SHAKE RATTLE RECIPES.pagesFROM THE ESSENT I A L PUREE K I
TCHEN
3 All-American
Three Nutritionally Dense Recipes for Great Tasting Shakes with
variations to end patient boredom.
A great snack or dessert can be made in under five minutes.
Convenient! Make once and serve twice. Freezer friendly.
Fridge
friendly.
An end to caregiver burnout! No worries about patients
dropping
weight.
Put on some music and Swirl Away!
EssentialPuree.com Quickies for Caregivers™ Series page 2
All contents of this book and the Essential Puree swirl logo are
copyright Gourmet Puree, LLC. Not to be reproduced or distributed
without written permission.
4
7
10
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The Memphis Shake: Peanut Banana Shake with Bacon Recommended Sound
Track: The Elvis Anthology
The Miami Shake: From the Cuban Kitchen Recommended Sound Track:
The Buena Vista Social Club
The Motown Shake: From the Soul Food Kitchen Recommended Sound
Track: The Motown Anthology
Kitchen Appliances: The Puréed Dessert Kitchen
About the Author 17
The Science of Puree 19
The Memphis Shake: Peanut Banana Shake with Bacon Recommended Sound
Track: The Elvis Anthology
It is said that the peanut butter and banana sandwich was Elvis
Presley’s favorite. If there are any purist Elvis fans out there,
please don’t write. I know the King liked the bacon, but unless you
can figure out a way to puree bacon or you have a source for bacon
extract to flavor this snack, we are going simple and basic on this
one. Think of this as a tribute shake.
Note to purists: If you want the flavor of the bacon, my
recommendation to you is to puree a slice of Canadian bacon with a
high speed blender using the pulse function until you break it
down. Then add a tablespoon of vanilla ice cream until the bacon is
dissolved. You need a Vitamix for this. A regular blender won’t
do.
Besides, if you are really a purist, you know that Elvis used to
fly to Vegas in the middle of the night on his private jet to get
the best version of the sandwich. So there.
Bacon-lovers, take note: I am experimenting with a vegetarian bacon
that will puree. It may not be actual bacon but it simulates the
flavor on the palate. The object is to get the flavor and the
texture. It’s a big secret, but I will reveal it at the precise
moment that it is perfected. Stay tuned.
I should really call this the Memphis plus because we add the
chocolate, as a matter of choice, of course. Elvis liked his
sandwich fried, but we made ours in a shake.
Let me know if you want to receive an email copy of a piece I wrote
about my exclusive VIP tour of Graceland on a trip to Memphis when
I researched who taught Elvis to dance. As a famous blues record
producer said to me at the time, nobody ever thought to ask the
question. That was in the phase of my writing career where I was
producing a
EssentialPuree.com Quickies for Caregivers™ Series page 4
documentary about Swamp Blues and two generations in a black
musical family, but that is a story for another time. I still have
the highball glasses that I bought in the Graceland store. They are
beautiful, with etched images of Elvis in the crystal, in gold
leaf.
We could have pureed the classic Elvis sandwich, but we don’t like
the texture of pureed bread unless it thickens a soup. So we chose
to make a thick shake. This falls into the Essential Puree category
of Straight to Puree. If you like, you can warm this up on the
stovetop while you listen to “Jailhouse Rock.”
It is a classic milkshake without the ice cream. If you like ice
cream and have no objection to dairy, by all means, add ½ cup of
chocolate ice cream or non-dairy ice cream to the blender when
pureeing this snack. The result is a creamy yet healthy frozen
treat that tastes of chocolate and nuts, with a banana
undertone.
This quickie shake has plenty of protein and is an excellent snack,
without the dairy overload. You can use milk if you like or keep
the version with the non-dairy milk.
Two hours before making this shake, cut up the two ripe bananas
into chunks and freeze them in a zip bag. At snack time, purée them
in the blender with a tablespoon of Nocciolata, the hazelnut
chocolate sauce with no trans-fats and protein powder. Mix the
peanut butter powder with a little water to make a loose paste,
then puree it with the almond milk until it is completely blended
in and smooth.
Leftover shake freezes nicely for another snack. If you have
thickened this to stabilize it, we recommend freezing in glass
containers. The gum thickeners stick to plastic.
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Ingredients: • Two ripe bananas, frozen and cut into 1” or 2”
chunks
• 2 tbsp. organic peanut butter powder (whisked until smooth with 2
tablespoons of water)
• 1 Tablespoon Nocciolata, the hazelnut-chocolate sauce (optional,
contains no trans-fats)
• ¼ cup almond milk, chilled, or ¼ cup chocolate cashew milk,
chilled
• 1 tablespoon good cocoa powder (optional)
• Optional: 1 scoop chocolate protein powder, whey or
plant-based
• Instant thickener to stabilize the shake
For the Puree: In the pitcher of a blender:
Add the peanut butter powder mixed with water
Add the hazelnut chocolate sauce
Add the two frozen bananas, broken into chunks
Add the almond milk as needed to keep this moist and smooth
Add the cocoa powder and the protein powder, adding almond milk if
needed
Blend until the desired thickness is achieved.
Swirl Away!
The Miami Shake: From the Cuban Kitchen Recommended Sound Track:
The Buena Vista Social Club
The author of this book grew up in Miami and is a huge fan of Cuban
food and Cuban music. She knows the authentic Calle Ocho
flavor.
Maduros are fried plantains. This is a traditional side dish in
many Latin and Hispanic kitchens. It is made from fresh plantains.
We give you the classic recipe below. For this dish, you have to
take on the persona of the abuela, the Spanish grandmother, and do
a little cooking. But if you have the nostalgia for the classic
comfort food, you won’t mind.
As we promised quickies for caregivers, we also give you a quickie
version below made from frozen plantains and flash roasted in the
oven or quickie “baked” in the microwave.
Our goal is to provide a nutritious snack or side dish for the
person with swallowing disorders. Our goal is to support the
caregiver. So choose which is best for the situation.
This shake may be served warm by placing it in a saucepan on the
stove-top on low heat.
INGREDIENTS • 1 pound frozen maduros (plantains)
• 1 cup cashew milk for the puree
• instant gum thickener, powder or gel, if necessary
DIRECTIONS Many traditional recipes use oil and fry the plantains,
but I have found that the best way to get a tender texture is to
bake in the over. I use a sheet pan and a silicone liner. I spread
the maduros in a single layer. I bake them at 325 degrees for 35 or
40 minutes
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until fork tender. These will puree without fibers. The oven baking
intensifies the flavor. There is less oil in this dish, making it
easier for digestion.
Do not burn and do not over-caramelize the plantain. While
caramelization may be desirable for flavor when eating this comfort
food, it does not produce a smooth and creamy puree, but creates
particles in the finished product.
When done, remove from oven and place on a plate. Allow to
cool.
Put the maduros in the bowl of a food processor or the pitcher of a
blender and blend with the cashew milk. Put the puree through a
mesh sieve with a silicone spatula to remove any fiber that is not
absolutely smooth for the swallow.
You can remove the shake from the pitcher of the blender and heat
gently on the stovetop and serve the shake warm. For a cool shake,
thicken and place in fridge until cooled.
For Thickening Once the puree is completely smooth, thicken to the
required thickness using either the powder form or the gel form of
xanthum gum thickeners. Use two packets or two scoops for honey
thickness for eight ounces and double that for pudding thickness.
If you use powder thickeners, place in fridge for five minutes
before serving.
Swirl Away!
Variation: This shake can be made with a cup of mango juice and a
teaspoon of guava jelly for a tropical fruit shake.
Variation: The Regular Banana Shake (not Plantains)
Let us clear up any confusion at the beginning. A banana is not a
plantain. We know that. It is different. That said, banana is a
great flavor for a shake and since it is similar in flavor to a
plantain, we include it in this section.
EssentialPuree.com Quickies for Caregivers™ Series page 8
Blend.
If you wish, you could add a half scoop of vanilla ice cream to the
shake to boost the calories.
You could add a few tablespoons of So CocoWhip whipped topping for
extra richness. This is made from coconut milk. If you want to add
full dairy whipped cream, by all means, that is an acceptable
substitution. Put it into the blender before you add the
thickener.
At the very end, take a packet of gel or gum thickener (if serving
from a large container, this will be either a pump of gel or a
scoop of powder).
Buzz the shake in the blender with the thickener. Let the shake
stand in the fridge for five minutes while it thickens, and serve.
The banana shake is usually served cold.
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The Motown Shake: From the Soul Food Kitchen Recommended Sound
Track: The Motown Anthology
This is a classic treat in soul food restaurants all over the
country: Warm Sweet Potato Pie topped with Whipped Topping and
Caramel Sauce.
You can soft bake sweet potatoes or use canned sweet potatoes. For
clean eating, please do not buy the kind floating in sugar-y syrup.
Get the kind packed without sugar.
We like the recipe because you can use more or less of the
soft-baked sweet potato to get the correct thickness for your level
of the NDD.
We have eliminated the crust for this shake, as pie crust may be
gummy in a shake.
At the holidays, you can substitute pumpkin puree and a teaspoon of
pumpkin pie spice and you have a great dessert for the holiday
season.
Here’s a piece of news: the sweet potato is good for you and may
even be classified as a superfood.
According to the South Beach Diet: Sweet Potatoes (and other bright
orange vegetables): An outstanding source of carotenoids
(including beta carotene), as well as vitamin C, calcium,
potassium, and iron, sweet potatoes (and other orange vegetables
such as carrots, pumpkin, and butternut squash) can help reduce
high blood pressure, fight cataracts and age-related macular
degeneration, and boost your resistance to colds and
infections.
We used one of the high speed blenders that will make soups to warm
this shake. There are various brands that do this. Vitamix,
NutriNinja and Nutribullet Rx are three of them.
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See product reviews in the resources section of this e-book. If you
do not have one of these blenders, make the shake as usual and warm
in a saucepan on the stovetop.
Ingredients • 4 medium sweet potatoes, approximately the same size
(1 ½ lbs.)
• 2 tbls. olive or vegetable oil
• ½ cup coconut milk
• Shake of allspice
• Tiny Shake of cloves
Toppings to be blended in at the end: (optional): • So CocoWhip
Whipped Topping (no transfats)
• St. Dalfour Organic Caramel Sauce (No refined sugar)
Directions If you are soft-baking potatoes, I recommend doing it a
day ahead or in the morning, so the potatoes have time to cool
before you remove them from their skins. This produces a sweet
potato with a velvet texture. With almost no labor, you have a
sweet potato with full flavor and excellent for puree:
Preheat oven to 300 degrees
Wash and dry potatoes and cut off sharp ends or blemishes.
Puncture each potato three times with knife to allow steam to
escape.
Put oil in a shallow bowl and brush outside of potato with
oil.
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Cover with aluminum foil. Line up on baking sheet, leaving distance
between for air to circulate.
Bake 90 minutes, until potatoes are soft. Remove from oven and
allow to cool enough to handle.
If you are using canned sweet potatoes. Simply add the contents of
a fifteen ounce can of sweet potatoes to the blender and puree
until smooth.
For the Puree For baked potatoes: Open foil and remove skins,
scraping out potato flesh and placing in bowl and mashing until
soft consistency with no fibers. Pick out any fibers.
Place potato flesh in blender with coconut milk and spices. Coconut
milk provides fat for proper absorption of vitamin A. Make sure the
spices are fully blended. Remove with a spoon any unblended
spices.
For those who like more sweetness, add a little honey to sweeten up
the puree. Or add a tablespoon of the caramel sauce for sweetness.
It is sweetened with agave and rice syrups.
The full fat coconut milk will give this pie a very creamy texture
and does not have the sugar content of evaporated milk, usually
used for sweet potato pie. For additional creaminess, add a
tablespoon or two of the So Coco Whip Coconut Whipped
Topping.
Use the soup function on a high speed blender such as the Vitamix,
the Nutribullet RX or the Ninja version. Or blend in a regular
blender and then head on the stovetop or in the microwave until
slightly warmer than body temperature.
Swirl Away!
My guiding principles for rating these products were: performance,
design, ease of cleanup, ease of storage.
Buy all at once, or add them one at a time.
All of them are easy to use. All of them serve a function. All of
them are labor-saving and time-saving.
These are qualities to consider in the purchase of kitchen
appliances. Reliability and ease of use are the two top qualities.
Will the machine do the job that needs to be done? Is it too
difficult to figure out?
Pleasure in use is also important. You have to like the machine.
Sometimes it is worth the investment so that you are not irritated
every time you use the machine. In the puree kitchen, you may use a
machine three times a day or more. This is a factor to consider
when purchasing your kitchen appliances.
Are quality appliances worth the investment? I think so. The issue
is the safety of the diet.
These brands are widely available in retail stores or easily
available online. If you wish to have the appliances overnighted to
you, you can order from the online retailers. If you want to take a
look at the product, go to a local store that carries the line and
examine them in the real world.
In setting up the dysphagia kitchen, over time, savings on food
costs mount up/ Your cost per serving is cheaper than buying
commercially prepared food.
You have better quality of food at a lower price.
The Happy Factor: The food tastes better and this leads to patient
satisfaction and harmony with caregivers.
EssentialPuree.com Quickies for Caregivers™ Series page 13
Here is the product review.
How to Set Up: For the dessert and snack kitchen, your two most
important appliances are your blender and your mini food processor
with the three cup bowl.
These appliances is that most of them are portable. They are
perfect for travel.
Your mini food processor can be bought at stores ranging from
department stores to kitchen stores, to discount stores, such as
Target and Wal-mart.
There are many brands, KitchenAid, Cuisinart, Black and Decker. All
are in the same price range. $30 to $40.
BLENDERS This is the most important tool for the puree kitchen. You
will use it two or three times a day, so choose a machine that you
like to use and that is easy to clean. The three brands of blenders
mentioned are your best tools because they clean so easily.
When I buy kitchen tools, I go to a store that has the machine on
display or a live demonstration. If possible, I try it out, or
watch the staff demonstrate. I visually check out the size of the
machine and its suitability for my space. If finding the time to do
this is a problem, watch the videos posted on the online retailers’
websites.
The high speed commercial blenders that can liquefy fruits and
vegetables with no particles are an investment. The patient’s
quality of life depends upon the food that is prepared in the
dysphagia kitchen. All these machines are durable. None made of
inferior materials. The specs are available online.
Note: Please stay away from blenders that have the well in the
bottom with the bottom that screws off and cleans separately. These
are a pain for the repeated daily usage of
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the puree kitchen. If you have one, you can make do, but I promise
you, with repeated daily use, you will soon give yours away and get
a new one.
Screwing the bottom on and off so you can clean the blades is
irritating. You have to screw the bottom on tight to get the seal
so the container does not leak. You have to use a gasket. The
gasket can get lost. The bottom must be unscrewed wash it in the
sink or put it in the dishwasher. Usually my hands were not strong
enough to unscrew the bottom once I got it screwed on tight. It was
always a struggle.
Consider whether you prefer the single blade or whether the
multi-tiered blade is a better choice. I prefer the multi-tiers.
You either need a multi-tiered blade system such as the one in the
Ninja (with the divine flat bottom container) or you need the
cyclonic action of the more powerful motor in the Vitamix or the
Nutribullet.
The Vitamix This is the Rolls Royce of blenders. As their
advertising states, they offer a lifetime warranty and they take
the place of a number of kitchen tools. They are also expensive.
They have a big footprint. They make a lot of noise.
They blend like no other. You may even cook soup in them and serve
a hot meal already pureed. They are relatively easy to clean. You
add a little kitchen detergent to the container and turn the
machine on for a few seconds. Then you rinse.
This is a once in a lifetime purchase. A doctor I have known for
many years, a dermatologist, bought one at Williams Sonoma. After 7
years, it died. He brought the old machine back to Williams Sonoma
and stated that he wished to buy a new one. They replaced it for
him, at no charge, because of the lifetime guarantee. True
story.
QVC has the best buy on the Vitamix and a wealth of information
online. If you buy it on QVC, you can try it out for 30 days to see
if it fits into your kitchen routine. If you don’t like it, you can
return it. This is a heavy duty machine, and has been used
EssentialPuree.com Quickies for Caregivers™ Series page 15
traditionally in the professional kitchen. It comes with an
instructional DVD. QVC has the most colors.
Amazon sells the Vitamix. It also has the choice of ordering a
refurbished Vitamix at a lower price.
You can also purchase it online directly from the Vitamix Company
or at major retail outlets such as Williams Sonoma.
The NutriNinja I used the Ninja for years for two reasons. I liked
the multi-tiered blades, and I loved the flat bottom. This is the
easiest for removal of puree and scraping the bowl clean. The lids
are excellent for storage. It is quiet. It is small.
The NutriNinja is the high speed nutrition extractor version of the
regular Ninja. . It was created to compete with the Nutribullet.
These designs are good for some purees. For the variety of foods
prepared in the puree kitchen, both the Nutribullet and the
NutriNinja have more limited application.
The Nutribullet Rx Pro This is available from HSN. It has two
cycles. The regular extraction cycle and the soup cycle. It has the
option of heating up food. It is a nutrition extractor. It is
excellent for cooking a small amount of dessert, say the warm apple
pie shake, at 110 degrees so you can serve it warm.
EssentialPuree.com Quickies for Caregivers™ Series page 16
About the Author
Shake, Rattle and Roll is the latest work from author, journalist
and scholar Diane Wolff. This e-book is written for caregivers and
focuses on the Quickie Dessert and Snack. Diane’s first cookbook
for the dysphagia kitchen, Essential Puree: The A to Z Guidebook,
contains 67 updated family recipes for starters and salads,
entrees, side dishes, sauces and desserts. It is a guidebook to
setting up and running a dysphagia kitchen.
An author of works of narrative history set in China, Diane has
traveled Asia for decades researching her work. She has been
seeking out stories and chasing down great food. Some years ago,
Diane gave up her life of reporting, researching and writing about
Asia when her mom asked her to come home from the high road in
Asia. From her experience in taking care of her mom, the late great
Cathie G, this book was born. Working in the kitchen, Diane took
notes, did her research on dysphagia and consulted healthcare
professionals of all kinds. She wanted to make sure that her mom
had good quality of life in the last years of her life. Quickies
for Caregivers came into being a collection of recipes created for
Diane’s mom.
Diane took care of her mom for five years. Through her experience
in teaching the caregivers, the aides and CNAs who supported and
assisted the family in caring for Cathie in a home healthcare
situation, Diane got a thorough education in dysphagia care from
Cathie’s primary physician and from the healthcare specialists who
supported Diane as a dutiful daughter turned caregiver. Diane felt
that her writing deepened through the experience. She also learned
a great deal about dysphagia care and feeding and created a diet
designed to give her mom a great experience, despite the swallowing
difficulty.
Through her own research in attempting to care for her mother,
Diane realized that there was a real need in the literature for
books that were in harmony with the great
EssentialPuree.com Quickies for Caregivers™ Series page 17
food revolution going on in the United States, that of clean eating
and nutritional healing.
Diane sought to blend the art of fine food with the science of the
puree for people with dysphagia and swallowing difficulties.
Through her study of Asian traditions, she sought to use the
techniques of visualization to relieve the sense of boredom or loss
and deprivation in dysphagia patients and those with swallowing
difficulties, whether permanent or temporary.
Through her long collegial relationship with the noted practitioner
of Traditional Chinese Medicine, TCM, Michael Broffman, Diane
incorporated the Chinese idea of the psychological aspects of
meals. Through her membership in a group of renowned food writers,
Diane received support in this approach from a British clinician,
Nicola Miller, who works in the field of Mental Health in England.
Working from the point of view of Western medicine, Nicola writes
of how she and her colleagues employed the other senses to make up
for the patient’s loss of the swallow.
Though the author had little acquaintance with the condition of
dysphagia before her mother was diagnosed, she soon realized that
the ability to eat is clearly a life and death matter.
What is at stake with the dysphagia patient? This is not pleasant
to speak of, but when a life is at stake, the discussion is
necessary. The most direct consequence is the necessity for a
feeding tube if the patient cannot eat. If the patient is able to
eat but does not eat correctly, the aspiration of food from
coughing may lead to bacterial pneumonia, a condition that may be
fatal and is extremely difficult to cure. In doing this work, Diane
heard stories from people whose family members supported her work
because their own loved ones had suffered the worst
consequences.
A demon for research, Diane devoured the material available in the
field when her mother was diagnosed. Her books are the works she
wished she had when her mother received the diagnosis.
EssentialPuree.com Quickies for Caregivers™ Series page 18
The National Dysphagia Diet
The National Dysphagia Diet (NDD) is the standard for dietary
treatment of swallowing difficulties.
In 2002, the American Dietetic Association (now called the Academy
of Nutrition and Dietetics) set the standards for the “National
Dysphagia Diet: Standardization for Optimal Care.”
As of the summer of 2015, the International Dysphagia Diet
Standardization Initiative is working to standardize the
terminology for food textures and liquid consistencies for use
around the world, in all cultures and with all age groups.
The following terms apply to modification for foods and beverages.
Your healthcare provider will determine which of these is
appropriate for you.
There is no “one size fits all” diet. All diets must be created
with the advice of one’s healthcare providers, namely physicians
and speech pathologists. Please consult your physician and speech
therapist if you have any questions.
The National Dysphagia Diet Levels If you’ve been told that you
need to modify food textures, these are the standards:
• The Regular Diet (Internationally known as “Level 7”) All foods
are acceptable. Foods may be hard and crunchy, tough, crispy and
may contain seeds, skins and husks. Persons on a regular diet have
the ability to produce saliva and chew for as long as it takes for
the food to form a cohesive “ball” (bolus) for safe swallowing.
Mixed textures are no problem. Some patients have a temporary need
for purée and return to the regular diet. Some patients remain on
purée for reasons indicated in their own medical history.
• Dysphagia Advanced Soft Diet (Internationally known as “Soft” or
“Level 6”) Foods of “nearly regular” textures with the exception of
very hard, sticky or crunchy foods. This texture requires chewing
and tongue control. Foods should be tender and easy to break into
pieces with a fork.
• Dysphagia Mechanical Soft (Internationally known as “Minced and
Moist” or “Level 5”) Foods with a moist, soft texture. Ability to
tolerate mixed textures needs to be assessed. Meats need to be
chopped or ground. Vegetables need to be well cooked and easily
chewed. Foods should be in small pieces (¼” or 5mm). No hard,
chewy, fibrous, crisp or crumbly bits. No husk, seed, skins,
gristle or crusts. No “floppy” textures such as lettuce and raw
spinach. No foods where the juice separates from the solid upon
chewing, like watermelon.
• Dysphagia Puréed (Internationally known as “Extremely Thick” or
“Level 4”) All food should be puréed to a homogenous, cohesive,
smooth texture. Foods should be “pudding-like” and hold its shape
on a spoon. Contains no lumps. Not sticky. Puréed foods can be
piped or molded and will not spread out if spilled. The prongs of a
fork make a clear pattern when drawn across the surface of the
purée.
Liquids The Essential Purée Guidebook does not deal with the Liquid
Diet, only liquids thickened as beverages, MEANING A NECTAR OR
HONEY CONSISTENCY.
Your healthcare provider will determine if you may use any of the
recipes in this book.
Here are the definitions of the three different consistency levels
for the Liquid Diet:
• Nectar Thick liquids coat and drip off a spoon like a lightly-set
gelatin. This consistency requires little more effort to drink than
thin liquid. It is easier to control though the swallow than thin
liquid and can flow through a straw or nipple. (Internationally
known as “Slightly Thick” or “Level 1”
• Honey Thick liquids are thicker than “nectar thick” and flow off
a spoon in a ribbon, like actual honey. This consistency allows for
a more controlled swallow. This consistency is difficult to drink
through a standard straw. (Internationally known as “Mildly Thick”
or “Level 2”)
• Pudding Thick liquids stay on a spoon in a soft mass but will not
hold its shape. It pours slowly off a spoon and is sip-able. This
consistency is difficult to draw though a wide-bore straw.
(Internationally known as “Moderately Thick and Liquidized” or
“Level 3”)
For Clinicians: A Note from the Authors of the National Dysphagia
Diet The NDD authors stress that the categorization process is a
work in progress and far from a perfect science, especially as
applied to the individualized needs of each dysphagia
patient.
While establishing liquid and food-related categorical protocols
may help to create a standardized “starting point” to evaluate the
specific needs of each patient, both the NDD task force and ASHA
experts acknowledge that there is much research to be conducted and
it should never be applied as a “one-size-fits-all” approach.
The International Dysphagia Diet Standardization Initiative (IDDSI)
work group has taken up the challenge to look at the dysphagia diet
from a global perspective.
They are a group of people from diverse professions including
nutrition & dietetics, medicine, speech pathology, occupational
therapy, nursing, patient safety, engineering, food science &
technology from around the world who have come together to
establish an international standardized terminology and definitions
for texture modified foods and thickened liquids for persons with
dysphagia.
In the next several years, clinicians just might see the next
evolution of a the NDD.
The above information on the National Dysphagia Diet is the
contribution of Laura Michael, a board member of the National
Foundation of Swallowing Disorders and an ambassador to the ISSDI,
the committee working on establishing international standards for
the National Dysphagia Diet. Laura is the author of a clinical
manual for caregivers that may be obtained from her website,
DysphagiaSolutions.com
Thickeners Instant Food Thickeners Instant food thickeners are used
to thicken liquids to the proper consistency for safe swallowing.
They also bind purées so the components of a dish do not separate -
they stabilize.
Instant food thickeners have come a long way in the last five
years. Starch-based thickeners, like ThickIt, used to be the
industry standard. Starch thickeners often add a starchy or pasty
flavor to liquids. They make liquids cloudy and can only be used in
certain liquids. Starch thickeners add carbohydrates and continue
to thicken on standing, so they can be difficult to use and don’t
taste great.
Times have changed. New products have come on the market. Gum-based
thickeners like Simply Thick and ThickenUp Clear, are now widely
available.
Liquids thickened with these new gum-based thickeners are clear and
taste just like the base beverage.
These thickeners do not add or alter flavor, mix easily into
liquids, and can be used in all types of beverages (including
alcohol and fizzy drinks). They do not continue to thicken upon
standing.
These thickeners come in two forms: gel and powder. Powdered
gum-based thickeners are no more expensive than starch thickeners.
The containers are smaller because powdered gum-based thickeners
are more concentrated than powdered starch thickeners.
Gel thickeners, like Simply Thick can be a bit more expensive than
starch thickeners, but the higher cost may be worth it if you
consume (and enjoy) the liquids you need for good health.
Simply Thick is a gel formula, gum-based thickener. It can be found
at some pharmacies or online at simplythick.com.
ThickenUp Clear, Thick & Easy Clear, and SloDrinks are powdered
gum-based thickeners.
ThickenUp Clear, a product of NestleNutrition, can be purchased at
many Walgreen’s stores or online. For more information:
thickenupclear.com.
Thick & Easy Clear, from Hormel Health Labs, can be purchase
online: homecarenutrition.com
SloDrinks produce beverage-specific gum-based thickeners in
individual portions. You can purchase SloDrinks at
Amazon.com.
How to Thicken Drinks Hydration is important for the dysphagia
patient, so it is important to have the ability to thicken
many types of beverages.
There is an art to thickening liquids, including fruit juices,
milk, coffee and tea, sodas and other carbonated beverages and
alcoholic beverages. Don't be shocked. Not every dysphagia patient
is alcohol-restricted.
One company has thought this need for hydration through and has
created an excellent line of products for every type of beverage.
It is called SlõDrinks.
This company was recommended to me by Laura Michael, the dysphagia
care expert. They have a special line for beer, wine and bar
drinks. If you are cleared for the consumption of alcoholic
beverages, the product is sold on Amazon and also on their
website.
I interviewed the founder of the company, Matthew Done. He
explained the reason why there are different products for different
drinks. Food science, dear readers, is important and it takes
time.
"A drink’s fat, sugar, temperature and pH levels affect a
thickener’s ability to thicken. . .As a result my company has
different thickeners for different drinks. I think we are the only
manufacturer to think this way, which is why it took 10 years to
perfect our products!"
As Matthew explained, "It is essential to first make sure the
thickener works in a drink and then calculate the amount required
to make it a specific consistency."
Different thickeners for different liquids. That is why the full
product line took 10 years to develope. SlõDrink thickeners are
available in nectar and honey consistencies. The company also
provides instructions for pudding consistency. You use less liquid
rather than more thickener to get to the correct consistency for
each individual.
The SlõDrinks website is informative. If you click on their YouTube
link, you will find a How To video, with Matthew himself
demonstrating how to use his company’s products.
ALL LIQUIDS must be thickened for the dysphagia patient. This
includes oral rinses and liquid medicines, such as cough medicines.
It is easy to overlook liquids such as mouthwash and liquid
medicines, but it is absolutely necessary.
SlõDrinks also makes a line of thickeners custom-tailored for
taking medication, such as flu medication in hot or cold liquid.
They have a second formula for pain medication and vitamins.
Pre-thickened Water and More Producers are now making pre-thickened
“clear” waters in both Nectar and Honey consistencies. These
beverages have no flavor, are clear and reliably consistent.
Two brands to consider are:
Thick & Easy Clear water, from Hormel Health Labs, has a slight
lemon flavor. It is available in Nectar and Honey consistency. You
can purchase it as single-serve 4 oz. portions and 48 oz.
bottles.
Thick & Easy also makes pre-thickened juices, coffee, iced tea
and milk. Thick & Easy® products can be purchased online at
homecarenutrition.com
ThickIt AquaCare H2O water, from Kent-Precision Foods, has no added
flavors. It is available as Nectar and Honey consistency. It is
available in 8 oz. bottles and 48 oz. bottles.
ThickIt AquaCare H2O makes a complete line of thickened juices,
coffee and iced tea. Find ThickIt AquaCare H2O water in your
grocery store or pharmacy. It is also available online:
thickit.com/ products/beverages
Reading Material
The Official Patient’s Sourcebook on Dysphagia, published by Icon
Health Publications, is available from icongroupbooks.com and
various booksellers such as Amazon and Barnes & Noble.
American Heart Association’s Nutrition Center
Heart.org/HEARTORG/GettingHealthy/NutritionCenter/Nutrition-Center_UCM_001188_
SubHomePage.jsp
American Diabetes Association Diet Pages
Diabetes.org/food-and-fitness/food/what-can-i-eat/
Choose My Plate Nutrition Guide published by U. S. Department of
Agriculture ChooseMyPlate.gov Click on videos for My Plate, Grains,
Fruits and Veggies
Food Pyramid for Latin and Asian Cuisines published by The Mayo
Clinic MayoClinic.com/health/healthy-diet/NU00190
On Food Safety Foodsafety.gov/keep/index.html
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