Monday, January 17, 2011

For Healing, Meals Made to Order

JULIEN COLLOT, who is 8 and has had leukemia, has been on a low-microbial diet since his two bone-marrow transplants, in 2006 and 2007. When he developed diabetes last year, he had to go low-fat and low-sugar as well.

So Pnina Peled, the executive chef at Memorial Sloan-Kettering Cancer Center, makes Julien his beloved shrimp scampi with Promise, a butter substitute, and eggplant Parmesan using egg whites, whole-wheat bread crumbs and soy cheese. When Julien told Ms. Peled about his love of pumpkin spice cake, she presented him one baked with egg whites and applesauce. After he rejected the hospital’s whole-wheat ravioli, she hauled her pasta maker on the subway from Brooklyn to roll out a handmade version.

“She came in on her day off with a stack of cookbooks and sat with us to come up with a menu for him,” Julien’s mother, Jacqueline Collot, said the other day as her son relished whole-wheat spaghetti dressed with sesame oil and topped with green beans minced fine to look like scallions — Ms. Peled’s response to his stated craving for “unspicy spicy noodles.”

“What Pnina offers Julien is a combination of love of food and the freedom that was taken away for so long,” Ms. Collot added. “To see him interested in meals gives us great comfort.”

Ms. Peled, who came to Sloan-Kettering a year ago after working in some of the city’s finest restaurants and winning an episode of the popular Food Network show “Chopped,” is part of a revolution in hospital food.

Bland broths, neon Jell-O and unidentifiable white-meat products are slowly becoming scarce. Instead, hospitals like the University of Texas MD Anderson Cancer Center in Houston and Cincinnati Children’s Hospital Medical Center have extensive room-service-like menus and give patients the freedom to order meals whenever they are hungry, while the kitchen staff at St. Jude Children’s Research Hospital in Memphis is happy to duplicate recipes provided by parents.

Sloan-Kettering patients, too, order meals from one of 75 room-service menus — kosher, halal, vegan, low-sodium, etc. But Ms. Peled said that when she started, she saw that patients who did not find anything appealing on the menu often would not eat at all, which motivated her to make the food service more flexible.
She has a team of 35 chefs from diverse backgrounds catering to the special requests of patients, particularly the younger ones, who come to the renowned cancer center from around the globe. In recent months, one chef has been serving dal, curries and rotis to a 16-year-old patient from India; another has made yellow rice for a 3-year-old Latino boy who wanted the version like his mother’s; and a third devised a menu of low-microbial foods for an 8-year-old girl from Italy who wanted dishes that reminded her of home, like fish Francese (it has a lemon sauce).

“There’s no substitute for a good diet, and appetizing food can make all the difference,” said Dr. Susan Prockop, a pediatric oncologist at Sloan-Kettering, noting that eating well can speed recovery and keep patients off intravenous nutrition.

Dominique Symonette, the registered dietitian in charge of pediatrics at the hospital, said that cancers, and chemotherapy, often result in mouth sores, nausea, vomiting and difficulty swallowing. Low-sodium, low-sugar and low-microbial diets — which limits raw and fresh food because of the risk of infection — are common for patients with compromised immune systems or those who are taking steroids or other medications long term.

Enter Chef Peled or one of her three sous-chefs, who spend an hour each afternoon meeting with pediatric patients and their parents to discuss food preferences. (Adult patients at Sloan-Kettering can also make personalized requests, but as the mother of a 2-year-old, Ms. Peled, 37, has a soft spot for sick children.)

Veronica McLymont, director of food and nutrition services at the hospital, says the customized approach has not increased costs because when the children get what they want, less food is wasted.

Read the complete story here.

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