Our Philosophy for the Care and Feeding of the Dysphagia Patient

Essential PureeThoughtsLeave a Comment

unsplash kitchenWe follow the Guidelines of the National Dysphagia Diet. We post them on our website. We include them in our books. We refer to them in our recipes. We create our recipes for the Level 4 or Puree Diet. Safe swallow for most patients. We suggest that all users of our resources consult their healthcare professionals for individual instructions.

Having done that, we use the best kitchen tools and techniques available to improve the quality of life and diet for the dysphagia patient. We use the newest and most powerful kitchen tools to puree foods that have previously thought to be difficult to break down to the right texture for the safety of the swallow. We mean the high speed commercial blenders that are more powerful than appliances made for the home market.

We use the newest and best kitchen appliances for the safest and healthiest cooking methods. This includes steamers, multi-cookers, rice cookers, pressure cookers of the new generations of kitchen appliances. With these appliances, we can render protein and vegetables into a tender texture, a uniform texture, a safe texture with no fiber, sinew, fat or skins and seeds.

We use the cleanest and the best quality ingredients, meaning the least processed. We use low fat, low salt, low sugar, and lean protein, as well as whole grains properly prepared. We use fresh fruits and vegetables when possible and frozen when necessary. We use organic, when available. We follow the Choose My Plate guidelines of proper portions of the food groups recommended by the Food and Drug Administration. We recommend go-to convenience foods for the days when the caregiver is time-challenged.

The important thing for the dysphagia patient is to get enough calories to maintain weight, because on the pureed diet, patients may lose weight. Proper weight maintenance is necessary for strong immune functioning, meaning, the body’s ability to fight off infection. We have been developing a series of recipes for healthy snacks and desserts for this reason. There is a noted lack of choices out in the commercial food market. So we are trying to get across the idea that it is very simple to have a healthy snack, with a little planning.

For example, in the Snicker Shake recipe, I use peanut butter powder that I bought in the whole foods store. You have to pay attention and really thin out regular peanut butter because of its consistency. With the peanut butter powder, you get the nutrition and you eliminate the prep. The powder is a convenience food.

I also recommend St. Dalfour Organic Caramel Sauce, because it does not contain white sugar but agave syrup. I could provide a recipe for making good caramel, not a caramel that is made from white sugar, the standard recipe, but one that is made from maple syrup. It is time-consuming and not everyone will do it. If the caregivers and family members have the convenient sauce on hand, they will get the thrill of making something that reminds everyone of childhood, the familiar combination of chocolate, caramel and peanut, with the cashew milk serving as the filling. The shake is the essence of the Snickers candy bar, but without the harmful ingredients.

The Essential Puree approach is to emphasize what is possible. We believe that the puree patient does not have to suffer and feel a sense of loss and deprivation. They can feel gratified and retain pleasure in food, one of humanities most basic activities. All this can happen in simple ways, with simple satisfactions. The patient gets a pureed meal or a shake that looks good, smells good and tastes like a favorite food. It is all about using one’s imagination. The idea is not to get stuck in old ways of doing things. This is not about drastic elimination. This is about solving the challenge of the pureed diet with good ingredients, appliances and healthy cooking techniques.

One expert that I consulted said that no raw foods could be eaten on a pureed diet. This was not for reasons of digestion. It is true that some gastrointestinal patients cannot tolerate raw foods.

Meanwhile, America had gone crazy for the Nutribullet, the nutrition extractor that was so powerful that it liquefied raw foods into a shake of whole vegetables without particles. The shake could be thickened, if necessary, with the great variety of xanthum gum thickeners now available in stores and online for home delivery. So we recommend the best thickeners.

The National Dysphagia Diet says that the diet was not meant to be one size fits all. It was meant to be flexible. The diet is not meant to be culturally restrictive in regard to traditional foods of global populations. Sometimes a sense of scientific superiority misses a basic fact of longstanding cultural and culinary tradition. The scientist may be underinformed. I speak of the original well-intentioned prohibition of early versions of the NDD against rice. I am going back more than a decade now.

When cooked in an Asian rice cooker or even better in a pressure cooker, rice is so soft that it may be smoothly pureed. I have lived in Asia. I know the techniques used by Japanese rice farmers, for my ex-husband lived on a Japanese rice farm while he was studying in Japan. Throughout China, Japan, Southeast Asia and India, mothers have been making a rice porridge as infant food for several thousand years, a smooth puree for babies. The same congee is fed to the elderly when they have no teeth and they cannot chew.

We emphasize context. What you get on the Essential Puree website is a combination of culinary history and family stories along with the recipes, the tips and tricks, as well as the sources for special ingredients. We are putting up recipes from the Soul Food Kitchen, the Latin Kitchen, the Indian Kitchen, and the Chinese Kitchen and others, for these recipes make up the great patchwork quilt of American cuisine. We have more nationalities in this country than any other country on earth, and their cuisine is both regional and national.

We have classic American comfort foods and we have global cuisine, American style. As Dr. Dee said, a nutritionist as well as a graduate of the Culinary Institute of America, if you use the right tools and cooking methods, you can puree anything. I believe in the buzz and the super-buzz. Get the right tool and swirl away. Turn properly cooked food, meaning food that is trimmed and tender, into a nutritionally extracted product that is completely liquefied but contains all the nutrients for maintaining good health. Thicken, if necessary, for the swallow.

We here at Essential Puree believe that the kitchen is a place of transformation, a place of alchemy, where the cook can change the composition of the human body down to the level of the cells. We believe in imagination and common sense, mixed with a proper respect for food and an abundance of caution and care. We believe in best practices.

We believe in food as medicine. We believe that food is love.

And we think that the healing power of food created with love should never be underestimated.

 

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