LB025 - IN-VITRO DIGESTION OF EN TUBE FEED DEMONSTRATING COAGULATION OF HYBRID PROTEIN (PLANT AND MILK-BASED PROTEINS) AND CASEIN DOMINANT BLENDS

LB025

IN-VITRO DIGESTION OF EN TUBE FEED DEMONSTRATING COAGULATION OF HYBRID PROTEIN (PLANT AND MILK-BASED PROTEINS) AND CASEIN DOMINANT BLENDS

P. M. Patel¹, D. Heckmann^1,*, F. Corpas-Vendrell¹, A. K. B. Opitz¹, N. Siegert¹

¹Fresenius Kabi, Bad Homburg, Germany

Rationale: Enteral nutrition (EN) tube feed (TF) products containing proteins are susceptible to acidic coagulation under gastric conditions. This phenomenon may lead to complications like tube clogging or delayed gastric emptying. To better understand the extent of coagulation, this study employed a dynamic in-vitro digestion model (TIM-1agc) to compare the behavior of different products under bolus and continuous feeding regimes.

Methods: TIM-1agc system simulated human conditions by incorporating gastric secretions, peristaltic movements, and controlled pH levels. Commercial EN TF products were tested: Fresubin Energy (FE), known to coagulate, and Nutrison Energy (NE), marketed as non-coagulating. Bolus feeding involved administering fixed volumes followed by a gastric emptying protocol, while continuous feeding maintained a steady flow. Coagulates were analyzed using microscopy and sieving techniques.

Results: Under bolus feeding, coagulation peaked approximately 90 minutes after digestion began and diminished after 150 minutes for FE and NE. With continuous feeding, products exhibited coagulation before reaching a steady state, with a reduction thereafter at pH of 4.9. Larger coagulates (>1 mm) were detected in all tested products.

Conclusion: Hybrid protein blend (plant and milk) coagulated in acidic pH range, despite being marketed as non-coagulating. As expected, the casein-dominated formula exhibited coagulation. This coagulation was observed regardless of the feeding regime. The larger coagulum particles identified in formulas may contribute to delayed gastric emptying. Therefore, careful consideration is warranted for all protein compositions, regardless of their stated coagulation properties.

Disclosure of Interest: None declared