Galactose in Parenteral Nutrition: A Metabolic Rationale Worth Investigating

by | Nov 26, 2025 | News

A recent hypothesis paper explores whether integrating galactose into parenteral nutrition, (traditionally dominated by glucose) may offer metabolic advantages, particularly for premature infants during a period of rapid development. The authors argue that current intravenous carbohydrate formulations do not reflect the carbohydrate composition of human milk, which naturally delivers a blend of lactose-derived glucose and galactose. Aligning parenteral nutrition more closely with this natural substrate profile could reduce metabolic strain, including hyperglycaemia and glucosuria, both common complications in neonatal intensive care. 

How Galactose Works in the Body

This paper explains how galactose is processed in the body and why it might be beneficial in parenteral nutrition. Unlike glucose, galactose is metabolised through pathways that release energy more gradually, which may reduce sudden spikes in blood sugar. By distributing carbohydrate processing across different pathways, galactose could ease the burden on immature glucose-handling systems in premature infants and help maintain more stable energy levels during a critical period of growth and development.

Potential Clinical Implications

While the study is primarily theoretical, upcoming research is expected to provide further support for these findings. Nevertheless, the hypothesis is reinforced by a growing body of evidence highlighting the importance of specific components of maternal milk in neonatal brain development. Careful selection of carbohydrate composition in IV nutrition could influence short-term metabolic responses, such as blood glucose stability, and potentially impact longer-term outcomes, including growth, organ maturation, and metabolic programming. The study calls for targeted research to test safety, dosing parameters, and efficacy in clinical settings.

Galactose in Functional Sugars

Galactose is also part of Dr. Coy’s functional sugar mixtures, used for its low-glycaemic profile and ability to provide more stable metabolic responses compared to conventional sugars. In food applications, galactose is digested and absorbed gradually through the gut–liver axis, naturally slowing its conversion to glucose and supporting a low-glycaemic, steady energy release. In parenteral nutrition, however, galactose enters the bloodstream directly, placing the entire metabolic load on the liver without the buffering effect of digestion. This difference in delivery means oral galactose supports stable post-meal glycaemia, while
galactose delivered directly into the blood is hypothesised to ease metabolic stress in premature infants by reducing sharp glucose rises and limiting glucose loss through the kidneys.

Broader Significance

This study illustrates a broader concept that is increasingly relevant across nutrition and metabolic research: not all sugars are metabolically equivalent, and careful consideration of carbohydrate type can influence physiological responses. In neonatal care, this could mean safer, more stable parenteral nutrition formulations. In everyday nutrition, it reinforces the importance of selecting sugars that provide steady energy without overloading metabolic pathways.

In conclusion, the hypothesis presents a biologically coherent argument for incorporating galactose into parenteral nutrition. It also underscores a key principle: understanding the metabolic properties of carbohydrates, whether for clinical or food applications, is central to designing strategies that support stable glucose regulation and overall metabolic health.

 

References:

Panfoli, I. (2025). Integration of parenteral nutrition with galactose may improve premature infant outcomes: A metabolic rationale. Journal of Nutrition & Metabolism, S0306-9877(25)00246-4. https://doi.org/10.1016/S0306-9877(25)00246-4

Coy, J. F. (n.d.). Intelligent Sugar. IntelligentSugars , from https://intelligentsugar.info/

Coy, J. F. (2024). The Dr Coy Principle. IntelligentSugars. https://intelligentsugar.info/wp-content/uploads/2024/08/The-Dr-Coy-Principle-2024.pdf