Feeding an Elemental Diet vs a Milk-Based Formula Does Not Decrease Intestinal Mucosal Growth in Infant Pigs

• Published in: JPEN. Journal of parenteral and enteral nutrition 2006-01, Vol.30 (1), p.32-39
• Main Authors: Stoll, Barbara, Price, Pamela T., Reeds, Peter J., Chang, Xiaoyan, Henry, Josef F., van Goudoever, Johannes B., Holst, Jens J., Burrin, Douglas G.
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Animals, Newborn; Biological and medical sciences; Cell Division - drug effects; Digestive system; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Enteral Nutrition; Female; Food, Formulated; Glucagon-Like Peptide 2; Glucagon-Like Peptides - metabolism; Intensive care medicine; Intestinal Mucosa - anatomy & histology; Intestinal Mucosa - drug effects; Intestinal Mucosa - enzymology; Intestinal Mucosa - growth & development; Investigative techniques, diagnostic techniques (general aspects); Lactase - metabolism; Medical sciences; Organ Size - drug effects; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Protein Biosynthesis - drug effects; Random Allocation; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Swine; Weight Gain
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/014860710603000132

Background: We previously showed that the level of enteral nutrient intake determines the rate of intestinal growth in piglets. Our objective was to determine whether providing enteral nutrition in the form of elemental nutrients (glucose, amino acids, lipid [ED]) rather than cow's milk formula (lactose, protein, lipid [FORM]) reduces small intestinal growth and lactase activity. Methods: Three-week-old piglets were fed either ED (n = 7) intragastrically or FORM (n = 6) orally for 6 days. Results: Intestinal protein and DNA masses, villus height, and crypt depth were not different in ED and FORM pigs. Crypt cell proliferation, measured by in vivo bromodeoxyuridine labeling, was significantly (p < .05) higher (+37%) in ED than in FORM pigs. Rates of mucosal protein synthesis (%/d), measured by in vivo 2H-leucine incorporation, were higher (p < .05) in ED than FORM (147 vs 89) pigs. Circulating concentrations (pmol/L) of the intestinotrophic peptide, glucagon-like peptide-2 (GLP-2), were also higher (p < .05) in ED than in FORM (148 vs 87) pigs. The mean lactase-specific activity (μmol/min/g) in proximal and distal segments was higher (p < .05) in FORM than in ED (124 vs 58) pigs. Conclusions: We conclude that intestinal mucosal growth and villus morphology are similar in pigs fed ED and FORM, despite higher cell proliferation and protein synthesis rates and lower lactase activity with ED. This implies that elemental diets may be as trophic as polymeric formulas to simultaneously provide nutrition and a stimulus for intestinal growth during bowel rest. Elemental diet did not alter small-intestinal morphology when compared to a polymeric formula. Elemental diet increased rates of mucosal protein synthesis, cell proliferation, and circulating glucagon-like peptide-2 concentrations, but lactase activity was decreased. Elemental diets can be tailored to simultaneously provide nutrition and a trophic stimulus for intestinal growth during bowel rest.