Consuming commercial formulas is perfectly acceptable for short-term use of a feeding tube. However, if you will be using a tube long-term, it is a good idea to talk to your doctor or nutritionist about blending your meals–then purchase a high-end blender, like a Vitamix! Blended, or Blenderized, Diets (BD) are basically just homemade meals that have been ‘liquefied’ into a fine puree so that they can fit into your feeding tube. Until recently (the past thirty years or so), blended diets were the only way to get food via the tube. The widespread availability of commercial formulas has caused both an increased use of feeding tubes and a broad acceptance of these formulas as the standard for tube feedings. As you’ll see, however, these commercial products have drawbacks and blending a nutritious diet of real food is the best solution for your long-term health.

Pros to BD

There are many benefits to blending real food. One of the biggest is that it allows you to limit your sugar intake. Cancer feeds on sugar, so reducing added sugar in our diet is especially important for oral cancer patients and survivors. Formula companies try hard to pack their product with calories and the right vitamins and minerals for a well-balanced diet. Unfortunately, the most convenient way to pack calories into an 8 ounce container of formula is with added sugar. For example, one bottle of milk chocolate Ensure Plus has 22 grams of sugar. Seven bottles a day (2,450 calories) gives you 154 grams of sugar every day. That’s around 40 teaspoons–almost a full cup–of sugar every day. According to the American Heart Association (AHA), you should have no more than 37.5 grams, or 9 teaspoons, of added sugar each day. Naturally occurring sugars, such as those in most fruits, are not a concern to the AHA. Yet too much added sugar can cause a whole host of health problems such as obesity, type II diabetes, cardiovascular disease, tooth decay, and non-alcoholic fatty liver disease. These problems are on top of your immediate concern about sugar’s effect on oral cancer.

No matter how hard formula companies work to load their products with an ‘ideal’ mix of vitamins and minerals, canned formula cannot compare to real, blended food. Vital new compounds or phytonutrients with health giving properties are discovered in natural food on an almost weekly basis. Commercial formula companies cannot keep up with our evolving knowledge of healthy food to copy the nutrients contained in a varied diet. By blending meals, tubies can consume a complete, balanced diet with the proper macro- and micro-nutrients, even the ones we aren’t aware of.

Another benefit to BD is that you can tailor your meals to meet your needs. Back in the Commercial Formulas for the Feeding Tube section, we highlighted different formulas to use in case of allergies. We also stated that, “unfortunately, some of the most common food allergens (such as soy, milk, wheat, and corn) are major ingredients in a large percentage of commercial formula.” This is especially true for corn. It is extremely hard to find a commercial formula that does not have corn in it. The only one we were able to find, Vivonex TEN, contains corn but is manufactured to be hypoallergenic. On the other hand, with a good blender (like a Vitamix) you can make a wide variety of meals with no corn. The same is true for any allergies (lactose, gluten, dairy, tree nut, legume, etc.) or special diets (vegetarian, vegan, ketogenic, paleo, BRAT, etc.). You can fine-tune your diet to meet your caloric and nutritional requirements on a day-to-day, or meal-to-meal basis. This flexibility allows you to vary your diet (just as oral eaters do) and deal with issues as they crop up, like blending chicken noodle soup and more clear fluids for a head cold.

Believe it or not, a fourth benefit to using BD is that you can’t taste your food. This is a great way to look at the silver lining of having a feeding tube. It’s true that you won’t be able to taste that glazed donut, extra large soda, or juicy bacon cheeseburger you were accustomed to having. But if you’re honest with yourself, that stuff was never good for your body and may even have contributed to your cancer in the first place. Now, you can blend all the healthy foods you want without having to worry about how they taste separately or together. Did you always have an aversion to okra, brussel sprouts, or lima beans? Now you can add these extremely healthy ingredients to your blend without needing to worry about your taste buds. The writer of this section frequently blends a sweet potato, can of sardines soaked in olive oil, and an apple with 8 ounces of water. The concoction likely tastes worse than it smells but it is packed with nutrition and has no taste in his PEG tube. Despite what you might think, a feeding tube can help you fall in love with real food and healthy, home-cooked meals.

Still another bonus to BD is that it’s easier than you’d think. It often takes less time to blend your food than it would take to make a meal if you were eating by mouth. Many times, high-end blenders like Vitamixers can do your cooking for you. As we discuss above, you don’t need to stress about how your ingredients will taste together so meal planning isn’t as difficult. You could also blend several meals at once on a Sunday so you don’t need to worry about what to make during the week.

Bolus feeding a blended meal feels remarkably different from consuming commercial formula. Formula is often compared to ‘eating a brick’ by many tubies. BD makes you feel ‘full’ and you will be able to tolerate much higher volumes of food than if you were consuming formula via gravity. BD ‘feels’ much different to your body. You may be able to tolerate much higher volumes because your body senses the ‘appropriateness’ of the food you’re eating.

An important benefit that can’t be overlooked is that blending real food brings more of a sense of ‘normality’ and de-medicalization to your health care. You have doubtless been through a difficult medical road to reach the point where you need to eat through a feeding tube. Whether you’re going through cancer treatment now, in between treatments, or a cancer survivor, just caring for and dealing with a feeding tube feels very medicalized and takes away one more aspect of control you have over your care. Being able to blend your own fresh, real ingredients at home goes a long way toward reestablishing that control and gives you the sense that in your own way you are fighting against your cancer and putting yourself on the right path toward recovery.

Finally, blending your food can improve the diet of your whole family. Once you start putting meals in a blender, you start appreciating food, not just for how it tastes, but how its nutrients will strengthen your health. Before getting a feeding tube, you may have had cravings for fried foods or fast food, or regarded a donut as a suffi