natural Science Foundation of China,No.81701881Nanjing Medical Science and Technology Development Foundation,No.YKK17102.
文摘BACKGROUND Intestinal mucosal barrier injury and gastrointestinal dysfunction are important causes of sepsis.However,few studies have investigated the effects of enteral underfeeding on gastrointestinal function in sepsis.Moreover,no consensus on goal enteral caloric intake has been reached in sepsis.AIM To investigate the effects of different goal caloric requirements of enteral nutrition on the gastrointestinal function and outcomes in the acute phase of sepsis.METHODS Patients were randomly assigned to receive 30%(defined as group A),60%(group B),or 100%(group C)of goal caloric requirements of enteral nutrition in this prospective pilot clinical trial.The acute gastrointestinal injury(AGI)grades,incidence of feeding intolerance(FI),daily caloric intake,nutritional and inflammatory markers,and biomarkers of mucosal barrier function were collected during the first 7 d of enteral feeding.The clinical severity and outcome variables were also recorded.RESULTS A total of 54 septic patients were enrolled.The days to goal calorie of group C(2.55±0.82)were significantly longer than those of group A(3.50±1.51;P=0.046)or B(4.85±1.68;P<0.001).The FI incidence of group C(16.5%)was higher than that of group A(5.0%)or B(8.7%)(P=0.009).No difference in the incidence of FI symptoms was found between groups A and B.The serum levels of barrier function biomarkers of group B were significantly lower than those of group A(P<0.05)on the 7th day of feeding.The prealbumin and IL-6 levels of group A were lower than those of group B(P<0.05)on the 7th day of feeding.No significant differences in the clinical outcome variables or 28-d mortality were found among the three groups.CONCLUSION Early moderate enteral underfeeding(60%of goal requirements)could improve the intestinal barrier function and nutritional and inflammatory status without increasing the incidence of FI symptoms in sepsis.However,further large-scale prospective clinical trials and animal studies are required to test our findings.Moreover,the effects of different protein intake on gastrointestinal function and outcomes should also be investigated in future work.
基金funded by the institutional budget of FBN Dummerstorfpartly supported by the Leibniz ScienceCampus Phosphorus Research Rostock.
文摘In recent years,interest in the larvae of black soldier fly(BSF)(Hermetia illucens)as a sustainable protein resource for livestock feed has increased considerably.However,knowledge on the nutritional and physiological aspects of this insect,especially compared to other conventional farmed animals is scarce.This review presents a critical comparison of data on the growth potential and efficiency of the BSF larvae(BSFL)compared to conventional monogastric livestock species.Advantages of BSFL over other monogastric livestock species includes their high growth rate and their ability to convert low-grade organic waste into high-quality protein and fat-rich biomass suitable for use in animal feed.Calculations using literature data suggest that BSFL are more efficient than broilers,pigs and fish in terms of conversion of substrate protein into body mass,but less efficient than broilers and fish in utilization of substrate gross energy to gain body mass.BSFL growth efficiency varies greatly depending on the nutrient quality of their dietary substrates.This might be associated with the function of their gastrointestinal tract,including the activity of digestive enzymes,the substrate particle characteristics,and their intestinal microbial community.The conceived advantage of BSFL having an environmental footprint better than conventional livestock is only true if BSFL is produced on low-grade organic waste and its protein would directly be used for human consumption.Therefore,their potential role as a new species to better close nutrient cycles in agro-ecological systems needs to be reconsidered,and we conclude that BSFL is a complementary livestock species efficiently utilizing organic waste that cannot be utilized by other livestock.In addition,we provide comparative insight into morpho-functional aspects of the gut,characterization of digestive enzymes,gut microbiota and fiber digestion.Finally,current knowledge on the nutritional utilization and requirements of BSFL in terms of macro-and micronutrients is reviewed and found to be rather limited.In addition,the research methods to determine nutritional requirements of conventional livestock are not applicable for BSFL.Thus,there is a great need for research on the nutrient requirements of BSFL.
