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Impact of nutrient density of nocturnal enteral feeds on appetite: A prospective, randomised, crossover study.
  1. Sharon L Evans (evanss21{at}onetel.com)
  1. Birmingham Children's Hospital, United Kingdom
    1. Anne Daly (anne.daly{at}bch.nhs.uk)
    1. Birmingham Children's Hospital, United Kingdom
      1. Anita MacDonald (macdonj{at}btinternet.com)
      1. Birmingham Children's Hospital, United Kingdom
        1. Paul Davies (p.davies{at}bham.ac.uk)
        1. Institute of Child Health, United Kingdom
          1. Ian W Booth (i.w.booth{at}bham.ac.uk)
          1. Institute of Child Health, United Kingdom

            Abstract

            Objective: To determine whether the energy density of isocaloric nocturnal enteral feeds (NEF) influences daily nutrient intake in children.

            Method: In a six week, randomised, crossover trial, the impact on spontaneous nutrient intake of manipulating the energy density of two isocaloric overnight feeds (1.0kcal/ml and 1.5kcal/ml) was compared in a group of 32 children aged 1-10y (or 8-25kg body weight) on long term, overnight enteral feeding at home. Total daily oral energy, protein, fat and carbohydrate intake was assessed using 3-day food diaries. Anthropometric data were also recorded during the study.

            Results: Spontaneous intakes of energy, protein, fat and carbohydrate from food were 20-30% greater when receiving the lower nutrient density feed (1kcal/ml). This was due to a gender effect; males consumed twice as much protein from food than females and slightly higher (but not significant) energy and fat intakes when on the larger volume feed. All children increased in weight, height and MUAC in the 6-week period, without significant difference between treatment groups.

            Conclusions: Children appear to tolerate and grow equally well, irrespective of the nutrient density and volume of NEF taken. However, it appears that children, will consume a more energy and nutrient dense oral diet when given their NEF as a higher-volume/lower nutrient density feed. This is particularly so for boys, whilst for girls, the volume of NEF or feed concentration appeared to have no impact on quantity of oral diet taken. However, further blinded studies with larger subject numbers would be useful to support these findings.

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