Tag Archives: low-protein

Garlic Roasted Eggplant Spaghetti Sauce

During this long, President’s Day weekend, I was looking for ways to shake-up the spaghetti and marinara I seemed to be eating all the time. I wanted to try something new and eggplant is something I did not have a lot of experience cooking. If you have never cooked with eggplant, try not to get freaked out by the brown seeds. Those are normal. And it is important to extract as much liquid from the eggplant when you press it between the paper towels. This will provide you with the best roasted flavor and texture as possible.

Garlic Roasted Eggplant Spaghetti Sauce, Low-protein, PKU Recipes, PKU Cooking, Phenylketonuria

Low-protein Garlic Roasted Eggplant Spaghetti Sauce

Ingredients:

  • 1 med-large eggplant, unpeeled and cut into large chunks
  • 1 tablespoon kosher salt
  • 2 tablespoons olive oil
  • ½ teaspoon garlic powder
  • 1 cup Classico Traditional Sweet Basil pasta sauce

Directions:

  • Preheat oven to 500 degrees.
  • Place eggplant in colander, sprinkle evenly with salt and let stand for approximately 2 hours.
  • Rinse salt from eggplant and press firmly between triple-layered paper towels.
  • Toss eggplant and olive oil together in a large mixing bowl.
  • Sprinkle garlic powder on top of eggplant/olive oil mixture, making sure to coat evenly.
  • Spread in single layer on large baking sheet.
  • Roast for approximately 30 minutes or until tender and brown. Stir every 10 minutes.
  • Allow eggplant to cool when done.
  • Separate into two, ½ cup servings (It is important to measure the eggplant after it is cooked because the size and weight of eggplant changes dramatically after it has been cooked).
  • Set one serving aside for sauce.
  • Store the second serving in the refrigerator until ready to eat at a later time.
  • Toss remaining ½ cup of roasted eggplant and 1 cup of pasta sauce into a sauce pan on medium-high heat.
  • Once sauce mixture is warm, serve on top of low-protein Aproten Spaghetti noodles.

Yield: 1 serving, plus an additional serving of roasted eggplant for later
Phe: 129 mg (sauce & eggplant only; add additional phe for low-protein pasta)

My oven seemed to run a little hot for 500 degrees and I did not really need to roast my eggplant for a full 30 minutes. In fact, I would venture to say that mine turned out slightly over cooked; however, I will get better with practice. Just watch the eggplant closely as you roast it on the baking sheet and if you feel that it is getting heavily browned, then remove it from the oven. Whenever you prepare to eat the left-over portion of the roasted eggplant, simply repeat the last two steps in the directions listed above. Depending on your preference, you may also want to top the dish with Daiya Mozzarella Shreds and serve with low-protein garlic bread.

–NM

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Portabella Stuffed Peppers

One of my favorite dishes that my mother would make when I was off-diet was stuffed peppers. Her original recipe called for mixing a pound of ground beef with a cup of minute rice, diced onion, salt, pepper and garlic powder in a large bowl. Once the mixture was combined, she’d cut the tops off of four green bell peppers, hallow-out the seeds and then fill each pepper to the top with the mixture.

Earlier today, I decided to try my hand at adapting this family recipe for a low-protein PKU diet and I was extremely pleased with how well this dish turned out! I substituted portabella mushrooms for the ground beef and instead of minute rice, I used Cambrooke Foods’s low-protein short grain rice. Here’s a closer look at the recipe and how I prepared it.

Ingredients:Low-Protein, Portabella Stuffed Peppers, PKU Recipes, Low-Protein Recipes

  • 5 medium-sized green bell peppers
  • 2 medium-sized portabella mushroom caps, diced
  • 1/2 large onion, diced
  • 1-1/3 c of Cambrooke imitation short grain rice
  • (4) 26 oz. cans of Campbell’s concentrated tomato soup
  • Garlic powder
  • Salt
  • Pepper

Directions:

  • To prepare the green bell peppers, slice the tops off and hallow-out the seeds.
  • Place the caps back on top of the peppers and set aside in a dutch oven.
  • In a large mixing bowl, combine portabella mushrooms, onion and imitation rice.
  • Once ingredients are mixed, add ½ cup of tomato soup and stir until well coated.
  • Add garlic powder, salt and pepper to taste.
  • Using a large spoon, scoop mixture into each bell pepper until filling is level with the top of the pepper.
  • Place the pepper cap on top of the now-stuffed pepper, use two toothpicks to secure the cap and place back inside the dutch oven.
  • Repeat until all five peppers have been stuffed and re-capped.
  • Pour the remaining condensed tomato soup in the dutch oven, filling in around the peppers until the peppers are at least half-way covered with the soup.
  • Place lid on dutch oven and bake at 350° for 1 hour.

Yield: 5 stuffed peppers
Phe: 161 mg per pepper*
Protein: 2.5 gm per pepper
Exchanges: 10.7 per pepper
Calories: 197 per pepper
Fat: 0.8 gm per pepper

* Based on 1.2 cup tomato soup mixed in with ingredients, not soup peppers are baked in.

Portabella Stuffed Pepper Leftovers

Invest in some plastic containers for storing extra servings in the refrigerator or freeze for later.

As you can tell, this recipe makes a ton of leftovers. I ate one pepper immediately and packaged the rest in Tupperware containers. I placed two servings in the fridge for eating later this week (maybe as a packed lunch for work) and froze the other two so they wouldn’t go bad. If you feel like you need a little more sustenance, serve the pepper along with Aproten low-protein noodles and use the extra tomato soup as gravy. Just be sure to add 68 mg of phe per ½ cup of tomato soup you top it with.

Enjoy!

–NM

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Planning a PKU Menu

I’ve said this before on PKU Parlor, but the ability to plan and organize is going to be instrumental for me adhering to the low-protein diet. And if you know me, then you know I have affinity for being obsessed with organization.

Allow me to introduce my new chalkboard wall…or as mother referred to it, my command center. 🙂

Menu-Board

After 10 coats of magnetic primer and two quarts of chalkboard paint, I have successfully turned one wall of my laundry room into a customizable reminder/menu board.

You may recall that in my last post, I briefly mentioned that I intended to plan-out my menu a week at a time. As you can see here, after I completed my grocery shopping, I jotted down the menu items on this chalkboard wall as a way to remind myself of any items left for eating as I get further into the workweek. At the end of the week, I erase the items and start all over again. The left-hand side of the board has a special section reserved for reminders, both PKU-related and non-PKU related.

Now it’s worth noting that planning a low-protein menu a week at a time can be challenging. Among other items, it demands a ton of fresh produce and an arsenal of spices for livening up what otherwise might be considered bland, low-protein foods. Since I don’t want to lose track of all the hard work put towards menu planning, I also plan on creating an electronic database of meal plans. I haven’t created the database yet, but when I do, I’ll likely create it using Microsoft Excel and include columns noting phe amounts and whether the recipe calls for low-protein products. The last of these discriminators will prove valuable for those moments when I find myself running low on low-protein foods and need to get through the coming week eating whatever is available in local grocery stores.

As I conclude this post, allow me to reflect on what today marks one week since first cutting out all high-protein food items in my diet. I agree that I feel better. That’s hard for me to admit since I prided myself for so long as someone who could eat whatever and still function at a high level. One of the harder things for me to do mentally is to stop counting calories and start to worry more about protein. I realize that eating low-protein won’t always align with low-calorie so I’m having a bit of a struggle letting go of that.

Until next time!

–NM

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Returning to the PKU Diet—Easy Does It!

Going from a completely liberated diet to one that consists of limited protein intake can be rather intimidating when you look at it from a 25,000-foot view. However, breaking-up the task in small chunks and tackling the goal with baby steps can make all the difference between success and failure.

That’s the approach I’m taking after recently deciding to give the low-protein diet a try. I first started this effort last week by committing to taking my formula four times a day. I didn’t worry about altering my diet any; just made sure that I had 60 grams of protein via formula and see how that goes.

Use the RxmindMe app to set reminders on your phone to take your formula.

Use the RxmindMe app to set reminders on your phone to take your formula.

For me, getting all the formula in was not a problem. I would take one with breakfast, the second at 10 a.m., a third near the end of the workday before heading to the gym, and the final before heading to bed. I even set reminders on my phone using RxmindMe and on my Outlook Calendar just in case I got caught-up with work and forgot to take a break for drinking my formula.

After about the third day of doing this, I started to get really strong headaches, especially right after waking up in the morning. At first, I attributed them to stress at work, but when they persisted even on into the weekend, I figured there might be something else at play. Eventually, I concluded that by not altering my diet, but still consuming 60 grams of protein through formula, I was in essence consuming twice as much protein as a non-PKU person would normally eat.

First time making Cook for Love's low-protein bread! The 2nd loaf (on the right) definitely came out better.

First time making Cook for Love’s low-protein bread! The 2nd loaf (on the right) definitely came out better.

The next step in my goal of returning to the low-protein diet was to cut-out all meat. Given the persistent headaches though, I decided to ramp-up my progress. I decided to try my hand at making Cook for Love’s sandwich bread—in fact, I made two loaves and have frozen the second for eating later. I also started incorporating a few low-protein modified foods such as Aproten pasta and Cambrooke’s rice. That being said, I went from eating 60-90 grams of protein to just 15 grams as of yesterday. And the best part? No headaches when I woke this morning!

I realize the real trick will be to continue this progress in the long term, but again, to keep from getting overwhelmed, you have to take it one day at a time. Today, I am going to work on building out my menu for the entire week. I’ll pick out some new recipes, search some free foods through Virginia Schuett’s Low Protein Food List and go from there. As I try new things or find tips to share, I’ll regularly post those here. Of course, if you have any to share, please feel free to do so in the comments section below.

–NM

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Billing PKU Formula According To Calories

Here’s something you may not know when it comes to the business of distributing and paying for PKU formula.

After trying the free sample of RESTORE LITE provided to me by Cambrooke Foods, I immediately connected with my clinic to have it added to my formula prescription. Apria Healthcare, which is the medical supply company that processes and ships my formula, called and told me, “We do not carry RESTORE LITE. We carry the regular RESTORE, but not the LITE.” After reporting this news back to my clinic, we decided to try Edgepark, a competitor of Apria Healthcare. What was Edgepark’s response? Not only does Edgepark not carry RESTORE LITE, they cannot carry the LITE because Apria, EdgePark and other “durable medical equipment” companies are reimbursed according to the number of calories in the formula.

PKU formula, Phenylketonuria formula, low-protein diet

The revelation that durable medical equipment companies are reimbursed according to the number of calories in PKU formula provides a whole new meaning to the phrase, “Spend your calories wisely!”

Call me crazy, but billing insurance carriers based on caloric value seems ridiculous, so while my dietician continues to search for an alternative medical supply company from which I can order my preferred formula, I decided to investigate this a little further.

A basic keyword Internet search turned up a 56-page document created by Abbott Nutrition and titled “Medicare Part B Enteral Nutrition Reimbursement Manual, 9th Edition.” Abbott Nutrition, which creates powdered PKU formulas such as Phenex-1 and Phenex-2, created this manual as a way to guide health care suppliers through the process of billing the U.S. federal health insurance program called Medicare. Here’s how the process is explained on page 9 of the manual:

Enteral nutrition formula is billed in “units.” A unit is defined as 100 Calories.

  • Calculation of units: Cal per day ÷ 100 = units per day
  • e.g., 6 cans/day  x 250 Cal/can = 1500 Cal/day ÷ 100 = 15 units/day
  • 15 units per day x 30 days per month = 450 units per month

Sound all Greek to you? Well, it does to me too. It appears that billing formula based on calories is a government-mandated method, but why (if I am not on Medicare) does it apply to me? Do durable medical equipment supply companies decide to apply this method across the board since they are already required to do so for Medicare patients? And what does that mean on a personal level? Do PKU patients now have to decide whether eating healthier is worth what is likely a significant increase in cost?

This way of thinking–whether it originates with the U.S. Government or with the medical supply companies–sounds all too familiar. For years, PKU patients have struggled with medical foods coverage based in large part on the incorrect assumption that a low-protein diet is cosmetic and only for achieving weight-loss.

Despite calorie count, medical formula is medical formula. Period.

If anyone from Cambrooke and/or Abbott Nutrition are reading this blog, I’d love to hear another perspective on this formula conundrum in the comment field below. Hopefully someone can explain why the 100-calorie difference you see between regular RESTORE and RESTORE LITE ultimately determines whether a patient in need receives their medical formula.

–NM

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Caring for Maternal PKU: Part III

Welcome to the third and final post in the Caring for Maternal PKU series. In Part I, readers were introduced to the research Kimberly R. Regis RN, MS, CPNP, conducted in support of her Doctorate of Nursing Practice final project at The Ohio State University. The objective of Regis’ research was to “describe the care needs and preferences of adult women of childbearing-age with PKU” by going directly to the women and asking about their experiences. In Part II of the series, we learned that despite being well-informed about the risks associated with maternal PKU, the group of women Regis interviewed had a relatively low combined pregnancy success rate. In an effort to see what factors—in addition to knowledge level—might be at play, Regis explored maternal PKU support systems by asking her participants the following questions:

  • What support systems do participants have that either help or hinder adherence to dietary management?
  • From the participants’ perspectives, what can be done to improve support for ongoing dietary management within the clinic service?

Maternal PKU, Pregnancy and PKU, PKU, PhenylketonuriaFor all of the women who participated in Regis’ study, family members were identified as being the greatest source of support. Mothers in particular were mentioned not only as a supporter but also as an individual who truly understood and empathized with what it was like to struggle with the low-protein diet. Other examples of how family members provided support included finding new recipes to cook or share with the PKU patient, or even in some cases, helping to pay for costly medical foods.

With regard to the support participants received from clinics, most felt that clinicians were friendly and supportive, but some concerns still existed. For example, some participants felt like information about new foods and treatment was only provided if the patient asked about it. Clinic staff did not always provide individualized advice and overall communication from the clinic occurred less frequently overtime.

Right now I’m still just in the monthly stages of taking my level every month, and that’s pretty much all that I hear from my nurse. And I never really hear from my dietician other than when I call her to order formula.”

The reality is that most PKU clinics are spread-thin and overworked because of having to respond to more than just PKU patients. But developing specialized care for maternal PKU is significantly more complicated than just refreshing clinical best practices. That’s because as Regis acknowledged, treatment for PKU has evolved over the years, allowing for more PKU patients to live longer and engage in “traditional” lifestyle activities such as pursuing advanced college degrees and starting families. Unfortunately, despite the need for individualized care, many PKU adults are still seeking treatment at a pediatric-focused facility such as Children’s Hospital. To be fair, participants within Regis’ study did not explicitly express concerns about receiving care from a pediatric institution; however, there was strong agreement on the need for more support beyond education.

What would this additional support look like? Regis suggests that social work, mental health and gynecological services may all be applicable for advancing the care of maternal PKU. No matter what the medical treatment of PKU will look like in the years to come, it must evolve to include geneticists, dieticians and nursing practitioners who understand and specialize in maternal PKU. Perhaps Regis herself said it best when she recognized women of childbearing age with PKU as being a “distinct population with the shared risk of having offspring with disabilities as a result of their genetic disorder.”

A distinct population – even one that is a subset of a group defined by a rare genetic disorder – should translate into individual, specialized care.

–NM

Caring for Maternal PKU: Part I

Caring for Maternal PKU: Part II

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Cook for Love’s Banana Bread

Cook for Love, Banana Bread, PKU, Low-Protein Diet, Phenylketonuria

This weekend I got an itch to try a new low-protein recipe. I’ve had my eyes on Cook for Love’s banana bread for about a year now, but because of work and grad school only now have I had the chance to give it a shot. Like most of the baking recipes on Cook for Love’s website, this banana bread started out with 2 cups of the website’s low-protein baking mix. I made a double batch of my own and stored it in a leftover Mix Quick bucket I had from Cambrooke Foods. Then using a Sharpie permanent marker, I labeled the bucket with its new contents, including all the individual ingredients and their amounts. This way, whenever I want to try another baking recipe from Cook for Love, I already have the baking mix assembled!

I was able to gather all of the ingredients from my local Kroger Marketplace with the exception of two items. I had to special order wheat starch from the Internet (either through Amazon.com or direct through Cambrooke Foods) and I had to make a separate trip to Wal-Mart in order to find cake flour (specifically Swans Down). Once I had everything in-hand, the preparation time was practically nothing!

Final review: After letting the loaf pan cool, I sliced a couple pieces and shared them with my husband. At first-bite, the bottom of my banana bread seemed chewy, like it had been over cooked, but as I cut slices closer to the center of the loaf, the chewiness disappeared. The banana bread was extremely moist, almost “spongy” like a poppy seed cake might be. My husband was surprised at how much the batter actually rose in the oven, even without eggs or traditional flour. Overall, this is a very delicious recipe and pretty darn hard to tell it’s not the real thing!

Hands on Time: 10 minutes
Cooking Time: 55-65 minutes
Yield: 1 loaf, 12 slices
Phe per Serving: 27 mg per slice

Out of respect for the hard work, sweat and tears that the folks at Cook for Love have invested in developing PKU-friendly foods, please visit their website to see details on the ingredients and specific cooking instructions for this recipe and many others.

–NM

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