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Monday, March 3, 2008

When food becomes a focal point of a holiday, it can become a challenge for parents with children on the ketogenic diet. The springtime holidays of Passover and Easter are no different. Although the modified Atkins diet is gaining in popularity and even working as a companion to the ketogenic diet, dietary restrictions remain for many people with epilepsy, making a holiday feast that all can partake of and enjoy a challenge.

Passover is sometimes called the "Feast of the Unleavened Bread." During Passover, the characteristic flat, unleavened "bread" known as matzah is eaten as a reminder that the Israelites ate "hurriedly-baked bread" when hastily preparing to depart from Egypt.

Easter is celebrated by Christians in commemoration of the Resurrection and is welcomed as a time of rebirth. Many Easter meals consist of specially baked breads and pies, often featuring eggs in particular. Spring lamb is another well known offering of an Easter feast.

Family Meals

Preparing family-style meals when trying to keep to the strict guidelines of the ketogenic diet can make the already daunting task of holiday cooking even more challenging. Can delicious meals, so looked forward to during holiday times, be prepared within the guidelines of the ketogenic diet that all those gathered at the table can enjoy?

Beth Zupec-Kania, RD, CD, with The Charlie Foundation, once again speaks with us about the diet and her kitchen-tested recipes. We encourage you to try Beth's tempting recipes, which are included at the end of the article.

Beth reminds us that for a person with epilepsy on the ketogenic diet, it is critical that all foods be carefully prepared and weighed on a gram scale. Children on the diet need everything measured out precisely. The diet must be managed and adjusted for each individual patient. Carbohydrate-rich foods such as bread, pasta, rice, crackers, candy and sweets are eliminated from the diet because these foods can upset the metabolic balance that the diet creates. Consistency is very important, and recipes used must fulfill the needs of the specific child.

For nearly 15 years, Beth has been helping patients and their families learn to prepare the precise meals and recipes that make the diet work. When she first began, she would prepare recipes on her own and then ask others to test the recipe. Some recipes, such as soups, breads without flour, and cheesecake, are more work intensive than others and require more tinkering. A lot of work and careful planning is involved to bring a seemingly tasty idea to a well thought out recipe that any cook might follow yielding consistent results.

Beth's Kitchen-Testing

Over the years, Beth has assembled a group of parents (currently six families) who work in a test kitchen trying recipes. Recipes are prepared, tasted, adjusted, and sent back to the drawing board, all in an effort to produce something edible and good that still conforms to the restrictions of the ketogenic diet. Some of the recipes they work on were popular in the past, and have gotten a new spin - such as her coconut cookies. Beth listens for feedback about recipes. What was a winner with the kids? Would you make it again? If not, what is the issue? What needs to be changed? Will the child eat it again a second time? Sometimes, substitutions can be made to accommodate a particular family's tastes, as with the lasagna recipe that Beth offers below - the eggplant may be omitted and replaced by another vegetable.

For those of you sitting down to a Passover or Easter table, we hope that the recipes that Beth offers below will please everyone at your holiday celebration.

Baked Parmesan "Noodles"

Ingredients:

  • 8 medium onions
  • 1/4 cup butter or 1/3 cup coconut oil (solid form)
  • 1/2 cup grated parmesan cheese

Preparation:

  • Thinly slice onions, press through centers with thumbs and spread onion rings across the
    bottom of a shallow 1 quart baking dish.
  • Cut butter (or coconut oil) into pieces and place on top of onions. Sprinkle parmesan over the top.
  • Bake in preheated 350 F. oven for 30 - 45 minutes, until golden brown on top.

Serves 6 - Approximately 9 grams of carbohydrate per serving. This delicious combination tastes like noodles.

Eggplant Lasagna

Ingredients:

  • 3 Tablespoons olive oil
  • 1 1b. lean ground beef or turkey
  • 1/2 cup onion, chopped
  • 3 cloves garlic, sliced
  • 1 cup mushrooms, sliced
  • 1/2 cup celery, chopped
  • 1 teaspoon Italian seasoning
  • 4 cups eggplant, peeled and sliced thin
  • 10 oz. provolone cheese, sliced
  • 8 oz. mozzarella cheese, shredded
  • 16 oz. good quality spaghetti sauce

Preparation:

  • Preheat oven to 350 F.
  • Place olive oil in a heated frying pan and sauté ground beef (or turkey) until cooked through. Remove from pan with slotted spoon, leaving oil, and set aside.
  • In same pan, sauté onions, mushrooms, garlic and celery until tender. Add Italian seasoning and sauté for another minute.
  • Grease bottom and sides of a 9x13 glass baking dish with olive oil. Layer half of the eggplant on bottom of pan. Sprinkle eggplant with additional Italian seasoning if desired. Layer half of the sautéed meat, half of the sauce and half of the provolone. Repeat layering with remaining eggplant, meat, sauce and provolone.
  • Sprinkle mozzarella over the top of the casserole, cover with foil, and bake for approximately 45 minutes or until heated through and cheese is melted. Remove foil for last 10 minutes to brown.

Serves 6 - Approximately 12 grams of carbohydrate per serving.

Almond Coconut Macaroons

Ingredients:

  • 4 egg whites
  • 1/8 teaspoon salt
  • 1/2 teaspoon vanilla extract
  • 1/2 teaspoon almond extract
  • 1/2 cup Splenda
  • 1/2 cup ground almonds
  • 2 cups shredded coconut (unsweetened)

Preparation:

  • Whip egg whites, salt and extracts until frothy. Slowly pour in the Splenda and whip until stiff peaks form. Be careful not to over whip until dry.
  • Gently, with a rubber spatula, fold in the almonds and coconut.
  • Line a cookie sheet with parchment paper, and drop rounded tablespoons of batter 1 inch apart onto cookie sheet.
  • Bake in a preheated 350 F. oven for 15 - 20 minutes, or until golden brown. Turn off the oven, open door slightly, and let macaroons sit in the oven until cool to allow the macaroon to dry.
  • Store in an airtight container.

Yield - 24 cookies. Approximately 3 grams carbohydrate per cookie.

Enjoy! Enjoy!

Authored by: Nonna Gale on 3/2008
Reviewed by: Steven C. Schachter, MD | Eric Kossoff, MD on 3/2008
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