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Composition of enteral diets and meals providing optimal absorption rates of nutrients in mini pigs^1,2,3

Background: Commercial enteral diets differ widely in nutrient composition. It is unknown whether the nutrient composition of the diets influences intestinal absorption.

Objective: The objective of this study was to investigate the effects of different enteral diets providing 60% of energy as carbohydrate, protein, or fat or 33.3% of energy from each nutrient on intestinal absorption in mini pigs.

Design: Kinetics of nutrient absorption were determined by perfusing a 150-cm jejunal segment. The kinetics of absorption were used to determine optimal relations between the absorption and recovery of each nutrient. From these data, the optimal nutrient composition of the diets providing complete absorption of the macronutrients in the shortest intestinal length was evaluated. Absorption of nutrients was further determined after oral administration of 4 corresponding meals.

Results: With all enteral diets, the absorption of nutrients displayed saturation kinetics. Absorption rates of carbohydrate were significantly larger than those of fat and protein. Consequently, the amounts of nutrients remaining unabsorbed per unit length of jejunum differed among the macronutrients. After administration of various test meals, the length of the small intestine required for complete absorption of the nutrients depended on the composition of the meals. The shortest intestinal length for complete absorption was needed for a diet providing 48% of energy as carbohydrate, 23% as protein, and 29% as fat. This composition closely matched the nutritional requirements.

Conclusion: The nutrient composition of diets can optimize intestinal absorption. This may be especially important in patients with malabsorption or short-bowel syndrome.

Key Words: Enteral nutrition • macronutrients • short-bowel syndrome • intestinal absorption • nutrient requirements • malabsorption • meal composition • pigs

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