AURORA — About six years ago, Lisa Wingrove’s husband, Andrew Irvine, started losing weight without dieting or extra exercise. Initially, he was pleased to shed some dad-bod weight.
But his wife noticed that the pounds were falling off far too swiftly. In six weeks, he lost 28 pounds.
“I knew something was not right with Andrew, but I didn’t know what it was,” she said.
It was lymphoma. Like many cancers, it was metastasizing so quickly that “in the broadest term,” Wingrove said, Irvine was suffering from malnutrition. His body was metabolizing calories as fast as a professional athlete’s, breaking down muscle far more swiftly than it could be replaced.
Worse, his appetite flagged. His favorite meals no longer appealed to him. Wingrove, an oncology specialist clinical dietitian at the University of Colorado Cancer Center, was alarmed. As Irvine entered treatment, she knew it was crucial for him to dramatically increase his intake of protein, carbohydrates and healthy fats.
“As the caregiver, you know the patient needs to eat, but if they have no appetite, or if they get full quickly, then there’s frustration on both sides,” Wingrove said.
So she thought about how to coax him into eating. What she learned through trial and error became the foundation for Culinary Comfort, the free monthly workshop Wingrove presents at the University of Colorado Anschutz Health and Wellness Center.
At a Culinary Comfort class, cancer patients in treatment, people whose cancer is in remission and their caregivers meet to learn how to modify favorite meals and how to appeal to unpredictable appetites.
Wingrove, wearing a black Culinary Comfort polo shirt, cooked a meal at a demonstration kitchen as attendees looked on.
While she cooked, she explained why certain ingredients, flavors and textures are more likely to appeal to someone whose sense of taste and ability to swallow has been changed by the disease or the treatment, or both.
“There are so many contributing factors to this problem that it’s important to take a step back and have a discussion with the patient about what they think they can tolerate,” she said.
“As a caregiver, do you really need a big plate that you’re tempted to fill up, and that’s going to be challenging to finish? Or could using a small side plate look less intimidating to a patient? And think in terms of portions, not calories. Don’t count calories, and don’t weigh yourself every day, or it’ll drive you crazy. Once a week is fine. And remember, weight loss often has an element of dehydration.”
That’s because many cancer patients have trouble swallowing. Even drinking water can be difficult. Water slips down the throat so quickly that a cancer patient can accidentally aspirate it into the lungs. Then the patient will be even more reluctant to drink.
Swallowing is even more difficult if the patient has a tumor in his throat, she said, because the liquid must navigate the tumor. If the patient is undergoing radiation, then his throat will be sore as well as clogged.
“So what we tell people is that we really need soft, thick liquids to transition that area,” she said.
“If you have swallowing issues, something that’s thick and moves slowly means you’re less likely to aspirate it. So we encourage people to thicken liquids by adding oatmeal or cooked rice, so it’s easier to swallow. Using a sauce is very helpful, too. We had a whole class recently on sauces.”
Karen Wehling, who endured chemotherapy for Stage IV colorectal cancer about four years ago, found Wingrove’s tips immensely helpful. During treatment, she lost a half-pound to a pound a day. Her sense of taste disappeared, making it even harder to recuperate from surgery.
“The current situation is that my (gastrointestinal) tract has been altered, and therefore it is sensitive to certain foods,” she said.
“I am doing well, with no evidence of disease for over two years and nine months, but recurrence is extremely high with my diagnosis. I try to eat well, and I have used the recipes I was given in the Culinary Comfort class. They are high in protein, with a good number of vegetables, and they keep the unhealthy fat level low.”
One of her favorite Culinary Comfort recipes uses powdered peanut butter to make a high-protein sauce that’s one of the class favorites. The powdered peanut butter has less fat than regular peanut butter.
“The powdered peanut butter is for those of us attempting to be more healthy, and the second with real peanut butter adds fat and calories, and is helpful for those of us losing weight and needing increased calories,” Wehling said.
“Both are important for me to know about. The lean recipe is good for the present. The other is good if and when the cancer returns, and I need to increase my weight.”
Following are some Culinary Comfort recipes that are high in protein and healthy fats.
Wingrove says her patients find adding sauce to food makes it easier to swallow.
A variety of textures, as in the Thai noodle salad, makes a dish more appealing, visually and in the mouth, than a single-texture food.
Claire Martin: 303-954-1477, cmartin@denverpost.com or twitter.com/byclairemartin
Thai noodle salad
All recipes adapted by Lisa Wingrove
Ingredients
7 ounces rice noodles
4 teaspoons lime juice
1 teaspoon fish sauce
2 or 3 cloves garlic
½ to 1 teaspoon of sugar
4 green onions, sliced
1 small cucumber, peeled and thinly sliced
1 yellow bell pepper, thinly sliced
Directions
Put the noodles in a large bowl and cover with boiling water. Leave for 5 minutes, or until the noodles are soft and pliant. While noodles hydrate, combine remaining ingredients in a bowl, and mix well to combine. Add noodles and toss.
Serves six. Calories per serving: 51. Fat: 0. Protein: 2 grams. Carbohydrates: 3 grams. Sugars: 4 grams. Fiber: 4 grams. Sodium: 144 grams.
Mahlee’s Chicken
Ingredients
2 teaspoons oil
2 tablespoons fish sauce
2 tablespoons chilli in soya paste
1 ½ pounds chicken breast, sliced into strips
½ ounce unsalted cashews
1 to 2 large dried chiles, broken into bite-size bits 6 green onions, sliced
Directions
Combine the oil, fish sauce and chilli in soya paste. Marinate the chicken in the mixture. In a hot frying pan, toast the cashews and chile pieces quickly, and transfer them to a plate or bowl. Flash-fry the chicken in the same pan. When the chicken is nearly cooked through, add the green onion, cashews and chile bits. (For patients who need to increase calories, increase the amount of cashews to 7 ounces.)
Serves four. Calories per serving: 252. Fat: 8 grams. Protein: 40 grams. Carbohydrates: 3 grams. Sugar: 4 grams. Fiber: 4 grams. Sodium: 144 grams.
Mushroom Sauce
Ingredients
3 teaspoons butter cup shallots8 ounces portobello mushrooms
4 ounces shiitake mushrooms
2 teaspoons fresh thyme, chopped ½ cup white wine 1 teaspoon Dijon mustard
Directions
Melt butter in a pan over medium heat. Add chopped shallots. Slice mushrooms and sauté with the shallots, working in batches to allow the mushrooms to brown. Add thyme and a sprinkle of salt or pepper as needed. Increase heat to high and add wine. Allow the wine to reduce in the pan. Add mustard, stir through, and serve.
Smoky Pepper Sauce
Ingredients
2 teaspoons olive oil4 bell peppers (two red, two yellow), sliced thinly
½ teaspoon sweet paprika
Pinch saffron (optional) ½ cup vegetable broth
1 teaspoon tomato paste
Pinch salt
Directions
Heat oil in a sauce pan on medium heat. Add sliced peppers. Sauté until the peppers start to sweat. Add paprika and saffron, and cover with lid. As the peppers soften, add half the broth. When peppers are soft, add tomato paste and remaining broth.
Place half the sauce in a blender to process. Return the processed sauce to the pan; salt to taste and serve.
Chandon Beni Sauce
Ingredients
1 cup cilantro, chopped
1 teaspoon thyme
2 cloves garlic
Dash hot sauce
2 teaspoons white vinegar
½ cup olive oil
Directions
Put all ingredients in a blender and process. Makes 1 cup.
