Title of Invention	"A PROCESS FOR THE PREPATION OF ENTERNAL FOOD, USEFUL AS A FOOD FOR PATIENTS AT HYPERCATABOLIC STATE ESPECIALLY THE THERMALLY INJURED PATIENTS"
Abstract	A process for the preparation of enteral food useful as a food for patients at hypercatabolic state especially the thermally intured patients, which comprises: I)Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess water separately for a ceriod ranging from 12-30 hr, II) Germinating the said soaked seeds separately for a period ranging froml- 4 days by known methods, III)Drying the germinated cereals separately either in sun or in mechanical aryer by known methods, iv) Removing the rootlets of dried cereal sprouts separately by known methods, v) Kilning the resultant green malts separately in the temperature range of 50-70°C for a period in the range of 30-60 min, vi) Dehusking malted paddy in rice shelter by known methods, and mcistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-20 minutes separately and milling the individual malted cereals separately in abrassive, comminuting, friction, roller, attrition or alike mills alone or in combination , and sieving off through 80 -120 mesh sieve to prepare cereal malt flours. vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of the seed remain in the product, viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min, ix ; Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec. x) Preparing curd (yogurt) by known methods containing 2-4xl03 cfu of Lactic acid bacteria per mi curd using bovine milk cultured with known strains of pure Lactic acid bacteria, xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi; separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii) , mashed egg in the range of 15-25% obtained in step (ix), pasteurized fresh milk ( 0.5 - is" %) ) , sucrose ( 5 - 10 %) , fish oil ( 5- 10%) , soya oil ( 5 -10%),

Title of Invention

"A PROCESS FOR THE PREPATION OF ENTERNAL FOOD, USEFUL AS A FOOD FOR PATIENTS AT HYPERCATABOLIC STATE ESPECIALLY THE THERMALLY INJURED PATIENTS"

Abstract

A process for the preparation of enteral food useful as a food for patients at hypercatabolic state especially the thermally intured patients, which comprises: I)Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess water separately for a ceriod ranging from 12-30 hr, II) Germinating the said soaked seeds separately for a period ranging froml- 4 days by known methods, III)Drying the germinated cereals separately either in sun or in mechanical aryer by known methods, iv) Removing the rootlets of dried cereal sprouts separately by known methods, v) Kilning the resultant green malts separately in the temperature range of 50-70°C for a period in the range of 30-60 min, vi) Dehusking malted paddy in rice shelter by known methods, and mcistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-20 minutes separately and milling the individual malted cereals separately in abrassive, comminuting, friction, roller, attrition or alike mills alone or in combination , and sieving off through 80 -120 mesh sieve to prepare cereal malt flours. vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of the seed remain in the product, viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min, ix ; Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec. x) Preparing curd (yogurt) by known methods containing 2-4xl03 cfu of Lactic acid bacteria per mi curd using bovine milk cultured with known strains of pure Lactic acid bacteria, xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi; separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii) , mashed egg in the range of 15-25% obtained in step (ix), pasteurized fresh milk ( 0.5 - is" %) ) , sucrose ( 5 - 10 %) , fish oil ( 5- 10%) , soya oil ( 5 -10%),

Full Text	This invention relates to a process for preparation of enteral food useful as a food (nutritional support) for patients at hypercatabolic state especially the thermally injured pat i ents. Proper nutritional support not only helps to cure the disease, but also prevents it's recurrence and decreases the mortality and morbidity of hospitalised patients, and also cut down the hospita1iration expenses substantially. Very often, hospitalised patients need special nutritional care. Liquid foods or enteral foods are administered orally or through feeding tube to the patients whenever the patient is not able to take normal or even semi-solid foods due to functional or organic disorder, but the gut functions normally. Enteral foods are also given to patients, as a part or total nutritional support to cope up with the extended nutritional requirements in some of the special phvsiotogica1 conditions such as complicated pregnancy, anorexia, burn inlury, sepsis, trauma etc. Development of enteral formulae for meeting nutritional requirement of needy patients is receiving greater attention in recent years. A wide range of enteral foods suitable for patients of different physiological conditions are produced mainly in USA, Japan, Australia and some European countries and marketed globally, but in India only two brands of general category enteral foods have been introduced and that too very recently (Table 1). Table 1: Some of the General Category and Disease Specific Enteral Foods Specially designed formula (Table Removed) It is very well known that patients suffering from cirrhosis of liver, burns or thermal injury, renal failure and some other physiological conditions require special nutritional support. Accordingly, enteral foods for patients suffering from hepatic, renal and some other diseases have been developed and marketed mostly in developed countries. To the best of our knowledge, no packaged food is available , that meets the nutritional requirements of patients suffering from hypercatabolic conditions especially of the burns or thermally injured patients, The physiological conditions of burn patients is marked with increased basal metabolic rate, raised core temperature, hyperdynamic circulation, protein catabolism, futile substrate cycling, lipolysis, loss of lean body mass, suppressed immune response followed by severe infection, stress induced hyperacidity, development of ilias combined with anorexia and poor wound healing. These conditions cause nutritional imbalance, specifically with reference to protein, energy and electrolytes. The hormonal imbalance caused due to burn injury induces the release of higher levels of catecholamine which raise the abnormally high metabolic rate. Because of this and to cope up with the changed nutritional and metabolic states, the patients need the diet that is exceptionally rich in energy, protein and some of the vitamins Depending upon age. sex and various physiological conditions, the thermally injured patients with over 3O% burn surface area or patients under hypercatabo1ic state require 2OOO to 50OO R'ca 1 energy and 80-2OO g of protein of high biological value, backedup with appropriate levels of vitamins, minerals and other protective nutrients per day. This special nutritional demand has to be met right from the day one of burn injury till a satisfactory nutritional status of the patient is achieved, otherwise the patient goes into negative nitrogen balance, suppressed immunomodu1atory system followed by infection which generally lead to mortality. In most of the cases, blenderized foods containing mainly egg, milk, fruit juice, sugar and high protein health food are administered to thermally injured patients. Such foods generally do not provide some of the specific nutrients and adequate quantities of vitamins and minerals and also may not meet the extended requirement of calorie and protein. Some of ths ingredients may be allergic and the possibility of microbiological contamination also exists. The advantages of egg as one of the ingredients of the blenderised foods for burn patients has been well recognised and many a time fresh beater, egg is fed to the patients perorally in the form of eggnog or other recipe. But. the practical difficulty of feeding quite a large quantity of egg limits the egg based food intake. Moreover, the fresh egg fed as such often causes digestive problems and its biotin is also not available to the patients. Boiled or heat treated egg protein is more easily digestible, but heat treatment coagulates the egg proteins rendering it unsuitable for enteral feeding, and because of this peroral feeding of egg based food has not been practiced hitherto. The chemically defined or modular enteral foods may meet the gross nutritional needs but may not contain the specific nutrients in desired proportion, possess poor sensory attributes, high osmolality, lack in natural microflora and many a times cause diarrhoea, vomiting and exert high renal load, which further complicate the patients conditions. On the other hand, enteral foods prepared from natural food ingredients maintain intestinal mucosal integrity and normal metabolism. Such foods also diminish the transfer of bacteria from the lumen across the intestinal wall into the 1ymphovascu1ar system and control gastric stress ulceration besides supplying the nutrients in usual food form. Therefore, enteral foods for burn patients based on natural food ingredients are highly desirable. The food for burn patients should contain proteins rich in high proportion of branched chain amino acids (BCAA) and arginine. and iipids rich in W '3 and H fatty acids. The BCAA supply energy for enhanced local metabolism and help in synthesis of immunomodu1atory compounds such as immuno-g1obu1 in, leucocytes and lymphocytes. The arginine helps in improving the immune status by enhanching the function of urea cycle, diminishing protein catabolism and raising the competence of T-1ymphocytes. W 3 and M c- fatty acid contribute for rapid wound healing, enhancing immunity to infection, maintenance of blood viscosity and cell membrane integrity. It is heartening to note that. some of the Medical Institutes/Hospitals in the country reluctantly admit patients with more than 50% of total burn surface area (TBSA), mainly because of non availability of proper food to meet their nutritional need, which often leads to morbidity and mortality of the injured ones. The forgoing discussions indicate that, there is a dire need for development of a food that meets the nutritional requirements and also the protective components for patients at hypercatabo1ic state particularly the burned patients, based on natural food ingredients that provide protein containing BCAA and arginine, lipids supplying H i ar. d W c- fatty acids and packed with tissue building, immunity development components and the essential vitamins and minerals. Therefore, the main object of the present invention is to provide a process for preparation of enteral food specially useful as a food for the patients under hypercatabo1ic state with special reference to burn injury. Another object of the present invention is to provide a process for preparation of enteral food useful for the patients under hypercatabo1ic state containing egg as one of the food components and still the food slurry maintain a free flowing state even after heating. Yet another object of the present invention is to provide a process for preparation of enteral food useful for the patients under hypercatabo1ic state that makes use of natural ingredients such as cereals rich in easily digestible carbohydrates, proteins rich in sulphur amino acids, BCAA and arginine, and vegetable or animal oil sources that provide W and H c fatty acids. Accordingly, the present invention provides a process for preparation of food useful for feeding the patients at hypercatabo1ic state with special reference to burns or thermally injured patients which comprises; i) Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess water separately for a period ranging from 12-3O hr, ii) Germinating the said soaked seeds separately for a period ranging from 1-4 days by known methods, iii) Drying the germinated cereals separately either in sun or in mechanical dryer by known methods. iv) Removing the rootlets of dried cereal sprouts separately by-known methods, v) Kilning the resultant green malts separately in the temperature range of 5O-7O°C for a period in the range of 3O-6O mi n. vi) Dehusking malted paddy in rice sheller by known methods, and moistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-2O minutes separately and milling the individual malted cereals separately in abrassive, communiting. friction, roller, attrition or alike mills alone or in combination, and sieving off the seed coat and coarse bran by sifting through 8O-12O mesh sieve to prepare cereal malt flours, vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of the seed remain in the product, viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min, ix ) Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec. x) Preparing curd (yogurt) by known methods containing 2-4xl09 cfu of Lactic acid bacteria per ml curd using bovine milk cultured with known strains of pure Lactic acid bacteria, xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi) separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii), mashed egg in the range of 15-25% obtained in step (ix) , pasteurized fresh milk ( 0.5 - 3 % ) , sucrose ( 5 - 10 %} , fish oil ( 5- 10%) , soya oil ( 5 -10%), edible gum (0.5 -3% ) and glycerin (0.5-2%), (xii) Mixing the resultant blend with potable water to prepare a 25-35% solid contents slurry, heating the slurry at a temperature ranging 55- 65° C by raising the temperature at the rate of 2-3°C per min, maintaining the slurry at that temperature for 5-20 min further, raising the temperature to boiling, bailing for 5-10 rain and cooling to ambient temperature, (xiii) Adding the curd obtained in step (x) , and also the premix of vitamins and minerals to the slurry, (xiv) Homogenising the mixture by known methods and spray drying the slurry at 160-190°C air temperature and 60-80°C material temperature. In an embodiment of the present invention, 15-3O% of any of the cereal malt flour alone or mixture of them, 10-2O% of finger millet malt flour, 5-15% amaranth seed flour. 5-15% defatted and heat treated soya flour, 70-100 ml (equivalent to 15-25% solids) of mashed whole egg, 15O-2OO ml (equivalent to 15-25% solids) of fresh milk, O.5-3% exudate gum preferably acasia. 5-lO% fish oil preferably from Cod-liver, Menhaden or of similar source, 5-10% soya oil, 5-10% sucrose, O.5-2% glycerin, 5-15ml% curd enriched with Lactic acid bacteria and 2-6% premix of a pharmaceutical grade vitamins and minerals are blended and the slurry is homogenised and spray dried at 160-190° air temperature and 60 80°C material temperature. Preparation of low fibre and enzyme rich malt flour from cereals for the enteral food may be effected by steeping the viable seeds separately in excess water, germinating the steeped seeds separately by known methods, drying the sprouts separately either in sun or mechanically, removing the rootlets separately by known methods, kilning the derooted malts separately either by passing warm air or by contact heat and moist conditions the malted cereals separately and milling the malts separately and sieving off the seed coat and bran. The soy flour is heat treated preferably toasted by known methods. The eggs used may be fresh avian eggs preferably from hen and fish oil may be from Menhaden, Sardine, Herring or Cod liver or similar source. Soya oil may be from any of the genetic source of soyabean freed from non edible matter. The gum used may be purified plant or sea weed exudate preferably from acasia. The full fat or partially toned milk may be from cow or buffalo or goat. The glycerin used may be of food or pharmaceutical grade. The curd may be from edible milk-cultured with pure culture of Lactic acid bacteria. Vitamins and minerals may be of British/1ndian/United States pharamacopia grade. The cereals and finger millet may be malted to enrich them with hydrolytic enzymes, to enhance their protein and carbohydrate digestibility, mineral availability and thus to improve their overall nutritional quality. The amaranth seeds are processed substantially to gelatinise the starch and to develop aroma yet most of the nutrients of the seed remain in the product. The ingredients for the enteral food are selected so that the food not only serves as the nutritional support to the patients but also helps in the speedy recovery from the burn injury. The cereal malts provide easily digestible carbohydrates, proteins, calcium and other essential minerals and sulphur amino acids and also are of diuretic characteristics. Amaranth serves as a good source of protein as well as arginine. Egg, besides having high biological value protein provides branched chain amino acids. Defatted soy not only contributes to the proteins of the food but also provides dietary fibre component of the food. The dietary fibre helps to reduce the occurrence of diarrhoea and constipation and also contributes for other well known nutritional and physiological benefits. Soy and fish oils. the good sources of W o and W fatty acids respectively, help in immune system development. Curd serves as a main source of Lactic acid bacteria which facilitates to maintain the desirable intestinal microflora and also helps in digestion and absorption of nutrients in the intestine and colon. The plant gums help in tissue building. The cereal malt enzymes partially hydrolyse the starch and proteins, reduce the water holding capacity of the food and enable to prepare energy dense (1 to 2 Kcal per ml of food) at free flowing slurry consistency. Using the process of the present invention, it is possible to prepare an enteral food that could meet the nutritional requirement or serve as a nutritional supplement to the patients at hypercatabo1ic state, especially the burns or thermally injured ones. This particular process to prepare high-protein, high-energy food based on day to day used food materials such as cereals, egg. milk, fish oil, vegetable oil, sugar, plant gum, glycerin and provides proper nutritional support to hypercatabo1ic or burn patients. The cereals with over 95% germination are steeped in excess water for 12-24 hr and germinated for 48-72 hr. During germination the sprouts are kept moist and mixed occasionally to aerate and to facilitate uniform germination. The sprouts are sundried or mechanically dried at 4O-6O°C to about 14% moisture. The root and shoot are removed by brushing and the derooted green malt kilned at 55-65°C either in air or by contact heat. The malted paddy is dehusked mechanically in rice sheller. To the dehusked rice malt and other malted cereals 3-7% additional water is sprayed, tempered for 5-15 min and the individual malts are separately milled in abrassive. comminuting, friction, roller, attrition or alike mills alone or in sequence or in combination with one or more milling systems. The seed coat and coarse bran are removed from the flour by sifting the meal through 8O - 12O mesh sieve. The defatted soya flour is toasted in a grain roaster at 60-8O°C for 15-3O min. Fresh egg (yolk and white together) are mashed in a wet blender for 10-15 sec. The malt flours from one or more cereals, amaranth seed flour, soya flour, glycerin, gum acasia, sugar, fish and soya oils and milk-are blended with mashed egg. To the blend, predetermined quantity of water is mixed to obtain 25-35% slurry. The slurry is heated by raising the temperature at the rate of 2-3^C per min upto about 60°C and maintained at that temperature for iO-20 min. the contents are boiled for about 5-10 min and the slurry is cooled to ambient temperature. Freshly prepared curd enriched with Lactic acid bacteria, amounting to 10% of total milk and the predetermined amount of vitamins and minerals are mixed and the slurry is homogenised. The slurry is dried in a spray dryer maintained at 160-19O°C inlet temperature and 6O-80°C material temperature. The enteral food thus prepared is immediately packed in air tight containers. The food should be reconstituted in warm water at 2O-4O % slurry consistency and fed to the patients orally or through tube depending upon the age and physiological conditions of the patients. The examples given below illustrate the process of the present invention. These examples should not be construed to limit the scope of the invention. Any modification within the scope of the description given above from part of the present i nvent ion. Example 1 Clean viable barley (Hcrdeum vuigare) seeds are steeped in excess water for 24 hr, changing the steep water twice and germinated upto 72 hr at about 25°C. During germination the sprouts are kept moist by spraying water and mixed gently once in 24 hr to prevent interlocking of rootlets. The sprouts are dried at about 50°C in a air dryer, derooted in a brushing machine and the green malt kilned at about 55°C for about 45 min in a grain roaster by contact heat. Malted barley seeds are sprayed with additional 5% water, tempered for about 1O min and milled in a roller mill adjusted to O.465 and O.O35 mm break roll and O.O65 and O.O35 mm reduction roll clearance. The flour fractions from break rolls, reduction rolls and bran duster through are pooled together. Amaranth seeds are popped in hot air medium at about 23O C. The detached seed coat is separated by aspirating and the popped seed material is pulversied. The defatted soya flour is toasted at 80°C for 3O min by contact heat in a grain roaster. Fresh hen's egg, free from shell is mashed in a wet blender for about 7 sec. To illustrate the scope of the present invention, in this example. 3Og barley malt flour, lOg popped amaranth seed flour, 5g toasted soya flour, 8Om1 emulsified egg, 5g sugar, ig gum acasia, 5g Cod liver and 2.5g soya oils both containing O.O2% tertiary butyl hydroxy quinone (TBHQ). Ig glycerin and 180 ml milk are blended and the blend is mixed with water to prepare 3O% slurry. The slurry is heated in a steam jacketed cooker with constant stirring, raising the temperature at the rate of 2-3°C per min to 60°C. maintained at that temperature for about 15 min. then raised to boiling, boiled for about 5 min and cooled to ambient temperature. To the cooled slurry 18 ml curd containing 2.3xlO cfu Lactic acid bacteria per ml and the premix of vitamins and minerals containing 4.000 1U vitamin A (as acetate), 45O IU vitamin D (as cho1eca1cifero1), 17.85mg vitamin E (as alpha-tocopherol acetate) O.5mg thiamine mononitrate, O.5 mg riboflavin, O.15mg pyridoxine hydroch1 oride, 0. 75mcg cyanocoba 1 arnine, 5.O mg nicot inamide, 0.815mg calcium pantothenate, 30mg ascorbic acid, O.O125mg biotin, 22.75mg calcium phosphate, 13.88mg phosphorus, ii.lSmg magnesium oxide light,1 8.96mg ferrous sulphate, O.218mg manganese sulphate, 28.5mcg iodine, il.Omg zinc, 0.2395mg copper (as copper sulphate), O.O44mg sodium borate, 4.66mcg chromium (as chromium sulphate), 4.6mcg selenium (as selenium di-monohydrate), ll.SSmcg molybdenum (as molybdenum trioxide), 166 mg sodium chloride are added and homogenised in a wet blender. The slurry is spray dried at about 170°C inlet and about 7O°C material temperature. The product is stored in air tight containers. Example 2 Viable seeds of Intan variety of paddy (urwa ativa) steeped in excess water for 24 hr, germinated for 72 hr. The sprouts are dried in a mechanical drier at 5O°C, derooted in a brushing machine and dehusked in a rubber roller paddy sheller at 11OO rpm. The brown rice malt is moistened with 3% additional water and milled in comminuting mill and the meal sieved through 10O mesh sieve to prepare malt flour. In this example, an illustration of the another scope of the present invention, 3Og rice malt flour, lOg popped amaranth seed flour, 5g toasted soya flour, 80ml mashed hen's egg, 5g sugar, Ig gum acasia, 5g Cod liver and 2.5g soya oils, both containing 0.02% TBHQ, Ig glycerin and 180 ml fresh pasteurized milk are blended and mixed with water to prepare a 30% slurry. The slurry is heated in a steam jacketed cooker with constant stirring, raising temperature of the mass at the rate of 2-3"°C per min to 6O°C. maintained at about 6O°C for about 15 min, after which the temperature is raised to boiling, boiled for 10 min and the contents are cooled to the ambient temperature. To the cooled mash, 18ml curd containing 2.3x109 cfu Lactic acid bacteria per ml and a premix of vitamins and minerals containing 4,OOO IU vitamin A (as acetate), 45O 1U vitamin D (as cho1eca1cifero1), 17.85 mg vitamin E (as alpha-tocopherol acetate). 0.5O mg thiamine mononitrate, O.5O mg riboflavin, O.1525 mg pyridoxine hydroch1 oride, O.75 mg cyanocoba1amine, 5.O mg nicotinamide, O.815 mg calcium pantothenate, 3O.O mg ascorbic acid, O 0125 mg biotin, 22.75 mg calcium phosphate, 13.88 mg phosphorus, 11.16 mg magnesium oxide, 18.96 mg ferrous sulphate, O.218 mg manganese sulphate, 28.5mcg iodine, 11.0 mg zinc. 0.2395 mg copper (as copper sulphate), 0.044 mg sodium borate, 4.66mcg chromium (as chromium sulphate). 4.6Omcg selenium (as selenium di-monohydrate), 11.66 meg molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride are added. The slurry is homogenised in a wet grinder and spray dried at 17O°C inlet and 7O°C material temperature. The product is stored in air tight containers. Example 3 Viable seeds of finger millet ( roracana) steeped in excess water for 16 hr and germinated for 48 hr. The sprouts are dried at 50°C in a air dryer, derooted in a brushing machine and the green malt kilned at about 6O°C for about 45 min in a grain roaster by contact heat. Malted millet seeds are sprayed with additional 7% water tempered for about 1O min and milled in a comminuting mill fitted with O.5 mm screen and the meal is sieved through 100 mesh sieve and the tailings were given another pass in the same mill set up and sieved through 100 mesh sieve. The flour fractions are pooled together. In this example. to illustrate yet another scope of the present invention, 30g finger millet malt, lOg popped amaranth seed flour. 5g toasted soya flour. 80m1 mashed egg, 5g sugar, ig gum acasia. 5g Cod liver and 2.5g soya oils both containing O.O2% TBHQ, Ig glycerin and 180ml fresh milk are blended and mixed with water to prepare about 3O% slurry. The slurry is heated in a steam lacketed cooker with constant stirring and raising the temperature at the rate of 2 3°C per min to 65°C and maintained at 65°C for about 15min and boiled for about 5min. The contents are cooled to ambient temperature. To the cooled mash, 18ml curd containing 2.3x109 cfu Lactic acid bacteria per ml and a premix of vitamins and minerals containing 4,OOO IU vitamin A (as acetate), 450 IU vitamin D (as cholecalciferol). 17.85mg vitamin E (as alpha tocopherol acetate I.P.), O.SOmg thiamine mononitrate, O.BOmg riboflavin, O.1525mg pyridoxine hydroch1 oride, O.75mg cyanocoba1 amine, 5.0mg nicotinamide. O.815mg calcium pantothenate, 30.O mg ascorbic acid, 0.0125 mg biotin, 22.75mg calcium phosphate, 13.88mg phosphorus. 11.16 mg magnesium oxide, 18.96 mg ferrous sulphate, 0.218 mg manganese sulphate. 28.5mcg iodine, 11.0 mg zinc, 0.2395mg copper (as copper sulphate), 0.044mg sodium borate, 4.66mcg chromium (as chromium sulphate), 4.60 meg selenium (as selenium di monohydrate), 11.66 mg molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride and 0.3% natural orange flavour are added and the slurry is homogenised in a wet grinder and spray dried at 170°C inlet and 7O°C material temperature. The product is stored in air tight contai ners. Example 4 Clean viable seeds of barley, finger millet and rice (padddy) are steeped separately in excess water for 16, 24 and 24 hr respectively. The finger millet is germinated for 48 hr whereas barley and rice are germinated for 72 hr separately. During germination the sprouts are kept moist by spraying water and mixed gently once in 24 hr to prevent interlocking of roots. The sprouts are dried separately at 50°C in a air dryer and derooted separately in a brushing machine. The green malt of barley and rice are kilned separately at about 55°C and millet at about 6O°C for about 45 min in a grain roaster by contact heat. Malted rice is dehusked in rubber roller sheller. The shelled rice (brown rice) malt and finger millet are sprayed with additional 3% and 7% water respectively, tempered for about 10 min and milled in a comminuting mill fitted with O.Bmm screen and the meal is sieved through 1OO mesh sieve. The tailings of first pass are remilled and sieved through 10O mesh again and the flour fractions were pooled together. Malted barley is sprayed with 5% additional water, tempered for about 15 min and milled in roller flour mill setup with O.465 and 0.035 mm break roll and O.O65 and O.O35 mm reduction roll clearance. In this example, to illustrate yet another scope of the present invention, lOg barley malt, lOg rice malt flour, lOg finger millet malt, lOg popped amaranth seed flour, 5g toasted soya flour, 8Om 1 mashed egg, 5g sugar, Ig guia acasia, 5g cod liver and 2.5g soya oils together containing 0.025% TBHQ, Ig glycerin and 180ml equivalent of fresh milk are blended and the blend is mixed with water to prepare about 30% slurry. The slurry is heated in a steam jacketed cooker with constant stirring and raising temperature at the rate of 2-3°C per min to 60°C, maintained at about 6O°C for about 15 min and further the temperature raised to boiling, boiled for 5 min and the mass is cooled to ambient temperature. To the cooled mash, 18 ml curd containing 2.3xl09 cfu Lactic acid bacteria per ml and the premix of vitamins and minerals containing 4,000 II! vitamin A (as acetate). 45O JU vitamin D (as cho1ecalcifero1). 17.85 mg vitamin E (as alpha-tocopherol acetate), 0.50 mg thiamine mononitrate. 0.5O mg riboflavin, O.1525 mg pyridoxine hydroch1 oride, 0.75 mg cyanocoba1amine, 5.O mg nicotinamide, 0.815 mg calcium pantothenate, 3O.O mg ascorbic acid, O O125 mg biotin, and minerals like 22.75 mg calcium phosphate, 13.88 mg phosphorus, 11.16 mg magnesium oxide. 18.96 mg ferrous sulphate. 0.218 mg manganese sulphate, 28.5 meg iodine, 11.0 mg zinc, 0.2395 mg copper (as copper sulphate), O.O44 mg sodium borate, 4.66 mg chromium (as chromium sulphate). 4.6O meg selenium (as selenium di monohydrate), 11.66 meg molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride are added. The slurry is homogenised in a wet grinder and sprav dried at 170°C inlet and 7O°C material temperature. The product is stored in air tight containers. The information on the composition and related parameters of enteral food are presented in Table 2. Table 2: Nutrient Composition and Related Parameters of Enteral Food for Burn Patients (Table Removed) Soy oi1, milk and fish oil * at 30% slurry concentration Comments : The food is a rich source of arginine, branched chain amino acids, W 3 and W 6 fatty acids and is suitable for Tube feeding or Oral supplement, The advantages of the invention are; 1. The process enables preparation of enteral food for patients at hyper catabolic state especially the burn or thermally injured patients, based on natural food ingredients, yet it contains easily digestible carbohydrates, proteins of high biological value containing branched chain amino acids and arginine and good sources of soluble dietary fibre, W and H c fatty acids and the essential vitamins and minerals with special reference to zinc and ascorbic acid which have -special role in wound healing. The food forms a nutritional package for burn patients. 2. The invention enables feeding heat treated egg to the patients in sufficient quantity in slurry form which heterto has not been possible. 3. The food becomes microbiological safe during cooking and spray drying. 4. The process of the invention permits alterations in the proportion of ingredients and incorporation of additives if desired, in any appropriate manner to suit the need of patients of different age, groups and of different physiological cond i t i ons . 5. The food prepared as per the process of the invention contains predigested carbohydrates, partially hydrolysed proteins and supplies adequate calorie and protein besides providing specific amino acids and fatty acids that are needed for meeting enhanced metabolism, tissue building and immunity development in the burn pat i ents . 6. The food prepared following the process of this invention reconstitues well with water, milk or any other potable fluids of choice and forms free flowing homogenous slurry suitable for tube feeding at 1.5-2 Kca1 per ml and enables to feed the quantity sufficient to meet the full nutritional requirements of the needy pat i ents. 7. The food prepared by the process as described in examples 1 to 4 has desirable aroma and acceptable taste inspite of having strong and characteristic flavoured ingredients such as fish oil and heat treated egg. and enables to feed heat treated egg ir. sufficient quantity to the patients in liquid form. We claim - 1. A process for the preparation of enteral food useful as a food for patients at hypercatabolic state especially the thermally injured patients, which comprises: i) Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess water separately for a period ranging from 12-30 hr, 11) Germinating the said soaked seeds separately for a period ranging froml- 4 days by known methods, iii) Drying the germinated cereals separately either in sun or in mechanical dryer by known methods, iv) Removing the rootlets of dried cereal sprouts separately by known methods, v) Kilning the resultant green malts separately in the temperature range of 50-70°C for a period in the range of 30-60 min, vi) Dehasking malted paddy in rice shelter by known methods, and moistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-20 minutes separately and milling the individual malted cereals separately in abrassive, comminuting, friction, roller, attrition or alike mills alone or in combination , and sieving off through 80 -120 mesh sieve to prepare cereal malt flours. vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of the seed remain in the product, viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min, ix ) Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec. x) Preparing curd (yogurt) by known methods containing 2-4xl09 cfu of Lactic acid bacteria per ml curd using bovine milk cultured with known strains of pure Lactic acid bacteria, xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi) separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii) , mashed egg in the range of 15-25% obtained in step (ix) , pasteurized fresh milk ( 0.5 -25 % ) , sucrose ( 5 - 10 %) , fish oil ( 5- 10%) , soya oil ( 5 -10%), edible gum (0.5 -3% ) and glycerin (0.5-2%), (xii) Mixing the resultant blend with potable water to prepare a 25-35% solid contents slurry, heating the slurry at a temperature ranging 55- 65° C by raising the temperature at the rate of 2-3°C per min, maintaining the slurry at that temperature for 5-20 min further, raising the temperature to boiling, bailing for 5-10 rain and cooling to ambient temperature, (xiii) Adding the curd obtained in step (x) , and also the premix of vitamins and minerals to the slurry, (xiv) Homogenising the mixture by known methods and spray drying the slurry at 160-190°C air temperature and 60- 90 ° C material temperature , to get the desired product. 2. A process as claimed in claims 1-5 , wherein the slurry of 20 -35 bricks is dried in a spry drier maintained at an air temperature varying from 160-190°C and material temperature 60-90 ° C and the food forms free flowing slurry at 1 - 2 Kcal per ml and remains in homogeneous slurry from inspite of containing egg proteins as one of the components. 3.A process for the preparation of enteral food useful as food for patients at hypercatabolic state especially the thermally injured patients substantially as here described with reference to the examples.

Full Text

This invention relates to a process for preparation of enteral food useful as a food (nutritional support) for patients at hypercatabolic state especially the thermally injured pat i ents.
Proper nutritional support not only helps to cure the disease, but also prevents it's recurrence and decreases the mortality and morbidity of hospitalised patients, and also cut down the hospita1iration expenses substantially. Very often, hospitalised patients need special nutritional care. Liquid foods or enteral foods are administered orally or through feeding tube to the patients whenever the patient is not able to take normal or even semi-solid foods due to functional or organic disorder, but the gut functions normally. Enteral foods are also given to patients, as a part or total nutritional support to cope up with the extended nutritional requirements in some of the special phvsiotogica1 conditions such as complicated pregnancy, anorexia, burn inlury, sepsis, trauma etc.
Development of enteral formulae for meeting nutritional requirement of needy patients is receiving greater attention in recent years. A wide range of enteral foods suitable for patients of different physiological conditions are produced mainly in USA, Japan, Australia and some European countries and marketed globally, but in India only two brands of general category enteral foods have been introduced and that too very
recently (Table 1).
Table 1: Some of the General Category and Disease Specific Enteral Foods Specially designed formula
(Table Removed)
It is very well known that patients suffering from cirrhosis of liver, burns or thermal injury, renal failure and some other physiological conditions require special nutritional support. Accordingly, enteral foods for patients suffering from hepatic, renal and some other diseases have been developed and marketed mostly in developed countries. To the best of our knowledge, no packaged food is available , that meets the nutritional requirements of patients suffering from hypercatabolic conditions especially of the burns or thermally injured patients,
The physiological conditions of burn patients is marked with increased basal metabolic rate, raised core temperature, hyperdynamic circulation, protein catabolism, futile substrate cycling, lipolysis, loss of lean body mass, suppressed immune response followed by severe infection, stress induced hyperacidity, development of ilias combined with anorexia and poor wound healing. These conditions cause nutritional imbalance, specifically with reference to protein, energy and electrolytes. The hormonal imbalance caused due to burn injury induces the release of higher levels of catecholamine which raise the abnormally high metabolic rate. Because of this and to cope up with the changed nutritional and metabolic states, the
patients need the diet that is exceptionally rich in energy, protein and some of the vitamins
Depending upon age. sex and various physiological conditions, the thermally injured patients with over 3O% burn surface area or patients under hypercatabo1ic state require 2OOO to 50OO R'ca 1 energy and 80-2OO g of protein of high biological value, backedup with appropriate levels of vitamins, minerals and other protective nutrients per day. This special nutritional demand has to be met right from the day one of burn injury till a satisfactory nutritional status of the patient is achieved, otherwise the patient goes into negative nitrogen balance, suppressed immunomodu1atory system followed by infection which generally lead to mortality.
In most of the cases, blenderized foods containing mainly egg, milk, fruit juice, sugar and high protein health food are administered to thermally injured patients. Such foods generally do not provide some of the specific nutrients and adequate quantities of vitamins and minerals and also may not meet the extended requirement of calorie and protein. Some of ths ingredients may be allergic and the possibility of microbiological contamination also exists. The advantages of egg as one of the ingredients of the blenderised foods for burn patients has been well recognised and many a time fresh beater, egg is fed to the patients perorally in the form of eggnog or
other recipe. But. the practical difficulty of feeding quite a large quantity of egg limits the egg based food intake. Moreover, the fresh egg fed as such often causes digestive problems and its biotin is also not available to the patients. Boiled or heat treated egg protein is more easily digestible, but heat treatment coagulates the egg proteins rendering it unsuitable for enteral feeding, and because of this peroral feeding of egg based food has not been practiced hitherto.
The chemically defined or modular enteral foods may meet the gross nutritional needs but may not contain the specific nutrients in desired proportion, possess poor sensory attributes, high osmolality, lack in natural microflora and many a times cause diarrhoea, vomiting and exert high renal load, which further complicate the patients conditions.
On the other hand, enteral foods prepared from natural food ingredients maintain intestinal mucosal integrity and normal metabolism. Such foods also diminish the transfer of bacteria from the lumen across the intestinal wall into the 1ymphovascu1ar system and control gastric stress ulceration besides supplying the nutrients in usual food form. Therefore, enteral foods for burn patients based on natural food ingredients are highly desirable.
The food for burn patients should contain proteins rich in
high proportion of branched chain amino acids (BCAA) and arginine. and iipids rich in W '3 and H fatty acids. The BCAA supply energy for enhanced local metabolism and help in synthesis of immunomodu1atory compounds such as immuno-g1obu1 in, leucocytes and lymphocytes. The arginine helps in improving the immune status by enhanching the function of urea cycle, diminishing protein catabolism and raising the competence of T-1ymphocytes. W 3 and M c- fatty acid contribute for rapid wound healing, enhancing immunity to infection, maintenance of blood viscosity and cell membrane integrity.
It is heartening to note that. some of the Medical Institutes/Hospitals in the country reluctantly admit patients with more than 50% of total burn surface area (TBSA), mainly because of non availability of proper food to meet their nutritional need, which often leads to morbidity and mortality of the injured ones.
The forgoing discussions indicate that, there is a dire need for development of a food that meets the nutritional requirements and also the protective components for patients at hypercatabo1ic state particularly the burned patients, based on natural food ingredients that provide protein containing BCAA and arginine, lipids supplying H i ar. d W c- fatty acids and packed with tissue building, immunity development components and
the essential vitamins and minerals.
Therefore, the main object of the present invention is to provide a process for preparation of enteral food specially useful as a food for the patients under hypercatabo1ic state with special reference to burn injury.
Another object of the present invention is to provide a process for preparation of enteral food useful for the patients under hypercatabo1ic state containing egg as one of the food components and still the food slurry maintain a free flowing state even after heating.
Yet another object of the present invention is to provide a process for preparation of enteral food useful for the patients under hypercatabo1ic state that makes use of natural ingredients such as cereals rich in easily digestible carbohydrates, proteins rich in sulphur amino acids, BCAA and arginine, and vegetable or animal oil sources that provide W and H c fatty acids.
Accordingly, the present invention provides a process for
preparation of food useful for feeding the patients at
hypercatabo1ic state with special reference to burns or
thermally injured patients which comprises;
i) Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess
water separately for a period ranging from 12-3O hr,
ii) Germinating the said soaked seeds separately for a period ranging from 1-4 days by known methods,
iii) Drying the germinated cereals separately either in sun or in mechanical dryer by known methods.
iv) Removing the rootlets of dried cereal sprouts separately by-known methods,
v) Kilning the resultant green malts separately in the temperature range of 5O-7O°C for a period in the range of 3O-6O mi n.
vi) Dehusking malted paddy in rice sheller by known methods, and moistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-2O minutes separately and milling the individual malted cereals separately in abrassive, communiting. friction, roller, attrition or alike mills alone or in combination, and sieving off the seed coat and coarse bran by sifting through 8O-12O mesh sieve to prepare cereal malt flours,
vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of the seed remain in the product,
viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min,
ix ) Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec.
x) Preparing curd (yogurt) by known methods containing 2-4xl09 cfu of Lactic acid bacteria per ml curd using bovine milk cultured with known strains of pure Lactic acid bacteria,
xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi) separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii), mashed egg in the range of 15-25% obtained in step (ix) , pasteurized fresh milk ( 0.5 - 3 % ) , sucrose ( 5 - 10 %} , fish oil ( 5- 10%) , soya oil ( 5 -10%), edible gum (0.5 -3% ) and glycerin (0.5-2%),
(xii) Mixing the resultant blend with potable water to prepare a 25-35% solid contents slurry, heating the slurry at a temperature ranging 55- 65° C by raising the temperature at the rate of 2-3°C per min, maintaining the slurry at that temperature for 5-20 min further, raising the temperature to boiling, bailing for 5-10 rain and cooling to ambient temperature,
(xiii) Adding the curd obtained in step (x) , and also the premix of vitamins and minerals to the slurry,
(xiv) Homogenising the mixture by known methods and spray
drying the slurry at 160-190°C air temperature and 60-80°C material temperature.
In an embodiment of the present invention, 15-3O% of any of the cereal malt flour alone or mixture of them, 10-2O% of finger millet malt flour, 5-15% amaranth seed flour. 5-15% defatted and heat treated soya flour, 70-100 ml (equivalent to 15-25% solids) of mashed whole egg, 15O-2OO ml (equivalent to 15-25% solids) of fresh milk, O.5-3% exudate gum preferably acasia. 5-lO% fish oil preferably from Cod-liver, Menhaden or of similar source, 5-10% soya oil, 5-10% sucrose, O.5-2% glycerin, 5-15ml% curd enriched with Lactic acid bacteria and 2-6% premix of a pharmaceutical grade vitamins and minerals are blended and the slurry is homogenised and spray dried at 160-190° air temperature and 60 80°C material temperature.
Preparation of low fibre and enzyme rich malt flour from cereals for the enteral food may be effected by steeping the viable seeds separately in excess water, germinating the steeped seeds separately by known methods, drying the sprouts separately either in sun or mechanically, removing the rootlets separately by known methods, kilning the derooted malts separately either by passing warm air or by contact heat and moist conditions the malted cereals separately and milling the malts separately and sieving off the seed coat and bran. The soy flour is heat treated
preferably toasted by known methods. The eggs used may be fresh avian eggs preferably from hen and fish oil may be from Menhaden, Sardine, Herring or Cod liver or similar source. Soya oil may be from any of the genetic source of soyabean freed from non edible matter. The gum used may be purified plant or sea weed exudate preferably from acasia. The full fat or partially toned milk may be from cow or buffalo or goat. The glycerin used may be of food or pharmaceutical grade. The curd may be from edible milk-cultured with pure culture of Lactic acid bacteria. Vitamins and minerals may be of British/1ndian/United States pharamacopia grade.
The cereals and finger millet may be malted to enrich them with hydrolytic enzymes, to enhance their protein and carbohydrate digestibility, mineral availability and thus to improve their overall nutritional quality. The amaranth seeds are processed substantially to gelatinise the starch and to develop aroma yet most of the nutrients of the seed remain in the product.
The ingredients for the enteral food are selected so that the food not only serves as the nutritional support to the patients but also helps in the speedy recovery from the burn injury. The cereal malts provide easily digestible carbohydrates, proteins, calcium and other essential minerals and sulphur amino acids and also are of diuretic characteristics. Amaranth serves
as a good source of protein as well as arginine. Egg, besides
having high biological value protein provides branched chain
amino acids. Defatted soy not only contributes to the proteins of
the food but also provides dietary fibre component of the food.
The dietary fibre helps to reduce the occurrence of diarrhoea
and constipation and also contributes for other well known
nutritional and physiological benefits. Soy and fish oils. the
good sources of W o and W fatty acids respectively, help in
immune system development. Curd serves as a main source of
Lactic acid bacteria which facilitates to maintain the desirable
intestinal microflora and also helps in digestion and absorption
of nutrients in the intestine and colon. The plant gums help
in tissue building. The cereal malt enzymes partially hydrolyse
the starch and proteins, reduce the water holding capacity of the
food and enable to prepare energy dense (1 to 2 Kcal per ml of
food) at free flowing slurry consistency.
Using the process of the present invention, it is possible to prepare an enteral food that could meet the nutritional requirement or serve as a nutritional supplement to the patients at hypercatabo1ic state, especially the burns or thermally injured ones.
This particular process to prepare high-protein, high-energy food based on day to day used food materials such as
cereals, egg. milk, fish oil, vegetable oil, sugar, plant gum, glycerin and provides proper nutritional support to hypercatabo1ic or burn patients.
The cereals with over 95% germination are steeped in excess water for 12-24 hr and germinated for 48-72 hr. During germination the sprouts are kept moist and mixed occasionally to aerate and to facilitate uniform germination. The sprouts are sundried or mechanically dried at 4O-6O°C to about 14% moisture. The root and shoot are removed by brushing and the derooted green malt kilned at 55-65°C either in air or by contact heat. The malted paddy is dehusked mechanically in rice sheller. To the dehusked rice malt and other malted cereals 3-7% additional water is sprayed, tempered for 5-15 min and the individual malts are separately milled in abrassive. comminuting, friction, roller, attrition or alike mills alone or in sequence or in combination with one or more milling systems. The seed coat and coarse bran are removed from the flour by sifting the meal through 8O - 12O mesh sieve. The defatted soya flour is toasted in a grain roaster at 60-8O°C for 15-3O min. Fresh egg (yolk and white together) are mashed in a wet blender for 10-15 sec. The malt flours from one or more cereals, amaranth seed flour, soya flour, glycerin, gum acasia, sugar, fish and soya oils and milk-are blended with mashed egg. To the blend, predetermined quantity of water is mixed to obtain 25-35% slurry. The slurry
is heated by raising the temperature at the rate of 2-3^C per min upto about 60°C and maintained at that temperature for iO-20 min. the contents are boiled for about 5-10 min and the slurry is cooled to ambient temperature. Freshly prepared curd enriched with Lactic acid bacteria, amounting to 10% of total milk and the predetermined amount of vitamins and minerals are mixed and the slurry is homogenised. The slurry is dried in a spray dryer maintained at 160-19O°C inlet temperature and 6O-80°C material temperature. The enteral food thus prepared is immediately packed in air tight containers. The food should be reconstituted in warm water at 2O-4O % slurry consistency and fed to the patients orally or through tube depending upon the age and physiological conditions of the patients.
The examples given below illustrate the process of the
present invention. These examples should not be construed to
limit the scope of the invention. Any modification within the
scope of the description given above from part of the present
i nvent ion.
Example 1
Clean viable barley (Hcrdeum vuigare) seeds are steeped in excess water for 24 hr, changing the steep water twice and germinated upto 72 hr at about 25°C. During germination the sprouts are kept moist by spraying water and mixed gently once

in 24 hr to prevent interlocking of rootlets. The sprouts are dried at about 50°C in a air dryer, derooted in a brushing machine and the green malt kilned at about 55°C for about 45 min in a grain roaster by contact heat. Malted barley seeds are sprayed with additional 5% water, tempered for about 1O min and milled in a roller mill adjusted to O.465 and O.O35 mm break roll and O.O65 and O.O35 mm reduction roll clearance. The flour fractions from break rolls, reduction rolls and bran duster through are pooled together. Amaranth seeds are popped in hot air medium at about 23O C. The detached seed coat is separated by aspirating and the popped seed material is pulversied. The defatted soya flour is toasted at 80°C for 3O min by contact heat in a grain roaster. Fresh hen's egg, free from shell is mashed in a wet blender for about 7 sec. To illustrate the scope of the present invention, in this example. 3Og barley malt flour, lOg popped amaranth seed flour, 5g toasted soya flour, 8Om1 emulsified egg, 5g sugar, ig gum acasia, 5g Cod liver and 2.5g soya oils both containing O.O2% tertiary butyl hydroxy quinone (TBHQ). Ig glycerin and 180 ml milk are blended and the blend is mixed with water to prepare 3O% slurry. The slurry is heated in a steam jacketed cooker with constant stirring, raising the temperature at the rate of 2-3°C per min to 60°C. maintained at that temperature for about 15 min. then raised to boiling, boiled for about 5 min and cooled to ambient temperature. To the cooled slurry 18 ml curd containing 2.3xlO cfu Lactic acid bacteria
per ml and the premix of vitamins and minerals containing 4.000 1U vitamin A (as acetate), 45O IU vitamin D (as cho1eca1cifero1), 17.85mg vitamin E (as alpha-tocopherol acetate) O.5mg thiamine mononitrate, O.5 mg riboflavin, O.15mg pyridoxine hydroch1 oride, 0. 75mcg cyanocoba 1 arnine, 5.O mg nicot inamide, 0.815mg calcium pantothenate, 30mg ascorbic acid, O.O125mg biotin, 22.75mg calcium phosphate, 13.88mg phosphorus, ii.lSmg magnesium oxide light,1 8.96mg ferrous sulphate, O.218mg manganese sulphate, 28.5mcg iodine, il.Omg zinc, 0.2395mg copper (as copper sulphate), O.O44mg sodium borate, 4.66mcg chromium (as chromium sulphate), 4.6mcg selenium (as selenium di-monohydrate), ll.SSmcg molybdenum (as molybdenum trioxide), 166 mg sodium chloride are added and homogenised in a wet blender. The slurry is spray dried at about 170°C inlet and about 7O°C material temperature. The product is stored in air tight containers.
Example 2
Viable seeds of Intan variety of paddy (urwa ativa) steeped in excess water for 24 hr, germinated for 72 hr. The sprouts are dried in a mechanical drier at 5O°C, derooted in a brushing machine and dehusked in a rubber roller paddy sheller at 11OO rpm. The brown rice malt is moistened with 3% additional water and milled in comminuting mill and the meal sieved through 10O mesh sieve to prepare malt flour. In this example, an

illustration of the another scope of the present invention, 3Og rice malt flour, lOg popped amaranth seed flour, 5g toasted soya flour, 80ml mashed hen's egg, 5g sugar, Ig gum acasia, 5g Cod liver and 2.5g soya oils, both containing 0.02% TBHQ, Ig glycerin and 180 ml fresh pasteurized milk are blended and mixed with water to prepare a 30% slurry. The slurry is heated in a steam jacketed cooker with constant stirring, raising temperature of the mass at the rate of 2-3"°C per min to 6O°C. maintained at about 6O°C for about 15 min, after which the temperature is raised to boiling, boiled for 10 min and the contents are cooled to the ambient temperature. To the cooled mash, 18ml curd
containing 2.3x109 cfu Lactic acid bacteria per ml and a premix
of vitamins and minerals containing 4,OOO IU vitamin A (as
acetate), 45O 1U vitamin D (as cho1eca1cifero1), 17.85 mg vitamin
E (as alpha-tocopherol acetate). 0.5O mg thiamine mononitrate,
O.5O mg riboflavin, O.1525 mg pyridoxine hydroch1 oride, O.75 mg
cyanocoba1amine, 5.O mg nicotinamide, O.815 mg calcium
pantothenate, 3O.O mg ascorbic acid, O 0125 mg biotin, 22.75 mg
calcium phosphate, 13.88 mg phosphorus, 11.16 mg magnesium oxide,
18.96 mg ferrous sulphate, O.218 mg manganese sulphate, 28.5mcg
iodine, 11.0 mg zinc. 0.2395 mg copper (as copper sulphate),
0.044 mg sodium borate, 4.66mcg chromium (as chromium sulphate).
4.6Omcg selenium (as selenium di-monohydrate), 11.66 meg
molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride
are added. The slurry is homogenised in a wet grinder and spray
dried at 17O°C inlet and 7O°C material temperature. The product is stored in air tight containers.
Example 3
Viable seeds of finger millet ( roracana) steeped in excess water for 16 hr and germinated for 48 hr. The sprouts are dried at 50°C in a air dryer, derooted in a brushing machine and the green malt kilned at about 6O°C for about 45 min in a grain roaster by contact heat. Malted millet seeds are sprayed with additional 7% water tempered for about 1O min and milled in a comminuting mill fitted with O.5 mm screen and the meal is sieved through 100 mesh sieve and the tailings were given another pass
in the same mill set up and sieved through 100 mesh sieve. The flour fractions are pooled together. In this example. to
illustrate yet another scope of the present invention, 30g finger millet malt, lOg popped amaranth seed flour. 5g toasted soya
flour. 80m1 mashed egg, 5g sugar, ig gum acasia. 5g Cod liver and 2.5g soya oils both containing O.O2% TBHQ, Ig glycerin and 180ml
fresh milk are blended and mixed with water to prepare about 3O% slurry. The slurry is heated in a steam lacketed cooker with
constant stirring and raising the temperature at the rate of 2
3°C per min to 65°C and maintained at 65°C for about 15min and
boiled for about 5min. The contents are cooled to ambient
temperature. To the cooled mash, 18ml curd containing 2.3x109
cfu Lactic acid bacteria per ml and a premix of vitamins and minerals containing 4,OOO IU vitamin A (as acetate), 450 IU vitamin D (as cholecalciferol). 17.85mg vitamin E (as alpha tocopherol acetate I.P.), O.SOmg thiamine mononitrate, O.BOmg riboflavin, O.1525mg pyridoxine hydroch1 oride, O.75mg cyanocoba1 amine, 5.0mg nicotinamide. O.815mg calcium pantothenate, 30.O mg ascorbic acid, 0.0125 mg biotin, 22.75mg calcium phosphate, 13.88mg phosphorus. 11.16 mg magnesium oxide, 18.96 mg ferrous sulphate, 0.218 mg manganese sulphate. 28.5mcg iodine, 11.0 mg zinc, 0.2395mg copper (as copper sulphate), 0.044mg sodium borate, 4.66mcg chromium (as chromium sulphate), 4.60 meg selenium (as selenium di monohydrate), 11.66 mg molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride and 0.3% natural orange flavour are added and the slurry is homogenised in a wet grinder and spray dried at 170°C inlet and 7O°C material temperature. The product is stored in air tight contai ners.
Example 4
Clean viable seeds of barley, finger millet and rice (padddy) are steeped separately in excess water for 16, 24 and 24 hr respectively. The finger millet is germinated for 48 hr whereas barley and rice are germinated for 72 hr separately. During germination the sprouts are kept moist by spraying water and mixed gently once in 24 hr to prevent interlocking of roots.
The sprouts are dried separately at 50°C in a air dryer and derooted separately in a brushing machine. The green malt of barley and rice are kilned separately at about 55°C and millet at about 6O°C for about 45 min in a grain roaster by contact heat. Malted rice is dehusked in rubber roller sheller. The shelled rice (brown rice) malt and finger millet are sprayed with additional 3% and 7% water respectively, tempered for about 10 min and milled in a comminuting mill fitted with O.Bmm screen and the meal is sieved through 1OO mesh sieve. The tailings of first pass are remilled and sieved through 10O mesh again and the flour fractions were pooled together. Malted barley is sprayed with 5% additional water, tempered for about 15 min and milled in roller flour mill setup with O.465 and 0.035 mm break roll and O.O65 and O.O35 mm reduction roll clearance. In this example, to illustrate yet another scope of the present invention, lOg barley malt, lOg rice malt flour, lOg finger millet malt, lOg popped amaranth seed flour, 5g toasted soya flour, 8Om 1 mashed egg, 5g sugar, Ig guia acasia, 5g cod liver and 2.5g soya oils together containing 0.025% TBHQ, Ig glycerin and 180ml equivalent of fresh milk are blended and the blend is mixed with water to prepare about 30% slurry. The slurry is heated in a steam jacketed cooker with constant stirring and raising temperature at the rate of 2-3°C per min to 60°C, maintained at about 6O°C for about 15 min and further the temperature raised to boiling, boiled for 5 min and
the mass is cooled to ambient temperature. To the cooled mash,
18 ml curd containing 2.3xl09 cfu Lactic acid bacteria per ml and the premix of vitamins and minerals containing 4,000 II! vitamin A (as acetate). 45O JU vitamin D (as cho1ecalcifero1). 17.85 mg vitamin E (as alpha-tocopherol acetate), 0.50 mg thiamine mononitrate. 0.5O mg riboflavin, O.1525 mg pyridoxine hydroch1 oride, 0.75 mg cyanocoba1amine, 5.O mg nicotinamide, 0.815 mg calcium pantothenate, 3O.O mg ascorbic acid, O O125 mg biotin, and minerals like 22.75 mg calcium phosphate, 13.88 mg phosphorus, 11.16 mg magnesium oxide. 18.96 mg ferrous sulphate. 0.218 mg manganese sulphate, 28.5 meg iodine, 11.0 mg zinc, 0.2395 mg copper (as copper sulphate), O.O44 mg sodium borate, 4.66 mg chromium (as chromium sulphate). 4.6O meg selenium (as selenium di monohydrate), 11.66 meg molybdenum (as molybdenum trioxide), 166.6 mg sodium chloride are added. The slurry is homogenised in a wet grinder and sprav dried at 170°C inlet and 7O°C material temperature. The product is stored in air tight containers.
The information on the composition and related parameters of enteral food are presented in Table 2.
Table 2: Nutrient Composition and Related Parameters of Enteral Food for Burn Patients
(Table Removed)
Soy oi1, milk and fish oil
* at 30% slurry concentration
Comments : The food is a rich source of arginine, branched chain
amino acids, W 3 and
W 6 fatty acids and is suitable for Tube feeding or
Oral supplement,
The advantages of the invention are;
1. The process enables preparation of enteral food for patients at hyper catabolic state especially the burn or thermally injured
patients, based on natural food ingredients, yet it contains easily digestible carbohydrates, proteins of high biological value containing branched chain amino acids and arginine and good sources of soluble dietary fibre, W and H c fatty acids and the essential vitamins and minerals with special reference to zinc and ascorbic acid which have -special role in wound healing. The food forms a nutritional package for burn patients.
2. The invention enables feeding heat treated egg to the
patients in sufficient quantity in slurry form which heterto has not been possible.
3. The food becomes microbiological safe during cooking and
spray drying.
4. The process of the invention permits alterations in the
proportion of ingredients and incorporation of additives if
desired, in any appropriate manner to suit the need of patients
of different age, groups and of different physiological
cond i t i ons .
5. The food prepared as per the process of the invention contains
predigested carbohydrates, partially hydrolysed proteins and
supplies adequate calorie and protein besides providing specific
amino acids and fatty acids that are needed for meeting enhanced
metabolism, tissue building and immunity development in the burn
pat i ents .
6. The food prepared following the process of this invention
reconstitues well with water, milk or any other potable fluids
of choice and forms free flowing homogenous slurry suitable for
tube feeding at 1.5-2 Kca1 per ml and enables to feed the quantity
sufficient to meet the full nutritional requirements of the needy
pat i ents.
7. The food prepared by the process as described in examples 1 to
4 has desirable aroma and acceptable taste inspite of having
strong and characteristic flavoured ingredients such as fish oil
and heat treated egg. and enables to feed heat treated egg ir.
sufficient quantity to the patients in liquid form.

We claim -
1. A process for the preparation of enteral food useful as a food for patients at hypercatabolic state especially the thermally injured patients, which comprises:
i) Soaking viable seeds of cereals preferably barley, paddy (rough rice), wheat and finger millet (minor cereal) in excess water separately for a period ranging from 12-30 hr,
11) Germinating the said soaked seeds separately for a period ranging froml- 4 days by known methods,
iii) Drying the germinated cereals separately either in sun or in mechanical dryer by known methods,
iv) Removing the rootlets of dried cereal sprouts separately by known methods,
v) Kilning the resultant green malts separately in the temperature range of 50-70°C for a period in the range of 30-60 min,
vi) Dehasking malted paddy in rice shelter by known methods, and
moistening the outer layers of the brown rice malt and malted cereals with 2-7% additional water and tempering for 5-20 minutes separately and milling the individual malted cereals separately in abrassive, comminuting, friction, roller, attrition or alike mills alone or in combination , and sieving off through 80 -120 mesh sieve to prepare cereal malt flours.
vii) Preparing edible flour from amaranth seeds by processing substantially by known methods so that most of the nutrients of
the seed remain in the product,
viii) Toasting defatted soy flour at a temperature in the range of 70~90°C, for 15 - 20 min,
ix ) Homogenising together the yolk and the white from fresh avian eggs preferably from hen, for a period ranging from 5-15 sec.
x) Preparing curd (yogurt) by known methods containing 2-4xl09 cfu of Lactic acid bacteria per ml curd using bovine milk cultured with known strains of pure Lactic acid bacteria,
xi) Blending malt flours in the range of 15 - 30% obtained from different cereals in step (vi) separately or mixture of them, edible amaranth seed flour in the range of 5 - 15% obtained in step (vii) , soya flour in the range of 5 - 25 % obtained in step (viii) , mashed egg in the range of 15-25% obtained in step (ix) , pasteurized fresh milk ( 0.5 -25 % ) , sucrose ( 5 - 10 %) , fish oil ( 5- 10%) , soya oil ( 5 -10%), edible gum (0.5 -3% ) and glycerin (0.5-2%),
(xii) Mixing the resultant blend with potable water to prepare a 25-35% solid contents slurry, heating the slurry at a temperature ranging 55- 65° C by raising the temperature at the rate of 2-3°C per min, maintaining the slurry at that temperature for 5-20 min further, raising the temperature to boiling, bailing for 5-10 rain and cooling to ambient temperature,
(xiii) Adding the curd obtained in step (x) , and also the premix of vitamins and minerals to the slurry,
(xiv) Homogenising the mixture by known methods and spray
drying the slurry at 160-190°C air temperature and 60- 90 ° C material temperature , to get the desired product.
2. A process as claimed in claims 1-5 , wherein the slurry of 20 -35 bricks is dried in a spry drier maintained at an air temperature varying from 160-190°C and material temperature 60-90 ° C and the food forms free flowing slurry at 1 - 2 Kcal per ml and remains in homogeneous slurry from inspite of containing egg proteins as one of the components.
3.A process for the preparation of enteral food useful as food for patients at hypercatabolic state especially the thermally injured patients substantially as here described with reference to the examples.

Documents:

1355-del-1996-abstract.pdf

1355-del-1996-claims.pdf

1355-del-1996-complete specification (granted).pdf

1355-del-1996-correspondence-others.pdf

1355-del-1996-correspondence-po.pdf

1355-del-1996-description (complete).pdf

1355-del-1996-form-1.pdf

1355-del-1996-form-2.pdf

1355-del-1996-form-3.pdf

1355-del-1996-form-9.pdf

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Patent Number

190436

Indian Patent Application Number

1355/DEL/1996

PG Journal Number

30/2003

Publication Date

26-Jul-2003

Grant Date

24-Feb-2004

Date of Filing

20-Jun-1996

Name of Patentee

COUNCIL OF SCEINTIFIC AND INDUSTRIAL RESEARCH

Applicant Address

RAFI MARG, NEW DELHI-110 001, INDIA

Inventors:

#	Inventor's Name	Inventor's Address
1	MEERA CHAKRAVARTY	CENTRAL FOOD TECHNOLOGICAL RESEARCH INSTITUE, MYSORE, INDIA
2	NAGAPPA GURUSIDDAPPA MALLESHI	CENTRAL FOOD TECHNOLOGICAL RESEARCH INSTITUE, MYSORE, INDIA

PCT International Classification Number

A23L 1/29

PCT International Application Number

N/A

PCT International Filing date

PCT Conventions:

#	PCT Application Number	Date of Convention	Priority Country
1			NA