Increased protein intake is associated with improved hand grip strength and quality of life in home enterally tube fed adults using a high-energy, high-protein feed

Green, B.P.; Wong, Eric; Andrews, SJ; Hampshire-Jones, K.; McKinnon, Simon; Brooks, C G; McAdam, Rodney; Gray, Stuart R.; Vickers, Carinna; Blake, Y.; Sekhon, G.; Merrick, Susan; Faerber, J.; Mather, Paul; Gilbert, E.; McBride, R.; Coombes, Annie E.; Walker, Mary E.; Owen, A.; Davies, J.; Richardson, Scott; Carr, Susan; Mapson, Rachel P; Spivey, John F.; Draper, Stephen B.; Kendall, F.; Hubbard, G.P.; Stratton, R.J.

doi:10.1016/j.clnesp.2019.12.005

Cited by 2 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of patients did not report any GI symptoms throughout the study; however, some patients reported GI symptoms with various levels of severity whilst on the KD during the control period, at a similar level to that report in both randomized controlled trials 13 and uncontrolled studies 12 of the KD, and in other studies of the use of nutritional support in various disease areas. [20][21][22][23] More absent symptoms were reported during the intervention period with the use of the 2.5:1 ratio feed compared to the control period. This is encouraging and was predominantly driven by the lower incidence of mild and moderate GI side effects.…”

Section: Discussionmentioning

confidence: 99%

Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride‐containing liquid feed in children and adults with drug‐resistant epilepsy following a ketogenic diet

Griffen,

Schoeler,

Browne

et al. 2024

Epilepsia Open

View full text Add to dashboard Cite

ObjectiveTo investigate incorporating a ready‐to‐use 2.5:1 ratio liquid feed into a ketogenic diet (KD) in children and adults with drug‐resistant epilepsy.MethodsFollowing a three‐day baseline, patients (n = 19; age: 19 years [SD 13], range: 8–46 years) followed a KD for 28 days (control period), then incorporated ≥200 mL/day of a ready‐to‐use liquid feed, made with a ratio of 2.5 g of fat to 1 g of protein plus carbohydrate and including medium chain triglycerides ([MCTs]; 25.6% of total fat/100 mL) for 28 days as part of their KD (intervention period). Outcome measures (control vs intervention period) included gastrointestinal (GI) tolerance, adherence to KD and intervention feed, dietary intake, blood ß‐hydroxybutyrate (BHB) concentration, seizure outcomes, health‐related quality of life (HRQoL), acceptability and safety.ResultsCompared to the control period, during the intervention period, the percentage of patients reporting no GI symptoms increased (+5% [SD 5], p = 0.02); adherence to the KD prescription was similar (p = 0.92) but higher in patients (n = 5) with poor adherence (<50%) to KD during the control period (+33% [SD 26], p = 0.049); total MCT intake increased (+12.1 g/day [SD 14.0], p = 0.002), driven by increases in octanoic (C8; +8.3 g/day [SD 6.4], p < 0.001) and decanoic acid (C10; +5.4 g/day [SD 5.4], p < 0.001); KD ratio decreased (p = 0.047), driven by a nonsignificant increase in protein intake (+11 g/day [SD 44], p = 0.29); seizure outcomes were similar (p ≥ 0.63) but improved in patients (n = 6) with the worst seizure outcomes during the control period (p = 0.04); and HRQoL outcomes were similar. The intervention feed was well adhered to (96% [SD 8]) and accepted (≥88% of patients confirmed).SignificanceThese findings provide an evidence‐base to support the effective management of children and adults with drug‐resistant epilepsy following a KD with the use of a ready‐to‐use, nutritionally complete, 2.5:1 ratio feed including MCTs.Plain language summaryThis study examined the use of a ready‐to‐use, nutritionally complete, 2.5:1 ratio (2.5 g of fat to 1 g of protein plus carbohydrate) liquid feed, including medium chain triglycerides (MCTs), into a ketogenic diet (KD) in children and adults with drug‐resistant epilepsy. The results show that the 2.5:1 ratio feed was well tolerated, adhered to, and accepted in these patients. Increases in MCT intake (particularly C8 and C10) and improvements in seizure outcomes (reduced seizure burden and intensity) and KD adherence also occurred with the 2.5:1 ratio feed in patients with the worst seizures and adherence, respectively.

show abstract

Section: Discussionmentioning

confidence: 99%

Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride‐containing liquid feed in children and adults with drug‐resistant epilepsy following a ketogenic diet

Griffen,

Schoeler,

Browne

et al. 2024

Epilepsia Open

View full text Add to dashboard Cite

show abstract

“…Furthermore, the increase in oral food intake for some patients while taking the intervention feed may also explain the observed increases in nutritional intake. Similar increases in energy and protein intake have led to clinical (quality of life) and functional (hand grip strength) improvements with a polymeric enteral feed containing similar levels of energy and protein: 1.5 kcal/mL and 7.5 g protein/100 mL (Nutrison Protein Plus Energy ® , Nutricia Ltd.) [ 32 ]. Whether the findings of improved gastrointestinal tolerance, compliance and improved nutritional intake in this pilot study would translate to improvements in quality of life and hand grip strength should be determined in future research.…”

Section: Discussionmentioning

confidence: 99%

“…As this was a pilot study, with gastrointestinal tolerance as the primary outcome, the complexity and lack of data from studies of similar feeds rendered a power calculation on this outcome difficult, yet this was comparable to studies in similar populations [ 32 ]. Statistical procedures were performed using software package IBM SPSS Statistics v24 (IBM SPSS v24.0, Armonk, NY, USA).…”

Section: Methodsmentioning

confidence: 99%

Complex Enterally Tube-Fed Community Patients Display Stable Tolerance, Improved Compliance and Better Achieve Energy and Protein Targets with a High-Energy, High-Protein Peptide-Based Enteral Tube Feed: Results from a Multi-Centre Pilot Study

et al. 2020

View full text Add to dashboard Cite

This pilot study evaluated a high-energy, high-protein, peptide-based, (medium-chain triglycerides) MCT-containing enteral tube feed (Nutrison Peptisorb Plus HEHP®, Nutricia Ltd., Trowbridge, BA14 0XQ, UK.) containing 1.5 kcal/mL and 7.5 g protein/100 mL. Fifteen community-based, enterally tube-fed adults (42 (SD 16.3) years) received the intervention feed daily for 28 days, with gastrointestinal tolerance, compliance and nutrient intake assessed at baseline and after the intervention period. Incidence and intensity of constipation (p = 0.496), nausea (p = 1.000), abdominal pain (p = 0.366) and bloating (p = 0.250) remained statistically unchanged, yet the incidence and intensity of diarrhoea improved significantly after receiving the intervention feed (Z = −2.271, p = 0.023). Compliance with the intervention feed was significantly greater compared to the patient’s baseline regimens (99% vs. 87%, p = 0.038). Compared to baseline, use of the intervention feed enabled patients to significantly increase total energy (1676 kcal/day (SD 449) to 1884 kcal/day (SD 537), p = 0.039) and protein intake (73 g/day (SD 17) to 89 g/day (SD 23), p = 0.001), allowing patients to better achieve energy (from 88% to 99%, p = 0.038) and protein (from 101% to 121%, p < 0.001) requirements. This pilot study demonstrates that a high-energy, high-protein, peptide-based, MCT-containing enteral tube feed maintains gastrointestinal tolerance and improves compliance, energy and protein intake in complex, enterally tube-fed, community-based adult patients, though more work is recommended to confirm this.

show abstract

Increased protein intake is associated with improved hand grip strength and quality of life in home enterally tube fed adults using a high-energy, high-protein feed

Cited by 2 publications

References 0 publications

Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride‐containing liquid feed in children and adults with drug‐resistant epilepsy following a ketogenic diet

Tolerance, adherence, and acceptability of a ketogenic 2.5:1 ratio, nutritionally complete, medium chain triglyceride‐containing liquid feed in children and adults with drug‐resistant epilepsy following a ketogenic diet

Complex Enterally Tube-Fed Community Patients Display Stable Tolerance, Improved Compliance and Better Achieve Energy and Protein Targets with a High-Energy, High-Protein Peptide-Based Enteral Tube Feed: Results from a Multi-Centre Pilot Study

Contact Info

Product

Resources

About