title: Nutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults.
abstract: Serious nutritional and contamination risks may be involved in the preparation of blenderized tube-feeding diets and in the handling of commercial diets. Their nutritional and microbiological quality in home settings is unknown. The objective of this study was to assess the nutritional and microbiological quality of commercial enteral and homemade blenderized whole foods diets intended to adult patients in home nutritional therapy.
  
  
  
  In a cross sectional study, 66 samples of commercial (CD) and noncommercial (NCD) enteral diets were collected at the homes of patients in home enteral nutritional therapy, 33 of each type. Commercial diets were either powder (PCD; n = 13) or liquid (LCD; n = 20). The samples were analyzed in laboratory to assess their nutritional and microbiological quality. Anthropometric data of mid upper arm circumference (MUAC) and triceps skinfold (TST) thickness were obtained from the patients' medical records.
  
  
  
  NCD presented significantly lower values for protein, fat, fiber, carbohydrate and energy while water content was significantly higher. PCD and LCD did not show any statistically significant differences between them. In the NCD, the values measured for macronutrients and energy corresponded to less than 50% of the prescribed values (except for fat). In CD, protein value was about 20% more than the prescribed value; fat and energy values corresponded to approximately 100% of the prescription, while carbohydrate corresponded to 92%. Regardless the type of the diet, prevalence of undernutrition was high in both groups though patients of the NCD presented a higher percentage. Samples of NCD complied significantly less with the microbiological standards; only 6.0% complied with the standard for coliform bacteria. Escherichia coli was detected in 10, 2, and 2 samples of NCD, PCD and LCD, respectively.
  
  
  
  Homemade blenderized enteral diets showed low values of energy and macronutrients, delivered less than 50% of the prescribed values and had high levels of bacterial contamination.
authors.affiliation: Postgraduate Program in Nutrition, Universidade Federal de São Paulo, Brazil.
authors.forename: Maricy Machado Cavalca
authors.initials: MMC
authors.lastname: Vieira
authors.affiliation: Postgraduate Program in Nutrition, Universidade Federal de São Paulo, Brazil.
authors.forename: Valdirene Francisca Neves
authors.initials: VFN
authors.lastname: Santos
authors.affiliation: Postgraduate Program in Nutrition, Universidade Federal de São Paulo, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bottoni
authors.affiliation: Postgraduate Program in Nutrition, Universidade Federal de São Paulo, Brazil. Electronic address: tania.pnut@epm.br.
authors.forename: Tania Beninga
authors.initials: TB
authors.lastname: Morais
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D005516:Food Microbiology; D063427:Food Quality; D005526:Food, Formulated / Q000032:analysis / Q000382:microbiology / Q000592:standards*; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009753:Nutritive Value; D055815:Young Adult
keywords: Enteral nutrition; Food composition; Food contamination; Home care services; Nutritional support