title: Enteral nutrition formula selection: current evidence and implications for practice.
abstract: Many new enteral nutrition (EN) formulas have been created over the past several decades with a variety of intended uses. Although each is intended to promote improved outcomes, research is often unclear and, in many cases, conflicting. It is important to note that EN products are considered medical foods by the U.S. Food and Drug Administration and therefore do not have to complete premarket review or approval and are not regulated to the same extent as pharmaceuticals. While standard EN formulas are designed to meet the basic macro- and micronutrient requirements of individuals who cannot meet nutrition needs orally, specialty EN products have been developed to exhibit pharmacologic properties, such as immune-enhancing formulas containing arginine, glutamine, nucleotides, and ω-3 fatty acids. With the vast number of products available, rising costs of healthcare, and the drive toward evidence-based practice, it is imperative that clinicians carefully consider research regarding use of specialty formulas, paying close attention to the quality, patient population, clinical end points, and cost to patient and/or facility.
authors.affiliation: Hennepin County Medical Center, Minneapolis, Minnesota britta.brown@hcmed.org.
authors.forename: Britta
authors.initials: B
authors.lastname: Brown
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Kelly
authors.initials: K
authors.lastname: Roehl
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Melanie
authors.initials: M
authors.lastname: Betz
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage* / Q000627:therapeutic use; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods* / Q000592:standards; D005526:Food, Formulated / Q000592:standards; D006801:Humans; D007107:Immune System / Q000187:drug effects*; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards
chemical_list: D000276:Adjuvants, Immunologic
keywords: enteral formula; enteral nutrition; formulated food; medical food; nutrition therapy; nutritional support; pharmaconutrition; tube feeding