Optimental - 8 oz cans

  - Case of 24
190363
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Features:
  • Only Available for purchase by healthcare providers/facilities for treating patients in an institutional setting while under the care of a licensed healthcare professional.
  • Contains a specialized protein system
  • Designed for those with malabsorptive conditions
  • Ready-to-feed elemental formula
  • Vanilla flavor
Product Overview:
Usage:
OPTIMENTAL is a ready-to-feed elemental formula containing a specialized protein system, structured lipids, fructooligosaccharides (FOS), and elevated levels of antioxidants. It is scientifically designed for the dietary management of patients with malabsorptive conditions, such as Crohn's disease or metabolic stress, and acute trauma.
Malabsorptive conditions such as:
  • Metabolic stress
  • Crohn's disease
  • Short-bowel syndrome

 

Features:
  • Complete, balanced nutrition
  • For sole-source or supplemental nutrition
  • For oral or tube feeding
  • Provides at least 100% of the RDI for 24 key vitamins and minerals in 1422 Cal (six 8-fl-oz servings)
  • Structured lipid system combines medium-chain triglycerides (MCTs) with eicosapentaenoic acid (EPA) for increased absorption of omega-3 fatty acids
  • Contains elevated levels of antioxidants: vitamins C and E, and beta-carotene
  • Lactose- and gluten-free
  • Supplemented with L-arginine
  • Low residue
  • FOS to help support digestive tract health
  • Vanilla flavor
    Caloric Distribution
    Per 8 fl oz Per Liter % Calories
    Calories 237 1000 —
    Protein, g 12.2 51.3 20.5
    Fat, g 6.7 28.4 25.0
    Carbohydrate, g 32.9 138.5 54.5
    Water, g* 198 835 —

    * 1 g water = 1 mL water = 1 cc water.
 

 

Availability:
Ready-To-Use
8-fl-oz cans, 24/case
Vanilla #54638

HCPCS Code B4153 (for 8-fl-oz can)

Product information and values listed are subject to change. Please refer to product label or packaging for the most current information. 		 

 

Administration:

Use under medical supervision. Not for parenteral use.

Minimum tube size for gravity feeding is 8F; 5 F for pump feeding. Use of a pump is recommended when smaller tubes are used.

 

 

Ingredients:
-D Water, maltodextrin (corn), sugar (sucrose), soy protein hydrolysate, structured lipid [interesterified sardine oil and medium-chain triglycerides (fractionated coconut oil)], partially hydrolyzed sodium caseinate, fructooligosaccharides (FOS), canola oil, soy oil, calcium phosphate tribasic, natural and artificial flavors, L-arginine, sodium citrate, magnesium phosphate dibasic, diacetyl tartaric acid esters of mono-diglycerides, magnesium chloride, potassium citrate, ascorbic acid, choline chloride, gellan gum, taurine, d-alpha-tocopheryl acetate, L-carnitine, zinc sulfate, ferrous sulfate, niacinamide, calcium pantothenate, manganese sulfate, thiamine chloride hydrochloride, pyridoxine hydrochloride, beta-carotene, riboflavin, cupric sulfate, vitamin A palmitate, folic acid, biotin, potassium iodide, sodium selenate, phylloquinone, cyanocobalamin and vitamin D3.  

 

Protein:
OPTIMENTAL contains a protein blend that includes soy protein hydrolysate (SPH). Animal research has indicated that SPH may be enterotropic by increasing cell number and reducing cell death in the GI tract.1 This characteristic of a hydrolyzed protein source may help support normal gut structure, reduce epithelial cell loss, and facilitate absorption. The amino acid profile of OPTIMENTAL meets or surpasses the standard amino acid profile for high-biologic-value protein set by the National Academy of Sciences.2


Protein Profile

Percent of total calories from protein 20.5
Protein content 51.3 g/L

Protein Source
Soy protein hydrolysate (SPH) 67%
Partially hydrolyzed sodium caseinate 28%
Free arginine 5%

Cal/N ratio 122:1
Nonprotein Cal/N ratio 97:1
 

 

Fat:
OPTIMENTAL contains a structured lipid combining fish oil with MCTs. Structured triglycerides are formed by randomly re-esterifying the fatty acids from long-chain triglycerides (LCTs) and MCTs.3 This rearrangement can result in improved absorption and metabolism of long-chain fatty acids (LCFAs) compared to absorption of LCFAs from physical mixes of fish oil and MCT oil.4 Fish oil (refined, deodorized sardine oil) is an abundant source of omega-3 fatty acids, including EPA and docosahexaenoic acid (DHA). EPA functions as a precursor of certain prostaglandins and leukotrienes that have inflammation-modulating properties.5 OPTIMENTAL contains EPA at a level of 540 mg/8 fl oz (2290 mg/L) and DHA at a level of 230 mg/8 fl oz (970 mg/L). The level of MCT oil in OPTIMENTAL is 1.9 g/8-fl-oz serving (8.0 g/L), which provides 28% of fat calories. As recommended by the American Heart Association,6 less than 30% of calories in OPTIMENTAL are provided from fat. The fat calories supply a balanced amount of polyunsaturated, monounsaturated, and saturated fatty acids.


Fat Profile

Percent of total calories from fat 25.0

Fat Content 28.4 g/L
Polyunsaturated fatty acids (9%) 9.7 g/L
Monounsaturated fatty acids (6%) 5.96 g/L
Saturated fatty acids (10%) 11.32 g/L

Fat Source
Sardine oil/MCT structured lipid 60%
Canola oil 18%
Soybean oil 18%
Emulsifier (diacetyl tartaric acid esters of mono-diglycerides) 4%

Cholesterol <30 mg/L
 

 

Carbohydrate:
The carbohydrate sources in OPTIMENTAL are maltodextrin, sucrose, and FOS. FOS are indigestible sugars that occur naturally in onions, barley, bananas, and other common foods.7 FOS are not digested by the gastrointestinal enzymes.8 These oligosaccharides remain intact through the small intestine and pass into the large intestine, where they are fermented by bifidobacteria and other microorganisms in the colon to lactate and the short-chain fatty acids (SCFAs) acetate, propionate, and butyrate,9,10 which serve as a nutrient source for the cells that line the colon.11,12


Several studies have shown that supplementing human diets with FOS increases the number of bifidobacteria.9,13,14 In an in vitro study, FOS fermentation resulted in the greatest growth of acid-producing bacteria and the lowest pH. These factors, in turn, did not support the growth of some pathogenic bacteria, eg, Clostridium difficile.10,15

Carbohydrate Profile

Percent of total calories from carbohydrate 54.5
Carbohydrate content 138.5 g/L

Carbohydrate Source
Maltodextrin 55.7%
Sucrose 40.0%
Fructooligosaccharides 4.3%
 

 

 

Vitamins and Minerals:
OPTIMENTAL provides at least 100% of the RDIs for 24 key vitamins and minerals in 1422 Cal (six 8-fl-oz servings). Carnitine and taurine are conditionally essential nutrients that may become depleted during periods of metabolic stress.16,17 OPTIMENTAL contains 25 mg/8 fl oz (110 mg/L) of both L-carnitine and taurine.


OPTIMENTAL also contains elevated levels of the antioxidants vitamin C, vitamin E, and beta-carotene. Antioxidants act as scavengers and control potentially damaging intracellular biochemical reactions by eliminating prooxidants and free radicals.18 The amount of vitamin C in OPTIMENTAL is 50 mg/8 fl oz (215 mg/L).

The all-natural form (R,R,R stereoisomer; d-alpha-tocopherol) of vitamin E has been shown to be preferentially absorbed and accumulated in the central and peripheral nervous systems, unlike synthetic isomers. It may be advantageous to consume the R,R,R stereoisomer to maximize transport and replenish deficient nervous system tissues.19 OPTIMENTAL contains 50 IU/8 fl oz of R,R,R-d-alpha-tocopherol.

Beta-carotene, a carotenoid compound, has provitamin A activity and is found naturally in the diet. Beta-carotene is useful for dietary supplementation of retinol equivalents to the diet. OPTIMENTAL is fortified with 0.84 mg/8 fl oz (3.6 mg/L) beta-carotene, which provides 1115 IU/8 fl oz (4660 IU/mL) of the vitamin A activity in the product.

  

 

Osmotic Concentration:
The main determinants of the osmolality of a formula are simple carbohydrates, electrolytes, amino acids, and small peptides. OPTIMENTAL contains maltodextrin, sucrose, and FOS as the carbohydrate sources, and a hydrolyzed protein system containing small peptides and free amino acids.

 

Osmolality* (mosm/kg H2O) 540
Osmolarity (mosm/L) 583

* Measured on undiluted product using vapor pressure methodology. 		 

 

Renal Solute Load:

Renal solute load represents the solutes excreted per liter of product consumed. The major determinants of renal solute load are dietary protein and electrolytes. Each milliequivalent of sodium, potassium, and chloride contributes approximately 1 mosm to the renal solute load; in adults, each gram of protein contributes approximately 5.7 mosm.

Renal Solute Load (RSL)

Electrolyte Content (mEq/L) Contribution to RSL (mosm/L)
Sodium 46 46
Potassium 45 45
Chloride 38 38
Protein content 51.3 g/L x 5.7 = 292
Total RSL 421
 

 

References:
Clinical Documentation
Griffiths AM, Pendley FC, Issenman RM, et al: Elemental versus polymeric enteral nutrition as primary therapy for active Crohn's Disease: A multi-centre pediatric randomized controlled trial (abstract). J Ped Gastroenterol Nutr 2000;31(suppl 2):S75.

References


1. Birke H, Thorlacius-Ussing O, Hessov I: Trophic effect of dietary peptides on mucosa in the rat small bowel (abstract). JPEN 1990;14(suppl):26S.

2. National Research Council: Recommended Dietary Allowances, ed 10. Washington, DC: National Academy Press, 1989.

3. Merolli A, Lindemann J, Cerrito E, Del Vecchio AJ: Medium-chain lipids: New sources, uses. Inform 1997;8:597-603.

4. Kenler AS, Swails WS, Driscoll DF, et al: Early enteral feeding in postsurgical cancer patients: Fish oil structured lipid-based polymeric formula versus a standard polymeric formula. Ann Surg 1996;233:316-333.

5. Gottschlich MM: Selection of optimal lipid sources in enteral and parenteral nutrition. Nutr Clin Pract 1992;7:152-165.

6. Dietary guidelines for healthy American adults: A statement for physicians and health professionals by the Nutrition Committee, American Heart Association. Circulation 1988;77:721A-724A.

7. Spiegel JE, Rose R, Karabell P, et al: Safety and benefits of fructooligosaccharides as food ingredients. Food Technol 1994;48:85-89.

8. Molis C, Flourie B, Ouarne F, et al: Digestion, excretion, and energy value of fructooligosaccharides in healthy humans. Am J Clin Nutr 1996;64:324-328.

9. Hidaka H, Eida T, Takizawa T, et al: Effects of fructooligosaccharides on intestinal flora and human health. Bifidobacteria Microflora 1986;5:37-50.

10. May T, Mackie RI, Fahey GC Jr, et al: Effect of fiber source on short-chain fatty acid production and on the growth and toxin production by Clostridium difficile. Scand J Gastroenterol 1994;19:916-922.

11. Cummings JH, Macfarlane GT: A review: The control and consequences of bacterial fermentation in the human colon. J Appl Bacteriol 1991;70:443-459.

12. Macfarlane GT, Cummings JH: The colonic flora, fermentation, and large bowel digestive function, in The Large Intestine: Physiology, Pathophysiology, and Disease. New York: Raven Press Ltd, 1991, pp 51-92.

13. Mitsuoka T, Hidaka H, Eida T: Effect of fructooligosaccharides on intestinal microflora. Die Nahrung 1987;31:427-436.

14. Garleb KA, Snook JT, Marcon MJ, et al: Effect of fructooligosaccharide containing enteral formulas on subjective tolerance factors, serum chemistry profiles, and faecal bifidobacteria in healthy adult male subjects. Microb Ecol Health Dis 1996;9:279-285.

15. Modler HW, McKellar RC, Yaguchi M: Bifidobacteria and bifidogenic factors. Can Institute Food Sci Tech J 1990;23:29-41.

16. Iapichino G, Radrizzani D, Colombo A, Ronzoni G: Carnitine excretion: A catabolic index of injury. JPEN 1988;12:35-36.

17. Paauw JD, Davis AT: Taurine concentrations in serum of critically injured patients and age- and sex-matched healthy control subjects. Am J Clin Nutr 1990;52:657-660.

18. Sies H, Stahl W, Sundquist AR: Antioxidant functions of vitamins: Vitamins E and C, beta-carotene, and other carotenoids. Ann N Y Acad Sci 1992;669:7-20.

19. Sokol RJ, Butler-Simon N, Conner C, et al: Multicenter trial of d-a-tocopheryl polyethylene glycol 1000 succinate for treatment of vitamin E deficiency in children with chronic cholestasis. Gastroenterology 1993;104:1727-1735.

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Optimental - 8 oz cans
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what is an equivalent
Asked on Jan 21, 2012 7:14:40 AM by nurse b from homecare
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IS THIS PRODUCT ALL VEGAN?IF NOT WHAT DOES IT CONTAIN? IS IT KOSHER
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Part Number(s): 827 0175

Mfg Part Number(s): 54638

Scrip Part Number(s): 827 0175

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