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Enteral and Parenteral Feeding and Orexigenic Peptides

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Diet and Nutrition in Critical Care

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Abstract

Feeding in the first months of life seems to influence the risk of obesity and susceptibility to some diseases, including atherosclerosis. The mechanisms of this relationship are unknown. However, the alterations of secretion of the peptides of the gut-brain axis may likely be responsible for future dietary habits. Among the peptides involved in the regulation of food intake, ghrelin and orexin A constitute the peripheral, orexigenic part of the gut-brain axis. Both peptides stimulate the expression and release of the neuropeptide Y and the agouti-related peptide – the central neuromediators of feeding behaviors. The direct effects of various formulas in infants fed either enterally or parenterally on the fasting and postprandial ghrelin and orexin plasma concentrations have been studied. However, only a few studies in humans included the information on the relationship of orexigenic peptides and parenteral nutrition. Moreover, the data is not consistent mostly due to different indications for parenteral nutrition and the variable duration of the infusions. Continuous parenteral nutrition caused continuous stimulation of the secretion of ghrelin and orexins in infants. Plasma concentrations of these peptides during long-term continuous parenteral nutrition were similar to the postprandial concentrations in the children fed enterally. However, lack of modulation of the secretion of orexigenic peptides, typical for fasting/postprandial phases, during continuous parenteral nutrition may be responsible for alterations in metabolism and development in children fed this way. Among the formulas designated for enteral infant feeding, highly hydrolyzed formulas strongly affect fasting and postprandial ghrelin and orexin A plasma concentrations with possible deleterious developmental effects.

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Abbreviations

AgRP:

Agouti-related peptide

IV:

Intravenous

NPY:

Neuropeptide Y

OXA:

Orexin A

PN:

Parenteral nutrition

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Authors and Affiliations

  1. Department of Clinical Biochemistry, Polish-American Institute of Pediatrics, Jagiellonian University, Collegium Medicum, Wielicka St. 265, 30-663, Krakow, Poland

    Przemyslaw J. Tomasik & Krystyna Sztefko

Authors
  1. Przemyslaw J. Tomasik
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  2. Krystyna Sztefko
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Correspondence to Przemyslaw J. Tomasik .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Tomasik, P.J., Sztefko, K. (2015). Enteral and Parenteral Feeding and Orexigenic Peptides. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_12

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  • DOI: https://doi.org/10.1007/978-1-4614-7836-2_12

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