Macronutrients and energy in home‐prepared enteral tube feeding: Comparison between food composition table estimates, nutrition labels, and laboratory analysis

Abstract

Background The effectiveness of home enteral nutrition depends on the supply and delivery of the prescribed nutrients. This study compared the macronutrient and energy values of home‐prepared enteral tube feeding analyzed in the laboratory with the same information calculated from labels and food composition tables. Methods A total of 107 enteral formulations were analyzed: 66 commercial enteral formulas (CEFs), 19 homemade enteral preparations, and 22 blended enteral preparations (BEPs). The values of macronutrients and energy and the ratio between the values found in the laboratory and the calculated values were all evaluated. The tolerance limit of acceptable variation was 20%. The results were subjected to chemometric methods using principal component analysis (PCA) and hierarchical cluster analysis (HCA). Results In the three categories of the enteral formulations, the calculated values for protein and fat were higher than those obtained in the laboratory. The calculated values for energy were higher than those obtained in the laboratory for the BEPs and CEFs. The CEFs had the highest percentage within the limit of acceptable variation for carbohydrate and protein, whereas the BEPs presented the lowest values for fat and energy. In the exploratory analysis of data using PCA and HCA, it was possible to verify similarities and discrepancies between the enteral formulations analyzed in the laboratory with those calculated from the labels and food composition tables. Conclusion The enteral formulations showed differences between the values of macronutrients and energy analyzed in the laboratory and those calculated from labels and/or food composition tables.

Assessment of the risk of contamination of enteral nutrition bottles based on the simulation of home use conditions and hygiene procedures

“…1,4 However, this system makes it difficult to individualize the dietary prescription and does not correspond to the reality experienced in the households of several developing countries, such as Brazil, 9,14,16 as it represents an expensive and difficult alternative for patients, especially those with low income. [17][18][19] Thus, the open administration system, especially with the use of HEPs and BEPs, remains a viable alternative for patients who require this type of nutrition care. 7,20,21 Although the open administration system is cheaper, it still comes at a high cost for families who need to purchase bottling materials, which are usually single-use, as recommended by manufacturers.…”

“…The closed system, with the use of ready‐to‐hang liquid and sterile CEFs, is most recommended, as it does not require prior handling and presents a lower risk of contamination 1,4 . However, this system makes it difficult to individualize the dietary prescription and does not correspond to the reality experienced in the households of several developing countries, such as Brazil, 9,14,16 as it represents an expensive and difficult alternative for patients, especially those with low income 17‐19 . Thus, the open administration system, especially with the use of HEPs and BEPs, remains a viable alternative for patients who require this type of nutrition care 7,20,21 .…”