醫院自製天然養生灌食配方的營養成份探討
Evaluation to Nutrient Composition of Hospital-Made Healthy Tube
Feeding Formula
中文摘要 管灌飲食是醫院及長期照護體系中常見的一種飲食方式，自從1970 年以來，商 業配方因方便使用及人力節省已然成為主流，但其雖可提供符合基本營養素建議 量，但卻由於不含天然食材，因而未能涵蓋近年來被一一發現存在植物界，對人 體健康極為重要的化合物，簡稱植化素(phytochemicals)。臺北市立聯合醫院營養 部，於2005 年起陸續推出以營養豐富且多樣化之天然食材為主的自製天然養生 灌食配方(養生配方)及蔬果精力湯，供應予住院及護理之家個案使用。為暸解配 方在經過烹調、攪打、過濾等製備過程後實際供應之營養量，與依據食品營養成 份資料庫計算值的差異，收集6 套不同食材製作之養生配方和 1 套蔬果精力湯樣 本，實際檢測其具代表性的營養素及植化素含量。研究結果顯示，營養素及植化 素實測值顯著高於計算值者有：熱量、蛋白質、膳食纖維、維生素A、葉酸、β -胡蘿蔔素、茄紅素、葉黃素/玉米黃素等，因食品營養成份資料庫不完整，少許 食材沒有數據可供參考。低於計算值者則有鈉和植物固醇。實測值顯示，以一日 提供1,800 kcal 之蛋白質、脂肪、醣類分別佔總熱量之 18.8%、30.5%、50.7%； 礦物質中鋅含量僅達我國成年男性每日營養素參考攝取量(Dietary Reference Intakes; DRIs）的 61%，配方食材設計上尚有調整空間；至於維生素 A、維生素 B1、葉酸、鈣等，均可達到每日參考建議量(DRIs)以上；此外，此灌食配方尚含 有多數商業配方所缺乏的 β-胡蘿蔔素（14.2 mg）、茄紅素（36.7 mg）、葉黃素 （10.3 mg）、玉米黃質（22.4 mg）、多酚類（716 mg）及植物固醇（140 mg）等 植化素。因此本研究顯示，使用多元化食材製備之天然養生灌食配方，可提供適 當的營養素及豐富的植化素，對於需長期以管灌飲食維生的個案，應優先選擇其 做為管灌飲食中的主要供應配方。後續研究值得更進一步探討此類天然食材灌食 配方的臨床應用及效益。 英文摘要Tube feeding diet is widely used in many hospitals and nursing homes in Taiwan. Since 1970, commercial formulas have almost become the standard for the reasons of convenience and man-power saving. Recently, the studies have revealed that a variety of phytochemicals in plant foods only are very important to human health, however, the commercial tube feeding formula does not provide these components. Therefore, we have added natural foods into the formula since 2005 to re-made healthy blended tube feeding formula (NFB formula) and fruit-vegetable juice (FV juice) to the in-patients in Taipei City Hospital and the residents in the nursing home. To
understand whether the nutrient contents in the formula change after cooked, blended, and filtered, we collected six different formulas and one fruit-vegetable juice made from a variety of foods, and measured the actual nutrient contents including
phytochemicals as compared with the calculated values based on the food
composition table. The results showed that the measured nutrient contents, including energy, proteins, dietary fiber, vitamin A, folic acid, lycopene, lutein and zeaxanthin, were higher than the caculated values. Some of foods were not analyzed due to insufficient nutrient databases. However, sodium and plant sterol contents were lower compared with the calculated values. The measured values revealed that proteins, lipids, and carbohydrates were 18.8%, 30.5%, and 50.7% of total energy, respectively, in 1,800-kcal daily supply of the formula (NFB-FV formulas). Zinc content was only 61% Dietary Reference Intakes (DRIs) for the adult males, which can be further adjusted by modification of recpes. Vitamin A, B1, folic acid, and calcium contents were above the DRIs. In addition, our formula contains β-carotene (14.2 mg), lycopene (36.7 mg), lutein (10.3 mg), zeaxanthin (22.4 mg), total phenol (716 mg), and phytosterol （140 mg）, which not provided by most commercial formulas. Therefore, adequate nutrients, various choices of foods, and rich in phytochemicals blended tube feeding formulas are considered preferentially for long-term care patients receiving tube feeding. Further studies are required to investigate these natural feeding formulas in clinical efficacy.
