Desenvolvimento e viabilidade de uma formulação enteral exclusiva em alimentos in natura e minimamente processados, adicionada de farinha de inhame (Dioscorea cayenensis)

Abstract

Enteral Nutritional Therapy (ENT) is considered the priority therapy of choice when the patient is unable to physiologically use the oral route. Under these conditions, ENT offers benefits such as maintaining the integrity of the intestinal barrier, improving immune function and reducing oxidative stress. There are two types of formulations used to provide nutrition to these patients, which are commercial and handmade enteral formulations. The latter have been reemerging due to the interest in adopting a healthier eating style with the exclusive use of unprocessed and minimally processed ingredients and for bringing the patient closer to the family context. When formulating handmade enteral diets, some professionals use industrialized ingredients that contribute only to energy intake without bringing any other additional benefit, such as corn glucose, refined sugar, corn cereals and maltodextrin. Yam flour (Dioscorea cayenensis) can be a substitute for these industrialized products, in order to provide both energy properties and phytochemical compounds related to several benefits to the human body. Given the lack of studies with enteral diets composed of yam flour, the general objective of this study was to develop an exclusive handmade enteral formulation with unprocessed and minimally processed foods, added to yam flour and to evaluate its nutritional composition, osmolar parameters, physical-chemical, microbiological and perform cost analyses. The yam flour was obtained based on the methodology of Guedes et al. (2021). A search for previous studies and information from the renowned Dietary Guidelines for the Brazilian Population served as coordinates for the formulation of the handmade enteral diet. The energy calculation was performed based on the average weight obtained by Walpole et al. (2012) multiplied by calories per kilogram of weight, according to the Brazilian Society of Parenteral and Enteral Nutrition. DRIs (Dietary Reference Intakes) were used to establish the percentage of macronutrients and, for micronutrient calculations, the RDA (Recommend Dietary Allowances) or AI (Adequate Intakes) were taken into account, according to availability. The evaluation of hygienic-sanitary quality (coliforms at 45°C, coagulase positive Staphylococci, Bacillus cereus and Salmonella spp.), analysis of osmolar, physicochemical (water activity, viscosity, physical stability, fluidity and dripping) and formulation cost were carried out. Data were tabulated using Microsoft Excel 2016 and analyzed using the IBM Statitical Package for Social Sciences (SPSS) version 21.0. The yam flour obtained presented a fine and odorless texture that could be added to the handmade enteral diet, in which it presented a brown color and a liquid-pasty texture. There was a contribution of 11% in energy content, 17% in fiber content and improved content of all micronutrients, according to DRIS recommendations, after adding yam flour to the handmade enteral diet. The proposed diet presented adequate microbiological, osmolar and physicochemical parameters. It also obtained cost reductions of 70.91%, 74.06% and 75.71%, when compared to three standard commercial formulas. The results of this study gave rise to an accepted patent application, number BR 10 2021 015443 8, and the diet can be adopted and reproduced by industries. However, it is recommended to carry out further studies that provide newer strategies to ensure and spread the use of exclusive formulations in unprocessed and minimally processed foods, in order to provide health benefits.