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Diarrhea is a common problem with potentially serious consequences for elderly tube-fed patients. A review of the literature indicates that diarrhea has been associated with the use of antibiotics, low blood albumin concentration, and a lack of fiber in the diet. This study documents the observed effect of dietary fiber on the incidence of diarrhea in 50 tube-fed patients. Over a 3-week period, patients who received fiber-containing formula had fewer liquid/loose stools than patients who received fiber-free formula. Nurses who care for elderly, tube-fed patients can help to improve outcomes by advocacy and interdisciplinary collaboration with registered dietitians and primary providers and by teaching assistive staff the importance of accurate recording of bowel function.

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The effects of three dietary phosphorus concentrations on magnesium balance in very low birth weight (VLBW) infants were measured. The infants consumed one of three special formulas for 20 consecutive days. Magnesium balance was calculated by measuring food intake, urinary magnesium and fecal magnesium. The highest dietary phosphorus concentration resulted in a higher (P < 0.05) fecal loss of magnesium. Net absorption and net retention of magnesium were lower (P < 0.10) in the high phosphorus group. A modest (33 per cent) increase in dietary phosphorus resulted in a decrease in magnesium absorption in VLBW infants.

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Five sources of dietary fiber were compared for their effect on blood and liver cholesterol. The effects of soybean fiber, rice bran (full fat), oat bran, barley bran and mixed bran on total blood cholesterol concentrations and liver cholesterol concentrations were measured in beef-fed C57BL/6 male mice. Each diet contained cooked beef, beef tallow, corn starch and 7% dietary fiber from one of the five fiber sources. A control group consumed a fiber-free diet. Dietary cholesterol was provided by the beef and beef tallow only. The experimental diets were fed for 3 wk; blood and liver were collected when the mice were 18 wk old. The liver cholesterol concentration in the rice bran-fed group was the lowest of the six diet groups and was significantly different than concentrations in the oat bran-fed group and the barley bran-fed group (P less than 0.05). The oat bran, mixed bran, and barley bran did not significantly lower blood cholesterol in the mice. Both the soybean fiber and rice bran diet groups had significantly lower total blood cholesterol than did the fiber-free controls (P less than 0.05). The soybean fiber group also had significantly lower blood cholesterol than the mixed-bran group.

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Dietary pectin's effects on intestinal 14C-starch absorption, oxidation to 14CO2 and intestinal weight were studied. Rats were adapted to either a 5% pectin diet or a control diet for 10 or more days before test meals of the same composition but containing 14C-starch were fed., One hour after the test meal, more 14C label remained in the stomach as well as the entire gastrointestinal tract of pectin-fed rats. Also, less 14C had reached the distal quarter of the small intestine at one hour. Rats eating the 5% pectin diet had higher wet and dry weights of the small intestine. A separate group of pectin-fed rats exhaled more 14CO2 than controls during the first hour after the test meal. Amount of 14C in the gastrointestinal tract and exhalation of 14CO2 did not differ between diet groups at 2, 3, or 4 hours after the test meal. Results indicate that dietary pectin caused a decrease in starch absorption during the fist hour after the meal and it led to an increase in small intestinal weight. Dietary pectin also resulted in a higher percentage of ingested 14C appearing as 14CO2 during the first hour after the test meal.

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The effects of dietary pectin and fat level on digestive enzyme activities in the pancreas and small intestine and on intestinal bile acid levels were investigated. In unfed rats, dietary pectin did not influence the pancreatic enzymes studied, but a higher level of corn oil in the diet lowered the amylase activity in the pancreas, increased pancreatic lipase activity and slightly lowered the chymotrypsin and trypsin activities. Diet did not change the dry weight of the pancreas. In the fed rats, dietary pectin increased the dry weight of the small gut wash plus the mucosal scraping. Dietary pectin increased the small intestinal lipase and chymotrypsin levels and at the low level of fat only, increased amylase and trypsin activities in the small intestine of fed rats. Intestinal lipase levels were higher and amylase levels lower in rats consuming the high level of corn oil. These results indicate that changes in dietary fat level led to changes in the amylase and lipase content of secreted pancreatic juice and that differences in absorption associated with diets containing pectin could be the result of increased material in the small intestine.

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