Nutrient intake from habitual oral diet in patients with severe short bowel syndrome living in the southeastern United States.
OBJECTIVE
Little data are published on the habitual home oral diet of patients with short bowel syndrome (SBS).


METHODS
We assessed nutrient 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.


RESULTS
We studied 12 women and 7 men, age 48 +/- 3 y of age (mean +/- SE) receiving parenteral nutrition for 31 +/- 8 mo following massive small bowel resection (118 +/- 25 cm residual small bowel). The patients demonstrated severe malabsorption of energy (59 +/- 3% of oral intake), fat (41 +/- 5%), N (42 +/- 5%) and CHO (76 +/- 3%). Oral energy intake was 2656 +/- 242 kcal/d (39 +/- 3 kcal/kg/d) and oral protein intake was 1.4 +/- 0.1 g/kg/d. Food/beverage intake constituted 49 +/- 4% of total (enteral plus parenteral) daily fluid intake, 66 +/- 4% of total daily kcal and 58 +/- 5% of total daily N intake. Oral fat intake averaged 92 +/- 11 g/day ( approximately 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 seven patients (37%) were taking oral multivitamin-mineral supplements and only six subjects (32%) were taking oral iron and calcium supplements, respectively.


CONCLUSIONS
In these SBS patients, an oral diet provided a significant proportion of daily nutrient intake. The types of foods and fluids consumed are likely to worsen malabsorption and thus increase PN requirements. Oral intake of essential micronutrients was very low in a significant proportion of these individuals.
Estívariz
Concepción F
CF
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Luo
Menghua
M
Umeakunne
Kayellen
K
Bazargan
Niloofar
N
Galloway
John R
JR
Leader
Lorraine M
LM
Ziegler
Thomas R
TR
D000222:Adaptation, Physiological; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000493:pharmacokinetics; D004041:Dietary Fats / Q000008:administration & dosage / Q000493:pharmacokinetics; D004044:Dietary Proteins / Q000008:administration & dosage / Q000493:pharmacokinetics; D019587:Dietary Supplements; D002149:Energy Intake; D004734:Energy Metabolism; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007422:Intestines / Q000502:physiology; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000378:metabolism; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D015596:Nutrition Assessment; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D009751:Nutritional Requirements; D012720:Severity of Illness Index; D012778:Short Bowel Syndrome / Q000378:metabolism* / Q000473:pathology; D015144:Southeastern United States; D014815:Vitamins / Q000008:administration & dosage / Q000378:metabolism
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D008903:Minerals; D014815:Vitamins; D009584:Nitrogen