Recipe With Calories and Percentages


In my last post I tried to emphasize how impossible, and unnecessary, it is to create a perfect recipe for blended meals.  Fortunately our bodies are designed in such a way that we can survive and thrive (barring other problems) WITHOUT “perfect” nutrition. Of course, we desire to have and provide excellent nutrition (except when I want chocolate chip cookies), right?  But you know I am talking about blended meals for tube-dependent persons.  Somehow we perceive or know that a person who needs a tube in order to receive nutrition perhaps needs better nutrition than most. Although in my case I don’t know that for certain.  However, if I could have given my older children the nutrition I have given Natalie I certainly would have!

Last night I concocted a recipe, which follows, and then calculated the percentages of carbs, fats, and proteins. I did this by looking up the nutritional information about each ingredient at reliable online resources. By counting up total calories, total grams in each category, multiplying those grams times the number of calories in each category and then dividing by the total number of calories, blah blah blah. You get the picture. This is a vegetarian recipe:

1 avocado

1 tomato

2 c. chopped zucchini

1 c. chopped walnuts

4 c. romaine lettuce

2.5 c. water

16 oz. can garbanzo beans, drained

1 c. cooked quinoa, drained

½ c. coconut milk

When I blended this recipe, I added the garbanzo beans last, after blending all the other ingredients well.  Beans = starch production = gluey texture. I only blended for about 30 seconds after adding the beans.  With the lowest possible setting, I blended for 2 more minutes to stir out as much air as possible.  The final result was approximately 9 cups of blended food.

The total calories = 2155

Not bad, because that means 29.9 calories/ounce.  Calorie density is important in blended meals because we can only put so much food in a person’s stomach at a given meal.  Blended meals have a higher volume, typically, because of the liquid required to attain a consistency that can be pushed through a skinny little tube!

However, with this recipe, the ratios come out like this:

59% fat, 30% carbs, 11% protein

Ouch!  Not enough protein, too much fat, not enough carbs.  I’m sure that many of my recipes have TONS of protein, not enough carbs and adequate or too much fat.  I will be evaluating my other recipes to see how they come out.  It takes a while to calculate, so please be patient.

But guess what?  I AM GOING TO FEED THIS TO HER – HAPPILY!!!  Because I know it is all good food, good for her and will serve her well.

If you have any thoughts, please share them!!

Basics of a Blended Meal Recipe


Feeding someone via g-tube for medical reasons is most typically done via “formula”, for instance Pediasure, Enfamil, Ensure. When we take just a MOMENT to see what all the food experts recommend, it is clear they believe whole foods are better than supplements. Getting our nutrition from the actual foods we eat, as opposed to a “formula” is recommended everywhere I look. I have yet to hear a single nutrition expert say “Go buy a bunch of Ensure and drink that every day for best nutrition. And give your kids Pediasure… much better than the food at the grocery store.” So I continue to believe feeding my g-tube dependent daughter blended meals, rather than “formula” is best for her. By blended meals, I mean taking actual food, blending it in my super-duper blender and giving it to her through her tube.

It isn’t necessary that we turn blended meals into a fancy formula, or detailed recipe, or anything that complex. Think of all the toddlers running around, growing, sleeping, laughing, and learning who survive on cheerios, applesauce and grilled cheese sandwiches who REFUSE to eat any vegetables! I would guess that most of the people who are tube-dependent for nutrition have some overarching medical condition that necessitates the g-tube. Those medical conditions may require avoiding certain foods. Those medical conditions may have something to do with a fragile digestive system, so consult a physician first!

If your tube-dependent person can have real food, then a blended meal is certainly a possibility! Don’t stress over doing it “exactly right”. There is no such thing. We do not eat exactly the same things, same amounts, same nutrients every day ourselves. Our hunger waxes and wanes, our cravings wane. Some days I am desperate for lots of green food! Some days, I can tell I need more protein. This is true for tube-dependent people as well.

Generally, however, there are ratios we can follow for proteins, fats, and carbs:

Protein: 25 – 35% of total calories

Carbohydrate:s 40 – 50%

Fats: 20 – 30%

With carbohydrates at 40 – 50% it will take more than green veggies or fruits!  This is where grains and beans come in.  More on this next post, plus a new recipe!

Recipe


Making blended meals to feed via g-tube is not really complex.  I am convinced that anyone can do it!  Putting effort into the nutritional value of blended meals is just like putting effort into the nutritional value of our own meals. I strive to feed my family meals containing lots of fresh vegetables, fruits, grains, nuts and good proteins.  Very often I can take the leftovers of a family meal and blend them up into a meal for my 13 year old daughter, who is tube fed.  I’ll add more leafy greens or whatever I feel is needed to balance out the leftovers.

Today I am experimenting with escarole and quinoa.

Escarole

Endive

Endive is the cousin of endive.  They have very similar (identical?) nutritional profiles.

All leafy greens contain anti-oxidants which are thought to be important for best health and cancer prevention.

Escarole and endive also contain calcium, Vitamins C, A, Calcium, Phosphorus and Iron, Thiamine, and Niacin.

Escarole and endive have a slightly bitter taste to them and I don’t normally like that kind of taste, so I haven’t served these greens to my family in the past. Well, Natalie is my guinea pig! Of course, she will not actually taste it, but her blended meals will familiarize me with escarole and then putting it in a salad is just one step away!

Today’s recipe also includes broccoli.  I have advised against broccoli in the past because it is a cruciferous vegetable. These vegetables tend to produce varying amounts of gas in people. I have blanched the broccoli, enough to break down the crunch-factor a bit, hoping to reduce the gas production. It seems that ingestion of digestive aids, like pineapple, papaya, and perhaps lemon juice or vinegar can help the body in the processing of these vegetables.  I have not found any studies that support this, however.

Back to the recipe: I’ve mentioned quinoa before and I really like this “grain”.  It is actually a protein AND a relative of leafy greens!

Recipe:

1 cup cooked quinoa

1 c. cooked broccoli

1 c. liquid used to cook broccoli, or more as needed for consistency

1 c. water

2 c. escarole

1 tomato

½ c. walnuts

1 c. fresh pineapple (or canned in its own juice)

Blend and refrigerate.  Feed as you usually do for any other blended meal.

Calories:

Quinoa has 250 calories in 1 cooked cup.

Pineapple has 149 when including the juice

½ c walnuts has 91 calories

The broccoli has 50 calories, tomato probably only 10 – 20, escarole only about 20. So we are getting a total of approximately 600 calories for 7 – 7.5 cups when the air is slowly blended out.  That means it is only 10 calories/ounce.  By adding ¼ c. olive oil to the recipe, we add only  4 ounces, but 480 calories, bringing it up to … let’s see 1080 divided by 64 = 16.875 calories/ounce.  Still a bit on the lean side, but very healthy.  Olive oil is a good fat, and no offense, but your brain is about ⅔ fat, and needs fat in order to, believe it or not, maintain the correct electrical conductivity of the cells! Olive oil’s main component is monosaturated oleic acid.  Oleic acid is one of the most common fatty acids in myelin: the proective sheath the covers communicating neurons in the brain.    Drink up!     ;D

Perhaps this recipe is a once-a-day recipe, as opposed to a three-times-a-day recipe. Finding protein sources (like quinoa) other than meat has been established as a very smart health practice. I will be working on more quinoa recipes in the days to come. One of them is for me – I found a recipe for a quinoa, salad greens, strawberries, blueberries, watermelon salad. Sounds great, doesn’t it?!  Come on over for lunch!

More changes


As the mom of a child with “special needs” (that is such an understatement sometimes, isn’t it?!)  who is fed blended meals via g-tube for medical reasons (except of course that sensory processing disorder is NOT an accepted diagnosis),  change is a constant!  Fortunately, I’m good with change.  I kind of like it.  Otherwise I get bored.

Last week was a trip to “Grammy’s” house in Wisconsin.  With her tiny fridge we don’t have the luxury of taking pre-made blended meals with us. This time we took 2 days worth of frozen blended meals with us and our trusty VitaMix blender.  One of the things I did while there, which has been an exploration all summer, is give her a chance to get really hungry.  This worked rather well, as she actually ate a pizza lunchable twice each day, or hot dogs.  Not the best nutrition or enough calories, but the fact that she was eating twice a day, every day was really fun!  So I only had to feed her blended meals twice a day which was a bit of a break for me.  I haven’t checked her weight yet, but her clothes are fitting just the same.  She has continued to eat more, self-feeding, since we came home.

The other thing I tried was a slightly different egg recipe.  I made 6 hard-boiled eggs, threw them in the blender with some water, a large bunch of spinach and too many almonds. What is too many almonds, you ask?  Well, more than 10.  I was really trying to give her a calorie bump, but I think it was just too “rich” for her.  She felt sick for a couple hours after I fed her.  So perhaps the lesson is too-many-nuts-might-make-you-sick.  Sorta like if I eat too much fiber maybe.

Enjoy the last of summer!

More Traveling


I am getting ready for a short trip to my Mom’s.  She has a wonderful house but her refrigerator is tiny.  As I travel with my special needs child, different situations call for different plans.  Blending meals to feed her via g-tube has worked out very well for us.  Sometimes transporting that food is a challenge!  In this case, transporting isn’t a problem, storing it once we get there is the problem.

This time, I will take all my usual equipment, but NOT the week’s worth of food.  I will take two days worth of food with me and my trusty Vita-Mix blender!  I’ll make food each day while I’m there in order to have enough space to store it in my mum’s refrigerator.  I’ll definitely use some of my easier recipes, like an egg meal.  I will take along my food press and some ramen because blending pasta doesn’t work so well.

And of course, we’ll buy her favorite foods to eat while we are there: Ramen, pizza, hot dogs, and black olives.  Can you say SALTY??

And Another Thing….


Let’s see, 9 years of blended meals for g-tube feeding… the last handful of years have been pretty steady. Just since Natalie has turned 13 she has been telling me a few times a day that she is hungry!! On a typical day, she is fed 4 times.  One of those times she self-feeds with a pizza “lunchable” and that is supplemented (lack of calories) with a few syringes of her blended meals.

In the past, I have just added more nuts or more olive oil to bump up the calories and that has been adequate.  I can see this being a long-term increase in calorie requirements for her and I want to not just give her more fat, but more protein, veggies, etc.  In other words, I want to keep the ratios in balance.

I am starting to give her nine 2-oz syringes per feeding instead of eight.  I wait 10 minutes after her 8th syringe before giving the final one.  This is to allow her tummy some time to be able to accommodate the additional food.  After a week of that, I will just do the 9th syringe in a typical 3 minute interval with the first eight syringes.  (see here if you want to know more about my timing system)

Since most of my recipes are in the 25 – 30 calorie per ounce range, that means I am giving her another 200 – 240 calories per day.  I will see how her weight goes and if she complains about being hungry still.  If she still complains about being hungry, I will have to see about what to do next.  I don’t want to go to five feedings a day – that would be really cumbersome!

I have also been increasing her self-feeding opportunities – if she is hungry, I want to use that to help her increase her independence when it comes to eating!