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

Douglas G. Burrin, Barbara Stoll, Ruhong Jiang, Xiaoyan Chang, Bolette Hartmann, Jens Juul Holst, George H. Greeley, Peter J. Reeds

Research output: Contribution to journalArticlepeer-review

186 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1603-1610
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume71
Issue number6
DOIs
StatePublished - Jun 2000
Externally publishedYes

Keywords

  • Cell proliferation
  • Enteral nutrition
  • GLP-2
  • Glucagon-like peptide-2
  • Low-birth-weight infants
  • Minimal enteral feeding
  • Neonatal nutrition
  • Neonatology
  • PYY
  • Peptide YY
  • Premature infants
  • Preterm infants
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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