The Best Way to Make a BD: Choosing Your Menu

Actually, the title of this sub-section is a misnomer. There is no ‘best’ way to make a blended diet. You need to make foods that work the best for you and your situation. The great thing about BD is that it can be tailored to the individual. We’ve included a few recipes on this website, but they are merely examples to inspire you and give you a place to start when adapting your own diet. Our advice is that you read the rest of this section, the section on blenders, and the section on the mechanics of tube feeding and get the proper materials and knowledge at hand before you dive in and start mixing.

It’s important to note that it is ok to mix real food with the formula you are currently taking. However, you should also be aware that if you are switching to a BD because you can’t tolerate your commercial formula, this won’t change just because you’re adding in real food. In fact, if your body is having a difficult time digesting formula, it may have an even harder time with blended nutrients on top of formula. Commercial formulas are complex products with an unnatural mix of ingredients that may be stretching your digestive system to its limits. Adding another food could overload your system, and you may conclude that the added food is the problem, rather than the complicated mixture of foods. If you’re going to try BD, then we recommend you replace formula with a mix of real foods thinned with water or another liquid that you know your body will tolerate.

When constructing BD, you should be cognizant of getting the proper amount of calories, fats, carbohydrates, protein, dairy, fruits and vegetables, in consultation with your doctor and/or nutritionist. A good technique is to create a daily menu that has portions from each group of these nutrients in it. Over time, you can vary the ingredients within the groups. So, you might change out which vegetable you blend or the source for your protein. The most important rule for this technique is that you have an overarching goal for your nutrition. If you want a minimum of two servings of fruit and five servings of vegetables, you should plan your meals accordingly. Decide if you will try to make each meal ‘complete’ with a balanced blend of each necessary ingredient or if you will aim for reaching your nutrition goals at the end of a 24 hour period (e.g. make a primarily ‘fruit’ blend in the morning and a mostly ‘vegetable’ blend in the afternoon).

As you know, there are countless diets to choose from. With a high-end blender, like the Vitamix, you have a great deal of flexibility when making your meals. For the ‘overarching nutritional goal’ we mention above, we recommend you use the United States Department of Agriculture’s (USDA) Choose My Plate approach (http://www.choosemyplate.gov, formerly known as the Food Pyramid) when blending your meals. The main idea here is that you would aim for 50% or more of your diet as fruits and vegetables, use whole grains as much as possible, and alternate the ingredients over time. The next section describes how MyPlate might work for you in practice.

Choose My Plate

To give you ideas for where you might start when planning your BD diet, we’ll use choosemyplate.gov to build a daily menu using estimated amounts from each of the recommended food groups. We will then blend the meal and divide it up into individual feeds to eat throughout the day.

Grains
As I’m sure you’ve heard since childhood, whole grains are an important part of a well-balanced diet. This food group includes foods like wheat, corn, rye, oats, quinoa, rice, barley, and spelt. It also includes food made from these grains such as bread, crackers, pasta, oatmeal, grits, and cereal. You should shoot for a diet with at least 50% whole grains. Servings are measured by the ounce–e.g. one ounce equals a slice of bread or 1/2 of a cup of uncooked pasta.

Fruits
All fruits fit in this category. They could be raw, cooked, fresh, dried, canned or frozen. 100% whole fruit juice falls in this category, but try to make sure at least half the fruit in your diet is fresh fruit. Fruit servings are measured by the cup and one cup of fresh fruit or fruit juice is the same as half a cup of dried fruit.

Vegetables
There is an incredible array of different vegetables to choose from. From leafy greens to dark green veggies (cabbage, broccoli, etc.), to red and orange colored (peppers, pumpkins, carrots), starchy vegetables (sweet potatoes, corn, potatoes), legumes (they could also count as proteins), and even mushrooms. There are so many great vegetables to choose from and now you can’t use taste as an excuse not to eat them! Some vegetables can be eaten raw, some are best cooked; you can also use canned or frozen veggies. A good practice is rotating your vegetables by color so you get a good spread of this important food group. Like fruit, vegetables are measured by the cup. In the case of leafy greens, two raw cups is equivalent to one cup cooked.

Proteins
You can get protein from any type of meat, nuts and seeds, processed soy products, and legumes. Like we said above, legumes like peas or beans can be used as a protein. If you use them as the protein portion of your meal, be sure you include other vegetables too. Alternatively, you could have meat as your protein source and add legumes for your vegetable. Protein is measured by the ounce. One ounce of meat or seafood equals 1/4 of a cup of cooked legumes, one egg, a tablespoon of nut butter, or 1/2 an ounce of seeds or nuts.

Dairy and Dairy Substitutes
This food group includes any type of animal milk plus all of the products made from the milk–as long as most or all of the calcium isn’t lost. So, cheese, ice cream, kefir, and yogurt count as dairy while butter, cream and cream cheese do not. There are milk substitutes made from nuts or grains like almond milk and soy milk. They are fortified with calcium so they fall into this category. You don’t necessarily need animal milk products as long as you ensure you get the missing nutrients–like calcium–in other ways. Discuss this with your nutritionist, as well as how much fat you want to get out of this food group. Dairy is measured by the cup, where one cup of whole milk or yogurt equals one and a half ounces of natural cheese or two ounces of processed cheese.

Take note of the amount of fats and oils you add to your blends. There are different views on how much fat should be included in our diets. Many tubies provide for a daily fat allowance, add a bit of extra fats and oils to their meal, then rotate through different sources to get the fat they need. If you blend foods that are already high in fat like certain meats or avocados or mayonnaise, then you wouldn’t need as much added oil. Get your nutritionist’s opinion on this.

Also try to avoid too many empty calories that come from refined sugar, hydrogenated fat, trans fat, or alcohol. These calories have no nutritional value. They can harm your digestion, cause a glycemic spike, or add unhealthy fat to your body. All of our junk food, processed food and fast food is made up of mostly empty calories. Soda cans are full of 100% empty calories. If you are completely tube fed, you gain nothing from putting soda through your tube. You don’t taste it anyway and water will hydrate you far better. Some nutritionists