Mother’s Day Dessert – Safe for the Whole Family

When I saw the cover of the May 2016 Better Homes and Gardens® magazine, I was inspired!

Mother’s day is right around the corner and what better idea than to make a delicious modified dessert for the mom who’s having trouble swallowing but that the whole family can share and enjoy.

The recipe in the magazine is for “Showstopping Meringue Desserts”. Crispy, marshmallow-y meringues are unsafe to consume for someone on a puree diet because they consist of several different textures and dissolve on the tongue, making it impossible to control the swallow. Add whole fruit and the original recipe is definitely off the list of “okay” foods if you are having trouble swallowing.

So I created a recipe that is every bit as beautiful and delicious.

The whole family can eat this and not feel like they are being cheated…just ask my girlfriends who ate these for dessert at our “girls’ lunch” yesterday!

This recipe is easy to make ahead and scale up or down, as needed.

  • 1 – 8 oz. brick Cream Cheese, softened
  • ½ cup Powdered Sugar
  • 1 teaspoon Vanilla Extract
  • 1 – 8 oz. container Whipped Topping, thawed
  • 1 jar Lemon Curd
  • Seedless Blackberry Jam
  • Blueberry Syrup
  • Mint for garnish, optional

In a large bowl, mix cream cheese with a mixer until smooth. Add powdered sugar and vanilla and beat until smooth. Fold in whipped topping.

Drop rounded half cup portions on a parchment lined sheet pan that will fit in your freezer. Form a well in each mound, making a shell, and freeze for at least 4 hours or overnight.

When you are ready to serve, peel the frozen shells off the parchment and place on individual plates or on a platter. Place the shells in the refrigerator for 20 minutes or allow them to sit at room temperature for about 10 minute so they can soften.

Add 1 1/2 tablespoons of lemon curd to each shell and top with small dollops of seedless blackberry jam and drizzle with blueberry syrup. Serve and enjoy!

Serves 8

The shells can be made ahead up to a month ahead, just freeze them until they are firm before you cover them with plastic wrap

.

If you are concerned about carbohydrates and fat, you can easily substitute Neufchatel cheese and “lite” whipped topping.

Nutritional Info each: 325 calories; 17.25 gm fat; 40 gm carbohydrates; 135 mg sodium; 0.33 gm protein

Advertisement

“How to Puree Just About Everything” – A How-To Video

Though I haven’t posted recently, I have been busy.

I am in the process of filming cooking lessons on the techniques neccessary to puree almost every food. There will be five lessons in all.

The cooking lessons will be on a DVD that will be included in the purchase of my care manual “Making Every Bite Count”. Because this information is essential to living on a puree diet, I hope to make all the full length videos available to view online for a small fee.

Through these cooking lessons, I will show you how to modify the foods you love so you can still eat them if you are on a puree diet.

First up: Meat

Pureeing meat can be a real challenge! Cooked meats can be hard to puree because meat protein form tight bundles that need can be difficult to chew, let alone puree. When pureeing meat, keep in mind that:

  1. you need to start-out with cooked meat
  2. meats that are easier to chew will also be easier to puree
  3. you’ll need broth or other cooking liquid
  4. you’ll need an instant food thickener to bind the puree into a cohesive mass for safe swallowing
  5. purees don’t have to be soupy
  6. purees can taste great!

This video is just a snap-shot of the full video, so take a look and get some ideas!


Perfectly Safe Popsicles

If you’ve been prescribed thickened liquids and you miss eating ice cream and other frozen treats, this video will help you

 


Want to make bread, cakes and baked goods safer for those with a swallowing problem? Watch this video!


Swallowing Problems? What to do about Thanksgiving dinner.

Family eating at the dinner table

Gathering at the holiday table is one way we share our love, show our humanity and honor our cultural traditions. For manyof us, holiday feasts like Thanksgiving and Christmas don’t feel like a holiday without certain well known and loved dishes. Traditional foods and recipes are handed down from one generation to the next, keeping alive our memories and honoring those no longer at the table.

For most of us, feasting with friends and family is basic to our humanity. But when you are having trouble swallowing, the act of eating can be scary, difficult or even dangerous.  Needing to be conscious of every bite you take, how you position your head and thinking through the swallow is no picnic! It can create anxiety, prevent you from being in the moment, taking part in the conversation at the table and enjoying the occasion like everyone else. Those who are recovering from a stroke, are having treatment for cancer or who are living with dementia may already feel isolated.  Not being able to share traditional family meals in a “natural” manner may be frustrating and challenging and can make matters worse.

It is understandable when those with swallowing problems may be tempted to “cheat” during the holidays and eat foods that are not part of their eating plan. Sharing traditional foods with family and friends is how we celebrate! Platters get passed and everyone takes a little bit of this and maybe a whole lot of that. Traditional foods have a special place at the holiday table but if those foods are the wrong texture, they can be a problem for someone who is at risk for aspiration. Aspiration is when a small particle of food or liquid enters the trachea (a.k.a. the airway or windpipe).  Aspiration can cause choking and aspiration pneumonia, both of which can be life-threatening.

Whether your family celebrates a holiday dinner with roast beef, turkey or ham, it is possible for someone with dysphagia to eat almost everything on the dinner table with a few modifications.

If you are on a Mechanical Soft Diet, remember to take small bites of soft, well-cooked foods. Add gravy and sauces to your foods to make them moister and easier to chew and swallow. Dark meat turkey is often more moist and tender so choose thigh meat and cut it into small pieces. Be mindful when eating foods with mixed textures. Avoid foods that aren’t easy to chew like nuts and raw vegetables. Stick with roasted vegetables and stay away from the crudité plate. Have the pumpkin pie instead of the pecan pie.

If you’ve been prescribed a puree diet, you’ll need a make a few additional modifications to many foods to make them the right texture for you.  To puree a single serving or two, you will find that a powerful mini food processor will become an invaluable tool.  Full-size food processors and blenders won’t work because they are too big to efficiently puree one or two portions to the correct texture. You will also need an instant food thickener like ThickenUp Clear® or ThickIt®.

Here is a puree plan for most traditional foods:

Turkey

Roasted Turkey/Beef/Ham/Brisket

  • In a mini food processor, place cooked a 2 – 3 oz. portion of cooked meat and process until finely chopped. Add 2 tablespoons of broth and process again until very finely chopped. Add 1 scoop instant food thickener and puree until smooth. The texture should be as thick as mashed potatoes. For visual appeal, place the meat in the corner of a quart-size zip-top bag and seal. Snip off the corner with the meat, and pipe the puree onto a plate in the approximate shape and size of a serving of meat.

Mashed Potatoes & Gravy

  • No modifications needed, just make sure the potatoes and gravy are lump-free and the potatoes are firm (not soupy).

Stuffing

  • Avoid stuffing. Try slurried dinner rolls (below) which taste a lot like stuffing.

Sweet Potatoes

  • Mash with lots of butter.

Green Bean Casserole

  • No mushroom soup allowed. Instead, puree a portion of well-cooked green beans and fried onions in a mini food processor with a small amount of cooking liquid. Add 1 scoop of Instant Food Thickener (I like ThickenUp Clear) and blend until smooth. You are looking for a texture like smooth mashed potatoes.

Dinner rolls

  • Use only soft dinner rolls. NO SEEDS OR WHOLE GRAINS! Make a slurry with ¼ cup of chicken broth and ½ scoop of Instant Food Thickener (ThickenUp Clear) and mix until it thickens. Pull apart the roll and cover with the slurry. Set aside for about ten minutes, until the roll has absorbed the slurry. Reheat as needed.

Cranberry Sauce

  • Canned smooth, jellied sauce is okay.

Pumpkin Pie

  • Filling only. No crust.

Apple Pie

  • Puree the filling in a mini food processor. No crust.

If you crave apple pie a la mode, check-out the archived recipe on this blog.

With a few modifications, you or someone you love can safely enjoy a holiday feast!


Braised Red Cabbage and Family Ties

With the change of weather and cooler temperatures, I’ve been craving braised red cabbage, something I don’t normally eat. But I don’t want just cabbage. I want potato pancakes made from shredded potatoes, or “rosti” which are Swiss hash browns and meat. Gotta’ have some sort of pork seasoned simply with salt and pepper; the darker the meat, the better.

I don’t normally eat this way. All summer, I live on salads and vegetable-based meals combined with some grilled meats and maybe some grilled fish. But for the last couple of weeks, I’ve wanted cabbage, potatoes and pork; German comfort food.

I think my craving may just have something to do with the genealogy my sister, Renda, has been doing.  Recently, she traced the maternal side of our family back to our great-great-great-great grandmother Catharine Brodbeck, who emigrated from Baden, which is in southwestern Germany, through the city of Breman, to the US in 1854. Catharine traveled with her nine (!) children on a small ship, landing in New York on the day after Christmas in 1854. She then traveled to Ohio to join her husband, the father of her children. Catharine had a total of 14 children but the nine she traveled with ranged in ages from seventeen to as young as four years-old.

When I think of the kind of woman great-great-great-great grandma Catherine must have been, I’m in awe. She traveled half way around the globe, without her husband, with nine children in tow. When she climbed aboard that ship, she’d left behind her home and her extended family. Like so many immigrants, she and her children left their homeland to escape war and economic hardship. Baden is on the banks of the Rhine River, an area that has seen struggle and conflict for centuries.

Once aboard that small ship, what was daily life like for Catharine and her children? How she they feed everyone?  What did they eat? I can’t imagine traveling for weeks and weeks with nine hungry, growing children.

And when they arrived in the US, how did the family travel the 540+ miles overland between New York and Ohio?  How long did that trip take? How did she feed everyone then? She and her children made this journey a century before the interstate highway system, with its convenient rest stops and exits for food and restroom breaks. Cars wouldn’t become commonplace for another six decades. What drive, determination and optimism they must have had to have completed just that part of the journey!

So, last night when I made a dinner of braised red cabbage with rosti and grilled country-style pork chops for my family, I thought of her. These foods I’ve been craving are traditionally German. Did Catharine feed her family these foods, as well? Is she why I crave them?  As I looked across the dinner table at my nine year-old son, I thought about Catharine. I could feel her presence so I told my son her story, which is his story, too.

Sharing and eating goes far beyond nourishing the body, it also touches the soul and honors the past. Braised red cabbage = family ties for me.

 Spicy red cabbage stewed with apples

 

Braised Red Cabbage

2 tablespoons butter

1 medium head of red cabbage, quartered, cored and cut into ¼ inch strips

1 tart green apple, skin-on, quartered, cored and cut into ¼ inch slices

¼ cup apple cider vinegar

¼ cup water

3 tablespoons granulated sugar

2 teaspoons salt

¼ teaspoon ground black pepper

¼ teaspoon ground cinnamon

In a heavy large skillet or Dutch oven, melt butter over medium heat.  Add the cabbage and apple and toss until all is coated with butter and begins to melt. Add the vinegar, water, sugar, salt, pepper and cinnamon and mix thoroughly. Reduce the heat to a bare simmer, cover and cook for about one and a half hours, stirring occasionally and adding more water, as needed, to prevent sticking.

This dish is even better the second day!

For a mechanical soft diet: no modifications.

If you are on a puree eating plan:

In a mini food processor, pulse ½ cup braised red cabbage with 2 tablespoons water. Once finely chopped, add ½ teaspoon instant food thickener and process until completely combine. It should have the texture of firm mashed potatoes.

Yield: 6 servings

97 calories. 3 gm fat, 17 gm carbohydrate, 4 gm dietary fiber, 3 gm protein. 800 mg sodium. 44% Vitamin C. 181% Vitamin A.


Autumn Pie Smoothies

apple drawing

Autumn is in the air and apples and pumpkins are in season.

It seems that everywhere you look, there are pumpkin-spiced lattes, pumpkin bagels, pumpkin cupcakes, pumpkin pancakes not to mention apple pie, baked apples, apple cider, apple this and apple that! Both fruits (and yes, pumpkin is technically a fruit!) are full of vitamins, fiber, phyto-nutrients and other goodness. Because pumpkin is full of Vitamin A and fiber, it is a super-food. Combine pumpkin with a powerful anti-inflammatories like cinnamon, ground ginger or other warm spices and you have an especially delicious super-food!

The old saying: “An apple a day keeps the doctor away” is grounded in truth…though the saying does not include the all-American apple pie…which is too bad! The good news is that an apple pie smoothie can be just what the doctor ordered when you have trouble swallowing and can no longer eat a traditional apple pie. This apple pie a la mode smoothie recipe includes great anti-inflammatory spices (cinnamon and ground ginger) that boost overall health and is so delicious that you won’t miss the crust.

These autumn-in-a-glass smoothies are delicious and nutritious…even if you are not having trouble swallowing!

 

Pumpkin Pie Smoothie

 ½ banana, chopped (and frozen is possible)

1 container honey Greek yogurt

4 ice cubes

½ cup canned pumpkin

1 cup orange juice

½ teaspoon pumpkin pie spice (or cinnamon)

1 teaspoon finely ground flaxseed meal

1 tablespoon honey, maple syrup or brown sugar (optional)

Place all ingredients in a blender and blend until perfectly smooth. If too thick or chunky to drink, add more juice and re-blend until smooth. Taste and adjust spices and sweeten, as needed.

Makes one generous serving

Nutritional Info:

375 calories, 12 gm protein, 4 gm fat, 73 gm carbohydrate. 388% RDA Vitamin A, 88% RDA Vitamin C, 30% RDA Calcium, 13% RDA Iron.

 

Apple Pie a la mode Smoothie

 ½ banana, chopped (and frozen if possible)

1 container vanilla Greek yogurt

4 ice cubes

½ cup canned apple pie filling

1 cup apple juice or apple cider

¼ teaspoon ground cinnamon

¼ teaspoon ground ginger

1 teaspoon finely ground flaxseed meal

1 tablespoon honey, agave nectar or brown sugar (optional)

Place all ingredients in a blender and blend until perfectly smooth. If too thick or chunky to drink, add more juice and re-blend until smooth. Taste and adjust spices and add sweetener, as needed.

Makes one generous serving

Nutritional Info:

475 calories, 12 gm protein, 4 gm fat, 103 gm carbohydrate, 6 gm fiber, 103% RDA Vitamin C, 28% RDA Calcium


Finally, a new Care Manual!

A care manual for living with swallowing problems.

A care manual for living with swallowing problems.

I’ve developed a tool for living with a diagnosis of dysphagia, it is called:

“Making Every Bite Count”

Cooking for Someone with a Swallowing Problem

This care manual helps you how to manage your condition and

keeps your information and research organized

It includes:

• Basic nutrition and how to make every bite count for someone who is having trouble getting enough to eat and drink by mouth.

• How to incorporate the standards of the National Dysphagia Diet into your normal eating habits.

• “How to Puree Just About Everything” – a cookbook with simple techniques on how to modify common, everyday foods.

• Delicious, easy recipes that the whole family can enjoy.

• Updated lists of regular, pre-made modified foods found in most grocery stores.

• Reviews of protein-calorie enhancers, specialty nutritional products, kitchen equipment and more!

• A swallowing screening tool.

• Pre-punched pages for monthly updates.

• Pockets and sleeves for keeping your paperwork and doctors’ orders in one place.

The purchase of this care manual also includes a monthly email update with seasonal recipes, advice, new product introductions and the latest information on webinars and support groups for living with or caring for someone with swallowing problems.

For more information or to order this care manual, please visit my website: http://www.dysphagiasolutions.com


The Perfect Puree Day by Laura Michael

Dysphagia Cafe

Getting proper nutrition can be difficult when you have trouble swallowing. The inability to eat the right foods safely can lead to malnutrition. Maintaining proper nutritional intake is a key to overall good health and a high quality of life1. The National Dysphagia Diet2 defined the standard of what pureed food is, but offers little information on how to incorporate pureed foods into an active lifestyle.

The Challenge: Is it possible to eat healthy and well on a puree diet without using your blender or food processor? Can you still eat out? Yes! Let’s answer that challenge by offering breakfast, lunch, and dinner options for those on a modified diet.

Breakfast. Pre-made smoothies, available in the freezer case at most grocery stores, are a good option. Custom-made smoothies can be found at Whole Foods®, Einstein Bros.®, McDonalds®, Starbucks® or any juice bar. Smoothies that contain…

View original post 937 more words


Cookbook Review – Part 2

Book 4.1

 

I purchased, read and tested recipes from the four best-selling “Dysphagia Cookbooks” on Amazon.  Each is well written and insightful but there are specifics that are unique to each book. Each is a “labor of love” for the author. If you purchase one of these books, I encourage you to read the forewords and acknowledgements as you will find something of value in each.

As a passionate cookbook reader, collector and author, I currently have more than 100 cookbooks in my collection. I subscribe to every food magazine that is currently published and I can’t seem to part with my 20 year collection of the now defunct “Gourmet” magazine. If you called me a “food-wonk”, you would not be far off. I have developed my own techniques and recipes and have combined them into a guide: “Cooking for Someone with Swallowing Problems”.  This guide teaches the techniques you need to modify everyday foods and beverages. It has recipes and suggestions for eating out and stocking your pantry with pre-made, common everyday foods found in the grocery store. This guide is designed as a reference tool so you can modify the everyday foods you love so you can come close to living the life you had before you developed dysphagia. It is available for purchase for $29.95, which includes shipping and handling. If you want to purchase one, contact me directly: laura@dysphagiasupplies.com.  As part of the purchase of the guide, you will receive monthly updates, articles and new recipes.

The four best-selling “Dysphagia Cookbooks” on Amazon are:

  •  “Soft Foods for Easier Eating Cookbook” by Sandra Woodruff, R.D. and Leah Gilbert-Henderson, Ph.D.  This is “A Complete Guide” to dysphagia management.  The first 101 pages cover everything you need to know about stocking your pantry with food and kitchen equipment, thickening liquids, staying healthy, special considerations and more! If you can, take the time to read the first 101 pages, they are truly enlightening. The approximately 200 recipes follow the National Dysphagia Diet guidelines. The recipes are simple and easy to follow. Each recipe includes nutritional information and offers suggestions for substitutions and modifications. There are also tips for menu planning. The last thirty pages lists support organizations as well as products, manufacturers and distributors of products that make life easier for living with swallowing problems.

 o   This book was written in 2010, therefore it does not list many of the, new or improved products, new suppliers and support groups that have been developed in the last four years and there are many.

  •  “Down Easy: A cookbook for those with swallowing difficulties” by Judy Best. This book is especially helpful for someone recovering from cancer. The author, Judy Best, a graduate of a Le Cordon Bleu cooking school, was inspired to write this book as her husband was recovering from throat cancer.  If you want to learn to eat again after you’ve been on a feeding tube, this book offers great tips. The recipes are simple, easy to follow, use whole foods and natural ingredients.  Each recipe also has a complete nutritional breakdown and addresses whether it is gluten-free. This cookbook would appeal to someone who is transitioning to “regular” foods.

o    The author has assigned her own “Down Easy Swallowing Levels”, so the recipes don’t follow the standards set by the National Dysphagia Diet. If you have been given a care-plan for the National Dysphagia Diet, it may be a bit confusing if/how you use the recipes.

  • The “Easy-to-Swallow, Easy-to-Chew Cookbook” by Donna L. Weihofen, R.D., M.S, JoAnne Robbins, Ph.D., CCC-SLP, and Paula A. Sullivan, M.S., CCC-SLP. Part one of the cookbook covers information about how we swallow, and gives tips for managing some of the conditions that occur with swallowing problems. Part two contains approximately 150 recipes that will appeal to someone who enjoys the basic American diet. Each recipe includes a complete nutritional breakdown. This book is written for someone who is on a “Mechanical Soft” diet or who just needs foods that are easy to chew. It doesn’t completely address purees and how to modify each recipe for a “Puree” diet.

o    Written about the same time the National Dysphagia Diet was developed, it does not use the same terminology.  This book was published in 2002, so it can be a bit hard to find.

  •  “The Dysphagia Cookbook” by Elayne Achilles, Ed.D.  In this cookbook, most of the recipes are written for someone who can eat soft foods.  The author offers good advice on how to stock your refrigerator and pantry with foods that are easy to prepare and eat. The book also offers tips for traveling and eating out. The approximately 150 recipes will appeal to a wide variety of people.

 o   The recipes do not use the standards set by the National Dysphagia Diet, so you may need to read carefully and adjust the final dish.  This book does not include nutritional breakdowns of the recipes.