Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Henriques, Gilberto Simeone; Miranda, L.; Generoso, Simone de Vasconcelos; Guedes, Eduarda Guimarães; Jansen, Ann Kristine

doi:10.1590/1678-457x.33616

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…The level of pH in ONS determines the solubility of protein, as well as the interaction with other substances, such as medication. Most of ONS was developed at pH 6.8, which is close to neutral pH, while lower pH may decrease protein solubility (Henriques, Miranda, Generoso, Guedes, & Jansen, 2017;Klang, McLymont, & Ng, 2013).…”

Section: Effect Of Different Dextrose Equivalent (De) Of Tapioca Malt...mentioning

confidence: 99%

Development of nutritionally complete oral nutritional supplement using tapioca maltodextrin as a carbohydrate source

Astina¹

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Carbohydrate is a major composition in oral nutrition supplement. Modification of carbohydrate composition using tapioca resistant maltodextrin (TRM) may improve the glycemic response. This study aimed to investigate the effect of TRM and TRM containing-ONS on glycemic response, satiety, and gastrointestinal (GI) tolerability in healthy individuals. Physicochemical properties and sensory evaluation of developed ONS were also investigated. In Phase I, the peak of plasma glucose and insulin response after TRM (50 g) ingestion was lowest compared to 50 g glucose (GL) and tapioca maltodextrin (TM) in 16 healthy participants. Peak of plasma glucose of TRM, GL, and TM were 104.60±2.63, 135.87±4.88, and 127.93±4.05 mg/dl, respectively, while peak of serum insulin was 13.001±2.12, 47.90±11.93, and 52.96±17.68 µIU/ml. No significant effects were observed on subjective appetite during 180 min of study. Fifty grams of TRM increased flatulence in healthy participants. In phase II, three formulas were developed: original (0 g TRM), RMD15 (2.7 g TRM), and RMD30 (5.4 g TRM). The RMD30 significantly had lowest viscosity (viscosity of original, RMD15, RMD30 were 36.37±0.25, 34.60±0.06, 34.07±0.09 cP, respectively) and highest water activity (0.35±0.01, 0.33±0.01, 0.37±0.01 respectively) compared to original formula. The overall acceptability scores of developed formula were more than 7. In phase III, seventeen healthy participants were included to examine the acute effect of 1 serving of three developed formulas on glycemic response and tolerability. The RMD30 formula showed lowest postprandial blood glucose compared to original and RMD 15 (113.33±4.44 vs 119.25±4.67 and 114.42±6.43 mg/dl, respectively). Meanwhile, the Area Under Curve of serum insulin in RMD30 group was lower by 33.1% compared to original group (2,320±570.76 vs 3,470.12±531.86 µIU/ml). Subjective appetite responses were not significantly different among three formulas. All formulas were well tolerated by healthy participants. In phase IV, RMD30 formula was chosen to be supplemented in normoglycemic and prediabetic participants. Bodyweight did not significantly change after ingestion of 1 serving/d of RMD30 for 3 weeks (66.56±3.66 vs 66.99±3.69 kg, p=0.069). Food intake significantly increased at week 3 following supplementation compared to baseline (1,144.87±87.10 vs 1,477.76±94.16 kcal, p=0.001), without affecting habitual food intake. There were no significant changes in gastrointestinal symptoms. In conclusion, TRM lowers the postprandial plasma glucose and insulin response in healthy participants. Incorporation of TRM in nutritionally complete ONS decreased viscosity and increased water activity, while increased the sensory acceptability score. The replacement of TM using TRM by 30% in ONS decreased the insulin response, without significantly affected the glucose and satiety. Supplementation of RMD30 daily for 3 weeks increased total food intake in healthy and prediabetic participants. Developed formula was well-tolerated in acute and three-weeks study.

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Section: Effect Of Different Dextrose Equivalent (De) Of Tapioca Malt...mentioning

confidence: 99%

Development of nutritionally complete oral nutritional supplement using tapioca maltodextrin as a carbohydrate source

Astina¹

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Nutritional Value and Physical Quality of Oral Nutritional Supplements Made from Purple Sweet Potatoes to Treat Malnutrition in Patients with Cancer

Kurniasari

Susetyowati

Hardianti

et al. 2024

CNF

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Background: Malnutrition often occurs in patients with cancer, which eventually leads to decreasing response to therapy and increased morbidity and mortality rate. Oral Nutrition Supplements (ONS) are necessary to provide additional nutritional intervention to prevent and treat malnutrition in cancer patients. Purple sweet potato is a local food that is abundantly available in Indonesia and can be utilized as a basic ingredient for producing a modified ONS formula that is not only high in nutritional value but also has good physical quality. Objective: This study aimed to evaluate the nutritional value and physical quality of purple sweet potato-based ONS. Methods: A new local food-based formula was formulated by using purple sweet potato as the main ingredient. This new formula, which was then mentioned as the treatment formula, was subsequently compared with the control formula. The control formula was made from ingredients commonly used for producing ONS in hospitals in Indonesia, such as milk powder, sugar, oil, and other additives such as maltodextrin and creamer. Meanwhile, the treatment formula was labelled into three treatment formulas based on the differences in the proportions of white egg flour and whey protein as a protein source in each treatment formula. The treatment formula was formulated by using local ingredients of purple sweet potato flour and egg white flour by adding whey protein, extra virgin olive oil, omega-3 powder, sugar, and creamer. A proximate analysis was conducted to analyze the nutrient content of the formula and the viscosity and osmolarity tests were conducted to evaluate the physical qualities of the formula. The laboratory analysis results were described as descriptive data, then analyzed by using One-Way ANOVA. The determination of the best treatment formula in the form of effectiveness (Nh). Results: The results of the proximate test and physical quality showed that the best formula based on the highest Nh value of 0.75 was P3 with 245 kcal energy, 8.8 g (14%) protein, 6.5 g (24%) fat, and 37.8 g (62%) carbohydrate, viscosity 28.1 cP, and osmolarity 492.3 mOsm (iso-osmolar) per serving size (200 ml). Conclusion: Formula P3 which contains more egg white flour than whey protein is the best formula that has the best nutritional value and good physical quality.

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Green Banana mixed Diet is Beneficial in the Management of Childhood Persistent Diarrhea: an Open, Randomized-Controlled Trial (Preprint)

Hossain¹,

Sarmin²,

Islam³

et al. 2021

Preprint

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BACKGROUND Persistent diarrhea (PD), diarrhea for ≥14 days, accounts for 36%-56% of all diarrhea-related death. Studies demonstrated that green banana helps in the resolution of diarrhea. OBJECTIVE We assessed whether a lactose-free diet rice suji (RS) or rice suji containing green banana (GB-RS), improves outcome compared with 3/4th strength rice suji (3/4th RS) in 6 to 35 months old children having PD in the icddr,b Dhaka hospital. METHODS In this open-labeled, randomized, controlled trial, children with PD not improving with milk suji (the initial diet) received any of the three study diets: GB-RS, RS, 3/4th RS. The primary outcome was the percentage of children who recovered from diarrhea by day 5 with an intention to treat analysis. RESULTS From 1st December 2017 to 31st August 2019, we randomly allocated 45 children to each group. By day 5, 66 children recovered from PD, of whom 26 (58%), 14 (31%), 26 (58%) received GB-RS, RS, and 3/4th RS respectively. Significantly more resolution of PD occurred in GB-RS and 3/4th RS groups compared to RS group [relative risk (RR) 1⸱71, 95% CI 1⸱19-2⸱60; p=0⸱019]. Two (10%) children died, one each in RS group and GB-RS group. TaqMan array card (TAC) identified EAEC, rotavirus, norovirus, EPEC, astrovirus, and Campylobacter as the major pathogens associated with PD. CONCLUSIONS GB-RS and 3/4th RS are efficacious in the management of PD in young children. We also demonstrated a wide range of entero-pathogen associated with PD by TAC which needs further study to find a causal link. CLINICALTRIAL ClinicalTrials.gov, ID: NCT03366740 Registered on 8th December 2017 INTERNATIONAL REGISTERED REPORT RR2-10.2196/15759

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Osmolality and pH in handmade enteral diets used in domiciliary enteral nutritional therapy

Cited by 3 publications

References 15 publications

Development of nutritionally complete oral nutritional supplement using tapioca maltodextrin as a carbohydrate source

Development of nutritionally complete oral nutritional supplement using tapioca maltodextrin as a carbohydrate source

Nutritional Value and Physical Quality of Oral Nutritional Supplements Made from Purple Sweet Potatoes to Treat Malnutrition in Patients with Cancer

Green Banana mixed Diet is Beneficial in the Management of Childhood Persistent Diarrhea: an Open, Randomized-Controlled Trial (Preprint)

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