Nutritional analysis of blenderized enteral diets in the Philippines

The objective of this study was to analyze the nutritional quality and viscosity of blenderized enteral tube feedings (BTFs) from four hospitals in the Philippines. Samples of two different BTFs (one standard and one modified) were collected from each hospital on three separate occasions and analyzed for macronutrients, micronutrients, and viscosity. There was considerable variation among the BTFs for the concentrations of most nutrients measured. For standard BTF samples, the caloric density ranged from 66-123 kcal/100g and the percentages of total weight for protein, carbohydrate, and fat ranged from 1.5-4.0%, 8.6-21.4%, and 0.27-3.40%, respectively. Levels of specific vitamins were undetectable in 10 standard and 15 modified BTF samples. In samples where vitamin levels were detectable, results were: vitamin A, 625-8850 IU/kg; riboflavin, 0.40-5.00 mg/kg; and pyridoxine, 0.14-3.00 mg/kg. Mineral concentrations also varied greatly (eg calcium, 64-524 mg/kg; sodium, 148-886 mg/kg; iron, 3.0-13.7 mg/kg; and zinc, 1.8- 11.5 mg/kg). Correlation coefficients were statistically significant only for carbohydrate (r = 0.48, P = 0.017). Measured values tended to be lower than expected values for all nutrients, although the difference was statistically significant only for calories (P = 0.023). The viscosity of BTF samples ranged from 2.3-45,060 centipoise, excluding three samples that were too viscous for analysis. This study demonstrates that hospital prepared blenderized enteral tube feedings render unpredictable levels of micronutrients and macronutrients and appear likely to deliver less than the desired amounts of nutrients. Additionally, the viscosity of these feedings may be unsuitable for infusion through feeding tubes.