Nutrient Profiles of Enteral Feeds in Selected Hospitals in Accra, Ghana.

Abstract

Background: During critical illness, the body goes through hypermetabolic stress which can lead to serious complications when not immediately reversed. Nutrition support in the form of enteral nutrition is provided to help the body recover. Commercial formulas have been designed to cater for nutrient needs of the critically ill however, due to financial costs and tolerability on the part of patients, hospital-prepared enteral feeds are provided. Some studies have focused on the benefits of hospital-prepared enteral feeds to the critically ill. In other parts of the world, the provision of such feeds have faded. The practice is done in Ghana but there is limited documented research for its use. Aim: To assess the nutrient profiles of hospital-prepared enteral feeds in two selected hospitals in Accra. Methods: A cross-sectional study design was employed. Twenty-one (21) dietitians and six (6) diet cooks were interviewed in the study. Three (3) hospital-prepared enteral feed samples were collected from the two hospitals on three different days and their energy and nutrient values were analysed. The recipes used in the preparation of the feeds were then analysed using ESHA Food Processor and Nutrient Analysis software. Means and standard deviation were used to describe results. The energy and nutrient values obtained from the chemical analyses of the hospital-prepared enteral feeds were compared to commercial formulas using independent sample t-test. Results: Ensure, Complan, Casilan and hospital-prepared enteral feeds (fortified porridges and soups) were the types of enteral feeds used in the two hospitals. Hospital-prepared enteral feeds were commonly used although there were no standardized documented recipes for their preparation in the two hospitals. Statistically significant differences were

observed in all nutrients with the exception of energy, carbohydrate, vitamin C and sodium between the two hospitals. Statistically significant differences were observed in the energy and nutrient values of hospital-prepared enteral feeds compared to commercial formulas in both hospitals with the exception of vitamin C (p = 0.331), iron (p = 0.765), sodium (p = 0.160) phosphorus (p = 0.090) in Hospital A, fibre (p = 0.770) and sodium (p = 0.094) in Hospital B. Conclusions: The study showed that fortified porridges and soups were the types of hospital-prepared enteral feeds used in the two hospitals with fortified soup being commonly used. The commercial enteral formulas frequently used in the two hospitals were Ensure, Complan, Casilan. There were no documented standardized recipes in the two selected hospitals. Significant differences were observed in all nutrient values with the exception of energy, carbohydrate, vitamin C and sodium of hospital-prepared enteral feed samples investigated by chemical analyses between the two hospitals. Again, the energy and nutrient values of hospital-prepared enteral feeds samples differed from the commercial enteral formulas. Therefore, documented standardized recipes should be developed in all hospitals to guide cooking that will help improve nutrition and prevent inconsistencies in nutrient values