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A Survivor’s Guide Through a Healthy Kitchen Author: Bill Horton Introduction Diet and food preparation are special problems for those of us who have COPD, and the few articles I’ve found on the subject seem to be written by scientists, to scientists, and not very useful to the average patient or care giver. Those of us with COPD need more than just advice on the proper nutrients, maximum fiber and minimum salt. We must also deal with loss of appetite and/or poor senses of smell and taste, and we also have days when we fight that indigestion caused by our many medications. Some must also contend with excessive under or over-weight problems and, to make matters even worse, we are often dismayed by the energy it takes to just prepare and eat a meal. For many, there is also the problem of "getting on in years," and the need to prepare meals for only one or 2 persons (including the fun of trying to please the second palette), or the difficulty of standing while preparing the food, or tolerating the heat in the kitchen, or the complications of an accompanying health problem, like osteoporosis, diabetes, or "heart trouble." So, I've undertaken this project. But it’s a lot of ground to cover, so please understand that I must limit this project to specific COPD-patient concerns. Oh, I'll cover good general nutritional advice (like the use of minimum salt, moderate sugar, unsaturated fats, and lots of liquids) but those folk with dietary restrictions imposed by other diseases or health conditions will have to exercise the same caution they would with any "cookbook." I have a solid academic background in chemistry, nutrition, and physiology; I have COPD; and am a fair-to-middlin’ cook. But I am not a doctor, or a nutritionist, nor a dietitian. My advice should be reviewed by the patient’s physician and specifically excludes consideration of dietary implications of any other diseases. I dislike reinventing things, so I will refer you to other common, readily available (free, on the Internet), sources, for details, background, or related information. This will allow me to be more concise and avoid boring you with too much technical stuff. Those who are entirely new to the subject of nutrition may find the glossary to be helpful; it’s in the Appendix. Contents:
The digestive tract is a continuous tube that runs through your body from the mouth to the anus, with a number of separate, specialized sections. It’s purpose is to take in and process water and foodstuffs, and to extract from them the nutrients needed for life and health. For its entire length, the inside of this tube is coated with a mucous membrane (to protect and lubricate it) and contains a generous supply of minute blood vessels that carry away the nutrients and water, to organs and tissues that await their delivery. Humans are omnivores, meaning they are equipped to eat a variety of foods, including meats, grains, and fibers. Each part of our digestive tract, from our lips and teeth to our colons, is designed to accommodate and process a varied diet. But the stuff we eat must be digested before it can be utilized. That means it must be reduced to a water-soluble state in order to pass through the wall of the "tube" into the blood stream. The stuff we cannot digest (make water-soluble) is excreted as feces. Digestion begins in the mouth, when food comes in contact with saliva. As you chew (to reduce the food to more-quickly-digestible bits) enzymes in the saliva begin the process of converting starch to sugar, and breaking down other complex molecules. Once swallowed, the food goes to the stomach, where it gets an acid bath and a thorough churning and soaking, further reducing the physical size of the bits and simplifying their chemical complexity before handing the mixture off to the small intestine. Most digestion occurs in the small intestine: started by enzymes and stomach acids, the process is continued by friendly "micro flora" bacteria that convert fats, proteins, and some portions of fibers or bones, to water-soluble molecules. These molecules can then pass through the walls of the blood vessels and enter the blood stream. Once in the blood stream, these nutrients are available to every organ and muscle in the body, where they can be used for a variety of purposes. Some "foodstuffs," such as sugar, table salt, alcohol, and caffeine, are readily soluble in water and require little digestion before entering the blood stream. In fact you can often feel the effect of ingesting them within a minute or 2 or swallowing. Fats, proteins, and fibers are chemically and physically more complex and take longer to digest. It’s a wonderful system, able to accept all manner of foods and extract from them the stuff the body needs to survive and to thrive. But that is child’s play, compared to the system that delivers and uses those nutrients. Your body needs nutrients to support the daily activity of living, and to repair the normal wear and tear to the structure and the machinery, and to feed the systems that defend it from infections and things that would damage it. Some of these organs will use the stuff to remanufacture proteins, fats, fibers, and other non-soluble compounds needed to maintain your health; excess nutrients will be converted to fat and stored. Sound like a waste of energy? It is, but it’s necessary. If it were different, the body would lose it’s ability to move its resources around quickly and to use them where they are most urgently needed: fats couldn't be burned for energy, nor could they be stored as reserves, and vegetable proteins couldn't be substituted for animal protein when the hunter returned empty-handed. Believe me, it works better this way, even though you have little control over it. And you have precious little control. Your brain, with its auto pilots, senses your body’s needs and sets the priorities. Your brain, heart, lungs, and the regulatory glands get first crack at everything. If you are in danger, emergency supplies may be rushed to the legs and arms, and the digestive system will be told to shut down. Under normal circumstances, the repair of bone and muscle goes on, twenty-four hours a day, but during long periods of stress, (such as a major illness) there may be a shortage of some building materials, or fuels, and maintenance is deferred, causing you to incur atrophy and erosion. But, you do have some control, and you must use it, if you are to best manage your disease. You can regulate your diet to optimize your body’s supply of essential nutrients, and you can exercise regularly to help maintain a balance in its utilization of those nutrients.
You must keep in mind these basic facts of living with COPD:
COPD forces you to accommodate many changes in your life. To revise your eating and food preparation habits you need to retrain your palette and change some old habits. If you give my ideas a sixty-day trial, you'll explore many new flavors and textures that you will genuinely enjoy and, as you apply these principles, you will find yourself eating foods you like and will discover many ways to vary your menu to avoid boredom. Traditional wisdom has held to the rule, "Refined carbohydrates cause excessive CO, so get more calories from fats than from sugars." The new school says, "Calories are the key, get them right, other things follow. I subscribe to this position (see Appendix), and will prefer a diet that is at least as heavy in complex carbohydrates as in fats or oils. As mentioned above, many of us are "senior citizens" who live alone or have only 2 in the household. Under these circumstances, many of us find "cooking" to be such a bother that we skip meals or eat "convenience foods" or snacks. I'll attack that problem with menu ideas that make it easy to prepare several meals at the same time, freezing or refrigerating leftovers for future use. Grocery shopping can be fun but, if you are SOB and toting an oxygen bottle, it quickly loses some of its appeal. It also exposes you to inclement weather, allergens, and contagious diseases carried by the general public. I'll tell you how to stock your pantry and refrigerator to reduce the number of trips you make to the market, and I'll try to stay within your budget.
Nutrients may, generally, be grouped as carbohydrates, fats, proteins, and minerals. Water isn't a nutrient, but certainly is a requirement. Some purists say vitamins are essential, but aren't "nutrients." I include them all, because they are pertinent to the COPD patient’s regimen, and managing the disease demands a familiarity with them. As opposed to children, who need copious quantities of certain nutrients to support growth, adults need "only" the nutrients essential to maintain their bodies and furnish the energy for personal activity levels. Generally speaking, we require water to keep every cell healthy and flush out wastes; calcium and phosphorus to maintain our bones and teeth; proteins to maintain our muscles; fats and carbohydrates for energy, and; vitamins and trace minerals for nerve cells, etc. Should we have a good week hunting or fishing, or harvest a bumper crop of corn or peanuts, our bodies can store some of these nutrients for a while, to carry us through the lean times. Others cannot be stored and are required daily. (To keep it simple, you can remember that fats, proteins, minerals, and fat-soluble vitamins can be stored for future use and, conversely, that water, carbohydrates, salts, and water-soluble vitamins must be replaced daily.) Interestingly, during lean times when carbohydrates are in short supply, the body can substitute fat or protein as an energy source, whether it is being consumed in lieu of carbohydrates, or has been stored in muscles and fat deposits. The converse is not true, however; if fats and proteins are absent from the diet, the body can't manufacture them, regardless of how much carbohydrate is consumed. This leads us to the term, "balanced diet," the amounts of carbohydrates, fats, proteins, minerals, vitamins, and water, needed to meet the body’s immediate and long-term needs for these nutrients. It refers to the quality of the food one consumes. The quantity of food consumed is another matter, and can easily get into some areas outside my field of knowledge. I address the matters I feel germane to the COPD patient, including weight gain and weight loss, however, I urge those whose weight problems are associated with medications to seek the advice of both a pulmonologist and a nutritionist, for it is a medical (not nutritional) problem. I have included, in the Appendix, web resources to 2 computer analyses of your "ideal" body weight and an explanation of calculating your BMI (Body Mass Index) devised to calibrate "obesity." I urge you to avoid taking either as gospel, for I believe that individual physiology leaves a 10% to 15% margin of error, but they are the best tools we have. So, what are the nutritional requirements of an adult COPD patient? My approach follows these guidelines:
Serving sizes are a constant source of amazement and amusement, (especially the efforts of the experts to make them understandable to us common folk). One talks in terms of cups, ounces, and tablespoons, another in liters and grams, while someone else says, "large onion" and "medium potato," "the size of a deck or cards," or "as big as your fist." (I especially like that, because the bigger one is, the bigger one’s portions may be.) Whichever book you follow, you can be sure that few restaurants serve you a "single portion" of anything. I will keep it simple and consistent, using the old-fashioned measures of cups, tablespoons, etc., but it becomes relatively moot, as we progress, because the size of your servings will depend upon your personal likings, habits, and tastes. You should, however, learn to read and understand the nutritional labels now found on virtually all packaged foods. See the Appendix for details. The generally accepted standards for "servings," are expressed in these terms (from U.S. Department of Agriculture publications):
A peanut butter and jelly sandwich, then, is 2 servings of bread, 2 of sugar, and one of the meat/nuts category, demonstrating that shows that the "Daily Guide" of the USDA (below) does not imply that we eat to excess:
Following this "guide" will lead to a daily intake of 1,600 to 2,800 Calories, depending upon the choices you make and the number of servings you consume. It also assures a balanced diet, for each entry represents one of the "basic food groups" essential to your total nutritional needs. It’s not necessary to be fanatic about meeting each requirement every day. However, if you go heavy on veggies one day, and skip the meats, you should make up for it the next day or 2. At the very least, your menus should aim at maintaining a balance, across each week. Examples of "balanced daily menus" (both within USDA Guidelines) are: For one wishing to lose weight:
Those who need to gain weight:
If you are under or over-weight, and if your doctor has not advised a different course of action, and if you are serious about improving the situation, please return to the Appendix and re-read sections A and B, because for the next four weeks we are going to retrain your palette and we are going to find out whether the problem lies in your glands or in your hands. If, at the end of four weeks of following "my" diet and menus, you haven't made some progress, you really should insist upon different medical attention. The services of a certified clinical nutritionist, or a gastroenterologist are most certainly indicated. Now, go to Dietitian - Healthy Body Calculator (Johns Hopkins) and Nutrition Analysis Tool (University of Illinois) and calculate your "Ideal " weight and calorie requirement. These calculations will give you average values for average people who don't have COPD, based upon your input for "activity level." These values are the lowest levels likely to meet your needs because these formulae don't consider your need to expend extra energy to breathe. Add 15-20% and note the value (here________).
Refer back to the calorie count you noted, above. If you are underweight, add 750 calories; if you are overweight, subtract 750 calories; if you are neither, use the noted number. Now you have your personal goal for daily calorie intake; make a note of it (here__________). I now refer you to section C. of the Appendix. Study this carefully because it will make it much easier to meet your diet objectives. Now move to Section F. of the Appendix and click on Eating Right with CyberDiet. Browse through several pages and familiarize yourself with its content and organization. Bookmark this site because you will use it often, the first few weeks of this diet. Those who are over-weight should clean out cupboards and refrigerators of all candy, pastries, snacks, and other high-calorie foods that tempt you to overeat. If there are others in the family without a weight problem, let them keep that stuff out of your sight; otherwise, throw it out or give it away. Naturally, the opposite is true of you who are underweight; get rid of low-fat milk, yogurt, cheese, salad dressings, lunch meats, soups, etc., etc., etc. Section V. will deal with re-stocking your pantry; section VI. will discuss re-training the palette. For the moment, be assured that this "house cleaning" is essential to your success; you must change your eating habits. I’m now going to ask you to itemize everything you ate yesterday and, from the "Cyberdiet" data, to calculate your caloric intake and note it (here________). Calculate the difference between this value and your daily goal and note it (here________). Are you surprised? Given a realistic exercise regimen, the route to a good diet is the proper balance of nutrients, and the way to lose weight is to eat less; the way to gain weight is to eat more. The secret to accomplishing these goals lies in making food preparation easier, the results more appetizing and interesting, and in developing new habits. I hope you are not disappointed by the simplicity of this approach, but I never promised a miracle, or a rose garden and, while my suggestions may seem simple, many of you may find the process quite difficult.
Before we were side-tracked into the mire of the digestive process, nutrition, and over/under weight problems, I said my primary objective was to help COPD patients learn how to prepare nutritious meals with minimal effort. I also said I would cater to those who live alone or with only one "companion." It’s time to return to that tack. A well-stocked pantry is an essential to this objective, because it will allow you to act spontaneously, exercise creativity, achieve variety, and re-educate your palette, and save time. If you shop judiciously, you will stock up on those foods you enjoy most and wind up saving money, as well. Fresh produce is identified in the menus or recipes, as needed. Save wide-mouthed glass and plastic containers to store foods in the pantry and refrigerator after the package has been opened. You’ll need lots of pint and half-pint sizes and several as large as a half-gallon. A number of smaller containers will be needed for remainders from opened, half-used canned items. Reclosable plastic bags work well for many left-overs that go into the refrigerator or freezer. Fresh fruits and vegetables should be kept in paper bags in the refrigerator or (like onions and potatoes) in a net bag in a cool, dry pantry. For The Pantry:
For The Freezer: (packaged in single or double serving bags, when possible):
When I’m having one of my better days, I actually like to go grocery shopping; otherwise, I’d rather have a root canal. I know some folks who prefer shopping in the early morning, others like a midnight trip. You know yourself best. You know when you usually feel best, when the weather is likely to be kindly, the crowds the leanest, the clerks the most helpful. Pick those days and hours as your grocery shopping times, and prepare for them:
You will probably do all your shopping in one or 2 stores. If you are on oxygen, or if you have other physical complications, make your special needs known to the store management; some stores offer powered shopping carts, a clerk to assist you through the store, or other special services such as "personal" shopping and home delivery. They want your regular business and will try to accommodate you, even to special-ordering items not normally carried on their shelves. If you ever need help, ask for it. Give the store manager a copy of this booklet and suggest he give copies to other customers with similar needs. Some produce departments sell salad vegetables, sliced, cubed, or diced, by the pound, saving you the expense of buying whole heads of cabbage, cauliflower, etc., when you need only a cup or 2. They will usually cut their fruits (to allow you to sample the quality before buying). Avoid buying a lot more than you will use between shopping trips (but, of course, even if you waste 15 or 20% of some vegetable, your cost is much less than eating at a restaurant). When buying canned goods, get the right container size. If it’s in a resealable container, it’s easy to store the leftover portion and the larger size is usually more economical. If it’s a product you use frequently, or know you can easily incorporate into a second meal, or into leftovers that will freeze nicely, get the larger units. If it’s not resealable, or a commonly-used product, buy the next-to-smallest container; avoid paying the premium charged for "single-service" packages. When you find a desirable type of meat, fish, or poultry on sale, buy enough for several meals, then ask the butcher to cut it into meal-size pieces, wrapping each separately. (You can put them in plastic freezer bags when you get home.) This applies equally well to a large fish filet, a beef loin, or whole chickens. If you shop at a supermarket, they probably offer many items under their store brand. Compare food labels with your usual, national-brand, product. If they are equal in nutritional content, try the store brand, at least once. It could save you money and, if you really don’t like it, most stores will exchange the empty container for your favorite brand. If the grocery has an in-store bakery, look for their day-old rack. If you find whole-grain or multi-grain breads, buy a couple; you can always freeze the second one. Whatever you do, keep away from the pastries if they are not on your diet. However, once in a while, as your budget allows and your taste is inclined, you should treat yourself to a visit to the deli department and buy one or 2 side dishes for dinner, tonight, or pick up a special sandwich for lunch.
Proper planning of your menus will take into account the major factors in your personal lifestyle. Some of us still work or have commitments to care for grandchildren, or do volunteer work; some are early risers, others are night owls; most have limited energy and others have complications or disabilities from other disease. Give all these matters proper consideration and adapt my suggestions to your situation. My "rules" are few:
Keep the "basic food groups" in mind as you plan your menus and try to satisfy your personal requirements, and your caloric goal, every day. But it’s also important to consider other objectives: you should avoid meals in which everything is fried, or bland, or the same color. Your plate should please the eye and palette at the same time as it meets your nutritional needs. As you read my menu suggestions, try to picture each meal as if I were serving it to you; see if it doesn’t have more appeal than mayonnaise on white bread. When appropriate, my menus will suggest making enough for left-overs, then suggest how to use them. If your budget will allow it, vary your menus with some (not more than 25%) frozen entrees or frozen dinners. Some brands are delicious; some are even nutritious. Explore your supermarket for ideas and see how you can work them into snacks, salads, and old recipes. Breakfasts: The word, "breakfast," means, literally, "breaking of the over-night fasting period," and is the time to refuel your engine for the day. Skipping or skimping on breakfast can lead to the "ten-o’clock slump," when you find yourself weak, fatigued, or ravenously hungry. Use it as a time to pick up both your energy and your spirits. Make breakfast part of your daily routine. It’s also a good time to take your morning medications, including your daily vitamin tablet. You can follow any of these menu suggestions, regardless of your weight-gain or weight-loss objectives, simply by increasing or decreasing the serving sizes. Make your own variations, experiment, substitute grits for cereal, scrambled for poached, but eat a good breakfast.Again, I say, "Open your mind; experiment with new flavor combinations, different sauces, and interesting textures. Be careful, when reading these menus, or other recipe ideas, to watch for (and cross out) any foods to which you have an allergy or which are contraindicated with one of your medications. If you are uncertain, ask your doctor or pharmacist.
Okay, now you have the idea; every breakfast should include fruits, liquids, and an entree. For the sake of brevity, let’s just think of other entrees you might make easily and, if possible, with left-overs:
If you absolutely don’t have the time, energy, or appetite, drink an "instant breakfast." The national brands and store brands are pretty similar (check the labels) and, with whole milk, deliver about 335 calories. You can boost that to about 500 calories by using half-and-half, instead of whole milk, and you’ll kick it up even further if you put it in a blender and add ½ cup of ice cream or a tablespoon of canola oil (about another 100 calories). Each of these recipes is much cheaper than the canned "supplement" products. My friend, Mark Mangus, devised the following recipe for those who really need to gain weight, cautioning you to drink no more than 2 a day: Mix, in a blender or milkshake machine
TOTAL 750 calories** Mark suggests you vary the formula, from time to time, by changing flavors or adding fruits and juices to the vanilla variety. * If you use a lower-fat product, the calorie count will be reduced. Lunches Lunch can be the most difficult meal of the day to plan. Those COPD patients who live alone often find themselves unmotivated to fix a "real" meal; Those who are gainfully employed may "eat out" or carry a lunch; those who stay at home while the spouse works will have to coordinate the lunch menu with a dinner menu that meets the needs of both parties. This should be a "pick-me-up-meal," the easiest of the day, requiring the least time and effort to prepare, but offering a variety of tastes, textures, and colors. It’s a good time to use left-overs. It’s a great time to try a salad or a raw vegetable plate. It’s also a good time to experiment. For example, if you include a raw vegetable plate, try dipping the veggie bits in one or more salad dressings, such as French and Blue Cheese, or sprinkling some, like broccoli, cauliflower, or asparagus, with rice vinegar. If you prefer the food blanched, try it, but stay with the dressings; this is part of reeducating your palette.
Other lunch entrees can include left-overs from last night’s dinner, or single-servings you have stored in the refrigerator or freezer. Enhance them with fresh vegetables, fresh or canned fruits, cottage cheese, yogurt, crackers or chips. Snacks: The nature of your snacks will vary, depending upon where and when you take them. If you work outside the house, you might like the pre-packed crackers with cheese or peanut butter, or a wide-mouth thermos with fruit or vegetable pieces in it. 2 virtually universal favorites are a trail mix, or nuts, in a plastic bag, and an "energy bar." If you’re at home, you can also enjoy corn chips, a chunk of fresh cheese, a glass of milk, or a dish of ice cream. My personal preference in snacks leans toward the nuts and seeds. They are rich in oils and proteins, have wonderful flavors, and keep well in the pantry or on an end table. I include walnuts, pecans, peanuts, sunflower, and pumpkin seeds. Most can be purchased in either salted or unsalted form. Try washing them down with a lemonade or limeade. You might enjoy yogurt with fresh strawberries, blueberries, or raspberries, or a gelatin mold with canned or fresh fruits. If you are underweight, or if your capacity just won’t handle the quantities in a suggested menu, you need more (and larger) snacks. If you are overweight, cut your snacks to the minimum required to take the edge off your appetite. Whatever you do, include your snacks in your menu planning and food journal. Dinners: Despite the best advice of dietitians and nutritionists, we tend to make the evening meal our largest. It may be because that’s when the spouse or companion is home, when we have had the longest time to prepare it, or because it’s the way we were brought up. If this is not true for your case, you may certainly substitute these menu ideas for those I listed for lunch, and vice versa. Some of the dinner menus call for preparing larger quantities than you will eat. That is deliberate; I will suggest uses for leftovers in the recipe section. [For the sake of brevity, I’m omitting the beverage in the following menus:]
Other easy-to-prepare dishes for dinner include a cold-meat platter (from left-overs or the deli) with a variety of crackers, breads, and mustard or relish; canned beans, served chilled, with diced onion, sweet pepper, cracked pepper, honey, and vinegar; large fresh tomato stuffed with tuna salad, dressed with a lemon or lime vinaigrette, and; on a cool winter night, it’s hard to beat a bowl of chili con carne with all the cornbread and "greens" you can eat. VII. Recipes and Food Preparation In the following recipes, I suggest the quantities of herbs and seasonings in rather vague or minimal amounts because our taste buds vary greatly, one from the other, and you should learn to taste each dish as you are preparing it and to adjust things to your liking. As you do this, make a note to yourself, so you can repeat your successes. I ask, however, that that you first try the dish with the minimal spicing-up, and give the flavor of your basic ingredient a chance to win your heart. (This is not my position when eating burgers at a fast-food joint; in that situation, I want all the condiments possible, to disguise the flavor of the meat.) When I suggest the use of salt, it is in the minimum quantity required to avoid "starchy" tastes in potatoes, pastas, etc. Most recipes are "no-salt added," allowing you to do this at the table, as you like. If I offer a choice of herbs, or you want to experiment further, look at the Appendix for a list of traditional herb applications. Try eating more and more of your vegetables raw; they have their maximum food value and flavor in this state. If you must cook some of them, try blanching or steaming, leaving them al dante (firm, rather than mushy.) When serving soups, try adding raw cabbage a few minutes before removing it from the stove, or some raw spinach or parsley after it leaves the stove and before serving. You may also add sliced or diced onions to a dish of beans, chili, or meat soups, and top it with shredded cheddar or grated parmesan or romano. I suggest contrasting textures, flavors, or colors in a recipe or menu, like a honey-lime vinaigrette, or adding pumpkin seeds to a salad. This is a technique of many chefs; it stimulates the eye and the palette, and it adds interest to every meal. Plan for left-overs. It takes little more time and energy to boil one or 2 extra hard-cooked eggs, slices of bacon, patties of ground beef, or servings of broccoli, cauliflower, etc., and many of these foods keep better after being blanched or cooked, than in their raw state. If you don't expect to use them immediately, most will freeze quite handily. Please note that my recipes call for extra large eggs and extra virgin olive oil. These are your best values and are usually the most healthful. If you don't have one, buy an egg poacher. They aren't expensive and the product is a tasty break from the fried or scrambled variety. Potatoes come in 2 basic types, "baking," and everything else. Baking potatoes may be called "Idaho" or "Russet." Others may be called "red," "new," California white," or "Kathadin," and they should be your choice for boiling, frying or adding to soups. Baking potatoes are drier and have a mealy texture; the others have more moisture and retain their firmness (if you over-cook them). I like store-bought tomatoes; unless I pay twice the usual price and they are tasteless and have no color. Unless you have access to true "home-grown" varieties, with the rich, tart flavor and deep red color, I suggest canned tomatoes, whole, sliced, or diced. Not only are they going to be less expensive, many brands now offer tomatoes with peppers, onions, herbs, and spices, making their preparation a breeze. Keep your mixing bowls and measuring cups convenient to your workspace. Have a half-dozen or so ramekins, custard cups, and cereal bowls at hand, to hold each ingredient as you dice, slice, or otherwise prepare it. It simplifies the mixing process greatly. When cooking a dish with mixed vegetables, add the longest-cooking item first and follow, at appropriate times with the others. For example, carrots take longer than potatoes, cauliflower takes a bit longer than broccoli, sweet peppers take longer than onions, and I like my garlic under cooked, rather than roasted. If you must add them all at once, cut the longest-cookers into the smallest pieces. If it is a meat-based dish, add the vegetables after the meat is nearly done. Don't undercook or overcook the vegetables; savor the individual flavors and textures. On the other hand, if you're making a stew, or chili con carne (which always tastes better when warmed-over), you should add the vegetables and herbs as soon as the meat has been seared. This allows the flavors to commingle (a process called maceration). Then, there’s the matter of sanitation. While I think the fears of e. coli and salmonella infections have been over-hyped by the media, the dangers are real enough (and the consequences for the chronically ill are dire enough) to warrant taking care when handling foods. First, I suggest you buy liquid dish-washing detergent with antibacterial additives and put it in a pump dispenser; secondly, wash your hands before handling foods; wash all fresh poultry in cold running water before cutting, trimming, or dressing it, then wash the cutting board with antibacterial detergent (rinsing thoroughly) before using it for any other purpose; take the same precaution with cutting boards and hands after handling ground beef; gently wash the shells of eggs with the same detergent if the eggs are to be used in an uncooked recipe (such as mayonnaise), making sure to rinse and dry the eggs before breaking; lastly, cook all ground meats, poultry, eggs, and pork thoroughly, and be sure your shellfish are fresh (or fresh-frozen). It can't hurt to rinse all fresh vegetables and fruits before preparing or eating them. Invest in a refrigerator thermometer and adjust your refrigerator to hold a temperature of 40 degrees F; your freezer should be set at 0 to 10 degrees F. Label and date everything that goes in the freezer; try to use each item before it reaches six months of age. If you have a steamer, try using a sieve suspended over an inch or 2 of water in a covered pot; once you taste veggies steamed al dente, you'll rush to get a real steamer or 2. By the way, you can steam 2 different items simultaneously, if their cooking times are the same. If most of your meals are prepared for one or 2 people, invest in several small covered, non-stick, saucepans and a small double boiler; they will make preparation and clean-up easier and faster. Many of my recipes call for chicken and fish to be cooked "skin-on, bone-in," then instruct you to remove and discard (or use in a broth) the skin and bones. This technique enhances the flavor, makes it more tender by retaining natural "juices," and provides the greatest nutritional value. Those patients who are unable to handle solid foods would do well to "drink" pureed foods. If you have a blender or food processor, you should be able to puree (not "blend" or ""whip") a variety of nutritious meals from either raw or cooked (or a combination) of vegetables, fruits, and (even) some meats. If it is necessary to thin it out, you can add apple juice, tomato juice, etc. VIII. Appetizers Quesadillas pronto
Assemble four quesadillas by layering the cheeses and chiles on four tortillas, covering each with a tortilla, buttering one side and heating in a medium skillet or griddle until golden brown. Turn and brown the other side, remove to the plate, cut into quarters, and serve with sour cream and salsa. Options include adding slivers of cooked chicken, cooked marinated beef, or cooked crumbled sausage. Serves 4 to 6 Tortilla Roll-Ups
Spread the cream cheese on the flat bread, add the chiles and olives, then slices of the meats, in combination. Roll up, pinwheel style, and refrigerate for 2 or three hours, tightly covered. To serve, cut into ¾ inch slices. Serves 4-8 Gaspacho in a minute
Place the tomatoes, carrot, and garlic in the blender or food processor and puree. Add other ingredients to chop into "diced" or "minced" size. Chill and serve in a ramekin or soup dish, garnished with a slender stalk of celery. Try to resist the temptation to add a dash of vodka. Cheese Balls, by cracky
Cut the cheese into 1" cubes, roll into a ball, then roll in nuts, coating the cheese heavily. Serve chilled. Serves 2 - 4. IX. Desserts Rice Pudding a la Tony
Beat the first five ingredients thoroughly and pour the mixture into three large coffee mugs (or six ramekins, if you prefer smaller servings). Divide the rice and fruit evenly between the containers and stir gently. Place in a shallow baking dish, with a 1" water bath, and bake at 275 degrees about 1 ½ hours, until firm. Fruit Custard/Motley Medley Bread Pudding a la king Gelatins Aplenty Orange flavor with shredded carrots, raisins and walnuts (try pine nuts for variety) Fruit and Cheese Plate Medley Mothers’ Oatmeal Cookies
Preheat oven to 350 degrees. In a large bowl, combine flour, soda, ginger, and salt, then add remaining ingredients and stir well (but not overly long). Drop by tbsp, on an ungreased cookie sheet and bake 10 - 12 minutes, until edges are brown. X. Eggs Raw egg warning The American Egg Board states: "There have been warnings against consuming raw or lightly cooked eggs on the grounds that the egg may be contaminated with Salmonella, a bacteria responsible for a type of food poisoning…Healthy people need to remember that there is a very small risk and treat eggs and other raw animal foods accordingly. Use only properly refrigerated, clean, sound-shelled, fresh, Grade AA or A eggs. Avoid mixing yolks and whites with the shell." Those of us with COPD, or any chronic illness, should be especially careful to eat only well-cooked eggs and to wash our hands after handling egg shells (since that is where the bacteria is carried). Please, please, cook eggs with TLC. They should never be cooked over high heat, nor should they be added to a cold frypan. Treat them right and they will be tender and tasty; overcook them, they’ll be tough. This goes for "hard boiling" them, too; just simmer for 10 minutes, then cool quickly in iced water. 2-egg Omelet, plain
Beat eggs and water until well blended, incorporating some air into the mixture. Heat a 10-inch non-stick omelet pan or skillet and add butter or oil. When hot enough to "sizzle" a drop of water, add the egg mixture. The mixture will quickly begin to set at the edges. Using an inverted spatula, draw the cooked portion into the center, allowing the liquid to flow to the edges, tilting the pan as required.. Repeat until all egg mixture is set to desired firmness, add ¼ to ½ cup of other ingredients (if any), fold with spatula, and slide onto the plate. Serves 1 Scrambled Eggs Plus
Heat butter in non-stick frypan over medium heat, sauté` onion and pepper briefly, add bacon, then eggs. As the whites begin to cook, stir gently to desired state of "done-ness." Serves 1 Frittata Prego
Heat oil in large cast iron (or non-stick) skillet and brown the potatoes. Add onions and peppers and sauté until al dente. Add leftover cooked meat. Thoroughly beat eggs and cream in a small bowl, add herbs and black pepper, then add to skillet and stir to blend. Cook one minute on stovetop, then sprinkle with the cheese and place under broiler for 2 or three minutes, until the frittata puffs. XI. Grilling The Grill Drill Example 1 Chicken should be grilled with skin-on, bone-in, to hold juices in, get maximum flavor, and keep it tender. Remove skin and bone at the table. Try it au natural, or marinated in a vinaigrette of extra virgin olive oil, lemon (or lime), and mashed garlic. XII. Leftovers Leftover, not Leftout Salmon Patties a la Sir William
Combine the ingredients thoroughly in a medium bowl and allow to set, refrigerated, for 2 hours. Make into patties, adding water (if necessary) to hold together, and sauté` over medium heat until golden brown. XIII. Meat, Fish, Poultry Poached Chicken Breasts (etc.) Place the chicken parts in an appropriately large sauce pan and add cold water to cover to a depth of 1 inch. Remove the chicken to a clean bowl, add salt to the water, to taste, and bring to the boil. Return the chicken to the pot, bring back to a bare simmer, and hold, uncovered, for twenty minutes. Remove the pot from the heat, cover, and allow to stand for thirty minutes. Carefully lift the chicken from the pot and allow to cool. When tolerable to handle, remove skin and bones and return them to the pot. Store the chicken meat in appropriate container and refrigerate, or add to your immediate recipe. Return the pot to the stove and bring back to a simmer, cooking for thirty minutes longer. Remove and discard bones and skin, then pour broth through a sieve, into storage container. Refrigerate and, when cold, skim off the fat. Use in recipes calling for chicken stock or broth. Chicken Nicoise Salad
Combine ingredients in the order given, garnishing the plate(s) with the cilantro. Serves 1 to 3 Chicken, Black Bean, and Corn Salad
Combine chicken, beans, corn, and peppers. I a separate small bowl, mix sour cream, mayonnaise, and oregano thoroughly, then stir into chicken mixture. Refrigerate for one hour or more. Serves 1 or 2. Salmon, Baked with Dill
Preheat oven to 375. Rinse the fish and remove any loose scales. Spread vegetables in the center of large piece of aluminum foil, sprinkle with dill weed. Pepper the flesh of the salmon lightly and place it, skin-side up, on the vegetables. Lift the foil into a shallow baking dish, add the water, and close the foil tightly. Bake for 45 to 60 minutes, until the fish flakes off the skin.* Serves 4 to 6 *When you remove the salmon from the oven, hold the vegetables and juices in a small sauce pan, to which you then add the fish skin and bones (if any), add water to cover, then simmer for 30 minutes. Strain the broth and save for stock. Cajun Finger-Lickin’ Chicken Fingers
*you may substitute chicken thighs, or use a combination of meats. XIV. Salads Bean Salad, unadorned
Combine the first five ingredients and allow to blend flavors for 2 hours. Serve chilled or at room temperature, garnished with the parsley. Serves three. For a variation, serve it, chilled, over hot, cooked white or white/wild rice mix. Pasta and Chicken Salad (based on a recipe of my daughter, Mary)
Remove and discard the chicken skin, cube the meat into bite-size pieces, and add to the pasta shapes. Add the celery, pepper, onion, herbs, and seeds, and mix thoroughly. Combine oil, lemon juice, and garlic in a small bowl, whisking into an emulsion, then drizzle over the mixed salad. Serve on bed of lettuce with sprinkling of pepper. About 4 servings. Spinach Salad "Grande"
to taste salad dressing a sweet-tart combination, like honey Dijon is best) Tuna Salad Supreme
Separate the tuna into flakes and combine with all other ingredients. Serves 2 Carrot Salad with raisins
Whisk oil and vinegar to emulsify, add mustard and honey, stir in carrots and raisins, and refrigerate several hours. Serves 3 Tostados Pollo
Fry tortillas, individually, over medium heat, turning once, until they start to puff. Assemble the tostado by layering the beans, chicken, lettuce, tomatoes, onions, and cheese. Sprinkle with cilantro and drizzle with lime juice and top with sour cream. A salsa is optional. Serves 2 Spiced Bulgar Salad
Pour boiling water over bulgar wheat, in a small bowl and cover tightly with plastic wrap. Allow to stand for 15-20 minutes. In a larger bowl, combine all other ingredients. Fluff the bulgar with a fork and stir into vegetable mixture. Taste, adjust seasoning, and plate. Serves 2 Citrus Salad Originale
Peel the fruit and, with a paring knife, remove the grapefruit sections from their membranous covers. Quarter the orange s and slice ¼ in thick. Gently mix all ingredients in a stainless steel or ceramic bowl, and chill. Makes six to eight servings. XV. Sauces Creamy Mexican Salsa
Mix thoroughly and refrigerate. Creamy Basil Mayonnaise
Whisk olive oil and lemon juice to an emulsion, add other ingredients, stir, and refrigerate. XVI. Side Dishes Three-bean "Salad"
Gently combine beans and vegetables in large mixing bowl. In small bowl, whisk olive oil and vinegar to an emulsion, stir in honey and mustard, pour over bean mixture, season to taste, and refrigerate several hours. Serves 8. Canned Tomatoes Primo
Gently combine all ingredients and refrigerate. Serves 2 to 4 Fruit Compote, stewed Cole Slaw, a la Gillette
Place cabbage in medium bowl. In separate bowl, mix all other ingredients, adjust for flavor, then pour over cabbage. Chill, covered, for 2-3 hours. Serves 3 or 4. Pasta and Rice Variations Spinach Sauté Italiano
Heat oil over medium heat in a large frypan, add garlic, stir, and add spinach. Stir gently until spinach is wilted, dust with pepper and serve. Serves 2. XVII. Soups Tomato Soup with pizzazz
Combine soup and water in sauce pan until smooth, add other ingredients and refrigerate for 2 to 3 hours. Heat to the simmer and serve. Serves 2. Lentil Soup to die for
Place ham bone, bay leaf, one cubed carrot, and one cubed onion, in a large stewpot with enough water to barely cover. Simmer for 90 minutes. Remove the bone to a large bowl to cool, then remove vegetables, using a slotted spoon, and discard them. When the bone is cool enough to handle, remove the tender meat, then return the clean bone, the fat, and the gristle, to the pot and simmer for 3 hours. Remove the bone, fats, gristle, and vegetables, and discard them. Pour broth into a large container and chill until the fat congeals. Return de-fatted broth to the pot, add carrots, onions, and celery, in ½ inch cubes. Bring to a gentle boil, add potatoes, in 1-inch cubes, and tomatoes, with juice. Add lentils, stir gently, add oregano and pepper, adjust for taste, and simmer for 90 minutes. Serves 8. Soup Stocks, the rules Soup Making, more rules Innovative Soups, no rules Leftover Soups, variations on a theme Chile con Carne, incredible
Heat the oil in a large stewpot, and the ground meat, crumbled into small chunks, and brown thoroughly. Add seasonings and pepper, and toast a minute or 2 to release the aromatic oils. Reduce heat to medium, add garlic, onions, peppers, and celery and cook until the celery is fork-tender. Add catsup and water and simmer one hour. Add kidney beans and bring back to a simmer, then add tomatoes and bring to a simmer for ten minutes. Serve topped with shredded cheddar cheese and cornbread on the side. Serves about 12. Cornbread
Preheat oven to 425 degrees, with a 12-inch cast iron skillet inside. In a large bowl, mix dry ingredients thoroughly. In a small bowl, beat eggs and oil thoroughly, add milk and mix well. Add liquids to dry ingredients, stir briefly but well, and pour into hot skillet. Bake about 20 minutes, or until golden brown. Serve with butter and honey, or with molasses. Serves eight. XVIII. Snacks Veggies de jeur Dips Away! Nuts To You Soft Foods, for those REALLY bad days Orange Fluff Pick-me-up
Combine all ingredients in a blender until smooth and foamy. Pour and enjoy. Serves 1 or 2. If you feel festive, garnish with a sprig of mint. Staples Potatoes, Plain and Fancy Example 1 split the baked potato, scoop out the meat and mash with grated cheese, bacon bits, and/or diced onions. Return mixture to the skins and heat 3 or 4 minutes in the microwave. Works equally well with left-overs. Rice, With Interest Learn to love this staple food. It lends itself to many applications. These recipes ideas explore the basic, converted white rice most common to American palettes and are based on the typical recipe for preparing boiled rice: bring 2 ¼ cups salted water to the boil, add 1 cup of rice, reduce heat to a simmer, cover and cook twenty minutes, at which time you remove from heat, stir, replace cover, and allow to rest five minutes. This produces a relatively moist product with grains that separate easily. Try the brown rice, wild rice variations, etc., on your own. Variation 1 use chicken stock to cook the rice, adding bits of cooked chicken and/or shrimp, and ¼ cup raw, diced celery during the final five minutes of simmering. Add peanuts, allow to sit for five minutes, and serve. Season at the table with herbs. Barley, For A Change Often overlooked in most kitchens, barley is a wonderful change of pace from rice, potatoes, and paste. Try the following recipe, served with ham or chicken. Apricot-Barley Sunday Casserole
Preheat oven to 325 degrees. Heat the oil in a large frypan, over a medium heat, and sauté` the nuts, barley, and onions for five minutes, then transfer to a 2-quart casserole. Add broth, apricots, and dried fruit, and stir. Bake for one hour or more, until barley is al dente. Serves 2 or three. Pasta, Pasta, Pasta Pasta Shells with Sausage and Broccoli
Heat oil in skillet over medium heat and sauté garlic for twenty seconds, add chicken stock, broccoli, and sausage and simmer, covered, until broccoli is fork tender. Add pepper to taste, add pasta and toss, then take to the plate. Serves 2. Pasta e Fagioli, mangia, mangia
Bring the ham stock to a simmer in a 2-quart saucepan, then vegetables and simmer until celery is tender. Add beans, with their juices, the oregano and pepper, and simmer ten minutes, during which time you cook the pasta. Drain the pasta and put one half on each of 2 dinner plates, ladle the beans on the pasta and enjoy. Serves 2 Spaghetti with Sausages a la Jackie
Separate the sausage links, prick the skins several times with a sharp fork, and simmer in a one-quart saucepan for fifteen minutes. Remove sausage from saucepan, discard water, and brown the sausages for approximately ten minutes, turning often. Drain off any fat in the pan, add olive oil, garlic, onion, celery, and pepper, and sauté until celery is tender. Add tomatoes, herbs, and pepper, and simmer for thirty minutes. Pasta e Olio, caio
Simmer the pasta for eight to ten minutes, until tender to the tooth (al dente). While it is boiling, heat the oil in a large frypan, over a low heat, and sauté the garlic and the pepper. Remove from heat, add the cooked, drained pasta, toss to coat, and serve. Serves 2. Stir Frying Get into the Stir Beef With Broccoli
In a small bowl, mix the first six ingredients and let stand. Heat the oil to almost-smoking (drops of water dance) and brown the meat. Add other ingredients in the order shown, stirring each to coat in oil and cook briefly. When broccoli is fork-tender, add the sauce and cook until it thickens. Serve with steamed/boiled rice. Serves 2.
Thanks to my Kitchen Kabineteers, Yvonne Bedson, Lenore "Lee" Elkan, Gary Leach, Jane Gillette, Olivija Gwynne, Dorothy Manley, Terry Martone, Dori Moynahan, Jack Peterson, Ron Peterson, Bill Powell, and Anne Shea, for your encouragement, advice, and proofreading. Bon Appetit |
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