Substrate interaction in intravenous feeding. Comparative effects of carbohydrate and fat on amino acid utilization in fasting man

B. M. Wolfe, J. M. Culebras, A. J.W. Sim, M. R. Ball, F. D. Moore

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

Data are presented on the metabolic and endocrine effects of intravenous infusions in normal fasting man observed under highly controlled conditions over a period of 6 to 8 days duration. There are comparative data on a variety of intravenous feeding programs. The data on total starvation are based on studies from the literature, some of which were carried out in this laboratory. The data on low dose glucose, high dose glucose, glycerol, fat emulsion, and amino acids, each given separately, demonstrate changes seen with simple infusion of a single substrate in fasting. These data are now compared with the utilization of amino acid infusions when accompanied by low dose glucose, high dose glucose, glycerol, and fat emulsion. In all, 9 experimental intravenous feeding programs are presented, based on data from 35 subjects observed over a total of 370 subject-days. The findings show a strong interaction between glucose or lipid and protein metabolism. In fasting, glucose had protein sparing effect, most evident when given at high dose. Glycerol, in an amount equal to that contained in 2000 ml of 10% fat emulsion, had a mild protein sparing effect. Fat emulsion was no more effective. When amino acids were given alone, normal fasting human subjects were always in negative nitrogen balance with the daily nitrogen loss half that seen in starvation alone. Although amino acids given alone have a protein sparing effect, this is accomplished only at the expense of a high nitrogen excretion including an amount equivalent to the entire infusion plus an additional loss from the body's native proteins.

Original languageEnglish (US)
Pages (from-to)518-540
Number of pages23
JournalUnknown Journal
Volume186
Issue number4
DOIs
StatePublished - 1977

ASJC Scopus subject areas

  • Surgery

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