Gastric emptying of two whey-based formulas of different energy density and its clinical implication in children with volume intolerance.
OBJECTIVE
Whey-based formulas have faster gastric emptying than casein-based formulas. Isoenergetic, isovolumic, whey-based formulas of different osmolarity and fat content empty in a similar manner. Will the gastric emptying of high and low energy density whey-based formulas be similar?


METHODS
We studied the gastric emptying rate of equal volumes of two whey-based formulas of different energy density (4.18 kJ/ml and 6.27 kJ/ml) and osmolality (270 and 450 mOsm/kg, respectively) in 10 children (4.5-12 y) with volume intolerance and resultant inability to gain weight.


RESULTS
The two formulas had comparable gastric emptying rates at 30, 60, 90 and 120 min. Over a one month clinical trial, substitution of the lower energy density whey-based formula (no weight gain over 2 months) with an equal volume of the high energy density formula produced a mean weight gain of 1.17+/-0.5 kg per patient without change in tolerance.


CONCLUSIONS
The higher density whey-based formula can safely substitute an equal volume of a lower energy density formula to produce weight gain without affecting tolerance.


CONCLUSIONS
This provides an important intervention for increasing energy intake in children with volume intolerance or fluid restriction.
Khoshoo
V
V
West Jefferson Medical Center, New Orleans, Louisiana, USA. vkhoshoo@earthlink.net
Brown
S
S
D002364:Caseins / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004041:Dietary Fats / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D002149:Energy Intake / Q000502:physiology*; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D005526:Food, Formulated; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008894:Milk Proteins / Q000378:metabolism*; D009997:Osmotic Pressure; D011446:Prospective Studies; D011782:Quadriplegia / Q000503:physiopathology / Q000628:therapy; D013270:Stomach / Q000502:physiology; D015430:Weight Gain; D000067816:Whey Proteins
D002364:Caseins; D004041:Dietary Fats; D004044:Dietary Proteins; D008894:Milk Proteins; D000067816:Whey Proteins