Development of Hospital Enteral Formula for Diabetes Using Tempeh Flour with Dragon Fruit and Tomato Addition

Dian Wijayanti; Indah Wening Saraswati; Anggita Nadya Khairunnisa

doi:10.47134/ijhis.v2i2.48

Authors

Dian Wijayanti Rumah Sakit Umum Daerah Sleman
Indah Wening Saraswati Universitas Negeri Semarang
Anggita Nadya Khairunnisa Universitas Negeri Semarang

DOI:

https://doi.org/10.47134/ijhis.v2i2.48

Keywords:

enteral formula, diabetes, tempeh flour, dragon fruit, tomato, organoleptic properties

Abstract

This study aimed to develop a novel enteral formula for diabetes patients using tempeh flour with dragon fruit and tomato additions. An experimental design was employed to formulate and evaluate the nutritional content, viscosity, and organoleptic properties of the developed formula. Results showed that the formula had a high energy content of 926.1 kcal/100ml, with 41.6g/100ml of protein, 26.8g/100ml of fat, and 131.4g/100ml of carbohydrates. Viscosity testing indicated appropriate flow properties for enteral feeding, with 7ml of 10ml flowing in 10 seconds. However, organoleptic evaluation by seven panelists revealed low acceptance scores on a 4-point scale: color (mean 1.71), aroma (1.43), taste (1.43), and texture (2.29). While the formula demonstrates potential in terms of nutritional content and viscosity, significant improvements are needed to enhance its sensory acceptability. This research contributes to the development of plant-based enteral formulas for diabetes management, highlighting the challenges in balancing nutritional requirements with organoleptic qualities. The high carbohydrate content, while potentially beneficial for energy provision, raises concerns about glycemic control in diabetic patients. Further optimization of the formula's composition and clinical trials are recommended to assess its efficacy in diabetes care and to address the sensory and nutritional challenges identified in this study.

References

[1] IDF, IDF Diabetes Atlas 2021 _ IDF Diabetes Atlas. 2021. [Online]. Available: https://diabetesatlas.org/atlas/tenth-edition/%0Ahttps://diabetesatlas.org/data/en/world/

[2] F. H. Faidah, Y. Moviana, N. Isdiany, Surmita, and P. W. Hartini, “Formulasi Makanan Enteral Berbasis Tepung Tempe,” J. Ris. Kesehat. Poltekkes Kemenkes Bandung, vol. 11, no. 2, pp. 67–74, 2019.

[3] M. A. G. Rampengan, N. M. U. Dwipayanti, and P. C. D. Yuliyatni, “The Influence Combination of Dragon Fruit Juice (Hylocereus Polyrhizus) and Foot Exercise Therapy on Elderly with Diabetes Melitus in Kemutug Kidul Village Baturraden: Case Study,” International Journal Of Biomedical Nursing, vol. 11, no. 1. pp. 357–363, 2020.

[4] N. T. Trianita Siwi Utami, Sukesih, Muhamad Jauhar, Lasmini, “DRAGON FRUIT JUICE REDUCES BLOOD SUGAR LEVELS IN DIABETES MELLITUS CLIENTS,” Clin. Trials, vol. 9, pp. 601–610, 2000, [Online]. Available: http://dx.doi.org/10.1016/B978-0-12-436630-5.50046-5

[5] A. Amr and W. Raie, “Tomato Components and Quality Parameters. A Review,” Jordan J. Agric. Sci., vol. 18, no. 3, pp. 199–220, 2022, doi: 10.35516/jjas.v18i3.444.

[6] O. Ojo, S. M. Weldon, T. Thompson, R. Crockett, and X. H. Wang, “The effect of diabetes-specific enteral nutrition formula on cardiometabolic parameters in patients with type 2 diabetes: A systematic review and meta–analysis of randomised controlled trials,” Nutrients, vol. 11, no. 8, 2019, doi: 10.3390/nu11081905.

[7] M. B. Huhmann, S. Yamamoto, J. M. Neutel, S. S. Cohen, and J. B. Ochoa Gautier, “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, vol. 8, no. 1, 2018, doi: 10.1038/s41387-018-0053-x.

[8] R. Basiri, M. T. Spicer, C. W. Levenson, M. J. Ormsbee, T. Ledermann, and B. H. Arjmandi, “Nutritional supplementation concurrent with nutrition education accelerates the wound healing process in patients with diabetic foot ulcers,” Biomedicines, vol. 8, no. 8, pp. 1–14, 2020, doi: 10.3390/BIOMEDICINES8080263.

[9] A. Reynolds and J. Mitri, “Dietary Advice For Individuals with Diabetes,” Endotext, pp. 1–25, 2000, [Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/38078584%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC10725816

[10] G. Rizzo, “Soy-Based Tempeh as a Functional Food: Evidence for Human Health and Future Perspective,” Front. Biosci. - Elit., vol. 16, no. 1, pp. 1–16, 2024, doi: 10.31083/j.fbe1601003.

[11] P. E. Indonesia, “Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia 2021,” Glob. Initiat. Asthma, p. 46, 2021, [Online]. Available: www.ginasthma.org.

[12] P. Lam et al., “Complete IDDSI Framework Detailed definitions,” pp. 1–20, 2017, [Online]. Available: www.iddsi.org

[13] J. Doley, “Enteral Nutrition Overview,” Nutrients, vol. 14, no. 11, 2022, doi: 10.3390/nu14112180.

[14] S. A. Azer, A. K. Kanugula, and R. K. Kshirsagar, “Dysphagia,” pp. 1–14, 2024.

[15] M. Wakita, H. Masui, S. Ichimaru, and T. Amagai, “Determinant factors of the viscosity of enteral formulas: Basic analysis of thickened enteral formulas,” Nutr. Clin. Pract., vol. 27, no. 1, pp. 82–90, 2012, doi: 10.1177/0884533611427146.

[16] R. R. Bridget Hron, “Viscosity of Commercial Food Based Formulas and Home Prepared Blenderized Feeds,” Physiol. Behav., vol. 176, no. 5, pp. 139–148, 2018, doi: 10.4049/jimmunol.1801473.The.

[17] J. I. Boullata et al., “ASPEN Safe Practices for Enteral Nutrition Therapy,” J. Parenter. Enter. Nutr., vol. 41, no. 1, pp. 15–103, 2017, doi: 10.1177/0148607116673053.

[18] K. Y. Choo, Y. Y. Ong, R. L. H. Lim, C. P. Tan, and C. W. Ho, “Study on bioaccessibility of betacyanins from red dragon fruit (Hylocereus polyrhizus),” Food Sci. Biotechnol., vol. 28, no. 4, pp. 1163–1169, 2019, doi: 10.1007/s10068-018-00550-z.

[19] R. J. Vital, P. Z. Bassinello, Q. A. Cruz, R. N. Carvalho, J. C. M. De Paiva, and A. O. Colombo, “Production, quality, and acceptance of tempeh and white bean tempeh burgers,” Foods, vol. 7, no. 9, 2018, doi: 10.3390/foods7090136.

[20] M. Appiani, C. Cattaneo, and M. Laureati, “Sensory properties and consumer acceptance of plant-based meat, dairy, fish and eggs analogs: a systematic review,” Front. Sustain. Food Syst., vol. 7, 2023, doi: 10.3389/fsufs.2023.1268068.

[21] M. L. Petroni et al., “Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges,” pp. 1–23, 2021.