Dietary counseling versus dietary supplements for malnutrition in chronic pancreatitis: a randomized controlled trial.
OBJECTIVE
Up to 50% of patients with chronic pancreatitis (CP) are malnourished. There are limited data on the role of dietary intervention in improving the nutritional status of such patients. The aim was to compare the efficacy of medium chain triglyceride (MCT)-enriched commercial dietary supplements with dietary counseling for homemade food in the management of malnutrition in patients with CP.


METHODS
In a randomized controlled trial, consecutive undernourished patients with CP (body mass index [BMI] <18.5 kg/m(2)) at a tertiary care hospital were randomized to receive either dietary counseling for regular homemade food or commercial MCT-enriched dietary supplements for a period of 3 months to compensate for the dietary calorie deficit. All patients received standard management for CP including pancreatic enzyme supplements. Primary outcome measure was improvement in BMI.


RESULTS
Sixty malnourished patients with CP were randomized to counseling group (n = 29; mean age, 32 +/- 10 years; male, 83%) and supplementation group (n = 31; mean age, 28 +/- 10 years; male, 84%). BMI increased in both the counseling group and supplementation group (17.2 +/- 1.7 vs 18.1 +/- 1.8 kg/m(2), P = .001; 16.7 +/- 1.6 vs 18.2 +/- 1.6 kg/m(2), P = .001). There were similar improvements in triceps skinfold thickness, dietary intake, fecal fat, and pain score during a period of 3 months in both groups. There was, however, no significant difference between the counseling and supplementation groups with regard to any of the outcome measures.


CONCLUSIONS
Dietary counseling for a balanced homemade diet is as good as commercial food supplements in improving malnutrition in patients with CP.
Singh
Siddharth
S
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
Midha
Shallu
S
Singh
Namrata
N
Joshi
Yogendra Kumar
YK
Garg
Pramod Kumar
PK
D000328:Adult; D015992:Body Mass Index; D019587:Dietary Supplements; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000209:etiology; D009752:Nutritional Status; D050500:Pancreatitis, Chronic / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome