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Author Notes:

Correspondence: Thomas R. Ziegler, M.D., Department of Medicine, Division of Endocrinology, Metabolism and Lipids, General Clinical Research Center, Room GG-23, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322; Email: tzieg01@emory.edu

Acknowledgments: The authors thank the GCRC Metabolic Core Laboratory staff for technical assistance and the nurses and staff of the Emory University Hospital General Clinical Research Center for their care of the patients.

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Research Funding:

This work was supported, in part, by National Institutes of Health grant R01 DK55850, the General Clinical Research Center grant RR00039, and the Emory University Research Committee (TRZ) and a grant from the Spanish Instituto de Salud Carlos III del Ministerio de Sanidad y Consumo, BAEs 96/5515 and 97/5082 (to CFE).

Keywords:

  • Short bowel syndrome
  • diet
  • vitamins
  • minerals
  • intestinal rehabilitation

Nutrient Intake From Habitual Oral Diet in Patients With Severe Short Bowel Syndrome Living in the Southeastern United States

Tools:

Journal Title:

Nutrition

Volume:

Volume 24, Number 4

Publisher:

, Pages 330-339

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background and Aims Little data are published on habitual home oral diet of short bowel syndrome (SBS) patients living in the United States. Methods We assessed habitual macro-and micronutrient intake from oral food and beverages in 19 stable patients with severe SBS who live in the Southeastern United States. Intestinal absorption of energy, fat, nitrogen (N) and carbohydrate (CHO) was determined in a metabolic ward setting. Results We studied 12 women and 7 men, age 48±3 years (mean±SE) receiving chronic PN for 31±8 months following massive small bowel resection (118±25 cm residual small bowel). Patients had intact (N=5), partial (N=9), or no residual colon (N=5). The subjects demonstrated severe malabsorption of energy (59±3% of oral intake), fat (41±5%), N (42±5%) and CHO (76±3%). Average oral energy intake was 2656±242 kcal/day (39±3 kcal/kg/day) and oral protein intake was 1.4 ±0.1 g/kg/d. Oral food/beverage intake constituted 49±4% of total (enteral + parenteral) daily fluid intake, 66±4% of total daily kcal and 58±5% of total daily N intake. Oral fat intake averaged 92±11g/day (≈ 35% of total oral energy). Oral fluid intake averaged 2712±240 ml/d, primarily from water, soft drinks, sweet tea and coffee. Simple sugars comprised 42±3% of oral CHO intake. Usual dietary intake of multiple micronutrients were below the Recommended Dietary Allowances (RDA) in a large percentage of patients: vitamin A (47%), vitamin D (79%), vitamin E (79%), vitamin K (63%), thiamine (42%), vitamin B6 (68%), vitamin B12 (11%), vitamin C (58%), folate (37%), iron (37%), calcium (63%), magnesium (79%) and zinc (68%). Only 7 patients (37%) were taking oral multivitamin-mineral supplements and only 6 subjects (37%) were taking oral iron and calcium supplements, respectively. Conclusions In these SBS patients living in the Southeastern United States, oral diet provides a significant proportion of daily nutrient intake. However, the types of foods and fluids consumed are likely to worsen malabsorption and increase PN requirements. Oral intake of essential micronutrients was very low in a significant proportion of this cohort of SBS patients.

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© 2008 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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