REPLETION OF NUTRITIONAL PARAMETERS IN SURGICAL PATIENTS RECEIVING PEPTIDE VERSUS AMINO-ACID ELEMENTAL FEEDINGS

Although it was earlier assumed that protein must be completely hydrolyzed to amino acids for absorption, evidence exists of a dual system for uptake of both amino acids and di- and tripeptides. Research has shown that feedings with a large portion of nitrogen as the smallest peptides or as intact protein are more desirable in most conditions than free amino acid formulas; however, less is known about the nutritional efficacy of feeding medium-chain to larger peptides. Furthermore, elemental feedings have been traditionally formulated to be low in fat. Twenty surgical patients admitted to the University of Virginia Health Sciences Center were randomized to either a moderate-fat, peptide enteral formula with majority of peptide chain lengths five to 40, or to a low fat, all-free amino acid formula. After one week, serum prealbumin, transferrin and cholesterol concentrations improved in the peptide-fed group and declined slightly in the amino acid-fed group. The peptide formula was equally tolerated compared to the all-free amino acid formula, in spite of its moderate fat content, in all subjects including those fed via jejunostomy.