skip to main content

Pengembangan formula enteral hepatogomax untuk penyakit hati berbasis tepung kedelai dan tepung susu kambing

Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegoro, Indonesia

Received: 29 Jan 2020; Published: 18 Dec 2020.

Citation Format:
Abstract

Background: Patients with chronic liver disease were risk to be malnourished due to malabsorption, hipermetabolic condition, and not receiving adequate nutrients orally. Diet therapy through enteral feeding based on soybean flour and goat milk flour play role as an alternative formula for chronic liver patients since it contains high Branched-Chain Amino Acids (BCAA) and Medium-chain Triglyceride (MCT).

Objectives: to analyze viscosity, nutrient content, protein digestibility, and organoleptic properties of enteral feeding using soybean flour and goat milk flour.

Methods: An experimental study using 3 distinc formula with ratio soybean flour to goat milk flour was P1(45:55), P2(50:50), P3(55: 45).  Viscosity, fat, carbohydrate content, and energy density were analyzed using One Way Anova followed by Tukey test while protein content, protein digestibility, and energy density were analyzed using Kruskal Wallis followed by Mann Whitney test. Organoleptic properties were analyzed using Friedman followed by Wilcoxon test.

Results:The higher the soybean flour, the higher the formula viscosity (p=0.000) and protein (0.007). In contrast, the higher the got milk flour, the higher the fat (p=0.000), carbohydrate (p=0.000), energy (p=0.000) and energy density (p=0.013). Formula P3 has the highest viscosity (1.93±0.039 cP) and protein (9.66±0.16%), while P1 has the highest fat (27.33±0.15%), carbohydrate (65.97±0.23%), energy (1.175±3.04 kkal), energy density (1.17±0.00 kkal/ml), and protein digestibility (45.90±1.49%) among others. However, there is no effect of different formula toward protein digestibility (p=0.116). Organoleptic properties showed that the higher the got milk flour, the higher its acceptance in all aspect including color (p=0.046), flavor (p=0.000), taste (p=0.009) dan texture (p=0.002).

Conclusion: P1 was the best formula due to its level of viscosity, fat, energy, protein and energy density that meet requirements according to European Society for Clinical Nutrition and Metabolism (ESPEN). P1 also has the highest protein digestibility, and have the highest score of all organoleptic parameters.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Untitled
Subject
Type Research Instrument
  Download (753KB)    Indexing metadata
Keywords: enteral formula; chronic liver disease; soybean flour; goat milk flour

Article Metrics:

  1. Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World Journal Gastroenterology. 2014;20(40):14686–95
  2. Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, et al. Liver cirrhosis mortality in 187 countries between 1980 and 2010: A systematic analysis. BMC Medicine. 2014;12(145):1–24
  3. EASL The Home of Hepatology. Fast facts about liver disease. In: The International Liver Congress. Barcelona; 2016
  4. Sinurat LR, Purba BT. Peningkatan status gizi pasien sirosis hepatis melalui regimen nutrisi di RS Sari Mutiara Medan. Idea Nursing Journal. 2018;9(2):1-3
  5. Cheung K, Lee SS, Raman M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clinical Gastroenterology Hepatology. 2012;10(2):117–25
  6. Maharshi S, Sharma BC, Srivastava S. Malnutrition in cirrhosis increases morbidity and mortality. Journal of Gastroenterology and Hepatology. 2015;30:1507–13
  7. Bemeur C, Desjardins P, Butterworth RF. Role of nutrition in the management of hepatic encephalopathy in end-stage liver failure. Journal of Nutrition Metabolism. 2010;1–12
  8. Purnak T, Yilmaz Y. Liver disease and malnutrition. Best Practice & Research Clinical Gastroenterology. 2013;27:619–29
  9. Silva M, Gomes S, Peixoto A, Torres-Ramalho P, Cardoso H, Azevedo R, et al. Nutrition in chronic liver disease. GE Portuguese Journal of Gastroenterology. 2015;1–9
  10. Plauth M, Muller-Nothmann. A guide for patients with liver diseases including guidlines for nutrition. 8th ed. Freiburg: Falk Foundation; 2006. 1-70 p
  11. Hapsari HTP. Pengendalian mutu dalam proses pembuatan makanan enteral di rumah sakit dustira cimahi [Skripsi]. Bogor : Institut Pertanian Bogor; 2012
  12. Huda N. Formulasi makanan cair alternatif berbasis tepung ikan lele (Clarias gariepinus) sebagai sumber protein [Skripsi]. Bogor : Institut Pertanian Bogor; 2014
  13. Plauth M, Cabre E, Riggio O, Assis-Camilo M, Pirlich M, Kondrup J, et al. ESPEN guidelines on enteral nutrition: Liver disease. Clinical Nutrition. 2006;25:285–94
  14. Gokturk HS, Selcuk H. Importance of malnutrition in patients with cirrhosis. Turk J Gastroenterol. 2015;26:291–6
  15. Eghtesa S, Poustchi H, Malekzadeh R. Malnutrition in liver cirrhosis: The influence of protein and sodium. Middle East Journal of Digestive Disease. 2013;5(2):65–75
  16. Saputra D. Penentuan daya cerna protein in vitro ikan bawal (Colossoma macropomum) pada umur panen berbeda. ComTech. 2014;5(2):1127–33
  17. eBookPangan. Karakteristik kedelai sebagai bahan pangan fungsional [Internet]. Jakarta: eBookPangan; 2006. 1-28 p. Available from: eBookPangan.com
  18. Astawan M, Hazmi K. Karakteristik fisikokimia tepung kecambah kedelai. Pangan. 2016;25(2):105–12
  19. Genateh G, Mebrat A, Wubie A, Kendie H. Review on goat milk composition and its nutritive value. Journal of Nutrition Health Sciences. 2016;3(4):1–10
  20. Haenlein GFW. Goat milk in human nutrition. Small Ruminant Research. 2004;51:155–63
  21. Yangilar F. As a potentially functional food : goats’ milk and products. Journal of Food Nutrition Research. 2013;1(4):68–81
  22. Mwenze PM. Functional properties of goats’ milk : A review. Research Journal Agriculture and Environmental Management. 2015;4(9):343–9
  23. Zenebe T, Ahmed N, Kabeta T, Kebede G. Review on medicinal and nutritional values of goat milk. Academic Journal of Nutrition. 2014;3(3):30–9
  24. Ayustaningwarno F. Teknologi pangan teori praktis dan aplikasi. 1st ed. Yogyakarta: Graha Ilmu; 2014. 1-8 p
  25. eBookPangan. Pengujian organoleptik (evaluasi sensori) dalam industri pangan [Internet]. Jakarta: eBookPangan; 2006. 1-41 p. Available from: eBookPangan.com
  26. Agusman. Modul penanganan mutu fisis (organoleptik). Semarang: Program Studi Teknologi Pangan Universitas Muhammadiyah Semarang; 2013. 1-26 p
  27. Santoso EB. Pengaruh penambahan berbagai jenis dan konsentrasi susu terhadap sifat sensoris dan sifat fisikokimia puree labu kuning [Skripsi]. Surakarta : Universitas Sebelas Maret; 2013
  28. Bourne M, Santoso EB. Food texture and viscosity: concept and measurement. Second Edition. 2013. 78-81 p
  29. Lumbantoruan P, Yulianti E. Pengaruh suhu terhadap viskositas minyak pelumas. Sainmatika. 2016;13(2):26–34
  30. American Dietetic Association. National Dysphagia Diet Task Force, American Dietetic Association. Viscosity level for oral and enteral feedings. In: National dysphagia diet:Standardization for optimal care. Chicago: American Dietetic Association; 2002
  31. Lindriati T, Praptiningsih Y, Wijayanti DF. Karakteristik fisis gel edible film yang dibuat dengan variasi pH dan rasio kasein dan tapioka. Jurnal Imu Dasar. 2014;15(1):51-8
  32. Ravi R, Taheri A, Khandekar D, Millas R. Rapid profiling of soybean aromatic compounds using electronic nose. Biosensors. 2019.9(66):1-13
  33. Hamad A, Ma’ruf A. Produksi lecithin dari vegetable oils menggunakan proses acid degumming. In: Prosiding Senatek 2015 Fakultas Teknik, Universitas Muhammadiyah Purwokerto. Purwokerto: Universitas Muhammadiyah Purwokerto; 2015. p. 111–5
  34. Apri N. Profil medium chain fatty acids (MCFA) minyak kelapa (Virgin Coconut Oil/VCO, minyak simplah, pliek U, klentik, dan kopra) dibandingkan dengan minyak sawit. Sagu. 2013;12(2):23–31
  35. Shah ND, Limketkai BN. Nutrition issues in gastroenterology, series #160 : The use of medium-chain triglycerides in gastrointestinal disorders. In Parrish CR (ed). Practical gastroenterology. 2017:20-26
  36. Siregar NS. Karbohidrat. Jurnal Ilmu Keolahragaan. 2014;13(2):38-44
  37. Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schutz T, et al. ESPEN guideline on clinical nutrition in liver disease. Clinical Nutrition. 2019. https://doi.org/10.1016/j.clnu.2018.12.022
  38. Muchtadi D. Nutrifikasi Protein. In: Nutrifikasi Pangan. 1st ed. Tangerang Selatan: Universitas Terbuka; 2008. p. 1.1-1.4
  39. Duodu KG, Taylor JR., Belton PS, Hamaker BR. Factors affecting sorghum protein digestibility. Journal of Cereal Science. 2003;38:117–31
  40. Gilani GS, Xiao CW, Cockell KA. Impact of antinutritional factors in food proteins on the digestibility of protein and the bioavailability of amino acids and on protein quality. British Journal of Nutriion. 2012;108:S315–S332
  41. Kanaka DA, Ayustaningwarno F. Nilai cerna protein in-vitro biskuit dengan substitusi kecambah kedelai (Glycine max (L.) Merril) dan pisang (Musa paradisiaca sp.) sebagai makanan sehat untuk anak sekolah dasar. Journal of Nutrition College. 2015;4(2):141–6
  42. Budiman. Kandungan nutrisi dan daya cerna protein secara in vitro snack ekstruksi berbahan grits jagung yang disubstitusi dengan tepung putih telur sebagai sumber protein [Skripsi]. Bogor : Institut Pertanian Bogor; 2008
  43. Boyce J, Wijesinha-Bettoni R, Burlingame B. Protein quality evaluation twenty years after the introduction of the protein digestibility corrected amino acid score method. British Journal of Nutrition. 2012;108:S183-S211
  44. Ullah R, Khan S, All H, Bilal M, Saleem M. Identification of cow and buffalo milk based on beta carotene and vitamin-A concentration using fluorescence spectroscopy. Plos one. 2017;12(5):1-10
  45. Tehrany EA, Sonneveld K. Packaging and the shelf life of milk powders. In: Robertson GL, editor. Food packaging and shelf life : A pratical guide. 1st Editio. Boca Raton: CRC Press; 2009. p. 127–37
  46. Anggraeni RH, Legowo AM, Al-Baarri AN. Intensitas warna dan aroma pada susu skim kambing akibat proses glikasi dengan penambahan gula D-Fruktosa, L-Fruktosa, dan D-Tagatosa. Jurnal Aplikasi Teknologi Pangan. 2013;2(3):156-9
  47. BPOM. Peraturan kepala badan pengawas obat dan makanan nomor 22 tahun 2016 tentang persyaratan penggunaan bahan tambahan pangan perisa. Jakarta; 2016
  48. Darwin P. Menikmati gula tanpa rasa takut. Yogyakarta: Sinar Ilmu; 2014
  49. Gupta R. Nutrient analysis of raw and processed soybean and development of value added soybean noodles. Inventi Rapid : Life Style. 2014;1:1-6

Last update:

  1. The Effects of Hepatogomax Enteral Formula on Systemic Inflammation, Caecum Short-Chain Fatty Acid Levels, and Liver Histopathology in Thioacetamide-Induced Rats

    Hery D. Purnomo, Refani A. Kusuma, Elfrida Sianturi, Ryan F. Haroen, Muchamad R. Solichin, Choirun Nissa, Adriyan Pramono, Endang Mahati, Etika R. Noer, Karen L. Sweazea. Journal of Nutrition and Metabolism, 2023 , 2023. doi: 10.1155/2023/2313503
  2. Hepatogomax Improves Serum Albumin and Transaminase Enzyme Activity Levels in Sprague Dawley Rats Liver Cirrhosis

    Refani Alycia Kusuma, Etika Ratna Noer, Hery Djagat Purnomo, Adriyan Pramono, Endang Mahati, Choirun Nissa. Journal of Biomedicine and Translational Research, 8 (3), 2022. doi: 10.14710/jbtr.v8i3.15078
  3. Nutritional Value and Physical Quality of Oral Nutritional Supplements Made from Purple Sweet Potatoes to Treat Malnutrition in Patients with Cancer

    Fuadiyah Nila Kurniasari, Susetyowati Susetyowati, Mardiah Suci Hardianti, Anggun Rindang Cempaka. Current Nutrition & Food Science, 20 (2), 2024. doi: 10.2174/1573401319666230608162235

Last update: 2024-12-03 07:14:27

No citation recorded.