Minimal enteral nutrient requirements for intestinal growth in neonatal piglets: how much is enough?

Am J Clin Nutr. 2000 Jun;71(6):1603-10. doi: 10.1093/ajcn/71.6.1603.

Abstract

Background: Parenterally nourished preterm infants commonly receive minimal enteral feedings, the aim being to enhance intestinal function. Whether this regimen increases intestinal growth has not been established.

Objective: Our objective was to determine the minimal enteral nutrient intakes necessary to stimulate and to normalize neonatal intestinal growth.

Methods: Intestinal growth and cell proliferation were quantified in neonatal pigs given equal amounts of an elemental nutrient solution for 7 d. Different groups (n = 5-7 per group) received 0%, 10%, 20%, 40%, 60%, 80%, or 100% of total nutrient intake enterally, with the remainder given parenterally.

Results: In the jejunum, wet weight, protein mass, and villus height were significantly greater at enteral intakes >40%. Stimulation of ileal protein mass required a higher enteral intake (60%). In both segments, abrupt increases in DNA mass, crypt depth, ornithine decarboxylase activity, and crypt cells in S-phase occurred between enteral intakes of 40% and 60%. Circulating concentrations of glucagon-like peptide-2 and peptide YY, but not gastrin, increased significantly between enteral intakes of 40% and 60% and closely paralleled indexes of cell proliferation.

Conclusions: The minimal enteral nutrient intake necessary to increase mucosal mass was 40% of total nutrient intake, whereas 60% enteral nutrition was necessary to sustain normal mucosal proliferation and growth. Our results imply that providing <40% of the total nutrient intake enterally does not have significant intestinal trophic effects.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Animals, Newborn / growth & development*
  • Cell Division
  • DNA / analysis
  • Enteral Nutrition*
  • Food, Formulated
  • Gastrins / blood
  • Glucagon-Like Peptide 2
  • Glucagon-Like Peptides
  • Ileum / growth & development
  • Intestines / growth & development*
  • Jejunum / growth & development
  • Nutritional Requirements*
  • Organ Size
  • Peptide YY / blood
  • Peptides / blood
  • Proteins / analysis
  • Swine
  • Weight Gain

Substances

  • Gastrins
  • Glucagon-Like Peptide 2
  • Peptides
  • Proteins
  • Peptide YY
  • Glucagon-Like Peptides
  • DNA