My tips for blenderized tube feeding to make the most of your freezer, fridge and pantry...while minimizing your trips to the grocery store.
I’ve received some questions from colleagues recently in regards to blenderized tube feeding in situations where access to fresh groceries is limited. Of course, these are conversations in the context of COVID19 and the general rule to stay home for now, unless absolutely necessary. Trips to the grocery store are not off limits by any means, however, most people are interested in minimizing their contact with others and are therefore taking steps to reduce their frequency of grocery shopping.
So does this mean that people on blended diets for tube feeding should be changed to diets of commercial tube feed formula (this is what was implied in the questions I received from a few dietitians)? In my opinion, no. If a blended diet is working for you or your loved one, now is not the time to change. Not only could this disrupt your usual routine and overall tube feeding tolerance, it could be just as difficult to get commercial formula so I don’t see the benefit of making a switch. I’ve always told my clients that having a commercial formula (this could certainly be a food-based formula) on hand as a backup is a good idea in case of emergency, but a full diet switch to formula due to COVID19 seems to me to be unnecessary and potentially risky. People who eat by mouth are still eating "real food" and tube feeding doesn't have to be treated differently (my personal view).
What I would recommend is trying to stick to your usual blended diet as much as possible. If your usual diet incorporates lots of highly perishable food items, you should explore less perishable alternatives. For example, if you usually use fresh berries in your breakfast blend, it would be easy to make the switch to frozen berries (thaw before blending). Likewise, if you like to add fresh spinach to your blends, you could use a less perishable fresh green like kale instead. Kale lasts for weeks in the refrigerator if you store it in the crisper drawer in a plastic bag with a paper towel to absorb condensation. Other fresh veggies that are long lasting include for example, cabbage, potatoes, onions, squash, carrots, broccoli, cauliflower, and parsley. Remember that frozen vegetables are just as nutritious as fresh veggies. I think it’s great to have frozen peas in your freezer because they can be thawed easily, they contain a decent amount of protein and blend really easily. Pretty much any vegetable is available in frozen form. Even avocado which can really boost the calorie content of your blends. Keep in mind that canned vegetables are also an option too.
What about protein? Well, in our current situation with COVID19, there hasn’t been any issues with electricity (different from natural disasters where electricity can be lost and therefore the ability to refrigerate food and use a blender). So, you are certainly able to use your frozen meat, fish and tofu. Just thaw and then cook thoroughly for use in your blends. There are, however, other sources of protein that don’t require freezing to be long lasting. Eggs can last for weeks in the refrigerator and are one of the best protein sources for blending. They can be scrambled in minutes and blend very easily. Even if your fridge is empty, you may still have plenty of protein options if you look in your pantry. Canned meats and fish are great for blending. There are also great plant based protein options such as dried lentils. They cook up in less than twenty minutes, are very high in protein and are easy to blend. Dried beans are extremely long lasting but do take quite a bit of time to soak and cook. Canned beans are ready to be used and offer an abundance of plant-based protein. Nuts and seeds are another great source of protein. If you’re worried about your blender’s abilty to break down nuts and seeds, you could soak them in the fridge for a day or so and they will soften somewhat. Another solution is to use nut butter. Finally, don’t forget that grains have protein! Quinoa, couscous, barley, oats, pasta, and rice, for example, are all shelf stable. Look at the package label to see how much protein there is per serving. You might be surprised.
When making blends, you should always follow your personal dietitian’s guidance as you may have special dietary requirements. That said, for most people, you’d want to be making sure that your blends have a balance of carbohydrates, protein, and fat. Options for fats are things like olive oil, butter, and the fat in nut butter. Luckily, oils are long lasting. Another easy fat source is coconut milk, the kind in the can that is usually used in cooking. This is a high fat, high calorie fluid that is a great way to boost the calorie content of blends. Read the label and think about how much you may want to add to your blend. A whole can of coconut milk for one meal would be a lot of fat so you’d probably want to use a lesser amount and add another fluid if needed.
Speaking of fluids for blending, Cows milk is usually a great option as it’s a source of extra protein, calcium and vitamins. However, being perishable, you may find yourself out of milk and if you buy too much, it can spoil. Better long term options would be milk alternatives such as soy milk or oat milk (read my blog post all about milks here), the kind that are shelf stable. Likewise, in addition to coconut milk mentioned above, shelf stable juices, ultra high temperature milk (shelf stable dairy), canned broth (keep in mind that broth is low in calories), and of course just plain water are options to use in blends.
In regards to fruit, apples and oranges are long lasting, as are melons, kiwis and bananas. Like vegetables, there are many frozen options, not to mention a plethora of shelf stable juices that will last for months.
There are also many shortcuts to preparing blended meals when you’re short on time, short on energy and trying to avoid frequent grocery store runs. You can buy frozen individual meals that just need to be quickly cooked in the microwave, cooled and then blended with enough liquid to get the right viscosity for your feeding method. Look for meals that don’t have meat with bones or any ingredients that you think might be troublesome to blend. Check the nutritional content to get an idea of the calories and protein content to make sure it aligns with your dietary goals. Canned soups, chili and pastas are another potential easy meal. Just open the can and put it into your blender and blend it up. Add liquid as needed. Get creative with your blends. You can blend foods like dry cereal, crackers, snack bars, chips and ice cream (melted). Did you know that in most countries, breakfast cereals are so highly fortified that can help protect you against vitamin and mineral deficiencies. Bonus- they blend well.
Finally, let’s quickly review label reading. Anytime you’re using a food that is coming out of a package, there should be information on the label about the nutritional content. Take a look. Get to know the nutritional content of your food so that you can make sure your meals are balanced and nutritious. I often speak about aiming to 1 calorie per mL with bends. Of course this isn’t necessary for everyone but for people who are new to blending, understanding this concept can help ensure that blended meals are highly nutritious and of a reasonable volume. So, if for example, your frozen meal provides 400 calories, blend it up with minimal liquid and hope to find that the volume of the blend isn’t much over 400 mL. If it took a ton of liquid to blend up and now the final product is a 1000 mL, that’s not good because of the time and energy it will take to consume that volume, not to mention how filling it would be while only giving you 400 calories.
The same goes with canned meals. Read the label. If it’s a 400 mL can of chili (most are) and the label says that it contains two servings that are 300 calories each, there would be 600 calories in the whole can. That’s great! That means if you blend the whole can, even if you add a half cup of plain water, you’re likely to get a nice fluid viscosity for tube feeding while having a final calorie concentration of 1 calorie per mL or higher (assuming the blend is equal to or less than 600 mL).
I hope that these tips can help you to maintain your blended diet successfully at home during these uncertain times. Reach out to your dietitian if you have questions about your blended diet and managing your nutrition at home with less access to grocery stores.