Energy absorption is reduced with oleic acid supplements in human short bowel syndrome.
BACKGROUND
Oleic acid premeal supplements have been described as a method to trigger the ileal brake and thus lengthen transit time and the opportunity for nutrient absorption. The aims of this study were to determine whether oleic acid supplements would lengthen transit time and improve absorption of nutrients in study participants with short bowel syndrome as well as affect diarrhea or patient weight.


METHODS
A double-blind, controlled, random-order crossover trial was conducted in 8 study participants with longstanding and severe short bowel syndrome, employing blue food color appearance, breath hydrogen testing, and radio-opaque markers as measures of transit time. Absorption of energy, protein, fat, and fluid was conducted by classic nutrient balance methods. Diarrhea was estimated by daily stool weight and number of bowel actions. Although 8 patients were enrolled, only 7 completed the study.


RESULTS
Transit time was not significantly different between oleic acid and placebo treatment, although peptide YY levels trended higher with the oleic acid treatment. Energy absorption was reduced 14% by oleic acid, significantly more than the 3% reduction by placebo. Fat, protein, and fluid absorption was not changed significantly. Neither diarrhea nor patient body weight was changed by oleic acid.


CONCLUSIONS
Energy absorption is reduced by oleic acid supplements in severe short bowel syndrome. The study may have lacked power to determine whether oleic acid affects diarrhea or body weight.
Compher
Charlene W
CW
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6096, USA. compherc@nursing.upenn.edu
Kinosian
Bruce P
BP
Rubesin
Stephen E
SE
Ratcliffe
Sarah J
SJ
Metz
David C
DC
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D003967:Diarrhea / Q000517:prevention & control; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D002149:Energy Intake / Q000187:drug effects*; D005260:Female; D005502:Food; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D019301:Oleic Acid / Q000627:therapeutic use*; D019894:Peptide YY / Q000187:drug effects; D011446:Prospective Studies; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors
D019894:Peptide YY; D019301:Oleic Acid