Basal energy expenditure and diet- induced modifications to thermogenesis in short bowel syndrome

Background & aim: The influence of food intake on diet-induced thermogenesis, in the absence of parenteral nutrition, has not been assessed in short bowel syndrome (SBS) patients. We studied basal energy expenditure (BEE) and diet-induced thermogenesis in SBS patients (n=8) and paired healthy adult volunteer controls (n=8). Methods: Energy expenditure was measured by indirect calorimetry (IC) before and after control diet intake. All study participants received oral control diet randomly given in 3 doses (A=1.0, B=1.5 and C=2.0)×1/6 of BEE calories. Bioelectric impedance was assessed. Pairing criteria for controls were: age, sex, body mass index. Results: No significant differences were found between SBS and paired healthy control groups in relation to absolute BEE (P=0.146) and when it was adjusted for body mass index, lean and fat body mass (P=0.861, 0.208 and 0.574, respectively). All diets promoted thermogenesis in both groups. The interaction between the control diet (A, B and C) and SBS and healthy control groups for diet induced thermogenesis presented a significant difference (P=0.026). When comparing groups (SBS vs healthy controls) in relation to the control diet (B and C) we observed: P=0.030 and 0.004, respectively. Conclusion: In patients with SBS it was observed that: (1) BEE measured by IC in absolute values or adjusted by lean body mass is similar to healthy control group; (2) Diet-induced thermogenesis was lower than the healthy control group for higher caloric diets (B and C).