Improved Gastric Emptying Whey-based formulas are associated with improved rates of gastric emptying when compared to casein predominant formulas.J Pediatr 1992;120:569-572
Decrease in gastric emptying time and episodes ofregurgitation in children with spastic quadriplegiafed a whey-based formula. Fried MD, Khoshoo V, Secker DJ, Gilday DL, Ash JM, Pencharz PB. Division of Clinical Nutrition, Hospital for Sick Children, Toronto, Ontario, Canada. J Pediatr. 1992 Apr;120:569-72.
Study ObjectiveTo determine whether whey-based formulas would improve the rate of gastric emptying and decrease the amount of regurgitation in patients with cerebral palsy, spastic quadriplegia, severe developmental delay, scoliosis who have been fed casein-predominant formulas.
Study MethodInclusion Criteria:Profound mental retardation with developmental delaySpastic quadriplegiaScoliosis> 3 years of ageGastrostomy tube fedClinical evidence of gastroesophageal refluxSubjects:Nine patients (age range 3-18 years) recruited from the clinical nutrition clinic due to frequent episodes of vomiting who were being fed a formula containing casein (80%) and soy (20%).Delayed gastric emptying was observed in all nine patients.
Study Method (cont)Subjects:Each patients participated in a double-blind, randomized trial with gastric-emptying scans that compared the effects of three different types of whey-based formulas: whey predominant, whey hydrolysate, and whey hydrolysate with 70% of the fat as MCT Whey hydrolysate Casein predominant Whey predominant Whey hydrolysate (70% MCT) 80% Casein / 20% 60% Whey / 40% 100% Whey 100% Whey Protein source Soy Casein hydrolysate hydrolysate Protein (gm) 5.1 3.4 3.6 6.0 Carbohydrate (gm) 20.0 17.2 16.6 19.1 Fat (gm) 6.6 7.7 7.7 5.8 Percentage of fat as 21.0 8.0 9.0 70.0 MCT Osmolality (mOsm/kg 314.0 470.0 403.0 318.0 water) Energy (kcal) 159.0 150.0 150.0 150.0
Study ResultsThe results of the gastric-emptying scans at 60 and 120 minutes are expressed as the mean ± SD percentage of residual gastric radioactivity for all 9 patients for ea. formula. 60 minutes 120 minutes Casein predominant 85%±11% 69%±14% Whey predominant 48%±19% 24%±18% Whey hydrolysate 56%±23% 31%±26% Whey hydrolysate 59%±19% 27%±13% (70% MCT)• The difference in the mean percentage of residual gastric activity among the three whey-based formulas at 60 and 120 minutes was not statistically significant• There was a reduction in episodes of vomiting in all patients fed whey-based formulas (2±2 episodes, range up to 7 episodes) compared to casein predominant formula (mean 12±11 episodes, range 4 to 35 episodes; p <0.05).
Study Results 100 Casein predominant Whey predominant 80 Whey hydrolysate Whey hydrolysate (70% MCT) 60 40 f ot necr e P 20 i rt sa G a ud se R 0 60 minutes 120 minutes l iJ Pediatr 1992;120:569-572
Study Summary The gastric emptying times associated with whey-based formulas were significantly shorter than casein-based formula Patients fed whey-based formulas had significantly fewer episodes of emesis than fed casein-based formula Whey-based formulas reduce the frequency of emesis by improving the rate of gastric emptying The difference residual gastric activity among the whey formulas at 60 and 120 minutes was not statistically significant.J Pediatr 1992;120:569-572