Nutritional therapy has been widely accepted in the treatment and prevention of malnutrition and the care of patients in critical health conditions. Some of the objectives of nutritional support are to provide the human body with nutrients to meet daily needs, promoting the physical development, preventing and correcting the malnutrition, and reducing the morbidity and mortality, supplying the specific health conditions [1], [2], [3], [4]. The clinical therapies employed include enteral nutrition (EN) and parenteral nutrition (PN), prescribed based on the individual patient’s needs, the state and evolution of disease, caloric density, and age, among other factors.

These artificial formulations (EN and PN) are generally fortified with essential trace elements for the human organism, including Cr, Cu, Fe, Mn, Se, and Zn [5]. A volume of 1300–1900 mL of the formulas is usually able to meet the Recommended Daily Intake (RDI) values of the micronutrients necessary to promote and maintain the physiological functioning of the human organism. However, the concentrations of the essential trace elements in these formulas should be sufficient to prevent deficiency, while avoiding excess that could lead to cumulative toxic effects [6].

Gottrand et al. [7] used inductively coupled plasma mass spectrometry (ICP-MS) and atomic absorption spectrometry to determine Ca, Cu, Fe, Mg, P, Se, and Zn in the blood plasma of pediatric patients undergoing prolonged enteral nutritional therapy. It was shown that after extended therapy, 94% of the children presented deficiency for at least one of the micronutrients evaluated, which was attributed to fiber supplementation, which interferes with micronutrient availability in pediatric patients receiving long-term enteral nutrition.

Nishiwaki et al. [8] observed that 6 months under nutritional therapy led to Cu deficiency in patients who underwent jejunostomy for prolonged EN. This study suggests that the absence of previous stages of digestion leads to a lower Cu bioavailability when administered via jejunal when compared with the patients who used gastrostomy. These patients presented higher levels of Cu in the blood than the group that received by jejunostomy. Santos et al. [9] found that 47% of 146 patients who underwent gastrostomy for long-term enteral feeding presented Fe deficiency resulting in anemia, which increases morbidity and mortality rates in hospitalized patients. These studies corroborate concerns about the nutritional status of patients receiving this type of therapy.

Some studies have also shown the contamination of formulas used for nutritional therapy. Maziero and Viana [10] investigated the presence of Al, Cd, Cu, Mo, and Pb in samples of EN formulas from commercial pharmacies in Brazil, using a high-resolution continuum source atomic absorption spectrometry (HR-CS GFAAS). Among the 5 samples analyzed, 2 exhibited Pb contamination at concentrations exceeding the maximum level permitted by Brazilian legislation (0.01 mg kg−1). Nascimento et al. [11] investigated the distributions of Cd and Pb in complexes formed with amino acids in PN samples. It was concluded that high contents of amino acids in EN and PN solutions could lead to the leaching of Cd and Pb during the stages of industrial processing or storage, due to the ability of amino acids to form complexes with these metallic species.

Santos et al. [12], Peres et al. [13] and Srikrishnaraj et al. [14] conducted surveys of studies concerning the mechanisms of Mn intoxication, finding that this element, despite being essential, can behave as a contaminant when ingested at high concentrations (>11 mg day−1). Excessive exposure to Mn can lead to the development of a syndrome called manganism, with symptoms analogous to those of Parkinson’s disease. The administration of parenteral solutions prevents the functioning of the homeostasis regulatory mechanism, increasing the risks of accumulation of Mn in the brain and subsequent neurotoxicity [15], [16], [17].

Various studies have focused on the determination of Cr in the samples of EN and PN formulas, due to concerns regarding the deleterious effects of excessive Cr blood levels [5], [18], [19], [20], [21]. Toxic effects of this element include kidney lesions, dermatitis, and allergies [22], [23], [24].

Then, the available information indicates the need for further investigation of the nutritional profiles and distributions of inorganic contaminants in enteral and parenteral nutrient formulations, due to the possibilities of nutrient deficits or toxic effects. Therefore, the goal of this study was to evaluate trace elements in the enteral and parenteral nutrition formulations, commonly used as an exclusive food source for individuals in critical health states. It is important to know the intake of inorganic micronutrients to avoid nutritional deficiencies in these patients which can be developed throughout the treatment with these formulations. The determination of inorganic elements was carried out by inductively coupled plasma optical emission spectrometry (ICP OES) and graphite furnace atomic absorption spectrometry (GFAAS) analytical techniques. From these results, it was possible to carry out the risk assessment to evaluate the safety of the studied matrices regarding metal ingestion.