Nitrogen balance

The concept of nitrogen balance dictates that the difference between nitrogen intake and loss reflects gain or loss of total body protein respectively. If more nitrogen (protein) is given to the patient than is lost, the patient is considered to be anabolic or “in positive nitrogen balance."

Nitrogen Balance = Nitrogen intake - Nitrogen loss

Blood urea nitrogen can be used in estimating nitrogen balance, as the urea concentration in urine.

Nitrogen Balance and Protein Metabolism

Nitrogen is a fundamental component of amino acids, the molecular building blocks of protein. Therefore, measuring nitrogen inputs and losses can be used to study protein metabolism.[1]

Positive nitrogen balance is associated with periods of growth, hypothyroidism, tissue repair, and pregnancy. Because of this, the intake of nitrogen into the body is greater than the loss of nitrogen from the body, so there is an increase in the total body pool of protein.

Negative nitrogen balance is associated with burns, serious tissue injuries, fever, hyperthyroidism, wasting diseases, and periods of fasting. This means that the amount of nitrogen excreted from the body is greater than the amount of nitrogen ingested.[2] A negative nitrogen balance can be used as part of a clinical evaluation of malnutrition.[3]

Nitrogen balance is the traditional method of measuring dietary protein requirements.[4] Determining dietary protein requirements using nitrogen balance requires that all nitrogen inputs and losses are carefully collected, to ensure that all nitrogen exchange is accounted for.[5] In order to control nitrogen inputs and losses, nitrogen balance studies usually require participants to eat very specific diets (so total nitrogen intake is known) and stay in the study location for the duration of the study (to collect all nitrogen losses). Because of these conditions, it can be difficult to study the dietary protein requirements of various populations using the nitrogen balance technique (e.g. children).[6]

Dietary nitrogen, acquired from metabolizing proteins and other nitrogen-containing compounds, has been linked to changes in genomic evolution. Species which primarily obtain energy from metabolizing nitrogen-rich compounds use more nitrogen in their DNA than species which primarily break down carbohydrates for their energy. Dietary nitrogen alters codon bias and genome composition in parasitic microorganisms.[7]

Sources of dietary nitrogen intake include meat, fish, dairy foods, eggs, nuts, legumes, grains, and cereals. Sources of nitrogen losses include urine, feces, sweat, hair growth, and skin growth.

See also

References
  1. World Health Organization Protein and amino acid requirements in human nutrition. WHO Technical Report Series 935
  2. "VII. Monitoring Nutrition Therapy". Archived from the original on 2011-09-28.
  3. Barbosa-Silva MC (May 2008). "Subjective and objective nutritional assessment methods: what do they really assess?". Curr Opin Clin Nutr Metab Care. 11 (3): 248–54. doi:10.1097/MCO.0b013e3282fba5d7. PMID 18403920. S2CID 26831957.
  4. Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids (Macronutrients). The National Academies Press: 2005
  5. Rand WM, Pellett PL, Young VR (2003). Meta-analysis of nitrogen balance studies for estimating protein requirements in health adults. Am.J.Nutr 77(1):109-127.
  6. Elango R, Humayun MA, Ball RO, Pencharz PB (2011). "Protein requirements of healthy, school-aged children determined by the indicator amino acid oxidation method". Am. J. Clin. Nutr. 94 (6): 1545–1552. doi:10.3945/ajcn.111.012815. PMID 22049165.
  7. Seward EA and Kelly S (Nov 2016). "Dietary nitrogen alters codon bias and genome composition in parasitic microorganisms". Genome Biology. 17 (226): 226. doi:10.1186/s13059-016-1087-9. PMC 5109750. PMID 27842572.
  • "Test Definition: NITF". Mayo Clinic Laboratories. (with clinical information & interpretation related to nitrogen balance and its clinical testing)
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