primitives squibble-squabble about feeding the elderly

[franksolich]

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=222x69235

Oh my.

This bonfire starts off innocently enough, and then the primitives get into it.

Why Syzygy  (1000+ posts)        Sun Sep-13-09 10:34 AM
Original message
 
Meal replacement drinks - a good idea? 

Meal replacements claim to be high in easily assimilated nutrition, but are the claims true? Are these drinks healthy?

On occasion over the last few years, I’ve known people, usually elderly, that were told by their physicians to take “Ensure” or “Boost”, or some other meal replacement beverage, in order to be certain they are getting all the nutrients they need. And even when a plate of healthy, real food is offered, the dutiful patient follows the doctor’s advice and chooses the artificial drink instead, believing they will get better nutrition from the drink than from the food. Doctors are doing their very best, but please remember that most have had very little if any nutrition training at all. The weight-loss industry also frequently markets meal-replacement beverages as part of their weight-loss plans. Having looked at the ingredient list on these beverages, I don’t think they should be recommended to anyone!

Here is the ingredient list for “Ensure”: water, sugar (sucrose), corn syrup, maltodextrin (corn), calcium caseinate, high-oleic safflower oil, canola oil, soy protein isolate, whey protein concentrate, corn oil, calcium phosphate tribasic, potassium citrate, magnesium phosphate dibasic, natural and artificial flavor, soy lecithin, sodium citrate, magnesium chloride, salt (sodium chloride), carrageenan, choline chloride, potassium chloride, ascorbic acid, ferrous sulfate, alpha-tocopheryl acetate, zinc sulfate, niacinamide, calcium pantothenate, manganese sulfate, cupric sulfate, vitamin A palmitate, thiamine chloride hydrochloride, pyridoxine hydrochloride, riboflavin, folic acid, chromium chloride, biotin, sodium molybdate, sodium selenate, potassium iodide, phylloquinone, vitamin D3 and cyanocobalamin.

After water, the first three ingredients are all sugar, two made almost certainly from genetically modified corn, as the product is not organic. Sugar devastates the body, accelerating heart disease, type 2 diabetes, obesity, osteoporosis, cancer and most other diseases of civilization. Soon after on the list are three vegetable oils, which increase inflammation due to their high omega 6 content (canola and corn oil being worse than the high-oleic safflower) and the fact that the oils are almost certainly refined, meaning they are rancid and will cause free radical damage in the body. Then we have soy isolate on the list, an endocrine disruptor, and whey protein, which is also a highly processed product. After that for the most part is a list of synthetic vitamins, mixed in with flavourings, which entails another long list of chemicals that they do not have to put on the label. Do the synthetic vitamins redeem the product?

I don’t think the isolated synthetic vitamins can overcome the fact that one has consumed a bottle/can of sugar and rancid vegetable oils, two of the most harmful ingredients one can have if one values one’s health. And of course, the poor liver has to detoxify all the chemical ingredients, of which there are many! Not a burden one wants to put on the liver if unhealthy!

The bottom line is to be healthy one needs to consume real food. What comes from a factory simply will never be as healthy as fresh foods that are picked, pulled out of the ground or chased after to obtain, or come from the ocean. The food needs to come from live sources, not made out of chemicals. Real food does not need to advertise that it is healthy. If a label is telling you it is healthy, it probably isn't.

I realize that these meal replacement beverages are a convenience, and sometimes when people are sick they need something liquid. There are so many healthier options than artificial meal-replacement beverages, if it is possible to take the time to make them. Soups made of bone broths, containing a variety of pureed vegetables, and possibly some pureed meat too. Smoothies with natural yogurt as a base, and filled with all kinds of wholesome, real food, including nuts, berries, coconut oil, an egg etc. Freshly made mixed vegetable juices with flax oil added.

It takes some planning, but one would get all the nutrition needed without the problems, and it would taste better too!

frazzled  (1000+ posts)      Sun Sep-13-09 10:51 AM
Response to Original message
 
1. Have you ever been around the truly elderly in a nursing home?

We spent the last three years of my mother-in-law's life tending to her in a nursing home. She suffered from a fair amount of dementia in her last years (she died at 95 a little over a year ago). There were many days when she could pick at a meal fairly well. Other times you couldn't get her to eat at all. But she was never eating enough. She would forget what she was doing half-way through. Or it was too much effort. She weighed less than 80 pounds at times. The liquid drinks are extras to boost much-needed caloric intake. You can't have an elderly person continually losing weight. She was given "Ensure"-type drinks between meals. She never took much of that either, but the extra calories helped to maintain her weight.

When she was ill and hospitalized, it was all we could do to feed her, teaspoonful by teaspoonful, these caloric and vitamin drinks. If we could get 1/4 of a can down we felt successful. Forget pureed foods--they are entirely gross to most of these folks, and make them gag.

So don't knock these drinks entirely. Your vegetable juices with flax oil will not taste good to a 95-year-old, and won't provide enough calories to put some flesh on their bones. For an entire skilled-nursing facility dealing with the truly aged, it would also be impossible to find the preferred home-made brew for each person's tastes.

We helped to feed many people in this excellent nursing home. Very few of them could eat a sufficient diet on their own, even though the food was pretty good.

Heddi  (1000+ posts)      Sun Sep-13-09 12:23 PM
Response to Reply #1
 
2. Exactly. I'm an RN, we use these all the time

not just because they're calorie dense, but because they're thick enough for people with swallowing problems without having to add thickner. they also come in flavors people like--strawberry, chocolate, vanilla.

When I have a patient in the late stages of Alzheimers, who has difficulty swallowing, who is about 12 hours away from having a tube put in their stomach for feedings because they won't eat enough to maintain weight or nutrition, I know that for the most part, I can go to them and ask if they want a chocolate or strawberry milkshake....it's a familiar flavour to them.

Also, in the elderly, one of the few things they can taste is "Sweetness"----so the sweet flavour of the Ensure or Boost actually can encourage them to drink more.

And much to the OP's chagrin, Boost and Ensure aren't the only meal replacements that are used in a hospital. There's Glucerna, Nehpro. HiCal, Jevity 1.2, TruamaCal, Jevity with Fiber....a whole host of meal replacements specifically designed for different patient populations and caloric needs. Boost and Ensure happen to be among the cheapest and the most readily available for the outside public.

And I can tell you that Jevity and TruamaCal and HiCal are nothing BUT nutrients and lipids and taste nothing like chocolate shakes---and are turned down repeatedly by patients on oral supplements.

We also attempt to get patients to eat pureed food before we go to the supplements, and I can tell you from years of experience that a patient who is in the throes of dementia and alzheimers, ravaged with cancer, weighing less than 40kg will 80% of the time ALWAYS accept Boost or Ensure. They will NOT take the pureed carrots, broth, soft meat, or whatever gross concoction of Bone Broth with Flax Seed that the OP suggested. 'Ms Jones, would you like some beef bone broth with flax oil and omega 10 supplement? Mmmm?? I'm sure it tastes nothing like it smells like, Ms. Jones. Uh, Ms Jones, please put down the bedpan....Ms Jones, please stop hitting the nurse..."

Then again, if the people who were so critical of the medical estabilishment actually HAD an ounce of experience *IN* the world of a medical professional, they'd know that 99.9% of the bullshit they post in this, and other forums, on a regular basis is just bullshit bunk nonsense.

Why Syzygy  (1000+ posts)        Sun Sep-13-09 12:38 PM
Response to Reply #2

3. And you aren't likely to offer this: 

Smoothies with natural yogurt as a base, and filled with all kinds of wholesome, real food, including nuts, berries, coconut oil, an egg etc.

Glad you got to have one of your little fits, Heddi. I know you so enjoy your poutrage.

Nevertheless, you are not the only concern when posting in this forum. Not even a little bit.

Doctors are doing their very best, but please remember that most have had very little if any nutrition training at all.

Heddi  (1000+ posts)      Sun Sep-13-09 04:44 PM
Response to Reply #3

6. Um, you know that nutrients don't just come in nuts, berries, egg

that the nutrients IN nuts, berries, and egg are available in the other nutritional supplements I mentioned: jevity, HiCal, Trauma Cal, TPN, PPN....all of these wacky medical things that hospitals use...they have NUTRIENTS in them. Pure nutrients in the case of TPN and PPN (i'll let you do the dirty work and look up what those are on your own). It's like a liquid multi-vitamin with a lipid base.

In the even of TPN and PPN, they are specially formulated DAILY--BY NUTRITIONISTS AND DIETITIANS at the hospital. Pharmacy weighs in with regards to renal and hepatic function, but the daily caloric and nutrient intake by patients is 100% regulated BY DIETITIANS AND NUTRITIONISTS.

So much for your "poutrage" about MD's having nutrition training.

More spouting about what you don't know---When patients are admitted to the hospital---and this is true for EVERY hospital I've worked in, there are "flags" that send out automatic consults. Some are consults for social services (uninsured, underinsured, homeless, unemployed, etc), some are for wound care (comes from a nursing home, diabetic, admitted with wound present, etc). Some are for dietary (has BMI less than a certain number for their age, emaciated, admitted with open wound, diabetic, from nursing home, etc).

Anyone over the age of 65, regardless of where they came from prior to admit, gets a nutrition consult. A Registered Dietitian and Nutritionist see all of these patients.

THEY are the ones who formulate **WHAT*** supplement they get, and how often. They set up calorie counts. They get daily weights on the patients and recommend TPN or PPN if necessary. They ultimately suggest a PEG tube if the patient is not gaining weight with supplements.

They follow not only the weight of the patient, but renal and hepatic function. They follow albumin and protein levels in the patients.

They "prescribe" daily diets for the patients, with certain percentage of the diet being protein, fat, carbohydrate.

NONE of this is done by an MD. The MD is ultimately the one who writes the order for TPN or PPN, or a PEG or G tube, but up to that point, all dietary needs of the patients are prescribed and ordered by the dietitian. NOT the MD>

But see, if you had relied on anything OTHER than anti-medical profession websites and "journals" (magazines), you might know this.

If you had any inkling in obtaining CORRECT and FACTUAL information, you might start with actually speaking with people who have first-hand knowledge of what happens in hospitals and nursing homes and the like.

But apparently that's not the case. You accuse me of having a fit, of having "poutrage". I laugh at that because it's not a fit...rather, a seemingly endless crusade to prevent the diarrhea of the fingers of medical misinformation that is posted daily, sometimes hourly on this forum.

Why Syzygy  (1000+ posts)        Sun Sep-13-09 07:51 PM
Response to Reply #6
 
8. We are well aware of your mission here; attempting to shut down discussion. It isn't going to work. I'll repeat, we all have the same member privilege to post our opinions in a civil manner. And you have the freedom to go all outrage over it.

I have immense first hand experience with hospitalization. Don't even try to guess. 

trotsky  (1000+ posts)        Sun Sep-13-09 08:28 PM
Response to Reply #8
 
11. Still beating that strawman!

No one is trying to "shut down discussion." Pointing out the myriad of ways that you are pathetically wrong is not silencing you. But since you lost the argument on facts, all you have left is to try and beat up on Heddi with your false accusations.

If anyone is silencing people, it's you, who repeatedly points out how many people you have placed on ignore.

Heddi  (1000+ posts)      Mon Sep-14-09 02:04 AM
Response to Reply #8
 
12. How am I trying to shut down discussion? By refuting your "facts" which aren't really facts at all, more like a conglomeration of word vomit scraped off the floor of the internet? Disagreeing with you, or the articles you post, or the conspiracies you promote is trying to shut down discussion?

This is not an echo chamber. I'm sorry that the often erroneous articles and opinion pieces and anti-medical propaganda that are posted in this forum will not go unchallenged.

There are a million pro-supplement, pro-homeopathy, anti-medicine, anti-science, anti-fact websites out there where my mentioning that I'm an RN that works in a hospital will get me banned before I make my second post. Find those websites if you want a website where people will not allow the tripe like you posted above to go unchallenged.

And who is this "We" you speak of in your subject line? Am I supposed to be frightened that there are more of you out there? I mean, I am, but I'm sure it's not for the reasons you're hoping for.

SidDithers  (1000+ posts)        Mon Sep-14-09 10:38 AM
Response to Reply #12
 
13. Wow... great posts in this thread...

Yeah.  franksolich finds internecine primitive squibble-squabbling fascinating.

BuddhaGirl  (1000+ posts)      Mon Sep-14-09 12:19 PM
Response to Reply #12
 
14. well, I'll cop to being a "we" because anytime someone posts anything about alternative medicine, herbs, homeopathy, etc., the usual crowd shows up to attack.

The OP's post was imho did not warrant some of the heavy-handedness a la "imanursesandyouarefullofcrap" in your reply, which also you utilized in this reply.

Everyone is entitled to their opinion, and is entitled to post about health here, whether it be alternative or traditional.

trotsky  (1000+ posts)        Sun Sep-13-09 02:24 PM
Response to Reply #2
 
4. Bingo, Heddi.

Then again, if the people who were so critical of the medical estabilishment actually HAD an ounce of experience *IN* the world of a medical professional, they'd know that 99.9% of the bullshit they post in this, and other forums, on a regular basis is just bullshit bunk nonsense.

Nail on the head.

supernova  (1000+ posts)        Sun Sep-13-09 03:37 PM
Response to Original message
 
5. They are for people who have problems getting enough nutrition through normal eating and drinking.

Others in this thread have already mentioned the elderly, especially those with dementia.

Certain cancer patients find these meal supplements useful as well, as sometimes your appetite disappears because you're either too sick to eat, or the chemo plays havoc with your taste buds and things that used to be enticing now aren't.

Also certain surgeries eliminate most or nearly all of the stomach so that you have to use liquid nutrition through a feeding tube that goes straight to the stomach. You don't even get the luxury of tasting it. You just need to get the calories in you.

Meal replacements have a place in the healthcare toolbox. Most people don't need them, but when you do, they can be a life saver.

Why Syzygy  (1000+ posts)        Sun Sep-13-09 07:41 PM
Response to Reply #5
 
7. I know all about stomach feeding tubes. 

My dad had one for a year. He couldn't swallow at all without throwing up buckets of blood. It's pretty ludicrous to assume most of us have not known someone elderly or terminally ill, or that we haven't been hospitalized ourselves.

I'm pretty sure the author linked in the OP wasn't talking about life or death situations. If someone is in hospice, there are entirely different considerations. But, when given the choice, it is healthier to choose something else.

tinrobot (1000+ posts)     Mon Sep-14-09 12:51 PM
Response to Reply #5
 
16. But these drinks seem to have mostly calories, not nutrition.

Perhaps these people need the calories, and that's fine.

If they're looking for nutrition, they'd be much better off tossing some vegetables into a juicer or making a smoothie with fresh fruits, yogurt, etc...

BuddhaGirl  (1000+ posts)      Sun Sep-13-09 08:04 PM
Response to Original message
 
9. no surprise that Ensure is owned by Abbott Labs

sugar (sucrose), corn syrup, maltodextrin (corn)...Yuck! Why is sugar one of the first ingredients?

Why Syzygy  (1000+ posts)        Sun Sep-13-09 08:19 PM
Response to Reply #9
 
10. Sugar is the first THREE ingredients.   

I don't want to criticize anyone doing hospice care. But I have to wonder what is the difference in giving this or a cola and a One a Day. Sugar is very hard on the body. 

salvorhardin  (1000+ posts)        Mon Sep-14-09 12:44 PM
Response to Reply #10
 
15. Sugar is very hard on the body?

You do know that our bodies run on sugar. That's like saying, "Gas is very hard on your car."

Of course, too much sugar in our diets leads to serious problems. That's as true of water or anything. People taking meal replacement drinks though are either not eating enough to get an adequate supply of sugar from their diet or need to have their diet restricted for medical purposes. The meal replacement drinks provide a precisely calibrated number of calories so doctors and care providers know exactly how much nutrition is being given. If the people taking these drinks could take your yogurt, nuts and berries smoothie then they would. Also, anyone taking meal replacement drinks needs to be closely monitored by their physician and nurses, especially if they are using them for weight loss (such as Optifast).

[tuolumnejim]

Thanks Frank, its great when DUmmies pawn each other. 

[VivisMom]

The stupid, it burns.

My dad-who is 63-drinks an Ensure with his breakfast every morning. He has a very physical blue-collar job, and the vitamins and such in that drink help to keep him (relatively) healthy and keep his energy up. When he does get sick, he pretty much exists on Ensure and chicken noodle soup because calories are necessary to fight off illness. If the day ever comes when that's all he can handle, I'm 100% sure he'd find Ensure more palatable than any sort of flaxseed-wheatgerm-the air in my mouth tastes better than this crap-smoothie.

My kid also drinks the Boost for Kids and Pediasure, as recommended by her pediatrician. She's a skinny little thing (not even 25lbs at 2.5) and a picky eater to boot; the doc recommended them not only for caloric intake, but also to help me make sure she gets the vitamins and minerals she probably isn't getting because she subsists solely on grilled cheese, PB&J, and milk.

The OP DUmmie misses the point...they are not replacements for meals, they're supplements. And you can bet your ass that when I am old and missing my teeth, I'd take an Ensure over whatever nasty-ass holistic-organic-natural crap they'd try to feed me.

[JohnnyReb]

Just give me one of Momma's biscuits, a piece of country ham and a glass of milk.

[Chris]

Thanks Frank, its great when DUmmies pawn each other. 

Reality and DU mix like oil and water.  Okay, more like Pepsi and Mentos.

[LC EFA]

Thanks Frank, its great when DUmmies pawn each other. 

Their Sept 11 forum is great for watching them fight tooth and nail. It also houses some of their ..less sane .. inhabitants.

[The Village Idiot]

The elderly can have digestion problems or just not be hungry when they ought to be. That is why ENSURE exists.

[The Village Idiot]

Just give me one of Momma's biscuits, a piece of country ham and a glass of milk.

mmmmmmmmmmmmmmmmmmmmmmmmmmmmmm

[Chris]

Black-eyed peas, country ham, and a few vegetables... soup heaven.

[Traveshamockery]

I think I like Heddi.  And giving people who are elderly or have dementia something with sugar as the first ingredient?  Oh, that's horrible.  And since it's made by Abbott Labs, they obviously put extra ingredients in that makes them have uncontrollable cravings for things like Lipitor and other expensive medications made by Abbott Labs.

I love the old "my father had a feeding tube for a year so I'm an expert in medicine."  Yes, taking care of a sick family member is a learning experience, but most likely the family member has a doctor or nurse dealing with the details. 

[AllosaursRus]

Lord! I must be dieing or a real DUmbass since me and "Toots" have an "Ensure" every morning. Doc says; since I'm so much of a carnivore, I EAT MEAT and stay away from RABBIT FOOD, it would be a great idea if I drank a supplement in the morning with my coffee!

I had no idea! Go figure!

edited for content

[The Village Idiot]

Lord! I must be dieing or a real DUmbass since me and "Toots" have an "Ensure" every morning. Doc says; since I'm so much of a carnivore, I EAT MEAT and stay away from RABBIT FOOD, it would be a great idea if I drank a supplement in the morning with my coffee!

I had no idea! Go figure!

edited for content

ObamaCare might put ENSURE out of business

[Doc Savage]

Heddi had it right.  But she made the mistake of stating facts.  Suprised that she was not alerted on.

[AllosaursRus]

Heddi had it right.  But she made the mistake of stating facts.  Suprised that she was not alerted on.

Heh, heh! Chances are she was!

[crockspot]

I'm imagining a fresh wheatgrass juice, with green froth on top.

Mmmmmmm mmmm. Yummy for my tummy.

 

[The Village Idiot]

I'm imagining a fresh wheatgrass juice, with green froth on top.

Mmmmmmm mmmm. Y***y for my t***y.

 

Sounds like someone might throw it up.

[DumbAss Tanker]

"primitives squibble-squabble about feeding the elderly"

But feeding them to what, exactly?

[Karin]

Man, when those guys fight, they really go at it.  How come that never happens here?  The closest we came is when the Civil War came up.  Oh my.  I peeked my head in the door, then quiety snuck away. 

[Randy]

I'm imagining a fresh wheatgrass juice, with green froth on top.

Mmmmmmm mmmm. Yummy for my tummy.

 

You forgot the tastiest part...




a dollop of dirt.

 

[LC EFA]

You forgot the tastiest part...




a dollop of dirt.

 

That, ain't dirt.

It's organic fertilizer.

[Randy]

That, ain't dirt.

It's organic fertilizer.

Mmmmmmmmm Fert i lizer. /Homer

[GOBUCKS]

I think I like Heddi.  

Heddi is allegedly a nurse who is apparently skilled at her profession.
She is also a DUmmy with over 1000 posts, so outside the walls of the hospital she is a hateful leftwing enemy of everything we value.
Hard to like someone like that.

[diesel driver]

Mmmmmmmmm Fert i lizer. /Homer

Tastes like $h*t to me....   

[Token]

Oh jeez, all this "genetically-modified" and "whole foods" sort of stuff, ugh, I get about as tired of all that as you guys do. There's very little evidence for any of these fantasies about food and I find them tiresome. I don't get how my fellow liberals bemoan waste and self-indulgence, then go straight to GNC where they pay $10 for a bottle of "organic" grape juice. Oh well, there's one born every day, as PT Barnum said, and my side of the fence is by no means immune.

[franksolich]

Oh jeez, all this "genetically-modified" and "whole foods" sort of stuff, ugh, I get about as tired of all that as you guys do. There's very little evidence for any of these fantasies about food and I find them tiresome. I don't get how my fellow liberals bemoan waste and self-indulgence, then go straight to GNC where they pay $10 for a bottle of "organic" grape juice. Oh well, there's one born every day, as PT Barnum said, and my side of the fence is by no means immune.

I myself am not in favor of genetically modified foods.

However, genetically modified foods tend to keep grocery prices lower, and the primitives are always squawking about "high" grocery prices.

For me, this is one of the most confusing things about the primitives; they want to have things both ways--pure food and cheap food--when one can have only one thing or the other thing, not both things at the same time.

One can have either natural food that's not cheap, or cheap food that's not natural.