Long-term nutritional status of an enterally nourished institutionalized population

Growth and nitrogen nutriture were evaluated during a yearlong study of 11 profoundly retarded nonambulatory institutionalized youth who were fed by gastrostomy and received anticonvulsants. The effects of dietary fiber and vitamin D were assessed by determining plasma levels and balances of zinc, magnesium, calcium, and phosphorus in a subset of six patients. Increase in body weight was 3.4 +/- 2.4 kg (means + SD), in height, 5.9 +/- 3.9 cm during the year. N balance remained positive throughout the study. Zn and Ca balances suggested that needs for this population may be greater than or equal to 150% of the Recommended Dietary Allowance. Vitamin D supplementation had no effect. Soy polysaccharide fiber intakes of 18-24 g/d compared with 0 or 12-20 g fiber/d significantly improved N and P retentions. Although the determination of nutrient needs of a severely disabled population is complex, our results suggest N and energy but not Zn and Ca allowances for a healthy population may be satisfactory guidelines.