Nutrient Intake From Habitual Oral Diet in Patients With Severe Short Bowel Syndrome Living in the Southeastern United States Concepción Fernández-Estívariz, M.D * , Menghua Luo, M.D. * , Kay Umeakunne, R.D., M.S. § , Niloofar Bazargan, M. D. * , John R. Galloway, M.D. † , Lorraine M. Leader, M.D. * , and Thomas R. Ziegler, M.D. *,§,‡ *Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322. §Department of Surgery, Emory University School of Medicine, Atlanta, GA 30322. †Department of General Clinical Research Center and Emory University School of Medicine, Atlanta, GA 30322. ‡Department of Emory Center for Clinical and Molecular Nutrition, Emory University School of Medicine, Atlanta, GA 30322. Abstract Background and Aims—Little data are published on habitual home oral diet of short bowel syndrome (SBS) patients living in the United States. Methods—We assessed habitual macro-and micronutrient intake from oral food and beverages in 19 stable patients with severe SBS who live in the Southeastern United States. Intestinal absorption of energy, fat, nitrogen (N) and carbohydrate (CHO) was determined in a metabolic ward setting. Results—We studied 12 women and 7 men, age 48±3 years (mean±SE) receiving chronic PN for 31±8 months following massive small bowel resection (118±25 cm residual small bowel). Patients had intact (N=5), partial (N=9), or no residual colon (N=5). The subjects demonstrated severe malabsorption of energy (59±3% of oral intake), fat (41±5%), N (42±5%) and CHO (76±3%). Average oral energy intake was 2656±242 kcal/day (39±3 kcal/kg/day) and oral protein intake was 1.4 ±0.1 g/kg/d. Oral food/beverage intake constituted 49±4% of total (enteral + parenteral) daily fluid intake, 66±4% of total daily kcal and 58±5% of total daily N intake. Oral fat intake averaged 92±11g/day (≈ 35% of total oral energy). Oral fluid intake averaged 2712±240 ml/d, primarily from water, soft drinks, sweet tea and coffee. Simple sugars comprised 42±3% of oral CHO intake. Usual dietary intake of multiple micronutrients were below the Recommended Dietary Allowances (RDA) in a large percentage of patients: vitamin A (47%), vitamin D (79%), vitamin E (79%), vitamin K (63%), thiamine (42%), vitamin B6 (68%), vitamin B12 (11%), vitamin C (58%), folate (37%), iron (37%), calcium (63%), magnesium (79%) and zinc (68%). Only 7 patients (37%) were taking oral multivitamin-mineral supplements and only 6 subjects (37%) were taking oral iron and calcium supplements, respectively. Conclusions—In these SBS patients living in the Southeastern United States, oral diet provides a significant proportion of daily nutrient intake. However, the types of foods and fluids consumed are Correspondence and reprint requests: Thomas R. Ziegler, M.D., Department of Medicine, Division of Endocrinology, Metabolism and Lipids, General Clinical Research Center, Room GG-23, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, email tzieg01@emory.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errorsmaybe discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Nutrition. Author manuscript; available in PMC 2009 April 1. Published in final edited form as: Nutrition. 2008 April ; 24(4): 330–339. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript