Which nutrition support increases the metabolic demand for thiamin?

Which nutrition support increases the metabolic demand for thiamin?

• A. Enteral nutrition with lipids only
• B. Parenteral nutrition due to the glucose load
• C. Oral glucose only
• D. PN with fat-free solution

Answer: (B)

Thiamin is a cofactor required for several key steps of carbohydrate metabolism, including the conversion of glucose-derived intermediates through glycolysis and into the TCA cycle. When a large glucose load is provided, as happens with parenteral nutrition, the body must metabolize a substantial amount of glucose quickly, which drives a greater demand for thiamin to support those enzymatic reactions. If thiamin supply isn’t adequate, glucose metabolism can falter, increasing the risk of deficiency effects and impaired energy production. Enteral nutrition that uses fats as the primary energy source doesn’t push glucose metabolism to the same extent, so thiamin demand isn’t as elevated. Oral glucose introduces carbohydrate, but the load is typically less intense and less immediate than a continuous IV glucose infusion used in parenteral nutrition, so the thiamin requirement rise is less dramatic. Therefore, parenteral nutrition with a glucose load most notably increases metabolic demand for thiamin.

Thiamin is a cofactor required for several key steps of carbohydrate metabolism, including the conversion of glucose-derived intermediates through glycolysis and into the TCA cycle. When a large glucose load is provided, as happens with parenteral nutrition, the body must metabolize a substantial amount of glucose quickly, which drives a greater demand for thiamin to support those enzymatic reactions. If thiamin supply isn’t adequate, glucose metabolism can falter, increasing the risk of deficiency effects and impaired energy production.

Enteral nutrition that uses fats as the primary energy source doesn’t push glucose metabolism to the same extent, so thiamin demand isn’t as elevated. Oral glucose introduces carbohydrate, but the load is typically less intense and less immediate than a continuous IV glucose infusion used in parenteral nutrition, so the thiamin requirement rise is less dramatic. Therefore, parenteral nutrition with a glucose load most notably increases metabolic demand for thiamin.