Wednesday, October 1, 2014

Gaining weight on a tight budget (something most of us just don't even need to think about!!)

Sometimes, when an issue pops up within our families, we don't want to share information with others just yet, as it feels very private. Other times, the issue at hand feels so overwhelming to us, that we simply don't have the energy to deal with the comments and input from others. (People say stupid things at time, meaning well, of course. But it's draining to have to deal with inappropriate "advice" AKA criticisms.) So we work within our small group, privately, until we've reached the point that what other people say won't affect our overall approach to the issue.

I've wanted to share some of what our family has been dealing with, here on my blog, for a while. But it just wasn't the time. Presently, I feel we've reached a good place in recovery, and it's "safe" to share.

My purpose in sharing this is to 1) possibly reach out to someone else going through a similarly difficult time in their family's life, so they will not feel so alone in their struggle, but also 2) some information from the recovery process for our situation could be helpful to another family.

One of our daughters has struggled with an eating disorder for a couple of years. She is actively restoring weight right now. It's not an easy process. Many individuals who find themselves needing to regain weight also find themselves requiring an enormous amount of calories and nutrients each day. When you combine this with loss of appetite, the situation can seem daunting.

Eating disorders are just one reason an individual may need to restore weight. When my mom was sick with cancer, weight loss and appetite were a huge struggle for her. Often times, the elderly lose their appetites, and weight loss is a health risk for them, as well. Sometimes, it's just a picky eater in the family with a small appetite to begin with, that necessitates a bit of intervention to put on a few pounds.

It's so hard for us, as eager eaters, to understand the frustration of needing to put on weight, isn't it? I look at a donut, and it magically jumps onto my mid-section.

But, for those who are trying to help a child, parent or other loved one put on a few pounds, I'm going to share some of our methods and "recipes", over the coming month or two. As always, take what works and leave the rest.

The number one tip I can offer other families trying to restore weight with an individual who just doesn't seem to have an appetite, is to set up an eating schedule. For the underweight individual, it can be so easy to go through an entire day subsisting on an amount of calories/nutrients which result in further weight-loss. Before you know it, it's the end of the day, and a daunting amount of food still needs to be consumed. So, for us, having a schedule of 3 meals, 3 snacks works.

We adjust our calorie and nutrient needs based on weekly weigh-ins. The safe amount to gain per week seems to be 1-2 pounds (similar to weight loss recommendations). If we've gained the appropriate amount for the past week, then I look at the next week's activity level, and add or subtract a small amount from each day's requirements. If we over-gained, then I reduce the next week's requirements, and if we've under-gained, then I increase, but all based on the math of 3500 calories equals 1 pound of weight.

I keep this information in a small notebook, so I know for sure what I'm supposed to be doing for meals each week, and we can track progress. I'm getting forgetful in my "old-age"!!

For us, we minimize anxiety around foods and ingredients if I put together meals for my daughter, and she gets her snacks. There will come a time when we transition to more intuitive eating. This is all part of the process of recovery.

Each meal and snack has it's own calorie requirement. To give you an example of how it unfolds for us, for a week when my daughter needs 2800 calories per day, we do 750 for breakfast, 200 mid-morning snack, 700 lunch, 200 mid-afternoon snack, 750 dinner, and 200 evening snack.

Snacks can be hard for us to get in, so we set the calorie requirement for those somewhat low. Another family might do better with fewer calories at meals, and more at snack time, for 6 mini-meals each day.

When my mom was battling cancer, she had similar calorie goals for each meal. Working within these goals helped to keep her weight from slipping dangerously low.


So, one of the biggest obstacles for us with meals is getting in a nutrient-dense breakfast in a short amount of time. There are meal replacement shakes that I know a lot of families use. Working on a tight budget, I'll share what we do that packs the nutrition, while keeping our costs reasonable.

The Nutrient-Dense, High-Calorie Breakfast Smoothie

I plan the next morning's breakfast the evening before, as I'm cleaning up the kitchen. If my plan is something like muffins and milk, my daughter's milk gets boosted to a smoothie. I calculate the calories of the muffin portion, and figure how many calories the smoothie needs to contain.

I set up all the ingredients for her smoothie the evening before, then in the morning, she or I dump it into the blender to whirl it smooth. She often expresses a flavor she's in the mood for, and I work with that.

I use a 1-pint canning jar, and begin adding ingredients to the jar, until I meet the calorie requirement. Cap and refrigerate overnight. Here are some ingredients that we use in our smoothies, but not all of them in the same smoothie!! :
  • milk (whole milk if possible, 160 calories per cup)
  • peanut butter (90 calories per tablespoon)
  • dry rolled oats (yes, that sounds weird, right? I found that ingredient on a list for body-building smoothies)
  • bananas
  • tofu
  • frozen and fresh fruit (chopped for items like orange segments or apple slices)
  • cocoa powder
  • sugar, honey, molasses, agave
  • canned pumpkin
  • applesauce
  • leftover cooked winter squash
  • cooked sweet potato
  • dry milk powder
  • whipping cream, oils
  • spices (cinnamon is a favorite for us, but also nutmeg is good) and flavorings (vanilla and maple are both yummy in smoothies)
  • leftover cooked brown rice
  • homemade Greek yogurt (300 calories per cup, adds a lot of protein and calcium, and good with frozen berries)
We work within the guidelines of 30/30/40 with respect to fat/protein/carbohydrates. The oils and whipping cream may sound over the top, but in a person with high nutrient needs, including lipids, the whipping cream and oils sometimes add that little bit extra to bring us into balance. We also try to incorporate a wide range of foods into the weekly plan, so the components of our smoothies vary from one day to the next.

I don't calculate ratios (the 30/30/40) on a daily basis, but every 7-10 days I do a mini-audit of one day's meals, just to see if we're on track.

A suggestion for coming up with a blend of flavors -- think about other meals/foods you've eaten and enjoyed. I make a delicious sweet potato/orange zest and nutmeg casserole. So for one smoothie variation, I add sweet potato, a couple of orange segments, nutmeg, and sweetening to the milk. Apple pie smoothies are good, too. Some applesauce, cinnamon, oats and sweetening added to the milk. And of course, we love peanut butter-chocolate. I add 2 tablespoons of canned pumpkin to these, at my daughter's request. Some cocoa powder, peanut butter, sweetening, canned pumpkin added to the milk -- yum. In an issue of Prevention magazine, several years ago, I found a simple tofu and orange juice smoothie recipe. I've done these for myself many, many times. (I like a bit of sweetening in mine; I believe the Prevention recipe was just tofu and oj.) My daughter likes tofu and frozen blackberries whirled into milk.

On extraordinarily busy mornings, sometimes the smoothie IS the whole breakfast. So adding grains in the form of oats or cooked brown rice, plus fruit or vegetables, milk, tofu, peanut butter for protein, and we have a meal in a glass. I've even taken to doing these for myself, when I know I've got a demanding morning ahead of me and no time to cook or eat a hot breakfast.

There you have it -- our version of a nutrient-dense beverage, based on real foods. For a price comparison, Boost nutritional drinks retail for about $1.50 for each 8 oz serving. A nutrient dense, home-made breakfast smoothie like what I serve, containing anywhere from 400-600 calories, costs between 40 cents and a dollar, depending on just how "fancy" we're feeling that day (and how inexpensively I've obtained ingredients).

And I won't even get into some of the "added" ingredients in commercial nutritional drinks. Ugh!!!

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16 comments:

  1. It always makes sense to plan your meals and food, but it is especially important when you have someone with extra nutritional needs. I hope your daughter continues on her road to recovery. We are all pulling for her.

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    1. Thank you, live and learn. We continue to make progress in the right direction. It's a long road.

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  2. You have alluded to this before, and I always thought, wow, what a challenge. You are trying to meet a variety of nutritional needs on a tight budget. What you are doing to meet this challenge sounds great. Tracking calories/nutrients, regardless of whether you need to gain/lose weight, is a good reality check to see if what you think you are doing, diet-wise, is actually what is happening. Your food plans sound tasty and are nutritionally balanced. Good work! I have seen recipes for smoothies which include adding oats--I've wanted to try them but smoothie-making isn't my favorite thing to do. :)

    I am glad to know I'm not the only one who sometimes needs to hunker down and not share everything with everyone until I am ready emotionally to do so. When my mom went through breast cancer a year and a half ago, I told a select group of people about it, but I didn't put it on our church prayer chain. I just wasn't ready to discuss my raw emotions with every person I would see at church. Like you say, sometimes the well-meaning comments of others add an additional burden at a time when you really need some of that burden lifted.

    I'm so happy for your daughter and really, your whole family, that she is on the road to recovery.

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    1. Hi Kris,
      Thank you for your well-wishes and prayers.
      You know, this dietary episode in our family's life has gotten me to study and give thought to how we eat. Sometimes what we hear in media-driven medical "news" isn't what fits our individual needs. I'll continue to look for foods and meal ideas that foster better mental and physical health for our family.

      I totally understand how you just didn't feel ready to have your entire church know about your mom's cancer. I've felt that way about my own family's struggles. With my emotions all at the surface, I just can't deal with even a simple "thinking of you" comment, in person, with all but my closest of friends.

      When my mom passed away, she had been sick for a very long time, and everyone I worked with knew. The week before she passed, I was taking large blocks of time off, and even the looks of sympathy from co-workers when I did go into work, would throw me into a flood of tears. It was so hard. Being vulnerable is not one of my strong suits.

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  3. Lili,
    Congratulations to your daughter on her ongoing recovery and I'm glad that she has a wonderful support system in her family.

    I am always so impressed with your use of whole ingredients in creative and yummy ways! I never would have thought to put sweet potato/orange/nutmeg in a smoothie but it sounds delicious. And so full of important nutrients. Sometimes, if I'm making a smoothie for myself, I'll throw in a little spinach or kale for added vitamins but my kids don't like "green" smoothies. :)

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    1. Thank you, Sharon.
      What's new in food news seems to change from one week to the next. I old enough to remember when butter was "bad" and margarine was "good".
      So my thinking is that sticking as close to how foods appear naturally is probably the best way for us to eat. And the bonus is, whole foods, real natural ingredients, are cheaper than manufactured food products. So, it's a win-win!

      We haven't ventured into green stuff in the smoothies, just yet. But I have a hunch that my daughter would go for that. We have mustard greens, kale and chard in the garden right now. I'm wondering what those greens would go well with in a smoothie? Thanks for the suggestion.

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    2. I threw beet greens in a blueberry smoothie last summer with success. The blueberries are dark and "hide" the green. Kids loved it and didn't know. Kale might be too strong, and I don't know what mustard greens taste like, but chard and spinach are more mild and should work.

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    3. Kris, I do have beet greens still in the garden! What a great way to disguise them. Now I'll have to hunt through the freezer and see if there are any blueberries. Strawberries might be okay, too, or even a cocoa powder-peanut butter smoothie. Thanks for the suggestions!

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  4. I've struggled as an adult with the opposite end of the spectrum and over eating. I can sympathize and know that the "one meal at a time approach" you are taking is what worked/is working for me.

    It is wonderful that she has you to work with her and the support of your family.

    I confess that I am not much of a smoothie person. I can drink them, but I'd just as soon have the ingredients separate. However, the idea of the pumpkin and peanut butter has intrigued me. I may have to try that.

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    1. Hi Shara,
      I've tended more towards the eating-too-much end of the spectrum in my life, especially when younger. And even now, I find that I simply eat better and have more energy, if I plan balanced meals for myself, and try to eat on a schedule. I also allow myself a small sweet treat after meals, a mini-dessert. Otherwise, I feel deprived and wind up eating too much junky stuff. There's so much interaction between mind and body when it comes to eating. We all need to find out what makes us tick and live accordingly.

      Pumpkin and peanut butter is actually a pretty good combo. Live and learn has a soup recipe on her blog for curried peanut-pumpkin soup that is really good. here's the link:

      http://liveandlearn-tossandturn.blogspot.com/2013/01/pumpkin-soup.html

      My family really enjoys this, in fact, I think we'll have it again this weekend.

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  5. I'm sorry that your daughter and family have been going through this. I am so happy that she is on her way to recovery!

    I definitely can relate to keeping quiet about an issue until one feels ready to share. When my Grandpa was diagnosed with terminal cancer early in January 2013, I did not feel that I could share that with my co-workers. I simply did not have the energy to discuss it and didn't really want to share such personal feelings/emotions with them at the time. I only discussed the situation with my family.

    Now that you feel the time is right to share, I am so glad that you did! I know that others can benefit from the information you shared about maximizing calories and nutrition on a tight budget.

    My Grandpa had a couple of battles with cancer a few years prior to being diagnosed with terminal cancer. He was a thin man to begin with. My Dad and the other family members helping with his care struggled with helping him to gain weight. He had lost weight from the cancer and treatments and had no appetite. My Dad and Grandma did purchase the Ensure drinks for my Grandpa. It was so costly. They ordered it by the case from a local pharmacy, but it was still expensive.

    All of your tips are excellent!

    Angie

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    1. Hi Angie,
      Thank you for your kind words.

      I'm sorry to hear about your Grandpa's battle with cancer. Cancer treatment not only dampens appetites, but it changes what tastes good, from one day to the next. Just as we'd find a meal that my mom would want to eat, the treatment would put her off of those foods.

      Ensure was a good thing for her, too. She would get terrible mouth sores from the treatment, and having food in her mouth was painful. So, her home nurse recommended using a straw with Ensure. And that really helped a lot. The straw would put the drink far enough back in her mouth to avoid much of the soreness.

      I do wish I'd known more about nutrition back then (30 years ago). I could have been more helpful to her.

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  6. I struggled with eating disorders for about 10 years during my teens and early 20's so I can empathize with what your daughter is going through. For me, though, once I started eating again the weight came back easily, lol!

    As an adult, my struggles have always been in the opposite camp - trying not to gain weight... but once I started cycling seriously I ended up in unfamiliar territory where I needed more calories, especially on days with 4 hour and longer rides. My situation is further complicated by my allergic condition (food dependent exercise induced anaphylaxis) which means that I have to be really careful what I consume both before and during a ride.

    Anyhow, I was having real problems because I would eat as much as I could before a ride, but inevitably a few hours in I'd be starving, and I'd really drag for the rest of the ride. I finally got some advice from my step mom (who is a doctor) and her basic advice was "you need more carbs, fat & salt." You know you're in strange territory when a doctor tells you that!

    We finally came up with a high calorie ride-morning breakfast consisting of eggs with potatoes and/or sweet potatoes, smothered in olive oil and salt. With that and homemade gatorade to drink along the way, I do MUCH better.

    So anyhow, it sounds like your smoothie recipe is wonderful, I'm wishing my allergies would let me do something like that on ride mornings. If your daughter ever feels up to exploring a savory breakfast, I highly recommend some variation on the potatoes & eggs theme. It's budget friendly and packs a good caloric punch!

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    1. Hi Cat,
      Gosh, I'm so sorry you had to struggle with ED when you were younger. Now, having had a bird's eye view of ED, I understand that it's about so much more than just not eating enough, or trying to be thin. I'm glad that you have moved past ED. "Survivor" stories are always good to hear.

      So interesting about what your mom, a physician, had to say. I've been reading about the importance of fats in our diet, for good mental health. I think our fat-phobic society is making some of us go overboard on limiting fat intake. Our whole family is eating more fats, as a result of my daughter's ED, and I have to say, my mental outlook and my physical endurance seems to have improved. I go for runs in the afternoons, and if I don't have a hearty lunch (including a fair amount of fats), I just can't run for very long.

      Thanks for the egg/potato suggestion for my daughter's breakfasts. We'll be giving those a try when I have a good store of potatoes again!

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    2. It's sooo true what you say about eating disorders. I didn't really start to get better until I realized that my problem actually had nothing to do with food or my body shape/size. Food & my body were just the battlegrounds upon which all of my internal wars were being waged.

      In a funny way, I credit my food allergies for getting me over the eating disorder. Somehow, having the allergies to deal with took food out of the realm of personal battles and put it squarely in the medical/health department. Of course, I still had all of the emotional stuff to deal with - but I am grateful that ended up in a situation where I was pretty much forced to start looking at it all, because I don't think I would have had the courage to open those doors otherwise.

      Wishing you and your daughter much love throughout the recovery process.

      xoxoxo,
      Cat

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    3. Cat, I've heard of similar results from an individual receiving a diagnosis of something like diabetes then changing their entire thought pattern about food and eating, and that part of the ED becomes no longer relevant. Of course, as you said, you still have to deal with all the emotional/thought process stuff that led to the ED. An important part of my daughter's recovery will be through her regular appointments with a counselor.

      Thank you so much for your kind words.

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