Title: Improving enteral nutrition with plant-dominant protein formulas
| Published: | January 21, 2025 |
Enteral nutrition (EN) via tube feeding is a key means of managing the nutritional intake of patients at risk of disease-related malnutrition. However, despite its necessity, EN can be hard for patients to tolerate. Now, Danone Research & Innovation (R&I) experts have led a milestone study showing how a plant-dominant nutritional blend could serve as an innovative solution: one that’s good for people and planet alike. Their findings have been published in Journal of Food Research International.
Upper gastrointestinal (GI) intolerance, which may cause uncomfortable symptoms like nausea, vomiting, reflux, and a sense of fullness, is a common side effect of EN. In fact, it is one of the main reasons why healthcare professionals might reduce or even stop EN treatment – but this can have a negative impact on patient nutrient status, their gastrointestinal tract, and even hamper their recovery. Instead, it is crucial to find new EN formulas with better GI tolerance.
A new era beyond dairy
For many years, EN protein content was predominantly sourced from cows’ milk, consisting of up to 80% casein. The conditions in the stomach, however, can cause casein to coagulate into a solid, delaying gastric emptying and contributing to GI intolerance. To address this issue, a non-coagulating protein blend was developed, featuring a higher proportion of whey and replacing much of the casein with soy and pea proteins. In recent years, this solution has been proven to be significantly better tolerated than casein-dominant alternatives.
Harnessing plant power
“For environmental as well as health reasons, EAT-Lancet recommends including a higher proportion of plant-derived protein in our diets,” Evan explains. “To support this protein transition, we formulated a new EN blend that’s composed mostly of soy and pea protein, with an even lower percentage of casein compared to the widely used dairy-dominant formulations. We knew this blend was nutritionally well balanced in terms of amino acids, but we needed to investigate its coagulation characteristics to understand how well it would be tolerated by patients.”
Evan and the Gut Biology research team put the plant-dominant formulation to the test in an in vitro stomach model – with positive results. “Comparing the coagulation of the plant-dominant solution to casein- and dairy-dominant incumbents, we found that our innovation significantly outperformed casein and showed similar performance to the previous dairy dominant EN blend,” Evan says. “Better yet, this held true across all four investigated EN matrices: standard and high energy, with and without fiber.”
As theorized in the new paper, the non-coagulation can be attributed to the molecular structures of soy, pea, and whey proteins, which differ from that of casein. The paper also suggests, for the first time, that the interaction between different protein types plays a role in coagulation during gastric digestion – a factor Evan sees as a promising area for further research.
More sustainable medical nutrition
“Our colleagues are currently investigating the gastrointestinal tolerance in clinical settings , and we anticipate their findings will confirm our results. Such an EN formulation could help to prevent malnourishment and support patients’ recovery- all while aligning with the global shift toward sustainable protein sources.”
With rigorous research and unique solutions like these, Danone R&I is using its EN leadership and medical nutrition innovation capabilities to power positive outcomes in sustainable ways: supporting the health of individuals, society, and our planet!
Find out more about our enteral nutrition and gut health expertise here.