Clinical nutrition products are described and characterised along their nutritional composition, caloric density and osmolality.
Figure 1: Formulation aspects in clinical nutrition
The nutritional composition of a clinical nutrition product is carefully designed. It contains protein, fat, carbohydrate, vitamins and minerals in such formulation that all relevant nutrients and the required energy are supplied in form of a complete and balanced diet. Next to standard formulations, the nutrient composition can be adjusted to nutritional and disease-specific requirements. A disease-specific formula for blood glucose control, for instance, contains primarily carbohydrates with low effect on blood glucose and insulin levels like isomaltulose. As a nutritive carbohydrate, isomaltulose adds to the caloric content of a product with 4 kcal/g. It contributes to the carbohydrate content of the formulation. In the nutrition information declaration it is considered under carbohydrates and, being a disaccharide, also under sugars.
The caloric density of clinical nutrition formulas varies between 1.0 and 2.0 kilocalories per millilitre product. With its 4 kilocalories per gram, isomaltulose contributes to the caloric value and thus to the caloric density of a formula to the same extent as other carbohydrates such as sugar, maltodextrins or starch.
The osmolality is also considered in clinical nutrition formulations. While general purpose formulas aim to have an osmolality similar to that of body fluids, nutrient-dense or hydrolysed formulas have a significantly higher osmolality. With a molar mass of 342.30 g·mol−1, isomaltulose adds to the osmolality of the product to the same extent as sucrose, and to less extent than monosaccharide sugars like glucose or fructose.