December 14, 2011

Better Versus Best

I almost called this post Dessert or Desert? But then I figured people might think I was going to talk about how bad spelling is on the internet lately.  No, I'm not - we all know how rotten spelling and grammar are getting these days and it's hardly news.  What that alternative title refers to is the trouble with actually finding real food in so many places these days.

As happens from time to time, I made some tactless comments with good intentions online, and managed to upset some people.  Part of it is that I forget how incredibly lucky I am.  Even though I live in small-town Western Australia, on a very low fixed disability pension, I can still manage to find (and grow) decent fresh food.  It still staggers me that with all the advances in modern civilization, and the explosion of consumer choice - I mean just think of the sheer SIZE of a supermarket these days - that an enormous percentage of the Western (especially American, it has to be said) urban population lives in a virtual food desert.  There is either no fresh or whole food available, or it is priced beyond the ordinary means of the average locals.  Very often what is available is factory-farmed, genetically mis-manipulated, artificially grown, processed, and OLD beyond belief, to the point of providing very little nutritional value.  But you can always find a cheap, tasty, fat-and-sugar laden frozen dessert made on a factory line somewhere from a bunch of industrial by-products from stuff that might once have qualified as food, or might not.

Really.  There exist in countless cities, towns and communities whole neighbourhoods that have NO access to fresh or whole foods.  And we tubies live in those places, too.

This is all a terrible shame, and an indictment on all of us; that we have allowed the very foundation of our health, wellbeing and even social fabric - food - to be so completely taken away from us in this way.

So while we all do what we can to fix our broken societies, we make do, and work around the problems as best we can.  That's why I ended up calling this post Better Versus Best.

It's all a matter of degrees after all, isn't it?  The decisions we make about our nutrition, I mean.  You all know I make a trade-off between the best possible nutrition I could have and factors lie ease, convenience and price.  Along with my pretty-good blends I use canned formula quite regularly; it's especially handy for going out places.  Again, I'm lucky in that I can handle it (as long as I have plentiful good food to balance it out), formula is subsidised to some degree by my government health system, and I CAN make blends of great fresh and whole foods.  Still, for various mainly psychological and availability reasons, I cut corners too and use pre-prepared stuff in my blends.  There is no good reason for me not to do this, as overall, my diet is good.

What to do with a Tube Food diet when you live in a food desert though?  Do you just throw your hands in the air, throw in the towel, and figure you can't win anyway?  No, of course you don't.  To torture some metaphors a little further, that knowledge you have gained about Real Food means you can't just stick your head in the sand now.  Or maybe there is a tiny bit of an oasis available to you, but you just can't afford the prices the locals charge for the good stuff.

Speaking of torture, some people find themselves in other invidious positions of bondage about the sorts of blends they feel they 'can' do.  I lost count a long time ago of the number of stories I've heard of threats from dietitians, doctors, and so on to call in child protective services, to refuse treatment, to even remove foster children from custody, for 'transgressions' such as daring to feed your child actual food, even when you can demonstrate very clearly that it really is, in fact and actually, far better for them than what has been prescribed.  I hear of dietitians who grudgingly agree to trials of blended food, insisting that parents and carers stick rigidly to recipes made for them by the dietitian, composed of highly refined or processed foods, fortified with all manner of artificial additives, presumably so they can justify themselves to their superiors should things come somehow unstuck.  "See, I did it by The Book - it's not my fault it didn't work."  This is not all that rare, sadly, right now.

What to do in the face of all this?  What I forgot when I offended by commenting on someone's blend (when I erroneously thought they were also saying their child had all sorts of terrible gastrointestinal issues, probably from the food) was my relative good fortune.  Turns out the child in question is actually thriving now they're off the formula, and given the situation with an obstinate RD, a foster-care situation and the subsequent financial difficulties with what is a pretty decent blend, all things considered.  One could never fault the parenting of the person in question.  This blend works for that child, and works for the family situation, so that's what matters.

The take-home message is that we might not be able to do best all or even some of the time, but that needn't stop us from doing better.

When people start using a blender to prepare food, and start dabbling in nutrient and calorie factors, a funny thing happens:  We get a totally different perspective on what is, and isn't food.  The scales fall from our eyes and we read ingredient labels, and discover things like The Thousand Names Of Sugar.  Then, faced with an entire society seemingly designed to ensure the oral eaters consume as much as possible of fast convenience foods high in all the wrong things but many of which are so cleverly marketed as 'healthy choices', it's no wonder that some of us fall into despair and let it demotivate us from doing the best we can given what we've got.  You know, just blending up a Carnation Instant Breakfast sachet with some Corn Syrup, 2% milk and Cheerios.

You can make an argument that this blend is 'better' than a can of formula, but do you know what?  I personally wouldn't say so, unless it's better tolerated than formula, and there's other, good food in the diet as well.  Then sure, it's better.  And if that's all you can do, then do it well, and feel good about it.

It's really easy to go too far with our urge to nourish well, especially when we're blending for the health and maybe even the very survival of a child or loved one.  We can obsess to the point of paralysis, and in fact this is exactly what happens with so many people when they first come to consider a blended diet - the question of "but how do I make sure it's complete?" can seem so incredibly overwhelming, especially for the majority of us who know with certainty that our own diets are a compromise at best and a health disaster at worst.  We often have a lot to learn very quickly about basic nutrition and we feel we have to get it right; right now.  The pressure can be too much, so we fold and go back to the canned formula, or the Carnation Instant Breakfast the RD told us we could try with some applesauce if we really must insist.

When that happens we can't feel sure of what best is, so we never move to something better.

And as with all things in life, it's a matter of direction and degree, not of absolutes.  This all applies to how oral eating folks nourish themselves too, you know.  As long as we're constantly looking to do better, we'll be moving always towards best.  Don't be holding out for best just because you can only do a little bit better.  DO that little bit better.  Better is the right direction.



  1. This is brilliant and applies to everyone, though especially stressful or difficult for tubies due to the risk-averse (but not really--there's risk with eating processed food but they can control it more easily as you point out) medical "experts'" pressure. Beans and rice are great. They may not be fresh broccoli, but so much better than McDonalds. Better is good enough. Just taking one extra step at a time. Getting in tune with our "guts" in more ways than one takes time.

  2. Thank you for this article. I was feeling torn because I have had a lot to get done on a quilt so I can get it mailed in time for Christmas. I have three total care kiddos two with J tubes and one on Blenderized boluses. I because of time constraints gave her a few cans of Complete this last week as I did not have the time to make enough blend . She did fine but I was feeling guilty!

  3. another great post. and it applies to so much in life. the control freaks in the medical system still piss me off (especially since they don't have a leg to stand on! you are not protecting a child from "serious harm" -- which you need to show in order to keep on power trippin' -- by insisting on formula when a well-tolerated [key!] diet of food is the parents' choice/preference. [insert necessary qualifications/exceptions here]). good lord, that just made no sense. what i mean to say is: you're full of sh*t if you bully parents who want to feed their child real food [asterisk here, again!]. your job is to help, not hinder.

  4. this article has given a lot of oxygen to me to try for better choices, yes,i agree that predigested formulas, do provide a freedom to mobility as a tubie coz of its ready to use availability.uzma

  5. one tiny point (because I get stuck on minutia, that's just who I am). When we focus on fresh fresh fresh, we could actually do better, especially for people in food deserts. The broccoli found in the produce section of a discount grocer in an urban area is probably of way worse quality and lesser nutrition than the frozen broccoli in their freezer section, which was probably frozen less than 24 hours after harvesting.

    I use frozen vegetables for Fiona's blends, because she "eats" way healthier than I can get the other kids to eat, and it's not realistic to buy fresh spinach all the time in the small amounts that she, a toddler, "eats". And green beans, those are frozen, too, because right now, fresh green beans are prohibitively expensive, but they're one of the few green veggies the older kids (the ones who are new to the family and my veggie-feeding ways) will eat. So I buy a ton of frozen beans, and some of them go in Fiona's blend. But even if I were buying them fresh, I'd have to grocery shop several times a week in order to have them "fresh"er than frozen.

  6. Thanks for the input and feedback folks, this post sure is proving a little bit popular. Kate you're so right about the frozen vegetables being in most cases far fresher and better quality (and weirdly enough often cheaper) than the 'fresh' stuff they display in supermarkets. Amber's note about rice 'n' beans is great too imo; I base a lot of my blends around this very ancient, available and healthful combination.

    It IS really important to acknowledge the other factors of our lives in the decisions we make, but by being a bit creative, and doing a bit of searching and learning, we can overcome more obstacles to good, affordable, easy nutrition than we often allow ourselves to believe.

  7. I appreciate the effort and thought put into this post, Aadhaar. Some days it is a 'milk blend' with a fresh fruit and slice of bread. Some days it's brown rice, cauliflower, red pepper, broccoli, chicken, sesame seeds and kefir. Sure, it's all a balance. ~Tonya

  8. Wonderful post, Eric! That "better" attitude is a nice cure to perfectionist thinking that immobilizes us from even attempting a forward step. I think it applies to a whole lot more than just choices for which foods to include in our blends!

    Kate's point is well made. One of our television star chefs, Alton Brown, frequently mentions the nutritional and taste benefits of frozen veggies (and canned tomatoes, interestingly) over out-of-season fresh. We also use frozen veggies and fruits during the winter months. These were likely to have been processed at the peak of ripeness rather than having been picked immature and forced to ripen.

    But come summertime when the garden is exploding (and our silly chickens are laying again...not sure what's up with "the girls" this winter), it's wonderful to be able to be able to include lovely fresh veggies and fruits. Our family is so blessed to have room for a big garden, but it's amazing what you can grow even in a tiny yard.

    Doorless, I too break out a can of Compleat when life is crazy and experience your same guilt. Maybe we should ask ourselves if it is really any worse than a trip through McDonald's?

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