Bomb calorimetry, the gold standard for assessment of intestinal absorption capacity: normative values in healthy ambulant adults

Abstract

Intestinal absorption capacity is considered to be the best method for assessing overall digestive intestinal function. Earlier reference values for intestinal function in healthy Dutch adults were based on a study that was conducted in an inpatient metabolic unit setting in a relatively small series. The present study aimed to readdress and describe the intestinal absorption capacity of healthy adults, who were consuming their usual (Western European) food and beverage diet, in a standard ambulatory setting. Twenty-three healthy subjects (aged 22-60years) were included in the analyses. Nutritional intake (energy and macronutrients) was determined with a 4-day nutritional diary. Subsequently, mean faecal losses of energy (by bomb calorimetry), fat, protein and carbohydrate were determined following a 3-day faecal collection. Finally, intestinal absorption capacity was calculated from the differences between intake and losses. Mean (SD) daily faeces production was 141(49)g (29% dry weight), containing 891(276) kJ [10.7(1.3)kJ g(-1) wet faeces; 22.6 (2.5) kJ g(-1) dry faeces], 5.2(2.2)g fat, 10.0(3.8)g protein and 29.7(11.7)g carbohydrates. Mean (SD) intestinal absorption capacity of healthy subjects was 89.4%(3.8%) for energy, 92.5%(3.7%) for fat, 86.9%(6.4%) for protein and 87.3%(6.6%) for carbohydrates. The present study provides normative values for both stool nutrient composition and intestinal energy and macronutrient absorption in healthy adults on a regular Dutch diet in an ambulatory setting. Intestinal energy absorption was found to be approximately 90%.