Short-term protein intake and stimulation of protein synthesis in stunted children with cystic fibrosis.
BACKGROUND
Stunted children with cystic fibrosis (CF) have less net protein anabolism than do children without CF, and the result is retarded growth in the CF patients. It is not known whether protein intake above that recommended by the Cystic Fibrosis Foundation would further stimulate whole-body protein synthesis.


OBJECTIVE
We studied the effects of 3 amounts of protein intake on whole-body protein synthesis and breakdown by using isotopic infusion of [1-(13)C]valine and [(15)N(2)]urea in children with stable CF who required tube feeding.


METHODS
In 8 pediatric CF patients, we administered 3 randomly allocated isocaloric diets with normal (NP), intermediate (IP), and high (HP) amounts of protein (1.5, 3, and 5 g . kg(-1) . d(-1), respectively) by continuous drip feeding during a 4-d period at 6-wk intervals. Each patient acted as his or her own control. On the fourth day of feeding, whole-body protein synthesis and breakdown were measured.


RESULTS
Protein synthesis was significantly higher in the HP group (x +/- SEM: 1.78 +/- 0.07 micromol . kg(-1) . min(-1)) than in the IP (1.57 +/- 0.08 micromol . kg(-1) . min(-1); P=0.001) and NP (1.37 +/- 0.07 micromol . kg(-1) . min(-1); P < 0.001) groups. There were no significant differences in protein breakdown. Net retention of nitrogen was significantly higher in the HP group (12.93 +/- 1.42 micromol . kg(-1) . min(-1)) than in the IP (7.61 +/- 1.40 micromol . kg(-1) . min(-1); P=0.01) and HP (2.48 +/- 0.20 micromol . kg(-1) . min(-1); P < 0.001) groups.


CONCLUSIONS
In stunted children with CF requiring tube feeding, the highest stimulation of whole-body protein synthesis was achieved with a short-term dietary protein intake of 5 g . kg(-1) . d(-1).
Geukers
Vincent G M
VG
Department of Pediatric Intensive Care, Academic Medical Center, Amsterdam, The Netherlands. v.g.geukers@amc.uva.nl
Oudshoorn
Johanna H
JH
Taminiau
Jan A J M
JA
van der Ent
Cornelis K
CK
Schilte
Piet
P
Ruiter
An F C
AF
Ackermans
Mariëtte T
MT
Endert
Erik
E
Jonkers-Schuitema
Cora F
CF
Heymans
Hugo S S
HS
Sauerwein
Hans P
HP
D001827:Body Height / Q000187:drug effects* / Q000502:physiology; D002247:Carbon Isotopes; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000378:metabolism* / Q000628:therapy; D004044:Dietary Proteins / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009587:Nitrogen Isotopes; D009751:Nutritional Requirements; D010288:Parenteral Nutrition; D011446:Prospective Studies; D014176:Protein Biosynthesis / Q000187:drug effects / Q000502:physiology; D011506:Proteins / Q000378:metabolism; D014508:Urea / Q000378:metabolism; D014633:Valine / Q000378:metabolism
D002247:Carbon Isotopes; D004044:Dietary Proteins; D009587:Nitrogen Isotopes; D011506:Proteins; D014508:Urea; D014633:Valine