Comment gérer la progression calorique lors de la renutrition

Details

Serval ID
serval:BIB_B23D6BC06199
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comment gérer la progression calorique lors de la renutrition
Journal
Nutrition Clinique et Métabolisme
Author(s)
Tappy L.
ISSN
0985-0562
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
31
Number
3
Pages
170-175
Language
french
Abstract
Total or partial starvation decrease both body fat mass and lean body mass. The latter comes along with a spectacular drop in intracellular glycogen and nucleotides phosphate, associated with decreased intracellular fluid volume and total body potassium, magnesium and phosphate pools. Upon renutrition, the provision of carbohydrate and the ensuing hyperinsulinemia cause a swift reversal of cellular hypometabolism, and to a rapid transport of extracellular phosphate, potassium and magnesium into the cells. This is more specifically related administration of carbohydrate and a rapid rise in plasma insulin concentration, which is responsible for an immediate increase in cellular energy metabolism, inhibition of lipid oxidation and stimulation of glycogen synthesis. These phenomenons can be some times at the origin of set of acute hydro-electrolytic imbalances and cardiac and neural dysfunctions known as "the refeeding syndrome". Occurrence of this syndrome can be largely prevented by a slow, graded administration of energy and carbohydrate upon initiation of refeeding and by the systematic administration of potassium supplement. The initial phase of refeeding also requires a careful monitoring of blood phosphate and magnesium concentrations, with administration of exogenous supplements when required.
Keywords
Internal Medicine, Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, Internal Medicine, Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism
Web of science
Create date
03/11/2017 18:15
Last modification date
20/08/2019 16:20
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