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Clinical nutrition, enteral and parenteral nutrition

Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome

European Journal of Clinical Nutrition volume 66, pages 1059–1065 (2012)Cite this article

Subjects

Abstract

Background/Objectives:

Colostrum is rich in immunoregulatory, antimicrobial and trophic components supporting intestinal development and function in newborns. We assessed whether bovine colostrum could enhance intestinal adaptation and function in adult short bowel syndrome (SBS) patients.

Subjects/Methods:

Twelve SBS patients in this randomised cross-over study received 4 weeks oral supplement of bovine colostrum or an iso-energetic and iso-proteinaceous control (2.4 MJ/d, 500 ml/day) separated by a 4-week washout period. Patients were admitted four times for 72-h periods of fluid, electrolyte and nutrient balance studies. Meals, faeces and urine were weighed, and energy, macronutrient and electrolyte contents were analysed to calculate net nutrient uptake. Body composition was measured by dual-energy X-ray absorptiometry scans, and functional tests of handgrip strength and lung functions were performed. Eight patients completed the study and were included in the analysis.

Results:

Both supplements (colostrum and control) not only increased protein (0.96±0.42 MJ/d, P=0.004 1.03±0.44 MJ/d, P=0.003) and energy (1.46±1.02 MJ/d, P=0.005, 1.76±1.46 MJ/d, P=0.01) absorption but also absolute faecal wet weight excretions (231±248 g/d, P=0.002, 319±299 g/d, P=0.03), compared with baseline measurements. Both supplements improved handgrip strength (P=0.03) while only the control supplement increased lean body mass (1.12±1.33 kg, P<0.049). Colostrum was not found to be superior to the control.

Conclusion:

Intake of high-protein milk supplements increased net nutrient absorption for adult SBS patients, but at the expense of increased diarrhoea. Despite high contents of bioactive factors, colostrum did not significantly improve intestinal absorption, body composition or functional tests compared with the control.

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Acknowledgements

We thank Jette Christiansen, Dorte Christensen and Birgitte Schou for their technical assistance; nursing staff at the Department of Gastroenterology, Rigshospitalet; Kjeld Christensen at the farm Assendrup Hovedgaard. We also thank Arla Food for providing the whey powder used in creating a control.

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Authors and Affiliations

  1. Department of Gastroenterology CA-2121, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

    P Lund, P B Mortensen & P B Jeppesen

  2. Department of Human Nutrition, Faculty of Life Science, University of Copenhagen, Frederiksberg, Denmark

    P Lund & P T Sangild

  3. Department of Paediatrics, Hans Christian Andersen Children’s Hospital Odense University Hospital, Odense C, Denmark

    L Aunsholt

  4. Department of Biomedical Sciences, Endocrinology Research Section, Faculty of Health Science, Panum Institute 12.2, University of Copenhagen, Copenhagen, Denmark

    B Hartmann & J J Holst

  5. Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

    J Mortensen

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Correspondence to P Lund.

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Lund, P., Sangild, P., Aunsholt, L. et al. Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome. Eur J Clin Nutr 66, 1059–1065 (2012). https://doi.org/10.1038/ejcn.2012.93

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