Influence of exchanging polyunsaturated fat for carbohydrate on bile acid and cholesterol excretion in ileostomy patients.

The effects of exchanging sunflower oil for isocaloric amounts of starch hydrolysate on bile acid and cholesterol excretion was studied in six ileostomy subjects. Enteral diets were used to minimize the influence of dietary fibre. Continuous drips of two low-cholesterol liquid enteral formulas, one medium-fat polymeric and one low-fat peptide diet, both containing sunflower oil, were administered for 4-d periods through nasogastric tubes in random order. Ileostomy sterol excretion was quantified by GLC. On the low-fat diet (more carbohydrate) compared to the medium-fat diet (more sunflower oil), net cholesterol excretion was lower in all subjects (P less than 0.05). Bile acid excretion tended to be higher (n.s.), so that mean net sterol excretion remained unchanged. The observations suggest that the consequences on total small bowel sterol excretion of replacing polyunsaturated fatty acids with carbohydrate are small or absent.