Early Enteral Fat Supplement and Fish Oil Increases Fat Absorption in the Premature Infant with an Enterostomy

Ayers, Kathleen; Chen, Yuegang; Helderman, Jennifer; Welch, Cherrie D.

doi:10.1016/j.jpeds.2013.01.056

Cited by 11 publications

(12 citation statements)

References 22 publications

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“…Recently, we reported that early enteral supplementation of ML and FO increased dietary fat absorption in premature infants after bowel resection and an ostomy [10]. The major finding from the current study is that this supplementation also increases dietary protein intake and absorption.…”

Section: Discussionsupporting

confidence: 53%

“…Enhanced intestinal adaptation by 16,16-dimethyl-prostaglandin E 2 [24] is blocked by inhibition of prostaglandin E 2 synthesis from AA [23], suggesting that the beneficial effect of dietary n-6 PUFA on intestinal adaptation might depend on prostaglandin E 2 synthesis [22]. The n-6 and n-3 PUFAs competitively share the same metabolic pathway and an excess of either one interferes with the metabolism of the other, reducing its incorporation into tissue lipid and altering their biological effect [10]. In premature neonate rat, FO-enriched diet decreased the intestinal n-6 AA [25].…”

Section: Discussionmentioning

confidence: 99%

“…By supplementing with both ML and FO, we prevented the decrease in intestinal n-6 AA that would have resulted from supplementation with FO alone. The only change in intestinal FA profile is an increase in n-3 EPA which has anti-inflammatory effects [10] and might have played a role in enhanced intestinal adaptation.…”

Section: Discussionmentioning

confidence: 99%

“…In our weanling rat model of SBS, high-fat diet enriched with fish oil (FO), compared to control diet, increased intestinal mucosal weight, DNA and RNA contents [8], and dietary fat absorption [9]. Recently, we translated this animal research into clinical study and reported that early enteral fat supplementation with Microlipid (ML) and FO increased fat absorption in premature infants with bowel resection and enterostomy [10]. We hypothesized that this nutritional approach increases dietary protein absorption and the intestinal RNA and protein in the same cohort of premature infants.…”

Section: Introductionmentioning

confidence: 99%

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Early Enteral Fat Supplementation Improves Protein Absorption in Premature Infants with an Enterostomy

Ayers

Chen²

2014

Neonatology

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Background: Early enteral fat supplementation and fish oil (FO) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterostomy. Objective: To test the hypothesis that early fat supplement and FO increases post-resection protein absorption, intestinal RNA, protein without decreasing intestinal arachidonic acid (AA) in premature infants with an enterostomy. Methods: 36 premature infants (<2 months old) with an enterostomy after surgical treatment for necrotizing enterocolitis or spontaneous intestinal perforation who tolerated enteral feeding at 20 ml/kg/day were randomized to usual care (control, n = 18) or early supplementing enteral Microlipid (ML) and FO (treatment, n = 18). Intralipid was decreased as the dose of enteral fat was increased. Daily weight, ostomy output and nutritional intake were recorded. Weekly 24-hour ostomy effluent was collected to measure fecal protein. Protein absorption was calculated by subtracting fecal protein from dietary protein. Tissue samples from the functional stoma and the nonfunctional distal diverted end were collected during bowel reanastomosis to measure RNA, protein, and fatty acid (FA) profile. Results: Compared to controls, the treatment group had higher protein absorption (g/kg/day) and intestinal RNA and protein (μg/mg tissue) proximal to the ostomy. The two groups had similar FA profiles except that the treatment group had higher n-3 eicosapentaenoic acid (EPA, μg/mg tissue) proximal to the ostomy. Conclusion: Early supplementation of enteral ML and FO to premature infants with an enterostomy increased dietary protein absorption, intestinal RNA, protein and n-3 EPA content without altering other FA content.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early Enteral Fat Supplementation Improves Protein Absorption in Premature Infants with an Enterostomy

Ayers

Chen²

2014

Neonatology

Self Cite

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show abstract

“…In line with these experimental findings a highfat diet, including fish oil stimulated protein and fat absorption as well as intestinal RNA and protein content in preterm neonates with an enterostomy [50][51][52]. Between the treatment and the control group there was no difference in weight gain, ostomy output, and duration of parenteral nutrition but the treatment group had lower bilirubin, fewer sepsis evaluations, less exposure to antibiotics, and had greater weight and length gain after reanastomosis [50].…”

Section: Dietary Fatsupporting

confidence: 53%