Estívariz Concepción F, Luo Menghua, Umeakunne Kayellen, Bazargan Niloofar, Galloway John R, Leader Lorraine M, Ziegler Thomas R
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Nutrition. 2008 Apr;24(4):330-9. doi: 10.1016/j.nut.2007.12.016.
Little data are published on the habitual home oral diet of patients with short bowel syndrome (SBS).
We assessed nutrient intake from oral food and beverages in 19 stable patients with severe SBS who live in the southeastern United States. Intestinal absorption of energy, fat, nitrogen (N), and carbohydrate (CHO) was determined in a metabolic ward.
We studied 12 women and 7 men, age 48 +/- 3 y of age (mean +/- SE) receiving parenteral nutrition for 31 +/- 8 mo following massive small bowel resection (118 +/- 25 cm residual small bowel). The patients demonstrated severe malabsorption of energy (59 +/- 3% of oral intake), fat (41 +/- 5%), N (42 +/- 5%) and CHO (76 +/- 3%). Oral energy intake was 2656 +/- 242 kcal/d (39 +/- 3 kcal/kg/d) and oral protein intake was 1.4 +/- 0.1 g/kg/d. Food/beverage intake constituted 49 +/- 4% of total (enteral plus parenteral) daily fluid intake, 66 +/- 4% of total daily kcal and 58 +/- 5% of total daily N intake. Oral fat intake averaged 92 +/- 11 g/day ( approximately 35% of total oral energy). Oral fluid intake averaged 2712 +/- 240 ml/d, primarily from water, soft drinks, sweet tea and coffee. Simple sugars comprised 42 +/- 3% of oral CHO intake. Usual dietary intake of multiple micronutrients were below the Recommended Dietary Allowances (RDA) in a large percentage of patients: vitamin A (47%), vitamin D (79%), vitamin E (79%), vitamin K (63%), thiamine (42%), vitamin B6 (68%), vitamin B12 (11%), vitamin C (58%), folate (37%), iron (37%), calcium (63%), magnesium (79%) and zinc (68%). Only seven patients (37%) were taking oral multivitamin-mineral supplements and only six subjects (32%) were taking oral iron and calcium supplements, respectively.
In these SBS patients, an oral diet provided a significant proportion of daily nutrient intake. The types of foods and fluids consumed are likely to worsen malabsorption and thus increase PN requirements. Oral intake of essential micronutrients was very low in a significant proportion of these individuals.
关于短肠综合征（SBS）患者日常家庭口服饮食的公开数据很少。
我们评估了居住在美国东南部的19例稳定的重度SBS患者从口服食物和饮料中摄入的营养物质。在代谢病房测定了能量、脂肪、氮（N）和碳水化合物（CHO）的肠道吸收情况。
我们研究了12名女性和7名男性，年龄48±3岁（平均±标准误），在大规模小肠切除术后（残余小肠118±25 cm）接受肠外营养31±8个月。患者表现出能量（口服摄入量的59±3%）、脂肪（41±5%）、N（42±5%）和CHO（76±3%）的严重吸收不良。口服能量摄入量为2656±242千卡/天（39±3千卡/千克/天），口服蛋白质摄入量为1.4±0.1克/千克/天。食物/饮料摄入量占每日总（肠内加肠外）液体摄入量的49±4%，占每日总千卡量的66±4%，占每日总氮摄入量的58±5%。口服脂肪摄入量平均为92±11克/天（约占口服总能量的35%）。口服液体摄入量平均为2712±240毫升/天，主要来自水、软饮料、甜茶和咖啡。单糖占口服CHO摄入量的42±3%。在很大一部分患者中，多种微量营养素的日常饮食摄入量低于推荐膳食摄入量（RDA）：维生素A（47%）、维生素D（79%）、维生素E（79%）、维生素K（63%）、硫胺素（42%）、维生素B6（68%）、维生素B12（11%）、维生素C（58%）、叶酸（37%）、铁（37%）、钙（63%）、镁（79%）和锌（68%）。只有7名患者（37%）服用口服多种维生素 - 矿物质补充剂，分别只有6名受试者（32%）服用口服铁和钙补充剂。
在这些SBS患者中，口服饮食提供了很大一部分每日营养摄入量。所摄入食物和液体的类型可能会使吸收不良恶化，从而增加肠外营养的需求。在这些个体中，很大一部分人必需微量营养素的口服摄入量非常低。
