• V Khoshoo and S Brown.
• West Jefferson Medical Center, New Orleans, Louisiana, USA. vkhoshoo@earthlink.net
• Eur J Clin Nutr. 2002 Jul 1;56(7):656-8.

ObjectiveWhey-based formulas have faster gastric emptying than casein-based formulas. Isoenergetic, isovolumic, whey-based formulas of different osmolarity and fat content empty in a similar manner. Will the gastric emptying of high and low energy density whey-based formulas be similar?DesignWe studied the gastric emptying rate of equal volumes of two whey-based formulas of different energy density (4.18 kJ/ml and 6.27 kJ/ml) and osmolality (270 and 450 mOsm/kg, respectively) in 10 children (4.5-12 y) with volume intolerance and resultant inability to gain weight.ResultsThe two formulas had comparable gastric emptying rates at 30, 60, 90 and 120 min. Over a one month clinical trial, substitution of the lower energy density whey-based formula (no weight gain over 2 months) with an equal volume of the high energy density formula produced a mean weight gain of 1.17+/-0.5 kg per patient without change in tolerance.ConclusionThe higher density whey-based formula can safely substitute an equal volume of a lower energy density formula to produce weight gain without affecting tolerance.ImplicationThis provides an important intervention for increasing energy intake in children with volume intolerance or fluid restriction.

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