Development and feasibility of an exclusive enteral formula unprocessed and minimally processed foods added with yam flour (Dioscorea cayenensis)

Abstract

Background and Aims

Homemade enteral formulas have been resurfacing with a view to offering a diet free of additives and composed of fresh foods for therapeutic use for the population using enteral diets. Prioritizing healthy food groups and including natural complements, such as yam flour, is a strategy that aims to guarantee nutritional support while preserving the particular technological properties of foods delivered via probe. Therefore, this study aimed to develop an exclusive homemade enteral formula with fresh and minimally processed foods, added with yam flour (Dioscorea cayenensis), according to the NOVA classification system; evaluate its nutritional, physicochemical, microbiological, rheological and osmolar characteristics, in addition to the production feasibility study.

Methods

All raw materials used for the homemade enteral formula belong to group 1 or 2 of the NOVA classification system. An energy value of 1550 kcal/day was defined for the diet formula, with a distribution of 45% carbohydrate, 20% protein, 35% lipids and 30g fiber. Analyzes were carried out in triplicate for osmolarity, water activity, viscosity, physical stability observed after 24 hours under refrigeration, fluidity along the probe path and drip verification using the gravitational method (mL/minute). Energy density was calculated according to the calories provided by the diet and expressed in Kcal/mL. Microbiological analyzes were performed in accordance with American Public Health Association standards and formula cost was obtained.

Results

The formula had a density of 0.64kcal/mL and osmolality of 248.92 mOsm/kg, being hypocaloric, hyperproteic and normolipidic. There was no microbial growth during the 24 hours of analysis. It showed pseudoplastic behavior (n=0.5), being approximately five times more viscous at rest (1543.3 mPa∗s) than in probe flow (30.1 mPa∗s). For thixotropy, a value (119 mPa∗s) was obtained. It is considered stable and homogeneous after refrigeration for 24 hours, with adequate fluidity and an average drip of 86±3.05 drops/min. The rheological characteristics were enhanced due to the presence of yam nutrients, including starch, non-starchy polysaccharides, glycoproteins, and dietary fiber, which provide the formula with an optimal consistency for enteral administration. It presented reduced cost (77.09%, 79.57% and 80.87%) when compared to three standard commercial formulas.

Conclusion

The NIEF proposal in this study is unprecedented in that it favors a healthier dietary pattern, according to the NOVA food classification system, for the vulnerable population that needs to use enteral nutrition. The formula presented adequate nutritional, physicochemical, microbiological and rheological parameters, in addition to its low cost, which makes the use of the proposed formula viable in patients undergoing enteral nutritional therapy.