Saturday, January 9, 2016

New Dietary Guidlines Ignore The Sick and Elderly

Every five years the US government releases new dietary guidelines for the American people. The guidelines were introduced this week and recommend a "healthy eating pattern" opposed to an unhealthy one, I guess. 

 "One new recommendation is that added sugar should be 10 percent of daily calories. That's about 200 calories a day, or about the amount in one 16-ounce sugary drink. The recommendation is part of a larger push to help consumers isolate added sugars from naturally occurring ones like those in fruit and milk. Added sugars generally add empty calories to the diet."  *Source

So...these are the new government guidelines for sugar intake. 200 calories of sugar is equivalent to 12.5 teaspoons per day (still a lot). Shouldn't these guidelines apply to the sickest among us too? Obviously not. 

"The carbohydrates in Isosource 1.5 Cal provide the majority of the calories in the tube feeding formula. Maltodextrin and sucrose act as the primary source of carbohydrates in the formula. A 250-ml can contains 44 grams of carbohydrate." * Source:

People on enteral formulas routinely are prescribed commercial formulas laden with sugars. As described above, Nestlés Isosource 1.5 has 44 grams of carbohydrates, mostly from sugars. If we do some simple math (hang with me, it's worth it): 

A typical adult patient requires 2250 calories per day (or 6 - 250 ml containers of Isosource @ 375 calories per container). At 44 g per of carbohydrates per box (remember, mostly from sugars) that totals 1020 g of carbs per day or 55.6 tsp. If we give the benefit of the doubt that only 75% of those calories are from sugar, that equates to 41.7 tsp of sugar per day.  That's 3.5x the recommended sugar intake of 12.5 tsp!

The new government guidelines say, to stay healthy, Americans should limit sugar intake to 12.5 tsp a day. YET, the medical community is routinely prescribing "semi synthetic nutritional formulas" that pump 3.5 times the amount of sugar into people who are sick and who NEED  REAL FOOD!

Now, I'm sure there are those who will take exception to my math. I'm not a Registered Dietician or Nutritionist. Here are some facts which are indisputable:

1)  Over the past few years the evidence against sugar has been mounting. In March of 2015 the World Health Organization issued the same guidelines as the US just restated. The WHO even took it a step further and stated that 5% of daily intake (6tsp) would "provide additional health benefits". The scientific evidence that sugar is a major contributing factor in cancer, heart disease and Type-II Diabetes is clear.

2)  Enteral formula is a big business cornered by a handful of global corporations. Add to that "nutritional supplements" like Boost (first three ingredients: Water, Corn Maltodextrin, Sugar) and Ensure (first three ingredients: Water, Corn Syrup, Sugar) which are marketed to seniors, and it's a multi billion dollar business.

3)  Liquid Hope, the worlds only organic, whole food feeding tube formula (, has a Medicare code (B4149).  In spite of this, patients continue to have a more difficult time getting approval for insurance coverage for Liquid Hope than they do more established formulas manufactured by the likes of Nestlés and Abbott. (File under: Things that make you go hmmm...).

4)  Speaking from personal experience and comparing notes with other "tubees", there are unhealthy side effects to the commercial formulas. Erratic gastrointestinal issues (and I'm being polite here), regurgitation which often results in aspiration, and spiking blood sugar levels are just a few. 

 There is a growing community of patients who have taken to "blenderizing" their own formulas. For those who have the time, the help and the willingness to do that, it's a viable and healthy option. But for patients not willing or able to prepare their own formulas, why should they have a harder time procuring a commercially made, Medicare approved, whole food formula than one which is now, by definition, considered unhealthy? 

In the coming  weeks we will be joining others to ask Congress to look into the nutritional content of these sugar loaded enteral formulas and supplements. In my opinion, it's a travesty that the sickest and most frail among us are being told by these global corporations that their products are "nutritionally dense" and full of healthy benefits.  

Patients and Seniors need to know - they deserve to know - what is going in their bodies. More important, they deserve equal access to healthy alternatives. 

Stay tuned for more...

*Note: These comments are my own and are not to be construed to be the opinion of Functional Formularies makers of Liquid Hope.