Rice Pudding

I have yet to find a way to make good chocolate or vanilla pudding fat free.  For now I rely on the little skim milk cups of pudding I can sometimes find in the grocery store.  But this morning I tried rice pudding for breakfast, and I thought it was fantastic.  I bet the girls would have eaten more of it if I had added cocoa powder, so I'll keep that in mind for fat free pudding in the future.  We made it with leftover brown rice, so it was extra healthy!  Yay fiber!

The recipe is adapted from one of my favorite cookbooks. It's not all low fat, but every recipe is perfected to full flavor (so making it fat free is generally still very tastey!).  (Don't tell, but this recipe technically was from the 'dessert' section... but in my book, all good breakfasts would also make great desserts...)

100% delicious

Cook a cup of rice according to the directions of the package.  We prefer brown rice for added nutrient density.  OR use 2 cups of whatever leftover rice is in the fridge and doesn't smell funny!

Put 4 cups fat free milk and 1/2 cup sugar in a medium pot, bring to a simmer, Add the rice and cook on a slow simmer, uncovered and stirring frequently (though I neglected it horribly and it still didn't burn! score!), until the mixture is thick (45 minutes ish).  Remove from heat and add a teaspoon of vanilla.  Serve warm or refrigerate and serve cold.

Breakfast this morning!

Flavor options:

• plain old vanilla
• add grated orange zest while it's cooking, maybe with a 2-3 almonds, chopped, on top
• add cinnamon, nutmeg, and 1/2 cup dried fruit at the end with the vanilla
• for a more Indian flavor (Yum!) add 1/2 teaspoon cardamom with the vanilla and sprinkle 1/3 cup toasted chopping pistachios on top of each bowl (if your fat intake can take it... let's see, 1/3 cup for the whole batch, it's supposed to serve 6 people, so slightly less than a tablespoon per person... 18 grams of fat in 1/3 cup of chopped pistachios, so... 3 grams of fat per tablespoon! not too bad!)
• unsweetened baking cocoa added with the vanilla would be great, too!  I'd estimate 1/3 cup for the whole batch would be about right, but add more for a darker chocolate flavor (another secret of our family is our oatmeal is often chocolate flavored for breakfast, using this same trick...)

Kettle Corn!!

I've finally figured out how to make a batch without burning it all.  The secret seems to be letting go of perfection - I cook popcorn in a whirley pop, which we were given by my parents, but I like to cook it until every.  single.  kernel.  is popped.  Which, when there is sugar added as for kettle corn, just doesn't work.  The sugar burns before every kernel pops.  Never fails.  Lower heat?  Doesn't matter.  Longer time cooking?  Doesn't matter.  Always burns.  So that's my secret.  Otherwise, here's the recipe:

Et voila!  Happy New year!

Heat a large pot (or a whirley pop) with 1/2 tablespoon coconut oil (olive oil works great, too) on medium high heat.  After it's getting warm, add 1/4 cup popcorn kernels, 1 teaspoon salt, 1/4 cup sugar, keep covered.  Toss around (or stir with whirley pop) at regular intervals until the popping  starts and then slows down.  Remove from heat at the first smell of anything burning, or when the popping has 1-2 second intervals between pops.  Let go of your perfectionism! Let some kernels be thrown out!

LPLD Pie Crust

The holiday season is rough without pie.  But as a fruit-based dessert, I was sure we could find a way to make it possible.

I grew up with my grandma's oil-based pie crust, nice and crisp.  I tried it with coconut oil and it worked great!  If you make a single crust (depending on the pie, you can put the one crust on the top or one on the bottom - who says you have to have two crusts?!?), put no fat into the interior of the pie, and eat an eighth of a pie, it will have approximately 7 grams of fat.  3.5 grams if you and your doctor have agreed your health allows you to consider coconut oil half the amount of fat due to its having a lot of medium chain triglycerides!  Certainly not an everyday food, but no longer on the 'never' list, either!

Grandma's Recipe:

Place 1 cup all-purpose, unbleached flour in a small bowl, add 1/2 teaspoon salt and stir.  In a 1/2 cup measuring cup, place 1/4 cup coconut oil (microwave it if it's solid), then add 2 1/2 tablespoons of cold water to the same measuring cup.  Add the whole measuring cup all at once to the flour/salt mixture, and stir with a fork until just combined.  Roll out dough between 2 pieces of wax paper that are roughly 12"x12" (square) until it makes a rough circle that fills to the edges on each side.  Peel off the top wax layer piece carefully and use the bottom waxed paper to place the crust into place on the pie.  Peel off the last piece of waxed paper carefully.  If you need to prebake the crust before filling it, bake it at 450 degrees for 10-12 minutes or until lightly browned.

Cherry pie with a top crust cut into overlapping stars.  So pretty!

Pie filling recommendations

• 6 cups thinly sliced granny smith apples, 1 tablespoon lemon juice, 3/4 cup sugar, 2 tablespoons tapioca, 1 teaspoon ground cinnamon, 1/4 teaspoon ground nutmeg (definitely a top crust)
• 5 cups blueberries with 1/2 cup sugar, a sprinkle of cinnamon,  and 1/4 cup tapioca (bottom crust)
• 5 cups strawberries with 1/2 cup sugar and 1/4 cup tapioca (bottom crust)
• Two cans of tart cherries cooked with sugar and cornstarch per the can directions (with a top or bottom crust)
• 3 cups chopped rhubarb, 1 cup strawberries, 1 cup sugar, 2 Tablespoons tapioca (with a top lattice crust)

What other pies do you wish you could make, or have you made successfully?

RareConnect Community

One of our greatest finds since having this diagnosis is the RareConnect Community for LPLD:

https://www.rareconnect.org/en/community/lipoprotein-lipase-deficiency

There's a place to write your story, make 'friends' with other people in the community (whether it's others with LPLD or other parents of people with LPLD), and discuss whatever is on your mind, The platform isn't perfect, it's difficult to search for old topics especially.  But it's something I rely on for the latest news on LPLD, and we even have an email pen pal for Monica that is Monica's age!

Two of three have LPLD!

Pasta Primavera

This is a recipe for the summer... maybe I'm already craving all these fresh vegies in this cold, but it will be amazing to eat this again when zucchini is in season again!

Ingredients:
3 carrots, cut into thin strips
2 medium zucchini (or one large) cut into thin strips
2 yellow squash, cut into thin strips
1 onion, finely sliced
1 yellow bell pepper, cut into thin strips
1 red bell pepper, cut into thin strips
additional vegetables, as desired, consider a small buternut squash, fennel, or bok choi, also cut into small pieces
1 tablespoon olive oil
salt and pepper to taste
1 tablespoon dry Italian herbs (or a dash of parsley, oregano, and basil)
1 pound whole wheat linguine (our favorite for this recipe, but use whatever noodle you want)
15 cherry tomatoes, cut in half

Directions:

Preheat oven to 450.  In a large heavy baking sheet or brownie pan, toss all the vegies with oil, salt, pepper, and dry herbs.  Put half the vegies on a separate sheet or brown pan and arrange evenly across the bottoms.  Bake until the carrots are tender and vegies begin to brown, stirring every 10 minutes.  This should take about 20 minutes.

Meanwhile, cook the pasta per the directions on the box.  Drain, reserving 1 cup of the cooking water.

Toss the pasta with the vegies in a large bowl to combine.  Toss with the cherry tomatoes and enough reserved cooking liquid to moisten.  Season with salt and pepper to taste.  Serve immediately.

Yum! End of summer harvest! Ignore the pineapple...

Adapted from this recipe.

Lettuce Wraps

Similar to those served as an appetizer at a popular Chinese chain restaurant, and a big hit in our family.  We use ground beef, but chopped chicken is excellent as well.

Ingredients:
Filling:
1 tablespoon oil
1 lb ground beef (or two boneless skinless chicken breasts)
8 oz can of water chestnuts, minced
2/3 cup fresh mushrooms
1 small onion, chopped
1 clove minced garlic
1 cup+ of other vegetables, including peppers or zucchini, chopped

Dip:
2 tablespoons sugar
1/2 cup broth
2 tablespoons soy sauce
2 tablespoons rice wine vinegar
2 tablespoons ketchup
1 tablespoon lemon juice
1/8 teaspoon sesame oil (packs surprising flavor!)
1 tablespoon mustard
2 teaspoons water
1-2 teaspoons garlic and red chile paste (if desired for spiceness)

Stir Fry Sauce:
2 tablespoons soy sauce
2 tablespoons brown sugar
1/2 teaspoon rice wine vinegar

Directions:
Make dip by combining all ingredients, mix well and refrigerate until ready to serve.

Heat oil in large frying pan or woke, saute meat until cooked through.  Remove meat, allow to cool and mince (if using chicken).  Leave remaining grease in cooling pan.  Prepare stir fry sauce by combining ingredients.  Heat the greasy pan again, on high heat, and add chicken, garlic, onions, water chestnuts, mushrooms, and other vegies.  Add stir fry sauce and heat through, for a few minutes.

Serve filling scooped into whole lettuce leaves, rolled slightly, and dipped into the dip as desired.  It's messy, but delicious!

Adapted from this recipe

Thoughts on parenting a child with LPLD

How do I teach my child to cope with this in a healthy way?
I want my daughters to understand, for sure, that if they eat too much fat, they will get sick.  They've never had pancreatitis to remind them with memories of severe pain, and I hope they never do.  My daughters, therefore, have to trust me, or maybe experience for themselves the milder stomach pains that some people with LPLD get when their triglycerides are too high.

The stereotype of adults that had childhood chronic disease, whether it's leukemia or diabetes, is that they never grow up.  They have had every detail of their lives managed for them since they were little, since it was necessary to keep them alive, but then as a result they never learn to take care of things by themselves or manage their own illness.  I've talked with parents of kids with severe food allergies and my friends who have childhood, or type I, diabetes to help me to try to prevent this.  

One way that we address helping her be in charge of her own disease is that, as Monica grows up, we expand our discussion of LPLD and what it means.  So, as a toddler, we would say certain foods would 'make her sick' and other foods would 'help her grow big and strong' (and other foods, like candy, are 'treat foods' that do not make her sick, but also don't help her grow big and strong).  As a preschooler, we expanded a little, with foods that she could eat a little of if she ate a good (non fat) meal, like a slice of avocado after a big bowl of non fat pasta.  That was our attempt to teach her balance at that stage.  Admittedly, it is hard to differentiate between a 'reward' for eating a big healthy meal, and a 'natural consequence' for eating low fat meals.  But we're trying!

Now as a kindergartener, we can discuss things a little more, and gradually introduce her to the idea that what matters most in deciding if she can eat something that is high fat, is 1: whether she thinks she can stop herself after just a bite or two, and 2: what fat she's had to eat for the last week, and whether she has special events coming up in the next week at which she might want to eat more fat.

Graham cracker gingerbread houses with nonfat frosting and nonfat candy! The Holidays are a tough time for budgeting fatty foods

What happens as a child with LPL grows up?
Medications don't work for this disease, as they all (at this point in time) work by altering the LPL enzyme; but people with LPLD don't have the LPL enzyme, so the medications don't work!  Surprisingly, individuals with LPLD don't seem to have many problems with heart disease or cholesterol buildup in the heart's blood vessels, which is usually why people with high cholesterol go on medications in the first place!  What good news!  The big lifelong consequences of LPLD seem to depend on pancreatitis; the more times the triglycerides have gotten high enough to cause pancreatitis, the more damage there is to the pancreas.  The pancreas functions in controlling blood sugar levels, and so with lots of damage, an individual can develop type II diabetes (and its own inherent medications, difficulties, and diet changes!).  The pancreas also puts enzymes into the digestive system that help breakdown food, and so with lots of damage, an individual can have chronic digestive symptoms such as bloating and foul smelling diarrhea, called pancreatic insufficiency.  The main goal in controlling LPLD, therefore, is controlling the diet to avoid having pancreatitis.

As a parent, I worry that fat will be set up as something Monica can never have, as something so delicious that she longs for it, the forbidden fruit.  That will set up trouble for when she wants/needs to rebel against us, as her parents.  When Monica is a teenager, we want her to rebel against us by wearing silly clothes, using offensive language, and getting her ears pierced without permission.  We don't want her to have a milkshake and a Big Mac.  That's why we use the phrase '(that food) will make you sick' instead of '(that food) is bad' or something similar.  Her getting to eat a fatty food should never have bearing on her behavior, her sweetness or naughtiness (our children are always inherently 'good,' and never inherently 'bad;' that's what I get for marrying a philosopher :) ).   Getting a spoonful of peanut butter is not a reward for doing chores, but it could be something she gets after eating very low to non fat meals for a while, as a natural consequence rather than a reward.  It's a small difference, but one we hope to emphasize to Monica and prevent her from getting pancreatitis, even as she matures and grows away from us as her parents.

Teresa laughing with her uncle - there are joyful things in life besides food!  But sometimes with LPLD it's hard to remember that.

But it's not fair!
Children with LPLD and their parents, alike, have this thought.  Frequently.  A lot of the solace in our family comes from our Catholic faith, and our (continually growing) understanding and acceptance of why God allows bad things to happen to good people.  We talk with Monica about Heaven, where she won't have LPLD anymore.  We talk about offering up her sacrifices for other people who are suffering (basically, praying that God might take away the suffering of someone else, even just a little bit, if you accept your current suffering without complaint, emulating even just a little Christ's suffering on the cross (this works for parents watching their child suffer, too)).

Monica's food choices have also helped me to realize that everyone in the world has foods that they should be eating in moderation.  It's not just Monica.  Yes, Monica's restrictions are more immediately life-threatening and painful.  Most people will suffer from their poor eating choices with heart attacks and the like years down the line, and Monica faces her consequences sooner.  Which, in a way, is a good thing, that it's easier to eat appropriately when the consequences are so close.  OK, OK, I'm kind of grasping at straws for 'good things' about having LPLD.  But it is true that everyone has foods that they should eat more of, and foods that they should eat less of.  Some people just get to ignore it for longer than Monica does.  Somehow this brings me comfort.  Sometimes.

What about my child's children?
Whether Monica and Teresa's children have LPLD, or are just carriers of it, depends on the genetics of who they marry. Since Monica and Teresa are women with LPLD, they will have particularly rough pregnancies and difficulties breastfeeding, possibly.  But that's a long post for another day.

Merry (low fat) Christmas!