Abbott’s Pediasure Harvest

I have already written on a new product coming out made by Nestle. Abbott has a new product coming out, too. There is plenty to say about this product, but first, I’d like to share some important information about Abbott as a company.

Abbott, like Nestle, has aggressively campaigned against home blended diets. If tube-fed people started making their own food instead of consuming the sugar loaded formulas made for tube feeding, Abbott would stop making money. So, of course, they’ve done what they can to discourage the use of blenderized diets and encourage the use of their own products instead.

In so doing, Abbott conducted some very shady “research” (I use quotations because the studies they did hardly pass as legitimate research). For example, Abbott went to Iran to a handful of hospitals already well documented to have kitchen food contaminated with large amounts of pathogenic bacteria. They tested their blended food prepared for tube-fed patients. Of course, since the food being blended was prepared in a kitchen full of contaminated food, the bacterial content of the blended food was not surprisingly rather high. Abbott has conducted other similar studies.

Abbott then sent pharmaceutical reps to doctors and dietitians to explain how horribly contaminated blended food has been shown to be, never mentioning where these studies were conducted. They made a ridiculous document explaining how dangerous consuming food is (the cover of this document ironically contains pictures of people eating food). There is a great video that talks more about this here.

In the document, Abbott makes multiple false and/or unsupported claims about enteral formulas and blenderized diets. For example, at the very beginning of the document, they claim that new formulas are improving tolerance and patient outcomes. There is no data to suggest this, especially in comparison to diets of real food. First, the formulas have changed very, very little since their introduction in the 1950s. In truth, every time blenderized diets and enteral formulas have been compared through case studies or research studies, the data enormously favored blenderized diets showing dramatic reduction in GI complications in over 90% of participants when they began a blenderized diet instead of consuming enteral formula. You can read more about these research studies and many others in my book, Stand for Food.

Abbott references “specialty formulas” that have been manufactured in the past decade, yet, they fail to mention that essentially none of these specialty formulas have ever been a part of a single clinical trial. Meanwhile, they continue to make their claims about how dangerous blenderized diets are, citing their flawed research in the process. Let me be clear. Blenderized diets have absolutely never been shown to increase the risk of infection or other health complications in a single properly conducted scientific study. Ever.

A survey, which you can learn about toward the end of this video, showed that less than 3% of respondents reported any incidents of foodborne illness in their child while feeding a blenderized diet. This is very far below the incidence of foodborne illness experienced by the general population, according to data from the CDC.

Abbott claims in their document that it’s unsafe to feed a person blended food with a feeding pump because the food is sitting at room temperature. A fellow BD mom friend of mine who is trained in food safety and sanitation and is even certified to teach classes on the subject, feeds her son a blended diet on continuous feeding not just through a g-tube, but through a j-tube and has done so successfully for a long time. She has tested the temperature of her son’s food in the feeding bag when it is surrounded by ice packs and the temperature of the food after it passes through the pump line and comes out of the extension tube and found that for a full 12 hours, the food remained at a safe temperature using this method.

Has Abbot even tested these things? Of course not. They just made this stuff up to keep themselves relevant in a market where people are losing interest in their products more and more as time passes. But, we BD moms are testing things all the time, and we are consistently finding the claims made by Abbott are simply untrue. Trustworthy company? No.

Now, let’s move on toward the actual product, PediaSure Harvest and the marketing pamphlet they are passing out to dietitians.

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They note that 59% of parents of tube-fed children feed their child a home blenderized diet. Abbott, of course, does not like that because it means we aren’t buying their products. They then list 6 steps a parent must go through to feed their child a blenderized diet in their attempt to make it sound utterly dreadul.

Step 1: Shop for the right ingredients. In other words, the parent must go grocery shopping, an activity that parents of orally-fed children around the world must do. I don’t see Abbott trying to market this product to replace food for orally-fed children so parents no longer have to go to the grocery store. Are they suggesting tube-fed children are not worth the effort of going to the grocery store?

And what are the “right” ingredients? Both Abbott and Nestle have tried to make it sound like blenderized diets require lots of specialty ingredients and weird concoctions of 34 perfectly measured ingredients in order to attain “complete nutrition.” Bradley has had pancakes, tacos, spaghetti, sandwiches, soup and much more through his feeding tube. I did not calculate every single nutrient to make sure his diet was “complete.” No one eats this way. A blenderized diet is not an attempt to make a formula out of food. It’s just feeding food like all other humans everywhere eat.

Step 2: Rinse and clean the food. Yes, if you buy fresh produce, it must be rinsed and cleaned. Just like all orally-fed people do. Eating orally doesn’t mean you don’t need to wash fresh produce. Everyone needs to do so. They are suggesting again that this effort is worth it for an orally-fed child, but that tube-fed children simply are not worth the same effort.

Step 3: Measure everything. Just like everyone does when preparing a recipe, whether they are preparing food for oral consumption or through the tube. Apparently, they are under the impression that tube-fed children are not important enough to bother with measuring food while orally-fed children are. Preparing nearly any meal requires most people to measure their ingredients.

Step 4: Blenderize. Yeah, you put food in the blender and turn it on for 2 minutes. This literally takes less than 5 minutes. Sure, you don’t have to do this for orally-fed people, but seriously. It’s 5 minutes. Our children are worth 5 minutes of effort.

Step 5: Divide into serving sizes. When my best friend made a pot of soup for her family the other day, she had to divide the soup into serving sizes in bowls. This was not cause to stop feeding her family food and to begin feeding them cans of formula instead. Yet again, the implication here is that tube-fed children are not worth the same effort given to orally-fed children every day.

Step 6: Clean equipment for next use. Just like everyone else must wash their dishes after preparing a meal for their children and feeding it to them. I spent a month in Cambodia once. I will never forget sitting alongside the river and watching a man carry a bin of dirty plates and cups and washing them in a river less than 10 feet from where someone else was bathing in the river. He had no soap. Just a scrub brush. Like many living in Phnom Penh, Cambodia, that river was the only source of water he had.

If he can manage to wash dishes, at least as well as he can, in such circumstances, surely the average parent of a tube-fed child living in an industrialized country is capable of washing dishes in their kitchen sink or in their dishwasher. Besides, the only additional equipment that needs to be washed is the blender, which is the easiest dish to wash if you have a high powered blender (and most people that feed a blenderized diet do). You simply fill the blender jar with water with a dab of soap and run it briefly before dumping the soapy water out and rinsing it. Occasionally, I have to take a bottle brush and scrub the sides, which takes very little time. Some like to do a second run with water and vinegar or even water and a touch of chorine for added measure. Though most do not do so.

After this horrifyingly offensive statement that Abbott doesn’t think tube-fed children are worth the same energy and effort as orally-fed children, it claims that their PediaSure Harvest is a good source of antioxidants. It has a little asterisk next to that and lists vitamin C, E, and selenium as the antioxidants. This is a “good source” of antioxidants? Hardly. There are so many antioxidants and phytonutrients that can be found in abundance in a varied diet of real food that PediaSure Harvest does not offer. Yet, they call this “nutritionally complete.” Just…no.

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Here, we find pictures of spinach, mango, broccoli, and such. Ironically, after making a big deal about how hard it is for parents to find the “right ingredients,” they then list ingredients in their formula, and all of those ingredients are easily found in almost any grocery store. Who has a hard time finding bananas at the grocery store? To get these products into a form that works in their liquid-y formulas, a lot of processing has to be done. As does super heating to make it shelf stable. This destroys much of the nutrients that can be found in this food. I notice they fail to mention this.

They mention their protein source is from soy, chicken broth, and rice. I have to wonder how much research Abbott did when developing this product. I’ve spoken with thousands of parents of children with feeding tubes and/or GI disorders. While soy is a great source of protein for many people, it is an ingredient that children with digestive disorders commonly have difficulty with. This was a very poor choice of a protein source for a product designed for tube feeding children.

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First of all, the title of this page is “Real Food Formula Nutrient Comparison.” Yet, neither of the formulas listed here are actually real food formulas. These are both formulas with a little bit of food added to them. They’re still loaded with sugar like every other enteral formula. These are absolutely not real food formulas. This is important to keep in mind because as Abbott and Nestle are making these terrible products and claiming they are the same as a blenderized diet, when children try them and have complications, dietitians and doctors may tell parents their child “failed” at the trial of a blenderized diet and should return to a more traditional formula. This would be entirely incorrect because a real blenderized diet is what would likely reduce or even eliminate the symptoms.

This page is just a comparison of PediaSure Harvest to Compleat Pediatric, made by Nestle. This is hardly a product to be comparing your product to. It has an enormous amount of sugar in it with really only trace amounts of food. Nestle markets this as a real food product, but it has ingredients that are terrible for health.

Nestle used to use corn syrup as their primary carbohydrate source in their Compleat Pediatric, but after enough complaints from parents, they switched to brown rice syrup. They did this because brown rice syrup sounds healthier. This is sadly not reality. Brown rice syrup has an extremely high glycemic index, far higher than even table sugar. It also can contain levels of arsenic inappropriate for a pediatric population. It is not a healthful ingredient, yet it is the most abundant ingredient in Compleat Pediatric after water. They don’t care if their product actually is healthier. They just care if it sounds healthier so people will buy it. Abbott is doing the exact same thing.

When we talk about a diet of real food, we are talking about food that people actually eat. No one sits around drinking glasses of brown rice syrup. If they did, they’d get sick. Abbott is showing that PediaSure Harvest is similar to Compleat Pediatric here. Not exactly a positive endorsement of PediaSure Harvest. I notice as much as Abbott talks about the “dangers” of bacteria in home blenderized diets, they never mention the dangers of long term high sugar diets (which virtually all of their enteral formulas consist of). Diets with these ingredients are strongly correlated with decreased immune function, increased inflammation, poor gut function, cardiovascular problems, and much more. These formulas are far from safe and their long term use has never been studied in a single clinical trial.

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This page continues the comparison to Compleat Pediatric. Notice rice maltodextrin is a carbohydrate source in PediaSure Harvest. This, like brown rice syrup, has a high glycemic index and isn’t going to do anyone’s health any favors.

The source of fat for PediaSure Harvest isn’t something that’s going to promote health, either. Tuna oil in every can? Is it even safe for children to consume fish oil over and over again every single day? I can guarantee Abbott has not checked prior to adding this to their product. They added it because, as you can see, Compleat Pediatric has no DHA in it, an extremely important fatty acid necessary for brain growth and development (so much for it being “complete nutrition”). Abbott wanted this upper hand on Compleat Pediatric.

While adding DHA to a child’s diet is a very good thing to do, adding fish oil every single day is in complete contradiction to the nutritional recommendations for children due to its potential for mercury content and blood thinning effects. Many children with heart defects have a feeding tube and are also on blood thinning medication due to their heart defect. I have serious concerns about any child being fed fish oil all day every day, but I am even more concerned for children with heart defects that are on blood thinning medication being fed this ingredient.

A far better source of DHA would have been from algae (in fact, the only reason fish contain DHA is because they either eat algae that has DHA or they eat other fish that have eaten algae with DHA). This is a much more safe source of DHA to be consuming on a daily basis. But, it is also more expensive and this would mean decreased profit margins for Abbott. It seems while they harp on the extreme “dangers” of blenderized diets and express such terrible concern for our children’s health, that concern stops quite abruptly as soon as it starts affecting their profit margins.

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“Real food parents want, nutrition children need. Now you can give them both with new PediaSure Harvest.” Parents that feed their children a blenderized diet have been giving their children both of these things for decades. Real food has the nutrition children need, and it has been giving children the nutrition they need for a very long time. And freshly blended food has far more nutrition in it than any canned preparation ever will. Now we can give both? We’ve been giving both all along.

If they want to imply that tube-fed children fed real food all this time haven’t been getting the nutrition children need, they are seriously misinformed. In fact, a study showed that children fed blenderized diets have perfectly normal blood levels relevant to nutrition. Our children are absolutely thriving on blenderized diets, and they are far more nourished than children being fed PediaSure Harvest could possibly be.

They think this has the “real food” parents want? No. It absolutely does not.

I’d like to end this with a quote from my book, Stand for Food:

“Stemming from this general recommendation is the question many parents of tube-fed children have been asked by medical professionals: why go through all the trouble of making food when you can just feed formula? No medical professional would ever ask the mother of an orally-fed child, ‘Why do you bother makingĀ  your child food? Why don’t you just feed formula?’ Yet, parents of tube-fed children are asked this question regularly.

“So, I will answer this question for anyone wondering. We don’t “just feed formula” because the ingredients in commercial enteral formula contribute to chronic illness and poorer health outcomes. Our children deserve natural fiber. Our children deserve carbohydrates from actual grains, fruits and vegetables rather than sugars. Our children deserve phytonutrients, natural enzymes, cofactors, beneficial bacteria and all of the other wonderful benefits real food brings that cannot be found in commercial enteral formula. And our children are absolutely worth the effort to provide this for them. That is why we don’t ‘just feed formula.”

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Have your Brownie Batter Cake, and Eat it, too

30412166_10155223495867414_2412361350660489216_oI sometimes witness a debate in the blenderized diet community. The question is asked, “If a child has a feeding tube, is it ok to feed treats and desserts through the feeding tube?”

The answers I see to this question generally fall into one of two ways of thought:

  1. Having a feeding tube doesn’t change what a child can be fed. If a child would be eating treats and desserts orally, he/she can have them through a feeding tube.
  2. I want to take advantage of my child’s feeding tube by feeding the most nutritious and healthful diet possible. So, I would not waste calories on junk food since my child cannot taste the food anyway.

I tend to fall somewhere in the middle. I, like those that answer according to the second way of thought, wanted Bradley to have a super nourishing diet through his feeding tube. I saw his tube as something to take advantage of. On the other hand, feeding some special snacks and treats can normalize tube feeding for both the parent and child (as well as for the adult tube-fed person). And that is no small thing.

Eating food is an emotional process whether we want to admit it or not. Because of this, feeding our children brings about various emotions, too. A parent can receive joy from feeding his/her tube-fed child a special treat. It can also bring joy to children as well as they watch their family members enjoy indulging in a special treat and get to participate with them. All of these factors have value in and of themselves. Moreover, tube-fed people do sometimes taste the food they are being fed.

But, I also say, why can’t we have it both ways? Can we have special treats that also nourish the body? Why does a special treat inherently mean junk food? Does it have to? I don’t think it does.

I submit this chocolate-y, lemon-y brownie batter cake as my proof. I know, I know. That is one long name. But it is the best name for this cake. It’s texture is like an under-cooked brownie (and who doesn’t love those?). With a light chocolate flavor and a touch of lemon, the cake is divine. The lemon frosting finishes it off. Ever had lemon and chocolate together? Probably in most foods, this wouldn’t pass. But, if done right, it can be a delicious combination.

Check out the nutrition profile below. These babies are loaded with healthy fats, protein, fiber, and plant-sourced iron (this source of iron will not constipate like other forms do). While the cake portion isn’t as sweet as your typical brownie, the frosting brings the richness you want in a dessert. And with an ingredient list that is nothing to feel bad about and lots to feel good about, indulge! Blend a brownie up in a little dairy alternative, and let your tubie enjoy it, too.

Added bonus? These brownies are both gluten and dairy free, which many tube-fed people require. While many children living with motility issues have difficulty with banana causing constipation, such a small portion of banana ends up in each piece, I don’t think this would be an issue.

To make the batter,

Ingredients:

  • 1 medium banana
  • 4 cups red beans, cooked (NOT kidney beans…actual red beans, typically found in Asian markets or onilne…if you cannot find red beans, you can replace with black beans, but note that the iron content will be reduced)
  • 2 Tbsp maple syrup
  • 1/2 cup date paste *(directions below at the end of the recipe directions)
  • 1/3 cup cacao powder
  • 1/2 cup raw cashews
  • 1/2 cup unsweetened coconut
  • 1/4 cup chia seeds
  • 2 cups old fashioned oats (not the quick cook kind)
  • 1/2 Tbsp baking powder
  • 1/2 Tbsp baking soda
  • 1 cup dairy alternative
  • Zest and juice of 2 lemons

Directions:

Preheat oven to 350 degrees. Line a 13×9 cake pan with parchment paper and set aside.

In a food processor, add the banana, red beans, maple syrup, date paste, cacao powder, cashews, coconut, and chia seeds. Process until relatively smooth, but will still be a little lumpy with some cashew pieces remaining. Set aside.

Add the oats, baking powder, and baking soda to your blender, and blend until ground into a fine consistency. Add this to a large mixing bowl. Empty the contents from the food processor into the mixing bowl as well, along with the dairy alternative and the lemon juice and zest. Stir until well combined. Transfer the mixture into the cake pan covered in parchment paper. It’s thick, so don’t worry about it being nice and pretty. Frosting will cover the top anyway! Bake in the oven for 45 minutes or until a sharp knife comes out clean.

*To make date paste, blend 1 cup of pitted dates with 1 cup of water until smooth. This is a great natural sweetener (I always keep some in the fridge) and a nice low volume boost for a blend.

For the frosting,

Ingredients:

  • 2 cups dairy alternative
  • 5 Tbsp tapioca flour
  • 6 Tbsp freshly squeezed lemon juice
  • 1 cup cashews
  • 2 tsp vanilla extract
  • 1/4 cup maple syrup
  • 6 medjool dates, pitted

Directions: Wait until the cake is done and out of the oven before making the frosting. If you don’t, all is not lost, but this frosting will be more difficult to spread if left to sit. It is much easier to whip this up when the cake comes out of the oven and pour right onto the cake.

Add all ingredients to a high powdered blender (such as a **Vitamix or **Blendtec) and blend on high for several minutes until it thickens. You will hear a change in sound from the blender when it thickens. When you hear this, turn it off immediately and pour onto the cake, spreading it as needed.

**If you do not have a high powered blender, you will need to soak the cashews in very hot water for an hour prior to blending. Add everything to the blender, and blend until smooth. Transfer to a medium pot and heat over medium-heat, stirring often until it thickens (this will take some time). 30264912_10155223495787414_5526419077863571456_o

Allow your creation to sit and rest for 30 minutes prior to serving. Yeah, I totally ate a piece before taking a picture of my cake. I have no regrets.

Makes 20 servings

1 serving =

  • 177 calories
  • 27 carbohydrates
  • 5 grams fiber
  • 7 grams fat
  • 5 grams protein
  • 3 mg iron