How to make Pureed "Bangers and Mash"....

Here is a cookery tutorial on how to make vegetarian "Bangers and Mash" to a thick puree consistency.  There are more videos on our YouTube channel which show you how to make different meals appropriately and give some handy tips.

https://www.youtube.com/watch?v=b7Ostj_9VqM

Feel free to like and comment on the videos, and please follow our channel!

We're on the University Website!

Here's a recent article written about our Dysphagia awareness campaign published on the De Montfort University website.
http://www.dmu.ac.uk/about-dmu/news/2014/december/how-living-on-pureed-lasagne-and-sloppy-mash-helped-three-dmu-students-highlight-a-life-changing-condition.aspx

Thanks...

Our five days on a modified diet is over and I would like to thank everyone for reading and sharing our blogs, watching our videos and donating. We have raised over £1000 for DementiaUK, which is more than double our original target, and the figure is still rising.  We hope our blogs have been enlightening, and that everyone who has come into contact with our campaign has learned something new about dysphagia or been inspired to find out more. We will be continuing with our campaign to raise awareness, and next week are running a workshop for health students within the university, about swallowing difficulties and their management.
If you haven't donated, and would like to, then here is the link:
 https://www.justgiving.com/j-white1/

Day 5 and a summary...

Breakfast:

Natural yoghurt with pureed pear and honey

This is a very healthy breakfast, packed with flavour.  Although it didnt fill me up as well as the readybrek, I really enjoyed it, and was able to got one of my 5-a-day in, with the pureed pear. 

I used fresh pears but you could use tinned. To puree the pears, you have to peal them, chop them up, and mix with a small amount of apple/pear juice. Then add thickener if necessary.     This does take some time, so I would recommend making the puree the night before. You can make a batch and use it for a few days, as long as you keep it in the fridge. 

Lunch:

Left over pureed curry

Just be aware of the consistency when you reheat this, and add water or thickener as needed.  Although I at this without the rice, it was still filling.

*NOTE: I would not recommend eating left over rice as not only does it go very solid and stodgy when left, but if its not kept properly, rice can give you very nasty food poisoning. 

Dinner:

Vegetarian "bangers and mash"  (thick puree)

I used Linda McCartneys sausages for this. I cooked them in the oven as normal, and then pureed them with some gravy.  Although they tasted good pureed, they had a grainy texture which took some getting used to, but I got used to that, they were enjoyable.  I piped them onto the plate  (so they looked more like sausages) and served with pureed mashed potato (with plenty of cheese in) and pureed broccoli and carrots. 

NOTE: you can have gravy with this meal as long as it is of the same consistency / slightly thicker than your recommended drinks.

Pudding/Snack:

Marble cake

You can still have cake on your pureed diet.... 

You put a thin (1cm wide) slice of cake into a tupperware box, and pour over it a solution of 150/200mls of fruit juice mixed with approximately 1 scoop of thickener.  You then need to leave this in the fridge for a few hours.  When you take it out, the cake should have soaked up the solution, and become soft enough consistency that if on a thick puree diet, you can eat it.  

NOTE: I found that I had to mix the softened cake up a bit with my spoon before eating it.

I used cranberry juice for the solution, and it went very well with my homemade chocolate marble cake, but my friends used orange juice, which also worked well. This is an enjoyable and fairly filling snack. 

I personally really enjoyed the process of baking, as it is something I do quite regularly. We made the cake so that our friends could have a slice at yesterdays dinner party, and we were able to have some the next day - so it is something you could share with family and friends which is really lovely. 

Although it seems a very minor thing, I took great pleasure in being able to taste the cake mixture before it was cooked, as throughout the week I have found it very difficult being unable to taste my cooking before it is pureed.

NOTE: uncooked cake mixture contains raw eggs, which could make you unwell. 

Alcoholic drinks:

I have tried a few different alcoholic drinks thickened this week, and I would definitely suggest going for a fruity flavored drink such as a spirit mixed with juice, or a cocktail. My usual drink of choice is wine, but I found that in this you could really taste the thickener, and it wasn't very pleasant.   Be aware that when thickening any carbonated drink, that if you are using a starch based thickener, it will react and bubble up, and may take longer to thicken.
* NOTE:remember to ask for your drinks without ice




What have I found most difficult this week?
The most difficult thing this week has been not being able to drink plain, unthickened water.


Did it affect my daily life? 
In terms of my daily life, the main impact was the amount of time I spent preparing meals. As a student with a busy schedule, who often needs to grab a quick meal in-between classes and extra curricular activities, I found this difficult, and had to be ultra-organised.

I thought that being on a modified diet might impact upon my social life, but it didnt. I was still able to go out with my friends, and earlier in the week, I went to the pub quiz. I took along a small tub of thickener and thickened my drink back at the table, along with my two friends who were also on a modified diet. Although people did ask what we were putting in our drinks, no-one was rude, they were just interested. Being asked, gave me opportunities to explain about dysphagia, and raise even more awareness.

Also, in the blog post from day 4, you can see that we had a dinner party, in which we cooked for both modified and regular diets. 

Weight and Nutrition:
I have been asked a number of times whether I have lost weight on this diet.  I haven't.  This is probably because, although I haven't been snacking like I usually would, most of my meals were fairly high in calories, as when I was blending food, I was often adding milk and cheese. And possibly also because I have actually been eating fairly large portions, because when blended, food looks much less.

However, some people do lose weight on these diets, and it is important to keep track. To combat weight loss you can fortify every meal (with cream and cheese) and drink higher calorie drinks such as hot chocolate, milk shake and smoothies on top of normal meals. You can also prepare appropriate consistency snacks, such as custard or angel delight.

Day 4...

Breakfast:
Readybrek and Nutella,

I had the same as yesterday for my breakfast, as it is fast to make, tastes good and keeps me full until lunch.


Lunch:
Left over Leek and Potato soup with Cheese

                                 

Again, when reheating this, it was necessary to add some milk and stir regularly.  I seasoned it with salt and pepper, and added some very finely grated cheese (which melted into the soup in the microwave).

*NOTE: it is ok to add cheese, but it must be melted and mixed in so grate it finely and stir.



Dinner:  
Vegetable Lasagne   (thick pureed consistency)

Pureed consistency lasagne

Regular consistency lasagne

We had a dinner party this evening and needed  to make both pureed and regular consistency meals. We therefore chose vegetable lasagne, as we could use the same ingredients for both, and then puree ours before putting it in the oven.  We did this whilst cooking the regular lasagne, as the pureed one needs half the amount of time in the oven.
This tasted really good and was full of flavour! We layered the pureed ingredients like you would for a normal lasagne which made it more interesting to eat.
We used blended pasta for the layers, but although we had seen examples of it done online, we really struggled to puree the pasta to a smooth consistency. It took a very long time, and needed mixing with alot of milk and butter, and even then, was still lumpy (which isn't appropriate for a puree diet). Polenta would be a better alternative, and is what we wanted to use, but it wasn't available in our local supermarket.


I really enjoyed eating as a group, as I have found that I've been eating on my own alot this week (as I would normally cook with my housemate), and when you are eating with other people, you tend to take less notice of the food.
It was good to know that it is possible to cater for a modified diet along side a regular one, without too much hassle.

Day 3...

Half way through our 5 days on a modified diet.

Breakfast:
Readybrek with Nutella.

As I said yesterday, I really enjoy having readybrek for breakfast, it is hot and it fills me up. I mixed it with nutella (chocolate and hazelnut spread) today, after a recommendation from a friend, and loved it! But then again, that isnt a surprise, as I am a self professed chocaholic. For some people this may be too sweet.

Lunch:
Butternut Squash Soup

This was lovely, as it is something that I often eat for lunch during autumn/winter. I actually bought this soup in a carton from my local super market, to save time during my busy lecture schedule. This might be a good way to take lunch with you to work, as many offices have a microwave you can use.

The main thing to note if you're going to do this, is that you must either buy smooth soup, or blend it until it is smooth. You must also be aware of the consistency, and add commercial thickener or cornflour where necessary (as I had to).

*NOTE: soup must be at least as thick as the fluids you have been recommended to drink

Dinner:
Vegetable Tikka Curry & Rice   (thick puree consistency)

This was a very satisfying meal. Because the curry had such a strong flavour, I took much less notice of the consistency.   Make sure not to add too much water when you're making the curry, so that it doesn't become too thin when you blend it (otherwise it will be necessary to add thickener or cornflour)  I used a curry paste instead of a jar of sauce.
The rice blended easily with a splash of milk but was very hot so be careful not to burn yourself
I served the curry on top of the rice so that i could eat them mixed (as the rice was quite bland).
I would also recommend serving with a table spoon of smooth mango chutney (you could blend some or buy the squirty tube).

*NOTE:  Using a garnish to improve presentation is fine. But do NOT eat it!


Desert/Snack: 
Banana, Chocolate and Peanut butter Chill

I blended two and a half  semi-frozen, sliced bananas with 3 desert spoons of peanut butter and 50g of dark chocolate. I added a small amount of thickener (but this might not be necessary) and placed it in the fridge to chill for a few hours,

This is a high protein snack that contains one portion of your daily fruit and veg.  It is also really tasty.

Some facts and figures about Dysphagia....

Dysphagia (the medical term for difficulties swallowing), affects a wide range of people, approximately:

• 90% of people with motor neurone disease (MND)
• 68% of people with dementia 
• 50% of people with head and neck cancer
• 40% of stroke survivors  (but this is as high as 78% initially)
• 30% of people with Multiple Sclerosis (MS) 

It is also possible to have dysphagia short term, caused by an infection (e.g. a UTI) or by the side effects of some drugs.

[figures taken from Health Care Services]

Dysphagia can be caused by difficulties at any of the 4 stages of a normal swallow, which are:

1. Oral Preparatory stage

2. Oral stage

3. Pharyngeal stage

4. Oesophageal stage

On average you swallow 580 times a day in order to eat, drink and manage saliva, and each swallow involves 25 different muscles, and 5 nerves. 

The swallowing process actually starts before the food or drink enters your mouth, because the sight and smell of food helps to trigger saliva, which aids the oral stage of the swallow, and ends with food and fluids arriving in the stomach.  
If dysphagia is not managed correctly, it can lead to choking, aspiration, pneumonia, malnutrition, dehydration and possibly even death.