Fresubin Protein Duo

Smart blending for sustained Amino Acid release.

Fresubin Tube feeds with protein Duo

 

Flexible protein source combinations for different patient needs 

Digestibility and kinetics of different protein sources vary with a significant impact on Amino Acid availability1. The Protein Duo concept in Fresubin Standard Tube Feeds smartly blends casein-based proteins with whey or soy-based proteins flexibly and adapted to products intended use in different patients.

Casein-based proteins have a physiological ability to aggregate in the stomach leading to a slow gastric emptying to the intestine and absorption to the blood.

With this, slow acting proteins such as casein, may have a modest effect on Muscle Protein Synthesis (MPS) but ensure a prolonged availability of Amino Acids by inhibiting whole body protein loss. 1

Slow acting proteins

Fast and intermediate acting proteins such as whey-based proteins and soy-based proteins empty faster from the stomach to the intestine.

This results in a rapid digestion of aminoacids that induces a pronounced aminoacidemia resulting in an increased Muscle Protein Synthesis (MPS) via mTOR stimulation. 2

Fast acting proteins

 

Fresubin Protein Duo: the smart protein fusion

Protein Duo

Protein Duo: 

Our dedicated and flexible protein source blend of slow to fast acting proteins in all Fresubin Standard Tube Feeds

 

Protein Duo concept - the smart blending for sustained Amino Acid release

Fresubin Tube Feeds provide adapted combinations and amount of fast to slow acting protein sources.
Fast acting proteins: Kick to muscle protein synthesis induced by rapid amino-acidemia in the blood stream.2
Slow acting proteins: Casein-based proteins provide a sustained slow release of amino acids into the blood stream, sometimes lasting for several hours.

 

Different absorption rates of protein

 

Different absorption rates (appearance of plasma Amino Acids over time in minutes) of different protein sources.
Adapted from: Atherton PJ, Wilkinson DJ and Smith K. 2016 and Tang JE, Moore DR et al. 2009

 

 

 

 

Flexible protein source combinations for different patient needs

Fresubin Standard Tubes

As patients are individuals,
in 
different conditions and different indications they may have different individual needs.

Flexible protein source combinations allow us, from a technological view point, to include high amounts of total protein, keeping the different patients’ needs in mind.

Fresubin Tube Feeds were the first to provide 50 grams of protein and 1000 kcal in 500 ml bag only.



 

 

Fresubin Tube feeds - Made with high quality proteins only


Amino Acid profile comparison

The branched chain Amino Acids (AA) Valine, Leucine and Isoleucine in Fresubin Standard Tube Feeds exceed the WHO recommendations for indispensable amino acids

In particular Leucine appear to be the most potent stimulus of protein anabolism (4,5)

Amino Acid profile of Fresubin standard tube feeds

Examples of digestibility scores for different protein sources (7,8)

Whey-, and Casein-based proteins and Soy proteins in Fresubin Standard Tube Feeds are known to have good PDCAAS* and DIAAS** scores, which translates to sources of good digestibility and absorption in the body.

 

*PDCAAS: Protein Digestibility Corrected Amino Acid Score

**DIAAS: Digestible Indispensable Amino Acid Score

Nutritional value of dietary products

 

 

Tissue Utilization of Proteins


Muscle protein synthesis

The effect of a Fresubin casein-based / whey-based protein blend product on muscle protein synthesis (determined via direct incorporation into muscle biopsy) in 0–4 h after feeding with and without exercises.9

Protein blends used in Fresubin Standard Tube Feeds are and will further be tested in a specifically dedicated clinical research program.







References

1. Boirie, Y., Dangin, M., Gachon, P., Vasson, M. P., Maubois, J. L., Beaufrère, B. et al. (1997). Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc. Natl. Acad. Sci. U.S.A. 1997;94(26):14930-14935.
2. Tang, J. E., Moore, D. R., Kujbida, G. W., Tarnopolsky, M. A., and Phillips, S. M. (2009). Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. J. Appl. Physiol. 107, 987–992. doi: 10.1152/japplphysiol.00076.2009
3. Xu ZR et al. The effectiveness of leucine on muscle protein synthesis, lean body mass and leg lean mass accretion in older people: a systematic review and meta-analysis. Br J Nutr 2015; 113(1): 25-34

Protein Sources products: Fresubin Original: sodium caseinate (from milk), soy protein; Fresubin Energy: sodium caseinate (from milk), whey protein (from milk); Fresubin 2 kcal HP calcium caseinate (from milk), whey protein (from milk) 

Calculated AA profiles Fresenius Kabi standard Tube Feeds (Status November 2019), not published.
4. McGregor RA & Poppitt SD. Milk protein for improved metabolic health: a review of the evidence. Mutrition & Metabolism 2013; 10: 46-59
5. WHO/FAO/UMU. Protein and Amino Acid Requirements in Human Nutrition. Report of a Joint WHO/FAO/UNU Expert Consultation, WHO Technical Report Series, No 935 (2007)
6. Walstra et al 2006; Sarwar et al; Deutz et al 1998; WHO 2007; FAO 2013; Maubois et al 2015 . PDCAAS & DIAAS measure digestibility & quantity of EAAs provided in a diet. PDCAAS uses fecal digestibility in mice DIAAS uses ileal digestibility in pigs
7. van den Braak CC et al. A novel protein mixture containing vegetable proteins renders enteral nutrition products non-coagulating after in vitro gastric digestion. Clin Nutr (2013); 32(5): 765-71
8. Mathai JK, Yanhong L & Stein HH. Values for digestible indispensable amino acid scores (DIAAS) for some dairy and plant proteins may better describe protein quality than values calculated using the concept for protein
9. Brook, M.S., Scaife, P., Bass, J.J., Cegielski, J., Watanabe, S., Wilkinson, D.J., Smith, K., Phillips, B.E., Atherton, P.J. (2021). A collagen hydrolysate/milk protein-blend stimulates muscle anabolism equivalently to an isoenergetic milk protein-blend containing a greater quantity of essential amino acids in older men. https://doi.org/10.1016/j. clnu.2021.01.002





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