人类蛋白质和氨基酸需求

　　人类蛋白质和氨基酸营养覆盖广泛、复杂、常被误解且有争议的临床研究和实践领域。加拿大麦吉尔大学医学系教授、犹太总医院内科与内分泌科主任医师、戴维斯夫人医学研究所高级研究员约翰·霍弗博士撰写的教程，阐述了奠定目前理解蛋白质和氨基酸营养基础的生物化学和生理学基本原则。该教程对以下主题进行了讨论：（1）营养蛋白质的身份，检测和重要性；（2）最低需求的定义和测定；（3）营养适应；（4）必须的氮排泄和最小蛋白质需求；（5）最小对比最适蛋白质摄入；（6）蛋白质摄入过多和不足的代谢反应；（7）身体组成成分和蛋白质需求；（8）不稳定的蛋白质；（9）氮平衡；（10）蛋白质和氨基酸的代谢更新原则；（11）评估蛋白质代谢更新的文章的一般准则；（12）氨基酸代谢更新对比清除；（13）水化氨基酸溶液的蛋白质含量；（14）特殊情况下的蛋白质需求，包括蛋白质分解代谢重症；（15）氨基酸的补充和添加，包括谷氨酸钠和谷氨酰胺；（16）蛋白质和氨基酸营养研究的前景。该教程除了提供实用信息，同时旨在证明严谨的生理推理的重要性，激发求知欲，并鼓励在人类营养领域出现新的观点。总之，该教程提供了现代教科书未涉及针对上述主题的内容。

JPEN J Parenter Enteral Nutr. 2016;40(4):460-74.

Tutorial: Human Protein and Amino Acid Requirements.

Hoffer LJ

Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada.

Human protein and amino acid nutrition encompasses a wide, complex, frequently misunderstood, and often contentious area of clinical research and practice. This tutorial explains the basic biochemical and physiologic principles that underlie our current understanding of protein and amino acid nutrition. The following topics are discussed: (1) the identity, measurement, and essentiality of nutritional proteins; (2) the definition and determination of minimum requirements; (3) nutrition adaptation; (4) obligatory nitrogen excretion and the minimum protein requirement; (5) minimum versus optimum protein intakes; (6) metabolic responses to surfeit and deficient protein intakes; (7) body composition and protein requirements; (8) labile protein; (9) N balance; (10) the principles of protein and amino acid turnover, including an analysis of the controversial indicator amino acid oxidation technique; (11) general guidelines for evaluating protein turnover articles; (12) amino acid turnover versus clearance; (13) the protein content of hydrated amino acid solutions; (14) protein requirements in special situations, including protein-catabolic critical illness; (15) amino acid supplements and additives, including monosodium glutamate and glutamine; and (16) a perspective on the future of protein and amino acid nutrition research. In addition to providing practical information, this tutorial aims to demonstrate the importance of rigorous physiologic reasoning, stimulate intellectual curiosity, and encourage fresh ideas in this dynamic area of human nutrition. In general, references are provided only for topics that are not well covered in modern textbooks.

PMID: 26796095

DOI: 10.1177/0148607115624084