RESUMO
Glycemic Index (GI) is a measure of carbohydrate quality and is recognised as a valid and reproducible method of classifying carbohydrate foods according to its effects on postprandial glycaemia. In this randomised crossover trial (RBR-7rjx3k) we determined the GI of nine enteral formulas, following the Food and Agriculture Organisation/World Health Organisation method. Forty healthy participants were included in the study (85% female mean age 27.1 ± 6.7 years). GI of the enteral formulas ranged from 40.5 to 85.2; four formulas had high GI (Nutrienteral 1.5®, Novasource GI Control®, Diamax®, Isosource Soya®), two intermediate GI (Fresubin 1.2 HP Fibre®, Nutrison Energy Multifiber 1.5®) and three low GI (Trophic 1.5®, Glucerna®, Novasource GC HP®). The GI coefficient of variation ranged from 22.9% to 83.6%. The effect of the enteral formulas with low GI in glycemic control of patients with enteral nutrition prescription needs to be test in future studies.
Assuntos
Nutrição Enteral , Índice Glicêmico , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Resumen: El uso de apoyo nutricional ambulatorio, enteral o parenteral, ha sido un paso necesario en la opti mización del soporte nutricional en pacientes, que, por diversas patologías, no logran cumplir con sus requerimientos por vía oral (VO). En el presente artículo se presentan las recomendaciones de la Rama de Nutrición, dirigidas a los equipos de salud que atienden pacientes pediátricos, que requieran alimentación enteral por un tiempo prolongado. Su objetivo general es entregar pautas para un co rrecto manejo en estos pacientes. Se describe la conformación ideal del equipo de salud para atención y seguimiento de dichos pacientes, los criterios de ingreso al programa y su forma de evaluación en el tiempo. Además, se describen características generales de la alimentación enteral, vías de admi nistración, fórmulas enterales disponibles, complicaciones de este soporte nutricional y por último monitorización y seguimiento del paciente.
Abstract The use of home enteral or parenteral nutrition has been a necessary step in the optimization of nu tritional support in patients who, due to several diseases, fail to meet their nutritional requirements by oral feeding. This article presents the recommendations of the Chilean Pediatric Society Nutritio nal Branch, aimed at health teams that treat pediatric patients who require enteral feeding for a long time. The general objective is to provide guidelines for the proper management of these patients. It describes the ideal conformation of the health team for the care and follow-up of those patients, the program admission criteria, and its evaluation method over time. In addition, it describes general characteristics of enteral feeding, routes of administration, available enteral formulas, complications, and patient follow-up.
Assuntos
Humanos , Criança , Adolescente , Nutrição Enteral/normas , Serviços de Assistência Domiciliar/normas , Pediatria , Sociedades Médicas , Chile , Doença Crônica , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normasRESUMO
Es conocida la alta prevalencia de desnutrición en pacientes hospitalizados, en los que el soporte nutricional es una herramienta clave de intervención. El objetivo fue describir las características y prácticas del soporte nutricional enteral en servicios de salud públicos del Departamento Central - Paraguay. Estudio observacional descriptivo transversal realizado en servicios de salud públicos del Departamento Central - Paraguay que brindan soporte nutricional enteral. Se aplicó una planilla de verificación para describir la planta física, infraestructura, equipamiento, organización y gestión, garantía de inocuidad y calidad y procedimientos relacionados a la nutrición enteral de los pacientes. Se utilizó como referencia la Guía de buenas prácticas, organización y funcionamiento de establecimientos de producción de fórmulas enterales y servicios de nutrición enteral. Un puntaje ≥70% fue considerado como un cumplimiento esperado. Se evaluaron 26 servicios de salud que fueron los que cumplían con los criterios de inclusión, de los cuales 20 correspondían al Ministerio de Salud Pública y Bienestar Social. Del total, 8 contaban con un espacio físico exclusivo para la preparación de fórmulas enterales; 10 cumplieron con los requisitos mínimos de planta física (de ellos, solo 3 tenían separación física de las áreas); 9 con infraestructura; 7 con equipamientos; 4 con la garantía de inocuidad y calidad; 8 con organización y gestión y 11 con los procedimientos relacionados a la nutrición enteral. Solo 6 cumplieron con un puntaje ≥70% (categoría "bueno"). Se observaron debilidades en el soporte nutricional enteral en servicios de salud públicos por lo que urge establecer medidas correctivas.
It is known the high prevalence of malnutrition in hospitalized patients, where nutritionalsupport is a key intervention tool. The objective was to describe the characteristics andpractices of the enteral nutritional support in public health services of the CentralDepartment-Paraguay. This was a cross-sectional study carried out in public health servicesof the Central Department in Paraguay that provide enteral nutritional support. A check listwas used to describe the physical structure, infrastructure, equipment, organization andmanagement, safety and quality assurance and procedures related to patient enteralnutrition. For the evaluation, a guide to good manufacturing practices, organization andoperation of enteral formulas production establishments and enteral nutrition services wasused as a reference. A score ≥70% was considered an expected compliance. Twenty six health services, which met inclusion criteria, were evaluated Twenty of them correspondedto the Ministry of Health. Eight of the total number had exclusive physical space for thepreparation of the enteral formulas; 10 met the minimum requirements for physicalstructure (only 3 had physical separation of areas); 9 had infrastructure; 7equipment; 4safety and quality assurance; 8 organization and management and 11 procedures regardingthe enteral nutrition. Only 6 met ≥70% score ("good" category).Weaknesses were observedin the enteral nutritional support of public health services, therefore to establish correctiveactions is urgent.
Assuntos
Humanos , Desnutrição , Nutrição Enteral , Saúde PúblicaRESUMO
BACKGROUND: When enteral formulas (EF) are administered orally as a supplement to the normal diet, they are often mixed with conventional foods or included in recipes in order to seek new flavors and textures and avoid monotony. The aims of this work were to study the bioaccessibility of Fe, Zn and Ca from commercial EF and the impact upon their incorporation into sweet preparations. Twenty commercial EF, before and after inclusion in sweet food (rice pudding, RP; banana smoothie, BS; tea, T; chocolate dessert, CD) were evaluated regarding Fe, Zn and Ca dialyzability (%DFe , %DZn , %DCa ) as an estimator of mineral bioaccessibility. RESULTS: Fe, Zn and Ca dialyzability from EF was variable and generally low. Heating during EF-sweet food preparation (T and CD) lowered values to 44.1 %DFe , possibly due to degradation of vitamin C, and 52.7 %DZn and 25.3 %DCa , due to the interaction with food components. CONCLUSION: EF and EF-sweet foods did not represent a good supply of Fe, Zn and Ca as recommended. This study demonstrated how the bioaccessibility of these minerals is affected by the food matrix in which EF is included as well as heating during food preparation.