背景:肠内营养(EN)涉及用营养配方代替人的全部或部分习惯性饮食。不同剂量的EN对肠道微生物组的影响仍未得到充分研究。
方法:健康成人更换全部(100%EN)或部分(85%EN,其能量需求的50%EN和20%EN)与EN一起使用7天。在干预前和第7天收集粪便样品。粪便pH值,短链脂肪酸(SCFA),进行支链脂肪酸(BCFAs)和16SrRNA测序。用7天的食物日记进行饮食评估。
结果:招募了61名参与者(31名女性;中位(IQR)年龄:24.7(23.0-27.8)岁)。EN对粪便微生物群的剂量依赖性影响,SCFA,观察到BCFAs)和pH,在EN摄入时可检测到的变化至少占能量需求的50%。100%和85%EN减少了纤维发酵类群的丰度,例如Agathobacter,Faecalibaterium,白弧菌和酸性球菌。并行,可能有害的生物,比如真细菌,放线菌,克雷伯菌增多.在50%EN组中,坚持高鱼饮食,蔬菜,土豆,非酒精饮料,和脂肪扩散,谷物产品含量低,牛奶,和肉类与微生物群结构变化呈负相关(r=-0.75,P=0.025)。当使用组成工具进行微生物群分析时,未观察到该信号。
结论:EN以剂量依赖性方式对粪便微生物群和饮食相关细菌代谢产物产生不利影响,特别是在至少50%的剂量。这项研究的结果对接受大量EN的患者的饮食管理和咨询具有重要意义。
BACKGROUND: Enteral nutrition (EN) involves replacing all or part of a person\'s habitual diet with a nutritional formula. The impact of varying doses of EN on the gut microbiome remains understudied.
METHODS: Healthy adults replaced all (100% EN) or part (85% EN, 50% EN and 20% EN) of their energy requirements with EN for 7 days. Faecal samples were collected before and on day 7 of interventions. Faecal pH, short chain fatty acids (SCFAs), branched-chain fatty acids (BCFAs) and 16S rRNA sequencing were performed. Dietary assessment was performed with 7-day food diaries.
RESULTS: Sixty-one participants (31 females; median (IQR) age: 24.7 (23.0-27.8) years) were recruited. A dose-dependent impact of EN on faecal microbiota, SCFAs, BCFAs) and pH was observed, with changes detectable at EN intakes of at least 50% of energy requirements. 100% and 85% EN reduced the abundance of fibre-fermenting taxa such as Agathobacter, Faecalibaterium, Succinivibrio and Acidaminococcus. In parallel, potentially harmful organisms like Eubacterium, Actinomyces, and Klebsiella increased. In the 50% EN group, adherence to a diet high in fish, vegetables, potatoes, non-alcoholic beverages, and fat spreads, and low in cereal products, milk, and meat negatively correlated with changes in microbiota structure (r = -0.75, P = 0.025). This signal was not observed when using compositional tools for microbiota analysis.
CONCLUSIONS: EN detrimentally influences the faecal microbiota and diet-related bacterial metabolites in a dose-dependent manner, particularly at doses of at least 50%. The findings of this study have implications for the dietary management and counselling of patients receiving high volume EN.