Actualización II de Nicaragua: NicarComidaYAgua

Feeding Martin in Nicaragua is both more and less challenging than in the States.

To be sure, Nicaraguans love their packaged foods. Chips, crackers, cereals. Breads. Whatever forms of snacks.

They also love their fresh food. Fruits, vegetables. Fish and shrimp and octopi pulled from the ocean and eaten the same day. (I hate that Martin eats octopi.) By now we’ve been able to locate the stands and trucks with the produce we want. Samara has a favorite fish monger and a carnecería for occasional chicken. Virtually nothing is organic, except some newfangled greens and the occasional imported quinoa. I am comforted by the fact that the food is grown locally, where Nicaragua’s stricter stance (than the U.S.) on genetically modified crops also reduces the presence of especially worrisome contaminants like glyphosate.

Martin’s breakfast is usually grain-free pancakes (say, plantains and peanut butter), or fritters, or eggs with vegetables, plus fruit. Dinner is rice and beans, or coconut-crusted chicken nuggets with vegetables, or quinoa pilaf, or peanut-butter stir-fry, or maybe ceviche. (Samara’s ceviche skills are said to be outstanding.)

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A Nicaraguan breakfast of plantain-and-peanut-butter fritters plus apple. Did you know apples can be grown in Central America? Neither did I.

Weekdays, Martin eats lunch at his camp. That development—eating with the other kids, and mostly what they eat—has been huge for Martin, who’s wanted all year to buy lunch at his school back home, which, of course, would be inconceivable: Have you seen U.S. school lunches? Here, at the camp, lunches are prepared fresh from organic ingredients, many grown on site, with focus on health. I met in advance with one of the camp directors and asked that they respect Martin’s dairy and beef allergies, and that he not be permitted to eat any gluten. No problem, they said. The directors reported that, for the first week, Martin had “lunch worries” and needed to be persuaded each day, anew, that in fact he would be fed. At first, he ate tentatively, mostly Nicaragua’s famous rice-and-beans dish, gallo pinto, or even arroz unadorned.

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The aftermath of Martin’s octopus, rice, and vegetables on the beach.

After the tentative first steps, Martin started taking advantage of everything offered. I mean, everything!, and that’s brought some slip-ups. Even though I pack healthy snacks, he wants the snacks the camp keeps on hand for all kids, which include popcorn, commercial yucca and plantain chips (fried in who knows what sort of refined vegetable oil), French fries, popsicles with food colorings and refined sugar. I don’t like the snacks aspect but am resisting the urge to make the camp pull back; eating at camp, plus the wide availability of fresh seafood and vegetables in Nicaraguan restaurants (not much pizza or pasta getting in the way), seems to be helping to reduce Martin’s food-related anxiety. I hear less, “Can I eat this? Can I eat that?” and more, “Hey, do they have octopus? How about rice?”

We are, however, in something of a popsicle crisis. Now that Martin has tasty a frozen refined-sugar stick, my homemade frozen-fruit popsicles just aren’t cutting it anymore.

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This is a “fancy” breakfast, like we have when guests are eating with us: pancakes and potatoes cooked with shredded vegetables.

The overall picture is that Martin has been eating 93.6% well, and 6.4% sugar and junk food. When I say sugar, I mean those aforementioned popsicles but also potatoes, rice (which also brings arsenic), and fruit. The fruit includes a daily smoothie from our favorite smoothie stand. Martin selects the three fruits he wants (usually pineapple, mango, and lemon), while from behind him I mouth “¡y aguacate!” to the smoothie-maker so that he’ll throw in some avocado, too. Martin professes not to like avocado, so I have to get creative, like sneaking it into a smoothie.

A few weeks ago, I discussed the situation with Martin’s doctor back home. Too much sugar, I confessed. A whole lot of fruit. Smoothies every day.

“You mean fresh, mineral-rich local fruit?” she asked.

“Some of it directly from the fields,” I replied.

“I think he’ll survive.”

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Another breakfast, this time plantain-and-egg pancakes with pineapple and raw energy bars that I made from almonds, dates, limes, and shredded coconut.

Feeding Them Both

Forgive me another post on food. I don’t usually hit food twice in a row—I’ll make this one quick.

Many are the challenges to feeding a three-member family when the child is mostly Paleo/low-sal/meaty, the mother is vegan, and the father is primarily pescatarian and prefers salads.

The vegan, who prepares the food, comes last. I’ll pretty much forage the (vegan) scraps of what the other two eat, so let’s take me out of the equation.

Sometimes I can feed Martin and Adrian the same meal, as with the “anything” pasta. Other times, I make a main course for Martin and repurpose it into a salad dish for Adrian. I’ve got quite adept at this repurposing. Add sliced avocado, maybe some fruit and nuts, and voila!, fancy salad.

Yesterday I made the promised white-bean skordalia. (Remember? The cannellini beans I forgot to soak?) For Martin, I scooped a heap of skordalia onto a plate and inserted two dozen raw carrot sticks, which poked out in all directions. I called this creation (which I forgot to photograph) a “moon flower.” Martin removed and ate the carrot sticks, then finished the skordalia with a spoon.

For Adrian, I made the skordalia the major protein in a salad, with pine nuts for flair. I added mixed greens with his favorite dressing—olive oil mixed with chickpea miso—and macadamia nuts and diced cucumber on top. I had fresh strawberries, so I finished dressing the plate with fresh strawberries.

Happy kid. Happy husband.

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ASD Recovery Recipe: Anything Pasta

So I’ve discovered that I can make a decent pasta meal out of anything “vegetable” in my refrigerator. Like, virtually anything.

Last night I planned to make white bean skordalia. By the time I discovered that I forgot to advance-soak the cannellini beans, I had only minutes to devise another dinner. I surveyed the kitchen and assembled these ingredients:

->Carrots, with their green tops. I always cook the carrot greens. Once when I was checking out, the supermarket cashier casually snapped off the carrot greens and tossed them in a garbage bin. I promptly commenced a lengthy oration on the benefits of carrot greens.

->Red onions.

->Garlic.

->Celery.

->Toasted onion salt. With Martin’s current low-salicylate diet limiting spices so much, I’ve been trying to get creative with salt.

->Pine nuts. I avoid the pine nuts from China. I’m not anti-China, but I am concerned with shortcomings in China’s food-safety schema.

->Green lentil pasta.

I prepped the carrots (greens and all) and celery in a vinegar bath, then cut them into pieces and put them in my food processor. October 13, 2011, I wrote a post titled, “Kitchen News: An Update on the Hunt for a Food Processor With Glass Bowl,” which (based on total unique views) is the most popular post ever to grace this blog. Five-and-a-half years later, I am still without a glass food processor. I processed the carrots and celery almost to a paste. Then I chopped the onions and garlic roughly and added them to the food processor.

While the pasta was cooking, I heated a generous amount of oil and fried the finely minced vegetables. When they were almost done, I added onion salt and a scoop of pine nuts.

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Finally I drenched the cooked pasta in cold water to prevent mushiness and added it to the veggie pan.

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The resulting dinner was pasta coated in lovely crunchy-garlicky bits. Martin said, “Oh yes, this is delicious!” and Adrian ate every last bit from the pan.

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Must remember—“night in a pinch” will henceforth be known as “garlic pasta dinner.”

Eureka!

Salicylates.

They are the compounds in many plant foods that keep them from spoiling. Most fruits, and some vegetables, are salicylate-rich, as are virtually all spices, with turmeric/curry being among the worst offenders. Animal products (meat, eggs, dairy) are low-salicylate unless they’re spiced or cured. According to my research so far, just about anything fermented is high-salicylate.

According to “drugs.com,” salicylates (in their synthetic form?) do more than delay food rot:

Salicylates are nonsteroidal anti-inflammatory drugs. They inhibit the synthesis of prostaglandin and other mediators in the process of inflammation and have anti-inflammatory, antipyretic and analgesic properties. Salicylates can be used to reduce fever, pain and inflammation such as in arthritis.

In any event, salicylates can cause food sensitivities. The Feingold Diet, an elimination diet popular among parents of children with behavioral challenges, recommends cutting salicylates (along with additives, colorings, and other irritants) then trying higher-salicylate foods one-by-one to test tolerance levels. I’ve found a handful of websites dedicated to low-sal diets—that’s the lingo, apparently, to avoid pronouncing “salicylate” constantly—including this one and this one. Some people try, miraculously, to manage a low-sal SCD regimen.

The last week of 2016, we were skiing again, in Park City, Utah. Christmas day we flew from New York City to Salt Lake City and spent the night in a downtown hotel. The next morning we drove to Park City and picked up our rental skis. That afternoon, as Martin took a lesson at the National Ability Center and Adrian skied a few initial runs, I went to the Whole Foods Market and stocked up to cook for seven days. We reconvened at our rented condominium, had dinner, and hit the sack.

Martin had been having a troublesome few months, as you may know. When Martin is having a tough time, even if he’s sleeping well (which, these days, he almost invariably is), I often find myself awake during the night, fretting. Such was the case that first night in Park City. I woke around 3:30 am (which is 5:30 am in New York, just about when I usually get up) and couldn’t go back to sleep, so I moved to the sofa with my iPad and started reading.

I’m not sure why I felt compelled to navigate directly to salicylates. I’d thought about salicylates once or twice in the distant past and, for whatever reason, not pursued the topic, probably because I was onto some other next big thing. But this occasion, in the wee hours on a Park City sofa, I read a page about salicylate sensitivity, then another. And another. And another. I read about hyperactivity. Anxiety. Sensitivity. Uncontrollable laughter.

I thought, “This sounds like Martin. This sounds a lot like Martin.”

Martin’s diet has been clean for years. We’ve done GAPS, modified GAPS, SCD, and custom variations to account for mitochondrial dysfunction. We’ve made much progress toward heal Martin’s gut; he no longer “postures,” his belly is flat, his bowel movements are works of art. Still, he exhibits physical manifestations that may be food-related, like occasional shiners and visible inflammation. I’ve taken him recently for allergy testing, both traditional and naturopathic. I’ve discovered the beef allergy and a few others, including horses (riding them, not eating them, though there was once an unfortunate incident in South America when Martin ate some jerky after I failed to recognize the local word for “horse”). I avoid what I’m told to avoid.

But I’ve never put Martin on a low-sal diet.

By this time it was 4:30 am. I texted my friend Stacey, “I think Martin might be salicylate-intolerant. I really think I might be onto something.”

Her reply came hours later, when we were already skiing: “I don’t even know what that means, but hey glad you’re getting somewhere.” To the extent one can hear frustration in a text message, I heard some frustration in hers. I know she’s been having an even tougher time with her son, and feeling like they aren’t making much progress toward recovery.

That evening, I texted back, truthfully: “At the moment, I’m getting nowhere. He’s a complete disaster today.” I mean, why did you think I was texting you about salicylates at 4:30 am? “But I’m going to try removing salicylates from his diet and see what happens.”

I couldn’t put my low-sal plan into effect immediately. I’d already spent hundreds of dollars at the Whole Foods Market, stocking us up for the week. I had freeze-dried pineapple (high-sal!), fresh sweet potatoes (high-sal!), Lärabars (dates and almonds, high-sal!), coconut oil (extra high-sal!). Plus, I couldn’t find just one website that compiled all the salicylate contents that I needed to know about. Nori seaweed? Ground flax meal? Kohlrabi? Who could give me these important facts? I spent my evenings, after skiing and cooking, surfing around to put together the most comprehensive list I could. Different sources even disagreed on the salicylate content in some foods, like cauliflower and parsley.

I searched for a low-sal cookbook and finally located one, which needed to be sent from New Zealand. I ordered it immediately.

I returned to the Whole Foods Market and picked up lower-sal safflower oil—the store didn’t have the sunflower oil I was looking for—and white potatoes for breakfast. For the ski week, I managed what I would call “reduced-salicylate” but not “low-salicylate.” Martin had turkey bacon (unacceptable for celery salt and spices) and bison hot dogs (same), plus carrots and other medium-sal veggies. His mountainside snacks were still the nut- and seed-based products I’d brought to Utah or purchased on-site, though I did make an effort to send the cashew (low-sal) versions instead of the almond (high-sal) versions.

Our second-to-last morning in Utah, when I was almost out of food, I made Martin a “breakfast tortilla,” which was peanut butter spread between two almond tortillas and fried. Peanut butter is medium-salicylate, and almonds are high-salicylate, making this breakfast the largest serving of salicylates he’d had all week. Midway through breakfast, Martin started laughing. Laughing so hard he could barely get food into his mouth. Laughing so hard he needed to leave the table to jump. Martin laughs inappropriately, often. But this was of a new magnitude.

I asked him what was going on. He replied, “I don’t know! I can’t stop laughing!”

Uncontrollable laughter. Was this salicylate-related? When Adrian emerged, from the shower, I relayed what had happened. He could also see for himself, as Martin was still laughing. We decided immediately to explore a low-sal diet to the fullest. Adrian said, “I support this. Let me know what you need from me.”

We arrived home late Monday night, January 2. Tuesday morning, I went shopping. This first shopping venture in the low-sal world felt strange. Martin will be eating starchy foods he loves that previously I kept in strict moderation, like potatoes and rice. For cooking, the only plant-based oils I use at home have been raw coconut and extra-virgin oil, both of which are extremely high-sal; now, along with rendered animal fat, I am urged to use sunflower or rice-bran oil, and even (gasp!) the refined forms. Honey, with all its beneficial properties, is out now, even manuka honey. Lower-sal sweeteners are the more refined forms, like sugar cane. (No way. I’ll be sticking to maple syrup and maple sugar, which are allowed.) No more fruit, except papayas, bananas, peeled pears, and peeled golden delicious apples.

Of course, I wonder why Martin is salicylate-sensitive now (if in fact I’m correct). Has he always been this way? Is it new? Will I ever know? Martin is a never-ending series of “why now?”

The cookbook from New Zealand arrived quite promptly, considering the distance it had to travel. I opened it with alacrity, ready to get to work.

. . . And found that virtually every recipe contains (gluten) flour or dairy. Most recipes contain both.

Looks like I’m back to improvising.

Alternative Medicine

In the post “Mid-Air Without a Net,” I wrote:

The taekwondo teacher wants to talk to you, [Samara] texted Saturday morning. He’s wondering if Martin is taking any drugs for his ADD.

 Oh no! I texted back. (More on that in a later post.)

It’s “later post” time.

When I received that text from Samara, I panicked. Mostly because I was in the middle of panicking about everything else, but still. I thought the Master Rob might tell us not to return Martin to class until we drugged him. I followed up the text and spoke with Samara, and the situation got worse (at least, in my head): When Master Rob asked her if Martin is taking any drugs for his ADD, Samara had responded that we do “alternative medicine.”

That’s a phrase I never use. To begin, I don’t consider treating Martin’s underlying health issues to be “alternative medicine.” We have chosen against trying to manipulate neuro-processing with drugs. We are pursuing non-pharmaceutical options. We are working with new discoveries in treating immune dysfunction. We have been lucky enough to find cutting-edge therapies. We are targeting overall health. We are following the path that, for our son, has garnered the best results. But alternative medicine—no.

At its most benign, I think, “alternative medicine” suggests that we’re a hippie-dippy family trying to cure a spectrum disorder with yoga. (No disrespect to yoga. Yoga is great for mindfulness. It does not, however, do much for the gut biome or neuro-receptors.) “Alternative medicine,” to some, suggests that we are treating our child as a laboratory experiment, or harming him, or failing to accept “proven” treatments that could benefit him. At its worst, I (like other biomed parents) fear that proclaiming “alternative medicine” could invite intervention by well-meaning individuals who think they know better for my son.

I met with Master Rob the next week. I explained that we aren’t pursuing pharmaceutical options at this time because we are trying to heal some gut and other health issues that affect Martin’s attention, and that using drugs would interfere with gaging our progress. I went on to say that we aren’t categorically against drugs but that we want to take this path as far as we can first. Master Rob said that he understood, and that he had resisted pharmaceuticals for his own son, who has ADD, until sixth grade, when he thought the transition to middle school had made them necessary. He said also that he was curious about Martin’s regimen in order to give him as much help and support at taekwondo as possible.

Good enough for me.

More… Inclusive

Three months ago, I reported that food is easy. Food became easy when I shifted from a “replicate what we used to eat” and “recipe” model to a minimalist model, like “(Brussels sprouts + oil + salt) + (lentils + paste[onion + ginger + garlic + turmeric+spices]) = meal.”

I’ve had another shift when it comes to ingredients. For years I’ve thought of cooking for Martin in terms of what I can’t use. I began with, “What would I like to make?” and proceeded to, “What are the ingredients I will have to substitute?” Example: “I’d like to make muffins,” followed by, “Grain flour. And right now, chicken eggs.”

We’re supposed to be avoiding eggs again.

Now, by contrast, I’m launching meals from a new spot. The ingredients come first. I begin with, “What foods will be healing and provide Martin with the particular nutrition he needs today?” and proceed to, “How can I combine those foods into a meal?” Example: Last night I checked the kitchen. Fresh food I had on hand that Martin could eat included peppers, onions, garlic, butternut squash, apples, romaine lettuce, cauliflower, celery, duck eggs, cashew cheese, bison chorizo, and bone broth. In the pantry I had a variety of nuts, along with rice crackers, LäraBars (Martin’s fave), and cookies I’d baked from almond flour, maple syrup, vanilla, baking powder, raisins, and almond chunks.

Today’s menu for Martin:

Breakfast: duck egg cups with peppers and onions; fresh juice made from romaine lettuce and apple.

School snack: Lära Bar.

School lunch: bison chorizo meatballs with added peppers; homemade cookies for dessert.

After-school snack: rice crackers with cashew cheese.

Dinner: cauliflower “fried rice” (no actual rice) with peanuts added for protein; bone broth. In the cauliflower rice recipe, I substituted celery and squash for peas and carrots (making do with what I had), and coconut aminos for soy sauce, since Martin can’t have soy.

So go the days, now. What do I have? What’s good for Martin? From those, what can I prepare?

Tomorrow’s breakfast forecast is nut butter between two almond-flour tortillas, fried in coconut oil and cut into six wedges. School lunch is shaping up to be vegetable lentils with quinoa. Salmon is defrosting for dinner, to be paired with cultured veggies. It’s a pretty good forecast.

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The cauliflower rice for dinner. Not too pretty, but Martin ate the whole bowl without pausing.

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This is not actually the breakfast I served that day, which I forgot to photograph. This is, however, pretty typical for breakfast: coconut-flour berry muffins with homemade veggie-fruit juice.

Food Is Easy

When we first started biomed, I altered Martin’s diet to remove grains, fruits (except avocado and limited tomato), starchy vegetables, dairy, soy, corn, refined sugar (actually, at that time, almost all sugar), and additives. Like any biomed newbie, I had my moment of standing in a Whole Foods Market trying not to cry because I couldn’t find anything my son could eat. I muddled though with elaborate concoctions. Dehydrated flax-seed crackers. Green purée. Spinach pie. When Martin started eating meat, chicken-and-egg bread.

With hindsight I realize that feeding Martin felt so complicated because I was trapped by my prior notions of diet. How could I replace bread to make his sandwiches? What crackers would he use for snacks? Pizza? Pancakes? How could I create a mini-gourmand with few of the ingredients associated with gourmet cooking? Could I invite friends over and offer them a dish of flax seeds?

Labor Day weekend we had three houseguests: my father, my niece (Martin’s buddy, Mandy), and my mother-in-law. In addition, we entertained friends for lunch on Saturday afternoon and Sunday afternoon. In our early biomed days, this might have created a meltdown scenario. (Mine, not Martin’s.) Not so today. Not so with my new mentality: simple meals, few ingredients of high quality.

Saturday morning, Adrian took Martin and Mandy to the gym so that I could prepare. On the counter I had two bags of baby Brussels sprouts; teardrop tomatoes, basil, and two cucumbers from my patio garden; avocados; red onions; garlic; an orange; and three pounds of potatoes. (I don’t do much with potatoes, usually. Organic potatoes are a once-in-a-while treat that Martin loves.)

The Brussels sprouts I washed and trimmed, then stirred with olive oil and ginger-orange salt and placed in a glass pan. The potatoes I washed and quartered, then stirred with olive oil and rosemary salt and placed in a glass pan. Side dishes—done except for baking.

Next I halved the teardrop tomatoes, sliced one cucumber and the basil thinly, and combined them with red onions, olives, capers, fresh lemon juice, crushed garlic, and olive oil. Salad—done.

Before our friends arrived, I made guacamole, which I set on the patio table next to a tray of raw vegetables. I also filled a dish with peanuts (no peanut allergies present that day). Snacks—done. I also sliced an orange and the other cucumber and put them in a glass jug with filtered water and lots of ice. Non-alcoholic beverage—done. Then I turned on the oven and set the Brussels sprouts and potatoes to bake.

Later, while guests were present, I brushed a large piece of salmon with olive oil, then added salt and capers. Main course for non-vegetarians—ready to grill.

The day before I had prepared a quinoa chocolate cake. To compliment the cake, I put coconut milk, vanilla extract, a dash of sea salt, and coconut crystals into my ice cream maker and set it to churn. When the ice cream was almost firm, I added fresh raspberries. Dessert—done.

That was the food I served: peanuts, and veggies with guac; grilled salmon, Brussels sprouts, potatoes, and tomato salad; cake and ice cream.

Everything was homemade and permissible for Martin to eat. Apart from the cake, preparing the entire afternoon’s menu took about 90 minutes. If our Saturday guests realized they were eating “recovery” food, they made no mention.

For our Sunday guests, the main course comprised burgers and vegetable burgers (no buns), sweet potatoes with coconut oil and cinnamon, garlic green beans, and more salad (the garden won’t quit).

When the time is right, I still enjoy making more complicated dishes; yesterday for dinner I fashioned “nutty patties” out of cashews, walnuts, tahini, onion, parsley, flax seeds (in a yummy way, seriously), and spices. But I’ve realized that life is easier when most meals comprise few ingredients simply prepared. I don’t need “replacements” for bread, crackers, pretzels, and other processed foods. No one misses them, anyway.