title: Corn-Soy-Blend Fortified with Phosphorus to Prevent Refeeding Hypophosphatemia in Undernourished Piglets.
abstract: BACKGROUND
  Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++).
  
  
  METHODS
  Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10).
  
  
  RESULTS
  Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means±SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding.
  
  
  CONCLUSIONS
  We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets.
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Anne-Louise
authors.initials: AL
authors.lastname: Hother
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.|Department of Clinical Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Lykke
authors.affiliation: Department of Public Health, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Martinussen
authors.affiliation: Department of Animal Science, Aarhus University, Foulum, Denmark.
authors.forename: Hanne Damgaard
authors.initials: HD
authors.lastname: Poulsen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Mølgaard
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.|Department of Clinical Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Per Torp
authors.initials: PT
authors.lastname: Sangild
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.|Department of International Health, University of Tampere, Tampere, Finland.
authors.forename: André
authors.initials: A
authors.lastname: Briend
authors.affiliation: Department of Large Animal Sciences, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Christian Fink
authors.initials: CF
authors.lastname: Hansen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.|Department of Clinical Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thymann
mesh_terms: D000818:Animals; D049628:Body Size; D001835:Body Weight; D002118:Calcium / Q000652:urine; D004032:Diet / Q000662:veterinary*; D005260:Female; D005527:Food, Fortified; D017674:Hypophosphatemia / Q000473:pathology / Q000517:prevention & control / Q000662:veterinary*; D008274:Magnesium / Q000097:blood; D044342:Malnutrition / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D010758:Phosphorus / Q000097:blood / Q000737:chemistry* / Q000652:urine; D012709:Serum Albumin / Q000032:analysis; D013025:Glycine max / Q000737:chemistry* / Q000378:metabolism; D013552:Swine; D003313:Zea mays / Q000737:chemistry* / Q000378:metabolism
chemical_list: D012709:Serum Albumin; D010758:Phosphorus; D008274:Magnesium; D002118:Calcium