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Structured Triacylglycerols in Clinical Nutrition

  • Chapter
Intestinal Lipid Metabolism

Abstract

In recent years, intense interest and substantial investigation has been extended to dietary lipids because of their many nutritional, structural, and regulatory functions. A growing body of evidence is quite convincing that a forthcoming major advance in clinical nutrition will be the determination of the optimal types of lipid when formulating specialized diets. Among clinicians caring for the critically ill there is a consensus that dietary lipids are an important source of energy because of their caloric density and low osmolality. In addition they provide a source of essential fatty acids, linoleic acid (18:2n−6) and α-linolenic acid (18:3n−3), that are important for growth and for numerous physiological events related to their effects on eicosanoid metabolism and thus hemodynamics, inflammation, and immunocompetence in patients with various disease states. Dietary lipid also serves to facilitate the absorption of fat-soluble vitamins (A, D, E, K) and other important nutrients (i.e. carotenes, lycopene, flavonoids) that have not been established as essential.

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References

  • Akoh, C. C., 1995, Structured lipids-Enzymatic approach, INFORM 6:1055–1061.

    Google Scholar 

  • Allardyce, D. B., 1982, Cholestasis caused by lipid emulsions, Surg. Gynecol. Obstet. 154:641–647.

    PubMed  CAS  Google Scholar 

  • Angelillo, V. A., Bedi, S., Durfee, D., Dahl, J., Patterson, A. J., and O’Donohue, W. J., 1985, Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia, Ann. Intern. Med. 103:883–885.

    PubMed  CAS  Google Scholar 

  • Babayan, V. K., 1987, Medium chain triacylglycerols and structured lipids, Lipids 22:417–420.

    Article  PubMed  CAS  Google Scholar 

  • Bach, A., and Babayan, V. K., 1982, Medium-chain triacylglycerols: An update, Am. J. Clin. Nutr. 36:950–962.

    PubMed  CAS  Google Scholar 

  • Bach, A., Storck, D., and Meraihi, Z., 1988, Medium chain triglyceride-based fat emulsions: An alternative energy supply in stress and sepsis, J. P. E. N. 12(suppl):82–88.

    Google Scholar 

  • Belin, R. P., Bivins, B. A., Jona, J. Z., and Young, V. L., 1976, Fat overload with a 10% soybean oil emulsion, Arch. Surg. 111:1391–1393.

    Article  PubMed  CAS  Google Scholar 

  • Bistrian, B. R., 1997, Novel lipid sources in parenteral and enteral nutrition, Pro. Nutr. Soc. 56:471–477.

    Article  CAS  Google Scholar 

  • Bonanome, A., and Grundy, S. M., 1988, Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels, N. Engl. J. Med. 318(19): 1244–1248.

    Article  PubMed  CAS  Google Scholar 

  • Carnielli, V. P., Luijendijk, I. H. T., van Goudoever, J. B., Sulkers, E. J., Boerlage, A. A., Degenhart, H. J., and Sauer, P. J. J., 1995, Feeding premature newborn infants palmitic acid in amounts and stereoisomeric position similar to that of human milk: Effects on fat and mineral balance, Am. J. Clin. Nutr. 61:1037–1042.

    PubMed  CAS  Google Scholar 

  • Christensen, M. S., Hoy, C.-E., and Redgrave, T. G., 1994, Lymphatic absorption of n-3 polyunsaturated fatty acids from marine oils with different intramolecular fatty acid distributions, Biochim. Biophys. Acta 1215:198–204.

    Article  PubMed  CAS  Google Scholar 

  • Christensen, M. S., Mullertz, A., and Hoy, C.-E., 1995a, Absorption of triacylglycerols with defined or random structure by rats with biliary and pancreatic diversion, Lipids 30:521–526.

    Article  PubMed  CAS  Google Scholar 

  • Christensen, M. S., Hoy, C.-E., Becker, C. C., and Redgrave, T. G., 1995b, Intestinal absorption and lymphatic transport of eicosapentaenoic (EPA), docosahexaenoic (DHA), and decanoic acids: Dependence on intramolecular triacylglycerol structure, Am. J. Clin. Nutr. 61:56–61.

    PubMed  CAS  Google Scholar 

  • Crosby, L. E., Swenson, E. S., Babayan, V. K., Bistrian, B. R., and Blackburn, G. L., 1990, Effect of structured lipid-enriched total parenteral nutrition in rats bearing Yoshida Sarcoma, J. Nutr. Biochem. 1:41–47.

    Article  PubMed  CAS  Google Scholar 

  • DeMichele, S. J., Karlstad, M. D., Babayan, V. K., Istfan, N., Blackburn, G. L., and Bistrian, B. R., 1988, Enhanced skeletal muscle and liver protein synthesis with structured lipid in enterally fed burned rats, Metabolism 37:787–795.

    Article  PubMed  CAS  Google Scholar 

  • DeMichele, S. J., Karlstad, M. D., Bistrian, B. R., Istfan, N., Babayan, V. K., and Blackburn, G. L., 1989, Enteral nutrition with structured lipid: Effect on protein metabolism in thermal injury, Am. J. Clin. Nutr. 50:1295–1302.

    PubMed  CAS  Google Scholar 

  • du Toit, D. F., Villet, W. T., and Heydenrych, J., 1978, Fat-emulsion deposition in mononuclear phagocytic system, Lancet 2:898.

    Article  PubMed  Google Scholar 

  • Fan, S. T., Lo, C. M., Lai, E. C., Chu, K. M., Liu, C. L., and Wong, J., 1994, Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma, N. Engl. J. Med. 331:1547–1552.

    Article  PubMed  CAS  Google Scholar 

  • Filer, L. J., Jr., Mattson, F. H., and Fomon, S. J., 1970, Triacylglycerol configuration and fat absorption by the human infant, J. Nutr. 99:293–298.

    Google Scholar 

  • Finley, J. W., Leveille, G. A., Dixon, R. M., Walchak, C. G., Sourby, J. C., Smith, R. E., Francis, K. D., and Otterburn, M. S., 1994, Clinical assessment of SALATRIM, a reduced-calorie triacylglycerol, J. Agric. Food Chem. 42:581–596.

    Article  CAS  Google Scholar 

  • Fischer, G. W., Hunter, K. W., Wilson, S. R., and Mease, A. D., 1980, Diminished bacterial defense with Intralipid, Lancet 2:819–820.

    Article  PubMed  CAS  Google Scholar 

  • Forbes, G. B., 1978, Splenic lipidosis after administration of intravenous fat emulsions, J. Clin. Path. 31:765–771.

    Article  PubMed  CAS  Google Scholar 

  • Freidman, Z., Marks, K. H., Maisels, M. J., Thorson, R., and Naeye, R., 1978, Effect of parenteral fat emulsion on the pulmonary and reticuloendothelial systems in the newborn infant, Pediatrics 61:694–698.

    Google Scholar 

  • Fujimoto, K., Price, V. H., Granger, D. N., Specian, R., Bergstedt, S., and Tso, P., 1991, Effect of ischemia-reperfusion on lipid digestion and absorption in rat intestine, Am J. Physiol. 260:G595–G602.

    PubMed  CAS  Google Scholar 

  • Gollaher, C. J., Fechner, K., Karlstad, M., Babayan, V. K., and Bistrian, B. R., 1993, The effects of increasing levels of fish oil containing structured triacylglycerols on protein metabolism in parenterally fed rats stress by burn plus endotoxin, J. P. E. N. 17:247–253.

    CAS  Google Scholar 

  • Gottschlich, M. M., 1992, Selection of optimal lipid sources in enteral and parenteral nutrition, Nutr. Clin. Prac. 7:152–165.

    Article  CAS  Google Scholar 

  • Greene, H. L., Hazlett, D., and Demaree, R.,1976, Relationship between Intralipid-induced hyperlipemia and pulmonary function, Am. J. Clin. Nutr. 29:127–135.

    PubMed  CAS  Google Scholar 

  • Hamawy, K. J., Moldawer, L. L., Georgieff, M., Valicenti, A. J., Babayan, V. K., Bistrian, B. R., and Blackburn, G. L., 1985, Effect of lipid emulsions on the reticuloendothelial system function in the injured animal, J. P. E. N 9:559–565.

    CAS  Google Scholar 

  • Haumann, B. F., 1997, Structured lipids allow fat tailoring, INFORM 8:1004–1011.

    Google Scholar 

  • Hinton, P. S., Peterson, C. A., McCarthy, D. O., and Ney, D. M., 1998, Medium-chain compared with long-chain triacylglycerol emulsions enhance macrophage response and increase mucosal mass in parenterally fed rats, Am. J. Clin. Nutr. 67:1265–1272.

    PubMed  CAS  Google Scholar 

  • Hubbard, V. S., and McKenna, M. C., 1987, Absorption of safflower oil and structured lipid preparations in patients with cystic fibrosis, Lipids 22:424–428.

    Article  PubMed  CAS  Google Scholar 

  • Jandacek, R. J., Whiteside, J. A., Holcombe, B. N., Volpenhein, R. A., and Tavlbee, J.D., 1987, The rapid hydrolysis and efficient absorption of triacylglycerols with octanoic acid in the 1 and 3 positions and long chain fatty acid in the 2 position, Am. J. Clin. Nutr. 45:940–945.

    PubMed  CAS  Google Scholar 

  • Jensen, G. L., Mascioli, E. A., Meyer, L. P., Lopes, S. M., Bell, S. J., Babayan, V. K., Blackburn, G. L., and Bistrian, B. R., 1989, Dietary modification of chyle composition in chylothorax, Gastroenterol 97:761–765.

    CAS  Google Scholar 

  • Jensen, G. L., Mascioli, E. A., Seidner, D. L., Istfan, N. W., Domnitch, A. M., Selleck, K., Babayan, V. K., Blackburn, G. L., and Bistrian, B. R., 1990, Parenteral infusion of long- and medium-chain triacylglycerols and reticuloendothelial function in man, J. P. E. N. 14:467–471.

    CAS  Google Scholar 

  • Jensen, G. L., McGarvey, N., Taraszewki, R., Wixson, S. K., Seidner, D. L., Pai, T., Yeh, Y. Y., Lee, T. W., and DeMichele, S. J., 1994, Lymphatic absorption of enterally fed structured triacylglycerol vs. physical mix in a canine model, Am. J. Clin Nutr. 60:518–524.

    PubMed  CAS  Google Scholar 

  • Jensen, M. M., Christensen, M. S., and Hoy, C.-E., 1994, Intestinal absorption of octanoic, decanoic, and linoleic acids: Effect of triacylglycerol structure, Ann. Nutr. Metab. 38:104–116.

    Article  PubMed  CAS  Google Scholar 

  • Johnson, R. C., Young, S. K., Cotter, R., Lin, L., and Rowe, W. B., 1990, Medium-chain triacylglycerol lipid emulsion: Metabolism and tissue distribution, Am. J. Clin. Nutr. 52:502–508.

    PubMed  CAS  Google Scholar 

  • Kaminski, D. L., Adams, A., and Jellinek, M., 1980, The effect of hyperalimentation on hepatic lipid content and lipogenic enzyme activity in rats and man, Surg. 88:93–100.

    CAS  Google Scholar 

  • Kayden, H. J., Senior, J. R., and Mattson, F. H., 1967, The monoglyceride pathway of fat absorption in man, J. Clin. Invest. 46:1695–1703.

    Article  PubMed  CAS  Google Scholar 

  • Kenler, A. S., Swails, W. S., Driscoll, D. S., DeMichele, S. J., Daley, B., Babineau, T. J., Peterson, M. B., and Bistrian, B. R., 1996, Early enteral feeding in postsurgical cancer patients: Fish oil structured lipid-based polymeric formula versus a standard polymeric formula, Ann. Surg. 223:316–333.

    Article  PubMed  CAS  Google Scholar 

  • Klemann, L. P., Aji, K., Chrysam, M. M., D’Amelia, R. P., Henderson, J. M., Huang, A. S., Otterburn, M. S., and Yarger, R. G., 1994, Random nature of triacylglycerols produced by the catalyzed interesterification of short-and long-chain fatty acid triacylglycerols, J. Agric. Food Chem. 42:442–446.

    Article  CAS  Google Scholar 

  • Lanza-Jacoby, S., and Tabares, A., 1990, Triacylglycerol kinetics, tissue lipoprotein lipase, and liver lipogenesis in septic rats, Am. J. Physiol. 258:E676–E685.

    Google Scholar 

  • Lanza-Jacoby, S., Lansey, S. C., Cleary, M. P., and Rosato, F. E., 1982, Alterations in lipogenic enzymes and lipoprotein lipase activity during gram-negative sepsis in the rat, Arch. Surg. 117:144–147.

    Article  PubMed  CAS  Google Scholar 

  • Lanza-Jacoby, S., Phetteplace, H., and Tripp, R., 1995, Enteral feeding a structured lipid emulsion containing fish oil prevents the fatty liver of sepsis, Lipids 30:707–712.

    Article  PubMed  CAS  Google Scholar 

  • Levene, M. J., Wigglesworth, J. S., and Desai, R., 1980, Pulmonary fat accumulation after Intralipid infusion in the preterm infant, Lancet 2:815–818.

    Article  PubMed  CAS  Google Scholar 

  • Ling, P. R., Istfan, N. W., Lopes, S. M., Babayan, V. K., Blackburn, G. L., and Bistrian, B. R., 1991, Structured lipid made from fish oil and medium-chain triacylglycerols alters tumor and host metabolism in Yoshida-sar-coma-bearing rats, Am. J. Clin. Nutr. 53:1177–1184.

    PubMed  CAS  Google Scholar 

  • Macfie, J., Smith, R. C., and Hill, G. L., 1981, Glucose or fat as nonprotein energy source? A controlled clinical trial in gastroenterologic patients requiring intravenous nutrition, Gastroenterol. 80:103–107.

    CAS  Google Scholar 

  • Maiz, A., Yamazaki, K., Sobrado, J., Babayan, V. K., Moldawer, L. L., Bistrian, B. R., and Blackburn, G. L., 1984, Protein metabolism during total parenteral nutrition (TPN) in injured rats using medium-chain triacylglycerols, Metabolism 33:901–909.

    Article  PubMed  CAS  Google Scholar 

  • Mascioli, E. A., Babayan, V. K., Bistrian, B. R., and Blackburn, G. L., 1988, Novel triacylglycerols for special medical purposes, J. P. E. N. 2(suppl):127S–132S.

    Google Scholar 

  • Mascioli, E. A., Randall, S., Porter, K. A., Kater, G., Lopes, S., Babayan, V. K., and Blackburn, B. R., 1991, Thermogenesis from intravenous medium-chain triacylglycerols, J. P. E. N. 15:27–31.

    CAS  Google Scholar 

  • McKenna, M. C., Hubbard, V. S., and Pieri, J. G., 1985, Linoleic acid absorption from lipid supplements in patients with cystic fibrosis with pancreatic insufficiency and in control subjects, J. Pediatr. Gastroenterol. Nutr. 4:45–51.

    Article  PubMed  CAS  Google Scholar 

  • Mendez, B., Ling, P. R., Istfan, N. W., Babayan, V. K., and Bistrian, B. R., 1992, Effects of different lipid sources in total parenteral nutrition on whole body protein kinetics and tumor growth, J. P. E. N. 16:545–551.

    CAS  Google Scholar 

  • Merolli, A., Lindemann, J., and Del Vecchio, A. J., 1997, Medium-chain lipids: New sources, uses, INFORM 8:597–603.

    Google Scholar 

  • Metges, C. C., and Wolfram, G., 1991, Medium- and long-chain triacylglycerols labeled with 13C: A comparison of oxidation after oral or parenteral administration in humans, J. Nutr. 121:31–36.

    PubMed  CAS  Google Scholar 

  • Mok, K. T., Maiz, A., Yamazaki, K., Sobrado, J., Babayan, V. K., Moldawer, L. L., Bistrian, B. R., and Blackburn, G. L., 1984, Structured medium-chain triacylglycerols and long-chain triacylglycerols are superior to physical mixtures in sparing body protein in the burned rat, Metabolism 33:910–915.

    Article  PubMed  CAS  Google Scholar 

  • Nordenstrom, J., Jarstrand, C., and Wiernik, A., 1979, Decreased chemotactic and random migration of leukocytes during Intralipid infusion, Am. J. Clin. Nutr. 32:2416–2422.

    PubMed  CAS  Google Scholar 

  • Pomposelli, J. J., Moldawer, L. L., Palombo, J. D., Babayan, V. K., Bistrian, B. R., and Blackburn, G. L., 1986, Short-term administration of parenteral glucose-lipid mixtures improves protein kinetics in porta caval shunted rats, Gastroenterol. 91:305–312.

    CAS  Google Scholar 

  • Seidner, D. L., Mascioli, E. A., Istfan, N. W., Porter, K. A., Selleck, K., Blackburn, G. L., and Bistrian, B. R., 1989, Effects of long-chain triacylglycerol emulsions on reticuloendothelial system function in humans, J. P. E. N. 13:614–619.

    CAS  Google Scholar 

  • Sheldon, D. F., Peterson, S. R., and Sanders, R., 1978, Hepatic dysfunction during hyperalimentation, Ann. Surg. 113:504–509.

    CAS  Google Scholar 

  • 113:504–509. Small, D. M., 1991, The effects of glyceride structure on absorption and metabolism, Annu. Rev. Nutr. 11:413–434.

    Article  PubMed  CAS  Google Scholar 

  • Smith, R. E., Finley, J. W., and Leveille, G. A., 1994, Overview of SALATRIM, a family of low-calorie fats,J. Agric. Food Chem. 42:432–434.

    Article  CAS  Google Scholar 

  • Sobrado, J., Moldawer, L. L., Pomposelli, J. J., Mascioli, E. A., Babayan, V. K., Bistrian, B. R., and Blackburn,G. L., 1985, Lipid emulsions and reticuloendothelial system function in healthy and burned guinea pigs,Am. J. Clin. Nutr. 42:855–863.

    PubMed  CAS  Google Scholar 

  • Am. J. Clin. Nutr. 42:855–863. Summers, L. K., Frayn, K. N., Quinlan, P. T., Ilic, V., and Fielding, B. A., 1998, The effect of triacylglycerol-fatty acid positional distribution on postprandial metabolism in subcutaneous adipose tissue, Br. J. Nutr. 79:141–147.

    Article  PubMed  CAS  Google Scholar 

  • Sundstrom, G., Zauner, C. W., and Arborelius, M., 1973, Decrease in pulmonary diffusing capacity during lipid infusion in healthy men, J. Appl. Physiol. 34:816–820.

    PubMed  CAS  Google Scholar 

  • Swails, W. S., Kenler, A. S., Driscoll, D. F., DeMichele, S. J., Babineau, T. J., Utsunamiya, T., Chavali S., Forse,R. A., and Bistrian, B. R., 1997, Effect of a fish oil structured lipid-based diet on prostaglandin release from mononuclear cells in cancer patients after surgery, J. P. E. N. 21:266–274.

    CAS  Google Scholar 

  • Swenson, E. S., Selleck, K. M., Babayan, V. K., Blackburn, G. L., and Bistrian, B. R., 1991, Persistence of metabolic effects after long-term oral feeding of a structured triacylglycerol derived from medium-chain triacylglycerol and fish oil in burned and normal rats, Metabolism 40:484–490.

    Article  PubMed  CAS  Google Scholar 

  • Teo, T. C., DeMichele, S. J., Selleck, K. M., Babayan, V. K., Blackburn, G. L., and Bistrian, B. R., 1989, Administration of structured lipid composed of MCT and fish oil reduces net protein catabolism in enterally fed burned rats, Ann. Surg. 210:100–107.

    Article  PubMed  CAS  Google Scholar 

  • Teo, T. C., Selleck, K. M., Wan J.M. F., Pompeselli, J. J., Babayan, V. K., Blackburn, G. L., and Bistrian B. R.,1991, Long-term feeding with structured lipid composed of medium-chain and n-3 fatty acids ameliorates endotoxic shock in guinea pigs, Metabolism 40:1152–1159.

    Article  PubMed  CAS  Google Scholar 

  • Tso, P., Karlstad, M. D., Bistrian, B. R., and DeMichele, S. J., 1995, Intestinal digestion, absorption and transport of structured triacylglycerols and cholesterol in rats, Am. J. Physiol. 268:G568–G577.

    PubMed  CAS  Google Scholar 

  • Tso, P., Lee, T., and DeMichele, S. J., 1999, Lymphatic absorption of structured triglycerides vs. physical mix in a rat model of fat malabsorption, Am. J. Physiol. 277(Gastrointest. Liver Physiol. 40):G333–G340.

    PubMed  CAS  Google Scholar 

  • Venus, B., Patel, C. B., Mathru, M., and Sandoval, E. D., 1984, Pulmonary effects of lipid infusion in patients with acute respiratory failure, Crit. Care Med. 12:293.

    Google Scholar 

  • Venus, B., Smith, R. A., Patel, C., and Sandoval, E., 1989, Hemodynamic and gas exchange alterations during intralipid infusion in patients with adult respiratory distress syndrome, Chest 95:1278–1281.

    Article  PubMed  CAS  Google Scholar 

  • Wardlaw, G. M., Snook, J. T., Park, S., Patel, P. K., Pendley, F. C., Lee, M. S., and Jandacek, R. J., 1995, Relative effects on serum lipids and apolipoproteins of a caprenin-rich diet compared with diets rich in palm oil/palm kernel oil or butter, Am. J. Clin Nutr. 61:535–542.

    PubMed  CAS  Google Scholar 

  • Wheeler, E., 1995, Commercial potential for Salatrim, INFORM 6:1156–1159.

    Google Scholar 

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DeMichele, S.J., Bistrian, B.R. (2001). Structured Triacylglycerols in Clinical Nutrition. In: Mansbach, C.M., Tso, P., Kuksis, A. (eds) Intestinal Lipid Metabolism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1195-3_22

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