pone.0329207.t017 -

Objective This study aimed to investigate the impact of different energy levels and ingredient ratios on the nasogastric tube patency of pureed diets, optimizing the formulations to meet the nutritional requirements of elderly nasogastric feeding patients while minimizing tube blockage risk. Methods The study followed the guidelines of the “ Chinese Resident’s Balanced Diet Pyramid ” and formulated five different energy levels of pureed diets (900 kcal, 1200 kcal, 1500 kcal, 1800 kcal, and 2100 kcal) using natural food groups. The diets consisted of seven major food categories: cereals and tubers, vegetables, meats, milk, oil, salt, and fruits. The liquid formulations for the above energy levels were prepared according to the concentration standards for special medical purpose foods (FSMPs). The maximum injection force required for nasogastric feeding was measured via a texture analyzer. The nutritional components of the pureed diets at different energy levels and ingredient ratios were evaluated via West China Hospital Nutrition Software. Spearman correlation analysis, multiple regression analysis, and random forest models were used to explore the relationships between energy levels, nutritional components, ingredients, maximum injection force, and tube patency. Results The study revealed that as the energy density increased, the maximum injection force of the pureed diets significantly increased ( p < 0.05), particularly at the 2100 kcal energy level, where the “rice‒carrot‒beef” formula reached the highest value (117.59 ± 0.26 N), whereas the “FSMP” formula at 900 kcal presented the lowest injection force (9.62 ± 0.20 N). There was a significant difference in the impact of different energy levels and formulations on the maximum injection force ( p < 0.05). Spearman correlation analysis indicated that carbohydrate ( ρ = 0.736) and dietary fiber ( ρ = 0.668) contents were significantly positively correlated with the maximum injection force ( p < 0.05). Multiple regression analysis further revealed that ...