Blended Diet Research Articles

Blended diets for children and young people: applying the evidence to nursing practice.

Enteral tube feeding is commonly used for children and young people with complex health and care needs. Blended diets are becoming more widely used and there is increasing evidence to show the benefits of a blended diet for children, young people and their families. This article aims to collate recent evidence on blended diets and describe the implications for nursing practice. Studies exploring blended diets have identified benefits such as improved gastrointestinal symptoms, positive engagement with families around food and mealtimes and the normalisation of enteral tube feeding. Research has also explored the nutritional and microbial content of food blends as well as the viscosity and risk of tube blockage. These are key considerations when supporting families to make informed decisions and use blended diets safely. Nurses play an important role in supporting the safe and effective use of blended diets as part of a wider multidisciplinary team. It is necessary that they have an understanding of the evidence underpinning nursing practice in this area.

The impact of an enteral formula with food-derived ingredients on dietetic practice at a specialist children's hospital in the UK: Retrospective study.

Blended tube feeds are reported to be better tolerated in some children compared to standard commercial enteral formulas, allowing children to normalise feeding by having similar foods as the rest of the family. However, a blended tube feed is contraindicated in patients who are immunocompromised or require post-pyloric feeding as a result of a food safety risk. Other contraindications for blended diet include children who require continuous pump feeding via gastrostomy or nasogastric feeding tube (< 12 Fr) and fluid restrictions. To meet the demands of consumers, manufacturers have developed enteral formulas with food-derived ingredients (EFI). Commercially available EFIs are relatively novel in the UK. The present study aimed to monitor the implementation of an EFI by dietitians in a specialist children's hospital. A single-centre retrospective study was conducted to monitor the dietetic practice of commencing a commercially available EFI (Compleat® paediatric; Nestlé Health Science; 1.2 kcal/ml with 14% food-derived ingredients). Using electronic medical notes, data were collected on all children who commenced an EFI via an enteral feeding tube in a specialist paediatric hospital between August 2022 and December 2023. Data were gathered on demographics (age, sex and primary diagnosis), anthropometric measurements (weight-for-age Z-score and height-for-age Z-score), feed regimens (feed volume, feeding route, mode of feeding [continuous, bolus]), gastrointestinal symptoms (gastro-oesophageal reflux, vomiting, abdominal discomfort, constipation and loose stools) and geographical discharge area for children on home enteral nutrition. Seventy children were included in the analysis. The mean ± SD age was 4.7 ± 6 years. The median admission weight-for-age Z-score was -1.50. The most common primary diagnosis was a neurological impairment in 37/70 (47%) children. Most children were fed via a percutaneous endoscopic gastrostomy 31/70 (44%) and 8/70 (11%) of the children fed directly into the jejunum. The most common reason being gastrointestinal symptoms, 58/70 (83%). The most common gastrointestinal symptom reported before commencing an EFI was loose stools in 22/58 (38%) children. Within 7 days of commencing an EFI, there was reported improvement in gastrointestinal symptoms in all categories. In total, 42/70 children were discharged on an EFI. In our specialist children's hospital, EFI is primarily implemented by dietitians in children who are already established on an enteral formula displaying gastrointestinal symptoms. However, dietitians are increasingly implementing an EFI as their first-line whole protein enteral formula. Furthermore, an EFI was also implemented as a compromise to a blended diet.

Blended diet in enteral feeding: current guidance.

The practice of administering blended food via enteral feeding tubes has been growing in popularity in recent years. Concerns have been raised as this practice was perceived to increase risk of gastrointestinal intolerance, allergic reactions, nutritional insufficiency, tube blockages, and infection compared with using commercial enteral feed (CEF), the gold standard, as well as risk of litigation against the professional due to their support of practice that is not evidence-based. However, research has shown that the physical, social and emotional benefits from receiving blended diet may outweigh the previously suggested risks. Guidance has been updated to encourage discussions around blended diet while informing the tube-fed individuals, families and carers of potential risks, potential benefits, barriers, considerations for training, safety and contraindications.

Integrated metabolomics and microbiome analysis reveal blended oil diet improves meat quality of broiler chickens by modulating flavor and gut microbiota

This study was to evaluate the effects of different dietary oils in chicken diets on meat quality, lipid metabolites, the composition of volatile compounds, and gut microbiota. Nine hundred female 817 crossbred broilers at one day old with an average body weight of 43.56 ± 0.03 g were randomly divided into five treatments, each consisting of 6 replicates of 30 birds. The control group received soybean oil (SO); other groups received diets supplemented with rice bran oil (RO), lard (LO), poultry fat (PO), and blended oil (BO), respectively. All diets were formulated as isoenergic and isonitrogenous. Compared with SO, RO decreased ADG and 42 d BW (P < 0.05). Compared with the RO, BO increased ADG and 42 d BW and decreased FCR (P < 0.05). Compared with SO, BO increased 24 h a* value and reduced the malondialdehyde (P < 0.05), and further improved drip loss of breast muscle. The proportions of C18:0 and saturated fatty acid were the highest in LO, and the proportions of C16:1, C18:1, and monounsaturated fatty acids were the highest in BO. The content of C18:2, C18:3, and polyunsaturated fatty acids were the highest in SO. The contents of glyceryl triglycerides and total esters in BO were significantly higher than those in the SO and LO group (P < 0.05). There was a substantial increment in the relative abundance of PPARα, ACOX1 and CPT1A transcripts in breast of chickens fed BO (P < 0.05). Further, dietary BO increased the relative cecal abundance of Firmicutes phylum, Ruminococcus_torques and Christensenellaceae_R-7 genera, and decreased that of Campylobacterota, Proteobacteria, and Phascolarctobacterium (P < 0.05). Genera g_Lactobacillus and Christensenellaceae_R-7 may mainly be involved in the formation of volatile flavor compounds in breast muscle. In conclusion, dietary BO improved the flavor of chickens by increasing the concentration of triglycerides and volatile flavor compounds, improving gut microbiota structure, and suppressing lipid oxidation. The potential positive effects of BO may be associated with the regulation of lipid metabolism.

“Real food” enteral formulas in everyday clinical practice

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.

Omnivore diet composition alters parasite resistance and host condition.

Diet composition modulates animals' ability to resist parasites and recover from stress. Broader diet breadths enable omnivores to mount dynamic responses to parasite attack, but little is known about how plant/prey mixing might influence responses to infection. Using omnivorous deer mice (Peromyscus maniculatus) as a model, we examine how varying plant and prey concentrations in blended diets influence resistance and body condition following infestation by Rocky Mountain wood ticks (Dermacentor andersoni). In two repeated experiments, deer mice fed for 4 weeks on controlled diets that varied in proportions of seeds and insects were then challenged with 50 tick larvae in two sequential infestations. The numbers of ticks successfully feeding on mice declined by 25% and 66% after the first infestation (in the first and second experiments, respectively), reflecting a pattern of acquired resistance, and resistance was strongest when plant/prey ratios were more equally balanced in mouse diets, relative to seed-dominated diets. Diet also dramatically impacted the capacity of mice to cope with tick infestations. Mice fed insect-rich diets lost 15% of their body weight when parasitized by ticks, while mice fed seed-rich diets lost no weight at all. While mounting/maintaining an immune response may be energetically demanding, mice may compensate for parasitism with fat and carbohydrate-rich diets. Altogether, these results suggest that a diverse nutritional landscape may be key in enabling omnivores' resistance and resilience to infection and immune stressors in their environments.

Blended diets for tube-fed children and young people: a rapid review update

BackgroundMany children and young people with complex health and care needs use enteral feeding tubes to optimise their nutritional intake in the UK and other countries. Blended diets as an...

Organization of the stomy patient nutrition. Choice of food substrate

Feeding through an artificial fistula is used to organize the nutrition of patients with prolonged severe dysphagia. Gastrostomy is the most common operation to provide nutrition when oral intake is not possible. According to the information system of the St. Petersburg Territorial Compulsory Medical Insurance Fund, from 01.01.2015 to 10.20.2020, 2391 operations of imposing a nutritional fistula were paid. The choice of a food substrate for feeding an ostomy patient is difficult. Previously, pureed diets of mixed products were used; since 2000, in large hospitals, these diets have been replaced by branded enteral nutrition. The development of malnutrition, up to kwashiorkor and sarcopenia, has been noted in patients receiving an unbalanced pureed diet for a long time. The real properties of the blended diet do not allow it to be introduced into the gastrostomy without dilution with water. Blockage of gastrostomy tubes, due to the density of nutrition, is one of the frequent problems of such nutrition. On the contrary, branded enteral nutrition is fluid, well balanced in terms of the main food nutrients, vitamins and minerals, with a given energy value in small volumes of liquid. With long-term nutrition with commercial mixtures, intestinal dysbiosis develops with a loss of microbiota biodiversity. In the case of feeding a patient with a blended table, microbial biodiversity is preserved, a number of gastroenterological complaints and allergies or food intolerances to artificial nutrition ingredients are stopped. The choice of food substrate for the patient, its combination of wiped table and branded food is under study.

Fecal metabonomics combined with 16S rDNA sequencing to analyze the changes of gut microbiota in rats fed with different protein source diets.

When blended, animal and plant proteins can complement each other in terms of amino acid composition and release time. In this study, we investigated whether the blended protein diet has a better feeding effect than the single protein diet, and to reveal the differences in growth and intestinal microbiota composition caused by the blended protein diet. Forty Sprague Dawley (SD) rats received diets with different protein sources, including casein (C), whey protein (WP), black soybean protein (BSP), and black soybean-whey blended protein (BS-WP), for eight weeks. To investigate the effects of blended protein supplement on gut microbiota and metabolites, we performed a high throughput 16S rDNA sequencing and fecal metabolomics profiling. In addition, we determined growth and serum biochemical indices, and conducted intestinal morphology analyses. Compared to those in the BSP and WP groups, the daily body weight gain and feed conversion efficiency increased in the BS-WP group. Serum biochemical indices indicated that the protein utilization efficiency of the WP and BS-WP groups was relatively high, and the BS-WP blended protein diet improved the protein adoption rate. The BS-WP blended protein diet also improved intestinal tissue morphology and promoted intestinal villi development compared to the single protein diets. Furthermore, dietary protein altered the composition of gut microbiota, the gut microbial diversity of rats fed with the BS-WP diet was significantly (P < 0.05) higher than that of the other groups. The difference in dietary protein corresponded with an alteration of fecal amino acids and their metabolites, and tryptophan and tyrosine metabolism were the key mechanisms leading to the changes in fecal microbial composition. Dietary protein sources played an important role in the growth and development of rats by influencing intestinal metabolism and microbial composition. The BS-WP blended protein diet was more conducive to nutrient absorption than the single protein diet. Furthermore, blended protein increased the diversity of intestinal microbes and aided the establishment of intestinal barrier function.

Clinical guideline highlights for the hospitalist: The use of blended diets in children with enteral feeding tubes.

The Use of Blended Diets in Children With Enteral Feeding Tubes: A Joint Position Paper of the ESPGHAN Committees of Allied Health Professionals and Nutrition RELEASE DATE: January 1, 2023 PRIOR VERSION(S): n/a DEVELOPER: ESPGHAN Committees of Allied Health Professionals and Nutrition FUNDING SOURCE: ESPGHAN Committees of Allied Health Professionals and Nutrition TARGET POPULATION: Pediatricians, Pediatric Hospitalist.

Optimizing nutrition IN pediatric intestinal pseudo-obstruction syndrome.

Pediatric intestinal pseudo-obstruction (PIPO) encompasses a variety of rare, heterogeneous, and disabling disorders that severely affect gastrointestinal motility and are associated with high morbidity and mortality. PIPO management is complex and focuses on maintaining an optimal nutritional status, improving gut function, relieving symptoms, and treating complications. Nutritional issues prevail, and PIPO patients often experience severe undernutrition and faltering growth. Thus, nutritional management plays a pivotal role for achieving the most favorable clinical outcomes. The calorie and nutrient intake of each patient needs to be tailored to age, extent and severity of gut involvement and nutritional needs to support an optimal nutritional status. After defining the extent and severity of gut dysmotility, an experienced team should perform a careful nutritional assessment. An oral diet should always be encouraged and might include bite and dissolve solids, liquid diet or simple oral stimulation. If oral caloric intake is inadequate, liquid gastric feeds should provide the subsequent step. In the presence of severe gastric dysmotility, continuous post-pyloric feeding represents a viable option. In the most severe cases, parenteral nutrition (PN) is required to meet appropriate nutritional requirements. Pediatric data on this topic are scarce and mainly extrapolated from adult studies. In this review, we discuss current evidence and knowledge regarding nutritional options, implications of the use of different feed types, including a blended diet, and the use of PN. Moreover, based on our experience and the evidence from the literature, we propose a flow chart to guide the nutritional management of PIPO patients.

Copper Deficiency Anemia Due to Low-Calorie, Blended Enteral Diet: Case Report.

Copper deficiency is an uncommon cause of hematologic abnormalities in children that is often overlooked or misdiagnosed. When found, specific recommendations on dose, duration, or frequency of copper repletion are lacking in the current literature. This report describes the case of a 4-year-old boy who presented to a university medical center in the midwestern United States with persistent macrocytic anemia found to be caused by copper deficiency secondary to a low-calorie, blended enteral diet. Intravenous copper supplementation was initiated at 40 μg/kg/d for a total of 6 days, followed by enteral supplementation of 2 mg cupric oxide. This repletion regimen ultimately improved the patient's copper deficiency and resolved anemia within 1 month.

An observational investigation of the faecal microbiota and metabonome of gastrostomy fed children, on blended and formula diets

ABSTRACT Gastrostomy fed children traditionally have a Formulae diet (FD), which fulfills nutritional requirements; however, many families are adopting Blended diets (BD), which are what the whole family would eat. We undertook an observational investigation of the colonic microbiota and metabonome in a small group of gastrostomy fed children, who were either on an FD or BD, and compared, where possible to their siblings (17 FD, 28 BD, 19 HS). There was no increase in complications in tube blockage or infection rates, but a significant improvement in the prevalence of bowel problems, a reduction in medication and an increase in quality of life. Metataxonomic analysis showed that the FD group was significantly different to the Sibling group, and that families did not cluster together. Whole sample metabonomics showed no differences between groups; however, univariate analysis of biologically important metabolites did differ. Changing to a BD resulted in no increase in complications or risks, but improved the overall quality of life for the children and families.

Determinants in parents' decision to use blended diets with gastrostomy-fed children and young people: A mixed methods study.

Children fed via a gastrostomy are provided with commercial produced formula feeds. They are not offered blended diet (BD) as an alternative, and it is not formally supported in the UK due to concerns regarding nutritional content, contamination and tube blockages. Despite this increasing numbers of families are opting to use BD. To discover why parents opt to use of BD with their children and young people who are fed via gastrostomy. This mixed methods study comprised a qualitative phase of 18 in-depth interviews with parents who were using BD with their child. The quantitative phase comprised a survey of 208 parents, 140 of whom used BD and 68 did not use BD. The in-depth interviews identified four overarching themes that influenced parents' decision to use BD; loss, conflict, empowerment and quality of life. Responses from the survey revealed differences between those who did and did not use BD in levels of self-efficacy, views about formula feeds, rating of their child's health and stools. Concerns about formula feeds and less perceived need for it are key determiners in parents' decision to use BD. These views are influenced by social constructs and individual beliefs and circumstances. Those using BD were more likely to rate their child's stools as being normal and rated their child's health more highly than those not using BD.

Elevated branched-chain amino acid inclusions generate distinctly divergent growth performance responses in broiler chickens offered wheat- and/or sorghum-based, reduced-crude protein diets

The objective of this study was to determine the effects of elevated branched-chain amino acid (BCAA) inclusions in 187.5 g/kg crude protein (CP) diets based on wheat, sorghum or a wheat-sorghum blend on performance parameters of broiler chickens from 7 to 28 days post-hatch. The first tier of BCAA inclusions relative to lysine were leucine 105, isoleucine 65 and valine 75. The second tier was an elevation of leucine to 150 individually and in the third tier leucine was maintained at 150 and isoleucine and valine were elevated to 75 and 85, respectively. A 3 × 3 factorial array of these dietary treatments were offered to a total of 324 male Ross 308 broiler chickens housed in six replicate cages per treatment with six birds per cage. The assessed performance parameters included growth performance, relative abdominal fat-pad weights, nutrient utilisation, apparent jejunal and ileal digestibility coefficients of starch, protein (N) and amino acids and free amino acid concentrations in systemic plasma. Treatment interactions were observed for weight gain (P < 0.001) and FCR (P < 0.014). Elevated BCAA inclusions in sorghum-based diets significantly increased weight gain by 9.26 % (1451 versus 1328 g/bird) and numerically improved FCR by 0.86 % (1.378 versus 1.390). In contrast, elevated BCAA inclusions in wheat-based diets significantly depressed both weight gain by 9.49 % (1288 versus 1423 g/bird) and FCR by 8.33 % (1.665 versus 1.537). Wheat-based diets (5.68 g/kg) generated significantly lighter relative abdominal fat-pad weights than either sorghum-based (13.48 g/kg) or blended diets (12.95 g/kg). Sorghum-based and blended diets supported superior energy utilisation and N retention in comparison to wheat-based diets. Similarly, sorghum-based and blended diets supported higher jejunal and ileal starch digestibility coefficients than wheat-based diets, but wheat supported significantly higher jejunal protein (N) digestibility by 10.5 % (0.726 versus 0.657). Treatment interactions were observed for ileal digestibility of 4 amino acids (arg, lys, val, gly), BCAA inclusions significantly influenced 3 amino acids (ile, leu, thr) and the feed grain significantly influenced 10 amino acids (his, ile, leu, met, phe, ala, asp, glu, pro, tyr). Elevating BCAA inclusions in wheat-sorghum blended diets significantly increased free plasma concentrations of leucine and influenced concentrations of isoleucine and valine. However, BCAA inclusions significantly decreased plasma concentrations of threonine, asparagine plus aspartic acid, cysteine, glycine, proline, and serine. Consideration is given to possible reasons for the remarkable weight gain treatment interaction following elevated BCAA inclusions to sorghum- or wheat-based diets.

The Use of Blended Diets in Children With Enteral Feeding Tubes: A Joint Position Paper of the ESPGHAN Committees of Allied Health Professionals and Nutrition.

This joint position paper of the Committees of Allied Health Professionals (CAHP) and Nutrition (CON) of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) provides a comprehensive guide for health professionals to manage blended diets in children via gastrostomy tubes. A systematic literature search was performed from 1992 to 2021 using Pubmed, MEDLINE, and Cochrane Database of Systematic Reviews and recent guidelines reviewed. In the absence of evidence, recommendations reflect the authors' expert opinion. Final consensus was obtained by multiple e-mail exchange and virtual meetings of the CAHP and CON. Reported benefits of blended diets include reduced GERD and infections, improved defecation, level of alertness and attention span, skin conditions, and appearance of hair and nails. Families report a sense of greater normality. Small case series, cross-sectional surveys, questionnaire-based small case studies, reports of personal experience, and single-center pilot studies are available in the medical literature. A total of 20 recommendations for practice were made based on the results and consensus process. There is little evidence published to formally inform about the potential health benefits or risks of this practice and how to use it in the best way. This leaves health professionals caring for such patients in a relative vacuum regarding what to consider when providing a duty of care to patients and carers who wish to pursue this method of feeding. This article provides guidelines for safe and appropriate use of a BD, but more research is needed.

A multidisciplinary approach to providing blended diet within the acute setting.

Due to advances in medical care, including nutrition and hydration, children with neurological impairment are surviving longer. Many of these children are fed using a commercial formula via an enteral feeding tube. However, families are now becoming more interested in administering blended diet via their child's gastrostomy in a bid to reduce often significant gastrointestinal symptoms including reflux, constipation, gagging and retching post fundoplication. To describe the process undertaken by the authors' short-life working group to create safe, robust pathways to enable children to have access to blended diet while in the acute hospital setting. A multidisciplinary team short-life working group was established, which consisted of representatives from nursing, dietetics and catering. Following this a scoping exercise was undertaken to assess what practices were carried out in other health boards, prior to the creation of documentation. In conjunction with senior management and the Central Legal Office, the authors' short life working group has created safe, robust documentation and pathways to enable children in a large tertiary paediatric centre to access blended diet while in the acute setting. Due to the recent COVID-19 pandemic the pilot study to trial these documents within the neurology ward was delayed, however this work is ongoing. Furthermore, the authors will be looking to train nursing staff within ward areas to administer blended diet within the ward setting.

202 Evaluating Finishing Performance of Cattle Fed High-Moisture Corn: Steam-Flaked Corn Blends with Modified Distillers Grains

Abstract Steam-flaked corn (SFC) and high-moisture corn (HMC) offer benefits to the cattle feeding industry including improvement of feed efficiency (G:F) and a guarantee of grain supply, respectively. Popularity of SFC in the Midwest is increasing. A study compared finishing cattle performance when fed HMC, SFC, or blends. The objective was to determine the optimum inclusion of HMC:SFC ratio with or without modified distillers grains (MDGS) included at 20% of the diet. This study utilized 120 yearling steers (352 kg; SD=7.1 kg) individually fed using the Calan gate system in a completely randomized design with cattle stratified by body weight (BW). Treatments included: 100% HMC, 50:50 blend HMC:SFC, or 100% SFC fed with and without 20% MDGS. Additionally, a 25:75 blend and a 75:25 blend of HMC:SFC was fed with MDGS only for a total of 8 treatments (DM basis). Cattle were on feed 140 d with 3-d initial BW and 1 d final BW and carcass weight and characteristics. Animal was the experimental unit with 15 replications per treatment. A tendency for an interaction (P = 0.11) was observed for ADG between distillers inclusion and ratio of HMC:SFC. Cattle fed diets with no distillers grains had improved ADG when fed a blend of HMC:SFC (P = 0.07), but gain was not impacted (P = 0.59) as SFC replaced HMC in diets with 20% MDGS. Feeding MDGS increased carcass weight, ADG, intake, and fat thickness compared with control diets (P ≤ 0.04). For diets containing 5 ratios of HMC:SFC with 20% MDGS, feeding greater inclusions of SFC had no impact on intake or ADG (P ≥ 0.31) but tended to linearly improve G:F (P = 0.09). Overall, including MDGS in HMC, SFC, or blended diets increased carcass weight, ADG, and intake and G:F was improved as SFC increased in diets with MDGS.

The Response of The Addition of Ginseng Leaves (Talinum Paniculatum Gaertn) Mix Supplements in Rations to The Performance of Broiler Production

The aim of this study was to determine the response of adding ginseng leaf supplements (Talinum Paniculatum Gaertn) to the diet on the introduction of meat products, including dietary intake, body weight gain and dietary transformation in broilers. The subjects of the study were 100 broilers with five treatments and four replicates grown from DOC for 33 days. A control treatment was a 100% mixed diet (A), and B was a mixed died with 0.5% ginseng leaf mixture supplement. Treatment C was a mixed died with 1% ginseng leaf mixture supplement, with 1.5% ginseng leaf mixture supplement (D treatment), and with 2% additive to the ginseng leaf mixture (E treatment). The blended diet consisted of corn, palm meal, soybean meal, fishmeal, oil, and top mix. The variables measured were diet intake, weight gain, and diet conversion. The research method used an experiment with a completely randomized design. The results showed that the addition of the ginseng leaf meal feed additive to the diet had no significant effect (P&gt; 0.05) on dietary intake, body weight gain, and diet conversion. The conclusion of this study is that the addition of up to 2% of the ginseng leaf meal feed additive to the diet did not negatively affect the appearance of the product and broilers.

Monitor gastrointestinal tolerance in children who have switched to an "enteral formula with food-derived ingredients": A national, multicenter retrospective chart review (RICIMIX study).

BackgroundEnteral tube feeding intolerances, such as diarrhea, are commonly reported in children. In the pediatric population, interest is growing in the use of blended diets for the management of enteral feeding intolerances. Fiber within a blended diet stimulates the growth of beneficial gut bacteria, which in turn produce short‐chain fatty acids, which are utilized as energy substrates for enterocytes. Enteral formula manufacturers have responded to this trend towards “real‐food” blended diets and developed an enteral formula with food‐derived ingredients. The aim of this study was to collect data relating to feed tolerance in children who had switched to an “enteral formula with food‐derived ingredients.”MethodsA national multicenter retrospective study.ResultsDietitians collected data from 43 medically unwell children between March 2021 and July 2021. Significant improvements were reported in children who had switched to an “enteral formula with food‐derived ingredients” in retching 17 of 18 children (95%), flatulence 6 of 8 children (85%), loose stools 10 of 11 children (90%), and constipation 10 of 11 children (90%). These improvements in gastrointestinal symptoms were reflected in weight change during the one month period measurements were collected (baseline, 19.5 kg [SD, 9]; 1 month, 20.1 kg [SD, 9]; P = 0.002).ConclusionWe have observed beneficial outcomes in medically complex children who have switched to an “enteral formula with food‐derived ingredients.” Our data should motivate healthcare professionals to implement more research to better evaluate the clinical impact and mechanisms of action of blended diets and enteral formulas with food‐derived ingredients.