Tube fed patients - does tube feeding keep us sick or even worse?

[Viala]

I don't know, but it seems a basic feeding formula keeping fresh in the fridge for a few days doesn't seems that difficult. Amounts would have to be calculated with cronometer.com

I compared formulas of Martin and Howard, they are not the same, the biggest general differences are in fats, carbs and ingredients, here's a comparison for 1000ml which is about 1540kcal:
M H
Fat 50g 77g
Carbs 190g 138g

Most minerals are in similar amounts and Martin's formula has 1,5mg Fluoride per 1000ml, I didn't check vitamins. Also ingredients differ a lot.

Here are Howard's formula major ingredients for comparison:
Purified Water, Organic Hydrolyzed Pea Protein, Organic Brown Rice Syrup Solids, Organic Agave Syrup, rganic High Linoleic Sunflower Oil, Organic MCT Oil, Vitamin and Mineral Blend†, Organic Flaxseed Oil, Organic Agave Inulin, Organic Pea Starch, Organic Sunflower Lecithin, Organic Locust Bean Gum, Organic Rosemary Extract, Organic Spectra™ Phytonutrient Blend‡.

There is also Vitamin and Mineral Blend and Organic Spectra™ Phytonutrient Blend including extracts and concentrates from vegetables and fruits, plant powders that you mentioned.

 

[pamojja]

fats, carbs and ingredients

Those have of course be addapted to an indivual tolerance. For exampe if I only go above 50-60g per day of net-carbs (sometimes fiber amount is added), I immetiately get diabetic. And since protein can't be increased too much (otherwise its converting into glucose too), I could only bulk up with healthy fats.

 

[pamojja]

• Water ..a high mineral content mineral water like Rodgaska DonatMg. Has 1g of Mg, 1.5g Na, ..and even 3mg of Litium per liter.
• Maltodextrin ..a bit of honey instead. For the bulk of carbs I would use plant powders available organic (brocccoli, kale, spirulina, beet, carrot, tomato, kelp, blueberry, acerola...), also digestion aiding spices
• Milk Protein ..curd from organically raised sheep or goat (non-A1 casein). Add other organic protein powders upto what's needed.
• Vegetable Oil ..demeter quality of greek olive oil. Liquid fish oil.
• MCT Oil ..organic
• Soy Protein ..soft boiled organic eggs pureed into the water/curd base
• Starch ..resitant potato starch. For more fiber would also add milled flax, sesame, chia seed, inulin..
• All the other essential vitamins and minerals most convinient with LEF-mix powder. Which sadly also contains Maltodextrin. Sunday.de doesn't has unneccesary filler and takes care to include organic ingredents, but don't have it at such high doses as in LEF-mix. They do have however a higher dose B-complex.

Just today after talking about, Sunday.de introduced a Multi similiar to LEF-mix also available as powder, up to Friday with a 10% discount (code: SUPPORT21): https://www.sunday.de/spezieller-bedarf/vital-21/

True Clean Label

• Highest purity, pure active ingredients: 100% active ingredients, without additives
• Free from any additives and adjuvants
• 100% declaration - all ingredients on the label
• We do not use any hidden excipients that do not require declaration
• Highly pure water and entanol extracts, free of extraction residues and solvent residues
• Without release agents such as magnesium stearate and silicon dioxide
• Without colorants like titanium oxide
• Without sweeteners like aspartame, dextrose or sugar substitutes
• Without artificial preservatives like sorbic acid
• Free from nanoparticles
• Free of allergens and incompatible substances (lactose, gluten, histamine)
• Vegan, without genetic engineering
• Free from pesticides, radioactivity and heavy metals
• Bottling and encapsulation in the EU, certified according to HACCP, GMP / ISO 22000 2005
• Manufacture in a manufactory on semi-automatic machines with low running speeds, low pressure and low temperatures for optimal preservation of nutrients
• High quality, light-protected glass packaging, guaranteed free of BPA and other plasticizers

Translated with www.DeepL.com/Translator (free version)

 

[Martin aka paused||M.E.]

Just today after talking about, Sunday.de introduced a Multi similiar to LEF-mix also available as powder, up to Friday with a 10% discount (code: SUPPORT21): https://www.sunday.de/spezieller-bedarf/vital-21/

Looks good... And it's cheaper thank you

Ingredients;
Vitamin C (lipid-coated, with citrus bioflavonoids) ⤉, L-arginine-alpha-ketoglutarate (2: 1) ⤉, glycine, choline bitartate, trimethylglycine / betaine, taurine, sophora japonica flower extract (with quercetin), magnesium bisglycinate, L-glutathione reduced⤉, vitamin E complex (natural tocopherols), L-ornithine⤉, L-tyrosine⤉, L-proline, retinyl palmitate, nicotinamide, L-tryptophan⤉, thiamine HCl, riboflavin, D-calcium pantothenate , Acetyl-L-carnitine, potassium citrate, Q10 ubiquinone⤉, L-histidine, R-alpha lipoic acid (Bio Enhanced®), zinc mono-L-methionine sulfate⤉, calcium citrate, lycopene (from tomato), pyridoxal-5-phosphate, Pyridoxine, lutein (from Tagetes erecta), sodium borate, silicon *, vitamin D3 (vegetable), manganese gluconate, methylcobalamin, D-biotin, lemon peel extract *, L-methyltetrahydrofolate (as calcium salt Magnafolate® Pro and glucosamine salt Quatrefolic®), sodium picolinate Selenium methionine, vitamin K2 MK7 all-trans microencapsulated (K2VITAL®), potassium iodide.

Edit: it lacks iron 🤔

 

[pamojja]

And it's cheaper thank you

It seems a bottle with the powder for €29,90 lasts 21 days. While the bottle with 240 capsules for €49,90 (exactly same ingredients; both without 10% discount) lasts 30 days.

Inhalt: 118,7 g

Inhaltsstoffe / 2 1/4 ML (5,65g) % NRV *

Vitamine & Coenzyme
Vitamin C 1000 mg 1250
Vitamin B1 (Thiamin-HCI) 45 mg 4091
Vitamin B2 (bioaktiv) 45 mg 3214
Vitamin B3 (bioaktiv) 50 mg 313
Vitamin B5 (bioaktiv) 45 mg 750
Vitamin B6 (bioaktiv als P-5-P u. Pyridoxin) 25 mg 1786
D-Biotin (B7, bioaktiv) 500 µg 1000
Folat (B9) (als Quatrefolic®, Magnafolate Pro®) 800 µg 400
Vitamin B12 (als Methylcobalamin) 600 µg 24000
Cholin (als Cholin-Bitartrat) 250 mg -***
TMG/Betain (bioaktiv) 250 mg -***
Vitamin A 3500IE (1050µg) 131
Vitamin-E-Komplex 200IE (133,3 mg) 1174
Vitamin D3 (pflanzlich) 1000 IE (25µg) 500
Vitamin K2 MK7 (100% all-trans, K2Vital®) 100 µg 133
Coenzym Q10⤉ 30 mg -***
R-Alpha-Liponsäure (Bio Enhanced®) 25 mg -***

Aminosäuren
AAKG⤉ 500 mg -***
Glycin 325 mg -***
Taurin 200 mg -***
L-Glutathion reduziert⤉ 150 mg -***
L-Ornithin⤉ 100 mg -***
L-Tyrosin 100 mg -***
L-Prolin 100 mg -***
L-Tryptophan⤉ 50 mg -***
Acetyl-L-Carnitin 45 mg -***
L-Histidin 25 mg -***

Mineralstoffe & Spurenelemente
Magnesium (als Mg-Glycinat) 150 mg 60
Kalium⤉ 35 mg 1,75
Zink 25 mg 250
Calcium 20 mg 2,5
Silizium (aus Bambus)* 3 mg -***
Bor 3 mg -***
Mangan 2 mg 100
Chrom 200 µg 200
Molybdän 75 µg 150
Selen (als Selenmethionin) 70 µg 127
Jod 8 µg 5

Pflanzenstoffe
Quercetin (aus Sophora japonica) 150 mg -***
Lycopin (aus Tomate) 20 mg -***
Lutein (aus Tagetes erecta) 6 mg -***
davon Zeaxanthin 1,5 mg -***

* aus Anbau ohne Pflanzenschutzmittel
⤉ aus Fermentation
** der Nährstoffbezugsmenge
*** Keine Referenzmenge

Edit: it lacks iron 🤔

Also LEF-mix lacks iron. Since iron should only be supplemented with tested deficiency. Of course, in your case you'll have to include a source of iron. Upping some of the essential minerals: copper (cocoa powder), iodine (kelp powder) and selenium (brazilnut butter) too.

Content: 360g

Serving Size 3 scoops (approx. 12 grams) (per day)

Servings Per Container About 30

Amount Per Serving

Vitamin A (as beta-carotene, acetate) (5,000 IU)1500 mcg^
Vitamin C (as calcium ascorbate, ascorbic acid, ascorbyl palmitate, magnesium ascorbate, niacinamide ascorbate, acerola extract) 970 mg
Vitamin D3 (as cholecalciferol) (2,000 IU) 50 mcg
Vitamin E (as D-alpha tocopheryl succinate, D-alpha tocopherol) 67 mg
Natural mixed tocopherols (providing gamma, delta, alpha, beta tocopherols) 60 mg
Thiamine (vitamin B1) (as thiamine HCl) 125 mg
Riboflavin (vitamin B2) (as riboflavin, riboflavin 5’-phosphate) 50 mg
Niacin (as 61% niacinamide, 38% niacin, 1% niacinamide ascorbate) 190 mg•
Vitamin B6 [as pyridoxal 5’-phosphate (100 mg), pyridoxine HCI (5 mg)] 105 mg
Folate (as L-5-methyltetrahydrofolate calcium salt) 680 mcg°
Vitamin B12 (as methylcobalamin) 600 mcg
Biotin 3000 mcg
Pantothenic acid (as D-calcium pantothenate with 5 mg pantethine) 600 mg
Inositol 250 mg

Calcium (as Ca ascorbate, D-calcium pantothenate, dicalcium phosphate) 140 mg
Iodine (as potassium iodide) 150 mcg
Magnesium (as magnesium oxide, citrate, arginate, glycinate, taurinate, ascorbate) 420 mg
Zinc (as zinc citrate, L-OptiZinc®3 zinc mono-L-methionine sulfate) 35 mg
Selenium [as sodium selenite, SelenoExcell®4 high selenium yeast, Se-methyl L-selenocysteine] 200 mcg
Copper (as TRAACS®13 copper bisglycinate chelate) 1 mg
Manganese (as manganese citrate, gluconate) 1 mg
Chromium [as Crominex®5 3+ chromium stabilized with Capros® amla extract (fruit), PrimaVie® Shilajit] 500 mcg
Molybdenum (as molybdenum amino acid chelate) 125 mcg
Potassium (as potassium citrate) 35 mg

N-acetyl-L-cysteine (NAC) 600 mg
Taurine 200 mg
Trimethylglycine (TMG) (as betaine anhydrous) 100 mg

Broccoli concentrate blend [broccoli powder, extract (sprout, floret, seed) (providing glucosinolates, sulforaphane)] 525 mg
Decaffeinated green tea extract (leaf) [std. to 45% epigallocatechin gallate (EGCG)] 325 mg
Acerola extract 4:1 (berry) 300 mg
Bitter orange citrus bioflavonoids (peel, fruit) [std. to 50% hesperidin] 200 mg
Fruit/berry proprietary blend [European elder, blackberry, blueberry, sweet cherry, cranberry, plum, persimmon (Diospyros kaki) powders] 200 mg
Wild blueberry anthocyanin extract (fruit) 150 mg
Sensoril®12 Ashwagandha extract (root, leaf) [std. to 32% oligosaccharides, 10% glycoside conjugates] 125 mg
Silymarin [from milk thistle extract (seed)] 100 mg
CherryPure®1 sour cherry (tart cherry) proanthocyanidin powder (skin) 85 mg
POMELLA®9 pomegranate extract (fruit) [std. to 30% punicalagins] 85 mg
MirtoSelect®11 bilberry extract (fruit) 30 mg
BioVin®7 grape proanthocyanidin extract (whole grape) 25 mg
Leucoselect®6 grape seed proanthocyanidin extract 25 mg
Bio-Quercetin phytosome (providing 5 mg quercetin [from Japanese sophora concentrate (flower bud)], phosphatidylcholine complex [from sunflower])15 mg
Bromelain [from pineapple (stem)] (2400 gelatin digestive units/gram) 15 mg
Lutein [from marigold extract (Tagetes erecta) (flower)] (providing 465 mcg trans-zeaxanthin) 15 mg
Olive extract (fruit) (providing polyphenols, hydroxytyrosol, tyrosol, oleuropein) 12.5 mg
Sesame seed lignan extract 10 mg
Luteolin [from Japanese sophora (flower bud)] 8 mg
Apigenin 5 mg
Boron (as boron amino acid chelate) 3 mg
Lycopene [from LycoBeads®8 natural tomato extract (fruit)] 3 mg
Delphinidins [from Delphinol®2 maqui berry (Aristotelia chilensis) extract (fruit)] 2 mg
Cyanidin-3-glucoside (C3G) [from black currant extract (fruit)] 1.25 mg

Other ingredients: maltodextrin, natural orange flavor, silica, stevia extract, luo han guo extract.

^RAE (retinol activity equivalents). °DFE (dietary folate equivalents). •NE (niacin equivalents).

edit: So by any means, if one wants the most for one bucks - especially by trying to get as much as possible at once for tube feeding - LEF-mix with its about 2g additonal per serving as plant extracts could never be beaten - by buying those plant extracts separate again.

What I do, in a different situation, I take half of the cheapest and in Vitamin/Minerals complete Multi: LEF-two-per-day capusules at $18,- per 120 capsules lasting 4 months. And add a bid of LEF-mix. So I get a bit of the advantages of both: at the cheapest price, with a bid of the most varied phytonutrients of any Multi throughout the day.

Serving Size 2 capsules
Servings Per Container 60

Amount Per Serving

Vitamin A (as beta-carotene, acetate) (5,000 IU)1500 mcgˆ
Vitamin C (as ascorbic acid, calcium and niacinamide ascorbates) 470 mg
Vitamin D3 (as cholecalciferol) (2,000 IU) 50 mcg
Vitamin E (as D-alpha tocopheryl succinate, D-alpha tocopherol) 67 mg
Thiamine (vitamin B1) (as thiamine HCI) 75 mg
Riboflavin (vitamin B2) (as riboflavin, riboflavin 5’-phosphate) 50 mg
Niacin (as niacinamide, niacinamide ascorbate) 50 mg•
Vitamin B6 (as pyridoxine HCI, pyridoxal 5’-phosphate) 75 mg
Folate (as L-5-methyltetrahydrofolate calcium salt) 680 mcg°
Vitamin B12 (as methylcobalamin) 300 mcg
Biotin 300 mcg
Pantothenic acid (as D-calcium pantothenate) 50 mg
Inositol 50 mg
Alpha lipoic acid 25 mg
Natural mixed tocopherols (providing gamma, delta, alpha, beta) 20 mg

Iodine (as potassium iodide) 150 mcg
Magnesium (as magnesium oxide) 100 mg
Zinc (as zinc citrate, L-OptiZinc® zinc mono-L-methionine sulfate) 25 mg
Selenium [as sodium selenite, SelenoExcell® high selenium yeast, Se-methyl L-selenocysteine] 200 mcg
Manganese (as manganese citrate, gluconate) 2 mg
Chromium [as Crominex® 3+ chromium stabilized with Capros® amla extract (fruit), PrimaVie® Shilajit] 200 mcg
Molybdenum (as molybdenum amino acid chelate) 100 mcg
Boron (as boron amino acid chelate) 3 mg

Bio-Quercetin phytosome (providing 5 mg quercetin [from Japanese sophora concentrate (flower bud)], phosphatidylcholine complex [from sunflower]) 15 mg
Marigold extract (Tagetes erecta) (flower) [std. to 5 mg trans-lutein, 155 mcg trans-zeaxanthin] 11.12 mg
Apigenin 5 mg
Lycopene [from LycoBeads ® natural tomato extract (fruit)] 1 mg

Other ingredients: vegetable cellulose (capsule), starch, maltodextrin, vegetable stearate, dicalcium phosphate, silica, microcrystalline cellulose.

also of note: all the LEF multis lack in choline.

 

[Lisa108]

Sunday.de belongs to the Schweikart group. I don't know how reliable / unreliable that is. His degree is in marketing.

 

[Lisa108]

For those interested in homemade tube feeding, there is a small pediatric study (the BLEND study) which found an increased calorie requirement (+50%) to maintain BMI while on blended diet.

They cite an adult study which also found increased calorie need, but for adults it was +20%.

(Reasons where unclear, assumed connection was the increased intake of fiber). Something to keep in mind for calculations...

Other findings after 6 months were: more diverse intestinal microbiome, less gastro symptoms and lower need for acid-suppressive agents.

[Page #1 of the supplementary material shows an example for what parents used as recipe. ]

 

[pamojja]

Sunday.de belongs to the Schweikart group. I don't know how reliable / unreliable that is.

Googling brings up different Schweikarts. Sunday.de isn't as relyable as for example LEF, for example they don't shy away to send you a particular ordered supplement lasting a year, but expiring already in 3 months. (Which however isn't an issue with newly indroduced supplements as this Balance 21 multi, at least 2 years from expiring.)

LEF would discount already expiring within half a year for half the price. However, that's sadly true for most other EU supplement sellers too, all are much less relyable than LEF or iherb.

But the most advantage with Sunday.de - beside trying to sell as clean products they're able to, in recycle-able glass-bottles too - is that they sell most at reasonable prices at larger bottles (60-360 caps per bottles) and at therapeutic doses. Otherwise simply not affortable from within the EU, or not even avalable.


The reason I like to depend mostly on EU supplements is, because Austrian customs are unpredictable dangerous. They simply seach a data-base for any ingredient of a supplement if it is found also in medication. if found they declare it as illigal medicine import (practically impossible to do for a private person), confiscate and fine €260,-. On repeat up to €2600,-.

If sort of lucky and the custom officer considers it only a minor offence the fine is only €50,-. With no recourse to a repeal. Happened already for ALA, silimarin and nattokinase to me (confiscated and €50,- fined each). The one fine of €260,- for a $10,- of TMG I repealed. And luckily they couldn't process my repeal in the required time, therefore the fine was droped. I want to avoid such rediculous judicary hassle in the future just because of taking supplements.

 

[Lisa108]

Googling brings up different Schweikarts

I was referring to Dr. Jörg Schweikart, who is a member of the executive board of sunday.de .

He is the editor of a (online) publishing company called Dr. Schweikart Verlag, www.drschweikart.com
They host a plethora of domains for health topics and products.

You'll find direct links to sundays.de from there. Not illegal, I guess.
He writes a lot of the articles (about medical topics) himself and answers health questions in the comments, always as Dr. Schweikart. Not illegal (as he earned his degree), but maybe misleading (as he is not a Dr. med.)?

The homepage of sunday.de looks great. All those clean products. But what is the "True Clean label"? Well, they invented (and trademarked it) themselves...
https://www.trademarkelite.com/europe/trademark/trademark-detail/018320988/TRUE-CLEAN-LABEL

And who tests the quality of the products? I've yet to find which (hopefully independent) lab they use. With other suppliers you'd find at least a certificate that the product was tested for mold or pestizides...

So, I really don't know. May be a great guy, with the best of intentions. Good at marketing? For sure!

Sorry for derailing this thread, @Martin aka paused||M.E. Feel free to delete.

 

[pamojja]

With other suppliers you'd find at least a certificate that the product was tested for mold or pestizides...

Once I asked in a pharmacy what would justify 5 times the price of their pure ascorbic acid powder, compared to that cheap in other shops. Since all these days anyway comes from China. Answer was each batch is tested on being real ascorbic acid, not on any contaminants.

Therefore the question: Which European supplement suppliers does, if not even pharmacies do? Could you name them?

Remember the carcinogenic found in some batches of metformin and recalled later?