{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:53:27Z","timestamp":1785405207418,"version":"3.56.0"},"reference-count":36,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Agro-Industry and the Faculty of Medicine, Prince of Songkla University, Thailand"},{"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Malnutrition affects 20\u201371% of patients with head and neck cancer (HNC), owing to tumor location, treatment-induced toxicities, and systemic inflammation. Enteral nutrition is preferred when oral intake is inadequate, yet standard powdered formulas require labor-intensive reconstitution and carry a contamination risk. PSU Blen, a ready-to-drink chicken-protein-based polymeric formula, was developed to address these limitations. Methods: In this single-center study, thirty clinically stable patients with HNC on tube feeding were randomized 1:1 to PSU Blen or a commercial powdered polymeric formula (Blendera) for 4 weeks. The primary outcome was change in Patient-Generated Subjective Global Assessment (PG-SGA) score from baseline to week 4, analyzed under a prespecified non-inferiority framework (margin \u03b4 = 2 points, selected as a clinically acceptable upper bound based on published PG-SGA data). Secondary outcomes were handgrip strength, body weight, body mass index, serum albumin, hemoglobin, and platelet count. Results: The mean change in PG-SGA score was \u22121.13 (SD 0.92) and \u22120.87 (SD 1.36) in the PSU Blen and Blendera groups; the between-group difference was \u22120.27 points (two-sided 90% CI: \u22120.99 to +0.45), with the upper bound below the non-inferiority margin. Sensitivity analyses yielded consistent results. No significant between-group differences were observed for secondary outcomes, and both formulas were well tolerated, with no gastrointestinal intolerance or serious adverse events. Conclusions: PSU Blen demonstrated non-inferior nutritional outcomes based on the PG-SGA endpoint over 4 weeks, with comparable tolerability. Longer-term and multicenter studies are warranted to further evaluate its clinical utility and practical advantages in routine enteral nutrition practice.<\/jats:p>","DOI":"10.3390\/nu18132105","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:16:44Z","timestamp":1782699404000},"page":"2105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Inferiority of a Ready-to-Drink Enteral Formula on Nutritional Status in Patients with Head and Neck Cancer: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-3034","authenticated-orcid":false,"given":"Manupol","family":"Tangthongkum","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7631-4313","authenticated-orcid":false,"given":"Ploychanok","family":"Cherngwiwatkij","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9285-1328","authenticated-orcid":false,"given":"Saowakon","family":"Wattanachant","sequence":"additional","affiliation":[{"name":"Food Science and Technology Program, Faculty of Agro-Industry, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-4683","authenticated-orcid":false,"given":"Pakjira","family":"Benyapanya","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1543-7209","authenticated-orcid":false,"given":"Peesit","family":"Leelasawatsuk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4373-6395","authenticated-orcid":false,"given":"Chaitong","family":"Churuangsuk","sequence":"additional","affiliation":[{"name":"Clinical Nutrition and Obesity Medicine Unit, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8253-4756","authenticated-orcid":false,"given":"Kanjana","family":"Chimrung","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7873-1895","authenticated-orcid":false,"given":"Theepat","family":"Wongkittithaworn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9558-3895","authenticated-orcid":false,"given":"Sittidet","family":"Nualnim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/(SICI)1097-0347(199708)19:5<419::AID-HED9>3.0.CO;2-2","article-title":"Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications","volume":"19","author":"Sauerwein","year":"1997","journal-title":"Head Neck"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.nut.2016.11.008","article-title":"High prevalence of cachexia in newly diagnosed head and neck cancer patients: An exploratory study","volume":"35","author":"Dijkstra","year":"2017","journal-title":"Nutrition"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.4103\/0973-1075.164889","article-title":"Nutritional assessment of patients with head and neck cancer in North-East India and dietary intervention","volume":"21","author":"Bhattacharjee","year":"2015","journal-title":"Indian J. 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