THE PEASANT EVOLUTION: RENAL FRIENDLY RECIPES by Jyoti Fernandes & Renuka Coghlan

THE PEASANT EVOLUTION RENAL FRIENDLY RECIPES

Jyoti Fernandes & Renuka Coghlan

Working in partnership with:

Dorset County Hospital

Introduction Kevin likes bread, cakes and craves cherry tomatoes and melon.

David chose his favourite foods; multi seeded breads, cherry tomatoes, pickled anchovies and parmesan cheese.

Denise’s favourite foods were chicken, bacon, oatmeal and nutty bread. She also likes mushrooms.

Chris craves bananas but has not eaten any since starting dialysis which was many years ago. He also loves rhubarb crumble, dumplings, stewing steak, carrots and onions.

Gary too loves bananas, steak and kidney pudding and not forgetting Cornish pasties which serves as a tasty snack when on dialysis.

This recipe book is the culmination of the ideas and suggestions made as part of “Blood Makes Noise”, a film by Peter Snelling and a cooking project where people on dialysis worked with Jyoti Fernandes, a local chef and one of the founders of the Peasant Evolution (who grow local organic food in Dorset).

A group on twilight dialysis at Dorset County Hospital came up with a list of their favourite foods and of course some on their ‘wish list’ were high in the potassium, phosphate or salt that they believed they should avoid completely.

However Jyoti used her culinary skills to come up with some tasty recipes and together with the specialist knowledge of Renuka Coghlan, renal dietitian, ensured they were suitable for all renal patients.

“I would advise people starting dialysis not to worry too much because it is not as bad as you assume. It becomes a way of life.”

Dialysis patient

In the end everyone involved in the project was invited with their family to join Jyoti and the project team in a ‘Cooking with Jyoti’ evening where we all cooked some of the dishes you see in this book. At the end of the evening we all sat down to a sumptuous meal.

The recipes allow you to make a range of meals and snacks that are tasty, flavoursome, fit in with dietary prescriptions and hopefully inspire you to make your own renal friendly recipes.

Watch Blood Makes Noise online at www.mypockets.co.uk/bloodmakesnoise

All recipes are suitable for renal patients.

The recipes Snacks Bruschetta page 1 Baba ganoush page 1

Mains Beef stew & dumplings page 2 Goan pan fried mackerel with lime, mint & cucumber

page 3

Pasties page 4 Risotto with peas and parmesan

page 5

Salads Tabouli page 6 Carrot salad page 6 Leek vinaigrette salad page 7

Desserts Dorset apple cake page 8 Eton mess page 9 Pear tart page 10 Quick banoffee pie page 11

Salt: The savoury recipes are reduced in salt with no salt added in cooking. The flavour of the dish has been enhanced by using fresh herbs, spices and low salt stock cube if needed. Renal patients are advised to reduce their salt intake to 5 grams daily. The recipes are all low to medium in salt.

Potassium: It is important to keep to your allowance of potassium as advised by your dietitian. The recipes are analysed to show the amount of potassium per portion. The savoury dishes can be served with a portion of vegetables.

Phosphate: The total amount of phosphate per portion is provided for each recipe. If you have been prescribed a phosphate binder, remember to take this. You may also need to take a binder with some of the snacks. As a rule if the recipe contains more than 50mg of phosphate it requires a binder.

Protein: Your protein intake is individual for you and calculated by your dietitian.

The recipes included can be a main meal or snack.

Please see the table on page 12 for a breakdown of all the recipe’s nutritional content (salt, potassium, phosphate, protein and energy).

Bruschetta Ingredients

2 thick slices French stick / Ciabatta bread 1 teaspoon olive oil

Method

Servings 2 For the tapenade:

2 marinated or tinned anchovies (5 grams) 4 cherry tomatoes (40 grams) Freshly ground black pepper to taste

Fresh thyme or marjoram leaves to garnish

• Drizzle the olive on the bread.

• Finely chop the tapenade ingredients together.

• L ightly spread the tapenade on each slice of bread and bake on a low setting in the oven until crispy. Remove from the oven and garnish with thyme or marjoram. *Note; This tapenade mixture with a pinch of saffron or turmeric can be added to a serving of boiled cauliflower or courgettes to give it extra flavour.

page 1

Baba ganoush, aubergine dip Ingredients

650 grams aubergines Juice of 1 lemon 2 garlic cloves

Servings 12

3 tablespoons chopped mint or flat-leaf parsley 2 tablespoons extra virgin olive oil

Method • C ut the aubergines in half lengthways, drizzle with olive oil and roast in the oven or on a gas hob until soft.

• A llow to cool then scoop out the flesh in long strands, discarding the skins.

• Add the lemon juice, garlic and two-thirds of the chopped herbs.

• Mash the aubergines gently with a fork until it is a little creamy.

• Top with the remaining herbs.

• Pour a moat of oil around the edge and serve with the flatbreads.

Beef stew and dumplings Ingredients

100 grams raw onions diced 125 grams green pepper 1 tablespoon olive oil

Method • Sauté onions and green pepper in the olive oil.

• T oss the beef in flour and spices and then add to the onions and pepper. Brown the meat well.

1 tablespoon flour

• A dd enough water to cover the beef and cook on low heat at 140°C/275°F until beef is tender.

4 garlic cloves finely chopped

• I n a separate pan boil the carrots and green beans.

2 bay leaves

For the Dumplings

400 grams diced beef

1 teaspoon redcurrant jelly 5 juniper berries

125 grams of boiled sliced carrot 125 grams of boiled green beans

Servings 4

• Drain and then add to the stew.

• M ix all ingredients and form into balls the size a golf ball.

• P lace the dumplings on top of the stew, put the lid back on and allow to cook until the beef is ready.

For the Dumplings:

50 grams vegetable suet 100 grams flour

1 teaspoon thyme and rosemary

page 2

Goan pan fried mackerel with lime, mint and cucumber garnish Ingredients

300 grams fresh mackerel fillets 1 tablespoon vegetable oil 1 teaspoon lime juice

¼ teaspoon ground roasted cumin ½ teaspoon brown sugar

5 grams chopped fresh mint Pinch of dried chilli or a little fresh chilli to taste 50 grams of cucumber For the spice mixture:

2 teaspoons white vinegar

¼ teaspoon red chilli powder

1 teaspoon black peppercorns 1 teaspoon coriander seeds ½ teaspoon cumin seeds 6 cloves of garlic

¼ teaspoon turmeric powder

page 3

Method • Blend the spices and vinegar to a smooth paste.

• M arinate the fish in this mixture overnight or for a few hours.

• P an fry the fish in the oil until the skin is crispy and the flesh turns white.

• G rate the cucumber and remaining ingredients for the garnish. Sprinkle on the cooked mackerel and serve.

Servings 2

Pasties Ingredients

Making pastry is very simple, but if you prefer you can use ready made short crust pastry, however this is higher in phosphate.

Servings 4 Method • Heat the oil and sauté the chopped onions.

• Add the minced beef and brown well.

• B oil the diced carrots, swede and peas and add to the minced beef.

100 grams raw onion diced

• D ivide the pastry (see recipe below) into 4 equal balls. Roll each ball into rounds the size of a saucer.

250 grams minced beef

• D ivide the meat mixture between each pastry round putting the filling in the middle.

For the filling:

1 tablespoon vegetable oil 125 grams boiled diced carrot

• F old the other half of the pastry over, crimping the edges together to form a tight seal.

125 grams boiled peas

• P lace on a greased baking sheet of grease proof paper and bake at 220°C /425°F for 45 minutes until golden brown.

125 grams boiled diced swede dash of Worcestershire sauce

For the pastry

Black pepper to taste

• P lace the flour and vegetable margarine in a bowl. Rub the fat into the flour until the mixture resembles fine bread crumbs.

For the pastry:

• A dd 2 teaspoons of cold water to the mixture and mix to form a dough, adding more water if needed.

Mixed herbs

Pinch of nutmeg

110 grams plain white flour.

55 grams vegetable margarine

• W rap the dough in cling film and chill for at least 15 minutes before using.

Cold water to mix

page 4

Risotto with peas and parmesan Ingredients

Method

1 teaspoon olive oil

• S auté the chopped onion in olive oil. Add the rice and stir so the grains are well coated with oil.

250 grams risotto rice Arborio rice 1 low salt stock cube

• D issolve the stock cube in the water. Add this very slowly to the rice stirring continuously to prevent the rice from sticking.

600 millilitres water

• A dd the white wine towards the end when most of the liquid is absorbed.

100 grams boiled peas

• I n a separate pan boil the peas and add to the rice at the end.

Wedge of lemon

• G arnish with black pepper to taste, a squeeze of lemon juice, parmesan cheese and fresh herbs.

100 grams raw onion diced

20 millilitres white wine Black pepper

20 grams fresh parsley or basil for a garnish

20 grams parmesan cheese Thyme

Rosemary

page 5

This dish can be served with roast meat or fish. The risotto is a good alternative to potatoes as it is lower in potassium.

Servings 4

Tabouli Ingredients

200 grams fine bulgur wheat 200 millilitres boiling water 150 grams fresh parsley 50 grams fresh mint

Servings 6 4 cloves of garlic – crushed 100 grams finely chopped cucumber

50 grams finely chopped tomato Black pepper to taste

4 tablespoons lemon juice

Carrot salad

Servings 4

Ingredients

225 grams of raw carrots grated 75 grams finely chopped apple 10 grams currants

1 tablespoon lemon juice or cardamom infused white wine vinegar

1 tablespoon olive oil

Method

Method

• P our the boiling water over the bulgur wheat. Stir well and leave until the water is completely absorbed.

• Mix the grated carrots, chopped apples and sultanas in a bowl.

• M ix in finely chopped herbs, lemon juice, oil, pepper, cucumber and tomato.

• A dd the lemon juice or the cardamom infused white wine vinegar.

Add pepper and fresh herbs to taste.

page 6

Leek vinaigrette salad Ingredients

400 grams boiled baby leeks - cut into long strips

Servings 4 Method • Cut the leeks into long slices and wash well.

1 teaspoon olive oil

• B oil in unsalted water for a few minutes until al-dente. Drain.

½ teaspoon French mustard

• M ix the olive oil, vinegar and French mustard.

Drizzle onto the leeks and serve while still warm.

1 teaspoon white wine vinegar

page 7

Dorset apple cake

Servings 6

Ingredients

Method

125 grams sugar

• M ix flour, sugar, baking powder and cinnamon into a bowl.

175 grams plain flour 1 teaspoon baking powder

• S tir in the grated carrots and chopped cooking apple, mix well.

125 grams grated raw carrots

• Stir in the egg, oil and vanilla essence.

1 teaspoon cinnamon powder

• Line an 8 inch baking tin with grease proof paper

250 grams chopped cooking apple

• S poon the cake mix in and bake at 225°C /440°F for approximately an hour.

3 tablespoons sunflower oil

• T he cake is ready when a clean skewer inserted in the centre of the cake comes out clean or the cake feels springy to touch.

1 egg

1 teaspoon vanilla essence

page 8

Eton mess Ingredients

175 grams caster sugar 3 large eggs whites

Servings 6 Method • Pre heat the oven to 150°C or 300°F .

200 grams strawberries

• H ave the caster sugar measured and ready in a bowl.

130 grams raspberries

120 grams tinned peaches drained

• P lace the egg whites in a scrupulously clean bowl and whisk until they form soft peaks that slightly tip over when you lift the whisk.

570 millilitres double cream

• N ext, add the caster sugar, about a tablespoon at a time, and continue to whisk until each tablespoon of sugar has been thoroughly whisked in.

• T ake rounded dessert spoonfuls of the mixture and place them in rows on the lined baking tray (lined with greaseproof paper). Place the baking tray in the oven on the centre shelf, turn the heat down to 140°C /275°F and leave the meringues there for 1 hour.

• T urn the oven off and leave the meringues in the oven to dry out overnight, or until the oven is completely cold.

• W hip the double cream, mash the meringues, add the fruit and serve in sundae dish. Garnish with a few berries.

page 9

Pear tart Ingredients

500 grams puff pastry

800 grams tinned pears in light syrup drained

Servings 6 Method • R oll out the puff pastry into a rectangle or circle to fit on top of the dish you are using for the pears.

100 grams sugar

• B oil together the sugar, vanilla and butter to make a caramel sauce.

50 grams butter

• B utter the base of the oven proof dish. Pour the caramel sauce to cover the base. Place the tinned pears on top of the sauce, overlapping the pears if necessary.

1 vanilla pod halved lengthways with seeds scrapped out

• D rape the pastry over the pears, then tuck the edges down the sides and under the fruit.

• B ake in an oven at 180°C/ 356°F for 15 mins.

If a lot of juice bubbles up the side of the pan, pour it off.

• R educe the temperature to 160°C/ 320°F and bake for 15 mins more until the pastry is golden brown.

• L eave the tart to stand for 10 mins, and then invert it carefully onto a serving dish. Serve with cream or fromage frais.

page 10

Quick banoffee pie Ingredients

125 grams crushed digestive biscuits

50 grams butter melted

Servings 6 Method • T ip the biscuit crumbs into a bowl add the melted butter and mix well.

200 grams custard

• S poon the crumbs in a buttered tin or a ramekin dish. Chill for 10 minutes.

120 grams sliced banana

150 grams whipping cream

• M ash of the banana and mix with the custard.

Spread on the biscuit base.

1 teaspoon of finely grated chocolate to decorate

• Add the whipped cream on top of the custard.

page 11

• G arnish with the left over banana and a light dusting of grated chocolate.

Nutritional analysis of recipes Portion grams

Recipe per portion

Protein grams

Potassium millimoles (mmols)

Salt grams

Phosphate milligrams/millimols

Energy kcals

108

Quick banoffee pie

3

4

0.5

69/1.7

310

242

Pear tart

5

4

0.6

60/1.5

483

215

Eton mess

4

5

0.1

72/1.8

617

130

Dorset apple cake

4

4

0.2

115/2.8

269

103

Leek vinaigrette salad

nil

4

negligible

33/0.8

34

80

Carrot salad

nil

4

negligible

12/0.3

34

107

Tabouli

5

10

negligible

149/4

153

124

Risotto with peas & parmesan

7

5

0.1

168/4

303

Pasties

16

9

0.3

152/4

385

184

Goan pan fried mackerel

28

12

0.2

319/8

351

233

Beef stew & dumplings

26

15

0.2

258/8

407

30

Baba ganoush

neg

2

negligible

negligible

5

145g

Bruschetta

12

3

2 (high)

134/3.3

338

’Blood makes Noise’ was a project undertaken by the Arts in Hospital programme at Dorset County Hospital which worked with patients on dialysis in Dorchester. The project was funded by the Welcome Trust and British Kidney Patients Association (BPKA). The project had a special focus on the relationship between diet and kidney disease. The arts were seen as a way of engaging patients in self expression as well as addressing the difficulty around maintaining diet and fluid restrictions.

Photography by Peter Snelling, Renuka Coghlan, Jyoti Fernandes and Alex Murdin. page 12

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25 Arts in Hospital is a charity dedicated enhancing the healing environment.

Find out more and get involved at www.dchft.nhs.uk/about/arts.html Arts in Hospital, Dorset County Hospital, WIlliams Avenue, Dorchester DT1 2JY Charity registration no. 1056479