The Amelioration of Nutritional Status and Phase Angle, Safety, and Satisfaction in Tube-Fed Patients With Ready-to-Use Blenderized Diet With Chicken and Pumpkin

Main Article Content

Kulapong Jayanama
Piyanuch Maitreejorn
Thanwarin Tangsermwong
Pariya Phanachat
Prapimporn Chattranukulchai
Patcharavee Tanlakit
Daruneewan Warodomwichit


Background: The requirement of a hospital-made, blenderized diet, as a generally used and complete polymeric formula, is increasing beyond supply availability and accessibility. A ready-to-use blenderized diet with chicken
and pumpkin in a retort pouch was developed from regular use formula by nutritionists and dietitians to solve these problems. However, its clinical outcomes should be evaluated.

Objectives: To assess the efficacy and safety of a ready-to-use blenderized diet, and to examine the satisfaction of patients and caregivers.

Methods: Thirty adult patients in Ramathibodi Hospital with absolute tube feeding were included in a pre-post treatment comparative study and fed with the study formula for 14 days. Body composition measurements, nutritional status, clinical parameters, and biochemical tests were collected at baseline and day 14 after feeding. Complications were monitored daily. Satisfaction was evaluated at day 14.

Results: This study reported statistically significant improvements in nutritional status (P < .001), albumin (P = .003), prealbumin (P = .007), total lymphocytic count (P = .004), and phase angle (P = .02) after 14-day feeding. No major complications were reported. Satisfaction of product use was evaluated in the level of satisfied (27%) and very satisfied (73%).

Conclusions: The present study revealed that a ready-to-use blenderized diet with chicken and pumpkin was efficacious in ameliorating nutritional status, nutrition-related blood tests, and phase angle without any major complications.


Article Details

How to Cite
Jayanama, K., Maitreejorn, P., Tangsermwong, T., Phanachat, P., Chattranukulchai, P., Tanlakit, P., & Warodomwichit, D. (2019). The Amelioration of Nutritional Status and Phase Angle, Safety, and Satisfaction in Tube-Fed Patients With Ready-to-Use Blenderized Diet With Chicken and Pumpkin. Ramathibodi Medical Journal, 42(4), 12 - 21.
Original Articles


1. Edington J, Boorman J, Durrant ER, et al. Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clin Nutr. 2000;19(3):191-195. doi:10.1054/clnu.1999.0121.

2. Correia MI, Campos AC, ELAN Cooperative Study. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition. 2003;19(10):823-825. doi:10.1016/S0899-9007(03)00168-0.

3. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27(1):5-15. doi:10.1016/j.clnu.2007.10.007.

4. Chapman IM. Nutritional disorders in the elderly. Med Clin North Am. 2006;90(5):887-907. doi:10.1016/j.mcna.2006.05.010.

5. Feinberg J, Nielsen EE, Korang SK, et al. Nutrition support in hospitalised adults at nutritional risk. Cochrane Database Syst Rev. 2017;5:CD011598. doi:10.1002/14651858.CD011598.pub2.

6. Seron-Arbeloa C, Zamora-Elson M, Labarta-Monzon L, Mallor-Bonet T. Enteral nutrition in critical care. J Clin Med Res. 2013;5(1):1-11. doi:10.4021/jocmr1210w.

7. Gramlich L, Kichian K, Pinilla J, Rodych NJ, Dhaliwal R, Heyland DK. Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature. Nutrition. 2004;20(10):843-848. doi:10.1016/j.nut.2004.06.003.

8. Elke G, Schadler D, Engel C, et al. Current practice in nutritional support and its association with mortality in septic patients--results from a national, prospective, multicenter study. Crit Care Med. 2008;36(6):1762-1767. doi:10.1097/CCM.0b013e318174dcf0.

9. Alpers DH. Enteral feeding and gut atrophy. Curr Opin Clin Nutr Metab Care. 2002;5(6):679-683. doi:10.1097/01.mco.0000038812.16540.72.

10. Wilmore DW, Smith RJ, O'Dwyer ST, Jacobs DO, Ziegler TR, Wang XD. The gut: a central organ after surgical stress. Surgery. 1988;104(5):917-923.

11. Holmes S. Enteral nutrition: an overview. Nurs Stand. 2012;26(39):41-46. doi:10.7748/ns2012.

12. Mokhalalati JK, Druyan ME, Shott SB, Comer GM. Microbial, nutritional and physical quality of commercial and hospital prepared tube feedings in Saudi Arabia. Saudi Med J. 2004;25(3):331-341.

13. Mathus-Vliegen EM, Bredius MW, Binnekade JM. Analysis of sites of bacterial contamination in an enteral feeding system. JPEN J Parenter Enteral Nutr. 2006;30(6):519-525. doi:10.1177/0148607106030006519.

14. Sullivan MM, Sorreda-Esguerra P, Santos EE, et al. Bacterial contamination of blenderized whole food and commercial enteral tube feedings in the Philippines. J Hosp Infect. 2001;49(4):268-273. doi:10.1053/jhin.2001.1093.

15. Vieira MMC, Santos VFN, Bottoni A, Morais TB. Nutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults. Clin Nutr. 2018;37(1):177-181. doi:10.1016/j.clnu.2016.11.020.

16. Borghi R, Dutra Araujo T, Airoldi Vieira RI, Theodoro de Souza T, Waitzberg DL. ILSI Task Force on enteral nutrition; estimated composition and costs of blenderized diets. Nutr Hosp. 2013;28(6):2033-2038. doi:10.3305/nutr hosp.v28in06.6759.

17. Schiller LR, Pardi DS, Spiller R, et al. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis. J Gastroenterol Hepatol. 2014;29(1):6-25. doi:10.1111/jgh.12392.

18. Pisprasert V, Shantavasinkul PC, Rattanachaiwong S, Lepananon T, Komindr S. Moderately high-protein enteral formula improved retinol-binding protein in tube-fed patients: A multicentre open study. Nutr Health. 2017;23(3):203-209. doi:10.1177/0260106017729959.

19. Trakulhoon V, Prammanasudh B. An open study of efficacy, safety and body weight changing in the Blendera-tube fed patients. J Med Assoc Thai. 2012;95(10):1285-1291.

20. Komindrg S, Tangsermwong T, Janepanish P. Simplified malnutrition tool for Thai patients. Asia Pac J Clin Nutr. 2013;22(4):516-521. doi:10.6133/apjcn.2013.22.4.06.

21. Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11(1):8-13. doi:10.1177/014860718701100108.

22.Gupta N, Balasekaran G, Victor Govindaswamy V, Hwa CY, Shun LM. Comparison of body composition with bioelectric impedance (BIA) and dual energy X-ray absorptiometry (DEXA) among Singapore Chinese. J Sci Med Sport. 2011;14(1):33-35. doi:10.1016/j.jsams.2010.04.005.

23. Thibault R, Makhlouf AM, Mulliez A, et al. Fat-free mass at admission predicts 28-day mortality in intensive care unit patients: the international prospective observational study Phase Angle Project. Intensive Care Med. 2016;42(9):1445-1153. doi:10.1007/s00134-016-4468-3.

24. Genton L, Herrmann FR, Spörri A, Graf CE. Association of mortality and phase angle measured by different bioelectrical impedance analysis (BIA) devices. Clin Nutr. 2018;37(3):1066-1069. doi:10.1016/j.clnu.2017.03.023.

25. Vermeulen KM, Leal LL, Furtado MC, et al. Phase Angle and Onodera's Prognostic Nutritional Index in critically ill patients. Nutr Hosp. 2016;33(6):1268-1275. doi:10.20960/nh.770.

26. Huhmann MB, Yamamoto S, Neutel JM, Cohen SS, Ochoa Gautier JB. Very high-protein and low-carbohydrate enteral nutrition formula and plasma glucose control in adults with type 2 diabetes mellitus: a randomized crossover trial. Nutr Diabetes. 2018;8(1):45. doi:10.1038/s41387-018-0053-x.

Most read articles by the same author(s)