Effects of three liquid diets on nutrition-sensitive plasma proteins of tube-fed elderly men

The effects on three nutrition-sensitive plasma proteins of isocaloric feedings with three enteral formulas were compared in 10 tube-fed male nursing home residents. The enteral products were Isocal (based on whole protein), Peptamen (based on a mixture of oligopeptides), and Vivonex T.E.N. (based on free amino acids). The nutrition-sensitive plasma proteins were albumin, transferrin, and retinol-binding protein. After observation during four weeks of feeding with Isocal, each subject was then monitored during four weeks of Peptamen and four weeks of Vivonex T.E.N. The latter two products were alternated in a crossover design. The shift of Isocal to Peptamen did not significantly (P greater than .05) influence the serum level of albumin, transferrin, or retinol-binding protein. In contrast, the shift of Isocal to Vivonex T.E.N. or of Peptamen to Vivonex caused a significant (P less than .05) decline in all three plasma proteins, the kinetics of their reductions corresponding to their known half-lives. The behavior of the three nutrition-sensitive plasma proteins suggests that in elderly nursing home men without gastrointestinal disease the nutritional value of the protein component of the three formulas follows the order Isocal = Peptamen greater than Vivonex T.E.N. However, this conclusion will require confirmation by nitrogen balance studies.