The aim of the study was to determine if there is a difference between ileal and faecal assays for determining amino acid and N digestibilities in adult human subjects. Comparison of true ileal amino acid and N digestibilities was also made between adult human subjects and growing pigs to establish the usefulness of the pig as a model animal. Five subjects with established ileostomies and six subjects with intact large bowels consumed a constant diet consisting of meat, vegetables, fruit, bread and dairy products for 7 d with collection of ileostomy contents or faeces respectively over the last 4 d. The study was repeated using 25 kg body weight ileostomized and intact pigs. Apparent amino acid and N digestibility coefficients were determined. For human subjects the faecal digestibility values were significantly higher (P < 0.05) than the ileal values for Arg, Asp, Gly, Phe, Pro, Ser, Thr and Trp. The faecal digestibility of Met was significantly lower than the ileal value. Determination of DNA, diaminopimelic acid (DAPA) and the digestibilities of pectin, hemicellulose and cellulose in human subjects indicated that some microbial colonization had occurred a t the terminal ileum after formation of an ileostomy; however, this was not as extensive as in the large intestine. True ileal amino acid and N digestibilities were calculated after correcting for the endogenous contribution of amino acids a t the terminal ileum determined using a protein-free diet. There were no significant differences between adult human subjects and pigs for true ileal dietary amino acid digestibility except for Thr, Phe, Cys and Met. There were no significant differences between adult humans and pigs for the ileal digestibility of dry matter and the faecal digestibility of gross energy.Amino acid digestibility: Pig: Man

Changes in the plasma and urine levels of the trace metal zinc have been followed in a series of 37 adult patients totally supported by intravenous alimentation. Copper has also been determined in more recent cases. In such a seriously ill group, although urinary zinc loss may be very high at the height of catabolism, severe plasma depletion does not occur unless there is a subsequent phase of sustained anabolism and weight gain. In four patients plasma zinc fell to very low levels during this phase and three of this group developed a syndrome characterized by diarrhea, mental depression, para-nasal, oral and peri-oral dermatitis, and alopecia. The response to oral or intravenous zinc therapy is striking, except for hair regrowth which is delayed but eventually complete. The syndrome we have recognized in adult man has not been previously described. It resembles however the parakeratosis of zinc deficient swine and it is also very similar to Acrodermatitis enteropathica, a genetically determined disorder of infants very recently linked to zinc deficiency. Zinc is clearly essential to human metabolism and it should be included in all parenteral alimentation regimes particularly during the period of rapid, sustained, weight gain.

A high-fiber diet may protect against colon cancer because of the butyrate generated in the colon by bacterial fermentation of nonstarch polysaccharides. Butryrate can reverse neoplastic changes, at least in vitro, and resistant starch (RS) represents a source of butyrate in vivo. We examined the effects of replacing normal maize starch in the diet of rats with three preparations of RS on the amounts of starch, butyrate, and other short-chain fatty acids in the cecum. We examined the effects on fecal bulking and transit time, which have been suggested to protect against colon cancer. The RS preparations that we tested were potato starch, high-amylose maize starch, and an alpha-amylase-treated high-amylose maize starch. All had major effects on fecal weight and on the weight of the cecum but only slightly shortened transit times. All increased the amount of starch reaching the cecum and increased short-chain fatty acid production in the cecum; potato starch had the greatest effect and high-amylose maize starch the least. Potato starch, unlike high-amylose maize starch, enhanced the proportion of butyrate. Thus there were marked differences among sources of RS, even though these were all classified as RS2. The significance for colon cancer is discussed.

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The digestion of cellulose, hemicellulose, and lignin has been investigated in humans. Two groups of subjects were studied--healthy subjects with an ileostomy and normal subjects. Both were put on a fixed diet of known cellulose, hemicellulose, and lignin content. From the feces excreted the fiber components were measured by the acid and neutral detergent method. From the small bowel 84.5% of the ingested cellulose was excreted from the ileostomy subjects. From the normal subjects 22.4% of the ingested cellulose was excreted, indicating approximately 80% of the cellulose was digested in the normal subjects. From the water insoluble ingested hemicelluloses 27.5% were excreted from the small bowel, 4.0% from normal subjects. That is approximately 96% digestion of the hemicelluloses in normal subjects. Lignin was found to be undigested in both the small and large bowel. This has important implications in future fiber research.