Away for a while...

...but I hope to be back here soon.

Despite all the gardening posts on this blog, you did know I'm a clinical dietitian at a large, acute care hospital, yes?

Vancouver General Hospital remembers 100 years: Private ward dinner tray, 1933


And now my mind, energy, and time are focused on this work as well as preparing for an upcoming educational event. This is my latest "excuse" for why I'm unable to spend time on my -- or your -- blog.

See you soon, I hope. I miss my online time with you all.

(The photo has very little to do with my day-to-day work -- or present day reality -- but I do love this glimpse into history.)

Resources for people with dysphagia & those who care for them (collection #2)

Here are three more dysphagia resources I recommend for basic information and practical tips on eating safely and with enjoyment.


Dysphagia - This web page from the National Institute on Deafness and Other Communication Disorders in the U.S. provides a basic, easy-to-understand overview of dysphagia in a question and answer format. It also includes a clear diagram of anatomy involved in swallowing.


A Manual for People Living with ALS - ALS stands for Amyotrophic Lateral Sclerosis (ALS), the most common form of Motor Neuron Disease (MND).  A Manual for Living with ALS is available as a free PDF from the ALS Society of Canada. It includes a section on adapting to swallowing problems and maintaining good nutrition (pages 36  through 41) and a page of recommended cook books (page 81) as well as a section on maintaining oral health (pages 55 through 57).

Although some of the manual's information is region-specific (e.g. community resources), the content on food and nutrition will be helpful no matter where one lives.  


Puréed Foods for Swallowing Problems (PDF) - Wendy J. Dahl, PhD RD, developed this clear, concise resource that describes the characteristics of the ideal pureed food and explains how to prepare it as well make meals tasty and appealing. Dr. Dahl also is the author of Textured Modified Foods: A Manual for Food Production for Long Term Care, 2nd Edition.



Plum Crisp

My contribution to a pot-luck dinner hosted by a colleague. The other items on the menu: an apéritif made with homemade ginger syrup and soda water, white bean & kale soup, a rustic loaf of wholegrain bread, and a salad of mixed baby greens, sweet bell peppers and pecans. Did we eat with abandon? No, I wouldn't say that. But we did eat with freedom, enjoyment and gratitude.

Plum Crisp, adapted from a recipe for berry crisp in "Food to Live By", The Earthbound Farm Organic Cookbook

Plum Crisp

Makes one 1-quart crisp


2 cups frozen, pitted plums, thawed and cut in quarters
1 cup frozen apple-and-pear sauce, thawed
2 tablespoons cornstarch
2 tablespoons Turbinado sugar (use more or less depending on sweetness of fruit and your taste preference)
2 tablespoons maple syrup


1/3 cup unbleached all-purpose flour
1/2 teaspoon cinnamon
1/8 teaspoon salt
1/4 cup firmly packed dark brown sugar
1/3 cup old-fashioned rolled oats
3 tablespoons unsalted butter

1. Make the topping. Place flour, cinnamon, salt and brown sugar in a medium-size bowl. Stir together until blended. Add the butter in small chunks. Work the butter into the dry mixture with a fork or your fingers until it is in small, sweetlet pea-like bits. {Make mental note to self to try Heidi's recipe for crumb topping next time.} Add the rolled oats and stir to combine.

2. Set topping aside. {Take a break to give some love and a treat to any pet who knows some kitchen goodness is happening, a crumb or two may fall, and so is leaning heavily against your lower legs while you stand at the sink.}

3. Position a rack in the centre of the oven and preheat it to 375 degrees Fahrenheit.

4. Make the filling. Place the plums and apple-pear sauce in a large bowl. In a small bowl, combine the cornstarch and sugar until blended. And the cornstarch and sugar to the fruit. Toss gently to combine. Transfer the fruit mixture to a shallow baking dish. {I used a quiche/flan pan.} Drizzle the maple syrup on top of the fruit.

5. Sprinkle the topping over the fruit but do not pack it down.

6. Bake the crisp until the fruit juices bubble up around the edges of the baking dish and the topping turns golden. {In my convection oven, this took about 30 minutes.} Let the crisp cool slightly before serving it warm.

Adapted from a recipe for Summer Berry Crisp, Food to Live By: The Earthbound Farm Organic Cookbook, page 346.

Resources for people with dysphagia (collection #1)

Maple Custard, a nourishing, tasty, easy-to-swallow food

Last November, an intern's question prompted me to update my inventory of education material for people with dysphagia. Keen, energetic interns never fail to inspire me, but when we're so busy collecting and discussing new information, I don't have much time to refine my notes into a publishable blog post. You may have heard me lament I don't write quickly. You also may recall last week I vowed to finish some of the things I've started, blog posts being one of the main unfinished things.

This morning I pulled out the draft post where I'd compiled dysphagia resources, re-visited each site to refresh my memory about its content, and decided, yes, each one is well worth sharing. Here now, with brief commentary, are three resources.

Please note: Not every tip or recipe in these resources will be appropriate or safe for people with specific types of swallowing disorders who must limit their intake to a particular consistency for solids (e.g., pureed) and liquids (e.g., honey-thick).  Though people who can eat soft and minced/finely chopped foods usually also can eat pureed foods, the reverse is not necessarily true.


Meals for Easy Swallowing (PDF)

This is a publication from the ALS division of the Muscular Dystrophy Association (U.S.). An ALS clinic coordinator, registered dietitian, nurse & speech-language pathologist compiled recipes "derived from our patients and their creative spouses who translated their caring into foods that look good, taste good, are easy to chew and to swallow, and minimize discomfort." In addition to recipes for beverages, soups, breads, entrees, sauces, vegetables, and desserts there are helpful tips on food preparation, service, menu-planning. Most recipes are suitable for a pureed diet but there are some recipes for soft and minced textures, too.

A separate Nutrition Issues page discusses related topics such as maintaining weight, hydration, choking and feeding tubes.


WebWhispers Laryngectomee-Friendly Recipe Collection

WebWhispers is an international Internet group that provides information and support to laryngectomees and those with laryngeal cancer as well as more diverse group of persons with other head and neck cancers, permanent tracheostomies, caregivers and health care providers.

To help its members eat safely and with enjoyment, the website's library includes recipes "specifically tailored to laryngectomees at various stages or abilities." The Food-Nutrition-Recipes section also includes books and articles, practical tips for managing eating problems and more recipe links.


Easy to Swallow

Food stopped being a pleasure and instead became a chore.

~ Claire Wade

And so Claire Wade, a young woman with Myalgic Encephalomyelitis (Chronic Fatigue Syndrome), took steps to restore her joy in eating.  She collected recipes from renowned chefs, who included Nigella Lawson, Graham Kerr and Sophie Grigson, and published them on her site, Easy to Swallow. There are recipes for soups, main meals, vegetables, sauces, desserts and drinks.

Though the site hasn't been updated since September 2006, the content remains timely as well as tasty with helpful tips and creative, appealing recipes. I've picked a few to test including the Pumpkin & Ricotta Rotolo and the vegetable mashes and purées.

I'm facing up to the numbers. And they're spurring me into action.

Twenty days into the new year. Ten months since my last published Dietitian's Journal post. Five drafts partly completed. And one piece of advice (but not the only one) I'm going to try live by this year:

"Finish what you start" by Irina Troitskaya | Advice to Sink in Slowly

Yes, wise words, though I think in this case, it's advice to apply quickly.

Celebrating food, farms & gardens

Nutrition Month may be officially over but I forgot (!) to publish this post last week, so here it is now, a little late but still timely.

That all people in the community, at all times, have access to nutritious, safe, personally acceptable and culturally appropriate foods, produced in ways that are environmentally sound and socially just.

Richmond Food Security Society's Mandate

To help my knowledge keep pace with my passion for food security & environmental sustainability, on March 12th I attended the Richmond Food Security Society's Conference where I listened to stories that inspired and informed me.

After the sessions, I did some research to learn more about the speakers & their projects. If you're interested in food security and sustainability issues or setting up a healthy school lunch program or school garden project, I encourage you to check out the following resources:

Food For All – Making Food Security more Inclusive (Jelica Shaw, Claudia Li, Cease Wysse)

Oskayak Garden Project

Shark Truth

Farm 2 School & Food Gardens: How to advocate for healthy food in our schools (Joanne Bays & Michael Wolfe)

Farm to School

Food Gardens in Richmond - School Year Garden Toolkit

"Celebrate food...from field to table": cherish the soil

Because it's almost spring (at least according to the calendar if not the weather), I've had my hands in the soil. This has prompted many thoughts about the Nutrition Month theme and how much there is to celebrate -- but might overlook if we rush to the table.

Pots of freshly mixed organic soil & compost - ready for spring sowing

Vegetable gardens...are much more important than houses in the overall scheme of things. Agriculture is the foundation of civilization. Houses come and go, but soil must be cherished if food is to be grown for us to eat.  ~ Joan Dye Gussow, This Organic Life: Confessions of a Suburban Homesteader

Every time we eat, we owe a nod of gratitude to the soil for supplying us with the nutrients that keep us alive.  ~ Jeff Nield, Soil: The Real Black Gold
These two quotes (from two of my favourite "earthy" writers) prompt us to consider the soil for in fact it is the ultimate source of healthy food.
Jeff Nield's compelling, elegant essay describes some ways urban dwellers can protect and preserve soil. It ends with a positive but sobering message:
We are blessed to live in a physical environment [Metro Vancouver] that simply hasn’t been exploited long enough by human activity to be seriously degraded. But if we don’t learn to protect what lies beneath our feet, all our talk about local food will be moot as we munch on dirt cookies.

"Celebrate food...from field to table": Learn about your local food culture

A Chilliwack farm field

Last evening while doing a Google search on "soil", I stumbled upon this Slow Food Vancouver feature:

Securing the Food Future of the Lower Mainland by Paul Shorthouse

If you live in this region, I highly recommend reading the article.  And if you live outside the Lower Mainland, you, too, may want to read it for ideas on how to connect with and support local farmers. The feature provides fascinating, if not startling facts about our "food footprint", forecasts climate change's implications for the Fraser Valley and describes steps we can take to protect our farmlands. 

"Celebrate food...from field to table"

Nutrition Month 2011 begins today. And the theme begins with "celebrate", an excellent place to start because

Eating is not merely a material pleasure.
 Eating well gives a spectacular joy to life &
 contributes immensely to goodwill & happy companionship.
 It is of great importance to the morale.

~ Elsa Schiaparelli, Italian designer (1890-1973)


To come in subsequent posts: thoughts about the fields in which our food grows.

(Note: Black treacle "E" designed by Allison Carmichael for Jessica Hische's Daily Drop Cap, Guest Alphabet.)

Beautiful preserves...& a statement

Display of home-canned food, circa 1941-45, Library of Congress [No known restrictions on publication]

I'd like to go on record: My blog, like these preserves, is a GMO-free zone.

For now (but more to come soon), I will list only one authoritative source that has shaped my opinion and strengthened my convictions; here's one of David Suzuki's recent statements: More science needed on effects of genetically modifying food crops. Also on one of the David Suzuki Foundation blogs, Thought for food: Organic farming is good for you and the planet.


A.S.P.E.N.'s Clinical Nutrition Week 2011, Vancouver, Canada

(I'm attending this conference in my home city but it's in a part of downtown I rarely visit so I feel -- and am behaving -- a bit like a tourist.)

I'm happily immersed in the information & setting. Both have been incredibly inspiring. I'll share highlights from the talks as soon as I process my notes. But for now, here's what I look at between the sessions:

Canada Place

Canada Place

Vancouver Convention Centre

Vancouver Convention Centre & view of Coal Harbour

Stanley Park

Stanley Park

Digital Orca

Digital Orca at the Convention Centre (Artist: Douglas Coupland)


Dietetic Preceptorship

Hello, just a quick message to let you know despite appearances The Dietitian's Journal is not on hiatus nor am I on a vacation (except for a couple of brief visits to Queen Elizabeth Park).

I've been involved in an intensive and rewarding mutual learning experience with a dietetic intern.  I'm trying to begin 2011 with focus rather than multi-tasking so during the intern's time with me, I've set aside reading and writing for this blog.

Yesterday I discovered a free continuing education course on Dietetic Preceptorship that I'd like to share with you.

Dietetics Preceptor Training Program (scroll down the page to view the course description; to view the content in detail, you will need to register)

The course looks relevant and well-structured so I'm looking forward to working through all the modules, especially the section on critical thinking.


Happy, Healthy New Year

Winter coleslaw: this recipe includes cabbage, carrots, sweet bell peppers, celery & white turnip. This small bowl contains about one-and-half servings toward the "at least 5 a day" of fruits & vegetables.

Happy New Year, everyone.

I hadn't prepared a New Year's Day post, and a good thing, too, because I could never do better than Sophie's latest,

How to make healthy eating incredibly simple this year

So set aside any long or complicated list of resolutions you've made and go read it now. The principle Sophie describes is simple, powerful and 'makes the most difference.'

Snow Food


It's snowing.

I've just come in from the early morning Westie walk, my feet are still cold, and to warm myself up I'm dreaming of Sophie's breakfast quinoa, Vincci's risotto, Kathryn's spiced salad (& a picnic next spring), Kelly's latest recipe (Moroccan Spinach and Chickpeas), and Lucy's...well any of Lucy's recipes or photos will nourish me.

 What are your favourite cold weather foods?

Roasted eggplant & tomato sauce

This post has been sitting in draft form for over a month. I'm publishing it today, although in my part of the world we're past the season when we harvest eggplants and tomatoes from our home gardens or buy them at farmers markets. But I do want to share this recipe now (if it appeals to you, mark it to try later) because it's simple, tasty, nourishing, and very much in the spirit of An Honest Kitchen, which has been inspiring my new way of cooking.



A variation of Culinate's recipe for Eggplant and Ricotta Sauce, Sicilian-Style.

My modifications; I used:

1) More eggplant, fewer tomatoes
2) Heirloom tomatoes (Black Prince, Amish Gold) instead of Italian Plum
3) Martha Rose Shulman's method to roast the eggplant
4) Lots of golden oregano, fresh from the balcony, during cooking
5) No cheese

Baked eggplant

Addendum, November 8th: After I let this post sit in my drafts folder for over a month, I then rushed to edit and publish it -- and forgot to tell you how and with what I ate this sauce. You may be able to tell from the half-filled bowl in the middle photo I sampled quite a bit.  And rather than cook pasta, I simply warmed some pita breads cut in half, spread them with hummus and then generously filled them with the thick sauce. A very tasty and simple lunch, rounded off with a serving a yogurt and piece of fresh fruit.

Back to a more regular blogging schedule...

...after 4 weeks of mostly work (the usual stuff of a clinical dietitian's day plus mentoring dietetic interns and attending a nutrition support workshop) and some play (long, weekend walks absorbing colour & light and a bit of writing at the Hedge Society).


I really don't have much to say in this post. Just that I'm back. Hello. I hope you're enjoying this season (Autumn for some, Spring for others). And for those of us who are heading toward winter, let's remember the good things about cooler days and longer nights.  As a friend recently tweeted:

some say it's easier to eat well in the summer but I'm a much happier autumn winter cook. All those easy soups, beans, stews. Who's with me?

Mushroom-Kale-Barley Soup

During September, fresh tomatoes and eggplants occupied my attention so I completely missed National Mushroom month. In fact, I made this soup in July when organic mushrooms were on sale at a local supermarket. But soup and summer usually don't go together (unless we're talking gazpacho or chilled cucumber) so I saved the recipe and post for cooler days.

Now, neither I nor this humble soup can compete with the Mushroom Masters but I offer it to you today as a simple, nourishing, warming, everyday meal.



 Mushroom-Kale-Barley Soup

Adapted from The Clueless Vegetarian by Evelyn Raab, page 47. The original recipe does not include kale but I was harvesting the last leaves of the season from the plant on my balcony & thought they'd make a tasty, healthy and green addition to this soup so I tossed them in.

Serves 8 - 10

3 tablespoons (45 mL)  butter or vegetable oil [I used oil]
2 small onions, chopped
2 medium carrots, chopped
1 stalk celery, chopped
2 cloves garlic, squished
1 pound (3 L) vegetable broth
1 cup (250 mL) barley
[a handful of fresh, tender kale leaves -- I used young 'Lacinato' kale leaves]
1 teaspoon (5 mL) crumbled dried thyme
2 tablespoons (30 mL) chopped fresh parsley
2 tablespoons (30 mL) chopped fresh dill weed
salt & pepper to taste

In a large pot or Dutch oven, melt the butter [heat the oil] over medium heat. Add the onions, carrots, celery and garlic and cook, stirring for about 10 minutes or until tender. Add the sliced mushrroms and cook for another 5 to 8 minutes until the mushrooms have let out their juices, and the liquid is beginning to evaporate.

Now add the vegetable broth, barley and thyme, and bring to a boil. Cover the pot with a lid, lower the heat to a simmer, and let the soup cook, stirring occasionally for 1 1/2 hours.  If it is becoming too thick, add more water. Add the chopped parsley and dill [and kale, if desired], simmer for another 15 minutes, and season with salt and pepper to taste.


In my information foraging, I discovered a new book, nutrition facts, research &  growing guides on mushrooms:

An interview with Greg Marley, author of Chanterelle Dreams and Amanita Nightmares: The Love, Lore, and Mystique of Mushrooms

Nutrition facts

Mushrooms & Vitamin D

[Note: The Office of Dietary Supplements (OHS) cites research that shows "mushrooms provide vitamin D2 (erogocalciferol) in variable amounts. Mushrooms with enhanced levels of vitamin D2 from being exposed to ultraviolet light under controlled conditions are also available." I believe this is the study the OHS is referring to: Vitamin D2 Enrichment In Fresh Mushrooms Using Pulsed UV Light (PDF).]

How to grow edible mushrooms by Carolyn Herriot (renowned British Columbia gardener & author)

Growing mushrooms (from Channel 4 Food | Jamie Oliver)

Lentil Dal with Tomato & Kale

Lacinato Kale

Lacinato kale in late June, just before harvesting the first crop and combining ...

... with lentils, tomatoes & spices in this An Honest Kitchen inspired recipe.

Though I'd planned to save this post & recipe until Autumn, these past few days the weather's been cooler and wetter and my mood's been serious and introspective. Neither seems suitable for salads. So the time seems right to share this lovely dal recipe that's warming and comforting as well as simple, tasty and nourishing. Another winner from Kathryn & Lucy.


 Lentil Dal with Tomato & Kale

adapted from Lentil Dal with Tomato & Silverbeet in the Autumn 2010 issue of An Honest Kitchen by Kathryn Elliott & Lucinda Dodds.

Serves 3 - 4

1 cup (250 mL)  split red lentils, washed
2 cups (500 mL) water
2 slices fresh ginger
¼ teaspoon (1 mL) turmeric
2 tomatoes, roughly chopped
large bunch of young kale, about 2 cups (500 mL) of harvested leaves without stems, washed and roughly chopped [the original recipe calls for silverbeet]
1 tablespoon (15 mL) canola oil
1 teaspoon (1 mL) mustard seeds
1 bay leaf
1 dried chilli
1 teaspoon (1 mL) ground cumin
1 teaspoon (1 mL) ground coriander

To serve: rice and some natural yoghurt (optional)

Cook the lentils:  Put the lentils, ginger and turmeric into a heavy-based saucepan with a lid. Add water. Bring to the boil, turn down to a gentle simmer and place the lid on the pan. Cook for about 15 minutes, stirring occasionally to prevent the lentils from sticking to the bottom of the pan. The lentils should be starting to break down and lose their shape. You may need to add a bit more water, if the dal becomes too thick and gluggy.

Add the vegetables:  Add the tomatoes and kale. It will look like way too much greenery at this stage, but don't worry. Give the dal a quick stir and then place the lid back on the pan. Continue cooking gently, for about 10 minutes, until the kale has wilted and softened.

Make the tarka:  Heat the oil in a separate small saucepan or frying pan. When hot, but not quite smoking, add the mustard seeds. These should start popping almost immediately. Put in the bay leaf and dried chilli. Cook for a few more seconds, just until these start to brown, and then add the cumin and coriander. Swirl the spices around in the oil for a couple of seconds and then pour the contents of the saucepan into the lentils. The lentils may spit slightly when you do this, so take care. Cover the pan immediately and leave to absorb the flavours for a couple of minutes. Remove the lid, stir and season with salt and pepper.

Some of Kathryn & Lucy's notes with my comments in {parentheses}:

Dals get even better after they've been stored in the fridge overnight – the flavours soften and blend. They can also be frozen. {Yes, I enjoyed the dal for lunch the next day & froze a couple of portions for quick meals.)

This makes a mild flavoured dal. If you want more heat, then use a chopped up fresh chilli instead of the dried one. {I like a spicy dal so I'd also add a pinch or two more of the other spices.}

We've chosen to use split red lentils, as they're the quickest cooking. However you could use almost any type of split bean or pea in this recipe. Just be aware it may take longer to cook and need some extra water added during the  cooking. {I encourage you try the split red lentils -- they create a lovely colour scheme with the kale & tomatoes.}

A bowl of dal, with rice and mango chutney is comfort food for me [Lucy] — the silverbeet and tomato make for a wonderful, creamy dish.  {Mmmmmm.}


Elaine's nutrition notes:

This tasty combination of three, natural "superfoods" (lentils, tomato, kale) provides a full array of building blocks for good health, particularly protein, fibre, vitamin A, vitamin C, folate, assorted phytonutrients, potassium, calcium and iron. Truly the definition of a nutrient-dense recipe.

Nutrient analysis of Lentil Dal with Tomato & Kale (PDF) - I don't encourage healthy people to "count calories." But some individuals on special diets for health conditions (e.g., kidney disease, iron deficiency anemia, protein-energy malnutrition) may need this information either to make sure they're meeting their needs or not exceeding restrictions.

With my second crop of kale ready to harvest and farmers' market tomatoes at their peak, I'll be making this dal again soon.

Civic Dietetics

Cool Globes

Two of the Cool Globes on display at Vancouver's Science World this past spring

Last month while doing a search on "environmental nutrition", I stumbled across the new-to-me concept of "civic dietetics":

Making food system issues integral to dietetic practice represents a transition for the professional, calling for new applications of skills and expertise. Drawing from the work of Thomas Lyson on civic agriculture, we propose civic dietetics to mean the application of dietetics to enhance public health by addressing food system structures, impacts, and policies and their relationship to food choices....

It can be argued that the economic, ecological, and social sustainability—the “triple bottom line”—of the food system, matters as much as the nutritional value of its products. Civic dietetics provides such a framework. [bolding added]

Source: Beyond Eating Right: The Emergence of Civic Dietetics to Foster Health and Sustainability Through Food System Change  by JL Wilkins, J Lapp,  A Tagtow & S Roberts in the Journal of Hunger & Environmental Nutrition, Volume 5, Issue 1, 2010.

Here are some other results from my recent Google search on "civic dietetics":

Civic dietetics: opportunities for integrating civic agriculture concepts into dietetic practice

Local and Healthy, 2 messages or 1?

Civic Dietetics, Community Gardening and Food Recovery

National Dietitian Day -- It's all about change!

Civic Markets and Alternative Agrofood Networks


116/120This "cool globe", one of my favourites at the Science World display is called "cool careers". Made me think: perhaps "Civic Dietitian" is a new, evolving and essential role, if not career, for our times.

Tweeter's Digest: July edition

Well, hello there. Where has time gone? Until I checked my drafts folder earlier today, I hadn't realized I'd started writing 5 posts since mid-May. Time to finish & publish at least one of them.

Here's a round-up of resources I've shared on Twitter during the past couple of months:

Cancer Preventing Properties of Cruciferous Vegetables, a free full-text review article (PDF)

The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide, an open access, comprehensive database

Another reason to eat your beets: Nitrate in beetroot juice lowers blood pressure (original research article)

A recent, comprehensive review on dietary sodium & hypertension:  Blood Pressure Canada's background paper (PDF)

Salt Mountains, a compelling if not startling infographic on the prevalence of sodium in processed foods

How to cut down on sodium? Blood Pressure Canada says "Eat freshhhh!" and provides professional resources & educational tools on sodium on their well designed, informative web site.

Osteoporosis Canada recently released  new Vitamin D guidelines. 

After I read a thoughtful article on dietitians' roles in reducing food waste, on a whim I entered "don't waste food" into Google Images. The results included this classic poster from 1917: "Food - buy it with thought..."

Some further searching on "food waste" led to the excellent Love Food Hate Waste sites (main, Scotland, Wales, Australia). There's no Canadian version of this program -- yet -- but I'm hopeful.


I'll keep this list short, end here and give myself time to finish those other 4 posts. Perhaps I'll publish another one before the end of the summer, but the beans and beets take priority over words at this time of the season ;-).