Effects of Cyclic and Continuous Total Enteral Nutrition on 24-h Rhythms of Body Temperature and Urinary Excretions.

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To clarify the relationship between the pattern of diet intake and circadian rhythm in man, we measured body temperature and urinary excretions at 4-h intervals over a 24-h period in 18 patients who were in vegetative states and had been receiving total enteral nutrition (TEN) for at least 4 weeks. One group of patients was given a liquid diet intraduodenally and continuously throughout a day (continuous TEN), whereas the two other groups received their daily enteral feeding during a restricted time of day, either in the daytime from 0800h to 2000h (diurnal TEN) or in the nighttime from 2000h to 0800h (nocturnal TEN). In the diurnal TEN group, there was a clear body temperature rhythm with a peak at 2000h, whose pattern was similar to the well-established body temperature rhythm in normal subjects. The nocturnal TEN group also showed a temperature rhythm, but the peak appeared at 0400h. The continuous TEN group did not show any consistent body temperature rhythms. These effects of the schedule of TEN were quite similar to those on the circadian cortisol rhythm reported previously (J. Nutr. Sci. Vitaminol., 35, 639-647, 1989). In contrast to the body temperature rhythm, the rhythm of urinary excretions of water, sodium and potassium was little influenced by the schedule of TEN, showing a normal pattern with more excretions during the daytime in every group. Essentially the same effects were confirmed in a patient who received the three schedules of TEN in rotation for 5 weeks of each schedule. In conclusion, the timing of diet intake remarkably modifies the 24-h rhy-thms of body temperature and adrenocortical activity in man, as in laboratory animals, while it has no effect on the urinary excretion rhythm.
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Effects of Cyclic and Continuous Total Enteral Nutrition on 24-h Rhythms of Body Temperature and Urinary Excretions.

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