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Research article

A critical evaluation of the anabolic response after bolus or continuous feeding in COPD and healthy older adults

Renate Jonker, Nicolaas E.P. Deutz, Rajesh Harrykissoon, Anthony J. Zachria, Eugene A. Veley, Mariëlle P.K.J. Engelen
Clinical Science Jan 02, 2018, 132 (1) 17-31; DOI: 10.1042/CS20171068
Renate Jonker
Department of Health and Kinesiology, Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX, U.S.A.
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Nicolaas E.P. Deutz
Department of Health and Kinesiology, Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX, U.S.A.
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Rajesh Harrykissoon
Center for Pulmonary and Sleep Disorders, College Station Medical Center, College Station, TX, U.S.A.
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Anthony J. Zachria
Center for Pulmonary and Sleep Disorders, College Station Medical Center, College Station, TX, U.S.A.
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Eugene A. Veley
Department of Medicine, Division of Pulmonary Critical Care, Baylor Scott and White Health, College Station, TX, U.S.A.
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Mariëlle P.K.J. Engelen
Department of Health and Kinesiology, Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX, U.S.A.
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  • For correspondence: mpkj.engelen@ctral.org
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Abstract

After bolus and continuous enteral feeding of the same protein, different digestion and absorption kinetics and anabolic responses are observed. Establishing which mode of feeding has the highest anabolic potential in patients with chronic obstructive pulmonary disease (COPD) may aid in the prevention of muscle wasting, but an important confounding factor is the duration of assessments after bolus feeding. We hypothesized that the anabolic response to bolus and continuous feeding in COPD patients is comparable when methodological issues are addressed. Twenty-one older adults (12 patients with stage II–IV COPD and 9 healthy controls) were studied after intake of a fast-absorbing hydrolyzed casein protein–carbohydrate mixture either as a single bolus or as small sips (crossover design). Whole body protein synthesis (PS), breakdown (PB), net PS (PS − PB) protein efficiency (netPSPE), net protein balance (phenylalanine (PHE) intake – PHE hydroxylation) protein efficiency (netBalPE), and splanchnic PHE extraction (SPEPHE) were assessed using stable isotope tracer methodology. Bolus feeding assessments were done at 90, 95, and 99% of the calculated duration of the anabolic response. At 99%, netBalPE was higher for sip feeding than bolus feeding in both groups (P<0.0001). Nevertheless, bolus feeding was associated with a lower SPEPHE (P<0.0001) and higher netPSPE (P<0.0001). At 90% compared with 99%, PS and netBalPE after bolus feeding was significantly overestimated. In conclusion, several factors complicate a comparison of the anabolic capacity of bolus and continuous feeding in acute studies, including the critical role of SPE calculation and assumptions, and the duration of postprandial assessments after bolus feeding.

  • casein
  • nutritional supplementation
  • protein synthesis
  • protein anabolism
  • protein breakdown
  • Abbreviations

    AUC,
    area under the curve;
    COPD,
    chronic obstructive pulmonary disease;
    cTTR,
    plasma tracer-tracee;
    FEV1,
    forced expiratory volume in 1 s;
    FFM,
    fat-free mass;
    FVC,
    forced vital capacity;
    InfIV,
    intravenous infusion;
    netBalPE,
    net protein balance protein efficiency;
    netPSPE,
    net protein synthesis protein efficiency;
    PB,
    protein breakdown;
    PHE,
    phenylalanine;
    PS,
    protein synthesis;
    SPE,
    splanchnic extraction;
    TYR,
    tyrosine;
    WbRa,
    whole body rate of appearance
    • © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society
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    January 2018

    Volume: 132 Issue: 1

    Clinical Science: 132 (1)
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    A critical evaluation of the anabolic response after bolus or continuous feeding in COPD and healthy older adults
    Renate Jonker, Nicolaas E.P. Deutz, Rajesh Harrykissoon, Anthony J. Zachria, Eugene A. Veley, Mariëlle P.K.J. Engelen
    Clinical Science Jan 2018, 132 (1) 17-31; DOI: 10.1042/CS20171068
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    A critical evaluation of the anabolic response after bolus or continuous feeding in COPD and healthy older adults
    Renate Jonker, Nicolaas E.P. Deutz, Rajesh Harrykissoon, Anthony J. Zachria, Eugene A. Veley, Mariëlle P.K.J. Engelen
    Clinical Science Jan 2018, 132 (1) 17-31; DOI: 10.1042/CS20171068

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    Keywords

    casein
    nutritional supplementation
    protein synthesis
    protein anabolism
    protein breakdown

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