Is there a difference in metabolic outcome between different enteral formulas?
BACKGROUND
Despite appropriate enteral nutrition, many elderly patients do not reach a good metabolic outcome. Two nutrition formulas are commonly used in Israel with no evidence-based medicine to indicate preference of one over the other.


METHODS
We describe a 2-month observational study of patients fed by 1 of the 2 formulas. The first (Osmolite, Abbott Company, Abbott Park, IL) is without fiber, and the second (Easy Fiber, Easyline Company Givataim, Israel) in addition to containing fiber is also richer in protein, vitamins, and minerals. The formula was selected by the primary care physician before enrollment in the study and was not influenced by the investigators. Routine blood tests as well as body weight were monitored at the start of enteral feeding and during the 2 months following as part of the regular follow-up.


RESULTS
Fifty-seven patients were fed with the regular formula and 77 with the enriched one. No statistically significant differences were noted between the groups during the follow-up period, in body weight, cholesterol levels, total lymphocyte count, renal function tests, or electrolyte balance. However, in the enriched formula group there was a significant decrease in glucose (p < .05), and increase in albumin (p < .05) and hemoglobin (p = .01) levels.


CONCLUSIONS
Enteral feeding with enriched formula appears to improve albumin and hemoglobin levels as well as diabetic control, thus it may be more appropriate than the nonfiber diet for use in long-term care patients.
Kagansky
Michael
M
Hebrew University and Hadassah Medical School, Jerusalem, Israel.
Rimon
Ephraim
E
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D004734:Energy Metabolism / Q000187:drug effects* / Q000502:physiology; D004750:Enteral Nutrition / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D005526:Food, Formulated / Q000032:analysis / Q000592:standards*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008903:Minerals / Q000008:administration & dosage / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000378:metabolism
D001786:Blood Glucose; D004043:Dietary Fiber; D004044:Dietary Proteins; D006454:Hemoglobins; D008903:Minerals; D012709:Serum Albumin; D014815:Vitamins