TY - JOUR
T1 - Corn-soy-blend fortified with phosphorus to prevent refeeding hypophosphatemia in undernourished piglets
AU - Hother Nielsen, Anne-Louise
AU - Lykke Jensen, Mikkel
AU - Martinussen, Torben
AU - Poulsen, Hanne Damgaard
AU - Mølgaard, Christian
AU - Sangild, Per Torp
AU - Briend, André
AU - Hansen, Christian Fink
AU - Friis, Henrik
AU - Michaelsen, Kim F.
AU - Thymann, Thomas
N1 - CURIS 2017 NEXS 031
PY - 2017/1
Y1 - 2017/1
N2 - Background Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soyblends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). Methods Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10). Results Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means± SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/ wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. Conclusion We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets.
AB - Background Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soyblends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). Methods Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10). Results Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means± SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/ wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. Conclusion We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets.
U2 - 10.1371/journal.pone.0170043
DO - 10.1371/journal.pone.0170043
M3 - Journal article
C2 - 28081252
SN - 1932-6203
VL - 12
JO - P L o S One
JF - P L o S One
IS - 1
M1 - e0170043
ER -
