Can a super oral rehydration solution stimulate intestinal repair in acute viral enteritis?

This study was designed to screen several treatments for their effects on mucosal repair in an established model of piglet rotavirus enteritis. Six ingredients selected to facilitate repair were added to the oral rehydration solution (ORS) and subsequently to the diet: L-glutamine (GLN); rice solids; a soluble fiber (carboxymethylcellulose); nucleotides; polyamines; and fructooligo-saccharides. Rotavirus infection consistently induced a watery diarrhoea lasting 5 to 10 days and produced a jejunal mucosal lesion which was maximal at 3 days, post-inoculation (manifested by a reduction of villus surface area to 30% to 50% of normal). By 7 to 10 day post-inoculation, the villus surface area returned to 50% to 80% of normal. None of the supplemental ingredients added to the ORS had a significant effect in either shortening the clinical illness or in stimulating recovery of the affected mucosa. It is concluded that several types of "Super ORS" are ineffective in enhancing repair in viral enteritis in neonatal colostrum-deprived piglets. These results do not rule out beneficial effects of the additives tested in subjects with more extensive intestinal damage, in those who receive breast milk, or in those with bacterial enteritis.

Effect of phosphorus supply on mineral balance at high calcium intakes in very low birth weight infants

To evaluate the effect of varying phosphorus intake with constant high calcium intake (430 micrograms/kJ, or 180 mg/100 kcal), we randomly assigned 35 appropriate-for-gestational-age healthy male infants (birth weight, 715-1510 g) on day 21 postnatally to either standard-phosphorus (215 micrograms/kJ, or 90 mg/100 kcal), moderate-phosphorus (254 micrograms/kJ, or 106 mg/100 kcal), or high-phosphorus intake (287 micrograms/kJ, or 120 mg/100 kcal). Three-day mineral balances were determined after 7 d of the study diets. Weight and head circumference gain and intake of energy and vitamin D were not different for all groups. Calcium retentions were sufficient to meet intrauterine accretion in all groups. Phosphorus calculated to be available for soft tissue was significantly higher in the moderate- and high-phosphorus groups, and was sufficient to support soft tissue phosphorus accretion in these two groups. Total absorbed phosphorus and phosphorus tubular reabsorption were each affected by phosphorus intake. We conclude that very low birth weight infants fed high calcium may require greater phosphorus intake than that provided by formulas containing a ratio of calcium to phosphorus of 2:1. We suggest that the optimal mass ratio of calcium to phosphorus for formula for very low birth weight infants is from 1.6:1 to 1.8:1.

Solubility of calcium salts and carrageenan used in infant formulas did not influence calcium absorption in rats

Calcium absorption from tricalcium phosphate (TCP) was compared to that from calcium chloride, CaCl2, in the presence and absence of carrageenan in the rat model. There was no difference in percent calcium absorption as indicated by femur uptake of TCP or CaCl2 intrinsically labeled with 45Ca given by gavage (78.4 +/- 9.6 vs. 80.0 +/- 5.9, respectively). Thus, the difference in solubility of the two salts did not influence calcium absorption. When TCP was delivered by gavage in a solution containing 1% carrageenan, calcium absorption was not decreased compared to that of a control without carrageenan. In this model, calcium from TCP in the presence of up to 1% carrageenan is well absorbed.

Bone mineral metabolism in full-term infants fed human milk, cow milk-based, and soy-based formulas

OBJECTIVE

To study the hypothesis that ingestion of a modified soy-based formula with an improved mineral suspension system may result in bone mineral content similar to that observed in infants fed human milk or cow milk-based formulas.

DESIGN

Prospective, self-selected group of infants fed human milk randomized between the two formula-fed groups.

SETTING

University-based hospital nursery and follow-up.

PARTICIPANTS

Fifty-six normal, healthy, full-term infants, free of major malformations or disorders, including 17 infants fed human milk, 19 infants fed a cow milk-based formula, and 20 infants fed a soy protein formula were followed up to 6 months' postnatal age. The soy-based formula studied was modified to improve the suspendability of the minerals.

INTERVENTIONS

Infants were fed human milk or the study formula for the first 4 months, at which time beikost was permitted. Infants fed human milk received vitamin supplementation to provide 400 IU of vitamin D per day.

MEASUREMENTS

Anthropometric variables, serum calcium, magnesium, phosphorus, alkaline phosphatase, and parathyroid hormone levels were measured at enrollment, and at 8, 16, and 24 to 26 weeks' postnatal age. Bone mineral content at the distal third radius site was measured with single photon absorptiometry at these times. Growth in the infants did not differ significantly among the groups. There was no significant difference in serum calcium, magnesium, alkaline phosphatase, or parathyroid hormone concentrations among the infants during the study. Serum phosphorus was significantly lower at 8 weeks in the group fed human milk than in that fed the cow milk-based formula. Bone mineral content at 16 and 24 to 26 weeks was higher in the group fed the soy-based formula than in that fed human milk, and bone width was also higher at 16 weeks in the infants fed the soy-based formula.

CONCLUSIONS

Improving the suspendability of the mineral system in the soy formula results in bone mineralization in infants fed the soy-based formula similar to that measured in infants fed human milk and cow milk-based formula. We suggest that the suspendability of the minerals used is an important variable in the interpretation of the effect of feedings on the bone mineral status of infants.

Effect of lactose on mineral absorption in preterm infants

To determine whether a reduction of dietary lactose affects mineral absorption in preterm infants, a controlled, randomized, 72-hour balance study was conducted with very low birth weight infants (birth weights less than 1400 gm) fed Similac Special Care formula with a 50:50 carbohydrate blend of glucose polymers and lactose (n = 8) or a nearly identical formula with 100% carbohydrate as lactose (n = 10). The studies were conducted after at least 3 consecutive days of full oral feeds at a mean age of approximately 23 days. There was no difference between groups in percentage of apparent absorption of calcium, phosphorus, magnesium, zinc, copper, or manganese. Retention of these nutrients was similar to or greater than that which occurs in utero. Calcium absorption was 75% of intake. These results indicate that reducing the lactose content of premature-infant formulas to 50% of the carbohydrate does not impair mineral absorption.