Determination of nitrate and nitrite levels in enteral nutrition formula marketed in Turkey: A risk assessment study

In this study, the nitrite and nitrate levels of 37 enteral nutrition formulas of three different international brands marketed in Turkey were evaluated using high-performance liquid chromatography with diode-array detection (HPLC-DAD). Also, risk assessment of non-carcinogenic was calculated by models including hazard quotient (HQ) and hazard index (HI) in the deterministic model. Enteral nutrition formula consumption amounts obtained from individuals between the ages of 6–36 volunteers voluntarily participated in the study, and health risk assessments were calculated. The range of concentration of nitrate levels in enteral formulas of brands (B1, B2, and B3) was determined as 11.08 ± 2.88 (2.90–15.79), 11.64 ± 3.39 (2.92–22.93), and 10.66 ± 3.46 (4.92–15.37) mg/kg, respectively. The range of concentration of nitrite levels in enteral formulas of brands (B1, B2, and B3) was determined as 4.18 ± 1.10 (1.86–5.82), 3.70 ± 1.25 (1.29–5.26), and 3.38 ± 1.67 (2.00–5.29) mg/kg, respectively. The mean nitrate and nitrite levels of exposure from consumption of enteral nutrition formulas were determined as 0.14 and 0.11, 0.06 and 0.07 mg/kg bw/day for females and males, respectively. Nitrate and nitrite exposure levels calculated in the study did not exceed the ADI threshold values given by JECFA. The average HQ value calculated for the exposure of nitrate to male and female individuals was less than 1. Still, the P95 values calculated for nitrate were greater than 1.00 except for female and male individuals (24–36 ages). The HI value was found to be greater than 1.00 in all age groups of both genders. The presence of nitrites and nitrates in enteral nutrition formulas may lead to health problems in sensitive groups.