Archive for June, 2013

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Smoothies

June 27th, 2013

beet-smoothie1

 Who doesn’t love a smoothie?  It’s one of the best foods for people who need texture modification. They’re thick and they’re cold. Thick makes them safer to swallow and cold things make the swallow faster and more vigorous.

Smoothies are extremely versatile. There are dozens of recipe books , websites, and even smoothie juice bar/restaurants devoted to smoothies. Check out this website for example: http://allrecipes.com/recipes/drinks/smoothies/ or this one www.ehow.com/how_2217514_makesmoothies.html

There are an infinite number of combinations of vegetables and fruits, so you can be creative.  But whatever ingredients you’re using, you need to be sure that you thoroughly processed them (in a blender or food process)er, and that there are no remaining skins or seeds or other pieces left to float down the airway when swallowed. If in doubt, you can reprocess and then put the smoothie through a strainer.  As our goal is to have thick smoothies, follow the rule that the greater the number of frozen products you use, the thicker the smoothie will be. If your fruit or vegetable has a lot of fiber it will be thicker than those with less fiber. Water content matters, also, watermelon being one of the more “watery” fruits and hence will produce a more liquid smoothie. Nutrition content can be boosted by adding protein powder, tofu, milk or soy, or other nutritional supplements.

Here’s a basic formula for 2 tall servings (at least) of a fruit smoothie:

½ cup frozen fruit or vegetables

½ cup of fresh fruit or vegetable

1 scoop of protein powder

½ cup yogurt

¼ cup juice (optional)

Blend all together  for 4 to 5 minutes. Check for thickness. If not thick enough, process more.

My combination today was the following

½ mixed frozen mixed berries (from Costco)

½ fresh mango slices

1/2 cup plain Greek yogurt

1 scoop Vanilla Whey protein

 

Blended together, they resulted in a very thick delicious smoothie.IMG_0231

 

 

 

 

 

 

 

 

 

The formula is pretty much the same for vegetable smoothies, although I decided to try and use what I had in my frig which included kale and spinach. It ended up being quite tasty but exactly what we do NOT want in a smoothie. It was full of little particles even though I blended it repeatedly. I could feel little pieces clinging to my teeth. You can get into trouble with small particles falling into the airway under 3 different conditions: on 1) while you’re processing the food (bolus) through your mouth and you lose control of parts of it, usually because of tongue weakness;  2) if there is food left behind in your mouth (as in the case of this smoothie just described) or in the crevices within your throat or 3), rather rarely, as the swallow itself takes place because the airway stays open as you swallow. We want to avoid all three situations! So…I tried another mixture with success:

 

smoothest green smoothie

 

Blended Green Lemonade
serves 1-2

Ingredients:

3/4 cup water
1-2 kale leaves, stems removed
1/2 romaine heart
1/2 cucumber, chopped
1/4 ripe avocado
1/2 apple, cored
1 frozen banana
juice of 1 lemon
handful of ice

Directions:

Combine all of the ingredients in a high-speed blender, and blend until completely smooth. (You may need to use a tamper to help the ingredients reach the blades.)

Soft Scrambled Eggs

June 27th, 2013

IMG_0352Soft Scrambled Eggs

What packs more nutrition in a small space than an egg?  A large egg has 102 calories, minimal fat, nearly 7 grams of protein, and an array of healthy vitamins.  They’re also  yummy and good for you! What could be better? Perfect for breakfast, lunch, or dinner.

Eggs can be poached, scrambled, soft boiled,  baked, or made into a soft French omelet. Most ways of cooking eggs will make great food for swallowing.  Today, though, the focus is on the scrambled egg.

As is so often true in cooking, how to scrambled eggs engenders lots of strong opinions.  Today, we’re going to modify Julia Child’s approach. She whisked her eggs vigorously until they had a full head of froth but other cooks declare that the eggs not be whipped, but barely mixed.   Most agree with Julia , however, when she wrote in Julia’s Kitchen Wisdom (2000), that “Scrambled eggs should be soft, broken curds,” and the more tender and delicious they will be.”  You can see Julia’s technique on YouTube:  www.youtube.com/watch?v=1JUJ3IP8zA8.

In my opinion, it’s the ingredients and the slow stirring (I prefer using a rubber spatula) that will transform your eggs into soft curds of ambrosia.

Soft Scrambled Eggs

2 T.  salted butter

4 eggs, as fresh as possible

1
 tablespoon cream, milk, or crème fraiche, or water (not as yummy)

salt to taste

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Melt 1 tablespoon of  butter in a 10-inch sauté pan over medium heat.

 

 

 

 

 

 

 

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Meanwhile, break the eggs into a fairly large mixing bowl and whisk them until the whites and yolks are well blended and frothy bubbles begin to form on the surface of the eggs.

 

 

 

 

Add the milk or cream, and continue to vigorously  whip until frothy.

IMG_0341

 

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When the butter foam subsides, pour the eggs into the pan, lower the heat to medium-low and begin to stir—making sure to stir all parts of the pan to keep the eggs from sticking. Stir constantly while scraping bottom and sides of pan, until eggs are just thickened, creamy, and small curds begin to form, 3–4 minutes total. (If mixture begins to stick to pan while cooking, remove from heat; whisk gently for 30 seconds, then continue cooking over heat.)

 

Remove from heat.

 

  • Add 1/2 Tbsp. butter; whisk until melted. Season with salt; plate and serve.

 

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Foods that may fall in the airway or break apart

June 25th, 2013

 Dry muffins

Pound cake

Plain rice

Peas

Pound cake

Any soup with loose floating contents

Corn, mixed vegetables

Chili con carne

Minestrone and vegetable soup

Coconut

Fruit cocktail

Items containing celery

nuts, or raisins

Pretzels,

chips,

crackers, etc.

Bacon, sausage, ot dogs

Cheeses that crumble easily

Hard boiled or hard fried eggs

 

The swallow will usually be heightened if the bolus is:

 

cold

sour

hot

spicy

very sweet

 

 

 

Why thicken?

June 25th, 2013

mashed potatoesIf the food is thicker, it passes the mouth (the oral cavity) and holds together into a “cohesive bolus”. That is, it doesn’t break apart so that individual pieces can travel hither and dither down the throat into the airway and then into the lungs. Folks, this can be dangerous! Because food products that lie in the airway introduce bad bugs that can cause pneumonia.

So here’s one of the most important principles that the recipes in this blog will incorporate: there should be nothing eaten that has bits or particles that can break away from the mass of the bolus and drop into the airway. To meet that goal, the food will need to be thoroughly blended or strained. That is, the texture of the food is modified. Although, of course, there are many wonderful foods that are already thick enough and this blog has some yummy recipes for things like smoothies and ice cream and polenta and mashed potatoes, thick soup,and macaroni and cheese, and so forth. macaroni & cheese

So its no food that breaks apart: no popcorn for sure.No food that has two or more textures, vegetable soup, for example, that has a broth and pieces of vegetables. Does that mean no vegetable soup! No, no. It means that the batch of vegetable soup is run through a food processor, a blender, or attacked with an immersion blender until all the particles are gone, and there’s a smooth mass of soup. Now, that soup may still not be thick enough, so we’ll add perhaps a grated potato, or corn starch or potato starch that will be mixed into the soup to thicken it until there’s a thicker consistency that holds together when swallowed.

Soups are great and there’ll be a lot of soup recipes on this blog. We’ll try to make the soup as healthy as possible, with extra protein and other “good for you” ingredients. It can be hot soup, or cold soup. But it will be delicious. thick soup

But..what if you can’t cook? Don’t know the first thing about it. Well, you’ll just have to learn to do a few things, but it is possible to find plenty of nutritious foods in the supermarket  or the local deli all ready to eat or if not completely ready, merely needing a few adjustments.

Individuals without dysphagia have a protective cough. Food passing into the airway will cause a coughing fit. Think of what happens with popcorn when you’re at a movie and gobbling up those delicious kernels. All of a sudden, there’s an onset of a terrific cough. You feel something stuck–you can point to the outside of your neck and locate the place where it feels like something’s stuck. You cough and you cough and out pops whatever it was that triggered the cough in the first place, usually in the case of popcorn, its a little bit of skin from the kernel–a tiny bit–but it’s enough to cause a coughing fit and it’s enough for someone who has a problem to potentially have even a bigger problem

Thickened foods are safer, as a rule, for people with dysphagia. So the recipes on this blog specify ways to thicken. Naturally. That is, without commercial thickeners, products that are sold specifically to thicken foods or products that are themselves already thickened by these thickener.

These products are disliked by almost everyone who has had to use them on a regular basis. And whatever the manufacturers of such thickeners claim, the artificial thickeners make the food taste different, usually with an aftertaste that is unpleasant. The foods taste funny and they have a different mouth feel. In my classes that I teach on dysphagia, students who try the commercial thickeners find them barely tolerable and numerous research studies confirm this.

What I hope to show here is that there is a wide variety of delicious foods that can be prepared with “ordinary” kitchen products that are safe to swallow for most people with dysphagia. And, as an extra bonus, these are often foods that are called comfort foods and are loved by one and all. Of course, comfort food varies by culture and this blog hopes to include recipes from a variety of cultures.

But..what if you can’t cook? Don’t know the first thing about it? Well, it is possible to find plenty of nutritious foods in the supermarket  or the local deli all ready to eat, or if not completely ready, only needing a few additions to make it good and safe to swallow.

 

What’s this Blog About?

June 19th, 2013

Nutella-pudding

This is a blog for people who love to eat but have trouble swallowing. Mostly, these will be people whose problems have been called dysphagia by specialists. They’ve been told that they must have liquids that are thickened and foods that are thick and smooth, without any loose food particles (such as seeds or skins from fruit) that might be aspirated. Aspiration means that the food goes down the “wrong tube”–it goes into the airway and then into the lungs rather than down the throat and into the stomach.   Dysphagia has many causes and if you click here: http://www.dysphagia.com you can read about them.

Thickened foods are safer, as a rule, for people with dysphagia. So the recipes on this blog specify ways to thicken. Naturally. That is, without commercial thickeners, products that are sold specifically to thicken foods or products that are themselves already thickened by these thickeners.

What I hope to show here is that there is a wide variety of delicious foods that can be prepared with “ordinary” kitchen products that are safe to swallow for most people with dysphagia. And, as an extra bonus, these are often foods that are called comfort foods and are loved by one and all. Of course, comfort food varies by culture and this blog hopes to include recipes from a variety of cultures.

But..what if you can’t cook? Don’t know the first thing about it? Well, it is possible to find plenty of nutritious foods in the supermarket  or the local deli all ready to eat, or if not completely ready, only needing a few additions to make it good and safe to swallow.

 

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