WO2008010472A1 - Total enteral nutrition composition - Google Patents

Abstract

In order to supply a total enteral nutrition composition having an effect of preventing decreased absorption for a human who does not have a gastrointestinal organic disorder but cannot get sufficient nutrition from eating such as an elderly person or an inpatient, a total enteral nutrition composition containing proteins, carbohydrates, fats, minerals and vitamins, wherein sodium is contained in an amount of 165 mg or more per 100 kcal of the composition, and at least one member selected from glutamic acid, dipeptides or tripeptides containing glutamic acid, 5'-nucleotides and salts thereof is provided. It is preferred that per 100 kcal of the composition, 1.5 mg or more of zinc and 0.075 to 0.15 mg of copper are contained, the ratio of zinc/copper is 10/1 to 25/1, 0.3 mg or more of vitamin B1 and 0.25 mg or more of vitamin B2 are contained, and other vitamin trace elements are further contained. Glutamic acid and 5'-nucleotides exhibit an effect of preventing decreased absorption.

Description

 Specification

 Total enteral nutrition composition

 Technical field

 [0001] The present invention requires a novel nutritional composition, more specifically, nutritional support for the elderly, hospitalized patients, and the like, and a nitrogen source in the form of a protein that is free from organic changes and disorders in the digestive tract is a nutrient. The present invention relates to a general enteral nutrition composition for humans that can be used. In other words, proteins, fats, vitamins, minerals, etc. are effective when digestive absorption is attenuated due to aging or undernutrition, etc., without inflammation, necrosis, excision, motor paralysis, ileus, etc. The present invention relates to a comprehensive enteral nutrition composition that can be absorbed and replenished efficiently and restore nutritional status.

 Background art

 [0002] In recent years, there has been concern about poor nutritional status among elderly inpatients and elderly home caregivers. Among malnutrition, malnutrition caused by a combination of protein and energy deficiency is called protein 'protein energy malnutrition (PEM). The importance of is recognized. According to the “Research on Nutrition Management Services for the Elderly” between 1995 and 1998 (Principal investigator: Akira Matsuda et al., 1999 Ministry of Health and Welfare Report), those with PEM risk whose serum albumin level is less than 3.5 gZdL It was observed in about 40% of hospitalized patients and about 30% of home-visit patients. Reduced food intake, etc.Insufficient supply of appropriate protein and energy leads to severe malnutrition, resulting in infectious diseases due to decreased immunity, muscle weakness, and bedridden conditions. This has led to an increase in the number of days and medical costs. Bedriddens often develop pressure ulcers, but factors related to pressure ulcers are caused by factors such as insufficient energy intake, insufficient protein intake, impaired protein synthesis in the body, poor fat intake, and lack of trace elements such as zinc. It is given as. In addition, it is said that there are multiple complications such as vascular disorders, loss of appetite, and reduced immune capacity from undernutrition as characteristic factors involved in the development of pressure ulcers in the elderly (Clinical Nutrition 103, 4, 424 ~ 431 pages, 2003).

[0003] Enteral nutritional compositions that comprehensively include proteins, lipids, carbohydrates, vitamins, and minerals for subjects who need nutritional supplementation are known (Patent Document 1). This is only this A nutritional composition that enables nutritional management at the same time, including a specific proportion of milk protein and soy protein in the protein raw material in the composition, and omega-3 fatty acid and omega-6 fatty acid in the lipid It is characterized by inclusion at a specific ratio. Also known is a general enteral nutritional product that is made up of proteins, lipids, carbohydrates, emulsifiers, and hydraulics, and that specifies osmotic pressure and amino acid score (Patent Document 2).

 [0004] In particular, the amount of food that can be consumed with a large stomach capacity is limited in elderly people and highly undernourished humans. Therefore, enteral nutritional compositions that contain a high balance of nutritional components and high concentrations of vitamins, minerals, and other nutrients are important. For this reason, entero nutritional composition lOOmL that can be ingested by lOOkcal is sold on the market, and the demand is expected to increase in the future.

 [0005] At present, enteral nutrition is effective in improving serum albumin levels, which are nutritional indicators, maintaining appropriate concentrations of copper, zinc, sodium, etc. in blood and improving pressure ulcers. The drug is not yet known. In addition, the necessary ingredients are appropriately selected from the comprehensive viewpoint of combining a large amount of purified proteins and lipids with high purity and appropriately containing vitamins for smooth energy production in vivo. The combined total enteral nutritional composition has not been supplied so far. In particular, increasing the sodium content of nutritional compositions rich in protein has been limited in the past because of protein precipitation (salt prayer). However, since it may cause hyponatremia in the elderly, it is extremely important to increase the sodium content at the same time as the protein content in the Takagi Nerghi Total Enteral Nutrient Composition.

 [0006] On the other hand, when nutritional management is performed using the enteral nutrition method, sufficient enteral nutrition cannot be performed due to a decrease in digestion and absorption, and the reduction of the nutritional status of patients is a serious problem.

[0007] Glutamic acid has long been used as a seasoning in foods as an umami component. Recent research has revealed that glutamic acid promotes the excretion of food gastric power and has a positive effect on the gastrointestinal tract (Non-patent Document 1). It has been reported that glutamic acid and 5′-nucleotide are effective in reducing diarrhea when there is an organic disorder in the digestive tract, such as after a large operation (Patent Document 3). Glutamate and 5'-nucleotide are also useful for functional gastroenteropathy such as abdominal pain, stomach sag, heartburn, etc. It is disclosed that it is effective for functional gastroenteropathy and gastroesophageal reflux disease in the upper gastrointestinal tract of esophageal reflux (Patent Document 4).

[0008] On the other hand, there is a state in which digestion and absorption are attenuated due to mere aging, under-nutrition, etc. among the decrease in digestion and absorption. As a nitrogen source for supplementation at this time, proteins derived from animals and plants that excel in digestion and absorption are used. However, an effective nutritional composition that can restore the nutritional state at this time is still uncovered.

 Patent Document 1: Japanese Patent No. 3102645

 Patent Document 2: JP 2004-51494 A

 Patent Document 3: WO2006 / 001492

 Patent Document 4: WO2006 / 030980

 Non-Patent Literature 1 Gastroenterology: 130 卷, No. 4, Supple 2, A246, 2006

 Disclosure of the invention

 Problems to be solved by the invention

[0009] An object of the present invention is to provide an improved comprehensive system capable of supplying all the nutrients necessary for a person who cannot receive sufficient nutrition through meals, such as the elderly and hospitalized patients. Providing an enteral nutritional composition. Specifically, proteins, fats, and carbohydrates that are effective in improving serum albumin levels and pressure ulcers, which are nutritional indicators, and in improving blood mineral balance and remarkably improving the recovery of undernutrition. The aim is to provide a comprehensive enteral nutritional composition containing vitamins and minerals, especially zinc and copper, and also containing glutamic acid and 5'-nucleotide to improve the state of the intestinal tract and enhance absorption capacity. Furthermore, even if the protein content used as a nitrogen source is maximized, sodium is added so that the protein does not precipitate, and vitamin B and vitamin B2 are contained in a high content. It is to provide a novel integrated enteral nutritional composition that is effective in preventing malnutrition, improving pressure ulcers, and preventing it.

 Means for solving the problem

[0010] The total enteral nutrition composition of the present invention is used for humans who do not have an organic disorder of the gastrointestinal tract, and includes proteins, carbohydrates, fats, minerals, and vitamins, and has the following characteristics. By combining them together, the intended purpose is achieved. (1) Composition lOOkcal contains 165 mg or more of sodium, and contains at least one selected from glutamic acid, dipeptides or tripeptides containing glutamic acid, 5 ′ nucleotides or their salt strength. In order to prevent sodium deficiency, it is necessary to contain a high concentration of sodium. High concentrations of sodium cause protein precipitation due to salt prayer when the protein concentration is high, but this problem can be prevented by using sodium phosphate, sodium citrate, etc. as the main sodium source. Applying the knowledge that glutamic acid, dipeptide or tripeptide containing glutamic acid, 5 'nucleotide or their salts can be added to enhance the state of epithelial tissue of the digestive tract and prevent malnutrition due to decreased absorption. is there. The content of glutamic acid or the like in the composition is desirably 0.05 to 2.0% by mass.

 (2) As a nitrogen supply source, a long protein is used in the amino acid compound, and the protein contains at least one kind of milk protein or vegetable protein. Preferably, the composition lOOkcal contains 4.0 g or more, more preferably 5.0 g or more of protein.

(3) Composition per lOOkcal, the copper content is 0.15 mg or less, and the mass ratio of zinc to copper is 10 to 25, preferably 10 to 20, more preferably 13 to 20, particularly preferably 15 to 18. In this case, it is more preferable that the zinc content is 1.5 mg or more and the copper content is 0.075 to 0.15 mg. This is a feature derived from the finding that high copper content inhibits zinc absorption.

 (4) Yarn and adult product Contains at least 0.30mg of vitamin B1 and at least 0.25mg of vitamin B2 per lOOkcal. This is an application of efficient energy production by adding vitamin Bl, which is necessary for energy production of carbohydrates, and vitamin B2, which is necessary for energy production from lipid.

More specifically, it is desirable to contain 1.5 to 3.0 mg of zinc, 0.075 to 0.15 mg of copper, and 165 to 385 mg of sodium per lOOkcal of the composition. More preferably, the composition lOOkcal contains 1.8 to 3.0 mg of zinc, 0.09 to 0.12 mg of copper, and 185 to 385 mg of sodium. In addition, in order to promote the burning of carbohydrates and fats in the body, the amount of vitamin B1 0.4 to 2 mg It is desirable to contain 0.25-2.0 mg of Tamine B2. As other vitamins, it is desirable to mix at least 0.3 mg, preferably 0.5 to 2.0 mg of vitamin B6 and at least 1.0 g, preferably 1.0 to 10 g of piotin. In addition, 0.20 to 0.70 μg of vitamin B12 per lOOkcal, 20 to 80 g of folic acid, j8—force 100 to 450 μg of P-tin, 10 to 70 mg of hin and tamin C is better and more effective. give.

[0012] The energy source of the total enteral nutrition composition of the present invention is protein, carbohydrate, and fat. The ratio of energy supplied by proteins, sugars and fats is preferably adjusted in the range of 10 to 40% from proteins, carbohydrate power 40 to 80% and fat to 10 to 40%. The protein is preferably contained in an amount of 4.0 g or more, more preferably 5.0 g or more per lOOkcal of the composition. Protein sources include acid casein, sodium caseinate, casein calcium, whey whey protein, fish protein, egg protein, and animal proteins such as these hydrolysates, soy protein, wheat protein, and corn. Any of these proteins and vegetable proteins such as these hydrolysates can be used. It is desirable to use a mixture of animal protein and vegetable protein, and the ratio should be 4: 1 to 1: 4. It is desirable to include glutamine peptide and soy protein or its hydrolyzate as proteins. Furthermore, it is desirable that the total glutamine in the protein is at least 0.6 g per composition lOOkcal. Particularly preferred is a ratio of daltamine or glutamine peptide to soy protein or a hydrolyzate thereof: 1: 1 to 1: 4.

 [0013] Animal and vegetable absorbable fats can be used as the fat source. A medium chain fatty acid oil containing at least 35% by mass of fat and having a mass ratio of ω 3 fatty acid to ω 6 fatty acid in the fat of 1:10 to 1: 1 is preferable. Further, it is desirable that the medium-chain fatty acid triglyceride is 40 to 65% by mass in the fat and the mass ratio of ω3 fatty acid to ω6 fatty acid in the fat is 1: 4 to 1: 1. Medium chain fatty acids are fatty acids with 6 to 12 carbon atoms, and digestion and absorption are fast, so they are suitable as a therapeutic food for elderly and hospitalized patients!

 [0014] As the sugar source, dextrin, oligosaccharide, sucrose, glucose, fructose and the like are used alone or in combination.

[0015] In addition to the above ingredients, the protein contains essential amino acids to further enhance nutritional value. Certain leucine, isoleucine, norin, threonine, lysine, methionine, phenylalanin, and tributophane are added as needed. As minerals, calcium, iron, phosphorus, magnesium, potassium, iodine, mangan, selenium, chromium, molybdenum, etc. are added as needed to the specially mentioned sodium, zinc, and copper. .

 The invention's effect

 [0016] The comprehensive enteral nutrition composition of the present invention is a treatment or prevention of protein 'energy undernutrition (PEM) in human, prevention of pressure ulcer, improvement of blood albumin level, improvement of albumin globulin ratio. , Improved reduced sodium content, improved hemoglobin level, improved hematocrit level, improved blood and in vivo mineral balance, increased zinc content, increased peripheral lymphocyte count! ], There are significant effects such as increased function of the gastrointestinal epithelium.

 BEST MODE FOR CARRYING OUT THE INVENTION

[0017] In the total enteral nutrition composition of the present invention, a purified animal protein, plant protein, or a combination thereof is used as a protein source. In particular, for humans with cerebrovascular disorders or hyperlipidemic patients, taking a suitable ratio of animal protein to plant protein as a nutrient balance prevents arteriosclerosis and reduces blood fat. Is important for. In the total enteral nutrition composition of the present invention, it is recommended that the ratio of animal protein to plant protein is 1: 4 to 4: 1. Furthermore, it has been confirmed that the presence of abundant glutamine, which is attracting attention as an immunonutrition material, has a good systemic and intestinal immunity in humans. Furthermore, it is recommended to add purified dartamine such as ara-glutglutamine glycylglutamine. The total amount of glutamine in the composition of the present invention is desirably 0.6 g or more per lOOkcal.

[0018] Examples of glutamic acid, dipeptide or tripeptide containing glutamic acid, 5 'nucleotide, or salts thereof used in the present invention include, but are not limited to, the following. These are free glutamic acid, L-glutamic acid, dipeptidic (gal-glutamine) and tripeptides containing glutamic acid, 5'-inosinic acid or their sodium, potassium, calcium, and magnesium salts. Particularly preferred are sodium glutamate and 5'-sodium inosinate. Preservation, recovery, and maintenance of the good state of intestinal epithelial cells In other words, maintenance of epithelial cell diaminoxidase (DAO) activity requires supplementation of the appropriate protein mass, and glutamate promotes epithelial cell recovery. This maintenance of the intestinal epithelium is effective in preventing a decrease in absorption efficiency. It was found that an appropriate ratio of free glutamic acid and total protein is important for this improvement and maintenance effect. This ratio (free glutamic acid: total protein) is preferably from 1: 120 to 1: 3.

 [0019] The fat used in the total enteral nutrition composition of the present invention may be any fat source that can be ingested by humans. In particular, when a high rate of energy supply is essential, medium-chain fatty acid triglycerides, medium-chain fatty acid diglycerides, and medium-chain fatty acids with absorption rates from the intestinal tract comparable to glucose and high energy production rates are included in the structure. Fat containing is recommended. It also contains omega-3 fatty acids such as eicosapentaenoic acid and linolenic acid, which have anti-inflammatory effects, and these fats are essential, such as patients with inflammation other than the gastrointestinal tract and humans who need inflammation prevention. Requires an active salary. The total enteral nutrition composition of the present invention contains at least 35% by weight of total chain fatty acid oil, and the mass ratio of ω 3 fatty acid: ω 6 fatty acid in the fat is 1:10 to 1 : 1 is preferable.

 [0020] In principle, the required amount of minerals is determined based on the Japanese dietary intake standards. However, since the intake is reduced in elderly people and hyponatremia becomes a problem, the total enteral nutrition composition of the present invention has fortified sodium. The sodium source is not particularly limited as long as it is ingested or fed by humans, but sodium citrate and sodium phosphate are used as the main sodium sources in order to prevent protein precipitation by salting out. In the present invention, the effectiveness is shown when the sodium content is 165 mg or more per lOOkcal. Particularly, it has a remarkable effect at 185 to 385 mg per lOOkcal. Furthermore, it is preferable that it is 200-385 mg.

[0021] Zinc, which is greatly involved in the functions and structures of many enzymes in the body, is insufficient for humans with low nutritional status. Zinc supplementation increases blood zinc levels and is particularly useful for patients with or at risk for pressure ulcer wounds. Furthermore, since zinc absorption competes with copper, which is a divalent ion, it is necessary to mix the copper and zinc blending ratio and copper content so that they are advantageous for zinc absorption. In the total enteral nutrition composition of the present invention, At least 1.5 mg of lead, preferably 1.5-3.0 mg, and 0.075-0.15 mg of copper are blended, and the weight ratio of zinc to copper is 10-25, preferably 13-20, particularly preferably 15-18, most preferably 15. By doing, the effect which accelerates | stimulates wound healing, such as a pressure ulcer, is acquired. In addition, it is useful to add about 4.5-18 μg of selenium, a trace element with anti-acidic activity, to each product depending on the inflammatory condition of humans who need nutritional supplementation.

 [0022] Vitamins are important as coenzymes essential for many biological activities such as energy production, protein metabolism, and maintenance of physiological functions of skin and mucous membranes. However, the amount to be formulated for undernourished humans has been fully studied so far. The total enteral nutrition composition of the present invention contains at least 0.30 mg vitamin B1, at least 0.25 mg vitamin B2, at least 0.3 mg vitamin B6, and at least 1.0 g piotin per lOOkcal. The most effective formulation is 0.4-2.0 mg vitamin B1 per lOOkcal, 0.25-2.0 mg B2, 0.5-2.0 mg vitamin B6, and 1.0-10 g piotin. Furthermore, the addition of other vitamins is effective for improving or maintaining nutritional status, preventing malnutrition, treating or preventing pressure ulcers, and treating or preventing anemia. In the total enteral nutrition composition of the present invention, it is recommended that vitamin B12 having anti-inflammatory action, antioxidant action and anti-decubitus action, folic acid, β-strength rotin, vitamin C and the like are added. Specifically, per lOOkcal of the total abdominal nutrition composition of the present invention, for example, vitamin B12 is 0.20 to 0.70 g, folic acid is 20 to 80 g, j8-power rotin is 100 to 450 μg, and vitamin C is 10 to 70 mg. Blend. All these vitamins can be derived from any raw material that can be ingested by humans.

 [0023] In order to facilitate oral intake, the general enteral nutrition composition of the present invention can be added with a suitable flavor and non-calorie sweetener such as aspartame. In addition, ingredients such as indigestible dietary fiber for promoting defecation and, in some cases, pharmaceuticals to be administered orally are added as necessary within the range that does not hinder the function of the total enteral nutrition composition of the present invention. Caro can be.

[0024] Humans with undernutrition are often difficult to ingest orally, and in this case, tube feeding is actively performed through tube feeding. However, until now, the required protein is blended at a high ratio as in the present invention, and further addition of minerals causes precipitation. The viscosity of the liquid increased and tube feeding was impossible. As a result of research on the blending ratio of ingredients and manufacturing method, we have completed a low-viscosity liquid total enteral nutritional composition and made tube feeding possible for the first time. That is, the viscosity of the composition can be adjusted in the range of 6 to 18 mPa's (25 ° C), and this can be realized when excellent fluidity is essential. Furthermore, when giving a proper viscosity to the nutritional composition when feeding it to persons with difficulty in swallowing, etc., by adding an appropriate amount of a thickener to the low-viscosity total enteral nutritional composition of the present invention, It has an IJ point that can be given an appropriate viscosity.

[0025] The total enteral nutrition composition of the present invention is provided to humans with reduced nutritional status. For example, protein / energy undernutrition (PEM), hypoalbuminemia, hyponatremia, zinc It is particularly effective for humans suffering from deficiency, anemia, decreased hemoglobin and hematocrit levels, pressure ulcers or wounds, and decreased immune capacity. Therefore, the total enteral nutrition composition of the present invention makes a great contribution to these people who have had no effective composition so far.

 Example

[Example 1]

 Preparation of total enteral nutrition composition (Composition 1)

Considering the optimal nutritional effect for undernutrition, the nutrient composition [Table 1] was assembled. [Table 2] shows the raw material composition table of the liquid material for realizing this. In order to make the composition excellent in emulsification stability and do not cause precipitation of proteins, etc., sodium raw materials, protein raw materials and emulsifiers are blended according to the raw material blending table, and the pressure of the high-pressure emulsifier is set to 500-l, multiples of OOO KZM ² A liquid integrated enteral nutrition composition was prepared by carrying out a mulch emulsification step. That is, a good emulsion was prepared by repeating high-pressure emulsification of raw material and water using a high-pressure emulsifier. The ratio of animal protein to vegetable protein was 1: 1.5. The ratio of glutamine peptide to soy protein or hydrolyzate was 1: 1.4, and the ratio of ω3-fatty acid: ω6-fatty acid in the fatty acid yarn was 1: 3. This was filled into an aluminum bag using a normal filling machine, placed in a retort sterilizer, and sterilized under normal conditions. Even after one year, all components were stable and the viscosity was 9 mPa · s (25 ° C). [0027] [Table 1]

Table 1: Nutrient composition 1

[0028] [Table 2]

Table 2: Raw material formulation 1

〔実施例 2〕

Example 2

Preparation of total enteral nutrition composition (Composition 2)

The nutrient composition shown in [Table 3] was assembled in the same manner as in Example 1. [Table 4] shows the raw material composition table of the liquid material for realizing this. In the same manner as in Example 1, the sodium raw material, protein raw material, and emulsifier were combined, and the pressure of the high-pressure emulsifier was set to ^5. A plurality of emulsification steps were performed at 00 to 1,000 kgZcm ² to prepare a liquid integrated enteral nutrition composition. That is, a good emulsion was prepared by repeating high-pressure emulsification of raw material and water using a high-pressure emulsifier. The ratio of animal protein to vegetable protein was 1: 2. The ratio of glutamine peptide to soy protein hydrolyzate was 3: 1, and the ratio of ω3-fatty acid: ω6-fatty acid in the fatty acid composition was 1: 1. This was filled into an aluminum bag using a normal filling machine, placed in a retort sterilizer, and sterilized under normal conditions. Even after one year, all components were stable and the viscosity was 6 mPa's (25 ° C).

[0030] [Table 3]

 Table 3: Nutrient composition 2

[0031] [Table 4] 4: 2

 Example 3

Preparation of total enteral nutrition composition (Composition 3)

The nutrient composition shown in [Table 5] was assembled in the same manner as in Example 1. [Table 6] shows the amount of raw material blended to realize this. As in Example 1, with sodium raw material The protein raw material and the emulsifier were combined, and the emulsification step was performed a plurality of times by setting the pressure of the high-pressure emulsifier to 500 to 1000 kg, cm ² to prepare a liquid general enteral nutrition composition. That is, a good emulsion was prepared by repeating high-pressure emulsification of raw material and water using a high-pressure emulsifier. This was filled into an aluminum bag using a normal filling machine, placed in a retort sterilizer, and sterilized under normal conditions. All components of this liquid were stable even after one year, and the viscosity was 10 mPa · s (25 ° C).

[0033] [Table 5] Table 5: Nutrient composition 3

[0034] [Table 6] 6: 3

[Efficacy study]

Nutritional state recovery test of invention composition in undernutrition model

SD male rats were bred on a protein-free diet excluding AIN93g dietary protein for 3 weeks to create a malnutrition model. Similar models were tested in advance and confirmed that no pathological changes such as inflammation or necrosis were observed in the gastrointestinal tract. These low nutrition rats The groups were randomly divided into 3 groups (7 animals in each group). Administration of enteral nutritional composition is the same calorie test as in Example 1 total enteral nutritional composition (A), except that only sodium glutamate was removed from Example 1, and the nitrogen content was replaced with glycine to make it the same. Liquid (B) and commercial enteral nutrition product (C) were used. Each group of test animals was administered enteral nutritional composition by gastrostomy pump at a rate of 40 kcal per day for 5 days. On day 6 of administration, blood was collected, and total protein, albumin, blood sodium, potassium, and iron were measured. In addition, each group of rats was dissected and measured for intestinal epithelial cell diaminoxidase (DAO) activity and intestinal protein mass, which were used as nutritional indicators. The results are shown in Table 7.

 [0036] As shown in Table 7, in the blood test, total protein and albumin increased in Example 1 (A), and recovery of low nutritional power was revealed. On the other hand, the group receiving the commercial nutritional product (C) was delayed in recovery of nutritional status. The test solution (B) was found to be more effective than (C), but the results were inferior to those of the product (A) of the present invention. Furthermore, as a result of measuring minerals in the blood, Example 1 has a high value for iron, which is a representative of trace elements such as sodium and potassium as well as zinc and copper, and prevents in vitro loss of the administered minerals. The effect to do was recognized. Therefore, iron elevation is also effective against anemia and pressure ulcers, considering the high hemoglobin level in the blood.

 [0037] On the other hand, undernutrition makes it difficult to maintain the intestinal epithelium, thus resulting in poor nutrient absorption. In this experiment, the total protein in the intestinal epithelium was maintained at a high level in Example 1 (A), and DAO activity, which is a functional index of the intestinal tract, was extremely high. This is probably because the added sodium glutamate showed the effect of preventing the decrease in absorption. As a comprehensive judgment, it has been proved that the total enteral nutrition composition of the present invention is very effective in recovering from undernutrition.

 [0038] [Table 7]

[0039] It should be noted that in Examples 2 and 3, the same effect was observed in the same experiment. It was.

Industrial applicability

 The comprehensive enteral nutrition composition of the present invention is effective for the prevention of protein / energy undernutrition (PEM) humans by preventing the decrease in absorption caused by the addition of glutamic acid and 5'-nucleotide. Has excellent effects, improved serum albumin levels as nutritional indicators, improved pressure ulcers, improved sodium and potassium levels decreased in blood, improved hemoglobin levels, improved hematocrit levels, serum iron and zinc, etc. Increase the amount of trace elements. Therefore, the composition of the present invention can be used for treating or preventing hypoalbuminemia, and for healing or preventing pressure ulcers or wounds. Furthermore, since the composition of the present invention contains a high concentration of sodium, it is useful for the treatment or prevention of hyponatremia. Furthermore, since the composition of the present invention contains a high concentration of zinc, it is used for the treatment or prevention of patients who are deficient in zinc.

Claims

The scope of the claims  [1] Comprehensive enteral nutritional composition containing protein, carbohydrate, fat, mineral and vitamin, containing at least 165 mg sodium per lOOkcal, glutamic acid, dipeptide or tripeptide containing glutamic acid, 5 ' A total enteral nutrition composition for use in humans, which contains at least one selected from nucleotides or their salt strength and does not have an organic disorder of the digestive tract.  [2] The total enteral nutrition composition according to [1], wherein the protein contains at least one of milk protein and vegetable protein.  [3] The total enteral nutrition composition according to claim 2, wherein the protein content is 4.0 g or more per lOOkcal.  [4] The total enteral nutrition composition according to claim 3, wherein the protein content is 5.0 g or more per lOOkcal.  [5] The composition has a copper content of 0.15 mg or less and a mass ratio of zinc to copper per lOOkcal of 10 Zl to 25 The total enteral nutrition composition according to claim 1, wherein the vitamin B1 content is 0.30 mg or more and the vitamin B2 content is 0.25 mg or more. [6] The total enteral nutrition composition according to any one of claims 1 to 5, wherein the zinc content is 1.5 mg or more and the copper content is 0.075 to 0.15 mg per lOOkcal. [7] The composition per lOOkcal has a zinc content of 1.5-3.0 mg, a copper content of 0.075-0.15 mg, a sodium content of 165-385 mg, a vitamin B1 content of 0.4-2.0 mg, and a vitamin B2 content of 0.25. The integrated enteral nutrition composition according to any one of claims 1 to 6, wherein the mass ratio of zinc to copper is 10 to 20 mg. [8] The total enteral nutrition composition according to any one of claims 1 to 7, wherein the mass ratio of zinc and copper is 13Zl to 20Zl.  [9] The total enteral nutrition composition according to any one of claims 1 to 8, wherein the mass ratio of zinc and copper is 15 Zl to 18 Zl. [10] The composition according to any one of claims 1 to 9, wherein the composition has a zinc content of 1.8 to 3.0 mg, a copper content of 0.09 to 0.12 mg, and a sodium content of 185 to 385 mg per lOOkcal. Intestinal nutrition composition. [11] Vitamin B6 content is 0.3-2.0 mg and piotin content is 1.0-10 per lOOkcal of the composition The total enteral nutrition composition according to claim 1, wherein the composition is IX g. [12] Per composition lOOkcal, vitamin B12 content 0.20-0.70 μg, folic acid content 20-80  g, β-strength rotin content is 100-450 μg, vitamin C content is 10-70 mg 1 to: The total enteral nutrition composition according to item 1 of L 1. [13] The selenium content according to any one of claims 1 to 12, wherein the selenium content per lOOkcal is 4.5 to 18 μg The total enteral nutrition composition according to item 1. [14] The total enteral nutrition composition according to [1] or [1], wherein the mass ratio of the animal protein to the vegetable protein is 4: 1 to 1: 4. [15] The total enteral nutrition composition according to any one of [1] to [14], comprising a glutamine peptide as a protein and a soy protein or a hydrolyzate thereof. 16. The total glutamine in the protein is at least 0.6 g per lOOkcal of the composition. 15. The integrated enteral nutrition composition according to 15. [17] Specific power of glutamine peptide and soy protein or hydrolyzate 1-1: The total enteral nutrition composition according to claim 15 or 16, which is 4. [18] Contains at least 35% by mass of a medium chain fatty acid oil as a fat source, and ω in the fat The total enteral nutrition composition according to any one of claims 1 to 17, wherein a mass ratio of the 3 fatty acid to the ω6 fatty acid is 1:10 to 1: 1. [19] The composition according to claim 18, wherein the medium-chain fatty acid triglyceride is 40 to 65% by mass in the fat, and the mass ratio of the ω3 fatty acid to the ω6 fatty acid in the fat is 1: 4 to 1: 1. Enteral nutrition composition [20] The total amount of glutamic acid, dipeptide or tripeptide containing glutamic acid, 5 ′ nucleotide or a salt thereof is 0.05 to 2.0% by mass as free glutamic acid, dipeptide containing glutamic acid or tripeptide or 5′-nucleotide. Item 1. The total enteral nutrition composition according to Item 1-19, V or slip.  [21] The total enteral nutrition composition according to any one of [1] to [20], which prevents or ameliorates a malnutrition state in a human who does not have an organic disorder of the digestive tract. [22] A request to prevent and ameliorate hypoalbuminemia in humans without organic disorders of the gastrointestinal tract Claims 1-20 The total enteral nutrition composition of any one of 1-20. [23] The total enteral nutrition composition according to any one of [1] to [20], which prevents and ameliorates abnormal body mineral balance in a human who does not have an organic disorder of the digestive tract. [24] The integrated enteral nutrition composition according to any one of [1] to [20], which prevents or ameliorates anemia in a human having no organic disorder of the digestive tract. [25] Has no organic damage to the gastrointestinal tract! /, But is intestinal epithelial cell diaminoxidase (DAO) 25) The general enteral nutrition composition according to any one of claims 1 to 24, which is used for a human having reduced activity.  [26] The total enteral nutrition composition according to any one of claims 1 to 25, wherein the composition is liquid.