Navigating Plant-Based Blended Tube Feeding: What to Look For and What to Include
Navigating Plant-Based Blended Tube Feeding: What to Look For and What to Include by Hilarie Dreyer RD, CSP
With plant-based commercial products like Real Food Blends Quinoa Kale and Hemp pouch and Real Food Blends Mini, and the ability to blend food at home for tube feeding it is now simpler for those requiring tube feeding to meet their dietary preferences and nutrition goals with a plant-based approach.
As a Registered Dietitian and passionate advocate of blended tube feeding, it’s important to me to give those fed via feeding tube choice back in how they nourish themselves, while also respecting their beliefs and preferences.
Therefore, this article is not meant to advocate for any one specific diet. Rather, its purpose is to provide necessary information to make informed choices when following a plant-based blended tube feeding diet.
A Plant-Based Approach for Blenderized Diets: What Does It Look Like?
People who follow a plant-based diet tend to prioritize eating foods like fruits, vegetables, whole grains, beans, legumes, nuts, and seeds, and may limit or omit certain animal products such as meat, fish, eggs, and dairy.
There are many variations of this diet and it can look different from person to person. Some may opt for a strictly vegan diet, while others may opt to incorporate plant-based meals only on certain days of the week.
And guess what, it is the same for tube feeding! After all, for most people a feeding tube is just another way to get nutrients into the body.
Whether you eat by mouth or through a feeding tube, there are a few things to consider when following a plant-based diet. This article will review what nutrients might be missing, and how to incorporate them into your blended meals so you can maintain optimal health.
And because I’m all about making the blending process as simple as possible, I’ll be offering tips and tricks along the way, such as using ready-made products like Real Food Blends to save time on meal preparation. And don’t miss the sample one-day blended diet meal plan at the end!
Important Nutrients on a Plant-Based Blended Diet
Protein:
Protein is super important for keeping our bodies running smoothly, as well as building and maintaining muscle and bones. Animal-based proteins are especially great as they give us all the essential amino acids (building blocks of protein) that our bodies need.
Plant-based proteins don’t usually provide all the essential amino acids in the right amounts, but if you mix and match different plant-based foods, you can get the amino acids your body needs.
Here are some of my favorite plant-based protein sources for a blended diet:
- Tempeh
- Edamame
- Tofu
- Lentils
- Nuts and Seeds
Blended Tube Feeding Tips: Lentils thicken up blended meals quickly. I suggest starting with a small amount to avoid an overly thick meal.
Iron
Iron is important for our bodies and plays a role in oxygen transport. It does this through a special protein called hemoglobin found in our red blood cells. This oxygen delivery is important for our energy levels, keeping our cells healthy, and supporting our immune system.
If you’re looking to get enough iron on a plant-based diet, it can be a little tricky. This is because the kind of iron found in plant foods is not as easily absorbed as other types. To ensure your body is taking in the most iron possible, combine iron-rich foods with those high in vitamin C, such as oranges and strawberries.
Here are some of my favorite plant-based iron sources for a blended diet:
- Spinach and Swiss Chard
- Kidney Beans and Lentils
- Fortified Cereals
- Blackstrap molasses
- Tofu
Blended Tube Feeding Tips: Real Food Blends Quinoa Kale and Hemp packet contains 7 mg of iron in one packet! Blending in a citrus fruit or juice will help your body absorb the iron and get the most out of your meal.
Vitamin B12
Vitamin B12 is important to keep your brain, heart, muscles, and nerves healthy. Unfortunately, our bodies do not make B12 on their own so we need to get it from food or supplements. Those following a plant-based diet must pay special attention to vitamin B12, as it is only found naturally in animal foods.
Here are some of my favorite plant-based vitamin B12 sources for a blended diet:
- Fortified Nutritional Yeast
- Fortified Plant-Based Beverages (coconut, almond, oat, pea, rice and soy milks)
- Fortified Plant-Based Meat Alternatives
- Fortified Cereals
Blended Tube Feeding Tips: Adding fortified nutritional yeast to blended meals is an excellent way to add calories and get a good dose of vitamin B12. There are many shelf-stable options available, making it a pantry staple for those on a plant-based blended diet.
Vitamin D
Vitamin D is essential for healthy bones, a functioning immune system, and keeping nerves and muscles in good shape. Unfortunately, getting enough of it can be tricky. Fish and seafood are great sources of vitamin D, but otherwise it is not present in many foods, and it’s hard to get enough year-round sunshine (trust me, I live in Michigan and know the feeling!)
Here are some of my favorite plant-based vitamin D sources for a blended diet:
- Fortified Breads and Cereals
- Fortified Orange Juice
- Fortified Plant-Based Beverages
- Mushrooms (Exposed to UV Light – Labeled as Such on the Package)
Blended Tube Feeding Tip: Families I work with often opt for fortified plant-based beverages as the liquid base in blended meals to increase calories. In order to create high calorie, low volume meals, look for a plant-based beverage with at least 130 calories per 8 ounce serving.
Calcium
If you want to help keep your bones strong and support nerve and muscle health, it’s important to make sure that calcium is a part of your diet. Animal-based foods, like milk and yogurt, contain a lot of calcium and are easier for the body to absorb than plant-based calcium sources.
If you’re following a plant-based diet, don’t stress – there are many foods that are packed with calcium that are perfect for tube feeding. Try adding several of these nutrient-rich foods to your blended meals throughout the day to ensure you’re getting the calcium you need.
Here are some of my favorite plant-based calcium sources for a blended diet:
- Tofu in Calcium Sulfate Brine
- White Beans and Navy Beans
- Seaweed and Kelp
- Fortified Cereals and Oats
Blended Tube Feeding Tip: Tofu is a great addition to blended meals! It blends easily and is nutrient dense. Look for tofu in calcium sulphate, a commonly used coagulant in making tofu.
Zinc
Zinc is an important micronutrient that helps keep your immune system in tip-top shape! It also is vital for the proper functioning of the human body, in general.
Zinc can be acquired from both plant and animal-based foods, however it is less easily absorbed in plant-based sources than animal based-sources.
Here are some of my favorite plant-based zinc sources for a blended diet:
- Wheat Germ
- Hemp Hearts
- Fortified Cereals
- Pumpkin Seeds
Blended Tube Feeding Tip: If you’re looking for a calorie-rich way to amp up your blended meals, look no further than hemp hearts! Just 3 tablespoons can give you approximately 180 calories, depending on the brand, and you can usually find them in the baking aisle of your local grocery store!
Omega-3 Fatty Acids
Omega-3 fatty acids are essential for keeping your heart healthy. It can be difficult to get enough omega-3 on a plant-based diet as the main sources are found in animal products such as fish and eggs. You can get some of your omega-3 from plant sources like walnuts, chia seeds and flaxseeds. It is important to talk to your health care team about omega-3 supplements if you follow a strictly plant-based diet.
Your Recommended Nutrient Needs
Figuring out your nutritional needs can be daunting. Everyone’s needs vary, and it can be hard to track down reliable info. If you want to get a head start, the Dietary Guidelines for Americans is a great resource. When you’re ready, however, it’s best to consult with a dietitian or health care team to get your exact requirements.
Sample One-Day Plant-Based Meal Plan
If you’re looking for inspiration for your tube feeding regimen here is a sample plant-based meal incorporating Real Food Blends. The recipes are easy to follow and packed with nutrients!
Real Food Blends provides an easy way to incorporate real food into your tube feeding routine, without having to make every meal from scratch!
- Breakfast: ½ Acai Smoothie Bowl with Real Food Blends Mini recipe (250 mL)
- Lunch: 1 pouch Real Food Blends Quinoa, Kale & Hemp (240 mL)
- Snack: 1 pouch Real Food Blends Mini Prunes, Pears & Pumpkin (100 mL)
- Dinner: ½ Edamame Salad with Tahini and Real Food Blends Quinoa recipe (225 mL)
Provides: Approximately 1160 calories, 37 grams protein
Please note, this is simply a one-day meal plan and is not meant to be primary source of nutrition. Consult with your medical team before making any changes to your diet. If micronutrients are a concern, a 100% complete multivitamin can be a simple solution, and if needed an additional calcium supplement and sodium per clinician recommendation.
Recipes:
- 1 pouch Real Food Blends Mini Prunes, Pears & Pumpkin
- 1 acai smoothie packet (3.5 oz)
- 1 slice avocado (~1/8 avocado)
- 1 Tbsp hemp hearts
- 1/4 cup almonds
- 2 Tbsp honey
- 1 cup extra creamy oat milk
Add food and liquid to the blender and blend on high for ~2 minutes, or until completely liquified and with no chunks. You may need to strain the blended meal if there are any pieces/chunks.
This yields ~500 mL, with approximately 740 calories (1.5 calories per mL) and 15 g of protein for full recipe. This will make enough for 2 servings. Store unused portion in refrigerator for up to 24 hours. However, the exact nutritional content may vary by brand or type.
Edamame Quinoa Salad with Tahini
- 1 pouch Real Food Blends Quinoa, Kale & Hemp
- 1/4 cup edamame
- 1/4 cup red pepper, raw
- 1/4 cup cilantro, raw
- 3 Tbsp tahini*
- 2 Tbsp nutritional yeast
- 1/2 tbsp turmeric, ground
- 1/4 cup vegetable broth
Add food and liquid to the blender and blend on high for ~2 minutes, or until completely liquified and with no chunks. You may need to strain the blended meal if there are any pieces/chunks.
This yields ~450 mL, with approximately 725 calories (1.6 calories per mL) and 33 g of protein for full recipe. This will make enough for 2 servings. Store unused portion in refrigerator for up to 24 hours. However, the exact nutritional content may vary by brand or type.
*Contains sesame.
I hope this article has been helpful to you, and that you will enjoy making these nutritious blended meals for either yourself or your tube fed loved one!
Happy Blending,
Hilarie, RD, CSP
Hilarie Dreyer, RD, CSP is a registered dietitian with over 7 years of tube feeding experience. She is the founder of Blended Tube Feeding, a virtual private practice that supports families with blenderized diets. Her mission is to advocate for better acceptance of blenderized diets in the medical community and to support families with their blending journey along the way.
Kaz’s Story
Our baby boy, Kaz, is the youngest of three. Kaz was diagnosed with a rare genetic brain disorder called Lissencephaly before he turned one. This disorder is usually associated with feeding difficulties. With all the emotions we went through after his diagnosis, there was one “aha” moment. We realized this was the reason Kaz had such trouble bottle feeding. After a swallow study was done, the doctors recommended a G-tube be placed due to his silent aspiration. We were so grateful. No more bottle feeds that would take over an hour. No more watching our baby boy struggle and choke from drinking. But with the G-tube came a whole new set of issues.
Kaz was started on a standard formula, which caused many stomach issues. He was in constant pain from feeling bloated and constipated. Constant pain meant constant crying. After a month on the formula, the doctors became concerned about his weight gain, and we were concerned about all the pain he was in. We knew something different was needed, something real. We decided a blenderized diet would be best for him, but with three kids and a full-time job, there was absolutely no way I would have time to blend our own food. Then Real Food Blends came to the rescue and saved us! I was introduced to Real Food Blends through our wonderful Lissencephaly online community, and I immediately called the GI doctor to speak with him. After researching, he agreed this would be the best option to try, and the products were covered by our insurance.
Within two weeks we saw significant weight gain! No more bloating. No more constipation. We had our happy little boy back. His smile and wonderful giggles returned. We could see the joy on his face again. Kaz has been on Real Food Blends for two years and it has been an incredible blessing for him and our family. We recently took a trip to Hawaii to celebrate Kaz’s 3rd birthday. Traveling with the Real Food Blends packs and knowing Kaz would still be getting the nutrition he needed while on vacation was amazing.
We are so grateful for Real Food Blends, and the people behind the meals who put in time and research to ensure our G-tube fed families get the nutrients and variety they deserve. Kaz has been out of the negative percentile for weight for quite some time, thanks to Real Food Blends. Now that his weight is no longer a concern, we can focus on his muscle strength. Kaz is currently working on standing. Something we never thought we would see. To say this blenderized diet has changed our lives is an understatement. Thank you, Real Food Blends!
– Kim
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one mom’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
Evely’s Story
My daughter, Evely, is an amazing 6-year-old who loves music!
Our G-tube journey began when Evely was just 3 months old and recovering from heart surgery. This was initially thought to be temporary, but we would eventually receive several diagnoses that made swallowing challenging. We were prescribed several different commercial formulas. They made Evely sick every single time. Finding a tube feeding option with whole foods was very important to me. Reading the ingredient label on the commercial formulas was especially hard because I would maybe not have chosen them for Evely from a shelf in a supermarket.
I stumbled upon Real Food Blends website while doing some late-night research on G-tubes. Blending foods for Evely had become extremely time-consuming with the amount of time we were spending in hospitals and doctor’s offices. I was so grateful to have found a company that we could trust to bring ease to our situation. I also love that there is such a variety of options.
Evely has grown so much since starting Real Food Blends, “failure to thrive” has now been removed from her diagnosis list.
I recommend anyone part of the feeding tube community speak with their registered dietitian about a blenderized diet.
– Tameka
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one mom’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
Caroline’s Story
My daughter Caroline is a bright and smiley 3 year old who loves to play! She is a very active child but things haven’t always been this way. Caroline suffered severe oxygen deprivation known as Hypoxic Ischemic Encephalopathy during labor resulting in a brain injury that left her unable to coordinate oral movements necessary to drink from a bottle. She started with an NG tube at birth and had her G-Tube placed while she was recovering from her brain injury in the NICU at only 2 months old.
The NICU was the beginning of a long journey trying to find the right nutrition for our daughter. Soon after our daughter was born, we noticed that tube feeding times were very stressful and uncomfortable for Caroline and she was struggling to keep her food down. We tried one commercial formula after another, hoping to provide relief to our daughter, but none worked. She was incredibly uncomfortable and unable to keep food down. Reflux and tummy troubles ruled her life and ours.
Out of desperation, I scoured the internet and discovered parent forums discussing Real Food Blends as an option for kids like Caroline. As I read, I knew we needed to give it a try. I contacted her dietitian who ordered some samples for us to try over the course of a couple weeks. We created a feeding schedule, started Real Food Blends and sure enough, life for Caroline started to get a whole lot better.
As she transitioned onto Real Food Blends, we noticed a significant shift in our daughter’s comfort levels. She was finally able to relax and take a full feed without losing any food. Her growth became more stable and feeds changed from a time of high stress to a time of comfort. This newfound comfort opened the door to new opportunities which seemed impossible before starting Real Food Blends. She began to tolerate therapy, sleep, car rides, stroller rides and play time in a way that she never had before.
Now that we are able to get out of the house more without concerns of tummy troubles striking, I bring her food everywhere we go. We are a very active family so having her food conveniently packaged helps a ton. We use a combination of pump feeding and bolus syringe feeding with Caroline’s Real Food Blends, which has worked beautifully for our family.
As a mother, it means the world to me to know that my child is receiving high quality nutrition every day. I love being able to mix up the different flavors and talk with her about what she’s having for the day! For example, it was so fun to be able to give her the turkey flavor on Thanksgiving. I know it might seem like a small detail, but it opened a door for Caroline to relate to her peers. Her cousins and friends had a turkey dinner for Thanksgiving and so did Caroline!
Caroline has been on Real Food Blends for a year and a half now and we have never looked back. It has truly changed her life for the better and we couldn’t be more thankful that something like this exists as an option for families like ours.
– Lauren
*I was paid by Nutricia for my time to write this blog post, however my opinions are my own*
This is one mom’s experience with Real Food Blends and may not be the experience of others. Individual results may vary.
