livinghealthy - latham centers · 2019-06-08 · livinghealthy with pws | 3 authors patrice...

with Prader-Willi Syndrome

A complete resource for planning nutritious, delicious meals for individuals with PWS

Paul E. Donahue, Jr.Melanie Silverman, MS, RD, IBCLC

Patrice Carroll, LCSW

LivingHealthy

COOKBOOK AND NUTRITION TIPS


LivingHealthy

Pictured on Cover:

Roasted Vegetables, page 62.

Trifle, page 75.

Artichoke Topping, page 40, over Grilled Chicken, served with Baked Brown Rice, page 54.

Copyright © 2018 by Latham Centers, Inc.

LivingHealthy with PWS | 3

AuthorsPatrice Carroll, LCSWDirector of PWS Services, Latham Centers

Paul E. Donahue, Jr.Executive Chef, Latham Centers

Katrina Fryklund, MSPC Director of National Outreach, Latham Centers

Melanie Silverman, MS, RD, IBCLCExpert in PWS Nutrition, Independent Consultant

ContributorsMonique WilliamsPhysical Education/Health Teacher, Latham Centers

EditorsDawn Dinnan, MBADirector of Communications, Latham Centers

Katrina Fryklund, MSPCDirector of National Outreach, Latham Centers

PhotographersJennifer Harper-BurnsChef, Latham Centers

Paul E. Donahue, Jr.Executive Chef, Latham Centers

Graphic DesignSusie Perry of Perry DesignPocasset, Massachusetts

PrintingSunderland PrintingHyannis, Massachusetts

CREDITS


LivingHealthy

Special thanks for the support of: Lee Chamberlain, LCSWVP of Operations and COO, Latham Centers

Bobby LeonardiChef, Latham Centers

Jennifer Miller, M.D.Pediatric Endocrinologist, Independent Consultant

PWSA (USA)

Gerald J. Pouliot, III, M.Ed. Director of Children’s Services, Latham Centers

Kim WardChef, Latham Centers

Latham Centers is a place of hope, innovation, and excellence. Latham’s therapeutic residential school campus in Brewster and adult program with residential locations throughout Cape Cod and southeastern Massachusetts serve children and adults with complex special needs. Since 1970, Latham Centers has worked with students, adult residents, their families, and outstanding professionals to change lives—and even save lives. Latham is internationally recognized for its expertise in the care of individuals with Prader-Willi syndrome. The non-profit organization is accredited by the Council on Accreditation, and its dedicated, highly trained staff works around-the-clock to achieve its mission. Latham Centers’ service delivery values of mastery, belonging, generosity, and independence help ensure the well-being and happiness of every individual who calls Latham home.

4 | LivingHealthy with PWS

TABLE OF CONTENTS


LivingHealthy

Cooking for Someone with PWS by Executive Chef Paul E. Donahue, Jr. ................................. 5

Nutrition and Cookbook Evolution by Melanie Silverman, MS, RD, IBCLC ................................ 7

Guiding the PWS Journey by Patrice Carroll, LCSW .................................................................... 8

Dysphagia and Gastroparesis (Swallowing and Digestion) ....................................................... 10

Tasty and Healthy Tips and Substitutions ...................................................................................... 12

Customizing Fitness Routines for Individuals with PWS ............................................................. 14

Holiday Meal Preparation and Recipes .............................................16

Sample 7-Day Menu with Calorie Counts ............ 20

LATHAM CENTERS’ “RECIPES” FOR SUCCESS

MEAL PLANNING

TASTY TREATS FOR SPECIAL OCCASIONSDairy-Free Omega 3 Cupcakes ....72Fruit Parfait......................................74Trifle ..................................................75

BREAKFASTApple Cinnamon Oatmeal ..............30Cinnamon Raisin Oatmeal .............31Dairy-Free Smoothies.....................32Maple Oatmeal ................................33Pumpkin Spice Oatmeal .................34Scrambled Eggs with Cheese .......35Simple Omelet..................................36

SOUPS, SALADS & SAUCES Artichoke Topping ...........................40Chicken Salad ..................................41Cole Slaw..........................................42Potato Salad.....................................43Simple Salad ....................................44Stir-Fry Sauce ..................................45

MEALS & MEAL SIDESBaked Brown Rice ......................... 54Beans and Rice .............................. 55 Couscous ......................................... 56Eggplant Italiano ............................ 57Herb Roasted Pork Loin ................ 58Oven Roasted Cod or Salmon ...... 59Prime Rib Au Jus ............................ 60Quinoa .............................................. 61

Sweet Potato Salad ........................46Tomato Soup ....................................47Tuna Salad ........................................48Turkey Chili .......................................49Vegetarian Chili ...............................50

Roasted Vegetables ....................... 62Rosemary-Leek Roasted Potatoes ...................... 63Shrimp Scampi ............................... 64Sweet Potato Wedges .................. 65Tapenade ......................................... 66Turkey Taco Tuesday ..................... 67Winter Glazed Carrots ................... 68


Cooking for Someone with PWSBy Paul E. Donahue, Jr.Executive Chef at Latham Centers

This cookbook and guide for living healthy with Prader-Willi syndrome (PWS) is the result of many months of collaboration with people who care deeply about the health and well-being of the students and adult residents who call Latham Centers home. I started working as chef at Latham Centers in 2014 with the expectation that I would change the menu for the children in our special education school and the adults in our group residences. Never did I expect that the revamped menu would so positively impact our community of people with PWS.

New Menu PreparationDuring my first conversation with Melanie Silverman, expert in PWS nutrition, she suggested I learn about the Mediterranean style diet. I started reading about Mediterranean style foods high in Omega 3s such as flax seed, and learned that Omega 3s naturally benefit many aspects of general health. With an understanding of the many health challenge areas for individuals with PWS, I theorized that Omega 3s may benefit people with this diagnosis. For example, Omega 3s exert anti-aging effects on brain structure and function, which could help to improve cognition and memory. Also, Omega 3s are reported to sharpen the mind, so I was optimistic that our residents’ concentration and learning would be enhanced with this menu addition. I reviewed evidence that the Mediterranean style diet also helps to improve skin health. Considering the prevalence of skin-picking behaviors in the PWS population, I was hopeful this style diet would be valuable. Lastly, I considered the lactose and gluten sensitivities of many of our residents, as well as common allergies (for example, we are a nut-free campus).

Menu Roll-OutAfter reflecting on what we learned about Omega 3s, Mediterranean style foods, and lactose- and gluten-sensitive diets, we began to build a menu. It was like putting a puzzle together.

With help from Melanie and a team of Latham staff members, we created new recipes for a menu plan, with primary focus on the

I wanted to create a cookbook so that someone who doesn’t know how to cook, and has someone in their life with

Prader-Willi syndrome, can create these meals at home and

improve the quality of life for the individual with PWS.

– Paul E. Donahue, Jr.

“

“


nutritional needs of the individuals in our care. We were equally committed to great tasting food. We introduced the new Latham menu to our students first, then later to our adult residents.

The results have been dramatic and uplifting. Since the menu implementation:• our students and adult residents lost more than 400 pounds in one year

(98 residents),• there has been a reduction in insulin medication for some of our residents,• some of our adult residents previously diagnosed with sleep apnea no

longer need to use CPAP machines,• children and adults at Latham have reduced cholesterol counts and lower

blood pressure, and• we have observed an increase in our residents’ energy and motivation to

exercise independently.

I have reviewed diets that were identified in the past as “best practice” for the PWS community, however, menu development and testing in our school campus and adult residential kitchens have produced truly remarkable results for our program participants.

Though only you know what works and doesn’t work for your family member with PWS, I can tell you that our menu has resulted in weight loss and more motivation across the board. An especially positive outcome was the increase in daily calorie count for some of our residents. Our residents enjoy the taste of their meals and are simultaneously learning and feeling the benefits of healthy eating.

I hope this cookbook and healthy living guide proves helpful, regardless of whether you’re a seasoned chef or just learning the ins and outs of cooking for someone with Prader-Willi syndrome. Good luck to you and your family.

Paul has been cooking in fine- and casual-dining restaurants for over 30 years. Soon after he became Executive Chef at Latham Centers in 2014, he realized his true passion was in channeling his enthusiasm for cooking into changing lives for people with Prader-Willi syndrome and other complex special needs. He creates an ever-changing low-calorie menu based on collaborations with staff and experts, as well as regular interaction with residents about their likes and dislikes. He has become a “celebrity” to our students.


Nutrition and Cookbook EvolutionBy Melanie Silverman, MS, RD, IBCLC

Nutrition is complicated. Deciding what to eat can be a real source of confusion. When you have a child with Prader-Willi syndrome (PWS), nutrition becomes even more complex. While we need more research in energy metabolism and appropriate PWS diets, three key recommendations stand out:

First, a variety of fresh food is ideal.

Second, low fat diets are no longer recommended, even for the population not diagnosed with PWS.

Third, calorie control and exercise remain important.

Latham Centers is internationally recognized for its expertise and success in working with individuals with PWS. A couple of years ago, Latham became aware that low fat diets were not recommended and wanted to make a change in their menus. I was invited to Cape Cod to help make the change.

I spent three days with Latham’s head chef, Paul Donahue, and from the minute I met him, I was impressed with his passion for food, innovative thinking, and positive attitude. Our ultimate goal was to offer delicious fresh food while increasing the amount of healthy fats on the menus. I visited Cape Cod for three days, but the menu changes took months to complete. This was a massive undertaking in ordering, production, and detailed recipe analysis. Paul and his staff, with support from Lee Chamberlain and Patrice Carroll, made the change happen.

Latham Centers took time explaining the new menus to parents and residents, and transitioned slowly. We knew from the start we wanted to track outcome measures. Astonishingly, the majority of residents lost between 10 and 30 pounds over the course of a year with the new, more nutritious menus. These results were so exciting that Latham wanted to share some of the recipes with other families who have children or adults with PWS. With this cookbook we have created together, my hope is that you will find joy in cooking. There is an abundance of passion and care in each and every recipe.

Melanie Silverman MS, RD, IBCLC is a pediatric registered dietitian and board-certified lactation consultant. Melanie received her BA from Indiana University in Chemistry and Spanish and her Master’s Degree in Clinical Nutrition from Rush University in Chicago, Illinois. She spent seven years at the University of Chicago Medical Centers in the burn unit, PICU, NICU and follow-up clinics and has held a private consulting practice since 2003. Melanie has worked in Prader-Willi syndrome since 2004 when a very special family approached her for help with their son who was 5 months old with PWS. Since then, she’s made it her mission to help as many families as possible navigate the often-confusing world of nutrition for those with PWS.


Guiding the PWS Journey: Participants lose 400 pounds in one yearBy Patrice Carroll, LCSW

As a society, when we think about diet and weight loss, we tend to focus on numbers: How much weight has been lost? What is the blood pressure? How about cholesterol and blood glucose levels? We focus on clothing size and overall appearance: How has this person changed within the past year?

At Latham Centers, we focus on the whole person and the entire transformation that occurs with healthy eating and regular exercise, and how that affects a person’s overall quality of life. Due to our whole-person focus, variation in menu items, and enhanced exercise options, we have seen a dramatic combined weight loss of 400 pounds in one year for our 98 residents, and 95% of our students and adult residents are exercising regularly. Our residents have shown real pride in the entire process of becoming healthier—they are mindful about their eating and frequency of exercise; engaged in goal-setting; and working independently and in groups to achieve their overall health goals.

Living with PWS is a journey, and we are fortunate to help guide individuals diagnosed with PWS to be the best they can be and to live a quality life of their own definition. Like others with PWS, our residents battle anxiety and frustration, yet Latham’s program supports have allowed for a full transformation in our students’ and adults’ focus on food and skepticism toward physical fitness. Our residents have proven to critics (and most importantly, themselves) that their goals are attainable. Weight loss for someone with PWS goes far beyond numbers on a page; it improves those things that cannot be measured. A healthy life is essential to a quality life, and Latham takes pride in knowing that through our menu of food and exercise, we continue to support individuals in being the best they can be.

I’m pleased to share the remarkable story of Chris, a student at Latham who has PWS:

There was no denying Chris’ health was in jeopardy when I first met him. At the age of 17, he was overweight by close to 300 pounds with pitting edema, shortness of breath, chronic fatigue, and an overwhelming lack of self-esteem. Chris felt like a stranger to himself. He knew who he wanted to be—a fun, active and spirited young man with friends. None of these things could happen for Chris because he was trapped in a body that kept him down, stole his energy, and dictated where and when he could travel within his community. Chris was too large to fit in a standard car, had trouble getting up the stairs to a bus, and could only walk a few feet at a time.


When Chris came to Latham, he immediately began working on improving his life. Chris was determined to be the young man he knew that he was, underneath the heavy and burdensome layers that his syndrome had cruelly built up on him. Chris made friends quickly and as his self-esteem improved, so did his willingness to participate in every aspect of our Children’s Program. Chris was the first one in line for exercise and even with the struggles of movement, he put everything he had into pushing himself and giving it his all.

Chris spent this past year at Latham gaining back his mobility and winning the hearts of everyone who has met him. In one year, Chris lost 140 pounds and is feeling so good about himself that he now has a girlfriend. Chris regularly speaks about his journey and how his physical transformation has also transformed his soul. Chris’ life and spirit were saved through a combination of tenacity, healthy food, exercise, and a community that saw the very best in him.

Patrice Carroll is internationally recognized for her expertise in Prader-Willi syndrome. She provides consultation throughout the country and serves as co-chair of the PWSA (USA) Professional Providers Advisory Board. She has been working with individuals and families impacted by PWS since 1995.

Every day that I am here, I am

one step closer to becoming the

kid that I want to be.

– Chris, Latham student

““


Dysphagia and Gastroparesis (Swallowing and Digestion)

Through years of experience providing around-the-clock support to individuals with Prader-Willi syndrome, Latham Centers has developed in-depth knowledge of how to help reduce the likelihood of problems with two crucial food-related functions: swallowing and digestion.

Dysphagia definition and prevention:Dysphagia means difficulty in swallowing. For someone with Prader-Willi syndrome, this occurs predominantly due to low muscle tone as well as limited production of—and particularly thick—saliva. There are things we can do as caretakers and providers that help individuals with PWS swallow foods more easily, which ultimately helps avoid choking (and gastroparesis, discussed below). The lack of saliva (and consistency) increases the opportunity to choke and limits the ability to swallow. Gastroesophageal reflux (or GERD) is a common diagnosis in someone with PWS, and is defined by the high frequency of acid reflux. Doctors and scientists have found that commonly with PWS, there is a weakness of the pharyngeal muscles which are involved in moving food down the esophagus.

We recommend these strategies which have proven beneficial to our residents with PWS:

1) Softer Food Choices: Including less fibrous, softer foods in a low-calorie diet can help children and adults swallow and digest foods more easily. 2) Sipping Water: Drinking water frequently while eating encourages food particles to pass through the throat. 3) Infusion of Water: Adding mint, lemon, or other fruits into water naturally flavors the liquid. By infusing our residents’ water, the amount of water they drink daily has drastically increased because it tastes good! Tailoring this strategy to the likes and dislikes of the individual is important. An apple or orange lover might like a mixed water infusion. This also helps eliminate the desire for other sugar-heavy liquids such as sodas, diet drinks, and juices. 4) Slowing the Meal: Encouraging the individual with PWS to pause and take a sip of infused water between each bite helps food process through the throat and increases water intake.5) Chopsticks: Taking large bites increases the opportunity for food to get stuck, so instead of a fork or spoon, try chopsticks! Not only can chopsticks be fun, but they also help with motor dexterity and hand strength. Using chopsticks has the added benefit of slowing down fast eaters.6) Pre-Chop Food: Pre-chopping food into bite-size pieces naturally encourages smaller (and more) bites. 7) Adding Moisture to the Food: Softer foods will pass through the throat and digestive tract more easily. Chicken salad is easier to process than chicken breast. (See Chicken Salad recipe on page 47.)


Gastroparesis definition and prevention: Gastroparesis is the slowing or stopping of food as it goes through the digestive tract. In one study, five scientists measured gastric emptying in eight people with PWS. They found that gastric emptying was delayed in five of the eight people with PWS (https://www.pwsausa.org/wp-content/uploads/2016/12/Hidden-Gut-Issues-in-Prader-Willi-Syndrome.pdf). The repercussions of this slow metabolism can be life-threatening. When meals sit on top of meals in the stomach without digesting, build-up occurs and eventually the stomach fills, resulting in gastric dilation and rupture. Additionally, it is believed that someone with a PWS diagnosis does not produce enough—nor the same type of— bacteria as those with the typical digestive tract. Therefore, breakdown of the food in the stomach is limited.

To help encourage the movement of food throughout the digestive tract and bowels, the following strategies have proven successful at Latham:

1) Low Fiber Foods: Foods with high fiber content are harder to process. 2) Probiotics: Probiotics are essential to a healthy gut. Foods like yogurts that are high in probiotics (and are moist) will help the gut process other, more vitamin-rich foods such as vegetables. In addition to foods high in probiotics, medical providers should be consulted with about adding a probiotic vitamin into the individual’s medication routine.3) Eating Early and Moving Around: The residents in our program eat meals relatively early. Students eat dinner at 4:30 p.m. This allows time for those with PWS to stand up, move around, and digest food before bed-time. Staying upright after eating a meal is essential for proper digestion and can help relieve constipation.4) Smaller Meals: Smaller meals create less build-up in the gut and allow more digestion to occur between meals. Rather than three large meals, consider a light breakfast, two larger meals, and a couple scheduled low-calorie snacks.5) Minimum Chews Per Bite: Counting how many chews a child usually takes per bite of food and encouraging them to double that number will slow down their eating and help them digest their food better.

Lemon-infused water

Gastrointestinal Complaints and Hospitalizations PWSA (USA) has published a chart entitled “Evaluation of Individuals with Prader-Willi Syndrome with GI Complaints.” This valuable resource is included on page 76 (with permission). The content of this chart was written by medical professionals; this ‘GI lifesaving Chart’ is intended to be provided to doctors, ER staff, EMTs, and all caregivers of individuals with PWS. Please visit pwsausa.org for additional PWS research and educational materials.


1) Smoothies are a great way to start or end your day. You can make them dairy free (see Smoothies, page 32).

2) Make food fun: prior to your child’s birthday give them options. (See pages 72 and 73).

3) Soft food diet necessity? Try baby food for a short period of time. Also, overcook roasted vegetables to create tenderness.

4) Proper seasoning is key to making low-calorie food taste good. Using kosher salt goes a long way and brings out the natural flavors; it melts into the food. We prefer to use kosher salt instead of iodized in our recipes.

5) Thinking about a cookout but don’t want to serve hot dogs or hamburgers because of the calorie count? Consider replacing those items with chicken sausage.

6) Apple Cinnamon Tea is a treat that our residents love! The tea tastes sweet naturally so there is no need for honey or sugar. Make oatmeal with tea instead of water for extra flavor.

7) Try spicing up a vegetable based side-dish like our Roasted Vegetables (page 62) with Pesto. Then, serve it with a side of Quinoa (page 61). Suddenly, you’re turning two side dishes into a meal.

8) Apples are sweet and healthy! Add cinnamon and they are even more delicious. Be creative about other ways to cook them:

a. Crisps: Toss thinly sliced apples in cinnamon, then bake them in a 200-degree oven for 2-3 hours. Flip half-way through. Once the apples are dried but pliable, they are done.

b. Baked: core out the top of the apple (keeping the base intact). Then, fill the hollow with a teaspoon of maple syrup and cinnamon. Pre-heat the oven to 350 degrees F. Bake the apple in a dish with just a bit of water at the bottom of the pan for 15 minutes. The water helps the apple remain moist.

c. Mashed/Sauce: Try making your own Apple Sauce! Boil peeled apple pieces, cinnamon, and a little bit of sugar for about 15 minutes, then mash to your preferred consistency. Try boiling in Apple Cinnamon Tea for an extra burst of flavor.

Tasty and Healthy Tips and Substitutions

How to Make Low-Calorie Food Tasty

Chicken Sausage with Sautéed Mushrooms


Healthy Snack Ideas

1) Flavored Rice Cakes: served with peanut butter or Sun Butter.

2) Carrot and Celery Sticks: these are a great sensory-eating items. They can be served with peanut butter, Sun Butter, or hummus.

3) Pears: serve with low-fat cheddar cheese or honey.

4) Popcorn: instead of microwaved, serve Skinny Pop or air-popped popcorn.

5) 100-Calorie Snack Packs: these are great for on-the-go.

6) Half-Cup Cheerios: 50 Calories! 7) Cottage Cheese: for sweetness, add fruit or

1 teaspoon jam. 8) Hard Boiled Egg: approximately 80 calories. 9) Medium Size Fruits: pear, apple, orange. 10) Yogurt: serve with flax seed to add a crunch,

and/or fruit wedges to dip. 11) Apple Sauce: add a dollop of non-dairy

whipped cream. 12) Graham Crackers: a good snack because

they are low in calorie count, only 44 calories per cracker.

13) Pretzel Sticks: a great low-calorie crunchy item.

14) Crackers and Tapenade: put a tablespoon of our Tapenade (page 66) on your favorite crackers. We suggest using 100% Whole Grain Wheat Thins, approximately 8 calories per cracker.

15) Trail Mix with Popcorn: make this at home! Substitute (unbuttered) popcorn for nuts, add raisins, and include “apple crisps” (page 12).


I began working at Latham Centers in 2014 and quickly learned that for our students, exercise was not an interest, but simply an anxiety. Physical activity, however, can provide many benefits to people living with PWS, including management of common symptoms such as obesity, reduced muscle tone, and anxiety. By tailoring exercise routines to our residents’ interests and strengths, learning and listening to individuals’ needs, making exercise fun, and changing the menu, our individuals are more active. In fact, 95% percent of our residents are opting to exercise daily, a dramatic improvement from 50% in 2015. Our 98 residents have lost over 400 pounds in one year, and they are more fully engaged in their own routines and helping one another attain fitness goals.

When tailoring an exercise plan for someone with PWS, consider the following:

Complete the exercises with the individual Our residents needed to learn new exercise routines, but to do so they needed to be engaged. There is no better way to engage them than participating in the same activity! One of the most important things I’ve learned is that individuals who dislike physical activity will most likely hesitate to participate when simply given a directive. By engaging in independent and group activities with our residents, they develop an “I can do it, too” mentality. Also, by making a game out of the routine, or casually talking to our residents throughout physical education activities, they forget that they are working out and begin to have fun!

Understanding a short attention spanIt is best to keep someone with PWS occupied during their entire daily exercise time. Our residents are encouraged to work out daily for a 30-minute time-frame; this occurs in Physical Education class, during residential time, or in clubs. If they don’t exercise, we often see an increase in picking behaviors and other signs of anxiety. By minimizing down time, our residents stay focused on the activity at hand. We’ve added music and included group dancing during every lesson. It’s best to create some activity in-between activities, like skipping.

Present choices rather than demands, and always have a Plan B and Plan CIndividuals with PWS can face additional challenges which should be considered when creating an exercise plan. For example, someone with PWS may have low muscle tone which can contribute to poor balance, strength, and coordination. If presented with an activity they find difficult and believe they cannot complete, they will typically choose not to participate. By giving individuals choices to achieve the same challenges, they may choose an activity that is addressing the same objectives but in a different way. Always have a list of back-up activities as options in case Plan A doesn’t work!

Customizing Fitness Routines for Individuals with PWSBy Monique WilliamsPhysical Education and Health Teacher

Students participate in group dance at Latham Centers’ annual Field Day.


Exercises to do at homeThese Latham fitness favorites improve movement, balance, coordination, muscle strength, and endurance. We suggest doing these exercises as a family or in groups.

1. Fitness Bingo: Create a set of Bingo cards using a Bingo Card Maker online. Create the Bingo card using exercises that do not require equipment, but are quantifiable, i.e. 15 jumping jacks, 10 mountain climbers, 10 squats. Each participant is given a Bingo card. When an exercise is called by the Bingo caller, the participant must complete the exercise and then cross it off their card. Add some music and play for small prizes!

2. Around the USA Fitness: Improve fitness skills while practicing the geography of the USA! Create stations around the area similar to a map of the USA. We suggest creating a scenario where one wall of a room is the “Atlantic Ocean,” and the opposite wall is the “Pacific Ocean.” Include a couple cities of choice in-between. Post signs labeled with the name of a city, fitness objective, and directions to the next city. Participants perform the activity listed on each station card and move onto the next city until they make it back to their “hometown.”

Example: Chicago, IllinoisExercise: 25 Jumping JacksNext Destination: Phoenix, Arizona

Phoenix, ArizonaExercise: Make up your own exercise to Atlanta and BackNext Destination: Boston, Massachusetts

3. Shuffle the Deck: Using a deck of cards, spread them out in an area face down. Each person runs to the deck of cards, picks up a card and brings it back to their designated spot. Each card suit represents

the exercise they must complete and the number of times they must complete it.

Spade = jumping jacks Hearts = squats Clubs = mountain climbersDiamonds = overhead pressJoker = pick your own exerciseJack, Queen, King = 10Ace = 12

If a 3 of hearts is picked from the deck, 3 squats would be completed.

4. Celebrate Holidays with Fitness GamesHalloween: Create a themed scavenger hunt around the house with clues. Each clue reveals an exercise you must complete before moving onto the next clue.

Thanksgiving: Create a laminated turkey with detachable paper feathers. Label each feather with an exercise. The participant picks up a turkey feather, completes the exercise on the feather, and places the feather on the turkey. Once all exercises are complete, the turkey is finished.

Christmas/Hanukkah/Kwanzaa: Celebrate 12 Days of Christmas, 8 Days of Hanukkah, or 7 Days of Kwanzaa. Devise a different set of activities for each day of the holiday. Create a document where each day is given a number. Then, list three exercises per day (including stretching). Complete each activity the number of times represented by each day.

Example: 6th Day of HanukkahJumping JacksLungesSeconds of stretching

The participants would perform 6 jumping jacks, 6 lunges, and then stretch for 6 seconds.


The holidays are a time when families come together to celebrate, often around large meals. At Latham Centers, in a food secure environment, holidays can often be stressful. Residents are curious about upcoming meals, and many perseverate on the festivities and food. Because holiday-related anxiety can cause disruptions in home, school, and social environments, Latham’s kitchen staff works closely with Program staff to carefully plan.

The weekly menu at Latham is shared with the residents; they always know what to expect, and holiday weeks are no different. Chef Paul is thoughtful about calorie count and preparing fresh food, and he and his team masterfully incorporate traditional themes into meals and snacks.

Christmas and Hanukkah Around the winter holidays, Latham blends traditions and customs into our routines and menus. For the holiday meal, we serve ham or turkey and mashed potato with gravy. These are “treat days”, so we serve Christmas cookies and egg nog (for those without dairy sensitivities). It’s a lot easier than most think.

Chef Paul keeps both calorie count and the holiday spirit in mind while creating menus, and the next thing he knows, he is preparing for an extravaganza! We serve appetizers and plate the holiday meals on special china. Music is an essential part of the atmosphere, and it’s a festive accompaniment to excited chatter of our residents.

Holiday Meal Preparation and Recipes


Easter and Halloween:Candy Based HolidaysEaster and Halloween can be particularly difficult for someone with PWS. The challenge is in taking a holiday represented by gifts and candy, and changing the meaning. On these two days when children traditionally receive a bounty of sweets, Latham Centers creates a cheerful holiday in which food and candy are secondary to the days’ special events.

Our Easter egg hunt is filled with games and activities that are predominantly educational. Rather than candy and chocolate, students hunt for alternative items that can sometimes be great sensory items. We suggest:• Jump Rope– a perfect tool for exercise and

gaining balance skills.• Silly Putty Eggs– a great sensory item.• Bubbles– another great sensory item that also

promotes good deep breathing skills.• Pinwheels or Wooden Whistles– items that also

help with breathing. • Flower Seeds for Spring Garden– we love this

idea because it not only promotes planning and organizing, but also provides an opportunity to spend quality family time together in the warmer days ahead.

• Memory Games– these are an awesome way to improve children’s memory and executive functioning skills.

• Legos or Coloring Books Made for Older Kids and Adults– these are fun but also enhance children’s fine motor skills.

Our Easter meal is festive but not overdone. Chef Paul creates Deviled Egg Hatchlings, in which he makes a traditional deviled egg recipe, but saves the cap of the hard-boiled egg. He suggests using a small sliver of carrot for the beak and small pieces of black olives for the eyes.

On Halloween, we engage our students in a Halloween Parade in which they receive fun items from our staff at 12 different ‘stops’ on campus. Six of the items are small toys such as temporary tattoos, and six are small, single-wrapped candies. If a resident is on a chopped-food diet (see Dysphagia and Gastroparesis, page 10), we pre-chop tough-to-chew candies such as Laffy Taffy and Starburst. One of our students’ favorite stops during the Halloween Parade is the campus kitchen, where Chef Paul gives out a festive item such as the Rice Krispie Pumpkins or Graham Cracker Band-Aids (page 18).

After the Halloween Parade, our residents socialize with classmates and munch on their allotted treats. Students return the candy wrappers to staff to ensure all candy has been consumed. (Our residents understand that for their safety, no candy can be saved and eaten in their room or suite.) Residents participate in many fun and educational games throughout the day.

The evening concludes with a holiday themed dinner menu including specialties like Jack-o-Lantern Quesadillas and Dairy-Free Omega 3 Cupcakes with orange frosting (page 72).

Jack-O-Lantern cutouts in a whole wheat Quesadilla with Halloween

themed sides.

Deviled Egg Hatchlings


Graham Cracker Band-AidsEach Band-Aid is approximately 44 calories.

Ingredients: Graham crackers, quarteredCream cheese, sliced thinSeedless raspberry or strawberry jelly

Directions:For this Halloween themed treat, simply break the graham crackers along their perforated lines.Slice cold cream cheese into squares, approximately one teaspoon.

Place the little squares in the center of the graham crackers.

Put seedless jelly atop cream cheese, approximately ½ teaspoon.

Rice Krispie PumpkinsServes approximately 12 people. Each pumpkin is 162 calories.

Ingredients: 3 teaspoons butter10-ounce bag marshmallows6 cups Rice Krispies cereal12 Tootsie Rolls1 bunch of fresh mint

Directions:Melt butter in a large sauce pan over low heat.Add marshmallows and stir constantly until melted.

Remove from heat.

Mix in Rice Krispies.

Form small balls into the shape of a pumpkin (Tip: Add non-stick cooking spray (Pam) or Crisco to your hands before forming balls).

Use your finger to indent the top of the balls; place Tootsie Roll into indent.

Use a mint leaf to garnish. Add the mint leaves right before serving; they tend to wilt rather quickly.

Graham Cracker Band-Aids


ThanksgivingThanksgiving can be one of the most difficult days, as the holiday is entirely centered around the meal. Our residents look forward to a meal of turkey, stuffing, gravy, mashed potatoes, and all the other goodies that represent the classic holiday. Portions are determined by calorie count.

We agree with those who believe the best part of Thanksgiving is the leftovers. The day after the big Thursday meal, our culinary team serves Thanksgiving sandwiches on whole wheat bread for lunch. Our residents love this almost as much as the Thanksgiving Day spread! Valentine’s Day

Valentine’s Day traditions often include going out to eat at a restaurant. We turn Latham Centers into a restaurant that day; staff are the servers and students arrive dressed in their best to dine in the decorated dining room. Last year, our residents’ courses included chilled strawberry soup, a simple salad with fresh berries, and an entrée of grilled chicken with asparagus and Rosemary-Leak Roasted Potatoes (page 63). If dessert is to be served, we suggest a trifle or parfait with strawberry or raspberry yogurt and berries (page 74 and 75).

Roast Turkey with Mashed Potatoes, Gravy, and Cranberry Sauce

Chilled Strawberry Soup with Berries


Sample Menu and Grocery List

The following pages represent a seven-day sample menu, with no special treat days. We have included breakfast, lunch, dinner, and snacks.

The calorie-counts signify the range of daily calories for Latham Centers’ residents. Most recipes are included in this cookbook (see Table of Contents for page numbers). Recipes not included are marked with an asterisk.

Produceq Applesq Broccoli (or other vegetables to roast)q Carrotsq Celeryq Cucumbersq Garlicq Leeksq Lemonq Mesclun Greensq Onionq Orange (or other fresh fruit)q Pepper (red and/or green)q Sweet Potatoes (and/or white potatoes)

Meatsq Chicken Breastq Ground Turkeyq Pork Loin

Breads/Grainsq Couscousq Old Fashioned Oatsq Quinoaq Whole Wheat Bread

Dairy/Fridgeq Butter (unsalted)q Eggsq Cabot Light Cheddar Cheese (75% Less Fat)q Skim Milkq Yogurt

Frozenq Frozen Shrimpq Raspberry Puree

Spices/Baking Needs/Dryq Apple-Cinnamon Teaq Ancho-Chili Powderq Black Pepperq Brown Sugarq Cinnamonq Crushed Red Pepper Flakesq Cumin Powderq Dried Parsleyq Flax Seedq Honeyq Italian Seasoningq Kosher Saltq Rice Cakes

Sauces/Oilsq Light Mayonnaise q Light Olive Oilq Nut-Free Pestoq Peanut Butter or Sun Butterq Vegetable Stockq White Vinegar

Canned/Jarredq Artichoke Hearts (canned or jarred)q Black-Eyed Peasq Diced Tomatoq Garbanzo Beansq Marinara Sauce q Pinto Beansq Tomato Sauceq White Tuna

Our sample grocery checklist is intended to help with meal planning. This list serves as a suggestion for at-home chefs and will vary depending upon whether you’re building your pantry or shopping for one week of groceries. It can be photocopied and customized each time you go food shopping.

Abbreviation Key:t = teaspoonT = tablespoonC = cup

oz = ounceA.S. = afternoon snackE.S. = evening snacksl = slice

Grocery Checklist


MO

ND

AY

BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozSCRAMBLED EGGS ½ C ½ C ½ C ½ C ½ C ½ C ½ C 1 CSAUTÉED MUSHROOMS AND TOMATO* 1 T 1/8 C 1/8 C ¼ C ¼ C ¼ C ¼ C ¼ CWHOLE WHEAT TOAST ½ sl ½ sl 1 sl 1 sl 1 sl 1 sl 1 sl 1 slBUTTER 1 t 1 t 1 t 1 t 1 t 1 t 1 t 1 tFRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozSIMPLE SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 C(add below meats for chef salad)HAM ½oz ½oz ½oz ½oz 1oz 1oz 2oz 2ozTURKEY ½oz ½oz ½oz ½oz 1oz 1oz 2oz 2ozCHEDDAR CHEESE ½oz ½oz ½oz ½oz 1oz 1oz 2oz 2ozSALAD DRESSING ½ ½ ½ 1 1 1 1 1FRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozROASTED CHICKEN* 2oz 3oz 3oz 4oz 4oz 4oz 4oz 6ozARTICHOKE TOPPING 1 T 1/8 C 1/8 C 1/8 C 1/8 C ¼ C ¼ C ¼ CQUINOA 1/8 C ¼ C ½ C ½ C ½ C ½ C ½ C ¾ CFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. RICE CAKE 1 1 1 1 1 1 1 1HONEY 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TE.S. WHEAT THINS, 1 oz. BAG 1 1 1 1 1 1 1 1


BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 8oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozCOTTAGE CHEESE ¼ C ¼ C ¼ C ¼ C ½ C 1 C 1 C 1 CFLAX SEED 1 t 1 t 1 t 1 t 1 t 1 t 1 t 1 tWHOLE WHEAT ENGLISH MUFFIN ½ ½ 1 1 1 1 1 ½ 2BUTTER 1 t 1 t 1 t 1 t 1 t 1 t 1 t 2 tFRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozCHICKEN SAUSAGE* 1 1 1 1 ½ 2 2 2 2 ½ CARAMELIZED ONIONS* ¼ C ¼ C ¼ C ¼ C ¼ C ½ C ½ C ½ CTOSSED SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CDRESSING 2 T 2 T 2 T 2 T 2 T 2 T 2 T 2 TFRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozGROUND TURKEY (TACO TUESDAY) 3/8C ½ C ½ C ½ C ½ C ¾ C 1 C 1 CLETTUCE 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CSALSA ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CCHOPPED OLIVES ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CSHREDDED CHEESE 1T 1/8 C 1/8 C 1/8 C ¼ C ¼ C ¼ C ¼ CFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. 100-CALORIE SNACK PACK SHORTBREAD COOKIES 1 1 1 1 1 1 1 1E.S. BEAN DIP, ½ CUP 1 1 1 1 1 1 1 1 TORTILLA CHIPS, 1 oz. BAG

TU

ESD

AY


BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozOMELET, 3 EGGS 1 1 1 1 1 1 1 1BACON STRIPS 1 1 1 1 2 2 2 4SAUTÉED TOMATO & SPINACH ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CFRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozGRILLED CHEESE SANDWICH* (American cheese) ½ sl 1 sl 1 sl 1 sl 2 sl 2 sl 2 sl 2 slWHOLE WHEAT BREAD 1 sl 1 sl 1 sl 1 sl 2 sl 2 sl 2 sl 2 slTOMATO SOUP ½ C ½ C ½ C ½ C ½ C 1 C 1 C 1 CFRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozGRILLED CHICKEN* 4oz 4oz 4oz 6oz 6oz 8oz 10oz 12ozSTIR-FRY VEGGIES ½ C ½ C ½ C ½ C ½ C 1 C 1 C 1 CBAKED BROWN RICE ¼ C ¼ C ¼ C ½ C ½ C 1 C 1 C 1 CSTIR-FRY SAUCE ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. YOGURT 5-6 oz. FLAX SEED 1 t 1 t 1 t 1 t 1 t 1 t 1 t 1 tE.S. GRANOLA BAR 1 1 1 1 1 1 1 1

WED

NESD

AY


BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozWHOLE WHEAT PANCAKES* 1 1 1 2 2 2 3 4FRESH BLUEBERRIES ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CSYRUP 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TBUTTER 1 t 1 t 1 t 1 t 1 t 1 t 1 t 1 tFRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozTUNA SALAD ¼ C ¼ C ¾ C 1 C 1 C 1 C 1 ½C 1 ½CCUCUMBER SLICES 5 5 5 5 5 5 5 5KALAMATA OLIVES 3 3 3 3 3 3 3 3CARROT STICKS 5 5 5 5 5 5 5 5FRUIT 1 1 1 1 1 1 1 1 DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 4oz 4oz 4oz 8oz 8oz 8oz 8ozGRILLED CHICKEN* 2oz 3oz 4oz 4oz 4oz 5oz 6oz 9ozCOUSCOUS 1/8 C 1/8 C ¼ C ¼ C ½ C ½ C 1 C 1 CCARROTS ½ C ½ C ½ C ½ C ½ C ½ C ½ C ½ CTOSSED SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CDRESSING 1 T 1 T 2 T 2 T 2 T 2 T 2 T 2 TFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. 100-CALORIE SNACK PACK CHOCOLATE CHIP COOKIES 1/2 1 1 1 1 1 1 1E.S. APPLE SAUCE, ½ CUP 1 1 1 1 1 1 1 1ANIMAL CRACKERS, 1 oz. BAG 1 1 1 1 1 1 1 1

TH

UR

SDA

Y


BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozSCRAMBLED EGGS ¼ C ¼ C ¼ C ½ C ½ C ¾ C 1 C 1 CWHOLE WHEAT TOAST ½ sl 1 sl 1 sl 1 sl 2 sl 2 sl 2 sl 2 slJELLY 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TFRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozCHICKEN SALAD ¼ C ¼ C ¼ C ½ C ¾ C ¾ C 1 C 1¼ CKALAMATA OLIVES 5 5 5 5 5 5 5 5SIMPLE SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CDRESSING 1 T 1 T 1 T 2 T 2 T 2 T 2 T 2 TFRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozOVEN ROASTED COD 3oz 3oz 4oz 4oz 4oz 4oz 8oz 10ozTAPENADE 1 T ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CROSEMARY ROASTED POTATOES 1/8 C ¼ C ½ C ½ C ½ C ½ C ½ C 1 CROASTED BROCCOLI ¼ C ¼ C ½ C ½ C ½ C ½ C ½ C 1 CFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. RICE CAKE 1 1 1 1 1 1 1 1SUN BUTTER ½oz 1oz 1oz 1oz 1oz 1oz 1oz 1ozE.S. NUTRI-GRAIN BAR 1 1 1 1 1 1 1 1

FR

IDA

Y


BREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 4oz 4oz 8oz 8oz 8oz 8ozCHEERIOS ¼ C ¼ C ¼ C ¼ C ½ C 1 C 1 C 1 ¼ CYOGURT 3-4oz 3-4oz 5-6oz 5-6oz 5-6oz 5-6oz 5-6oz 5-6ozFRUIT 1 t 1 t 1 t 1 t 1 t 1 t 1 t 1 t

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozVEGGIE BURGER* (whole wheat bun, lettuce, and tomato) ½ ½ ½ 1 1 1 1 1SWEET POTATO SALAD ¼ C ¼ C ¼ C ¼ C ½ C ½ C ¾ C ¾ CPICKLE SPEAR 1 1 1 1 1 1 1 1FRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 4oz 8oz 8oz 8oz 8oz 8oz 8ozGLAZED SALMON (lightly brush with honey mustard) 2oz 3oz 3oz 3oz 4oz 4oz 7oz 10ozCAULIFLOWER (Roasted) ¼ C ¼ C ¼ C ¼ C ½ C ½ C ½ C 1 CPEAS (Steamed) 1/8 C 1/8 C 1/8 C 1/8 C ¼ C ¼ C ¼ C ½ CSIMPLE SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CDRESSING 1 T 1 T 1 T 2 T 2 T 2 T 2 T 2 TFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. APPLE SAUCE 2oz 4oz 4oz 4oz 4oz 4oz 4oz 4ozDAIRY-FREE WHIPPED TOPPING ½ T ½ T 1 T 1 T 1 T 1 T 1 T 1 TE.S. FRUIT CUP, ½ CUP 1 1 1 1 1 1 1 1POPCORN 3 C 3 C 3 C 3 C 3 C 3 C 3 C 3 C

SAT

UR

DA

Y


SUN

DA

YBREAKFAST (daily calories) 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozOMELET – 3 eggs 1 1 1 1 1 1 1 2SAUTÉED PEPPERS AND ONIONS ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ C ¼ CCHEESE (goes on omelet once plated) 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 CTOMATO SLICES 3 3 3 3 3 3 3 3FRUIT 1 1 1 1 1 1 1 1

LUNCH 1000 1200 1400 1600 1800 2000 2200 2400HERBAL TEA 12oz 12oz 12oz 12oz 12oz 12oz 12oz 12ozFAT FREE CREAMER 1 T 1 T 1 T 1 T 1 T 1 T 1 T 1 TSKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozTURKEY B.L.T.* (whole wheat suggested)(4 ounces of turkey & 2 slices bacon) ½ ½ 1 1 1 1 1 1FRUIT 1 1 1 1 1 1 1 1

DINNER 1000 1200 1400 1600 1800 2000 2200 2400SKIM MILK 4oz 8oz 8oz 8oz 8oz 8oz 8oz 8ozEGGPLANT ITALIANO 4oz 4oz 4oz 4oz 4oz 6oz 9oz 10ozMARINARA (canned/jarred) ¼ C ¼ C ¼ C ¼ C ½ C ½ C 1 C 1 CSHREDDED MOZZARELLA 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 C 1/8 CTOSSED SALAD 2 C 2 C 2 C 2 C 2 C 2 C 2 C 2 CSALAD DRESSING 2 T 2 T 2 T 2 T 2 T 2 T 2 T 2 TFRUIT 1 1 1 1 1 1 1 1

SNACKS 1000 1200 1400 1600 1800 2000 2200 2400A.S. PRETZEL STICKS - 1oz bag 1 1 1 1 1 1 1 1E.S. FRESH BLUEBERRIES, ½ CUP 1 1 1 1 1 1 1 1YOGURT, 5-6 oz. 1 1 1 1 1 1 1 1


Cinnamon Raisin Oatmeal, page 31.


BREAKFAST

It’s been said that breakfast is the most important meal of the day. After transitioning to our new menu high in energy-rich foods, we noticed an improvement in concentration both inside and outside of the classroom for students who were previously lethargic after meals. Jenna* came to Latham Centers with a variety of diagnoses, including Prader-Willi syndrome. By the end of each meal, she was often sluggish and ready for a nap. She would walk out of the dining room dragging her feet and showing no enthusiasm for any activity that followed. In just months after the dietary shift, the staff noticed a variety of changes. Jenna was eagerly anticipating the next activity before the meal ended. Instead of being exhausted and withdrawn, she was alert and curious about the upcoming non-food related event that would follow, and more engaged with her classmates. Rather than dragging her feet as she exited the dining room, she would hold her head proudly, often smiling and saying thank you to Chef Paul. Her energy and her attitude visibly improved because of the healthy meals she was eating. *Name has been changed to protect anonymity.


APPLE CINNAMON OATMEALPrep Time: 5 minutesCook Time: 15 minutes

We use apple cinnamon tea at Latham Centers for a mid-afternoon treat, and our residents love it. Staff members also love it because there is no need to add sugar or honey for sweetness. We learned that it’s a great way to add flavor to oatmeal as well!

INGREDIENTS:3 cups old fashioned oats 4 2/3 cups apple cinnamon tea¼ teaspoon kosher salt2 tablespoons brown sugar½ cup ground flax seed3 teaspoons ground cinnamon (1/2 teaspoon per serving)

DIRECTIONS:Boil tea in heavy saucepan. Stir in oats.

Return to boil, reduce heat to simmer.

Add salt, brown sugar, flax seed, and cinnamon. Stir well.

SERVES: 6

Approximate Calories:

150 per cup


CINNAMON RAISIN OATMEALPrep Time: 5 minutesCook Time: 15 minutes

Great oatmeal starts with plain rolled oats, or steel-cut oats, cooked with a little water, flavored tea, or milk. Top it with some wholesome ingredients, and it’s a feel-good start to the day.

INGREDIENTS:3 cups old fashioned oats 4 2/3 cups water1 teaspoon kosher salt1 cup raisins½ cup ground flax seed3 teaspoons ground cinnamon (1/2 teaspoon per serving)

DIRECTIONS:Boil water in heavy saucepan. Stir in oats.

Return to boil, reduce heat to simmer. Add salt, raisins, and flax seed. Stir well.

Add cinnamon as garnish.

SERVES: 6


150 per cup

SERVES: 6


150 per cup


DAIRY-FREE SMOOTHIETotal Time: 15 minutes

Everyone loves smoothies, and they can be served for breakfast, as a mid-day snack, or as a dessert! With so many variations and possible ingredients, it’s almost limitless. We have found that smoothies without dairy are best for our residents, however you can add your favorite yogurt to this recipe to make it creamier and more flavorful. This smoothie is nutritious as well; flax seed and raspberries are on the Top-20 list for Omega 3 packed foods, honey is a replacement for sugar, and cinnamon may improve digestion.

INGREDIENTS:2 cups mangos, diced½ cup raspberries 1 teaspoon flax seed4 tablespoons honey1 teaspoon cinnamon2 cups ice

DIRECTIONS:Puree all ingredients in blender until ice is crushed.

SERVES: 3


170 per 8 oz

Blueberry, Strawberry, and Mango Smoothies.


MAPLE OATMEALPrep Time: 5 minutesCook Time: 25 minutes

This breakfast smells delicious! Drizzling the maple syrup over the top after plating allows the sweet taste to make the biggest impact. There are approximately 52 calories in one tablespoon of maple syrup, so drizzle according to individualized calorie count.

INGREDIENTS:3 cups old fashioned oats 4 2/3 cups water¼ teaspoon kosher salt2 tablespoons brown sugar½ cup ground flax seed3 teaspoons ground cinnamon (1/2 teaspoon per serving)Maple syrup as garnish


Return to boil, reduce heat to simmer. Add salt, brown sugar, and flax seed. Stir well.

Warm the maple syrup and drizzle a little over the top of the oatmeal after it’s plated.

SERVES: 6


150 per cup


PUMPKIN SPICE OATMEALPrep Time: 5 minutesCook Time: 15 minutes

If you’d prefer to buy pre-packaged oatmeal rather than using old fashioned oats, check the label for sugar and sodium content, as well as calories. Some packets of instant oatmeal, for example, are loaded with up to eight teaspoons of sugar per serving.

INGREDIENTS:3 cups old fashioned oats 4 2/3 cups water1 small can pumpkin pie filling1 tablespoon pumpkin pie spice1 tablespoon vanilla¼ teaspoon kosher salt2 tablespoons brown sugar½ cup ground flax seed3 teaspoons ground cinnamon (1/2 teaspoon per serving)


Return to boil, reduce heat to simmer. Add pumpkin, pumpkin spice, vanilla, salt, brown sugar, and flax seed. Stir well.

Add 1/2 teaspoon cinnamon to each portion as it’s plated.

SERVES: 6


150 per cup


SCRAMBLED EGGS (WITH CHEESE)Prep Time: 5 minutes

Cook Time: 15 minutes

Scrambled eggs are a good source of protein and are easy to digest. We suggest folding in 1/8 cup Cabot (75% Less Fat Light Cheddar Cheese). By adding a small amount at the end of the recipe you will begin to see it melt and get a delicious bite. Sautéed vegetables are a great, flavorful option that can also be folded in to the scrambled eggs.

INGREDIENTS:1 tablespoon light olive oil4-5 eggs, whisked (about 1 cup)1 ½ teaspoons kosher salt 1 teaspoon black pepper2 tablespoons 1% milk or skim milk

Optional:Sautéed scallions, chives, or onions for flavor1/8 cup Cabot (75% Less Fat) Light Cheddar Cheese (60 calories), shredded DIRECTIONS:In frying pan, heat oil on low flame (simmer vegetables if adding).

Add eggs, salt and pepper. Once eggs start to cook, fold multiple times. Repeat until all eggs are cooked.

Fold cheese into the eggs after they are cooked, and before serving, so it starts to melt.

SERVES: 4Approximate Calories:

with Cheese: 90 per eggwithout Cheese:

75 per egg


SIMPLE OMELETPrep Time: 5 minutes

Cook Time: 15 minutes

By cooking down the vegetables prior to adding them into the omelet, the onions and peppers will be tasty and easier to digest. The taste of the small portion of cheese will be more pronounced by adding it on top of the omelet.

INGREDIENTS:1 ½ tablespoons olive oil½ cup green peppers, chopped½ cup onions, chopped8-10 eggs, whisked (approximately 2 cups)1 teaspoon kosher salt½ teaspoon black pepper2 tablespoons 1% milk or skim milk

Optional:1/8 cup Cabot (75% Less Fat) Light Extra Sharp Cheddar Cheese (60 calories), shredded DIRECTIONS:In frying pan, heat half the oil and simmer vegetables, salt, and pepper until soft. Remove from pan and set aside.

In same frying pan, add remaining oil, heat, and add whisked eggs.

Once cooked, add vegetables on one side of omelet and flip other over.

Add cheese to top while warm and serve when melted.

SERVES: 4Approximate Calories:

with Cheese: 90 per eggwithout Cheese:

75 per egg

38 | LivingHealthy with PWS Chef Salad, page 21.


SOUPS, SALADS & SAUCES

Mindfulness is a state of being when you are completely attending to the present and are aware of your surroundings as events occur. The practice of mindfulness reduces anxiety, increases focus, and teaches self-awareness. Our residents practice mindfulness throughout the day, during transitions, and before, during and after meal times. By improving the taste, aroma, and appearance of the food at Latham, our students have become more mindful of what they are eating and how they are eating. They mindfully smell the aromas from the kitchen, view a beautiful plate, then start to eat. Our residents are encouraged to be more thoughtful about how many times they are chewing each bite, and as a result they are more mindful about consumption.


ARTICHOKE TOPPINGTotal Time: 10 minutes

This recipe is great on grilled chicken or other proteins like fish. It’s simple to make and store. We use nut-free pesto as nuts are harder to digest for someone diagnosed with PWS, and many individuals have nut allergies.

INGREDIENTS:1 cup tomatoes, diced2 cups canned artichoke hearts, drained and diced½ cup nut-free pesto

DIRECTIONS:Dice tomatoes and artichoke hearts.Mix all ingredients well and serve cold or room temperature.

SERVES: 8


86 per serving


CHICKEN SALADPrep Time: 10 minutesCook Time: 45 minutes

Chicken is a good source of protein and leeks are a great source of Omega 3s. Traditionally, chicken salad is served on bread. We serve ours on a simple salad (page 44) to eliminate carbohydrates.

INGREDIENTS:2 ½ pounds chicken breast ½ leek, diced2 stalks celery, diced1 teaspoon kosher salt1 teaspoon black pepper½ cup light mayonnaise

DIRECTIONS:Heat the oven to 350 degrees F. Roast chicken until 160-degree internal temperature.Dice leek and celery, 1/8 inch pieces. Dice roasted chicken, ¼ inch cubes.Season chicken with kosher salt and pepper while warm.After chicken cools, mix all ingredients well.Serve on bed of greens or simple salad.

SERVES: 4-6


150 per half cup


COLE SLAWTotal Time: 15 minutes to 1.5 hours

Sometimes we use the 14-ounce bags of slaw from the produce section, which often include bits of broccoli or carrots. Other times, we dice an entire head of cabbage into small pieces. The vinegar begins to break down the cabbage prior to consumption, which may be helpful for avoiding gastroparesis and dysphagia (page 10).

We like to make this dish for special occasions like a barbeque. To maintain consistent portion size, it may be best to serve this dish with an ice-cream scoop, especially in groups.

INGREDIENTS:1 ½ tablespoons sugar2 tablespoons white vinegar2/3 cups light mayonnaise1 teaspoon kosher salt1 teaspoon black pepper1 head cabbage, chopped (or 14-ounce bag of chopped cabbage)

DIRECTIONS:Whisk sugar and vinegar until sugar is dissolved.Add remaining ingredients to mix.Pour over two 14-ounce bags of chopped cabbage, or 1 head chopped cabbage.Refrigerate one hour for cabbage to break down.

SERVES: 12


72 per cup


POTATO SALADPrep Time: 30 minutesCook Time: 30 minutes

While the skin of a potato is full of nutrients, it may be harder to digest than the inside of the potato; we suggest peeling the potatoes for texture and digestion. The number of servings in this recipe is dependent upon the size of the potatoes, so be cautious with serving size. It helps to use an ice-cream scoop for consistency when serving a large group.

INGREDIENTS:Vegetable/Potato Mix 3 large red or white potatoes, peeled and diced 1 red onion, diced1 leek, diced1 red pepper, diced

Dressing½ cup light mayonnaise½ teaspoon mild chili spice1 teaspoon cumin1 teaspoon kosher salt½ teaspoon black pepper

DIRECTIONS:Peel potatoes and dice in half inch pieces.Boil potatoes approximately 30 minutes or until tender (poke with a fork), and let chill. While cooling, dice red onion, leek and peppers.Mix all ingredients for the dressing, set aside.Combine cooled potatoes and diced vegetables.Pour dressing over mixed vegetables and potatoes. Toss and refrigerate.Serve chilled.

SERVES: 4-6


135 per serving


SIMPLE SALADTotal Time: 5 minutes

One cup of mesclun greens contains approximately 10 calories, and more protein than romaine or iceberg lettuce. Mesclun greens are also a better source of vitamin C than other lettuces!

Cucumbers, carrot sticks, and grape tomatoes add a crunch at chewing time (sensory eating) which some people with PWS love. Others need the vegetables cooked down and/or diced small so they are easier to chew and digest. It’s important to be cautious of the individual with PWS and his or her individualized needs to reduce risk of dysphagia and gastroparesis (page 10).

Use your favorite salad dressing, but try to keep the serving size under 130 calories (approx. 1.5 oz.).

INGREDIENTS:Mesclun greens Carrot sticksCucumbersGrape tomatoes

DIRECTIONS:Cut vegetables to preferred size. Cook if necessary.Place atop mesclun mix.Serve plain, or to make it a full meal, serve with Chicken Salad (page 41) or Tuna Salad (page 48).

SERVES: VARIESApproximate Calories:

20 per 2 cupswithout dressing


STIR-FRY SAUCEPrep Time: 20 minutesCook Time: 30 minutes

Making your own stir-fry sauce is the best way to avoid the high sodium content found in most store-bought sauces. This stir-fry sauce is best served with roasted/cooked vegetables, or protein rich meats such a pork, turkey, or shrimp. This is a great sauce to make in bulk and save for future use in a sealed refrigerator or freezer container.

INGREDIENTS:Slurry1 ½ cups water1 ½ cups corn starch

Dry Ingredients¼ cup ginger root, minced¼ cup garlic, minced½ cup scallions, minced1 teaspoon ground ginger1 teaspoon black pepper1 tablespoon ground garlic

Wet Ingredients¼ cup beef stock1 cup honey½ cup rice wine vinegar1/8 cup balsamic vinegar1/8 cup molasses4 cups water

MAKES 7 CUPS


45 per 1/4 cup

SUGGESTED STIR-FRY VEGGIES:(Serves 4)

1 small head of bok choy, shredded ½ carrot, shredded1 red pepper, julienned½ cup sugar snap peas½ cup mushrooms, sliced1 cup baby spinach½ cup water chestnuts½ cup baby corn

DIRECTIONS:SlurryBoil water. Add corn starch and stir well. Set aside.

SauceMince ginger root, garlic, and scallions.Combine dry ingredients in food processor until mixed.Combine wet ingredients in stock pot and stir with whisk.Add dry ingredients to wet and stir well.Bring to boil, thicken with slurry.Refrigerate.


SWEET POTATO SALADPrep Time: 30 minutesCook Time: 30 minutes

This is one of our residents’ favorite dishes! Leeks were added to the recipe when we increased the amount of Omega 3s in the Latham food plan.

INGREDIENTS:Vegetable Mix 3 large sweet potatoes, peeled and diced1 red onion, diced (approximately ¼ cup)1 leek, diced1 red pepper, diced

Dressing¼ cup light mayonnaise½ teaspoon mild chili powder1 teaspoon cumin1 teaspoon kosher salt½ teaspoon black pepper

DIRECTIONS:Peel sweet potatoes and dice in half-inch pieces. Boil sweet potatoes until tender (poke with a fork to test) and let sit to cool.While cooling, dice red onion, leek, and peppers.Mix together all ingredients for the dressing, set aside.Combine cooled potatoes and diced vegetables.Pour dressing over mixed vegetables and potatoes, toss, and refrigerate. Serve chilled.

SERVES: 4-6


60 per 3 oz


TOMATO SOUPPrep Time: 30 minutesCook Time: 30 minutes

By cooking down the garlic, flavor is added but does not give the recipe too much bite. Basil is rich in Omega 3s and adds a nice color! By making this recipe at home, much of the sodium added in canned tomato soup is eliminated.

INGREDIENTS:½ cup fresh basil, chopped5 pounds tomatoes, rough chopped¼ cup garlic, diced1 tablespoon light olive oil1 quart vegetable stock1 tablespoon kosher salt1 tablespoon black pepper1 quart marinara sauce

DIRECTIONS:Chop fresh basil.In stock pot, sauté tomatoes until soft. While cooking, dice garlic and sauté until very soft. Add basil, vegetable stock, salt, pepper, and marinara to sautéed garlic.Bring to boil, reduce heat.In blender, puree vegetable mix and sautéed tomatoes until well mixed. Serve from blender, warm.

SERVES: 6


45 per cup


TUNA SALADTotal Time: 30 minutes

This recipe is bread and carbohydrate free; however, you still get great taste and flavor!

Tuna is a lean protein and contains 22 grams of protein per three-ounce serving. One serving of tuna provides about half the protein necessary in a day for a typical adult female. Other protein sources, such as red meat, may be high in saturated fat, which can lead to weight gain. Tuna also contains Omega 3. Consuming one to two servings of fish per week, such as tuna salad, may help to decrease cholesterol and lower blood pressure, which may enhance immunity for people with PWS.

INGREDIENTS:1 tablespoon white onion, finely diced1 celery stalk, finely dicedOne 12-ounce can white tuna in oil or water½ cup light mayonnaise 1 teaspoon black pepper

DIRECTIONS:Finely dice white onion and celery. Mix vegetables with white tuna, light mayonnaise, and black pepper.Serve chilled and on simple salad (page 44).

SERVES: 4


150 per cup


TURKEY CHILIPrep Time: 30 minutesCook Time: 1 hour

Although chili can be served immediately after preparation, Chef Paul suggests letting this sit for a full day before serving. Giving chili time to sit lets all the flavors absorb into the turkey.It’s a great way to impress guests!

Turkey is lower in calories per serving than any other white meat. It has 10% fewer calories than chicken, depending on the meat cut and cooking style.

INGREDIENTS:½ white onion, diced½ green pepper, diced ½ red pepper, diced 1 leek, diced1 tablespoon light olive oil 3 pounds ground turkey½ tablespoon ancho chili powder ½ tablespoon cumin ½ tablespoon red pepper flakes, crushedOne 12-ounce can tomato sauceOne 12-ounce can diced tomato, drainedOne 12-ounce can black-eyed peas, rinsed¼ cup ground flax seed

DIRECTIONS:Dice onion, pepper, and leek to ½ inch pieces. Sauté in olive oil until tender.Add ground turkey and cook until turkey is browned.Add spices, diced tomatoes, tomato sauce, kidney beans and flax seed.Stir well, and cook all day on low heat (if time), stirring occasionally.

SERVES: 4-6


450 per cup


VEGETARIAN CHILIPrep Time: 30 minutesCook Time: 1 hour

Black-eyed peas and pinto beans are easy to digest, so we suggest using them in this chili recipe. Spices such as cumin begin to alter the chemistry of food. This may help the body’s ability to pass food through the digestive tract.

INGREDIENTS:1 white onion, diced 1 green pepper, diced 1 red pepper, diced 1 leek, diced 1 tablespoon light olive oil One 16-ounce bag frozen corn½ tablespoon ancho chili powder ½ tablespoon cumin ½ tablespoon red pepper flakes, crushedOne 6-ounce can tomato paste 12 oz can black-eyed peas, rinsed12 oz can pinto beans, rinsed12 oz can diced tomato, drained¼ cup ground flax seed Vegetable stock, if desired

DIRECTIONS:Dice onion, pepper, and leek to ½ inch pieces. In a large skillet, sauté in olive oil until tender.Add remaining ingredients to vegetable sauté.Add vegetable stock to thin as desired.Cook for at least one hour on low heat. This can also be heated all day.

SERVES: 4-6


270 per cup


Shrimp Scampi (page 64) with Quinoa (page 61) and Grilled Asparagus

52 | LivingHealthy with PWSPrime Rib Au Jus (page 60) with Green Beans and Roasted Cauliflower (page 62).

Individualized student calorie count also included in photo.


MEALS AND MEAL SIDES

At Latham Centers, we create an environment for our residents in which they can thrive. For our students and adults with Prader-Willi syndrome, this includes managing their expectations regarding food. When our residents know in advance what, how much, and when they are going to eat, they can relax and can focus on other things that enrich their lives. When extra, unexpected food is introduced, or they are in an environment with unlocked food, they tend to feel anxious, stressed, and out of control. The more secure they are about what they are going to eat, and when, the better their behavior. Making the mistake of allowing a food exception “just this once” makes care-taking difficult, and ultimately hurts the individual with PWS. It feels unfair that someone with PWS cannot eat what the others eat, and that caution around eating is a constant focus. But it is the reality for those with PWS. Maintaining a rigid plan and philosophy on eating — and organizing healthy meals with balanced sides — will benefit the entire family.


BAKED BROWN RICEPrep Time: 15 minutesCook Time: 45 minutes

Baking is another technique which softens vegetables. This is a simple recipe to cook while participating in other activities around the house before dinner.

INGREDIENTS:¼ cup garlic, minced½ cup onion, minced½ large carrot, minced½ leek, minced1 stalk celery, minced1 cup brown rice2 cups vegetable stock¼ cup dried parsley1 tablespoon kosher salt1 teaspoon black pepper

DIRECTIONS:Preheat oven to 400 degrees F.Mince garlic, onion, carrot, leek, and celery.Add all ingredients to 13x9 inch baking pan.Cover pan tightly with heavy-duty aluminum foil.Bake in oven for 45 minutes.

SERVES: 4


170 per half cup


BEANS AND RICEPrep Time: 20 minutesCook Time: 70 minutes

We use both white and brown rice at Latham Centers. Brown rice contains more fiber than white, but white rice can be easier to digest. Use your judgment when determining which rice you would like to use based on food likes/dislikes, and fiber sensitivities.

INGREDIENTS:½ white onion, minced½ stalk leek, minced1 small carrot, minced2 stalks celery, minced¼ cup garlic, minced1/8 cup light olive oil2 cups brown or white rice¼ cup dried parsley½ tablespoon kosher salt½ teaspoon black pepper4 cups vegetable stock1 can black-eyed peas

DIRECTIONS:Mince onion, leek, carrot, celery, and garlic.Sauté vegetables and garlic in olive oil until golden brown.Add uncooked rice, parsley, salt, and pepper; stir well.Add vegetable stock and bring to a boil.Reduce heat to low, add black-eyed peas (and their liquid) and let simmer for an hour.

SERVES: 4


285 per cup


COUSCOUSPrep Time: 15 minutesCook Time: 20 minutes

This recipe is dressed up with carrots, celery, and leeks. Cooking the vegetables prior to adding them into the couscous will soften the consistency and make this vegetable rich meal easier to digest. For more sensory eating, substitute a larger grain. Israeli couscous is a great option.

INGREDIENTS:½ teaspoon light olive oil1 tablespoon garlic, minced1 large carrot, minced1 stalk celery, minced½ leek, minced3 cups vegetable stock1 ½ cups couscous1 tablespoon dried parsley1 teaspoon kosher salt½ teaspoon black pepper

DIRECTIONS:Mince garlic, carrot, celery, and leek.Sauté vegetables to soften.In saucepan, bring stock to boil, add all ingredients, including softened vegetables.Reduce heat and keep covered, stirring occasionally until all liquid is absorbed (approximately 8-10 minutes).

SERVES: 4


130 per half cup


EGGPLANT ITALIANOPrep Time: 30 minutesCook Time: 25-35 minutes

When breading the eggplant, we suggest assembly line prep which includes the eggplant slices, flour mixture, egg mixture, panko mixture; this makes for a smooth breading process and helps to ensure that all the breading will stick to the eggplant slices while cooking.

INGREDIENTS:1 medium sized eggplant, unpeeled1 cup flour3 eggs, beaten¼ cup water¼ cup Italian seasoning1 cup panko bread crumbs

DIRECTIONS:Preheat oven to 400 degrees F.Slice eggplant in ¼ to ½ inch slices. Put aside.Beat eggs and add water. Put aside. Mix Italian seasoning and bread crumbs. Put aside. Dredge each slice of eggplant in the flour, then moisten in egg wash. Place moistened eggplant slice in breadcrumb mixture; coat evenly on both sides.Bake eggplant slices for approximately 15-20 minutes until evenly brown. Turn eggplant slices and cook for approximately 10-15 minutes until evenly brown.

SERVES: 6


140 per 4 oz


HERB ROASTED PORK LOINPrep Time: 20 minutesCook Time: 45 minutes

Cooked pork is one of the richest dietary sources of protein. It contains all the essential amino acids necessary for the growth and maintenance of our bodies. And the fresh basil is an excellent source of Omega 3s.

INGREDIENTS:½ cup garlic, minced1 pork loin (3-4 pounds)2 tablespoons olive oil1 cup fresh basil ¼ cup fresh thyme¼ cup fresh rosemary¼ cup fresh parsley1 teaspoon kosher salt½ teaspoon black pepper

DIRECTIONS:Preheat oven to 350 degrees F.Mince garlic.Coat pork loin with olive oil.Either finely chop the herbs or puree them together in a food processor with garlic. Add salt and pepper to mix. Apply the fresh herbs to the pork loin. Pack them tightly to the meat.Roast in oven for about 45 minutes.Serve with warm apple sauce.

SERVES: 6-8


60 per oz


OVEN ROASTED COD or SALMON WITH WINE-CITRUS OR HONEY MUSTARD GLAZEPrep Time: 20 minutesCook Time: 25 minutes

Most people who like fish enjoy cod because it is light and flakey, and is a good source of protein and vitamin B-12 (helps keep nerves and blood cells healthy). It is a low-fat fish which contains approximately 30 calories per ounce and five grams of protein (when raw). The Honey Mustard Glaze and Wine-Citrus Glaze are also delicious atop salmon, which has great nutritional value despite having approximately 25 more calories per ounce and 1 more gram of protein (when raw) than cod.

Salmon is high in docosahexaenoic acid (DHA), an Omega 3 fatty acid, as well as vitamin D. Both may support improvements in brain health. And Omega 3 found in salmon helps to lock moisture into skin cells, which may contribute to skin health and healing.

INGREDIENTS:1 pound cod or salmon, skinless

Honey Mustard Glaze¾ cup Dijon mustard½ cup light mayonnaise¼ cup honey½ teaspoon cayenne pepper1 teaspoon apple cider vinegar

DIRECTIONS:Honey Mustard GlazeMix Dijon mustard, light mayonnaise, honey, cayenne pepper, and apple cider vinegar. orWine-Citrus GlazeMelt butter and combine with wine, water, lemon juice, salt and pepper.

Cooking FishHeat oven to 275 degrees F.Slice fish in four equal segments, approximately 4 ounces each. Lightly coat fish with preferred glaze using spoon or culinary brush, allowing excess glaze to run off into pan. Bake fish until it is no longer pale in color and becomes flaky to the touch, 20-25 minutes.

SERVES: 4Approximate Calories:405 per 4 oz salmon

305 per 4 oz cod

Wine-Citrus Glaze2 tablespoons butter, melted½ cup white cooking wine¼ cup water1 tablespoon lemon juicePinch kosher saltPinch black pepper


PRIME RIB AU JUS Prep Time: 30 minutesCook Time: 60 minutes

Prime rib is a treat to make during the holiday season or special occasion – we do not suggest making this often, as red meats are not as beneficial to someone with PWS as pork, turkey, or fish. Make sure to consider pre-chopping the meat as the smaller the pieces, the easier they’ll be to chew.

We suggest limiting serving size to 3-5 ounces. A meat thermometer is needed.

INGREDIENTS:2 tablespoons garlic, minced1 stalk celery, chopped1 large carrot, chopped1 white onion, chopped1 large tomato, chopped

Liquid in the bottom of roasting pan:1 bouillon cube, dissolved in water

DIRECTIONS:Preheat oven to 350 degrees F.Mince garlic.Rough chop celery, carrot, onion, and tomato (approximately ¼ inch).Trim excess fat from the roast.Rub all sides of the roast with salt, pepper, and one tablespoon garlic.Toss vegetables in olive oil and place mixture evenly in bottom of roasting pan.Place the roast atop the vegetables.Roast for about 1 hour, or until internal temperature is 125 degrees F, using meat thermometer.

Au Jus GravyMix the juices, bouillon cube and remaining garlic in sauce pan.Bring to boil, reduce heat.Reduce mixture to thick consistency (about half as much liquid).

SERVES: VARIES


50 per oz

1 prime rib roast1 tablespoon kosher salt½ tablespoon black pepper1 tablespoon light olive oil


QUINOAPrep Time: 15 minutesCook Time: 30 minutes

Quinoa contains all nine of the essential amino acids. It’s a great alternative to white or brown rice. We enjoy using quinoa at Latham because many people have gluten sensitivities.

INGREDIENTS:2 tablespoons white onion, minced¼ leek, minced ½ large carrot, minced1 stalk celery, minced1 tablespoon garlic, minced1 cup dry quinoa 2 cups vegetable stock1 tablespoon dried parsley2 teaspoons kosher salt1 teaspoon black pepper

DIRECTIONS:Mince onion, leek, carrot, celery, and garlic.Mix all ingredients well.Bring to boil, reduce, simmer.

SERVES: 4-6


110 per half cup


ROASTED VEGETABLESPrep Time: 20 minutesCook Time: 40 minutes

All the vegetables on this list are on the Top-20 list of foods with Omega 3s. The more you roast the vegetables, the easier the food will be to chew and process.

Go light when you add the salt and pepper, and then add more to taste; the flavors from the vegetables will be more pronounced after roasting. Salt and pepper help to draw out the natural flavors.

INGREDIENTS:Light olive oilKosher saltPepper

Vegetable OptionsBrussels sproutsBroccoli Bok choyCauliflowerSpinachSummer squashGreen beansLeeks

DIRECTIONS:Preheat oven to 300 degrees F.Chop your choice of vegetables. Quantity to be determined by the number of guests.Toss in olive oil.Add salt and pepper.Place vegetables in roasting pan, uncovered.Roast for 20-40 minutes (depending on vegetable selection).

SERVES: VARIES


140 per cup


ROSEMARY-LEEK ROASTED POTATOESPrep Time: 30 minutesCook Time: 30 minutes

Red potatoes are particularly healthy because of the thin, nutrient-rich skins. These skins contain fiber, vitamin B, iron, and potassium. Though half of the fiber of a potato may come from the skin, peeling and roasting the potatoes is suggested for easier digestion.

INGREDIENTS:3-4 large red potatoes 1 sprig rosemary, rough chopped ½ leek, diced 1 tablespoon garlic, minced1 teaspoon kosher salt½ teaspoon black pepper1 tablespoon olive oil

DIRECTIONS:Preheat oven to 350 degrees F.Cut potatoes into wedges.Rough-chop rosemary.Dice leeks.Put all ingredients in large mixing bowl, toss well to coat.Line pan with additional oil or anti-stick spray.Roast for 20-30 minutes, or until soft.

SERVES: 4-5


30 per half cup


SHRIMP SCAMPIPrep Time: 20 minutesCook Time: 40 minutes

Shrimp is on the Top-10 list of foods containing Omega 3s, and fresh basil is on the Top-20 list. Traditionally, shrimp scampi is served with pasta, but sometimes we serve it with rice or quinoa.

INGREDIENTS:1 tablespoon light olive oil20 large shrimp, peeled and deveined 3 tablespoons garlic, minced3 tablespoon fresh basil, chopped3 tablespoons fresh parsley, chopped7 tablespoons white wine3 teaspoons lemon juice6 tablespoons chicken stock 2 tablespoons unsalted butter

DIRECTIONS:Heat oil in pan, add shrimp and sauté until partially translucent.Mince garlic, add to shrimp.Chop basil and parsley.When garlic begins to brown, add white wine (this will stop the garlic from cooking).Continue to simmer on low.Add all remaining ingredients except butter.Reduce liquid until 25% thicker. Add butter and melt.

SERVES: 4


350 per 5 shrimp


SWEET POTATO WEDGESPrep Time: 10 minutesCook Time: 25 minutes

Sweet potato wedges are a healthy alternative to “french fries,” and are still the perfect side for lunch or dinner. Sweet potatoes are an anti-inflammatory and contain high amounts of potassium, vitamin C, vitamin D, and magnesium. Compared to white potatoes, sweet potatoes have low carbohydrate levels.

INGREDIENTS:3 large or 4 small sweet potatoes 1 tablespoon light olive oil2 teaspoons kosher salt1 teaspoon black pepper

DIRECTIONS:Preheat oven to 450 degrees F.Halve the sweet potatoes lengthwise and cut each half into three long wedges.Toss with olive oil and spread on baking sheet.Sprinkle with salt and pepper.Bake for 15 minutes and then flip with spatula.Bake for another 5-10 minutes, until lightly browned.Sprinkle lightly with salt and serve hot.

SERVES: 4


76 per 4 wedges


TAPENADETotal Time: 10 minutes

This is a healthy, low-calorie complement to cod, salmon, or chicken. It’s great to prepare a night ahead of time, when you know you’ll have many meetings and appointments the following day. And just like a marinade, when you make this a day ahead of time, the flavors will pop.

INGREDIENTS:½ cup cucumber, peeled, de-seeded, and diced1 cup tomatoes, diced (approximately 1 cup)½ cup kalamata olives¼ cup capers, rinsedpinch black pepper

DIRECTIONS:Peel and de-seed the cucumber.Dice cucumber and tomato.Rough chop the kalamata olives.Mix all ingredients well. Put directly atop protein of choice.

SERVES: 8-10


9 per 1/4 cup


TURKEY TACO TUESDAYPrep Time: 5 minutesCook Time: 40 minutes

Per portion, turkey meat contains more protein per gram than beef, pork, or chicken. It’s also high in methionine, an essential amino acid required in protein usage by the body. Turkey is also loaded with vitamins B6 and B12.

We call it “Turkey Taco Tuesday” because it makes a traditional Tuesday festive. Sometimes people want to dress up the taco with lettuce or other crunchy toppings, while others simply prefer the meat over a simple salad. It allows our residents to get creative, have choices, AND eat healthy.

INGREDIENTS:3 pounds 85% lean ground turkey1 tablespoon light olive oil1 white onion, diced½ cup taco seasoning1 cup water1 tablespoon cumin1 tablespoon crushed red pepper flakes

DIRECTIONS:Cook turkey in frying pan with olive oil until turkey is browned.While cooking, dice onions into ¼ inch pieces.Simmer all ingredients together for 30 minutes.Serve on/with Simple Salad (page 44), or in a whole wheat soft or hard taco shell.

SERVES: 4


475 per cup


WINTER GLAZED CARROTSPrep Time: 5 minutesCook Time: 30 minutes

This is a great recipe for the holiday season, when you want to add something sweet into your dinner. One tablespoon of brown sugar contains approximately 52 calories, and when tossed evenly with hot carrots, adds a big punch of flavor!

INGREDIENTS:2-3 cups carrots, sliced1 tablespoon light olive oil1 tablespoon brown sugar

DIRECTIONS:Preheat oven to 300 degrees F.Toss carrots with olive oil.Roast in oven until soft.Prior to serving, toss with brown sugar.

SERVES: 4


74 per cup

69 | LivingHealthy with PWS Barbeque Chicken with Mashed Potatoes and Couscous (page 56).

Oven Roasted Salmon (page 59).Roasted Cauliflower (page 62) and Peas.

70 | LivingHealthy with PWSPineapple Parfait with Crumble Topping, page 74.


TASTY TREATS FOR SPECIAL OCCASIONS

People diagnosed with PWS often have low intrinsic motivation, and an external reward (such as a treat) is needed to encourage them to complete tasks that are not preferred (such as physical fitness). Without creativity and enthusiasm, exercise for our residents falls into a category of non-preferred task. When we made the decision to redesign our menu, we simultaneously decided to make our exercise program as vibrant and engaging as possible. We spoke to our residents ages 22+ who suggested a new idea that we were hesitant to start, but has worked well! Together, we created a reinforcement for consistent and quality exercise. Simply put – exercise eight out of every 10 days for at least 45 minutes and on the 10th day they receive a 100-calorie frozen yogurt. Since implementing this new practice, 59% more of our adult residents are exercising regularly, a jump from 38% to 97%.


DAIRY-FREE OMEGA 3 CUPCAKESPrep Time: 25 minutesCook Time: 25 minutes

Many people with PWS have dairy sensitivities. This recipe allows for a healthier alternative for birthday parties or get togethers! We offer the opportunity for our residents to pick the flavor of the icing so that it meets their special-day wishes. We use a cupcake pan meant for 12 desserts.

INGREDIENTS:Wet Bowl3 teaspoons vanilla extract3 teaspoons cider vinegar1 cup olive oil3 cups filtered water

Dry Bowl4 ½ cups flour3 cups granulated sugar¾ cup unsweetened cocoa powder (omit for yellow cupcakes)1 ½ teaspoons salt3 teaspoons baking soda¼ cup ground flax seed

DIRECTIONS:Preheat oven to 350 degrees F.In separate bowls, mix wet ingredients and dry ingredients.Combine wet ingredients into dry ingredients.Using a ¼ cup scoop, scoop batter into cupcake pan sprayed with non-stick spray.Bake at 350 degrees F for about 25 minutes (or use the toothpick test: is it free of batter when you pull it out of the cupcake center?)

SERVES: 12


300-600 per cupcake


Our residents fill out a sheet prior to their birthday which helps outline their special treat options.


FRUIT PARFAITTotal Time: 15 minutes

Parfaits are a simple, healthy dessert alternative. They are a great form of probiotics and are appealing to the eye. Use your best judgement; it’s hard to measure calories as it depends on thetype of low-fat yogurt used and amount/variety of fruit.

To see how we incorporate this recipe into Valentine’s Day, see Holiday Preparations (page 16).

INGREDIENTS:2 cups low-fat yogurt (1 or 2 favorite flavors)1-2 cups fruit of choice (we suggest strawberries, pineapple, blueberries, black and red raspberries)1 tablespoon non-dairy whipped cream (optional)

DIRECTIONS:Select a clear plastic or glass cup or bowl (large or individual sized).Make layers of each ingredient starting with the yogurt.Layer fruit atop yogurt.Alternate until complete.Top with non-dairy whipped cream if desired.

SERVES: 4-6Approximate Calories: 80 per half cup yogurt45 per half cup fruit


TRIFLETotal Time: 15 minutes

Trifle includes Nilla Wafers, and is a more caloric version of a parfait. The number of calories depends on the type of low-fat yogurt and fruit, just as with parfaits. Be cautious of someone’s calorie count as the trifle is portioned into the clear cup or bowl.

INGREDIENTS:2 cups low-fat yogurt (1 or 2 favorite flavors)1-2 cups fruit of choice (we suggest strawberries, pineapple, blueberries, black and red raspberries)8-12 Nilla Wafers1 tablespoon non-dairy whipped cream (optional)

DIRECTIONS:Select a clear plastic or glass cup or bowl (large or individual sized).Make layers of each ingredient, starting with Nilla Wafers.Layer fruit atop Nilla Wafers.Layer yogurt atop fruit.Alternate until complete.Top with non-dairy whipped cream if desired.

SERVES: 4-6Approximate Calories: 80 per half cup yogurt45 per half cup fruit17.5 per Nilla Wafer


chart pagefinal.indd 1 10/8/15 7:48 AM


Mediterranean Diet

Overview of the diethttps://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

Key principles of the diet http://www.eatingwell.com/article/16372/8-ways-to-follow-the-mediterranean-diet-for-better-health/

Recipe Ideas http://www.eatingwell.com/recipes/18314/cuisines-regions/mediterranean/

Omega 3s

What are they?https://www.hsph.harvard.edu/nutritionsource/omega-3-fats/

How much do people need?https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

Top 20 List of Foods Ranked as Quality Sources of Omega 3 Fatshttp://www.whfoods.com/genpage.php?dbid=84&tname=nutrient

Lists of Vitamin and Mineral Rich Foods

https://www.health.harvard.edu/staying-healthy/the-best-foods-for-vitamins-and-minerals

https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/factsheets/Vitamin_and_Mineral_Chart.pdf

https://www.webmd.com/food-recipes/guide/vitamins-and-minerals-good-food-sources#1

Reference/Citation

Bernstein, K., Burns, M., Clark, K., & Dorn, B. (2016). Hidden Gut Issues: Rethinking Food Choices and Meals for the Person with Prader-Willi Syndrome. Retrieved from https://www.pwsausa.org/wp-content/uploads/2016/12/Hidden-Gut-Issues-in-Prader-Willi-Syndrome.pdf

Recommended Websites and Citation

We have prepared a list of reputable websites for additional nutritional support for you and your family. Please be aware, with new research, some of these sites may become outdated over time. One timeless nutrition recommendation found throughout this cookbook and these sites is that fresh food is best. We hope you can incorporate as much fresh food as possible into your meals.


Afterthoughts…

Cooking Conversions

Measure Fluid Ounces Tablespoons Teaspoons

1 gallon 4 quarts 256 768

4 cups 1 quart 64 192

2 cups 1 pint 32 96

1 cup 8 ounces 16 48

¾ cups 6 ounces 12 36

½ cups 4 ounces 8 24

¼ cups 2 ounces 4 12

Connect online with Latham’s PWS expert! Weekly tips for the PWS community are posted on Latham Centers’ blog. Written by Patrice Carroll, Latham’s Director of PWS Services, the Tip of the Week is posted at https://www.lathamcenters.org/blog/category/tip-of-the-week/

Stay up to date with new recipes! Latham Centers will print new recipes in modules. Please visit us at LathamCenters.org for announcements about new cookbook modules and email us at [email protected] with any questions or ideas.

Visit us if you choose a Cape Cod vacation! Latham Centers’ Admissions Team invites you to schedule a campus tour and learn more about our services and our outreach. Cape Cod is a wonderful place to visit any time of the year and we welcome your inquiries at [email protected].

Measure Fluid Ounces Tablespoons Teaspoons

1 gallon 4 quarts 256 768

4 cups 1 quart 64 192

2 cups 1 pint 32 96

1 cup 8 ounces 16 48

¾ cups 6 ounces 12 36

½ cups 4 ounces 8 24

¼ cups 2 ounces 4 12

Latham Centers compassionately and creatively helps children and adults with complex special needs, including Prader-Willi Syndrome, to lead meaningful, abundant lives.

Copyright © 2018 by Latham Centers, Inc.

LathamCenters.org

9 781732 210905

52995>ISBN 978-1-7322109-0-5

$29.95

livinghealthy - latham centers · 2019-06-08 · livinghealthy with pws | 3 authors patrice...

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