The impact of nutritional support on appetite and food intake

Artificial nutrition (enteral tube feeding and parenteral nutrition) is inc reasingly being used in hospital and community settings to provide short- a nd long-term nutritional support to a diverse range of patients with acute and chronic conditions. Despite these methods of feeding being used either in conjunction with diet, or as a sole source of nutrition, the issue of th eir satiating ability has previously been largely overlooked. The consensus that emerges from this review is that nutrients provided by enteral tube f eeding or parenteral nutrition are not as effective as orally ingested nutr ients at relieving appetite sensations or suppressing food intake. When art ificial nutritional support is used as the sole source of nutrition, distre ssing appetite sensations may occur, even if full nutrient requirements are met by enteral tube or parenteral feeding. When used as a supplement to ad libitum food intake, enteral tube feeding and parenteral nutrition only par tially suppress oral intake, and total energy intake is increased. The mech anisms responsible for the poorer satiating ability of artificial feeding m ethods, relative to food intake, are not clearly understood, but the bypass ing of the upper gastrointestinal tract and associated cephalic phase respo nse by these methods of nutrient delivery may be important. (C) 2001 Harcou rt Publishers Ltd.