## 3 Results  
### Polyamine Content of the EN Formulas  
The analysis of the batches showed that the polyamine content in several bottles from the same batch may be similar (e.g., Fresubin Original Fibre, Impact, and Osmolite Plus). However, there may be differences (e.g., Isosource Protein Fibre) or not (e.g., Fresubin Original Fibre and Osmolite Plus) in bottles from different batches (Supplementary Table S1). In all cases, the average value was subsequently calculated as a reference to determine the patients' intake of polyamines. The analysis showed differences in the polyamine content across the 16 EN formulas included in this study. Significant differences in the total polyamine content (ANOVA, \(p<0.001\)) (putrescine, spermidine, and spermine) were observed, being higher in the Impact, Impact Enteral, Nutrison, Nutrison Advanced Diason Energy, Nutrison Energy, and Nutrison Energy Multifibre formulas, ranging from 22.92 to 41.69 nmol/mL. No significant differences existed between them (in those with at least three determinations in different samples) when adjusted for multiple comparisons. The polyamine content of these EN formulas was significantly higher than what was found in Fresubin Original Fibre, Isosource Protein Fibre, Nepro LP, Novasource GI Protein, and Nutricomp Hepa Osmolite Plus, and presumably than what was found in the Nepro and Osmolite formulas, which ranged from 1.05 to 3.38 nmol/mL (Table 2). \begin{table}
\begin{tabular}{l c c c c c c c} \hline \hline
**EN Formulas (\(n\))** & **Putrescine** & **Spermidine** & **Spermine** & **N-Acetyl** & **N-Acetyl** & **N-Acetyl** & **Total** \\  & & & & & & & \\ \hline Fresubin Original Fibre (8) & 1.87(0.2) & 11.46(0.66) & 2.55(0.17) & 42.39(5.72) & 0.58(0.05) & 0.28(0.04) & 15.88(0.95) \\ Fresubin Thickened (1) & 2.73 & 1.37 & 0.52 & 176.69 & 3.76 & 0.67 & 4.62 \\ Impact (4) & 5.81(0.4) & 12.48(1.27) & 10.82(0.99) & 20.81(0.58) & 1.45(0.3) & 1.47(0.33) & 29.1(2.48)\({}^{\dagger}\) \\ Impact Enteral (1) & 10.67 & 18.24 & 12.78 & 29.74 & 3.75 & 2.62 & 41.69 \\ Isosource Protein Fibre (6) & 5.88(1.04) & 10.04(1.72) & 1.52(0.27) & 2.27(19.99) & 0.66(0.07) & 0.20(0.02) & 17.43(2.58) \\ Nepro HP (2) & 4.91(1.26) & 2.24(0.63) & 0.55(0.26) & 3.54(5.08) & 1.27(0.73) & 0.14(0.11) & 7.7(2.15) \\ Nepro LP (5) & 15.80(4.3) & 1.05(0.2) & 0.4(0.1) & 29.74(0.9) & 1.79(0.93) & 0.08(0.01) & 3.50(5.04) \\ Novasource GI Protein (3) & 1.18(0.28) & 0.81(0.22) & 0.14(0.09) & 21.2(5.73) & 0.48(0.32) & 0.02 & 21.3(0.56) \\ Nutricomp Hepa (9) & 3.28(1.21) & 1.09(0.27) & 0.55(0.24) & 307.99(17.85) & 6.93(1.22) & 0.32(0.17) & 4.92(1.46) \\ Nutrusion (5) & 5.13(0.87) & 15.99(3.89) & 1.8(0.41) & 177.59(4.52) & 1.63(0.91) & 0.26(0.12) & 22.92(0.52)\({}^{\dagger}\) \\ Nutrusion Advanced & & & & & & & \\ Diason & 5.75(0.74) & 21.42(1.36) & 3.2(0.21) & 35.15(3.43) & 1.49(0.13) & 0.54(0.07) & 30.37(1.98)\({}^{\dagger}\) \\ Energy HP (10) & & & & & & & \\ Nutrusion Energy (1) & 11.13 & 13.91 & 1.16 & 287.73 & 1.25 & 0.18 & 26.19 \\ Nutrusion Energy Multifibre & 10.8(0.86) & 18.69(2.26) & 2.12(0.4) & 311.19(6.73) & 1.12(0.16) & 0.29(0.04) & 31.61(2.2)\({}^{\dagger}\) \\ Osmolite (1) & 1.7 & 1.2 & 0.16 & 19.82 & 0.39 & 0.22 & 3.06 \\ Osmolite Plus (3) & 1.96(0.03) & 1.25(0.08) & 0.17(0.01) & 19.43(0.96) & 19.43(0.96) & 0.09(0.01) & 3.38(0.11) \\ Oxepa (2) & 1.5(0.05) & 3.06(0.41) & 0.3(0.04) & 24.41(0.78) & 0.75(0.05) & 0.26(0.07) & 4.86(0.4) \\ \hline \hline \end{tabular} Values are presented as the mean (standard error of the mean) for a determined number (\(n\)) of different samples of the mmol/mL content of amines in general nutrition (EN) formulas. For total polyamines, \({}^{\dagger}\) significantly higher (with different values of \(p\)) regarding Fresubin Original Fibre, Isosource Protein Fibre (except Nutrition), Nepro LP, Novasource GI Protein, Nutricomp Hepa, Osmolite Plus.  
\end{table} 
Table 2: Polyamine content and total polyamines (considering the sum of putrescine, spermidine, and spermine) in EN formulas in nmol/mL (standard error of mean).