Fibre intake from enteral formulas: an Australian audit

This work was presented at the Australasian Society of Parenteral and Enteral Nutrition 2024 by the Tube Dietitian Team.

The below abstract has been published in the conference journal:

Background: Fiber intake is pivotal for gut health. For the home tube fed person, fibre sources include fibre-containing formulas (FCF), fibre-added formulas (FAF), or fibre supplemented through specific powder/liquid supplements or oral diet. This audit sought to assess fiber intake from enteral formulas in a cohort of home tube-fed clients relative to the recommended daily intake (RDI).

Methods: A retrospective audit was conducted on clients of a community-based HEN service. Fibre intake was calculated for each client based on the prescribed commercial formula amount. Average intake was calculated and then compared to the RDI. Adequacy was defined as 80% RDI. Descriptive statistics were performed, and outcomes were statistically analysed by gender, delivery method, and diagnosis (t-test, Chi-squared, and ANOVA, respectively).

Results: Ninety-nine clients were included (55% females, 47 (10-97) years of age, 868ml/day (125-1920ml) formula intake, 75% with a neurological condition). Overall, 14% (n=14/99) met the RDI, with a significant difference found between diagnoses (11% oncology vs. 3% neurology vs. 0% gastroenterology, p < 0.05). Fifty-five % (n=54/99) were on a FCF (>1g/100ml of fibre), and of those, 56% (n=30/54) were on a FAF. Among those on FCF, 27% (n=14/54) met the RDI, while for FAF, 27% (n=8/30) met the RDI. 

Conclusion: The findings highlight a concerning gap between the fiber intake of home tube-fed clients and the RDI, despite over half being on a FCF. While most clinicians would typically recommend FAFs to address this issue, only a third of these clients achieved sufficient fibre. Further research is needed to verify these findings and explore the feasibility and clinical benefit of blanket fibre supplementation for all home tube fed clients. 

Funding source: This research did not receive any funding.
Conflict of interest: The authors declare that they have no conflicts of interest.