title: Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis.
abstract: OBJECTIVE
  Gastroparesis can lead to food aversion, poor oral intake, and subsequent malnutrition. We characterized dietary intake and nutritional deficiencies in patients with diabetic and idiopathic gastroparesis.
  
  
  METHODS
  Patients with gastroparesis on oral intake (N = 305) were enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry and completed diet questionnaires at 7 centers. Medical history, gastroparesis symptoms, answers to the Block Food Frequency Questionnaire, and gastric emptying scintigraphy results were analyzed.
  
  
  RESULTS
  Caloric intake averaged 1168 ± 801 kcal/day, amounting to 58% ± 39% of daily total energy requirements (TER). A total of 194 patients (64%) reported caloric-deficient diets, defined as <60% of estimated TER. Only 5 patients (2%) followed a diet suggested for patients with gastroparesis. Deficiencies were present in several vitamins and minerals; patients with idiopathic disorders were more likely to have diets with estimated deficiencies in vitamins A, B(6), C, K, iron, potassium, and zinc than diabetic patients. Only one-third of patients were taking multivitamin supplements. More severe symptoms (bloating and constipation) were characteristic of patients who reported an energy-deficient diet. Overall, 32% of patients had nutritional consultation after the onset of gastroparesis; consultation was more likely among patients with longer duration of symptoms and more hospitalizations and patients with diabetes. Multivariable logistic regression analysis indicated that nutritional consultation increased the chances that daily TER were met (odds ratio, 1.51; P = .08).
  
  
  CONCLUSIONS
  Many patients with gastroparesis have diets deficient in calories, vitamins, and minerals. Nutritional consultation is obtained infrequently but is suggested for dietary therapy and to address nutritional deficiencies.
authors.affiliation: Gastroenterology Section, Department of Medicine, Temple University, Philadelphia, Pennsylvania 19140, USA. henry.parkman@temple.edu
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Yates
authors.forename: William L
authors.initials: WL
authors.lastname: Hasler
authors.forename: Linda
authors.initials: L
authors.lastname: Nguyan
authors.forename: Pankaj J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: William J
authors.initials: WJ
authors.lastname: Snape
authors.forename: Gianrico
authors.initials: G
authors.lastname: Farrugia
authors.forename: Jorge
authors.initials: J
authors.lastname: Calles
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Koch
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
authors.forename: Dorothy
authors.initials: D
authors.lastname: Petito
authors.forename: Carol Rees
authors.initials: CR
authors.lastname: Parrish
authors.forename: Frank
authors.initials: F
authors.lastname: Duffy
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: Aynur
authors.initials: A
authors.lastname: Unalp-Arida
authors.forename: James
authors.initials: J
authors.lastname: Tonascia
authors.forename: Frank
authors.initials: F
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D001361:Avitaminosis / Q000453:epidemiology* / Q000209:etiology; D001835:Body Weight; D048909:Diabetes Complications; D019587:Dietary Supplements; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000150:complications* / Q000178:diet therapy / Q000209:etiology*; D006801:Humans; D000090463:Iron Deficiencies; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011191:Potassium Deficiency / Q000453:epidemiology; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015032:Zinc / Q000172:deficiency
chemical_list: D015032:Zinc