This morning, before Linda and I got mired in yet more paperwork, I stumbled upon this article on the Harvard Health Publications website titled "Supplemental nutrition drinks: help or hype?"*
While the article addresses supplement drinks targeted for the broader market, it also clearly addresses formulas intended for specific medical needs including those who can't swallow. In my time chatting with others about feeding tube formulas Boost and Ensure have been on the list for some while Jevity and Osmolite, designed primarily for use with feeding tubes are also mentioned. I found these two paragraphs of particular interest (emphasis added):
"Supplemental nutrition shakes contain more than just healthy ingredients. “You may be getting more sugar than any of the other ingredients,” says Stacey Nelson, a dietitian from Harvard-affiliated Massachusetts General Hospital. “But if you can’t eat and that’s the only food that’s palatable, it’s better to get the calories.” Dr. Salamon agrees. “In that case, substituting one meal a day with a drink won’t hurt.” Both experts warn that people who can still eat may be risking too many extra calories by consuming the drinks. That can lead to weight gain and a list of complications associated with obesity, such as high blood pressure and diabetes.
Equally concerning is that nutrition in a can isn't the same as nutrition from food. "Even if they're fortified, they still won't contain all of the nutrients a whole food source would," says Nelson. Dr. Salamon questions the types of vitamins and dietary supplements in the drinks. For example, some include selenium. "It's not proved that we need selenium," she says."
Wait...we're talking about the same formulas and supplement drinks millions of Americans on feeding tubes are using as their primary source of nutrition, right? So, how is it we're cautioning people to limit their use of these products because of the risk of obesity and diabetes while sending new feeding tube patients away with cases of the same formulas as their primary source of nutrition?
The saving grace, if there is one, is this article dates back to 2013, before (at least I was aware of) any widespread discussion of this topic in the ALS community.
Yet, the question remains: Why are feeding artificial, sugar laden formulas to the sick, frail and elderly? The cynic (and business person) in me says "Follow the money!". And that default thinking may be correct. The financial website Research and Markets on May 11th of this year issued a report titled "Clinical Nutrition Products - Global Strategic Business Report 2015: Rising Incidence of Chronic Diseases to Kindle Markets".** Like the Morgan Stanley report in my last article, this points to a global investment opportunity in, among other areas, enteral nutrition.
What incentive is there for a Nestlé or an Abbott (and I pick on them because they are market leaders) to provide "food as medicine"? The formulas they make are cheap, high margin products. , organic, non-GMO whole food formulas, like Liquid Hope, require a more thoughtful, compassionate and patient centered approach. An approach, much like the Green House model we will use in our ALS/MS Residence that places the patient first.
Let's hope that families, advocates, patients and the handful of clinicians who have already recognized the importance of nutrition for healing, will initiate a grass roots effort to educate Doctors, Nurses, Nutritionists, Dietitians and even Legislators. To demand choice. To demand information. To demand sustenance for the weakest among us.
But people need to care. People need to do the tough work of educating themselves, of questioning your Doctor. The uncomfortable work of saying "No. There's a better way."
Do the work. Reap the reward.
*Harvard Publications Article: http://www.health.harvard.edu/staying-healthy/supplemental-nutrition-drinks-help-or-hype
**Research and Markets: https://globenewswire.com/news-release/2015/03/11/714246/0/en/Clinical-Nutrition-Products-Global-Strategic-Business-Report-2015-Rising-Incidence-of-Chronic-Diseases-to-Kindle-Market-Growth.html?print=1