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Nutritive Value of Elemental Formula With Reduced Osmolality

George G. Graham, MD; Gordon L. Klein, MD; Angel Cordano, MD, MPH
Am J Dis Child. 1979;133(8):795-797. doi:10.1001/archpedi.1979.02130080035005.
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• The osmolality of an elemental formula was reduced from 627 to 338 mOsm/kg H2O by replacing dextrose with corn syrup solids, reducing the content of casein hydrolysate, and replacing a portion of the medium-chain triglycerides with corn oil. In three convalescent malnourished infants, the protein quality of the formula was compared at isonitrogenous levels with that of a casein-sucrose-vegetable oil formula and was found to be at least as high: in all three nitrogen retention was higher than during a preceding casein period, and in one of the three it was also higher than during a following casein period. The levels of postprandial plasma amino acids suggested that threonine might be the first-limiting amino acid. Four severely malnourished infants received the formula as their only food during initial rehabilitation. The formula was well tolerated and supported satisfactory weight gain, linear growth, and serum protein regeneration.

(Am J Dis Child 133:795-797, 1979)

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