Micronutrient status of children receiving prolonged enteral nutrition.

BACKGROUND AND AIMS: The aim of this study was to assess the micronutrient status of children receiving prolonged enteral nutrition. METHODS: This cross-sectional single-center study included all 64 children (median age 6.8 years) receiving enteral nutrition providing >50% of daily energy intake for more than 6 months (median duration of enteral nutrition 43 months). The characteristics of the patients and mode of enteral nutrition were recorded. The concentrations of iron, zinc, copper, selenium and vitamins A, D, E and C were measured in plasma. RESULTS: Twelve children (19%) had iron deficiency. A high 25-hydroxyvitamin D concentration was recorded in 20% of the children, but none had associated hypercalcemia. Fifty-two children (81%) had low zinc concentrations in both plasma and erythrocytes. Plasma zinc, calcium, phosphorus and vitamin D concentrations were significantly lower in children receiving fiber supplementation. Abnormal micronutrient concentrations were found more frequently in the children receiving fiber supplementation. No other predisposing factors were associated with micronutrient deficiencies. CONCLUSION: Long-term enteral nutrition can lead to micronutrient deficiencies in children, whose micronutrient concentrations may require regular checking. Fiber supplementation might reduce the bioavailability of zinc, calcium, phosphorus and vitamin D.

Hospital-related undernutrition in children: still an often unrecognized and undertreated problem.

AIM: To evaluate the nutritional status of hospitalized children in Belgian hospitals and to analyse the impact of undernutrition on the degree of weight loss and duration of hospitalization. METHODS: In each hospital (one tertiary and three secondary hospitals), 100 consecutively hospitalized children were eligible for inclusion. Of these, 379 were included for analysis. Body weight, length and mid-upper arm circumference were measured at admission and body weight also at discharge. RESULTS: The median (range) age was 2.1 (0.8-17) years. On admission, 29 (7.7%) children were chronically malnourished and, depending on the parameter, between 2.4% and 9.8% acutely undernourished, while 12.1% had at least one subnormal parameter. Median (range) duration of hospitalization was four (1-64) days. Median (range) weight change was 0.0% (-15.6% - +13.9%). Weight loss of >2% was significantly (p < 0.05) more prevalent in tertiary (20.0%) than in secondary (10.2%) hospitals. Median hospital duration was 50% longer for chronically malnourished children (6.0 vs 4.0 days; p < 0.01). Only 36 children received a nutritional intervention. CONCLUSION: Acute undernutrition and chronic undernutrition remain frequent findings in hospitalized children in Belgium. Children with chronic undernutrition had a 50% longer hospital stay. Hospital-related undernutrition is an often unrecognized problem, because only one-third of the acutely malnourished children received nutritional support.