ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1621993
A multi-center, prospective, single-arm, open label, 13-month intervention study of a plant-based, high energy and protein enteral tube feed in home enterally tube fed patients
Provisionally accepted
Gary P Hubbard1*
Corbin Griffen1
Rebecca Capener1
Nicky Wyer2
Rebecca Martin3Rachel Raif3Lisa Green3Sheryl Sutcliffe3Elizabeth Michaels4Yvonne Dube4Johanna Bates5Alina Bidgood5Claudiu Brici5Daniel J Griffith6Hannah Meanwell7Elizabeth Diamond8Charlotte Lennon9Louise Lewis9Lyndsay Chandler9Lisa Szymanski10Jane Ward11Cerian Banks11Katharine Nosworthy12Natasha Glanville12Sarah Richardson12Maura Hardy12Samantha Morris13Carys Robinson13Anna Lumsdon13Naomi Hatchett14Lindsey Allan14Robyn McNaughton15Alison Campbell15
Janet Baxter15Stephanie Owen16Nola Blackburn16Emma Tripp17Helen Hitchings17Sheldon C Cooper6Ann McCloskey18Heidi Lewis19Rebecca J Stratton20,21- 1Danone UK, Wiltshire, South West England, United Kingdom
- 2University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- 3Calderdale and Huddersfield NHS Foundation Trust, Yorkshire, United Kingdom
- 4Leicestershire Partnership NHS Trust, Leicester, England, United Kingdom
- 5North East London NHS Foundation Trust, London, United Kingdom
- 6Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
- 7Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- 8Kent Community Health NHS Foundation Trust, Ashford, United Kingdom
- 9George Eliot Hospital, Nuneaton, United Kingdom
- 10Southern Health NHS Foundation Trust, Southampton, United Kingdom
- 11Northumbria Healthcare NHS Foundation Trust, North Shields, England, United Kingdom
- 12County Durham and Darlington NHS Foundation Trust, Seaham, United Kingdom
- 13University Hospital of North Tees, Stockton-on-Tees, England, United Kingdom
- 14Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, United Kingdom
- 15Perth Royal Infirmary, Perth, Scotland, United Kingdom
- 16Royal Derby Hospital, University of Nottingham, Derby, United Kingdom
- 17Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom
- 18Kingston Hospital NHS Trust, Kingston, Kingston upon Thames, United Kingdom
- 19University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- 20Danone Nutricia Research (Netherlands), Utrecht, Netherlands, Netherlands
- 21University of Southampton, Southampton, Hampshire, United Kingdom
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There is an emerging need for plant-based options for home enteral tube feeding (HETF) patients, however their long-term efficacy and safety needs to be established.Methods: Forty-one HETF patients (age: 51 years (SD 23); range 19-84 years; 54% male) participated in a multi-center, prospective, single-arm, open label, 13-month intervention study of a plant-based, high energy, high protein (2kcal/ml and 10g protein/100ml) enteral tube feed with or without added fiber (1.5g/100ml). Seventeen patients continued on the plant-based feed beyond day 28 (28D) with a 6-and 13-month follow-up (6M and 13M). Outcomes included gastrointestinal tolerance (GI), anthropometrics, muscle strength and function (handgrip strength, 30-second chair stand test (30SCST)), dietary intake, total daily feed volume and time for feeding, and safety.Results: Compared to patient's baseline feeding regimen, patients using the plant-based feed reported: greater absence of GI symptoms at all time points (+7-12%, p≤0.04); a reduced incidence and intensity of GI symptoms: bloating, burping at 28D (p<0.05) and constipation, flatulence at 13M (p<0.05); improved physical function between 6M and 13M (+2 30SCST repetitions, p=0.02), with maintenance of body weight, calf circumference and handgrip strength; total protein intake increased at all time points (+0.2-0.3g/kg/day, p<0.05); and total daily feed volume (-225 to -264ml/day, p<0.05) and estimated time for pump feeding (-2hours/day, p<0.05) reduced at all time points. Discussion: This longitudinal study highlights that a plant-based (vegan-suitable) high energy, high protein enteral tube feed has good tolerance in HETF patients, positive long-term effects on protein intake and potential benefits on physical function.
Keywords: plant-based, Home enteral tube feeding, High energy, High protein, Gastrointestinal tolerance, physical function
Received: 02 May 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Hubbard, Griffen, Capener, Wyer, Martin, Raif, Green, Sutcliffe, Michaels, Dube, Bates, Bidgood, Brici, Griffith, Meanwell, Diamond, Lennon, Lewis, Chandler, Szymanski, Ward, Banks, Nosworthy, Glanville, Richardson, Hardy, Morris, Robinson, Lumsdon, Hatchett, Allan, McNaughton, Campbell, Baxter, Owen, Blackburn, Tripp, Hitchings, Cooper, McCloskey, Lewis and Stratton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gary P Hubbard, Danone UK, Wiltshire, BA14 0XQ, South West England, United Kingdom
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