Fight Cancer with Food Chaining by Cheri Fraker, …...Magic Bullet to blend. Think Feed Store...

© 2015 C. Fraker Food Chaining: Oncology Rehab

Fight Cancer with Food Chaining by Cheri Fraker, CCC/SLP Oncology Rehab What is STAR Oncology Rehab?

Julie Silver, MD developed the program and is a breast cancer survivor.

This is a nationwide partnership with hospitals, cancer centers and rehabilitation

facilities and with clinicians who share the mission of advancing survivorship care.

These partnerships have had a profound and immediate impact on the way that

cancer care is delivered.

Oncology Rehab Partners’ mission is to advance survivorship care by making

evidence-based cancer rehabilitation the standard of care for survivors. Mission is

to provide healthcare professionals and institutions with the tools needed to

develop and deliver quality cancer rehabilitation services to the millions of

survivors throughout the world.

Fatigue

100% of survivors report fatigue and this is more common in those who have had

several types of treatment

Fatigue is not evaluated properly

Considered pathological when there is no recovery with rest, happens for long

periods of time and impacts ADL’s

Fatigue assessments FACIT-F and ICD10 and VAS

The FACT-G is part of FACT-F and assesses quality of life

Sleeping pills are not part of sleep hygiene

Assess sleep apnea on those who present with poor sleep, wake with headaches,

snore, restless

Fatigue recommendations for all cancer patients: address fatigue catastrophizing,

increase activity and screen before and after treatments

SAMPLE FOOD CHAINING PROGRAM: Judy

DIAGNOSIS: Oral cancer

INDIVIDUALIZED EATING PROFILE

TEXTURE PREFERENCES: Smooth


TASTE PREFERENCES: Flavored

TEMPERATURE PREFERENCES: Warm

APPETITE: Good

INTAKE: Fair, patient wants to eat, but has difficulty and has had to limit diet. Glossectomy

made eating very difficult.

CURRENT DIET/INDIVIDUALIZED EATING PROFILE

CALORIC SUPPLEMENTS: Ensure, Ensure Clear (peach), Carnation Instant Breakfast,

Smoothies and Milkshakes provided by RD

CURRENT DIET: Supplements, pudding, mashed potatoes and gravy, oatmeal. Patient is

very discouraged about current diet and is very aversive to supplements.

FAVORITE FOODS: Spaghetti, hamburgers, grilled salmon or chicken, Thai food (Pad Thai),

pot roast with vegetables. Patient wants to be able to eat these foods again. A Food

Chaining program was designed on this date to help this patient be able to eat past foods or

find new foods to add to the diet.

LEAST FAVORITE FOODS: Patient likes the following foods, but struggles to eat these food

items. Therapist provided suggestions to make foods easier to eat. Challenge foods

include: turkey, sausage (recommend that sausage be ground or blended in Magic Bullet,

add extra gravy) , pasta with heavy cheesy sauces (too sticky, avoid or thin sauces out with

more milk/liquids, or dip pasta in the sauce vs. coating with the sauce), highly seasoned

meats or hot BBQ sauce, Greek salad

PATIENT GOAL FOODS: Patient is requesting help with eating any of the five favorite

foods (spaghetti, hamburger, salmon, chicken, Thai food) as well as French bread with

butter, Chef salad, homemade chicken and noodles, pancakes or French toast. Therapist

suggested the following modifications to goal foods to make items easier to eat:

Goal Food Modifications/Food Chains-suggested new foods

Milk and Juice Thicken with ¼ tsp Jello Instant Pudding Powder (regular or sugar free) to 4-6 ounces of cold milk, shake vigorously. Makes a smoothie consistency drink.

Juice can be mixed with pureed fruit and ice, drinkable yogurt can be added also. Fruit Chillers, Italian Ice and Dole or Edy’s 100% Fruit Bars –


you can also let these melt down and drink if desired.

Breads/Pancake/French Toast, Hot Rolls, Toast, Crackers, small croutons

Cut foods such as pancake, French toast or soft breads into narrow strips or small pieces. Aldi’s French toast sticks are a good option in smaller pieces. Dip into syrup. Too much syrup may be difficult to control. Powdered sugar may also be an option (light dusting).

French bread is very chewy and may be more difficult to manage. Approach carefully. Inner part of French bread may be OK, pull off pieces.

Pull off small parts of hot rolls, Hawaiian bread or yeast rolls. Place under biting surfaces. Spray butter or spread, cinnamon butter (Land O Lakes) is also a good option.

Toast may be easier than some breads. Smaller pieces or strips of toast (no crust) may be easier.

Crackers-Roasted Vegetable or Whole Wheat Ritz crackers, Club Crackers, graham crackers are good options.

Meltable solids include peanut butter, sugar and shortbread cookies, vanilla wafers and pudding..

Noodle/Pasta dishes Pad Thai noodles, spaghetti noodles,

chicken and noodles can be chopped (in small regular size pieces) and mixed with additional sauce as a “binder” foods.

Instant potato flakes can be used to bind noodles or thicken any broth soup for extra calories and control.

Whipped sweet potato, a tomato based puree, whipped/blended spinach, etc can be in one section and used to ‘glue’ chopped many foods together. (Example: Alfredo sauce, chopped noodles and spinach


blended as a binder) Thicker sweet tomato basil soup may

be a great option for you (Lake Point Grille in Chatham has a great soup-be creative when you cook and reduce liquid slightly for more of a puree texture)

Find foods that compliment one another

Sauces can be separated from pasta, put cream sauce in a separate section or small bowl, dip to desired coating

Chicken and noodles can be blended, this is a balancing act. Keep good supplies of chicken broth, cream soups in your pantry. Chicken soup can be thickened with Cream of Chicken soup. It will be too hard to eat bites of chicken, noodles and broth at the same time. Separate and blend cooked chicken. It will have a lot of flavor and you can make it easier to eat by coating in thickened broth.

Meats Salmon and chicken can be shredded and paired with a cream sauce or mixed with pureed sweet or white potato to help bind the food item together.

Salisbury steak and Meat Loaf are good options

Egg salad, ham salad, tuna salad, seafood salads, chicken salads-use Magic Bullet to blend. Think Feed Store Chicken salad consistency. Recipe is chicken, mayo, celery, sprinkle of white pepper, lemon juice-blend in Food Processor or Magic bullet. Eat with a fork or in THIN amounts on crackers or toast.

Roast is a chewy food. I would suggest using your blender on this one with a lot of extra gravy and broth. Cook in a crock pot to make sure it is very soft. Balance out with


thinner consistency mashed potatoes and heavy amount of gravy or broth.

Beef stew can also be blended. Any soups can be blended to a nice smooth consistency too.

Veggie Burger or sausage patties may work (Morningstar brand-soft) Cut in narrow strips or process. Pork, Turkey, Mushroom or Black bean burgers are irregular texture-process these and add condiments. Freddy’s restaurant has Veggie Burgers too.

Chicken pot pie can be blended with extra sauce (quick meals)

Mushrooms, avocado, hummus, beans/lentils can be good substitutes for meat as well

A corn dog nugget or chicken nuggets can be processed in the Magic Bullet. It will come out looking like fine bread crumbs, mix with a condiment of your choice or with a gravy.

Pepperoni can be microwaved and will turn out like crispy chips

Nutella, Chocolate Jif peanut butter or peanut butter in your smoothies

Shopping Tip: Humphrey’s Meat Market sells pork BBQ, Italian Beef in smaller containers. You can add more BBQ sauce or other condiments as desired to these for quick and easy meals.

Tamales, you can add any sauce over the top, broth of chili, etc.

IF doctor clears you for this and you are done with chemo/radiation….Any deli meals/side dishes can be picked up and blended at home. If it doesn’t have bones in it, it can go into a blender. You can process potato salad, three bean salad, green bean casserole as well as meats or almost any side dish. Good day/bad day plan here. On bad


days, let the Magic Bullet take the work out of eating.

Chef Salad (this is a tough one)

Separate Chef salad ingredients into

segments around the bowl Make sure the ham, etc is cut the way

you can handle it. This meal is a lot of work but can be modified.

You can actually make 7 layer salad and blend the eggs/peas/dressing/cheese into a paste and eat shredded lettuce. Use dressings to thin it out to the right texture.

Avocado or Hummus (I like texture of Sabra Hummus) can help too.

Vegetables Whipped sweet potato Baked loaded sweet potato (blended

or mashed) Roasted vegetables Sweet potato fries Steak fries (baked) Healthy Garden Soup (vegetable

broth, 2 small single serve cans of tomato juice, 1 can Rotel if desired, 1 can drained diced tomatoes, zucchini, fresh mushrooms, onion, celery, garlic, white beans, spinach, mixed vegetables, white potato). Cook and blend well with immersion blender. Eat with mashed white potato, avocado, hummus, etc as a binder.

Supplements (use as needed) Shakes (see recipes I shared), be creative! You can reduce sugars, share with your dietitian.

Ensure Peach with tea (hot or cold) Ensure Peach can be frozen into ice

cubes and put in iced tea ScandiShakes Carnation Instant Breakfast SuperMilk, Super Yogurt or Super

Pudding (Lemon pudding can be a better option to avoid ‘sweet overload’)


Lemon pudding, lemon sherbet, lime sherbet can be good options to mix with a small amount of Sprite/Squirt or lemonade to make a tangy sour based smoothie

Whey or Protein powder added to smoothies

Desserts/Snacks Key Lime pie Lemon pie –not cream,

more gelatin based could be a good dessert.

You can purchase lemon pie by single slice at Shop-N-Save in frozen section or County Market in bakery)

Strawberry pretzel desserts can be blended

Cheesecake is always a good idea! Counter with a more sour/tart topping so it is not too sweet

Pies/cobbler/crisps-blend and mix with ice cream (rhubarb, Marie Callendar Triple Berry -if seeds aren’t a problem)

Process dry oatmeal flakes in the Magic Bullet for a few seconds, it makes a fine powder and is easier to eat as cooked oatmeal or as a topping on desserts

Hull-less popcorn (Okie Dokie, Pirate’s Booty, SmartPop)

Other Tips Liquids: Straw drinking or use of a Lil Spiller cup may improve control of liquids.

Condiments: Ketchup, mustard, honey mustard, chili sauce, tartar sauce, mayo, Ranch/salsa mix, BBQ sauce, A-1, Worcestershire sauce, oil and vinegar

Calorie boosters: Try non fat dry milk powder, Carnation Instant Breakfast, half-n-half, heavy cream, ScandiShakes, Ensure clear peach or berry added to tea, smoothies or iced, coffee drinks, lattes, dark chocolate, dark chocolate fondue, olive oil,


butter added to recipes. Coffee drinks can counter super

sweet aversion. (Decaf may be best option)

Therapist recommended that meat be cut in narrow strips and placed under the biting surfaces or blended.

Dips, cream soups, condiments, sauces and gravy were suggested to make meats easer to eat.

Fine ground meals can also be mixed with gravy, whipped white or sweet potato. Salmon, tilapia and flaked fish mixed with tartar sauce or a cream sauce may be easy to eat.

Tamale, cheese or meat Taquitos, ham, chicken, egg and tuna salad are also recommended to trial.

Meat can be placed in a food processor before mixing with mayonnaise to make it smoother and easier to eat. Sometimes cooked meat that has been frozen for an hour blends better.

A thin layer of this food can be added to a cracker or piece of toast once control improves.

Dip the DuoSpoon in any of these blends or binder foods and chew vigorously to improve your control.

MEALTIME RECOMMENDATIONS:

1) Cut foods such as pancake, French toast or soft breads into narrow strips or small pieces.

French bread is very chewy and may be more difficult to manage.

2) Salmon and chicken can be shredded and paired with a cream sauce or mixed with

pureed sweet or white potato to help bind the food item together.

3) Pad Thai noodles, spaghetti noodles, chicken and noodles can be fine chopped and mixed

with additional sauce as a binder foods. Instant potato flakes can be used to bind noodles.


4) Separate Chef salad ingredients into segments around the bowl.

5) General recommendations for meats: Therapist recommended that meat be cut in

narrow strips and placed under the biting surfaces. Dips, cream soups, condiments, sauces

and gravy were suggested to make meats easer to eat. Fine ground meals can also be

mixed with gravy, whipped white or sweet potato. Salmon and flaked fish mixed with

tartar sauce or a cream sauce may be easy to eat. Tamale, cheese or meat Taquitos, ham,

chicken, egg and tuna salad are also recommended. Meat can be placed in a food processor

before mixing with mayonnaise to make it smoother and easier to eat. A thin layer of this

food can be added to a cracker or piece of toast.

6) Meltable solids: Patient reported that she has not eaten crackers and she did not think

she could eat this food item. Therapist offered small pieces of Ritz cracker. She handled

this meltable solid food very well and was quite pleased that this food was so easy to eat.

Particular brands of crackers are recommended. Meltable solids include peanut butter,

sugar and shortbread cookies, Ritz cracker, graham cracker and Club crackers were

recommended.

7) Fruit and vegetable smoothie recipes were provided to the patient. Calorie boosters: Try

non fat dry milk powder, Carnation Instant Breakfast, half-n-half, heavy cream,

ScandiShakes, Ensure clear peach or berry added to tea, smoothies or iced, coffee drinks,

lattes, dark chocolate, dark chocolate fondue, olive oil, butter added to recipes.

8) Dairy: Cheese soup, yogurt smoothies, shakes, sherbet, cheese/salsa, sliced cheese cut in

strips, drinkable yogurt

9) Calorie boosters: Try non fat dry milk powder, Carnation Instant Breakfast, half-n-half,

heavy cream, ScandiShakes, Ensure clear peach or berry added to tea, smoothies or iced,

coffee drinks, lattes, dark chocolate, dark chocolate fondue, olive oil, butter added to

recipes.

10) Liquids: Straw drinking or use of a Lil Spiller cup may improve control of liquids.

11) Condiments: Ketchup, mustard, honey mustard, chili sauce, tartar sauce, mayo,

Ranch/salsa mix, BBQ sauce, A-1, Worcestershire sauce, oil and vinegar

Swallowing therapy services are recommended. Patient will be seen for 4-5 therapy

sessions.

Prognosis: Patient has excellent potential to improve nutritional status, hydration and

enjoyment of meals.


STATUS UPDATE: In three therapy sessions, this patient regained the ability to eat foods from all food groups. She is eating pastas, soft meats, vegetables, soups and crackers. Patient was thrilled to be able to eat chocolate again. Therapist updated Food Chaining program. Patient will contact therapist regarding progress in two weeks. Additional sessions will be scheduled if needed. Patient is very pleased with progress and has met all initial goals. Walt-Updated Therapy Program

Nutrition (follow up appointment)

- Ask RD if you need to watch sodium intake due to dizziness

- Ask RD about energy level and ways to boost protein, etc

- Is anemia an issue?

- We will then continue to modify diet to make foods easier to swallow (see below)

Dizziness

- Cawthorne Exercises

- Medications/side effects-discuss with MD

Meals

- Good Day/Bad Day Plan

Chili/Refried Beans

If you are having a bad day you can blend refried beans, chili or chili and a tamale (if not too spicy) into a more thin paste like consistency. This can be easier to eat. Soups with beans are a great source of nutrients. Baked beans, etc can also be blended. Bean burrito is also an option. Cheese sauce can be added over the top for additional calories. Hummus, guacamole, sour cream can make these foods easier to eat.

Vegetable Soups Great nutrient source for your overall health. Blend if needed. Try to aim for 5 servings of fruit/vegetables a day. Soups with lentils are a great option. A cup of soup with meals can help you meet this goal.

Noodles Be creative with a wide range of sauces with noodles. Change noodle size and density if you are having a bad day. Whole wheat pasta may also be a good option.

Eggs Egg salad, deviled egg, boiled egg (mashed),


fried egg…boiled egg can be a good snack option later in the day as well.

Oatmeal/Cereals Blended flakes before cooking for a smoother texture. You can add blended cooked apples/peaches or other fruits with cinnamon to add flavor. Steel cut oatmeal is a good nutrition choice too.

Shakes Always a good option (check the shake/smoothie recipes I issued to you before). Peanut butter or Nutella in shakes and smoothies can be a good option as well. Blended fruits (banana, peach) or banana pudding can be mixed with crushed cereal over the top if milk and cereal is too hard to eat

Meatloaf/Salisbury Steak Add extra gravy or sauce, blend if needed, pair with potatoes and gravy or a cup of potato soup. Stuffed peppers can also be blended.

Cheese Great option as a slice or cheese soup or sauce over other foods

Salami Ham, pastrami, summer sausage are also options

Turkey Turkey or Chicken salad can be a nice smooth texture if blended for a few seconds

Biscuit Gravy Fine ground meats and gravies or sauces, fine meat like TacoBell meat can be much easier to eat

SAMPLE FOOD CHAINING Meal Plan Food Item Breakfast

1) Eggs-explore in Egg Nog recipes, Egg Drop soup, egg muffin recipes (texture can be much easier to handle) or quiche. Egg muffins can be frozen too and heat well. Scrambled egg muffin sliders is a recipe for corn meal egg mixture and you make an egg sandwich out of it. Another option is to add a cheese

Lunch and Dinner Options Fish, salmon, chicken salad, tuna salad-add tartar sauce or other condiments for additional calories. Drizzle a small amount of oil in to chicken salad or tuna salad (buy packed in oil). Dark meat has more calories so you can make your chicken salad from chicken thighs instead of breast. Glenn likes Mexican so try chicken thighs in the crock pot with a jar or salsa and taco


sauce or cream sauce to well done scrambled eggs or go TexMex to make them easier to eat. Add salsa, cheese, peppers, onion, etc. How an egg is cooked is important. Many of my patients like deviled eggs or egg in a salad (green salad or chicken/tuna salad sandwich), French toast is also a good way to work eggs in to the diet. Corn bread or corn bread muffins are another way to work egg into the diet.

2) Sweet Rolls/savory breakfast breads. Fruit breads (apple, pumpkin, zucchini, banana) or muffins can also be another source of eggs. Sausage bread (fine ground cooked sausage rolled up in Rhode’s bread or other bread dough and baked), Pillsbury apple turnovers, waffles, pancakes with spray butter and dipped in syrup vs covered in syrup might be easier. Cream of Wheat with honey or syrup added, oatmeal cereal bars. Bisquick biscuits can be easier to handle on a day when nausea becomes a problem. Top with honey, jellies, jams, applebutter. Peanut butter/honey/jelly or Nutella on toast. Cake doughnuts or Old Fashioned Doughnuts are often easier to eat than glazed or jelly filled.

3) Coffee Drinks-add ice cream, Frappacino drinks from Starbucks (in grocery store), shakes, smoothies.

4) Oikos or other brands of vanilla Greek yogurt and fruits added. Powdered sugar sprinkle over the top can help too.

seasoning. Let it cook all day and shred fine. Cover with cheese, sour cream, veggies and enjoy. Italian chicken recipe is 6 chicken breasts or can sub thighs (need more if so because smaller), add one jar of Pepperoncini or banana peppers and some Good Seasons Italian dressing (the dry powder) and cook 5-6 hours in crock pot. Serve on hoagie rolls or Italian bread. Soups-potato (add butter, heavy cream, cheese) Chili is an excellent choice. Steak N Shake chili from grocery store is easy and convenient when you don’t feel like cooking. Try tamales mixed in with your chili as another meat source and way to add more protein. If you are ever up this way, Humphrey’s Market in Springfield has wonderful tamales in their frozen section. Very easy to eat. Baked enchilada is another good option. All beans are GREAT sources of nutrients. Sabra Brand hummus (WalMart) is chick peas and can be topped with salsa, shredded cheese, diced kalamata olives and served with chips, pita bread cut in strips, Frito scoops, etc. Black beans and salsa recipes can be great. Dirty Rice with fine ground beef, sausage, ground chicken or turkey and red beans/rice recipes are good options. Fried chicken livers at the grocery store deli may be better than you think. :D Sullivan has a great deli, so taste test new foods in very small portions. You will be surprised when you find new foods that you like.


Liquids-Hydrate!!! Super Chill Sparkling Tangerine-Lime water is my #1 GoTo for metallic after taste. ICE brand flavored waters are also high rated by my patients. Glenn likes lemonade so he may like lemon flavored water too. Orange and lemon slices can be added to a pitcher of ice cold water. Let set a while and then removed fruit or it becomes too bitter from rind. Crush has powdered flavor packets to add to waters. Much better than Mio, etc. Some people find they really like Chai Teas or other flavored teas when they stop liking coffee. Peach tea or mint tea may help with nausea.

Goal is ½ body weight in ounces of liquid/water a day

High Calorie Peanut Butter, Smoothies, Shakes, Frappes and Nogs.

Plumpy Nut is a high calorie peanut based food used in many developing countries to treat

malnutrition. This is a recipe that is similar to it and can be used as a high calorie food to

add to your diet.

½ cup peanut butter

½ cup vegetable oil

½ cup sugar (can be reduced)

½ cup dry milk powder

Blend well. Makes 2 cups. ½ cup =600 calories and 14 grams of protein.


The Basics

Basic Milkshake

1 cup whole milk, ¼ cup powdered milk, ½ cup ice cream or sherbet=335 calories

Basic Yogurt Shake

1 8 ounce carton yogurt with fruit, ¼ cup powdered milk, ½ cup whole milk=480 calories

Juice Shake

¾ cup juice (regular or juice that is not from concentrate-ex Simply Juice), ¼ cup powdered

milk, 1 ½ cup ice cream=645 calories

High Protein Milk

1 cup whole milk, ¼ cup instant dry milk powder OR 1 quart whole milk, 1 cup powdered

milk=200 calories.

Add other ingredients as desired for flavor and additional calories.

High Calorie Hot Chocolate

½ cup half and half, ½ cup whole milk, 2 T chocolate syrup, 2 T powdered milk. 387

calories.

New Tastes….

Grape Nog

1 ½ frozen juice concentrate, ½ T light brown sugar, ¾ cup whole milk, ¾ tsp vanilla

extract=325 calories

Orange Cooler

1 cup orange sherbet, 1 T frozen juice concentrate, 1 cup whole milk=390 calories

Strawberry Cheesecake

6-7 strawberries, ½ cup milk, 2 T powdered milk, ½ cup cottage cheese, 2 T honey=410

calories

Banana Flip

2 bananas, 1 pkg Carnation Instant Breakfast, 1 cup whole milk, ½ cup orange juice.


Raspberry Shake

¾ cup whole milk, 2 T powdered milk, ¼ of a 10 oz package of frozen raspberries, ¼ cup

vanilla ice cream, 1 T of sugar=345 calories

Chocolate Banana Sipper

¾ cup whole milk, 2 T chocolate syrup, ¾ tsp sugar, 3 ½ oz evaporated milk, ½ ripe

banana=430 calories

Cream Cheese and Jelly Whirl

2/3 cup whole milk, 2 T strawberry jelly or Smucker’s strawberry ice cream topping, 1

ounce cream cheese, 2 T powdered milk=370 calories

Cinnamon Peach Smoothie

1 cup whole milk, ½ cup yogurt, 1 cup diced peaches, 1 T honey, cinnamon to taste=390

calories

Cappuccino

¾ cup coffee, ¾ cup half and half, 1 tsp sugar, ½ tsp cocoa=265 calories

Marshmallow and Chocolate Shake

1 cup ice cream, ¾ cup whole milk, 3 T marshmallow crème (room temp), 4 T chocolate

syrup=720 calories

Almond Joy Shake

½ pint chocolate ice cream, 8 ounce cream of coconut, 1 T almond butter, ¼ cup half and

half=495 calories

Hawaiian Shake

1 ½ cup vanilla ice cream, ¾ cup pineapple juice, 1 medium banana=650 calories

Pumpkin Pie Shake

3 cup vanilla ice cream, 1 ½ cup whole milk, 1-15 oz can solid packed pumpkin, ¼ cup light

corn syrup, 1 tsp vanilla, ¼ tsp ground cinnamon, ¼ tsp cloves=4 servings at 365 calories

per serving. Mix in whipped topping for even more calories.


Strawberry Crush

2 cup frozen strawberries, ½ cup crushed pineapple, ½ medium banana, ½ cup water, 6 T

sugar, ¼ cup lemon juice, 2 T honey. 640 calories.

Peaches and Cream

1 cup whole milk, 1 cup canned peaches, 1 cup ice cream, ¼ tsp vanilla. 630 calories.

Apple Pie a la mode

1 cup apple pie filling, 1 cup vanilla ice cream, ½ cup whole milk, dash of cinnamon. 525

calories.

Orange Sherbet Shake

¾ cup orange sherbet, ½ cup 7 up, 2 T corn syrup, 2 T corn oil. 480 calories.

Strawberry Banana Shake

½ cup whole milk, ½ banana, 6 strawberries, ¾ cup lemon sherbet. 355 calories, 7 gm

protein.

Berry Freeze

1/3 cup whole milk, ¾ cup raspberry sherbet, 6-8 strawberries. 279 calories. 4 gm protein.

Raspberry Fizz

1 ½ cup raspberry juice, 3 scoops raspberry sherbet, ½ cup sparkling water. 255 calories.

Super Smoothies, Frappes, Shakes and Nogs- Edited-Source: Gretchen M. Garlow, MS, RD,

LDN, CNSC 7/15/2013

Mango Yogurt Smoothie

1 cup mango puree, from fresh, canned or frozen mango, 6 ice cubes, 1 pinch fresh ginger

(grated), 1 cup yogurt, ¼ cup whole milk or Ginger ale. Blend til frothy. Add milk and

Ginger ale to desired consistency. 346 Calories, 17 gm protein, 55 gm carbohydrate when

made with milk.

Apricot Ice Cream Smoothie

3 ice cubes, 2-3 cups ripe apricots, halved, seeded and sliced, 2 scoops vanilla ice cream or

1 cup frozen yogurt, 1 cup apricot nectar, 2 T yogurt. Put ice cubes in blender and blend to

a snow consistency, add apricots, ice cream and apricot nectar. Blend til frothy and creamy.

Adding just enough milk to make the blades run. Put in a glass, swirl with cream or yogurt


and serve by spoon. 485 calories, 9 gm protein, 80 gm carbohydrate when made with ice

cream.

Chocolate Hazelnut Smoothie

1 cup whole milk, 2 scoops chocolate ice cream, 3 T skim milk powder, 2 T Nutella or

Chocolate Jif, 1 T canola oil, 4 ice cubes. Combine all in blender and mix until smooth and

creamy. 840 calories, 23 gm protein, 80 gm carbohydrates. (Per serving-makes 2 servings at

420 cal each)

Banana Split Smoothie

½ cup strawberry sorbet, ½ banana, ½ cup whole milk, 3 T skim milk powder, 4 ice cubes,

3 T chocolate syrup. Combine and blend in blender until smooth and creamy. 484 calories,

14 gm protein, 98 gm carbohydrate.

Pumpkin Pie Frappe

1 cup pumpkin, fresh cooked or canned, ½ tsp cinnamon, 1 cup apricot nectar, 3 T

powdered skim milk. Combine all in a blender, blend til smooth and creamy. 305 calories,

12 gms protein, 68 gms carbohydrate.

Sweet Potato Frappe

½ cup baked sweet potato, 1 cup apricot nectar, ½ cup soft tofu, 3 T powdered milk, pure

honey or maple syrup (1Tbsp). Combine and blend until smooth. 487 calories, 22 gms

protein, 92 gms carbohydrate.

Cherry Almond Frappe

1 cup whole milk, 1/3 cup cherry cider, ½ cup vanilla ice cream, 2 T almond butter, 3 T

powdered skim milk or vanilla whey powder, ½ tsp almond extract, 4 ice cubes. Combine

and blend until smooth and creamy. 621 calories, 26 gm protein, 56 gm carbohydrates.

Powerccino

1 package Instant Breakfast mix, coffee or vanilla flavor, 1 cup whole milk, 2 scoops coffee

ice cream, 3 T skim milk powder, 1 T chocolate syrup, 4 ice cubes. Combine and blend until

smooth. 700 calories, 26 gm protein, 96 gm carbohydrate.

Peanut Butter Drink

½ cup whole , 3 T smooth peanut butter, 3 T chocolate syrup, ½ cup vanilla ice cream, ½

banana. Place all ingredients in blender and blend well. Pour in a tall, frosted glass.


Garnish with maraschino cherry, sprig of mint, whipped cream or nutmeg. 357 calories, 20

gm protein, 82 gm carbohydrate.

Peach Shake

1 canned peach half, 3 T dry milk powder, ¼ cup whole milk, 1 package vanilla instant

breakfast, 1 cup vanilla ice cream. Combine in blender and blend until smooth. 571

calories, 21 gm protein, 83 gm carbohydrate.

Fruity Yogurt Protein Shake

½ cup low fat yogurt, 3 T skim milk powder or protein powder made with soy or egg, ½

cup fresh or frozen fruit (cherries, berries, peach or melon), 1 banana, ¼ cup or more

vanilla soy milk, 1 or 2 pitted dates (optional), 2 ounces silken tofu, 12 almonds. Combine

all in blender, mix until smooth, add additional fruit juice if needed to reach desired

consistency. 450 calories, 25 gms protein, 65 gms carbohydrate.

Coco-Loco Shake

9 tsp Ovaltine Rich Chocolate Mix, 1 cup whole milk, 1 banana, 6 ice cubes. Combine in

blender and blend until smooth. 313 calories, 10 gm protein, 52 gms carbohydrate.

Pineapple Berry Freeze

1/3 cup whole milk, ½ cup fresh pineapple, ¾ cup raspberry sherbet, 3 T skim milk

powder. Place all ingredients in blender and blend well. Pour into tall frosted glass. Use

your favorite garnish –maraschino cherry, sprig of mint, whipped cream or dash of nutmeg.

329 calories, 12 gm protein, 59 gm carbohydrate.

Eggnog

½ cup whole milk, ½ cup pasteurized liquid egg such as egg beaters, 3 T powdered milk, ½

banana, 2 tsp honey. Combine and blend until smooth and creamy. 201 calories, 19 gm

protein, 19 gm carbohydrate.

Yogurt Nog

½ cup yogurt, ½ cup pasteurized liquid egg as egg beaters, 3 t powdered milk, ½ banana, 2

tsp honey. Combine and blend until smooth and creamy. 330 protein, 31 gm protein, 46 gm

carbohydrate.


Strawberry Nog

¾ cup whole milk, 3 T powdered milk, ½ cup pasteurized liquid egg beaters, ¾ cup

strawberry ice cream. Combine and blend until smooth. 475 calories, 33 gms protein, 46

gm carbohydrate.

High Protein Nog

1 cup whole milk, 3 t powdered skim milk, ½ cup pasteurized liquid egg, 1 T granulated

sugar, 1 tsp vanilla extract, dash nutmeg. Blend well and garnish as desired. 343 calories,

31 gms protein, 36 gms carbohydrate.

Super Strawberry Nog

¾ cup whole milk, 3 T skim milk powder, ½ cup liquid egg beaters, 1 scoop vanilla whey

powder, 2 T canola oil, ½ banana, 4 ice cubes. Combine and blend until smooth and

creamy. 883 calories, 60gm protein, 60 gm carbohydrate.

Dark Chocolate Avocado Smoothie Serving Size: ½ cup

Ingredients: 1 medium avocado , 1/2 cup dark semi sweet chocolate chips , 1/4 cup sugar ,

1/4 cup cocoa powder, unsweetened, 1 tsp cinnamon , 1 tsp vanilla extract , 1/3 cup

raspberries. Calories 497 , Fat 31 g, Carbohydrate 50 g, Protein 4.5 g, Sodium 20 mg

Additional Resources:

Oncology Nutrition Website http://www.oncologynutrition.org/

Fight Cancer with Food Chaining by Cheri Fraker, …...Magic Bullet to blend. Think Feed Store...

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