“Real food” enteral formulas in everyday clinical practice

Abstract

Enteral nutrition is a component of therapy for children whose ability to take in food by the natural route is impaired but whose gastrointestinal tract capacity still allows for nutrient digestion and absorption. According to guidelines, the optimum types of food for enteral feeding are ready-to-use commercial formulas (food for a special medical purpose, FSMP), which are classified into polymeric, oligomeric and amino acid/elemental. Using a blended kitchen diet as a sole food source is currently not universally recommended due to the higher risk of nutritional deficiencies and contamination with pathogenic microorganisms. However, in everyday practice, given isolated reports indicating their beneficial effects on gastrointestinal function, blended diets are attracting increasing interest and popularity. The so-called “real food” diets, available in some European countries and the USA, are a step towards the standardised and microbiologically safe use of natural nutrients in enteral nutrition. These fall into the category of industrial diets but, in addition to cow’s milk protein, they contain various other natural foods. This article summarises current knowledge on the efficacy and safety of “real food” diets. A small number of studies with limited reliability have been identified, making a joint summary of the obtained results impossible. Despite the limited scientific evidence, the descriptions of various clinical situations presented in the literature show a good clinical response in patients receiving “real food” diets. This suggests that such treatment should be attempted for children with significant gastrointestinal complaints and poor tolerance to standard enteral formulas.