New lipids in enteral feeding.
OBJECTIVE
Lipid sources for enteral nutrition continue to be an exciting area of investigation. It is timely to review recent developments which have largely contributed to thrust enteral feeding into a new era.


RESULTS
Although much more research needs to be done, there is a better understanding of the competitive relationships between n-6/n-3 fatty acids in conditions of metabolic and immune stress as well as in autoimmune and degenerative diseases. Although structured lipids are more completely absorbed and cleared, other more important clinical benefits need to be documented before they can be considered cost-effective. Immune enhancing formulas are the subject of controversy and some have been shown to be more effective than others. Enteral formulations with short-chain fatty acids are promising but more experimental work on the normal, and the sick colon is needed. Finally, there are a few isolated studies suggesting that enteral feeding with liposomes and with lipolytic products may have advantages when the digestive phase needs to be circumvented. The era of nutrigenomics, in which the effect of specific lipids on genes and proteins is being explored, is with us. We can look forward to nutrigenetics when the effect of genetic variation on the interaction between diet and disease will guide our practice.


CONCLUSIONS
Clinicians already have access to lipid sources and formulations which allow them to individualize enteral feeding programs. More clinical and technological research needs to be carried out, however, before products can be tailored to produce optimal effects in specific conditions.
Roy
Claude C
CC
Departments of Pediatrics and Nutrition, University of Montréal, Hospital Sainte-Justine, 3175 Ste-Catherine Road, Montréal, Québec, Canada H3T 1C5. croy@justine.umontreal.ca
Bouthillier
Lise
L
Seidman
Ernest
E
Levy
Emile
E
D004063:Digestion; D004750:Enteral Nutrition / Q000379:methods*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000493:pharmacokinetics; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage / Q000493:pharmacokinetics; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage / Q000493:pharmacokinetics; D005232:Fatty Acids, Volatile / Q000008:administration & dosage / Q000493:pharmacokinetics; D005526:Food, Formulated / Q000592:standards*; D006801:Humans; D007408:Intestinal Absorption; D008055:Lipids / Q000008:administration & dosage / Q000737:chemistry* / Q000493:pharmacokinetics; D008081:Liposomes; D009748:Nutrition Disorders / Q000628:therapy*; D009751:Nutritional Requirements
D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated; D005232:Fatty Acids, Volatile; D008055:Lipids; D008081:Liposomes