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United States Department of Agriculture

Agricultural Research Service

Research Project: ABSORPTION AND METABOLISM OF ESSENTIAL MINERAL NUTRIENTS IN CHILDREN Title: Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair

Authors
item Balay, Kimberly -
item Hawthorne, Keli -
item Hicks, Penni -
item Chen, Zhensheng -
item Griffin, Ian -
item Abrams, Steven -

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: September 5, 2012
Publication Date: September 12, 2012
Citation: Balay, K.S., Hawthorne, K.M., Hicks, P.D., Chen, Z., Griffin, I.J., Abrams, S.A. 2012. Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair. Nutrients. 4:1273-1281.

Interpretive Summary: There is very little data regarding trace mineral nutrition in infants with small intestinal ostomies, which are bags in the skin where stool is diverted when the intestines are damaged. We evaluated 14 infants with one ostomy to measure their zinc absorption and biochemical zinc and copper status. Zinc absorption was measured using a safe stable isotope technique. We found biochemical evidence of deficiencies of both zinc and copper in infants with small intestinal ostomies at both time points. Our data demonstrate that infants with an ostomy are at high risk for zinc and copper deficiency before and after intestinal reanastamosis. Additional supplementation, especially of zinc, should be considered during this time period.

Technical Abstract: There is very little data regarding trace mineral nutrition in infants with small intestinal ostomies. Here we evaluated 14 infants with jejunal or ileal ostomies to measure their zinc absorption and retention and biochemical zinc and copper status. Zinc absorption was measured using a dual-tracer stable isotope technique at two different time points when possible. The first study was conducted when the subject was receiving maximal tolerated feeds enterally while the ostomy remained in place. A second study was performed as soon as feasible after full feeds were achieved after intestinal repair. We found biochemical evidence of deficiencies of both zinc and copper in infants with small intestinal ostomies at both time points. Fractional zinc absorption with an ostomy in place was 10.9% +/- 5.3%. After reanastamosis, fractional zinc absorption was 9.4% +/- 5.7%. Net zinc balance was negative prior to reanastamosis. In conclusion, our data demonstrate that infants with a jejunostomy or ileostomy are at high risk for zinc and copper deficiency before and after intestinal reanastamosis. Additional supplementation, especially of zinc, should be considered during this time period.

Last Modified: 10/20/2014
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