AU604347B2

AU604347B2 - Nutrient mixture intended for the elderly

Info

Publication number: AU604347B2
Application number: AU19718/88A
Authority: AU
Inventors: Patrick Darmenton
Original assignee: Synthelabo SA
Current assignee: Synthelabo SA
Priority date: 1987-07-23
Filing date: 1988-07-22
Publication date: 1990-12-13
Anticipated expiration: 2008-07-22
Also published as: DK413888D0; AU1971888A; DE3864621D1; FR2618305B1; PT88085A; PT88085B; DK413888A; JPS6467164A; CA1336867C; NZ225527A; KR890001462A; ZA885372B; ATE66784T1; FR2618305A1; EP0300895B1; EP0300895A1; NO883264L; NO883264D0

Abstract

Polymeric, complete food mixture in the form of a fine emulsion, intended for oral or enteral feeding of the elderly, which mixture contains . calcium (> 0.066 g/100 ml) in combination with fluorine (0.05 to 0.25 mg/100 ml) and vitamin D (60 to 110 IU/100 ml), . folic acid (0.13 to 0.4 mg/100 ml), and . zinc (2 to 4.0 mg/100 ml).

Description

C 0 M KI 0 N W K A L. T If P A ST A I 0 F A U S T R A L I A PATENT ACT 1952 COMPLETE SPEC IFIC44DOf

(ORIGINAL)

hA FOR OFFICE USE C I.A~ Application Number: LodgeCd: complete Specification Lodged: Accepted: Publj shedz Priority: Related Art-: NAME OF APPLICANT: ADDRESS OF APPLICANT:

SYNTHELABO

58, rue do la Glaciare F 75013 PAR~IS

FRANCE

Patrick DARM'ENTON NAKE(S) OF INVENTOR(S) ADDRESS FOR SERVICE: DAVIES COLLISON, Patent Attorney:, 1 Little Collins Street, Melbourne, 3000.

COMPLETE SPECIFICATION FOR THE INVENTION ENTITLED: "NUTRIENT MIXTURE INTENDED FOR THE ELDERLY" The following statement is a full description of this invention, including the best method of performing it kntvn to us

-I-

"1 A- The present invention relates to a nutrient mixtture sui table for the elderly.

Fifty to sixty per cent of hospitalised old people are undernourished IROMAGNOLI JULARD et al. 1984; A4 DEVILLE CHAI3ROYJE 1986), and their lipid intake is very often unbalanced.

Prolonged confinement of old people to bad leads to Increased morbidity.

moreover, ageing of the population is a well known phenomenon in European countries and in the Uni~ted States, Ageing leads to substantial physiological changes, capable of affecting the requirements for certain nutrients, vitamins or minerals.

At the present time, there is no complete specific product for old people.

The present invention provides a complete nutrient mixture that is specifically designed to meet the nutritive needs of elderly individuals, which is in the form of a fine emulsion and which is suitable for oral, or enteral administration, comprising: more than 0.066 g calcium per 100 ml of mixture; 4 0.05 to 0.25 mg of fluorine per 100 ml of mixture; 60 to 110 1U vitamin D per 100 ml of mixture; 0.13 to 0.4 mg folic acid per 100 ml of mixture; I D 2 to 4.0 mg zdnc por 100 ml of mIxturo; inid 3.4 to 3.8 g of mixed oils per 100 ml of mixture, wherein from 25 to 75 of the lipidsh providorxl by said mixed oils is Cicosapantanoic acid anl the ratio of essential fatty acids to saturated fatty aiads in finid mixed oils is from 0.4 to 1.0 and tho ratio of n-6 norioa fatty acids to n-3 series fatty acif1s is 3.5.,to 10.0, The nutrient mixture of thd invention is n preferably roady-to-use, polymeric compcoto prnpnrati.on, in tn- form of a fine emulnion golloraly L. w'inq a pari$ch siza of from 300 to fO0nm, r r 0.43.

4.

*44 4 4, 4.9, 4 4

I

4 4 4.r IA 4i 900827,immdatO5l,a:\I9718syres,17 p.= 2 Preferably the nutrient mixture comprises lipids ouch that the lipid intake provided 1) contains eicosapentaenoic C20:5, (0.25 to of lipid intake), and 2) fulfils the following criteria EFA Essential fatty acids 0.4 to EFA Saturated fatty acids EFA series fatty acids 3.5 to 10,0 EFA series fatty acids.

The nutrient mixture may also comprise 2 to 8 mg niacin and 10 to 16.7 pg chromium per 100 ml of mixture.

It may also comprise a protein source containing 0.66 to 1.07 g arginine per 100 ml of mixture.

Administered by tube or orally, the nutrient mixture is specificallyadapted to the nutrient requirements of tho elderly, since it takes account of the protein, lipid, vitamin, mineral and trace element, etc., requirements specific to the elderly, and of intestinal absorption, and since it enables old people to be fed while averting complications due to stress.

The choice of the constituents of the nutrient mixture of the invention is directed towards several objec t ives.

1, To correct the nitrogen balance.

The nitrogen balance is defective in elderly subjects; this deficiency is aggravated by a stress situation. The calorie/nitrogen intake must be sufficient to provide for a favourable outcome.

o 2. To facilitate healing phenomena.

The restoration of a good protein intake pre- and postoperatively promotes healing.

However, a deficiency in folates leads to a delay in healing.

The nutrient mixture of the invention contains proteins in a quantity ranging from 10 to 16 g per day, and folic acid according to a daily intake of between 2 and 7 mg.

Moreover, it has proved useful that, in some cases, there should be arginine among the proteins.

3. To provide for a good Lipid intake, especially of linoleic and eicosapentaenoic acids.

To this end, the nutrient mixture of the invention contains a mixture of 2 or 3 vegetable oils and a fish oil, this mixture providing the requisite amounts of fatty acids. The lipid intake provided by the emulsion of the invention advantageously has a ratio between the sum of the essential fatty acids and the sum of the saturated fatty acids ranging from 0.4 to 1.0, and by a ratio

I

4between the sum of the n-6 fatty acids and the sum of the n-3 fatty acids ranging from 3.5 to 10.0, so as to supply substantial amounts of linoleic and eicosapentaenoic acids.

The nutrient mixture of the invention also contains MCT (medium-chain triglycerides) (20 to 30% of the Lipid intake provided), to supply the elderly with a lipid source which can be very rapidly absorbed intestinally and whose penetration into mitochondria does not require carnitine.

4. To normalize the glucose tolerance.

The elderly react more slowly to carbohydrate overload, as may be shown in the induced hyperglycemia test.

Thus, the nutrient mixture of the invention generally contains chrciium (150 to 250 which potentiates the peripheral action of insulin, and niacin (30 120 mg), which reinforces the action of the added trace element.

To increase the immune defences.

Among the different factors which affect the immune defences, zinc performs a fundamental role. The nutrient mixture of the invention contains from 2 to 4 mg of zinc per 100 ml of emulsion.

It also contains other constituents which are involved to various extents: vitamin A (daily intake provided: 4000 to 6000 IU), vitamin B 6 which affects cellular immunity (daily intake provided: 10 to 20 mg).

6. To combat decalcification.

The calcium Losses, of hormonal origin, which affect the elderly are responsible for 50,000 fractures per annum and for 1,000,000 vertebral compressions, mainly in women.

The nutrient mixture of the invention contains calcium at a level greater than 1 g/day, vitamin 0 at a level of between 1000 and 2200 IU/day, fluorine at a level of between 1 and 5 mg/day.

Moreover, the MCT present in the lipid intake provided, at a level of 20 to 30%, appear to promote the absorption of calcium, amino acids and magnesium BACH V.K. BABAYAN 1982).

7. To decrease oxidation phenomenona.

Among the causes of ageing, one of the hypotheses put forward is that of "free radicals". It has been Sdemonstrated that the level of survival rises in animals whose feed has been enriched with antioxidants.

In addition, a state of stress in a patient is characterized by the appearance of free radicals, whose presence is not desirable, especially if the patient is fed with unsaturated lipids (KIYOSHI TAKEDA et al. 1984-1986).

The nutrient mixture of the invention contains a Lipid-soluble antioxidant: vitamin E (30 to 150 mg/day) a water-soluble antioxidant: vitamin C (150 to 300 mg/day) i F f, 4 a *a a 4, 4 selenium (40 150 jg/day).

This trace element is the cofactor of glutathione oxidase, whose role is to reduce peroxides ROMBEAU 1984).

8. To facilitate intestinal transit.

Old people very often exhibit "sluggishness of the digestive system", which must be combated.

The presence of fibres in the emulsion contributes to this; it is desirable in the form of a daily intake of 3 to 12 grammes.

The non-limiting examples which follow illustrate the invention.

Example 1: Daily intake provided 84 to 97 g 68 to 76 g A Proteins: B Lipids: composition: MCT 20 borage oil 7.7% European olive oil 45.0% soybean oil 19.5% codliver oil 7.8% C Carbohydrates: hydrolysate of polyoses still containing 60 to of polysaccharides.

D Vitamins: A (IU) 240 to 265 g 4000 to 6000 i-' 51 (mng) 3 to 82 (mg) 3 to 6 S6 (mg) 10 to 8 12 (rig) 5 to C (mg) 150 to 300 D I10) 1200 to 2200 E (mg) 30 to 150 N IA C IN (mg) 30 to 120 *.FoLic acid (mg) 2 to 6 Pantothenic acid (mig) 10 to BIOTIN 180 to 260 '2.E MineraLs: *Na (mg) 1875 to 2250 VK mig) 900 to 2250 Ca (mg) 1200 to 3000 P (mg) 1000 to 2000 Mg (mg) 450 to 900 Fe (mg) 16 to Zn (mg) 40 to CL (mg) 1000 to 5100 F Trace eLements: I (4ig) 120 to 200 Mn (mg) 2.5 to Cu (mg) 2.5 to Cr ('jig) 150 to 250 MO (jig) 275 to 350 F (mg) 1 to -c 8- S e Pg G Miscellaneous L-carnitine (mg) emulsifier: soybean Lecithin (g) .fibres (from sugarbeet) (g) (optional) flavouring (such as vanilla, mocha, strawberry or chocolate) NaOH or HCL solution to adjust the pH water (ml) qs ZESSENTIAL FA 0.74 EFA 8.8 ESATURATED FA EFA (n-3) Example 2 A, C, D and E identical to Example 1 B L ip ids Composition: MCT 20 40 to 150 200 to 500 1.33 Z 6.6 3 12 2000 9* '4 4 *4 4 .9 .4 4.

borage oiL European olive oil waLnut oiL sardine oil EESSENTIAL FA 0.76 ESATURATED FA Example 3 A, D and E identical 8 Lipids: Composition: NCT borage oiL 15.3% 45.2% 15.1% 4.4% EFA 5.30 EFA (n-3) to Example 1 20 4 I -1,Wl I I

I

11 4 European olive oil soybean oil codLiver oil ZESSENTIAL FA =0.53 ESATURATED FA Example 4: P, C, D and E identical B L ip ids Composition: MCT borage oil European olive oil walnut oil codLiver oil ZESSENTIAL FA =0.75 ESATURATED FA ExampLe A, C, D and E identicaL B Lipids: Composition: MCT borage oil European olive oil walnut oil herring oil ZESSENTIAL FA 0.71 ESATURATED FA Example 6: A, C, D and E identical 56.5% 11.8% 7.7% EFA EFA (n-3) to Example 1 20 15.3% 42.8% 14.0% 7.9% EFA Cn-6) 4.83 EFA (n-3) to ExampLe 1 20 15.3% 40.3 1% 13.0% 11.4% EFA 5.07 EFA (n-3) 68 to 76 g to Example 1

I

10 00 4 4' 4,4 4 4 4'.

04'.' 0 44 4'.

0 0 4 04 0 U 4 B Lipids Composition: MCT borage oil European olive oil soybean oiL herring oiL EESSENTIAL FA =0 .7 4 ESATURATED FA Example 7: A, C, D and E identical t~Lipids Composition: MCT borage oil codLiver oil rapeseed oil ZESSENTIAL FA 0.67 ESATURATED FA ExampLe 8: A, C, D and E identicaL B Lipids Composition: MCT borage oil herring oil Lupin oil or rapeseed oil (2) ZESSENTIAL FA 0.56 ESATURATED FA 20 15.3% 3 4. 18.7% 11.4% ZFA =6.50 EFA (n-3) to EXampLe I 68 to 76 9 68 to 76 g 30 X '15 3% 2.4% 47.2% EFA 4.76 EFA (n-3) to ExampLe 1 68 to 76 g 30 20.4% 46.1% EFA 4.53 EFA (n-3) 11 1 48 04

S.

9, 89* 44 88* 8448 4 4W 44 A 00*089 84 04 9 84 04 8 48 4 004 40 0 O 04 4 44 44 0 4 0 0 4 00 ZESSENTIAL FA =0.66 EFA =4.81 ZSATURATED FA &FA (n-3) ExampLe 9: A, C, D and E identical to Example 1 B Lipids: 68 to 76 g Composition: MCT 30 borage oiL 20.4% sardine oil 1.4% Lupin oil or rapeseed oil (2)48% ZESSENTIAL FA =0.57 EFA =4.42 ESATURATED FA EFA (n-3) ZESSENTIAL FA 0.67 EFA =4.70 ESATURATED FA EFA (n-3) Example A, C, D and E identical to Example 1 B Lipids: 68 to 76 g Composition: MCT 30 bLackcurrent oil 17.6% herring oiL groundnut oil or safflower oil 48.9% or European oLive oil or American palm oil I- 12 ZESSENTIAL FA 0.59 ESATURATED FA 0.68 0.46 0. 56 EFA 6.75 EFA 6.67 4.22 5.69 44, 4 44 44 4 4 44 0 44 00 4 44 44 44 4 454 44 4 4 ExampLe 11: A, C, D and E identical to ExampLe 8 L ip idcs Composition: MCI bLackcurrant oiL 17.

10 codLiver oiL 2.

saffLower oil or hazeLnut oil )49.

o r oL ive o iL (3) or American paLm oil ZESSENTIAL FA kl) 0.69 EFA ESATURATED FA 0.64 EFA 0.53 0.5? 68 to 76 g 6% 4% 9% 6.76 5.95 5.33 5.74 Example 12: A, C, D and E identical to Example 1 B L ip idcs Composition: MCT bLackcurrant oil 17.

sardine oil 1.safflower oil or African olive oiL 50.

or American palm oil 68 to 76 g 6% 4% 9%

F

I

I EESSENTIAL FA 0.70 ESATURATED FA 0.53 0.57 ZFA 6.81 ZFA 4.76 (21) 5.77

I

.4

IA

Claims

3.4 to 3.8 g of mixed oils per 100 ml of 0 oa mixture, wherein from 25 to 75 of the lipids provided by said mixed oils is eicosapentanoic acid and the ratio of essential fatty acids to saturated fatty acids in said omixed oils is from 0.4 to 1.0 and the ratio of n-6 series fatty acids to n-3 series fatty acids is 3.5 to 10.0. 2. The nutrient mixture of claim 1, further comprising 2 to 8 mg of niacin and 10 to 16.7 pg of chromium per 0 94 100 ml of mixture. 0 D4 o The nutrient mixture of claim 1 or claim 2 further comprising a protein source containing 0.66 to 1.07 g of arginine per 100 ml of mixture. S°a 4. The nutrient mixture of any preceding claim, wherein said mixed oils consist of a mixture of at least 2 vegetable oils and a fish oil. The nutrient mixture of claim 4, wherein said mixed oils consist of medium-chain triglycerides, borage oil, European olive oil, one vegetable oil selected from the 'f9(827,inmmdat051,a:\19718syn.res,14 4 1$ group consisting of soybean oil, walnuL oil, and one Libi oil selected from the group consisting of cod liver o11i, sardine oil, and herring oil.
6. The mixture of claim 4, wherein said mixed oilu consist of medium-chain triglycerides, borage oil, ono vegetable oil selected from the group consisting of rapeseed oil and lupin oil, and at least one £fish oil consisting of herring oil and sardine oil.
7. The mixture of claim 4, wherein said mixed oilo consist of medium-chain triglycerides, and blackcurran oil, one vegetable oil selected from the group consisxtinj of groundnut oil, safflower oil, European olive oil, 4 American palm oil, olive oil, African olive oil, and f I. hazelnut oil, and one fish oil selected from the group consisting of herring oil, cod liver oil and sardine oil, o 0*
8. A complete nutrient mixture according to claim 1 and ~substantially as hereinbefore described with reference to the Examples. DATED this 27th day of August 1990. SYNTHELABO By Its Patent Attorneys DAVIES COLLISON fI t i 9008274imndatO51,a:\ 19718syn~res