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October 24, 1980

Man the Meal-Eater and His Interaction With Parenteral Nutrition

JAMA. 1980;244(17):1950-1953. doi:10.1001/jama.1980.03310170048026

CYCLIC parenteral nutrition provides hypertonic dextrose and amino acids alternating with dextrose-free periods. The periodicity of intermittent dextrose-amino acid administration may vary, as may the nature and quantity of substrate administered during the dextrose-free period. This technique of parenteral feeding has been prompted by awareness of man as a meal-eater and of his ability to institute hormonal and metabolic responses that are matched to the existing nutritional status and the varying input of nutrient materials that maintain body composition and functional capacity despite periodic feeding in a nonsteady state.1

Continual total parenteral nutrition (TPN) with hypertonic dextrose and amino acid solutions alters the hormonal milieu in which man normally maintains life, body composition, and function. Periodic feeding profiles are possible and may be appropriate in the group of patients characterized in Table 1. In this communication we review briefly how man, the meal-eater, responds to periodic feeding and how