Use of a Peptide Rather Than Free Amino Acid Nitrogen Source in Chemically Defined “Elemental” Diets

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Abstract
Previous studies have shown that amino acid (AA) residues are absorbed more rapidly from di- and tripeptides than from free AA. In the present study, an intestinal perfusion technique has been used in normal human subjects to compare absorption of AA residues and total α-amino nitrogen (N) from 4 partial enzymic hydrolysates of protein (50–80% of the N contents present as small peptides) and their respective equimolar free AA mixtures. α-Amino N absorption was greater from 2 casein hydrolytes and a lactalbumin hydrolysate than from the respective free AA mixtures but similar to that from a fish protein hydrolysate and its AA mixture. The considerable variation in absorption of individual AA residues from the AA mixtures was much reduced when the protein hydrolysates were perfused, as a number of AA which were poorly absorbed from the AA mixtures were absorbed to a greater extent from the protein hydrolysates. The casein and lactalbumin hydrolysates had a stimulatory effect on jejunal absorption of water and electrolytes. In contrast, the fish protein hydrolysate appeared to cause a mean net secretion of fluid and electrolytes. The findings indicate that when absorption is limited by diminished luminal hydrolysis or absorptive capacity, serious consideration might be given to using partial enzymic hydrolysates of whole protein rather than free AA mixtures as the N source in “elemental” diets. Care should be taken, however, in ensuring that the preparation of choice does not promote a net secretion of fluid and electrolytes for such a property could have a deleterious effect in the clinical setting.