Gas exchange modifications and dietinduced thermogenesis

When planning the calorie load the following points must be remembered.

1. Diet-induced thermogenesis depends primarily on the overall energy intake as well as the nutrient used (30-40 per cent of intake for protein, 6-8 per cent for glucose, and 3 per cent for fat).

2. Continuous infusion of nutrients at a rate balancing the energy expenditure seems to suppress diet-induced thermogenesis ( .Wy.m.orejnd C.§ip®n.t.!§L.19.9.3.).

Gas exchange largely reflects the composition of the oxidized fuels. In particular, carbon dioxide (CO 2) production per kilocalorie is maximum for glucose oxidation (100 per cent), and decreases to 93 per cent for protein oxidation and to 76 per cent for fat oxidation. In contrast, oxygen consumption per kilocalorie is maximum for lipids and decreases to 92 per cent for glucose. A mixture of medium- and long-chain triglycerides increases minute ventilation by 12 per cent, CO 2 production by 15

per cent, and oxygen consumption by 20 per cent compared with long-chain triglycerides ( Chassaid §t.M 1994). Moreover, the supply of any substrate at a rate exceeding the energy requirement results in storage as fat. Liposynthesis from glucose has a high energy cost (12 per cent of stored energy) and yields a large amount of CO2. The effect of a substrate load given at a rate not exceeding the energy demand will be almost negligible.

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