Nutritional support of pediatric patients with cancer consuming an enteral formula with fructooligosaccharides

The objective of this study was to determine the tolerance and effects of a fructooligosaccharide (FOS)-containing enteral formula on fecal microbiota, nutritional status, biologic and immunologic outcomes of pediatric patients with cancer. A prospective, randomized, double-blinded, controlled trial was conducted at Children's Hospital, Shanghai Medical University. Sixty-seven hospitalized patients (1-12 years old) diagnosed with cancer (stage 1-3) and undergoing chemotherapy met study inclusion criteria. Patients received at least 400 mL of an assigned formula for 13 to 30 days. The control group received enteral formula without FOS (control); the study group received the same formula with FOS (+FOS; 2 g/L). Stool samples on days 0, 3, 13, and 30 were analyzed for bifidobacteria, lactobacilli, and other microbiota. Biochemical markers of nutritional and hematologic status and anthropometrics were also assessed. The mean energy intake provided by the formulas was similar. At day 30 but not day 13, stool lactobacilli counts were significantly (P < .02) higher in the +FOS group. A similar trend was seen for bifidobacteria. There were no clinically significant differences between groups for nutritional or hematologic status. There were no differences in immunologic parameters assessed except for significantly higher α1-acid glycoprotein in the control at day 13 (P < .01). The prognostic inflammatory and nutritional index of +FOS at day 30 significantly decreased compared with control (P = .016). These data suggest that an enteral formula containing dietary FOS produced a mild prebiotic effect at day 30 without any gastrointestinal discomfort in pediatric patients with cancer. Both enteral formulas were well-tolerated and accepted.