Optimizing pureed diets via texture analysis: A study on the impact of different energy levels and ingredient ratios on nasogastric tube patency

This study explores the impact of nutritional components and ingredient characteristics on tube patency and blockage risk in nasogastric pureed diets, revealing key optimization pathways for pureed diet formulations. The energy density and ingredient selection of pureed diets significantly affect tube patency. High-energy diets provide higher nutritional density but significantly increase the injection force and blockage risk. Diet formulations should be optimized by reducing high-viscosity and high-hardness ingredients such as rice and beef, using rice flour to replace rice, and milk as the liquid component. For high-energy demands, the carbohydrate and dietary fiber contents should be controlled to reduce the injection force requirements and blockage risk. The study also developed a five-dimensional blockage risk warning model based on energy, protein, fat, carbohydrate, and dietary fiber (AUC = 0.91), classifying low-, medium-, and high-risk levels. Low-risk patients (energy≤1400 kcal/d, carbohydrates≤200 g/d, protein≤70 g/d) are recommended to use homemade formulas, whereas high-risk patients (energy≥1601 kcal/d, carbohydrates≥241 g/d, protein≥86 g/d) should use FSMP for full feeding to balance nutritional supply and tube patency. The findings of this study provide both theoretical and practical guidance for optimizing diets for dysphagia patients, emphasizing that adjusting formulations can effectively balance nutritional supply and tube patency, reduce blockage risk, and prevent malnutrition in homemade pureed feed. This has significant implications for reducing nasogastric complications and ensuring the safety of medical procedures.