EFFECT OF FORMULA CARBOHYDRATE (CHO) CONCENTRATION ON TOLERANCE AND NUTRIENT ABSORPTION IN INFANTS WITH SEVERE, CHRONIC DIARRHEA

Abstract

The role that the amount of dietary CHO has on formula tolerance and macronutrient absorption in 12 malnourished, lactose- and soy-intolerance infants < 1yr of age, admitted for severe, chronic diarrhea to Cotocho Hospital, S.Paulo, Brazil, was investigated. Infants underwent 2 successive 72-hr metabolic balances in a crossover design, during which they received in random order one of 2 formulas which had almost identical composition except for CHO and fat content. Breath samples were collected during each dietary period for H2 determination. Fecal fat, osmolality, nitrogen, and energy were determined. Results were analyzed by paired t test. There were no significant differences between the two feeding periods in weight gain, fecal nitrogen, peack breath H2 levels, and fecal osmolality. Tolerance to the low CHO formula was better than to the high CHO formula, as indicated by a significantly lower stool output (x̄ ± SE 387 ± 66 g vs 764 ± 128, respectively, p < 0.05), higher fecal pH (p < 0.05), and less fecal CHO (p < 0.05). Macronutrient absorption was also better with the low CHO formula as indicated by the significantly lower amount of total fecal calories from lower CHO excretion (p < 0.05) and better absorption of fat (p < 0.001). A significant correlation existed between CHO-derived energy in feces and stool output (p < 0.05). CHO content in formula has an overriding effect on tolerance and macronutrient absorption in infants with severe, chronic diarrhea.

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