The levels, single and multiple health risk assessment of 23 metals in enteral nutrition formulas

Enteral nutrition formulas are products that provide macro and micronutrients to patients who cannot receive their nutrition orally. In this study, the levels of 23 metals known to have potential health risks were determined by inductively coupled plasma mass spectrometry in a total of 28 enteral nutrition formula. Metal exposure was calculated according to three different daily energy intake scenarios (Scenario 1 = 50% oral nutrition + 50% enteral nutrition formula, Scenario 2 = 25% oral nutrition + 75% enteral nutrition formula and Scenario 3 = 100% enteral nutrition formula) and evaluated in terms of non-carcinogenic health risks. The mean levels of Fe, Co, Ni, Cu, Zn, Mo, Se, Li, Be, V, As, Sr, Ag, Cd, Sb, Ba, La, Hg and Pb in the samples analyzed were determined 12,000 ± 3300, 64 ± 1.6, 10 ± 13, 1300 ± 400, 8500 ± 2500, 75 ± 30, 61 ± 21, 0.34 ± 0.36, 0.05 ± 0.08, 7.3 ± 2, 1.6 ± 0.6, 457 ± 166, 0.02 ± 0.1, 0.14 ± 0.12, 0.01 ± 0.1, 74 ± 103, 0.63 ± 0.4, 0.05 ± 0.03 and 0.14 ± 0.7 μg/L. These metals were considered safe in terms of non-carcinogenic health risks when analyzed individually. However, when the target hazard quotient values of all metals were evaluated together, hazard index values were higher than the reference value of 1, for both men and women, indicating potential health risks.