The natural food matrix in tube feeding

Gastrointestinal (GI) symptoms such as reflux, diarrhea, constipation, and bloating are common among patients who depend on tube feeding. In clinical practice, these complaints are a major reason to seek alternatives to standard enteral formulas. In this context, interest in tube feeding based on real food is increasing.

What does scientific research show about tolerance?

In 2023, Sforza et al. published the scoping review The Impact of Blenderized Tube Feeding on Gastrointestinal Symptoms, in which they mapped the available scientific literature on this topic. A central concept in this review is the role of the natural food matrix.

What is meant by the natural food matrix?

The natural food matrix refers to the way nutrients naturally coexist in real foods. Rather than isolated nutrients, such as individual proteins, sugars, or fats real food contains a complex structure in which:

• macronutrients

• different types of fiber

• micronutrients and,

• bioactive compounds

are present in an interconnected manner.
According to the authors, this interrelationship may be relevant for the digestion and tolerance of enteral nutrition.

The study in brief

Sforza et al. conducted a scoping review in accordance with the PRISMA-ScR guidelines. They analyzed 12 studies published between 2011 and 2022 in which blenderized tube feeding (BTF) was used in children and adults. The included studies varied in design and quality and consisted mainly of observational and pre–post studies, supplemented by one randomized study.

The aim of the review was not to definitively demonstrate effectiveness, but to explore patterns observed in the literature regarding GI symptoms.

Consistent improvement in GI symptoms

Despite methodological differences, all included studies showed a consistent reduction in gastrointestinal symptoms after switching to blenderized feeding. Improvements were reported for, among others:

• reflux and gagging,

• diarrhea and constipation,

• abdominal pain, nausea, and bloating.

These findings were observed in both pediatric and adult patients, including neurologically vulnerable populations.

The food matrix as a possible explanation

Although the exact mechanisms were not investigated or proven, the authors discuss several hypothesis-generating explanations. One of these is the natural food matrix of blenderized feeding. The presence of:

• minimally processed food structures,

• a diversity of fiber types, and

• fewer isolated nutrients

may contribute to a different gastrointestinal response compared with highly processed, synthetic formulas.

The authors emphasize that these are not causal conclusions, but plausible explanatory models that warrant further investigation.

Relevance for clinical practice

For dietitians and physicians, this review provides valuable insights. It shows that:

• GI symptoms are common in tube-fed patients;

• blenderized feeding is associated with improved tolerance; and

• the natural food matrix may play a role in these observations.

At the same time, the article underscores the need for more well-designed, prospective research to further substantiate these findings.

Conclusion

The scoping review by Sforza et al. contributes to the scientific discussion on how the composition and degree of processing of tube feeding relate to gastrointestinal tolerance. The natural food matrix of real ingredients is mentioned as a possible explanatory factor. Although the current evidence is still limited, this concept provides a relevant framework for further innovation and research in enteral nutrition.

Bron:
Sforza, E. et al. (2023).
The Impact of Blenderized Tube Feeding on Gastrointestinal Symptoms: A Scoping Review.
https://www.researchgate.net/publication/368378772_The_Impact_of_Blenderized_Tube_Feeding_on_Gastrointestinal_Symptoms_a_Scoping_Review

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