Content of Poorly Absorbed Short‐Chain Carbohydrates (FODMAP) in Enteral Homemade Diets

Abstract

Background Recent studies have shown that commercial enteral formulas with low FODMAP (FO, fermentable oligosaccharides; D, disaccharides; M, monosaccharides; AP, and polyols) content decrease diarrhea of individuals receiving enteral nutrition therapy (ENT). There is no information, however, regarding the content of FODMAP in homemade enteral formula. The objective of this study was to assess energy and macronutrient content, and to quantify the amount of FODMAP content in homemade enteral formula, commonly prescribed for home use after hospital discharge. Methods Recipes of homemade enteral formula were requested from all hospitals and healthcare centers in a Brazilian city, totaling 24 recipes. The diets were quantified in relation to their energy content, macronutrients, and FODMAP content. Results Of the 19 hospitals, 68.4% prescribe only commercial enteral formulas at the time of hospital discharge, and 31.6% prescribe homemade enteral formula, both conventional and commercial. The homemade enteral formula showed a variation from 700 to 3000 kcal/d. The macronutrient levels of carbohydrates, proteins, and fats were 49.0% ± 6.8%, 17.4% ± 3.1%, and 33.5% ± 6.2%, respectively. On average, homemade enteral formula had 58.5% of high FODMAP content, 7.1% of moderate content, and 34.5% of low FODMAP content, considering that milk is the main food responsible for the high content of FODMAP. Conclusions Homemade enteral formula presented adequate nutrition characteristics and is rich in FODMAP. It is important to consider FODMAP in enteral diets prescribed for individuals intolerant to these carbohydrates by individualizing the diet prescription.

Estado nutricional e evolução clínica de idosos em terapia nutricional enteral domiciliar: uma coorte retrospectiva

“…The most prescribed formula was polymeric, normocaloric, normolipidic and normoproteic plus fibers, in agreement with other researches 18,33 . Prescription should always consider the clinical condition, nutritional status, access route, and expected results of HENT.…”

Accepted Safe Food‐Handling Procedures Minimizes Microbial Contamination of Home‐Prepared Blenderized Tube‐Feeding

“…Formula companies have responded with new whole‐food–based enteral products . These developments are concurrent with a desire to explore the impact of enteral formula ingredients on overall intestinal health and the microbiome . Prior to the introduction of a few whole‐food–based CEF products, most enteral formula choices were monotonous—primarily composed of simple carbohydrates, saturated fats—and lacking the benefit of phytochemicals and fiber from fruits and vegetables.…”

“…38 These developments are concurrent with a desire to explore the impact of enteral formula ingredients on overall intestinal health and the microbiome. 35,[39][40][41] Prior to the introduction of a few whole-food-based CEF products, most enteral formula choices were monotonous-primarily composed of simple carbohydrates, saturated fats-and lacking the benefit of phytochemicals and fiber from fruits and vegetables. A diet chronically high in solid fats and added sugars is associated with numerous chronic diseases.…”

Enteral nutrition management in stroke patients: a narrative review

“…A recent hypothesis suggests that diarrhea may be induced by the presence of poorly absorbed short-chain carbohydrates, including fermentable oligosaccharides (FOs), disaccharides (Ds), monosaccharides (Ms), and polyols (FODMAP) (86). Individuals with digestive impairment and problems with the absorption of these carbohydrates frequently exhibit intolerance to foods rich in FODMAPs, presenting abdominal distension, colic, and diarrhea, among other intestinal symptoms (87).…”