Fight Cancer with Food Chaining by Cheri Fraker, …...Magic Bullet to blend. Think Feed Store Chicken salad consistency. Recipe is chicken, mayo, celery, sprinkle of white pepper,
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pot roast with vegetables. Patient wants to be able to eat these foods again. A Food
Chaining program was designed on this date to help this patient be able to eat past foods or
find new foods to add to the diet.
LEAST FAVORITE FOODS: Patient likes the following foods, but struggles to eat these food
items. Therapist provided suggestions to make foods easier to eat. Challenge foods
include: turkey, sausage (recommend that sausage be ground or blended in Magic Bullet,
add extra gravy) , pasta with heavy cheesy sauces (too sticky, avoid or thin sauces out with
more milk/liquids, or dip pasta in the sauce vs. coating with the sauce), highly seasoned
meats or hot BBQ sauce, Greek salad
PATIENT GOAL FOODS: Patient is requesting help with eating any of the five favorite
foods (spaghetti, hamburger, salmon, chicken, Thai food) as well as French bread with
butter, Chef salad, homemade chicken and noodles, pancakes or French toast. Therapist
suggested the following modifications to goal foods to make items easier to eat:
Goal Food Modifications/Food Chains-suggested new foods
Milk and Juice Thicken with ¼ tsp Jello Instant Pudding Powder (regular or sugar free) to 4-6 ounces of cold milk, shake vigorously. Makes a smoothie consistency drink.
Juice can be mixed with pureed fruit and ice, drinkable yogurt can be added also. Fruit Chillers, Italian Ice and Dole or Edy’s 100% Fruit Bars –
you can also let these melt down and drink if desired.
Breads/Pancake/French Toast, Hot Rolls, Toast, Crackers, small croutons
Cut foods such as pancake, French toast or soft breads into narrow strips or small pieces. Aldi’s French toast sticks are a good option in smaller pieces. Dip into syrup. Too much syrup may be difficult to control. Powdered sugar may also be an option (light dusting).
French bread is very chewy and may be more difficult to manage. Approach carefully. Inner part of French bread may be OK, pull off pieces.
Pull off small parts of hot rolls, Hawaiian bread or yeast rolls. Place under biting surfaces. Spray butter or spread, cinnamon butter (Land O Lakes) is also a good option.
Toast may be easier than some breads. Smaller pieces or strips of toast (no crust) may be easier.
Crackers-Roasted Vegetable or Whole Wheat Ritz crackers, Club Crackers, graham crackers are good options.
Meltable solids include peanut butter, sugar and shortbread cookies, vanilla wafers and pudding..
Noodle/Pasta dishes Pad Thai noodles, spaghetti noodles,
chicken and noodles can be chopped (in small regular size pieces) and mixed with additional sauce as a “binder” foods.
Instant potato flakes can be used to bind noodles or thicken any broth soup for extra calories and control.
Whipped sweet potato, a tomato based puree, whipped/blended spinach, etc can be in one section and used to ‘glue’ chopped many foods together. (Example: Alfredo sauce, chopped noodles and spinach
blended as a binder) Thicker sweet tomato basil soup may
be a great option for you (Lake Point Grille in Chatham has a great soup-be creative when you cook and reduce liquid slightly for more of a puree texture)
Find foods that compliment one another
Sauces can be separated from pasta, put cream sauce in a separate section or small bowl, dip to desired coating
Chicken and noodles can be blended, this is a balancing act. Keep good supplies of chicken broth, cream soups in your pantry. Chicken soup can be thickened with Cream of Chicken soup. It will be too hard to eat bites of chicken, noodles and broth at the same time. Separate and blend cooked chicken. It will have a lot of flavor and you can make it easier to eat by coating in thickened broth.
Meats Salmon and chicken can be shredded and paired with a cream sauce or mixed with pureed sweet or white potato to help bind the food item together.
Salisbury steak and Meat Loaf are good options
Egg salad, ham salad, tuna salad, seafood salads, chicken salads-use Magic Bullet to blend. Think Feed Store Chicken salad consistency. Recipe is chicken, mayo, celery, sprinkle of white pepper, lemon juice-blend in Food Processor or Magic bullet. Eat with a fork or in THIN amounts on crackers or toast.
Roast is a chewy food. I would suggest using your blender on this one with a lot of extra gravy and broth. Cook in a crock pot to make sure it is very soft. Balance out with
thinner consistency mashed potatoes and heavy amount of gravy or broth.
Beef stew can also be blended. Any soups can be blended to a nice smooth consistency too.
Veggie Burger or sausage patties may work (Morningstar brand-soft) Cut in narrow strips or process. Pork, Turkey, Mushroom or Black bean burgers are irregular texture-process these and add condiments. Freddy’s restaurant has Veggie Burgers too.
Chicken pot pie can be blended with extra sauce (quick meals)
Mushrooms, avocado, hummus, beans/lentils can be good substitutes for meat as well
A corn dog nugget or chicken nuggets can be processed in the Magic Bullet. It will come out looking like fine bread crumbs, mix with a condiment of your choice or with a gravy.
Pepperoni can be microwaved and will turn out like crispy chips
Nutella, Chocolate Jif peanut butter or peanut butter in your smoothies
Shopping Tip: Humphrey’s Meat Market sells pork BBQ, Italian Beef in smaller containers. You can add more BBQ sauce or other condiments as desired to these for quick and easy meals.
Tamales, you can add any sauce over the top, broth of chili, etc.
IF doctor clears you for this and you are done with chemo/radiation….Any deli meals/side dishes can be picked up and blended at home. If it doesn’t have bones in it, it can go into a blender. You can process potato salad, three bean salad, green bean casserole as well as meats or almost any side dish. Good day/bad day plan here. On bad
days, let the Magic Bullet take the work out of eating.
Chef Salad (this is a tough one)
Separate Chef salad ingredients into
segments around the bowl Make sure the ham, etc is cut the way
you can handle it. This meal is a lot of work but can be modified.
You can actually make 7 layer salad and blend the eggs/peas/dressing/cheese into a paste and eat shredded lettuce. Use dressings to thin it out to the right texture.
Avocado or Hummus (I like texture of Sabra Hummus) can help too.
broth, 2 small single serve cans of tomato juice, 1 can Rotel if desired, 1 can drained diced tomatoes, zucchini, fresh mushrooms, onion, celery, garlic, white beans, spinach, mixed vegetables, white potato). Cook and blend well with immersion blender. Eat with mashed white potato, avocado, hummus, etc as a binder.
Supplements (use as needed) Shakes (see recipes I shared), be creative! You can reduce sugars, share with your dietitian.
Ensure Peach with tea (hot or cold) Ensure Peach can be frozen into ice
cubes and put in iced tea ScandiShakes Carnation Instant Breakfast SuperMilk, Super Yogurt or Super
Pudding (Lemon pudding can be a better option to avoid ‘sweet overload’)
Lemon pudding, lemon sherbet, lime sherbet can be good options to mix with a small amount of Sprite/Squirt or lemonade to make a tangy sour based smoothie
Whey or Protein powder added to smoothies
Desserts/Snacks Key Lime pie Lemon pie –not cream,
more gelatin based could be a good dessert.
You can purchase lemon pie by single slice at Shop-N-Save in frozen section or County Market in bakery)
Strawberry pretzel desserts can be blended
Cheesecake is always a good idea! Counter with a more sour/tart topping so it is not too sweet
Pies/cobbler/crisps-blend and mix with ice cream (rhubarb, Marie Callendar Triple Berry -if seeds aren’t a problem)
Process dry oatmeal flakes in the Magic Bullet for a few seconds, it makes a fine powder and is easier to eat as cooked oatmeal or as a topping on desserts
butter added to recipes. Coffee drinks can counter super
sweet aversion. (Decaf may be best option)
Therapist recommended that meat be cut in narrow strips and placed under the biting surfaces or blended.
Dips, cream soups, condiments, sauces and gravy were suggested to make meats easer to eat.
Fine ground meals can also be mixed with gravy, whipped white or sweet potato. Salmon, tilapia and flaked fish mixed with tartar sauce or a cream sauce may be easy to eat.
Tamale, cheese or meat Taquitos, ham, chicken, egg and tuna salad are also recommended to trial.
Meat can be placed in a food processor before mixing with mayonnaise to make it smoother and easier to eat. Sometimes cooked meat that has been frozen for an hour blends better.
A thin layer of this food can be added to a cracker or piece of toast once control improves.
Dip the DuoSpoon in any of these blends or binder foods and chew vigorously to improve your control.
MEALTIME RECOMMENDATIONS:
1) Cut foods such as pancake, French toast or soft breads into narrow strips or small pieces.
French bread is very chewy and may be more difficult to manage.
2) Salmon and chicken can be shredded and paired with a cream sauce or mixed with
pureed sweet or white potato to help bind the food item together.
3) Pad Thai noodles, spaghetti noodles, chicken and noodles can be fine chopped and mixed
with additional sauce as a binder foods. Instant potato flakes can be used to bind noodles.
STATUS UPDATE: In three therapy sessions, this patient regained the ability to eat foods from all food groups. She is eating pastas, soft meats, vegetables, soups and crackers. Patient was thrilled to be able to eat chocolate again. Therapist updated Food Chaining program. Patient will contact therapist regarding progress in two weeks. Additional sessions will be scheduled if needed. Patient is very pleased with progress and has met all initial goals. Walt-Updated Therapy Program
Nutrition (follow up appointment)
- Ask RD if you need to watch sodium intake due to dizziness
- Ask RD about energy level and ways to boost protein, etc
- Is anemia an issue?
- We will then continue to modify diet to make foods easier to swallow (see below)
Dizziness
- Cawthorne Exercises
- Medications/side effects-discuss with MD
Meals
- Good Day/Bad Day Plan
Chili/Refried Beans
If you are having a bad day you can blend refried beans, chili or chili and a tamale (if not too spicy) into a more thin paste like consistency. This can be easier to eat. Soups with beans are a great source of nutrients. Baked beans, etc can also be blended. Bean burrito is also an option. Cheese sauce can be added over the top for additional calories. Hummus, guacamole, sour cream can make these foods easier to eat.
Vegetable Soups Great nutrient source for your overall health. Blend if needed. Try to aim for 5 servings of fruit/vegetables a day. Soups with lentils are a great option. A cup of soup with meals can help you meet this goal.
Noodles Be creative with a wide range of sauces with noodles. Change noodle size and density if you are having a bad day. Whole wheat pasta may also be a good option.
fried egg…boiled egg can be a good snack option later in the day as well.
Oatmeal/Cereals Blended flakes before cooking for a smoother texture. You can add blended cooked apples/peaches or other fruits with cinnamon to add flavor. Steel cut oatmeal is a good nutrition choice too.
Shakes Always a good option (check the shake/smoothie recipes I issued to you before). Peanut butter or Nutella in shakes and smoothies can be a good option as well. Blended fruits (banana, peach) or banana pudding can be mixed with crushed cereal over the top if milk and cereal is too hard to eat
Meatloaf/Salisbury Steak Add extra gravy or sauce, blend if needed, pair with potatoes and gravy or a cup of potato soup. Stuffed peppers can also be blended.
Cheese Great option as a slice or cheese soup or sauce over other foods
Salami Ham, pastrami, summer sausage are also options
Turkey Turkey or Chicken salad can be a nice smooth texture if blended for a few seconds
Biscuit Gravy Fine ground meats and gravies or sauces, fine meat like TacoBell meat can be much easier to eat
SAMPLE FOOD CHAINING Meal Plan Food Item Breakfast
1) Eggs-explore in Egg Nog recipes, Egg Drop soup, egg muffin recipes (texture can be much easier to handle) or quiche. Egg muffins can be frozen too and heat well. Scrambled egg muffin sliders is a recipe for corn meal egg mixture and you make an egg sandwich out of it. Another option is to add a cheese
Lunch and Dinner Options Fish, salmon, chicken salad, tuna salad-add tartar sauce or other condiments for additional calories. Drizzle a small amount of oil in to chicken salad or tuna salad (buy packed in oil). Dark meat has more calories so you can make your chicken salad from chicken thighs instead of breast. Glenn likes Mexican so try chicken thighs in the crock pot with a jar or salsa and taco
sauce or cream sauce to well done scrambled eggs or go TexMex to make them easier to eat. Add salsa, cheese, peppers, onion, etc. How an egg is cooked is important. Many of my patients like deviled eggs or egg in a salad (green salad or chicken/tuna salad sandwich), French toast is also a good way to work eggs in to the diet. Corn bread or corn bread muffins are another way to work egg into the diet.
2) Sweet Rolls/savory breakfast breads. Fruit breads (apple, pumpkin, zucchini, banana) or muffins can also be another source of eggs. Sausage bread (fine ground cooked sausage rolled up in Rhode’s bread or other bread dough and baked), Pillsbury apple turnovers, waffles, pancakes with spray butter and dipped in syrup vs covered in syrup might be easier. Cream of Wheat with honey or syrup added, oatmeal cereal bars. Bisquick biscuits can be easier to handle on a day when nausea becomes a problem. Top with honey, jellies, jams, applebutter. Peanut butter/honey/jelly or Nutella on toast. Cake doughnuts or Old Fashioned Doughnuts are often easier to eat than glazed or jelly filled.
3) Coffee Drinks-add ice cream, Frappacino drinks from Starbucks (in grocery store), shakes, smoothies.
4) Oikos or other brands of vanilla Greek yogurt and fruits added. Powdered sugar sprinkle over the top can help too.
seasoning. Let it cook all day and shred fine. Cover with cheese, sour cream, veggies and enjoy. Italian chicken recipe is 6 chicken breasts or can sub thighs (need more if so because smaller), add one jar of Pepperoncini or banana peppers and some Good Seasons Italian dressing (the dry powder) and cook 5-6 hours in crock pot. Serve on hoagie rolls or Italian bread. Soups-potato (add butter, heavy cream, cheese) Chili is an excellent choice. Steak N Shake chili from grocery store is easy and convenient when you don’t feel like cooking. Try tamales mixed in with your chili as another meat source and way to add more protein. If you are ever up this way, Humphrey’s Market in Springfield has wonderful tamales in their frozen section. Very easy to eat. Baked enchilada is another good option. All beans are GREAT sources of nutrients. Sabra Brand hummus (WalMart) is chick peas and can be topped with salsa, shredded cheese, diced kalamata olives and served with chips, pita bread cut in strips, Frito scoops, etc. Black beans and salsa recipes can be great. Dirty Rice with fine ground beef, sausage, ground chicken or turkey and red beans/rice recipes are good options. Fried chicken livers at the grocery store deli may be better than you think. :D Sullivan has a great deli, so taste test new foods in very small portions. You will be surprised when you find new foods that you like.
Liquids-Hydrate!!! Super Chill Sparkling Tangerine-Lime water is my #1 GoTo for metallic after taste. ICE brand flavored waters are also high rated by my patients. Glenn likes lemonade so he may like lemon flavored water too. Orange and lemon slices can be added to a pitcher of ice cold water. Let set a while and then removed fruit or it becomes too bitter from rind. Crush has powdered flavor packets to add to waters. Much better than Mio, etc. Some people find they really like Chai Teas or other flavored teas when they stop liking coffee. Peach tea or mint tea may help with nausea.
Goal is ½ body weight in ounces of liquid/water a day
High Calorie Peanut Butter, Smoothies, Shakes, Frappes and Nogs.
Plumpy Nut is a high calorie peanut based food used in many developing countries to treat
malnutrition. This is a recipe that is similar to it and can be used as a high calorie food to
add to your diet.
½ cup peanut butter
½ cup vegetable oil
½ cup sugar (can be reduced)
½ cup dry milk powder
Blend well. Makes 2 cups. ½ cup =600 calories and 14 grams of protein.