Enteral nutrition feeding alters antioxidant activity in unstimulated whole saliva composition of patients with neurological disorders.
Tube feeding moves salivary antioxidant numbers up and down, but the clinical meaning is still unclear.
01Research in Context
What this study did
Sales et al. (2014) compared saliva from tube-fed neurological patients with saliva from matched controls.
They looked at antioxidant markers to see if liquid formula changes mouth chemistry.
No behavior program was tested; the team just collected samples and ran lab tests.
What they found
Some antioxidant values went up, others went down.
The pattern was too mixed to call tube feeding helpful or harmful.
In plain words: the diet shifts mouth chemistry, but we don’t yet know if it matters for health or behavior.
How this fits with other research
Austin et al. (2015) watched staff give medicine through tubes in Belgian ID homes. They saw frequent errors—wrong mixing, skipped flushes—showing that what goes through the tube can be risky in real life.
Carmeli et al. (2008) found lower antioxidant enzymes in the blood of people with ID plus hypothyroidism. Sales moved the lens to saliva and tube feeding, adding a feeding-route angle to the antioxidant story.
von Wirth et al. (2021) also used saliva, but tracked cortisol in kids with CP after therapy. Both teams show saliva can flag stress or redox changes; together they hint that mouth fluid tests could guide clinical choices in neuro-disability.
Why it matters
If you work with tube-fed clients, expect mouth chemistry to differ from textbook norms.
A future saliva strip might one day signal oxidative stress, but for now just note that diet delivery route counts.
Pair this with Austin et al. (2015): secure medication practices and regular mouth care matter as much as formula choice.
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02At a glance
03Original abstract
Patients with neurological disorders have an increased risk of oral and systemic diseases due to compromised oral hygiene. If patients lose the ability to swallow and chew food as a result of their disorder, enteral nutrition is often utilized. However, this type of feeding may modify salivary antioxidant defenses, resulting in increased oxidative damage and the emergence of various diseases. The aim of this study was to evaluate the effects of enteral nutrition on biochemical parameters in the unstimulated whole saliva composition of patients with neurological disorders. For this, enzymatic (superoxide dismutase - SOD; glutathione peroxidase - GPx) and non-enzymatic (uric acid; ferric ion reducing antioxidant power - FRAP) antioxidant activity, as well as a marker for oxidative damage (thiobarbituric acid reactive substances - TBARS) were analyzed. Unstimulated whole saliva was collected from 12 patients with neurological disorders and tube-feeding (tube-fed group - TFG), 15 patients with neurological disorders and normal feeding via the mouth (non-tube-fed group - NTFG), and 12 volunteers without neurological disorders (control group - CG). The daily oral hygiene procedures of TFG and NTFG patients were similar and dental care was provided monthly by the same institution's dentist. All patients exhibited adequate oral health conditions. The salivary levels of FRAP, uric acid, SOD, GPx, TBARS, and total protein were compared between studied groups. FRAP was increased (p<0.05) in the NTFG (4,651 ± 192.5 mmol/mL) and the TFG (4,743 ± 116.7 mmol/mL) when compared with the CG (1,844 ± 343.8 mmol/mL). GPx values were lower (p<0.05) in the NTGF (8.24 ± 1.09 mmol/min/mg) and the TFG (8.37 ± 1.60 mmol/min/mg) than in the CG (15.30 ± 2.61 mmol/min/mg). Uric acid in the TFG (1.57 ± 0.23 mg/dL) was significantly lower than in the NTFG (2.34 ± 0.20mg/dL) and the CG (3.49 ± 0.21 mg/dL). Protein was significantly lower in the TFG (5.35 ± 0.27 g/dL) than in the NTFG (7.22 ± 0.57 g/dL) and the CG (7.86 ± 0.54 g/dL). There was no difference in the salivary flow rate and SOD between groups. Enteral nutrition in patients with neurological disorders was associated with lower oxidative damage, resulting in increased salivary antioxidant capacity. These results emphasize the importance of oral care for this population to prevent oral and systemic diseases.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.03.003