Sterol and nutrient excretion in ileostomists on prudent diets

Nine ileostomists eating three diets (STAND, RESAT and EXFIB) were investigated in order to quantify the changes in sterol and nutrient excretion when shifting between a standard Western diet and two prudent diets. The RESAT diet had a moderate reduction in fat content to 30 per cent of energy, mainly through a reduction in saturated fat. The EXFIB diet had the same fat modification but in addition the dietary fibre content was raised to 3g/MJ according to current Swedish nutrition recommendations. The RESAT diet resulted in a lowered excretion of fat, but the excretion of nitrogen, energy, cholesterol and bile acids did not change compared with the STAND diet. The EXFIB diet resulted in a higher excretion of fat, nitrogen, energy and cholesterol compared with both the STAND and the RESAT diets (P less than 0.01). Bile acids showed no consistent excretion changes. Thus, a prudent diet, with moderate restricted total and saturated fat content, and a moderate increase in dietary fibre from natural food items, increased the excretion of cholesterol and fat from the small bowel when given to healthy ileostomists. A solely fat-modified prudent diet did not significantly change the pattern of excretion compared with a standard diet.