When we teach patients or clients to eat better, we inevitably review label reading and ingredient lists on packages. We instruct patients to look for cereals with more than five grams of fiber and less than four grams of sugar, or for breads whose first ingredient is whole grain.
But what do we tell our patients to look for in a recipe when they want to cook more at home? Not everybody has a knack for cooking or can immediately determine whether a recipe is healthy. Unlike packaged foods and food from restaurants, recipe books and websites are not required to provide nutritional information. The healthfulness of recipes can sometimes be hard to determine from the available information. For example, recipes that are advertised as low-calorie are sometimes very high in sodium.
Here are some tips to use with patients that can guide them through the wild west of the recipe rodeo.
A great place to start is with recipes that come from trusted sources. The USDA Nutrition.gov website has a variety of recipe collections from reliable sources that are searchable by food category and cost. They provide pictures, step-by-step directions, and nutrition information. Some recipe collections are even targeted to those with children or with health conditions like diabetes or heart disease. The recipes vary in terms of the skill level required, but they often have an emphasis on quick and easy weekday cooking suggestions. Besides recipes from the government, well-known commercial sites that provide nutrition information, such as eatingwell.com or cookinglight.com, can also be useful sources. Of course, the world of recipes is much larger than this, and almost any recipe that contains nutrition information can be used or adapted to fit into a patient’s meal plan.
But what about recipes that do not have nutrition information? Some of them are perfectly delicious and acceptable. When reviewing these recipes, the bulk of constructed dish should be made of healthful ingredients. While it is fair to use small amounts of less healthy ingredients to enhance flavor, such as small amounts of sharp cheeses or a couple of strips of bacon in a recipe designed to serve six or eight, healthful ingredients should be featured.
For example, most of the ingredients in a vegetable side dish should be fresh or frozen vegetables with limited amounts of added fats, sugars, and salt. Carbohydrate-heavy recipes, featuring grains and starches, should contain as much whole grain as possible, and for those who eat meat, recipes should use lean cuts. Also, the method of cooking is important. In general, patients should avoid deep frying and should pan fry on a limited basis. Whenever possible, they should favor more healthful methods like baking, broiling, or grilling.
Teaching patients how to modify recipes to fit with their meal plan is an excellent way to help them feel empowered and to open the door for them to experiment with a wide range of new dishes.
For example, let’s modify this common comfort food recipe for shrimp fettuccine alfredo from Delish:
- 1 lb. Fettuccine
- 3 tbsp. Butter, divided
- 1 lb. Shrimp, peeled and deveined, tails removed
- Kosher salt
- Freshly ground black pepper
- 2 cloves Garlic, minced
- 2 tbsp. All-purpose flour
- 1 c. Heavy cream
- 1/2 c. Whole milk
- 1 Egg yolk
- 1 c. Freshly grated Parmesan, plus more for garnish
- 1 tbsp. Chopped parsley for garnish
At its core, this recipe is an entrée using shrimp and pasta as its base ingredients. The pasta is white, so there is no fiber source, and the alfredo is composed of heavy cream, whole milk, and a sizeable amount of Parmesan cheese.
Luckily, there are better options. Here’s an alternative take on this dish from Diethood, which reduces saturated fat by cutting the Parmesan cheese, substituting skim milk, and using vegan butter.
- 12 ounces Fettuccine
- 1 bag (12 ounces) Frozen peas and broccoli
- 4 tbsp. Vegan butter
- 4 cloves Garlic, minced, divided
- 1 lb. Large shrimp (about 16), shelled and deveined, tails removed
- Salt and fresh ground pepper, to taste
- 1 tbsp. Olive oil
- 3 tbsp. All-purpose flour
- 1 c. Vegetable broth
- 1 c. Skim milk
- 1/2 c. Shredded Parmesan cheese
The fiber and vitamin/mineral content is elevated with the addition of peas and broccoli — definitely an improvement on the nutrition front. But because the recipe uses shrimp, a good amount of Parmesan cheese, regular vegetable broth, and salt, it will be high in sodium.
There are other modifications we can recommend that would make this dish even more healthful. Swapping in low-sodium vegetable broth, eliminating the extra salt, and cutting the half-cup of Parmesan cheese down to 1/3 cup will go a long way to reducing the sodium content to more acceptable levels. And switching to a whole-grain or bean-based pasta will up the fiber content.
Patients do not have to be great cooks or particularly creative in the kitchen to enjoy delicious, healthful meals. There are so many recipes at every level of cooking skill available. And with the right knowledge, patients will be able to identify which recipes can be used as-is and how to adapt dishes to their needs, making home meal planning easier than ever.
Helping patients effectively meal plan is a central component of Silver Fern’s approach to whole-health care. A Meal Plan Module is included in each of our disease programs, and it comprehensively assesses the patient’s current meal plan behaviors, their goals, and their barriers to effective meal planning, such as not liking to prepare and cook meals. Silver Fern’s Behavior Diagnostic Platform offers suggested actions that are tailored to patients’ individual assessment results. These suggestions provide actionable pathways of care to help patients develop the skills and knowledge to adjust their eating behaviors, set measurable goals, and overcome personal barriers to healthy meal planning.
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Nora Saul is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Nora has more than 25 years of experience in the field of diabetes education, consulting for the Joslin Diabetes Center and other industry partners. Nora leads content development for Silver Fern’s diabetes products and training.