Clinical Nutrition
Nutraceutics
Part I
Clinical Nutrition /Enteral Nutrition
What is clinical nutrition?
Clinical nutrition is nutrition of patients in health care.
It aims to keep a healthy energy balance in patients,
as well as providing sufficient amounts other nutrients
such as protein, vitamins, minerals.*
Parenteral Nutrition Enteral Nutrition: all non parenteral applications
only per mouth * Wikipedia
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Jun-12
Daily Basic Needs
kg body weight for 70kg
Water: 20-40ml 1400 - 2500ml
Aminoacids: 0.7-1.5g 50 - 100g
Carbohydrates: 2-6g 150 - 400g
Lipids: 0.5 – 1.5g 35- 100g
+ fibers
+ minerals
+ oligoelements
Energy* (/kg body weight/day)
Medical patient 30kcal
Postoperative patient 30 – 45kcal
Hypercatabolic patient 45 – 60kcal
Specific needs for specific diseases / ages …
* Merck manual
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Jun-12
Liquid parenteral preparations – Roquette’s offer
Lycadex PF
Neosorb PF
European parenteral nutrition
market (Mill USD)
Growth rate 9.8% year
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Jun-12
Liquid oral preparations
• Obtained via an UHT process
• Energy density 1.0 – 2.5 kcal /g
• Frequently isotonic
• Low viscosity
Typical Composition
Water: 75-84 %
Carbohydrates: 14-20 %
Protein: ~4%
Fat: 4-5 %
Minerals, trace elements
Vitamins
Eventually fibers 1-2 %
European tendency: hyper caloric preparations (min. 2kcal/g)
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Jun-12
Liquid oral preparations – Roquette’s offer
Carbohydrates: mainly starch derivatives
Maltodextrins (powder and liquid), glucose syrup
slow carbohydrates: tapioca dextrin's (Cleargum TA)
Proteins: usually milk proteins
Nutralys S – pea protein
Lipids: no offer
Fiber concept: Nutriose, high amylose starch, dextrin
Functional starch derivatives (e.g. as viscosifyer)
Clearam CI 20, CI 30
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Jun-12
Other oral preparations – Roquette’s offer
Creme products but also powders
Interest for patients with Dysphagia
Typically 1.5 kcal/g
Carbohydrates: mainly starch derivatives
Maltodextrins (powder and liquid), glucose syrup
slow carbohydrates: tapioca dextrin's (Cleargum TA)
Proteins: Nutralys S – pea protein
Nutralys W – soluble wheat protein
Fiber concept: Nutriose, Dextrin
Functional starch derivatives as viscosifyer
! e.g. Clearam CI 20 00, CI 30 00 or CR 20 30
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Jun-12
Proteins in clinical Nutrition
European Market
Dairy Proteins 16 kT (10.6 kT = Casein and Caseinate)
Soy 0.2 kT
Pea 0.1 kT
Rice 1.5 kT
• Dairy proteins become excessively expensive
• Other vegetable proteins are an alternative
for low allergy and lactose free products
• Pea protein acts as a complementary protein
to dairy proteins since it is cost effective
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Jun-12
Pea Protein in clinical Nutrition
Main nutritional facts
Digestibility : 98%*, low anti-nutritional factors
Amino Acid Score (AAS) – FAO 2008
95 for adults
88 for children 3-10 years old
PDCAAS** – FA0 2008
93 for adults
85 for children 3-10 years old
Complementary proteins : good synergy with cereal proteins for lysine,
cysteine + methionine/ with dairy proteins for arginine
Intermediate- fast protein
Not a major allergen (EU directive 2000/13/CE)
Pea protein is a valuable and highly digestible protein
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Jun-12
Proteins in clinical Nutrition
Key advantages of pea protein
Easy to use
high solubility, low viscosity, emulsifying capacity
Good taste
Alternative for soy and dairy proteins
no part of major allergen lists
Vegetarian products
Cost reduction in nutritional products
Nutralys S 85
Nutralys 85 XF exp
fine powder with improved taste in liquids
especially for powders for dissolving
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Jun-12
Fibers in clinical Nutrition
NUTRIOSE®: stable fiber
ACID STABLE THERMALLY STABLE SHEAR STABLE
Great stability at low pH,
making NUTRIOSE® perfect NUTRIOSE® shows terrific
NUTRIOSE® has excellent stability in high shear
for beverages, confections,
thermal stability showing no conditions, allowing for use in
and any other acidic
fibre loss in a variety of extruded products.
products
heated processing
EFFECTIVE DOSING
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Jun-12
Clinical Nutrition a dynamic market!!!
European market
Future important market segment for Roquette
* Source Kline
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Jun-12
Clinical Nutriton
Nutraceutics
Part II
Nutraceutics
Nutraceuticals ?
Hippocrates: “Let food be the medicine.”
Nutraceutical products typically claim to
prevent chronic diseases, improve health,
delay the aging process and increase life expectancy
Categories: Dietary Supplements / Functional Foods /
Medical food ( = “clinical nutrition”) / Farmaceuticals….
Food or food product that reportedly provides
health and medical benefits,
including the prevention and treatment of disease.*
European Union’s Food Supplements Directive of 2002
* Wikipedia
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Jun-12
Nutraceuticals Roquette’s offer
Products: Proteins
Fibers
Chlorella Microalgae
Lycatab mineral
…
Typical Applications:
Weight management (Nutriose, Proteins)
Bone health (Lycatab mineral, Proteins)
Detox (Chlorella)
Sports Nutrition (pea protein, maltodextrin)
Food supplement (Chlorella, Lycatab mineral)
…
Next slides some highlights on products and health benefits
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Jun-12
Chlorella Algae
20 photo bioreactors of 25 km of glass tubes each, that is to say
500 km of tubes in total
Photo bioreactors are housed in a green house of 1,2 ha.
Composition per 100g
Proteins 45-55 g
Carbs 30-35 g
Dietary fibres 15-26 g
Fats 8-13 g
Energy value 1350-1500 kJ
Chlorophyll 2.5-4.5 g
Carotenoids 50-200 mg
Lutein 50-120 mg
Vitamin B12 100 – 260 µg
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Jun-12
Chlorella: a cocktail of nutritional compounds…
- A high quality protein content
- A privileged source of vitamins and minerals
significant amount of vitamin B12
- A wide variety of pigments
A good source of chlorophyll
Interesting content in lutein
Benefits to be valued thanks to nutritionals studies (in
progress)
- The most studied benefits for humans are:
• Detoxification
• Immune system regulation properties
• Wound healing & anti-inflammation
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Jun-12
Lycatab mineral CC 190
Compound: CaCO3 90% and potato starch 10%
Meant for direct compression,
Food supplements
Calcium content 36%
Indications
Bone health
Calcium supplementation
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Jun-12
Soluble Fiber
Food labeling: « dextrin »
Fiber content: 85%
Indications
Fiber Source
Prebiotic effect Nutritionists recommend:
Gastrointestinal well beeing 25g/day minimum, optimally 30g/day (adults)
Weight management
Real daily uptake: between 10 and 20 g
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Jun-12
Weight management
Mean body weight over 9 weeks
−Randomized, placebo-controlled, double blind, parallel, single-center trial
−5 groups of 20 Chinese adult volunteers
−Orange juice twice daily alone or with NUTRIOSE® at 8g/d or 14g/d or 18g/d or 24g/d
−9 weeks
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Jun-12
Range of Pea protein Nutralys
Wheat Protein Nutralys W
Official claims in the EU (EC 432/2012) of 16. May 2012
- Protein contributes to a growth in muscle mass
- Protein contributes to the maintenance of muscle mass
- Protein contributes to the maintenance of normal bones
Protein is an important ingredient for:
sportive people
elderly people
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Jun-12
Proteins for sportive people
Specific amino-acid role and level NUTRALYS® Caseinate Whey Soya
content content content protein
content
Branched-chain amino acids 18.1% 22% 21.6% 17.4%
Energy metabolism
Maintenance of muscle protein
Regulatory role on glycemia when
low energy intake via modulation of
insulin signaling
Arginine 8.7% 8.3% 1.9% 7.3%
Immune system efficacy
Role in tissue healing and repair
Role in cellular division (collagen
formation and bone and tendon
development)
Essential amino acids (Leucine, Isoleucine,and Valine) are active in energy metabolism.
That is the reason why their storage in muscles lowers during effort. A higher consumption of
those amino acids helps the recovery for fatigued muscles.
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Legumes
Jun-12 protein are quite rich in branched-chain amino acids
Proteins for well aging
Sarkopenia
Increased Fat
48 years 70 years mass
old old
Muscle
mass
YOUNG OLD
ACTIVE SEDENTARY
Cross-sections at the mid thigh of males
Between 20 and 80 years old: - 30% muscle mass
incapacity to move: performance (hand grip) and muscle strength
Problem to swallow/masticate, fatigability and fall risk
Protein requirements (able-bodied): 0.83 g / kg / day
RDA: 1 g / kg / day and 11-15% of total calorie intake
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Jun-12
Proteins for well aging
Arginine and muscle metabolism
Arginine is involved in nitrogen metabolism, growth and cell division
Arginine is a precursor of creatine, which regenerates ADP in ATP in muscle
Muscular pools of creatine decrease during ageing
Need for a good dietary intake of Arginine to counteract ageing
Cysteine and nutrients absorption
Cysteine is involved in the metabolism of biliary salts
Cysteine is derived from methionine
Conversion from methionine to cysteine decreases during ageing
Need for a good dietary intake of Cysteine to counteract ageing
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Jun-12
Nutraceuticals Roquette’s offer
3 Nutrition & Health Themes
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Jun-12
Some Roquette concepts:
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Jun-12
Dedicated documentations for each concept or product
Examples:
Formulations / Recipes on request
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Jun-12
Some Roquette concepts:
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Jun-12
Some Roquette concepts:
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Jun-12
Nutraceuticals Roquette’s offer
Multitude of
- Health Benefits
- Functional Properties
- Cost Optimization Possibilities
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Nutraceuticals Roquette’s offer
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