Selenium content of enteral formulas

Enteral nutrition in Crohn's disease: an underused therapy

This paper reviews the literature on the history, efficacy, and putative mechanism of action of enteral nutrition for inflammatory bowel disease in both paediatric and adult patients. It also analyses the reasoning behind the low popularity of exclusive enteral nutrition in clinical practice despite the benefits and safety profile.

Serum concentrations of trace elements in patients with Crohn's disease receiving enteral nutrition

We investigated the trace element status in Crohn's disease (CD) patients receiving enteral nutrition, and evaluated the effects of trace element-rich supplementation. Thirty-one patients with CD were enrolled in this study. All patients were placed on an enteral nutrition regimen with Elental(R) (Ajinomoto pharmaceutical. Ltd., Tokyo, Japan). Serum selenium, zinc and copper concentrations were determined by atomic absorption spectroscopy. Serum selenoprotein P levels were determined by an ELISA system. Average serum levels of albumin, selenium, zinc and copper were 4.1 +/- 0.4 g/dl, 11.2 +/- 2.8 microg/dl, 71.0 +/- 14.8 microg/dl, and 112.0 +/- 25.6 microg/dl, respectively. In 9 patients of 31 CD patients, serum albumin levels were lower than the lower limit of the normal range. Serum selenium, zinc and copper levels were lower than lower limits in 12 patients, 9 patients and 1 patient, respectively. Serum selenium levels significantly correlated with both serum selenoprotein P levels and glutathione peroxidase activity. Supplementation of selenium (100 microg/day) and zinc (10 mg/day) for 2 months significantly improved the trace element status in CD patients. In conclusion, serum selenium and zinc levels are lower in many CD patients on long-term enteral nutrition. In these patients, supplementation of selenium and zinc was effective in improving the trace element status.

Advances in hospital nutrition

The General Clinical Research Center facilities have been largely responsible for expansion of knowledge in the field of hospital nutrition. Expansion of this knowledge base has led to major medical advances in this century. Without the meticulous attention necessary for metabolic balance studies many if not most of these advances would have been seriously delayed. The role that General Clinical Research Centers have played and will continue to play cannot be overestimated.

Selenium: clinical significance and analytical concepts

Selenium is an essential trace element in humans and animals. Its only established function in humans is the antioxidant activity of glutathione peroxidase, a selenoenzyme. Severe prolonged deficiency may cause a fatal cardiomyopathy. Iatrogenic causes of selenium deficiency include parenteral and enteral nutrition. Low plasma selenium is also found in malabsorption, cystic fibrosis, rheumatoid arthritis, neoplasia, and other varied clinical disorders. Death has resulted from a single massive ingestion of selenium, while chronic excessive intake causes skin, nail, and hair pathology. Extreme geographical variation in population blood and urine selenium levels and a marked age-specific variation in population reference intervals are important factors in understanding selenium nutrition. Nutritional requirements, biological availability, and metabolism are discussed in relation to geographical, age, and method variability. Sampling, processing procedures, and methods for selenium quantitation are reviewed. Selenium content in different biological matrices and reference values for pediatric, adult, and obstetric populations are provided.

Kinetics of a single administration of 74Se-selenite by oral and intravenous routes in adult humans

The purpose of this study was to explore the fate of a single dose of labeled selenium as determined by its route of administration. Thus, the appearance of a stable isotope of selenium, administered as 74-Se-selenite, was measured in plasma, urine, and feces, with neutron activation analysis, following a 81.7 micrograms dose of 74Se-selenite given either intravenously or orally in two groups (n = 4) of healthy, young adult men, who were otherwise maintained on a diet providing a constant and adequate selenium intake. From these isotopic data, measurable parameters of urine excretion, total body retention and selenite-exchangeable metabolic pool (Se-EMP) were defined to provide a quantitative assessment of selenium metabolism in these subjects. The initial 24-hr urine excretion of the label was higher for the intravenously administered label (18.2 +/- 2.1% of dose) compared to the oral dose (11.7 +/- 2.6% absorbed dose). Thereafter, the excretion of isotope was the same for both groups. For equivalent entry of Se into the body, measured total body retention and Se-EMP were the same for both groups. These initial kinetic data suggest that the overall utilization of selenium from a single administration of selenite is comparable for the two routes of intake and that the host's selenium requirement can probably be met adequately via the intravenous administration of selenite.