Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. May 6, 2016; 7(2): 306-319
Published online May 6, 2016. doi: 10.4292/wjgpt.v7.i2.306
Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature
Dominik D Alexander, Lauren C Bylsma, Laura Elkayam, Douglas L Nguyen
Dominik D Alexander, Lauren C Bylsma, EpidStat Institute, Ann Arbor, MI 48105, United States
Laura Elkayam, Exponent Inc., Health Sciences, Chicago, IL 60661, United States
Douglas L Nguyen, Department of Medicine, Irvine School of Medicine, University of California, Orange, CA 92868, United States
Author contributions: Alexander DD and Nguyen DL contributed to conception, design, analysis and interpretation of the data; Alexander DD, Bylsma LC, Elkayam L and Nguyen DL contribured to drafting of the article; Alexander DD, Bylsma LC and Nguyen DL contributed to critical revision of the article for important intellectual conten; all authors approved the final version of the article.
Conflict-of-interest statement: Dominik D Alexander, Lauren C Bylsma, Laura Elkayam, and Douglas L Nguyen have served as consultants to Nestle Health Science.
Data sharing statement: The data set and search algorithms are available from the corresponding author at douglaln@.uci.edu.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Douglas L Nguyen, MD, Assistant Clinical Professor of Medicine, Department of Medicine, Irvine School of Medicine, University of California, 333 City Blvd. West, Suite 400, Orange, CA 92868, United States. douglaln@uci.edu
Telephone: +1-714-4566745 Fax: +1-714-4567753
Received: August 10, 2015
Peer-review started: August 10, 2015
First decision: September 11, 2015
Revised: December 19, 2015
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: May 6, 2016
Processing time: 254 Days and 17.7 Hours
Abstract

AIM: To critically review and summarize the literature on nutritional and health outcomes of semi-elemental formulations on various nutritionally vulnerable patient populations who are unable to achieve adequate nutrition from standard oral diets.

METHODS: We conducted a comprehensive literature search of Pubmed and Embase databases. We manually screened articles that examined nutritional and health outcomes (e.g., growth, disease activity, gastrointestinal impairment, mortality, and economic impact) among various patient groups receiving semi-elemental diets. This review focused on full-text articles of randomized controlled clinical trials and other intervention studies, but pertinent abstracts and case studies were also included. Results pertaining primarily to tolerance, digestion, and absorption were summarized for each patient population in this systematic review.

RESULTS: Results pertaining primarily to tolerance, digestion, and absorption were summarized for each patient population. The efficacy of semi-elemental whey hydrolyzed protein (WHP) diet have been reported in various nutritionally high risk patient populations including - Crohn’s disease, short bowel syndrome, acute and chronic pancreatitis, cerebral palsy, cystic fibrosis, cerebrovascular accidents, human immunodeficiency virus, critically ill, and geriatrics. Collectively, the evidence from the medical literature indicates that feeding with a semi-elemental diet performs as well or better than parenteral or amino acid based diets in terms of tolerance, digestion, and nutrient assimilation measures across various disease conditions.

CONCLUSION: Based on this comprehensive review of the literature, patient populations who have difficulty digesting or absorbing standard diets may be able to achieve improved health and nutritional outcomes through the use of semi-elemental WHP diets.

Keywords: Semi-elemental diet; Malnutrition; 100% hydrolyzed whey protein; Nutrition; Malabsorption

Core tip: Patients with major chronic illnesses may not be able to achieve adequate macronutrient or micronutrient requirements through standard oral diet because of difficulties tolerating, digesting, or absorbing whole foods. In our systematic review, we summarized the literature on the numerous nutritional and health benefits of semi-elemental formulations across various nutritionally vulnerable patient populations. Overall, the literature demonstrates that semi-elemental diet performs consistently as well or better than parenteral or amino acid based diets in terms of tolerance, digestion, and nutrient assimilation measures across various disease conditions.