HN-02490274_Critical Review Methods for Nutritional Quality Evaluation of Enteral Formulas

A diet well-balanced in macro- and micronutrient content is the basis for a good health state. Most enteral nutrition (EN) formulas are designed also to meet the increased micronutrient needs in patients with increased losses or requests (e.g. moderately catabolic patients). For this reason, the micronutrient content in EN formulas is usually in excess for the needs of long term EN patients metabolically stable and without organ damage. This oversupply or undersupply could be harmful in particular in patients on long-term EN. However, despite the widespread use of EN, both in hospitals and at home, studies on the micronutrient compositions in the enteral mixtures are lacking, thus an evaluation of the amount of vitamins and trace elements in the currently available products requires consideration. For these reasons, this review summarizes the current knowledge of and evaluate the methodologic approaches reported for analyzing macronutrients (fats, proteins, and carbohydrates), water- and fat-soluble vitamins and minerals in enteral formulas. some minerals (calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc) have been analyzed by inductively coupled plasma pectrometry after wet-ashing. Selenium has been an analyzed by hydride generation and atomic absorption spectroscopy, and iodine content was measured by thiosulfate titration. Five vitamins (vitamins C and B-6, thiamin, riboflavin, and niacin) have been analyzed with the use of HPLC with ultraviolet detection. Two vitamins (folic acid and vitamin B-12) have been analyzed with the use of microbiological methods, and vitamin E has been measured with the use of HPLC with fluorescence detection.