(P03-019-24) Protein Quality Estimations for Plant-Based Enteral Formulas

Objectives: Plant-based enteral formulas for nutrition in adults and children recently gained popularity. Often, pea is the only protein source, and it requires amino acid (AA) supplementation (e.g., sulfur AA) to achieve adequate protein quality as a sole source. We estimated protein quality for selected pea protein-based enteral formulas, using 4 AA reference patterns for comparison.

Methods: Four plant-based, pea protein-containing enteral formulas were analyzed: A) Adult Peptide, 1.5 kcal/mL; B) Adult Standard, 1.4 kcal/mL; C) Pediatric Peptide, 1.5 kcal/mL; and D) Adult Real Food Peptide, 1.5 kcal/mL. Samples were drawn from a single product container from 7 unique lots of each formula and analyzed for total protein and AA content. Samples were hydrolyzed in 6M HCl, derivatized with AccQ-Tag reagents, and analyzed by UHPLC. Protein quality was estimated by calculating the Protein Digestibility Corrected AA Score (PDCAAS) using the following reference patterns: 1) FAO Food and Nutrition Paper 92, 2013, ages 3+ y; 2) US Institute of Medicine, 2002, ages 1+ y; 3) FAO Food and Nutrition Paper 51, 1991, ages 2-5 y; 4) FAO Food and Nutrition Paper 92, 2013, ages 0.5-3 y.

Results: The mean untruncated PDCAAS ranges across reference patterns were: 0.78‒1.04, 0.79‒1.09, 0.81‒1.05, and 0.79‒1.19 for formulas A, B, C, and D, respectively. All formulas met a target PDCAAS of 1.0 when compared against reference pattern 1 for ages 3+ y, and formulas B, C, and D met a PDCAAS of 1.0 versus reference pattern 2. However, for applications utilizing more conservative reference patterns, such as those for preschoolers, no formula met a PDCAAS of 1.0 for pattern 3, and only formula D achieved a PDCAAS of 1.0 for pattern 4. Of note, formula C, intended for ages 1-13 y, did not reach a PDCAAS of 1.0 for preschool reference patterns 3 or 4, although it did for pattern 2, which is more age-comprehensive and less stringent.

Conclusions: Although the selected pea protein-containing enteral formulas generally met the various AA reference patterns recommended for older children and adults; they did not consistently meet more conservative reference patterns established for preschoolers. Clinicians should be aware that communications regarding pea protein quality may vary depending on AA reference patterns utilized.

Funding Sources: Abbott Laboratories