Understanding What a Blended Diet Is
Defining the Blended Diet
A blended diet involves pureeing everyday table food into a smooth, liquid consistency that can be safely administered through an enteral feeding tube. It provides nutrition for individuals who cannot consume enough by mouth but can tolerate food delivered to their stomach. Unlike commercial formulas, a blended diet utilizes whole foods like fruits, vegetables, grains, proteins, and healthy fats, allowing integration of familiar foods. It can serve as a partial or complete source of nutrition under medical supervision.
When is a Blended Diet Recommended?
Blended diets are often considered for patients experiencing issues with standard commercial formulas, such as vomiting, diarrhea, reflux, or poor weight gain. They can be suitable for those with specific food intolerances as ingredients are customizable. Blended diets also offer psychological benefits by allowing individuals to share family meals. However, consultation with a dietitian and medical team is essential before starting, as it's not appropriate for everyone, particularly those with compromised immune systems or jejunostomy feeding tubes.
Types of Blended Diets: Homemade vs. Commercial
There are two main approaches: preparing homemade blends or using commercially prepared products. Both have distinct pros and cons.
Homemade Blended Diets
This method involves pureeing fresh or cooked foods with a high-powered blender to achieve a tube-friendly consistency. A quality blender is crucial to prevent tube blockages. Homemade blends offer high customization for individual needs and preferences. They can be more cost-effective and provide a sense of connection to food. However, this method requires careful planning, preparation time, and strict food safety practices to avoid contamination.
Common Ingredients for Homemade Blends:
- Grains: Cooked rice, pasta, or oats.
- Fruits: Fresh, frozen, or canned options.
- Vegetables: Cooked vegetables.
- Protein: Meats, fish, eggs, beans.
- Fats: Oils, avocados, nuts, seeds.
- Liquids: Water, broth, milk, or juice for consistency.
Commercial Blended Diets
These are pre-packaged, ready-to-use liquid diets made from whole foods. They offer convenience, particularly for busy families or travel. Many are nutritionally complete, providing a balanced intake of macro- and micronutrients. However, they are generally more expensive and offer less variety and customization than homemade options.
Comparison of Homemade vs. Commercial Blends
| Feature | Homemade Blended Diet | Commercial Blended Diet |
|---|---|---|
| Cost | Generally more cost-effective. | Often more expensive, though some insurance may cover. |
| Customization | Highly customizable; can cater to specific allergies and preferences. | Limited variety; ingredients are pre-determined. |
| Preparation | Requires significant time and specific kitchen equipment (high-powered blender). | Ready-to-use, minimal to no preparation time. |
| Nutrition | Requires careful monitoring and dietitian supervision to ensure adequacy. | Nutritionally complete formulations are available; some may need additional supplementation. |
| Food Safety | Requires strict adherence to food hygiene during preparation and storage. | Manufactured under sterile conditions, reducing risk of microbial contamination. |
| Convenience | Less convenient for travel; requires refrigeration/freezing. | Highly convenient for travel; many are shelf-stable. |
Key Considerations for a Successful Blended Diet
Implementing a blended diet requires careful management and should always be done in consultation with a healthcare team, including a dietitian.
Ensuring Nutritional Adequacy
When using a blended diet, especially homemade, working with a dietitian is crucial. They can assess nutritional needs and help create a balanced plan to ensure adequate calories, protein, vitamins, and minerals. Without expert guidance, there is a risk of deficiencies. A dietitian can also advise on fortifying blends for energy density.
Maintaining Food Safety
Homemade blends are not sterile, necessitating strict food hygiene to prevent foodborne illness. Key practices include thorough hand and surface washing, using clean equipment, cooking ingredients properly, and correctly storing blends in the refrigerator (up to 48 hours) or freezer (1-3 months). Reheating blends with meat to a safe temperature is also important.
Managing Consistency and Tube Blockage
Achieving the correct consistency is vital to prevent tube blockages. The International Dysphagia Diet Standardisation Initiative (IDDSI) provides texture guidelines. The aim is a smooth consistency, often achieved with a high-speed blender and possibly a sieve. Using a larger syringe (60ml) and flushing the tube with water before and after feeding can help. The thickness should match the tube size.
Potential Benefits of a Blended Diet
Families and patients have reported several benefits from transitioning to a blended diet:
- Improved Gastrointestinal Symptoms: Some evidence suggests blended diets can reduce reflux, constipation, diarrhea, and vomiting.
- Better Tolerance: Some individuals tolerate blended diets better than commercial formulas.
- Normalizing Mealtimes: Using blended family meals can enhance social inclusion.
- Diverse Nutrient Intake: Whole foods provide a wider range of nutrients than formula.
- Empowerment for Caregivers: Preparing blends can give caregivers a sense of control over nutrition.
Conclusion
A blended diet is a growing alternative to standard enteral formulas, offering the benefits of whole foods for individuals needing tube feeding. By blending real food, caregivers can provide customized and potentially better-tolerated meals, with reports of improved gastrointestinal symptoms. However, this approach requires significant commitment, including proper equipment, preparation time, and strict food safety. Crucially, a blended diet must be managed under the guidance of a qualified medical team and dietitian to ensure nutritional adequacy and safety. For resources on starting a blended diet, consulting a reputable organization such as the British Dietetic Association is highly recommended [www.bda.uk.com/static/33331d33-21d4-47a5-bbb79142980766a7/FINAL-Practice-Toolkit-The-Use-of-Blended-Diet-with-Enteral-Feeding-Tubes-NOV-2021.pdf].
