(P18-026-23) Blenderized Tube Feeds and Body Composition in Pediatrics

Objectives: The objective of this study was to determine the effect of blenderized tube feeds (or blends; pureed table food administered via gastrostomy) on body composition.

Methods: Children age 1-14 years were recruited from outpatient gastroenterology clinic at Boston Children’s Hospital. Inclusion criteria included gastrostomy or gastro-jejunostomy tube in place >3 months. Children with implanted electronic devices were ineligible. After informed consent, body composition was assessed using bioimpedance spectroscopy (SFB-7, Impedimed). Dietary history was analyzed in Cronometer. Fluid requirements were calculated using Holliday-Segar method. Fisher’s exact or linear regression were used to compare diet category with outcomes of interest with adjustment for age, sex and weight (kilograms) as appropriate.

Results: 20 children were recruited, 11 (55%) of whom received blends and 9 (45%) formula. Age, sex, medical comorbidities and concurrent medications did not differ between the groups. Blends provided higher % calories from fat (46±7% vs. 41±5%, P=0.03) and slightly lower % calories from carbohydrate (41±7% vs. 46±6%, P=0.06), despite similar calories (blend 79±32 vs. formula 79±32 kcal/kg, P=0.93). Importantly, there were no differences in fat or fat free mass (kg) between the diet groups when adjusting for age and sex, though there was a trend toward higher fat mass % (23.3±11.5% vs. 13.2±9.1%, P=0.07) and lower fat free mass % (76.7±11.5% vs. 86.8±9.1%, P=0.07) in patients receiving blends. Patients on blends received 61±27% of their calculated fluid requirements, while patients receiving formula received 85±35% of calculated fluid requirements (P=0.11). Despite the lower fluid intake with blends, there was no difference in measured total body water, extracellular or intracellular fluid volumes between groups. 

Conclusions: In this novel pediatric pilot study, no significant difference in fat or fat-free mass was observed with blends compared to formula. Most importantly, despite the increased viscosity of blends, there were no significant difference in total body fluid composition, providing reassurance that there are no deleterious effects on body composition or hydration status in pediatrics.

Funding Sources: NIH, NASPGHAN