title: Impact of nutrient density of nocturnal enteral feeds on appetite: a prospective, randomised crossover study.
abstract: OBJECTIVE
  To determine whether the energy density of isocaloric nocturnal enteral feeds (NEF) influences daily nutrient intake in children.
  
  
  METHODS
  In a 6 week, randomised, crossover trial, the impact on spontaneous nutrient intake of manipulating the energy density of two isocaloric overnight feeds (1.0 kcal/ml and 1.5 kcal/ml) was compared in a group of 32 children aged 1-10 years (or 8-25 kg body weight) on long term, overnight enteral feeding at home. Total daily oral energy, protein, fat and carbohydrate intake were assessed using 3 day food diaries. Anthropometric data were also recorded during the study.
  
  
  RESULTS
  Spontaneous intakes of energy, protein, fat and carbohydrate from food were 20-30% greater when receiving the lower nutrient density feed (1 kcal/ml). This was due to a gender effect; males consumed twice as much protein from food than females and had slightly higher (but not significant) energy and fat intakes when on the larger volume feed. All children increased in weight, height and mid-upper arm circumference in the 6 week period.
  
  
  CONCLUSIONS
  Children appear to tolerate and grow equally well, irrespective of the nutrient density and volume of NEF taken. However, it appears that children will consume a more energy and nutrient dense oral diet when given their NEF as a higher volume/lower nutrient density feed. This is particularly so for boys, while for girls the volume of NEF or feed concentration appeared to have no impact on quantity of oral diet taken. However, further blinded studies with larger subject numbers would be useful to support these findings.
authors.affiliation: Birmingham Children's Hospital, Birmingham, UK. evanss21@onetel.com
authors.forename: S
authors.initials: S
authors.lastname: Evans
authors.forename: A
authors.initials: A
authors.lastname: Daly
authors.forename: A
authors.initials: A
authors.lastname: MacDonald
authors.forename: P
authors.initials: P
authors.lastname: Davies
authors.forename: I W
authors.initials: IW
authors.lastname: Booth
mesh_terms: D000886:Anthropometry / Q000379:methods; D001066:Appetite / Q000502:physiology*; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D002675:Child, Preschool; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004435:Eating; D002149:Energy Intake / Q000502:physiology; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects / Q000032:analysis*; D006701:Home Nursing / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins