A multicenter study evaluating the gastrointestinal tolerance and acceptability of a novel high-energy, high-protein, plant-based enteral tube feed for adults

Abstract

Background & Aims

In 2023, 2.6 million Europeans were estimated to be vegan, approximately 3 % of the European population. Few plant-based products exist for patients who need tube feeding. Furthermore, the tube-fed population often have gastrointestinal intolerance to milk-based proteins due to underlying pathology. A plant-based feed may be better tolerated. This study aimed to evaluate acceptability, compliance and gastrointestinal tolerance of a novel high-energy, high-protein, plant-based enteral tube feed.

Methods

A single-arm, prospective study in three centers was conducted. Adults ≥16 years, established on a tube feed for disease-related malnutrition which provided ≥50 % of energy requirements were included. Patients were swapped from their usual feed to the study product Compleat® plant protein 1.6 (a plant-based, high-energy, high-protein tube feed) for seven days. Acceptability (patient satisfaction), compliance (volume of feed taken versus prescribed) and gastrointestinal tolerance (diarrhea, constipation, vomiting, nausea) were assessed by self-reported questionnaire. This included multiple-choice questions, Likert scales and free text comments.

Results

Twenty-one patients were recruited, of which five withdrew, two due to worsening gastrointestinal symptoms with the study product. Sixteen patients completed data collection, mean age 53.3 years, 44 % female, 56 % had cancer, 75 % had a gastrostomy. Mean daily volume of Compleat® plant protein 1.6 consumed versus prescribed was 992 mL v 1058 mL (94 % compliance). Mean calorie and protein intake was 1555 kcals and 82.6 g respectively and 69 % tolerated the study feed with no change in gastrointestinal symptoms compared to baseline, whilst 25 % reported significant improvements in their gastrointestinal symptoms. Forty four percent were satisfied with the new feed, 38 % were neither satisfied nor dissatisfied.

Conclusions

Compleat® plant protein 1.6 was very acceptable to patients and associated with high levels of compliance and good gastrointestinal tolerance. For patients who follow a plant-based diet Compleat® plant protein 1.6 offers an innovative enteral tube feed that does not contain added milk or soya ingredients. Clinicians could consider this feed when patients have gastrointestinal intolerance to a milk-based feed.