Metabolic response to malnutrition: its relevance to enteral feeding.

Malnutrition results in a wide variety of metabolic responses, depending on circumstances, from reactions to pure deprivation of nutrients to include the added stress of injury and sepsis. Important differences of response exist between adults and children. Weight loss with changes in carbohydrate, fat, and protein metabolism are well documented. Disturbances of fluid and electrolyte balance are newer areas of interest as are changes in requirements for micronutrients such as trace metals. Many of these metabolic changes are under hormonal control. The intestinal tract shares in the response to malnutrition, and the consequent changes in mucosal function determine the ability of the intestine to handle enteral feeds. Such a route for nutritional support is important in protecting intestinal function not only in absorption but also in hormone production. Enteral feeding is increasingly having an important role in the interactions between acute diarrhoeal disease and malnutrition.