Homemade diet versus diet industrialized for patients using alternative feeding tube at home- an integrative review

Franca, Sarah Cândido; Paiva, Sérgio Alberto Rupp de; Borgato, Maria Helena; Fontes, Cassiana Mendes Bertoncello; Simonetti, Janete Pessuto; Lima, Silvana Andréa Molina; Papini-Berto, Sílvia Justina

doi:10.20960/nh.1301

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Therefore, it is necessary to evaluate the evidence concerning the use of blended ENF compared with commercial ENF as the strengths and limitations of these formulas are not consistent. While previous reviews have tended to focus on a critical review of this topic [ 3 ], integrative review [ 17 ], and reviews involving children [ 18 ], there appears to be no evidence drawn from a meta-analysis on the nutritional value of blended diets in the adult population. The present review is a systematic review and meta-analysis that aims to compare the nutritional value, physical properties, and clinical outcomes of blended ENF with commercial ENF.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Although there are merits in using commercial “enteral nutrition formula” (ENF) compared with blended ENF, there is a growing preference for the use of blended ENF in many countries globally. However, the nutritional value and physical properties of blended ENF compared with commercial ENF may be limiting its use. We have not found any evidence of a meta-analysis on the nutritional value of blended diets in the adult population. Aim: The aim of this review was to compare the nutritional value, physical properties, and clinical outcomes of blended ENF with commercial ENF. Methods: The preferred reporting items for systematic reviews and meta-analyses were used for this review. The search strategy was based on a Population, Intervention, Comparator, Outcome framework. The following databases; Pubmed, EMBASE, PSYCInfo, and Google scholar were searched for articles of interest using keywords, Medical Subject Heading (MeSH) and Boolean operators (AND/OR) from the inception of each database until 23 February 2020. The articles were evaluated for quality. Results: Based on the systematic review and meta-analysis, four distinct themes were identified; Nutritional value, Physical properties, Clinical outcomes; and Adverse events. The findings of this review showed inconsistencies in the macronutrient and micronutrient values of the blenderised ENF compared with the commercial ENF. The results of the meta-analysis demonstrated that there were no significant differences (p > 0.05) between the blenderised ENF and the commercial ENF in relation to the fat and protein contents of the diets. However, the blenderised ENF was significantly lower (p < 0.05) than the commercial ENF regarding the energy content of the diets, with an overall mean difference of −29.17 Kcal/100 mL (95% CI, −51.12, −7.22) and carbohydrate content with an overall mean difference of -5.32 g/100 mL (95% CI, −7.64, −3.00). In terms of sodium, potassium, and vitamin A, there were no significant differences (p > 0.05) between the blenderised and commercial ENF, although significant differences (p < 0.05) were observed between the two diets with respect to calcium, phosphorus, magnesium, zinc, iron, and vitamin C contents. Furthermore, the blenderised ENF showed significantly higher levels (p < 0.05) of viscosity and osmolality than the commercial ENF. The significantly lower levels of some of the macro-nutrients and micro-nutrients in the blenderised ENF compared with the commercial ENF and the difference in the expected nutritional values may be due to the fact blenderised ENF is produced from common foods. Thus, the type of foodstuffs, cooking, and processing methods may lead to loss of nutrients and energy density. The deficits in the energy content and some of the macro- and micro-nutrients in the blenderised ENF compared with commercial ENF may have implications for patients’ health and clinical outcomes. The clinical implications of the underdelivering of nutrients may include increased risk of undernutrition, including energy malnutrition, which could have a negative effect on body composition and anthropometric parameters, morbidity, mortality, length of hospital stay, and costs. For outpatient care, this could increase the risk of hospital re-admission and homecare costs. Additionally, the higher viscosity and osmolality of the blenderised ENF compared with the commercial ENF can increase the risk of complications, including tube blockage, and impaired delivery of feed, water, and medications, with significant implications for patients’ nutritional status and health outcomes. Conclusion: The results of this systematic review and meta-analysis identified significant variability in the nutritional value of blenderised ENF compared with commercial ENF. Furthermore, the nutritional values of the blenderised ENF do not meet the expected recommended levels compared with commercial ENF and these may have implications for patients’ nutritional status and health outcomes, including the effect on body composition, morbidity, mortality, hospital re-admission, and costs. Further studies are needed to elucidate the nutritional value of blenderised ENF on patients’ clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

et al. 2020

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“…Franca et al [8] ao compararem as fórmulas industrializadas com as fórmulas artesanais, por meio de uma revisão de literatura, constataram uma tendência maior a aceitação das fórmulas industrializadas em relação ao sabor. Outra desvantagem apresentada nas fórmulas artesanais, foi que há uma alteração na composição dos alimentos, devido a sazonalidade, estoque e processamento do alimento, com isso, causando uma redução dos micronutrientes e macronutrientes.…”

Section: Discussionunclassified

Análise sensorial de suplementos nutricionais artesanais utilizados como alternativa terapêutica para idosos desnutridos

Dias¹,

Fortes

2019

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Introdução: A senescência vem acompanhada de diversas alterações fisiológicas acarretando em decréscimo do estado nutricional. Fórmulas artesanais e economicamente viáveis são de grande importância para o restabelecimento da saúde dessa população. Métodos: Estudo do tipo experimental e analítico realizado no Laboratório de Técnica e Dietética de uma universidade privada do Distrito Federal, entre dezembro de 2017 e janeiro de 2018. A primeira etapa do estudo consistiu na elaboração de três fórmulas artesanais (I, II e III) com alimentos naturais e adequadas nutricionalmente, a segunda etapa foi feita a análise sensorial das fórmulas artesanais; a terceira etapa foi feita o cálculo comparativo das fórmulas artesanais com as industrializadas existentes no mercado. Resultados: A fórmula III (leite integral zero lactose, cacau em pó, banana prata, farelo de aveia, pasta de amendoim e clara de ovo) obteve melhor aceitação em todos os parâmetros avaliados 8,44 ± 0,86, seguido da fórmula II (mandioca, beterraba, banana, aveia, melaço de cana, clara de ovo e arginina) 8,18 ± 0,74, em relação ao custo; a fórmula I (maltodextrina, clara de ovo, beterraba, óleo de canola, farinha de chia e glutamina) foi a menos onerosa e a fórmula III foi a mais onerosa, no entanto, todas foram economicamente viáveis quando comparadas as fórmulas industrializadas. Conclusão: O índice de aceitação das três fórmulas foi favorável, sendo a que possuiu o maior índice de aceitação em todos os parâmetros foi a III, assim como, em relação aos custos, todos apresentaram um valor reduzido em comparação as industrializadas.Palavras-chave: desnutrição, suplementos nutricionais, terapia nutricional.

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“…Although the use of blended family foods would reduce financial spending of the health care provider, the parents will have increased food bills and may not be able to purchase an expensive blender. Low-income families may struggle to afford the extra costs (59) . However, families would have to include their child’s food into the monthly budget if their child did not have the need for tube feeding and one could hence argue that the extra expense is therefore justifiable (24) .…”

Section: Risks Of Bdmentioning

confidence: 99%

The Use of Blended Diets in Children With Enteral Feeding Tubes

Köglmeier¹,

Assecaira²,

Banci

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives: This joint position paper of the Committees of Allied Health Professionals (CAHP) and Nutrition (CON) of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) provides a comprehensive guide for health professionals to manage blended diets in children via gastrostomy tubes. Methods: A systematic literature search was performed from 1992 to 2021 using Pubmed, MEDLINE, and Cochrane Database of Systematic Reviews and recent guidelines reviewed. In the absence of evidence, recommendations reflect the authors’ expert opinion. Final consensus was obtained by multiple e-mail exchange and virtual meetings of the CAHP and CON. Results: Reported benefits of blended diets include reduced GERD and infections, improved defecation, level of alertness and attention span, skin conditions, and appearance of hair and nails. Families report a sense of greater normality. Small case series, cross-sectional surveys, questionnaire-based small case studies, reports of personal experience, and single-center pilot studies are available in the medical literature. A total of 20 recommendations for practice were made based on the results and consensus process. Conclusions: There is little evidence published to formally inform about the potential health benefits or risks of this practice and how to use it in the best way. This leaves health professionals caring for such patients in a relative vacuum regarding what to consider when providing a duty of care to patients and carers who wish to pursue this method of feeding. This article provides guidelines for safe and appropriate use of a BD, but more research is needed.

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Homemade diet versus diet industrialized for patients using alternative feeding tube at home- an integrative review

Cited by 5 publications

References 12 publications

An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

Análise sensorial de suplementos nutricionais artesanais utilizados como alternativa terapêutica para idosos desnutridos

The Use of Blended Diets in Children With Enteral Feeding Tubes

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