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Feeding an Elemental Diet vs a Milk-Based Formula Does Not Decrease Intestinal Mucosal Growth in Infant Pigs

Barbara Stoll, PhD^*, Pamela T. Price, PhD, Peter J. Reeds, PhD, Xiaoyan Chang, MS^*, Josef F. Henry, MS^*, Johannes B. van Goudoever, MD, PhD, Jens J. Holst, MD^|| and Douglas G. Burrin, PhD^*

From the ^* USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Ross Products Division, Abbott Laboratories, Columbus, Ohio; Department of Animal Sciences, University of Illinois at Urbana–Champaign, Illinois (deceased); Erasmus MC–Sophia Children's Hospital, Department of Pediatrics, Rotterdam, Netherlands; and the^|| Department of Medical Physiology, The Panum Institute, University of Copenhagen, Copenhagen, Denmark

Correspondence: Barbara Stoll, PhD, Children's Nutrition Research Center, 1100 Bates Street, Houston, TX 77030. Electronic mail may be sent to bstoll{at}bcm.tmc.edu.

Background: We previously showed that the level of enteral nutrient intake determines the rate of intestinal growth in piglets. Our objective was to determine whether providing enteral nutrition in the form of elemental nutrients (glucose, amino acids, lipid [ED]) rather than cow's milk formula (lactose, protein, lipid [FORM]) reduces small intestinal growth and lactase activity. Methods: Three-week-old piglets were fed either ED (n = 7) intragastrically or FORM (n = 6) orally for 6 days. Results: Intestinal protein and DNA masses, villus height, and crypt depth were not different in ED and FORM pigs. Crypt cell proliferation, measured by in vivo bromodeoxyuridine labeling, was significantly (p < .05) higher (+37%) in ED than in FORM pigs. Rates of mucosal protein synthesis (%/d), measured by in vivo ²H-leucine incorporation, were higher (p < .05) in ED than FORM (147 vs 89) pigs. Circulating concentrations (pmol/L) of the intestinotrophic peptide, glucagon-like peptide-2 (GLP-2), were also higher (p < .05) in ED than in FORM (148 vs 87) pigs. The mean lactase-specific activity (µmol/min/g) in proximal and distal segments was higher (p < .05) in FORM than in ED (124 vs 58) pigs. Conclusions: We conclude that intestinal mucosal growth and villus morphology are similar in pigs fed ED and FORM, despite higher cell proliferation and protein synthesis rates and lower lactase activity with ED. This implies that elemental diets may be as trophic as polymeric formulas to simultaneously provide nutrition and a stimulus for intestinal growth during bowel rest.

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