Objective: the development and analysis of the macro and micronutrient composition of homemade enteral diets. Method: A standard homemade enteral diet was developed at three caloric concentrations -1500, 1800 and 2100 Kcal. After preparation and testing of viscosity, stability, odor and color, plus evaluation of cost, the chemical composition of the nutrients of the diets were analytically determined. Folic acid, vitamin D and vitamin B12 values were calculated using chemical composition tables. The results were compared with recommended nutritional standards for the elderly. Result: The diets exhibited normal macronutrient distribution. The 1500 caloric level presented some mineral and vitamin deficiencies. Suitable values were obtained at the other caloric levels for all minerals except magnesium. There were appropriate levels of all the vitamins in the 2100 Kcal diet, while vitamin E, D and B6 levels were below the recommended dietary allowances in the 1800 Kcal diet. Conclusion: The standard homemade enteral diets studied can contribute to the food and nutritional safety of elderly persons undergoing home care, if all are supplemented with magnesium and the 1800 Kcal diet is supplemented with vitamin E, D and B6. The 1500 Kcal diet was not nutritionally safe in terms of micronutrients.
ARTIGOS TEMÁTICOS / THEMATIC ARTICLES Avaliação química de macronutrientes e minerais de dietas enterais artesanais utilizadas em terapia nutricional domiciliar no sistema único de saúde Chemical evaluation of macronutrients and minerals from handmade enteral diets used in homecare nutritional therapy in the brazilian national health system Resumo Objetivo: este estudo objetivou avaliar quimicamente a composição de macronutrientes e minerais de dietas enterais artesanais prescritas para terapia nutricional domiciliar. Métodos: Foram coletadas fichas técnicas de dietas enterais artesanais padrão e padrão sem lactose, prescritas na alta hospitalar por hospitais públicos e pelo Núcleo de Apoio à Saúde da Família. Após preparo das formulações e avaliação de viscosidade, estabilidade, odor, cor e custo, foram selecionadas dietas de cinco locais, sendo agrupadas de acordo com as semelhanças na composição em Grupo A e Grupo B, e encaminhadas para análise química de macronutrientes e minerais. Os resultados foram comparados com as necessidades nutricionais propostas pelas Recomendações Dietéticas de Referência para homens de 51-70 anos. Resultados e Discussão: As dietas analisadas apresentaram distribuição normoproteica, normolipídica e normoglicídica. A quantidade total de fibra alimentar nas dietas do Grupo A ficou entre 12 g e 15 g, com 48% de fibra solúvel. No Grupo B, a fibra alimentar foi de 3,40 g, e na dieta padrão sem lactose, entre 6 e 8 g, apresentando 65% de fibra solúvel. Quanto aos minerais, todas as formulações estavam adequadas em ferro e a maioria, em cálcio, zinco, fósforo, cobre e sódio. Nenhuma formulação avaliada encontrou valores adequados de potássio e magnésio. Observou-se ainda baixa adequação de muitos minerais nas formulações de 1.200 Kcal. Conclusão: As formulações analisadas têm composição de macronutrientes adequada, necessitando de ajustes em fibras. Quanto aos minerais, aqueles deficientes precisam ser suplementados enquanto as adequações dietéticas não forem realizadas.
Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH) on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Dsmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mDsm/kg solvent), and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mDsm/kg solvent. Dn average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mDsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.
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