Effects of refeeding by cyclic enteral nutrition on body composition: comparative study of elderly and younger patients

Previous reports suggest that correcting the malnourished state may be more difficult in elderlypeople than in younger people. The aim of this study was to evaluate the effect of 21 days of cyclic enteral nutrition (CyEN) on nutritional and body composition parameters in elderly, compared with younger patients. Twenty-four patients younger than 65 years (mean age 50 years) and 26 patients 65 years of age and older (mean age 75 years) referred for refeeding, having lost at least 20% of their body weight or at least 10% in 3 months, were studied. All patients were ambulatory. Cyclic enteral nutrition was administered nocturnally via a nasogastric tube; in the daytime patients were allowed to eat normally and to walk. Resting energy expenditure was measured at day 0 by indirect calorimetry. Ten anthropometric and biological nutritional parameters and a global nutritional deficiency (GND) were measured at day 0 and 21. Body composition was measured at day 0 and 21 by bioelectric impedance analysis. Total energy intakes were 286% and 280% of resting energy expenditure in groups 1 and 2, respectively. Body weight, serum prealbumin, serum transferrin, 24 h urinary creatinine, and the GND (39.9% vs 23.3%; P< 0.01) improved significantly more in younger than in elderly patients. Fat free mass (3.9 vs 2.4 kg; P< 0.05) and body cell mass (2.7 vs 1.6 kg; P< 0.01) but not fat mass improved significantly more in younger than in elderly patients. In conclusion, 21 days refeeding by cyclic enteral nutrition with similar energy amounts is less effective to correct malnutrition in elderly than in younger patients.