Effects of early enteral bovine colostrum supplementation on intestinal permeability in critically ill patients: A randomized, double-blind, placebo-controlled study

Nutrition. 2019 Apr;60:106-111. doi: 10.1016/j.nut.2018.10.013. Epub 2018 Oct 12.


Objectives: In this study we sought to investigate the effect of early enteral bovine colostrum supplementation on intestinal permeability in intensive care unit (ICU)-hospitalized patients.

Methods: A total of 70 ICU-hospitalized adult patients were randomly assigned to receive a bovine colostrum supplement or placebo according to the stratified blocked randomization by age and admission category. Plasma endotoxin and zonulin concentrations were measured on days 5 and 10 of intervention.

Results: Out of 70 participants, 32 patients in the colostrum group and 30 patients in the control group were included in the final analysis of the outcomes. Plasma endotoxin concentration decreased significantly in the colostrum group on the 10th day (P < 0.05). Furthermore, plasma levels of zonulin reduced in the colostrum group significantly compared with the placebo group (P < 0.001).The incidence of diarrhea was significantly lower in the colostrum group than in the control group (P = 0.02).

Conclusions: Our results provide evidence that bovine colostrum supplementation may have beneficial effects on intestinal permeability and gastrointestinal complications in ICU-hospitalized patients. Further studies are needed to investigate the exact mechanism of action of these effects.

Trial registration: ClinicalTrials.gov NCT03186716.

Keywords: Colostrum; Diarrhea; Endotoxin; Intensive care unit; Tube feeding; Zonulin.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Animals
  • Cattle
  • Colostrum*
  • Critical Illness / therapy*
  • Diarrhea / epidemiology
  • Diarrhea / etiology
  • Diarrhea / prevention & control
  • Dietary Supplements*
  • Double-Blind Method
  • Endotoxins / blood
  • Enteral Nutrition / methods*
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / prevention & control*
  • Haptoglobins
  • Humans
  • Intensive Care Units
  • Intestinal Mucosa / metabolism
  • Male
  • Middle Aged
  • Permeability
  • Pregnancy
  • Protein Precursors / blood
  • Treatment Outcome


  • Endotoxins
  • Haptoglobins
  • Protein Precursors
  • zonulin

Associated data

  • ClinicalTrials.gov/NCT03186716