The Journal of Nutrition Vol. 127 No. 2 February 1997,
pp. 327-331
Copyright ©1997 by the American Society for Nutritional Sciences
Production of Egg Proteins, Enriched with L-Leucine-13C1, for the Study of Protein Assimilation in Humans Using the Breath Test Technique1,2
Pieter Evenepoel,
Martin Hiele,
Anja Luypaerts,
Benny Geypens,
Johan Buyse*,
Eddy Decuypere*,
Paul Rutgeerts, and
Yvo Ghoos3
Gastrointestinal Research Center, Division of Gastroenterology, Department of Medicine, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, 3000 Leuven, Belgium and * Laboratory of Physiology and Immunology of Domestic Animals, Faculty of Agricultural and Applied Biological Sciences, Department of Animal Production, 3001 Heverlee, Belgium
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
ACKNOWLEDGMENTS
LITERATURE CITED
ABSTRACT
Protein assimilation and metabolism studies are hindered by the lack of an adequate oral tracer, i.e., labeled proteins. We present a new and easily reproducible methodology for producing large amounts of egg proteins labeled with L-leucine-13C1. Laying hens were fed a 0.2% leucine-deficient food supplemented with 0.2% L-leucine-13C1 (99 atom %). At plateau, eggs containing highly enriched proteins were obtained. The 13C content of egg white relative to the total C content was 1.3371 atom %, corresponding to
= 206
. The overall tracer recovery in egg proteins was high (40.2%), making this method financially attractive as well. Accurately measurable levels of 13CO2 in breath were obtained after ingestion of a physiological load of labeled egg white proteins. Thus, egg proteins with sufficient 13C enrichment and applicable for human protein assimilation and metabolism kinetic studies were produced in an easily reproducible and highly efficient manner.
Key words:
leucine,
egg proteins,
stable isotopes,
protein metabolism,
humans.
INTRODUCTION
The study of the assimilation of proteins, i.e., the process of digestion and absorption in the gastrointestinal tract, remains the subject of current, intensive research. Protein digestion involves a complex series of degradative processes which are elicited mainly by the hydrolytic enzymes originating from the stomach, pancreas and the brush border of the small intestine (Alpers 1994
, Erickson and Kim 1990
, Freeman et al. 1979
). The result of this proteolytic activity is a mixture of amino acids and small peptides which are absorbed by the small intestinal enterocytes. Information about the overall rate and the different factors controlling the rate of the process of protein digestion and absorption in humans is scarce. This is due primarily to the lack of a safe (nonradioactive) and representative marker, which allows adequate measurement. The introduction of stable isotopes in fundamental biological research has created a number of perspectives, especially in the field of nutrition (Halliday and Rennie 1982
). A whole range of labeled amino acids is currently available. Different methodologies using labeled amino acids have been developed to study protein metabolism in vivo. 15N-labeled tracers are used in the so-called "end product" method; however, this method has some serious drawbacks (Bier 1991
). The most popular is that in which the turnover of a specific amino acid is measured by isotopic dilution, either during constant administration of a labeled amino acid ("constant infusion" method) or after the injection of the labeled amino acid contained in a large bolus of unlabeled amino acids ("flooding" method) (Garlick et al. 1994
, Matthews et al. 1981
, Millward et al. 1991
). 13C-Labeling of the amino acid has the great advantage that oxidation can be followed by measuring 13CO2 excretion in breath (Ghoos et al. 1988b
, Klein 1982
). L-Leucine-13C1 has been studied extensively. Only a few reports are available describing methods for producing large amounts of stable isotope-labeled proteins, which could be very helpful in studying the assimilation of proteins. In the future, these stable isotope-labeled proteins could also be of great help in the study of protein metabolism during feeding. Recently Boirie et al. (1995)
developed a method for producing large amounts of sufficiently enriched milk proteins labeled with L-leucine-13C1. However, the method described is rather unique and difficult to repeat in other laboratories. We present a new and more easily reproducible methodology for producing large amounts of highly enriched egg proteins. This was possible by feeding laying hens a leucine-deficient food supplemented with L-leucine-13C1.
MATERIALS AND METHODS
Production of 13C enriched protein.
An experimental study design was developed in collaboration with the laboratory of Physiology and Immunology of Domestic Animals. Chicken feed, containing only 0.6% leucine but completely in agreement with nutrient requirements (NRC 1994) for laying hens (for all other components) was formulated and manufactured by the Rijksstation voor Kleinveeteelt (Merelbeke, Belgium). Thereafter, the feed was supplemented with 0.2% L-leucine-13C1 (99 atom %, Euriso-top, Saint-Aubin, France) to meet the NRC requirement for leucine. The exact composition of the labeled chicken feed is given in Table 1. During peak egg production, a laying hen (Hisex brown, body weight of about 2 kg) was given free access to the L-Leucine-13C1-supplemented food. The hen was kept in an individual battery cage in an environmentally controlled room. The lighting schedule provided 16 h of light per day and temperature was maintained at 21 ± 1°C. The average daily feed intake of the hen was 100 g, with a maximum of 120 g. The animal experiment was approved by the Committee of Ethics of the University of Leuven.
|
Table 1.
Ingredients and calculated analysis of experimental diet
[View Table]
|
Eggs were collected daily and dated. Each egg was opened under sterile conditions and separated into white and yolk fractions. The fractions were weighed and stored at
15°C until further analysis. The isotopic enrichment of the two fractions of the 16 eggs laid from d 0 to 16 of the study was measured. Thereafter, analyses of isotopic enrichment were performed at regular intervals.
Analysis of isotopic enrichment of egg white and yolk.
The atom percentage (AP) of 13C of the egg white was determined using an elemental analyzer (ANCA-SL, Europa Scientific, Crewe, UK), coupled with a stable Isotope Ratio Mass Spectrometer (IRMS) detector. Samples containing 4 mg of lyophilized egg white were loaded into tin capsules and dropped into a furnace at 1000°C while in an atmosphere of oxygen. The tin ignited and burned exothermically, and the temperature rose to about 1800°C, oxidizing the sample. Complete oxidation was ensured by passing the combustion products through a bed of chromium trioxide at 1000°C using a helium carrier gas. A 15-cm layer of copper oxide followed by a layer of silver wool completed the oxidation and removed any sulfur. The products were then passed through a second furnace containing copper at 600°C where excess oxygen was absorbed. Water was removed in a trap containing anhydrous magnesium perchlorate. The gas stream passed into a gas chromatograph where carbon dioxide was separated from the other combustion products and was then bled into a mass-spectrometer for isotopic analysis. The results were expressed as a
13C-value (
), and thereafter converted to AP. Because the carbohydrate and lipid content of egg white is very limited (Johnson 1986
), the level of enrichment obtained by the method described can be assumed to be the same as the enrichment of the protein fraction within. The isotopic enrichment of the yolk can be determined in the same manner. However, because the yolk has a high lipid content, the results obtained will considerably underestimate the specific enrichment of the protein fraction within. Nevertheless, these determinations can be indicative of the enrichment pattern. The intraassay variability of this method, assessed by the coefficient of variation, was 0.39%.
Calculation of the exact amount of L-leucine-13C1 present in enriched egg white protein.
Knowing the exact amino acid composition (Table 2) and the isotopic enrichment of the egg white (measured), it is possible to calculate the amount of L-leucine-13C1 (99 atom %) present in the protein fraction of the egg white.
|
(1)
|
where APegg white = (measured) atom % enrichment of the protein;
= carbon atom fraction of position C1 within leucine in egg white protein, i.e., 0.0164;
= carbon atom fraction of the rest of all C-atoms in egg white protein, i.e., 0.9836, [9.83% of all C-atoms in egg white originate from leucine; knowing that each leucine molecule has six C-atoms, it can be stated that 1.64% of all C-atoms originate from position C1 within leucine (
). As a result, 98.36% is accounted for by the rest of all C-atoms in egg white (
)]; AP
= atom % enrichment of
(to be determined); and AP
= measured atom % enrichment of
(i.e., AP enrichment of unlabeled egg white = 1.08749).
|
(2)
|
where m = (to be determined) amount (mg) of L-leucine-13C1 (99 AP) incorporated into y mg of egg white protein (one milligram of egg white protein contains 0.0818 mg L-leucine); APL-leucine-1-13C = atom % enrichment of L-leucine-13C1 used for supplementation of the deficient food, i.e., 99; and AP
= calculated atom % enrichment of
.
|
Table 2.
The amino acid concentration and corresponding calculated C-concentration of egg white and yolk1,2
[View Table]
|
Rearrangement of Equations (1) and (2) provides a way for calculating the amount of L-leucine-13C1 (99 AP) incorporated into y mg of egg white protein.
This allows calculation of the ratio leucine-13C1 to total leucine in egg white as well as the efficiency of incorporation (i.e., 100 × incorporated leucine-13C1/administered leucine-13C1).
Calculation of the "maximal" 13C-enrichment of egg white protein.
Assuming random incorporation of either L-leucine-13C1 or L-leucine-12C1, maximal 13C-enrichment of egg white under current study conditions (0.2% deficient food) is reached when L-leucine-13C1 accounts for 25% of the total leucine in the egg white. The maximal 13C-enrichment of egg white can be calculated using a modification of Equation (1):
where APmax = maximal atom % enrichment of the protein;
= carbon atom fraction of 13C labeled position C1 within leucine in egg white protein when L-leucine-13C1 accounts for 25% of the total leucine in the egg white, i.e., 0.25·0.0164 = 0.00410;
= carbon atom fraction of the rest of all C-atoms in egg white protein, i.e., 1
0.00410 = 0.9959; AP
= atom % enrichment of
, i.e., 99; and AP
= measured atom % enrichment of
(i.e., AP enrichment of unlabeled egg white = 1.08749).
Solving this equation reveals that APmax = 1.4889, which can be converted to a
-value:
max = 345
.
Breath test studies.
Ten healthy volunteers (6 women, 4 men; mean age 24.5 y, range 18-41 y) participated. The anthropometric measurements (mean ± SD) for women were height, 1.66 ± 0.031 m; weight, 52.5 ± 5.1 kg; and body mass index, 19.1 ± 1.9 kg/m2. For men, the measurements were height, 1.80 ± 0.11 m; weight, 71.5 ± 13.2 kg; and body mass index, 22.1 ± 2.5 kg/m2. None was receiving any medication or had a history of gastrointestinal disease. The protocol was approved by the local ethical committee of the University of Leuven.
Subjects were studied after an overnight fast. The test meal consisted of 11 g of labeled egg white protein (13C content of egg white relative to the total C content was 1.2815, corresponding to
= 155.2
) mixed with 11 g of unlabeled egg white protein (
=
21.6
) and was cooked in a microwave oven. The L-leucine-13C1 (99 atom %) content was calculated as being 177 mg. The meal was ingested with 200 mL water. All test meals were consumed in less than 15 min.
Breath samples were collected in exetainers (Europa Scientific). Base-line samples were obtained in duplicate immediately before the ingestion of the test meal. After the test meal, breath samples were taken at 15-min intervals for 6 h. The ratios of 13C/12C in respiratory CO2 were determined using an automated inlet gas-IRMS (ABCA
20/20, IRMS, Europa Scientific). The data were expressed in percentage of administered dose of 13C recovered per hour and in cumulative percentage administered dose of 13C recovered over a 6-h period. All results were expressed as means ± SEM.
RESULTS
Production of 13C enriched protein.
Consecutive measurements of the egg white protein isotopic enrichment of eggs laid during a 16-d period following the initiation of the 0.2% L-leucine 13C1-supplemented feed showed a steady increase which reached the asymptotic portion of the labeling time curve after 9 to 11 d (Fig. 1). Further measurements (n = 13) performed at regular intervals from d 12 to 97 revealed a mean egg white protein isotopic enrichment of
= 206 ± 10
. The enrichment pattern of the total carbon content of the yolk was analogous apart from the fact that the asymptotic value of the time labeling curve was reached some days later. Applying the calculations, as described in Materials and Methods, the average amount of L-leucine-13C1 (99 AP) incorporated into 100 g of egg white (
= 206
) was 148 mg. It is known that the leucine content of egg white averages 902 mg per 100 g egg white (Table 2); thus, the ratio of L-leucine-13C1 to total leucine in egg white was 148/902 = 0.164. At plateau, it may be assumed that the ratio of L-leucine-13C1 to total leucine in the yolk is the same as in the egg white. Because 100 g of yolk contains 1360 mg of leucine, the amount of L-leucine-13C1 incorporated into 100 g of yolk at plateau was 223 mg (i.e., 1360 × 0.164). Finally, knowing the mean weight of the yolk and egg white fraction (18 and 38 g, respectively) and assuming a maximal daily feed intake of 120 g (containing 240 mg L-leucine-13C1), the efficiency of incorporation (see Materials and Methods) was calculated as 40.2%.
Fig. 1.
13C-enrichment (expressed as
) of egg white protein of eggs laid by a hen which had free access to a 0.2 g/100 g leucine-deficient diet supplemented with 0.2 g/100 g L-leucine-13C1 (99 atom %) beginning on d 0. Note that because the ovulation-oviposition cycle in the chicken is >24 h, an egg was not laid on every day of the feeding period (Johnson 1986
). *no egg.
[View Larger Version of this Image (34K GIF file)]
Breath test studies.
Figure 2 shows the mean 13CO2 excretion in expired breath, expressed in percentage of administered dose per hour, in 10 normal volunteers. The mean maximal percentage excretion of administered dose per hour was 5.75 ± 0.27 and was attained 168 ± 15 min after the protein meal was ingested. The mean cumulative percentage recovery of administered dose of 13C after 6 h (Fig. 3) was 19.71 ± 1.03.
Fig. 2.
13CO2 excretion curve, expressed in percentage of administered dose, recovered per hour (% dose/h), in 10 normal volunteers after ingestion of a test meal consisting of 11 g of labeled egg white protein (
= 155
) mixed with 11 g of unlabeled egg white protein (
=
21.6
). Values are means ± SD, n = 10.
[View Larger Version of this Image (17K GIF file)]
Fig. 3.
Cumulative 13CO2 excretion curve, expressed as cumulative percentage administered dose of 13C recovered over time (cumulative % dose), in 10 normal volunteers after ingestion of a test meal consisting of 11 g of labeled egg white protein (
= 155
) mixed with 11 g of unlabeled egg white protein (
=
22
). Values are means ± SD, n = 10.
[View Larger Version of this Image (13K GIF file)]
DISCUSSION
Stable isotope-labeled proteins can be helpful not only to study protein assimilation (e.g., determination of true digestibility) (Mahé et al. 1994
), but also to assess protein metabolism during feeding in humans. Indeed, oral administration of labeled proteins mimics the normal physiological situation in assessing protein metabolism during feeding, whereas this is not the case with free amino acids (Hoerr et al. 1993
). There are few reports which describe the synthesis of stable isotope-labeled proteins in sufficient amounts for use on a large scale. Uniformly, 15N-labeled milk proteins were obtained either by adding (15NH4)2SO4 to the diet of lactating cows (Colin et al. 1994
) or by infusing (15NH4)2SO4 directly into the rumen of the cow (Mahé et al. 1994
). If the label is 13C, a direct determination of amino acid oxidation can be obtained by measuring 13CO2 excretion in expired breath. 13C-Labeled proteins are therefore often preferred to other tracers. Because CO2 derived from the oxidation of a given amino acid represents only a small fraction of the total CO2 production, high enrichments are a prerequisite in obtaining accurate measurements of 13CO2.
Very recently, large amounts of milk proteins specifically labeled with L-leucine-13C1 were obtained by infusing L-leucine-13C1 directly into the bloodstream of lactating cows (Boirie et al. 1995
). The milk was collected during and after the infusion. Afterwards, the casein and whey protein fractions were purified by membrane separation techniques. The two fractions were sufficiently enriched to be used in human studies. Nevertheless, the described method is rather cumbersome. In contrast, the present method is simple and easily reproducible on the condition that the composition of the chicken diet has been well defined. Large amounts of highly enriched (
= 206
at plateau) and specifically labeled egg proteins can be obtained. The efficiency of incorporation (40.2%) is high, making this method financially attractive as well.
The course of the labeling time curve, characterized by an initial fast increase, which is followed by a further gradual increase towards a plateau value (i.e.,
= 206
in the case of egg white), is about the same as that described by Berthold et al. (1991)
. The initial increase in the time labeling curve of the yolk is much slower than in the case of egg white, an observation which reflects the difference in the physiology of egg protein production of the two egg fractions. Although beyond the scope of this study, it is known that the production and accumulation of egg yolk protein is spread over several days, whereas egg white proteins are produced within hours and for each consecutive egg separately (Johnson 1986
). Moreover, measured enrichment of the total carbon content of the yolk is lower than the enrichment of the corresponding egg white because of the high lipid content of yolk. Without clear proof, it is accepted, however, that the isotopic enrichments of the isolated protein fraction of the yolk and egg white are the same at plateau. The L-leucine-13C1 content of the yolk at plateau has therefore been calculated (see Results). Some day-to-day variations in 13C enrichment of the egg white may occur. These daily variations most probably result from the (de)synchronization of egg white formation with the diurnal food intake pattern. Indeed, egg white becomes relatively more 13C-enriched when the major part of the daily food is consumed during the period of egg white synthesis (i.e., 4-6 h after ovulation) and even more when the food intake is uniformly spread during that period.
Because we have been unable to calculate L-leucine-13C1 incorporation by direct analytical method (i.e., gas chromatography-mass spectrometry), the L-leucine-13C1 content in egg white has been calculated in an indirect way. In these calculating procedures, the fact that 13C might be incorporated into other amino acids via CO2 fixation has not been taken into account.
In the present study, L-leucine-13C1, an essential amino acid, was chosen to be incorporated because it is widely used in protein kinetic studies. Moreover, oxidation can be followed by measuring 13CO2 in breath. Generally, every amino acid labeled with a stable isotope can be incorporated by this method. The degree of enrichment is related to the content of the specific amino acid in the protein and the degree to which the food can be made deficient for the specific amino acid.
Breath test studies with healthy volunteers have shown that administration of 11 g of labeled egg white protein mixed with 11 g of unlabeled egg white protein gives a rapid increase of 13CO2 in breath, reaching a maximum after about 168 minutes (Fig. 2). The time course of breath 13CO2 is slower, however, than was encountered in a study in which the test meal consisted of a comparable amount of egg white protein simply mixed with free L-leucine-13C1. In the latter case, mean peak excretion was at 55 ± 6 min and the mean maximal percentage excretion of administered dose per hour was 5.4 ± 0.66 (n = 6). Differences in 13CO2 excretion kinetics are tentatively explained by differences in digestive events taking place when L-leucine is part of a protein, vs. L-leucine present as free amino acid in a protein meal.
In the present study, the mean cumulative percentage recovery of the administered dose of 13C after 6 h was 19.71. The course of individual 13CO2 excretion curves is very smooth, which is in contrast to the course of curves obtained with naturally 13C-enriched proteins (Ghoos et al. 1988a
). This smooth course suggests high accuracy, making this test a usable tool in protein assimilation and metabolism kinetic studies in humans.
The first data on the application of this 13C-labeled egg white protein in the study of protein assimilation in a clinical context have already been presented (Evenepoel et al. 1996a
and b). It was demonstrated that the pancreatic as well as gastric phase is important in the overall assimilation process of protein.
In conclusion, a method is described for obtaining large amounts of L-leucine-13C1-labeled egg proteins in a simple, noninvasive and reproducible manner. The use of this highly enriched substrate is promising for protein metabolism kinetic studies during feeding as well as for protein assimilation studies (e.g., using the breath test technique) in humans.
FOOTNOTES
1
Supported by De Vlaamse Executieve (European Concerted Action, BIOMED PL93-2139) and Nutricia (Nutricia Chair in gastrointestinal microenvironment).
2
The costs of publication of this article were defrayed in part
by the payment of page charges. This article must therefore be hereby marked "advertisement"
in accordance with 18 USC section 1734 solely to indicate this fact.
3
To whom correspondence should be addressed.
Manuscript received 21 February 1996. Initial reviews completed 21 May 1996. Revision accepted 8 October 1996.
ACKNOWLEDGMENTS
D. Halliday, London, is acknowledged for constructive discussions. We also thank D. Claus, N. Gorris, S. Rutten and L. Swinnen for excellent technical assistance.
LITERATURE CITED
-
Alpers, D. H.
(1994)
Digestion and absorption of carbohydrates and proteins. In: Physiology of the Gastrointestinal Tract (Johnson, L. R., ed.), pp. 1723-1749. Raven Press, New York, NY.
-
Berthold H.,
Hachey D. L.,
Reeds P. J.,
Thomas O. P.,
Hoeksema S.,
Klein P. D.
Uniformly 13C-labeled algal protein used to determine amino acid essentiality in vivo.
Proc. Natl. Acad. Sci. U.S.A.
1991;
88:8091-8095
[Abstract/Free Full Text]
-
Bier, D. M.
(1991)
Whole body protein kinetic measurements. In: Protein Metabolism in Diabetes Mellitus (Nair, K. S., ed.), pp. 61-68. Smith-Gordon and Company Limited, London, UK.
-
Boirie Y.,
Fauquant J.,
Rulquin H.,
Maubois J.,
Beaufrère B.
Production of large amounts of (13C)leucine-enriched milk proteins by lactating cows.
J. Nutr.
1995;
125:92-98
-
Ciba-Geigy Scientific Tables
(1981)
8th ed. vol. 1.
-
Colin, O., Laurent, F., Vignon, B. & Antoine, J. M.
(1994)
Influence de la dose d'apport sur le niveau d'enrichessement en 15N de fractions azotées du lait de vache. In: Les Isotopes Stables, Applications-Productions (Goldstein, S., Louvet, P., Soulieé, E., eds.), pp. 103-108. Commissariat à l'énergie atomique, France.
-
Erickson R. H.,
Kim Y. S.
Digestion and absorption of dietary protein.
Ann. Rev. Med.
1990;
41:133-39[Medline]
-
Evenepoel, P., Hiele, M., Geypens, B., Maes, B., Rutgeerts, P. & Ghoos, Y. (1996a)
Egg protein assimilation in pancreatic disease studied with a 13C-egg white breath test. Gastroenterology 110: A800 (abs.).
-
Evenepoel, P., Hiele, M., Geypens, B., Maes, B., Rutgeerts, P. & Ghoos, Y. (1996b)
Gastric digestion plays a substantial role in normal protein assimilation. Gastroenterology 110: A800 (abs.).
-
Freeman H. J.,
Kim Y. S.,
Sleisenger M. H.
Protein digestion and absorption in man. Normal mechanisms and protein-energy malnutrition.
Am. J. Med.
1979;
67:1030-1036
[Medline]
-
Garlick, P. J., McNurlan, M. A., Essen, P. & Wernerman, J. (1994)
Measurement of tissue protein synthesis rates in vivo: a critical analysis of contrasting methods. Am. J. Physiol. 266(Endocrinol. Metab. 29): E287-E297.
-
Ghoos, Y., Hiele, M., Rutgeerts, P. & Vantrappen, G. (1988a)
Casein digestion in normal subjects and patients with pancreatic disease, studied with a 13CO2 breath test. Gastroenterology 94: A145 (abs.).
-
Ghoos Y.,
Rutgeerts P.,
Hiele M.,
Vantrappen G.
Use of stable isotopes in gastroenterology: 13CO2 breath tests.
Klin. Ern.
1988b;
34:52-61
-
Halliday D.,
Rennie M. J.
The use of stable isotopes for diagnosis and clinical research.
Clin. Sci. (Lond.)
1982;
63:485-496
[Medline]
-
Hoerr, R. A., Matthews, D. E., Bier, D. M. & Young, V. R.
(1993)
Effects of protein restriction and acute refeeding on leucine and lysine kinetics in young men. Am. J. Physiol. 264 (Endocrinol. Metab. 27): E567-E575.
-
Johnson, A. L.
(1986)
Reproduction in the female. In: Avian Physiology (Sturkie, P. D., ed.), pp. 403-431. Springer-Verlag, New York, NY.
-
Klein P. D.
Clinical applications of 13CO2 measurements.
Fed. Proc.
1982;
41:2698-2701
[Medline]
-
Mahé S.,
Roos N.,
Benamouzig R.,
Sick H.,
Baglieri A.,
Huneau J.,
Tomé D.
True exogenous and endogenous nitrogen fractions in the human jejunum after ingestion of small amounts of 15N-labeled casein.
J. Nutr.
1994;
124:548-555
-
Matthews, D. E., Bier, D. M., Rennie, M. J., Edwards, R.H.T., Halliday, D., Millward, D. J. & Clugston, G. A.
(1981)
Regulation of leucine metabolism in man: a stable isotope study. Science (Washington, DC) 214: 1129-1131.
-
Millward D. J.,
Price G. M.,
Pacy P.J.H.,
Halliday D.
Symposium on `clinical aspects of protein and energy metabolism'. Whole-body protein and amino acid turnover in man: what can we measure with confidence?
Proc. Nutr. Soc.
1991;
50:197-216
[Medline]
-
Motil, K. J., Matthews, D. E., Bier, D. M., Burke, J. F., Munro, H. N. & Young, V. R.
(1981)
Whole-body leucine and lysine metabolism: response to dietary protein intake in young men. Am. J. Physiol. 240: E712-E721.
-
National Research Council
(1994)
Nutrient Requirements of Poultry. National Academy Press, Washington, DC.