Is there a difference in metabolic outcome between different enteral formulas?

Background: Despite appropriate enteral nutrition, many elderly patients do not reach a good metabolic outcome. Two nutrition formulas are commonly used in Israel with no evidence-based medicine to indicate preference of one over the other.

Methods: We describe a 2-month observational study of patients fed by 1 of the 2 formulas. The first (Osmolite, Abbott Company, Abbott Park, IL) is without fiber, and the second (Easy Fiber, Easyline Company Givataim, Israel) in addition to containing fiber is also richer in protein, vitamins, and minerals. The formula was selected by the primary care physician before enrollment in the study and was not influenced by the investigators. Routine blood tests as well as body weight were monitored at the start of enteral feeding and during the 2 months following as part of the regular follow-up.

Results: Fifty-seven patients were fed with the regular formula and 77 with the enriched one. No statistically significant differences were noted between the groups during the follow-up period, in body weight, cholesterol levels, total lymphocyte count, renal function tests, or electrolyte balance. However, in the enriched formula group there was a significant decrease in glucose (p < .05), and increase in albumin (p < .05) and hemoglobin (p = .01) levels.

Conclusions: Enteral feeding with enriched formula appears to improve albumin and hemoglobin levels as well as diabetic control, thus it may be more appropriate than the nonfiber diet for use in long-term care patients.