Almond & Orange Florentines

Posted on December 26, 2013 by Christy Anderson Brekken

I like to cook, therefore I like to listen to the Splendid Table. When I saw this Almond Florentine recipe on their website, I knew it would be keto-possible. Worked like a charm!

It is so easy, delicious and look at that fancy little cookie. Who could resist? It was a simple way to make an elegant holiday treat for Nora, and a batch with a little sugar for the rest of us!

A tip of you are making them for the whole family: reduce the sugar by at least half. I reduced the sugar a bit, and found them very very sweet. The orange still comes out, but I would like to taste the almond flavor too. The sugar is only for flavor, because Nora’s came out fine with no sugar at all.

One more tip: Kids like to zest oranges with a cheese grater or zester. Anders did the whole orange for me. Just make sure that they get the colored peel and avoid the white pith. Get them busy in the kitchen!

Nutrition information for 1 almond florentine cookie (recipe makes 10). Nutrition information provided by www.caloriecount.com

Almond & Orange Florentines
(makes 10 servings, 1.43:1 ratio)
30 g Egg whites
100 g Sliced almonds
2 g Orange zest

Preheat the oven to 300°F. Line a heavy baking sheet with a silicone mat or parchment paper brushed lightly with vegetable oil.

Measure and briefly beat the egg whites. Then gently mix them with the sliced almonds and orange zest. Measure 13 g portions of the mix to make little mounds on the lined pan, spaced a bit apart. Dip a fork in a small bowl of water and flatten each mound. Make them as thin as possible without big gaps between the almond slices.

Bake for about 12 minutes, until the cookies are golden brown. Cool completely before serving.

Nora’s cookies on left, rest of family’s on the right.

You can add a drizzle of high-quality dark chocolate for extra flavor. I use Green & Black’s 85% dark chocolate. Melt a square in a small silicone pinch bowl by putting it in the microwave for 30 seconds. Check and microwave again briefly if necessary to melt it.

Put one cookie on the gram scale and tare it. Drizzle the melted chocolate on to the cookie until you reach the desired amount. I used 1.5 grams of chocolate on Nora’s, which added 0.41 g carbs, 0.15 g protein, 0.75 g carbs (9 calories, 1.33:1 ratio).

The ratio is very low for her, so we make “hot chocolate” out of heavy cream and a pinch of cocoa powder, steamed with the espresso machine’s attachment. Lovely holiday treat.

Popcorn!

Posted on December 17, 2013 by Christy Anderson Brekken

Nora gets popcorn! What a revelation! I read on another keto-mom blog that popcorn was her son’s favorite snack, and I was kinda like “shyeah, right. Not gonna work for Nora. Too many carbs.” Sorry I doubted you Sara. Now I’m with it.

I did look up the nutrition facts on popcorn after I saw that blog post and still thought that it wouldn’t work easily. It didn’t have as much fiber as I expected, and Nora could probably only have a few grams. I thought that her few grams would just look pathetic next to a serving that the rest of us would get. And I didn’t have any popcorn in the house, so that was also a big barrier to trying it.

I was motivated to try it again because her class is having a popcorn party tomorrow for their accumulated good behavior. I bought some popcorn to test it out. Super easy way to make plain popcorn for everyone: put some plain kernels in a small paper bag and microwave it for a few minutes, take it out when the popping slows down, or it will burn. That’s it! You will never eat that chemical-laden microwave popcorn again!

For tomorrow’s popcorn snack, Nora will get:
4.5 g popcorn
5.5 g butter (melted on and drizzled on popcorn)
5 g melted coconut oil mixed with 8 g ground macadamia nuts and a drop of banana flavoring, chilled to make a “cookie”

162 calories
3.3 g carb
1.2 g protein
16 g fat
1.3 fiber
3.5:1 ratio

And look at all that popcorn! A near proper bowl! It is super carby per gram, but it’s so light that you get a lot of popcorn per gram. That’s the key to success.

This will be her morning snack at school when everyone has popcorn, so we will load her breakfast with protein and very little carbs so that she is evened out by lunch. She is excited! And it sure helps that she is up to 14 g carbs per day, on her way to 16-17 g. We can easily squeeze in a few extra carbs with snack.

I am sure that popcorn will also become a favorite snack for Nora too.

The simplest keto meals

Posted on December 15, 2013 by Ted Brekken

Ted here. This post is about the very simplest keto meals. Especially from the perspective of the secondary cook.

Christy is a food wizard. She gets food. She can create new things from basic components. She can produce batches of treats for Nora that we can use over the week. That is not an area of significant competence for me, but I can certainly make simple keto meals for Nora. So what do we do when energy and time are low, more complex treats are not available, and Nora needs to eat? Here is our most basic template for an easy lunch (or dinner).

Base:
Start with a base of avocado. Avocados are stellar. They are at about a 3.5:1 ratio on their own, plus they are fibrous. They can be simply diced, or spread as butter. We’ll generally start with 20 to 30 grams of avocado for a meal. Macadamia nuts (see more on them below) can also serve the role of a meal base. Both avocados and macadamia nuts work well to start the meal calculation because they are both high ratio, and give you a solid start on all four of the major constraints: carbs, protein, fat, and fiber.

Carbs:
The major sweet parts of the lunch come from apple, red pepper, carrots or berries (e.g., blueberries, strawberries, and raspberries). Peppers and raspberries get priority because of their high fiber and low carb content (relatively). Apples, blueberries, strawberries, and carrots pack much more of a carb punch, so those are added if the other major constraints are met and there is still a bit of carb to give. Generally there will be 5 to 30 grams of total fruit, depending on the mix.

Protein:
Cheddar cheese is the primary protein base. Nora likes it, it is easy to cut and weigh, and it has a good amount of fat too. It is versatile too in that it can be served sliced, cubed, shredded, melted, or melted and reformed. Something like 10 grams to 20 grams is typical. Sliced turkey and ham are also popular. Ham is nice because it has some fat. Sometimes we’ll put cream cheese and butter on the sliced meat and roll it up to get more fat in there.

Fat:
Cream is our primary fat, either mixed with water and a few drops of vanilla flavoring to make “milk,” or steamed in our espresso machine with a pinch of cocoa powder. The amount of cream will be between 10 and 40 grams, depending on what else is in the meal. We’ll might also look for opportunities to put butter on or in things. The other two big fat delivery mechanisms are macadamia nuts and kalamata olives. Those are especially nice if I want to avoid liquids (i.e., cream) in the meal, for example, with a packed lunch. Macadamia nuts do have some carbs, so it will use up some of that allotment, but their high fat and high fiber content provide a significant tradeoff for that. Kalamata olives are one of very few foods that have both fat and carbs, but no protein, so they make a natural keto complement to meat and cheddar. However, they have no fiber.

Fiber:
The fourth constraint. Generally I check for fiber when I am satisfied with the amount of carbs and the ratio of the meal. If the fiber content is too low — we shoot for about 11 grams of fiber for Nora over the day — then I’ll circle back and see if I can trade something out for more raspberries, macadamia nuts, or Flackers. Flaxmeal is another option, and can be mixed in with any butter in the meal.

Variety:
Lastly, we’ll check to see if there is a reasonable variety of textures and tastes. Meaning, is there something creamy and something crunchy? Is there something sweet and something salty?

A typical, very simple lunch:
8 g apple
15 g avocado
15 g cheddar cheese
8 g Flacker with 8 g butter
15 g macadamia nuts
13 g cream with water and vanilla flavoring to make “milk”
—————————
3.52:1 ratio
2.5 g carbs
6.9 g protein
33.1 g fat
4.4 g fiber
336 calories

At the bare minimum, if I have avocado, cheddar cheese, raspberries, and cream, I can cobble together the most basic tasty meal that satisfies all the constraints. Add some sliced meat, other berries, apples, peppers, carrots, cream cheese, macadamia nuts, kalamata olives, and Flackers, and we can switch things up enough to keep the simple meals interesting from day to day.

Keto clinic checkup and diet changes

Posted on December 13, 2013 by Christy Anderson Brekken

On Monday we made our way to Portland for another keto clinic check up with Dr. Wray. Nora continues to thrive. She is in her 20th month of seizure freedom! Her growth rate is right on track even after 2 years of diet therapy, 60th percentile for height and 75th for weight (I think she’s ready for a growth spurt). Dr. Wray reviewed her history and genetic testing and feels that there is no reason to keep her on a carb-restricted diet in the long term. Very good news.

Her labs were all fine. For those of you keeping score at home, her cholesterol panel was good at 188, triglycerides at 54, LDL (bad) minimally elevated at 135 and HDL (good) normal to good at 42. Her blood bicarb level was at 21, which is normally low but not too low.

We still can’t get Cytra-K in crystal form as before, so we will continue with baking soda (6 g dissolved in water given over the course of the day). She has avoided stomach upset after we learned to give small amounts of baking soda solution between meals. It seems to be a problem on an empty or full stomach. We have the option of using Cytra K oral solution (great cherry flavor!), but the stats I got from the dietician suggest that it has 3 g of carbs in her daily dose. We don’t think that’s a good trade off, when she could be getting 3 g of carbs through fruits and veggies. We will stick to the baking soda for as long as Nora tolerates it.

The biggest news is that we are going to adjust her diet to prepare for weaning her in April after her 2 years seizure-free. For the last 6 months she has been getting about 11 g carbs, 25-26 g protein and about 130 g of fat per day, which is 1300-1350 calories at a 3.5:1 ratio (fat to carb+protein).

That’s a small amount of carbs even by keto diet standards for this number of calories. When we increased her calories last time, the dietician suggested going up to about 16-17 g carbs, which felt like a big jump from 10 g of carbs, so we only increased it to 11 g at that time. Now we are going to keep the calories and ratio the same, but bring her carbs up to 16-17 g per day. That gives us a new daily target of 16-17 g carb, 20-21g protein, 128-133 g fat.

We will increase it by a gram every few days, so that she is up to 16 or 17 by the holiday break. Today she is up to 13 and is fine so far! When we told her that we were going to let her have more fruits and veggies she was so excited! It’s tiny baby steps to coming off the diet, but slow changes give us peace of mind. Slow but significant for Nora. Although she won’t do it all at once, going from 11 g to 16 g of carbs will feel pretty good!

I often get the question about “what does 1 g of carbs look like?” Of course, it depends on the food. It’s hard for me to answer on the fly because now I think in grams, not number of blueberries or baby carrots. Today I calculated one gram of carb for several of Nora’s regular foods. Some of them have significant fat and protein as well (so they are bigger servings), for those I listed their ratio too:

1 g of carbs in:
8 g blueberry
17 g macadamia nuts (5.43:1 ratio)
8 g apple
14 g carrot
11 g almonds (1.63:1 ratio)
46 g avocado (3.62:1 ratio)
15 g kalamata olives (4.5:1 ratio)
16 g strawberry (not pictured)
18 g raspberry (not pictured)

With 5 extra grams of carbs per day, Nora can have about 6 more baby carrots per day, or 40-50 small blueberries! That’s a lot!

Dr. Wray continues to be delighted by Nora, and to delight us. Anders joined us for the appointment because of a no-school snow day. Dr. Wray made a note of Anders presence in his follow-up report we received in the mail, and that is name is “pronounced with a soft A, which is the Norwegian articulation of his name.” See doc, we read these things with care. Anders thanks you.

Blueberry Panna Cotta

Posted on December 7, 2013 by Christy Anderson Brekken

Oh panna cotta! Where have you been hiding for the last 2 years? Why has it taken so long to discover you?

I’ve been a little obsessed with a cookbook put out by a fabulous restaurant in Portland, Toro Bravo. I haven’t even eaten there personally, but I’ve heard a lot about it. One of my life goals is to eat there. It’s 2 hours away, and often a 2 hour wait. It’s an attainable life goal; I like to have a few like that.

I’m reading this amazing, honest, detailed and hilarious cookbook, which has all of 7 dessert recipes, and start reading about panna cotta. John Gorham, owner, chef and author (who is free with cussing), tells about tasting the best ever panna cotta made by a pastry chef he worked with. The pastry chef replied:

This is the simplest recipe known to man. You can’t fuck it up. You can’t make it not amazing. It has four ingredients and takes five minutes and is foolproof so long as you pay attention.

Nora’s Thanksgiving panna cotta, extra fancy.

I’ve made custard. I’ve made ice cream. I’ve heated and stirred and cooled cream-based desserts. Panna cotta means “cooked cream.” I just assumed that something so Italian and so revered had to be difficult. The secret is out, and I’m making panna cotta. It was our Thanksgiving dessert.

The beautiful thing about panna cotta is that it doesn’t require sugar to make food-science magic. For ice cream, you need sugar to lower the freezing point. In baked goods, sugar plays a role in texture. In jams it makes the pectin gel. But all panna cotta really needs is cream and gelatin, and it gives back a soft luscious creamy dessert that can be flavored any way you want it.

The Toro Bravo recipe calls for gelatin sheets, which he claims are the key to success but require attention to detail. Contrary to the pastry chef’s opinion, it is “fuckupable” (his word, I’m just quoting here). I couldn’t find gelatin sheets at our fancy grocery store and I’m an old hand at powdered gelatin, so I found a recipe from another of my favorite chef-bloggers, David Lebovitz (and his recipe). He uses powered gelatin, and that’s good enough for me.

I’m up to 6 ingredients here. You have to use water with the powered gelatin, so that adds 1. I also included a bit of that whey protein I’m trying to use up. This recipe has so much fat that adding enough berries to get it to a 3.5:1 ratio was a heck of a lot of carbs at a time for Nora. The whey protein is undetectable in the panna cotta, but provides some needed protein to lower the ratio.

I used blueberries because Nora loves them and they are beautiful, but you can use any berries you like. Just adjust the amount of berries to get the correct nutritional breakdown. Blueberries are the highest-carb berry that we use, so if I substituted strawberry or raspberry it would be even more berrylicious!

Nutrition information for 1 serving of Blueberry Panna Cotta (recipe makes 8 servings). Nutrition information by www.caloriecount.com

Blueberry Panna Cotta
(makes 8 servings)
250 g Organic Valley heavy whipping cream
180 g Frozen blueberries
3 g Vanilla extract
2 g Gelatine powder
40 g Cold water
4 g Ultimate Nutrition whey protein powder

Warm and cream, vanilla and blueberries together in a small saucepan until the blueberries start to give up their juice and all is warm. Blend and mash them together so that they are well distributed.

When making a batch recipe, I’m concerned that one of the servings will be carb-heavy and often add the carb component separately to each serving. You can certainly warm the blueberries separately and divide them evenly on top of the cooled panna cotta, which I would recommend if your kid is very sensitive or just starting the diet. You need to be sure that every serving is what it says it is. I’m now comfortable doing this for Nora, but I was not always and I’m still careful.

Measure the cold water into a medium sized bowl, so that the water is broad but not very deep. Evenly sprinkle the gelatin powder over the surface of the water and let it sit, undisturbed, for 5 to 10 minutes.

If you want to be able to turn your panna cotta out on to a plate to serve, lightly grease 8 small cups with coconut oil. I just served ours in the cups. We used wine glasses for our fancy Thankgiving dessert, but I did the rest in ramekins and small tea cups.

Pour the warm cream mixture into the water and gelatin and stir well, so that the gelatin can dissolve completely and evenly. You won’t be able to tell, so stir a little longer than you normally would just to be sure.

Divide evenly into the 8 prepared cups, about 60 g each. Depending on how long you warmed the cream, you might have lost a bit of water. You could measure them at 59 g each to be safe and not come up short. If you incorporated the blueberries into the cream, make sure you get about the same number of chunks in each cup (this will depend on how big your blueberries are. If you are really uptight, count them and divide by 8!)

Chill for at least 2 hours to set until firm. If you make David Lebovitz’s recipe for the rest of the family, I think he skimps a bit on the gelatin, or ours just had to sit much longer to get a firm gel. Add a bit more gelatin than he suggests if you want to be able to eat it sooner rather than later.

One last tip: If your cream is clumpy and separated, you will probably get a thin layer of grainy butter at the top of your panna cotta. It’s doesn’t ruin it, but you should know. Keep the lumps out if you can.

Bringing Keto to Kindergarten, Part 3

Posted on December 5, 2013 by Christy Anderson Brekken

It’s almost half way through the school year!

When things are going along fine but you know there are potential problems lurking, it’s hard to feel really at ease. You can’t really know that things will be fine until something goes wrong and you see how everyone handles it. We had our first real keto-problem at school yesterday. It was handled perfectly. We have a new kind of peace of mind about Nora at school.

We have been sending her “milk” in a small mason jar with a drink/pour lid. I’ve always been afraid that it will pop open and spill all over the lunch box, losing all of that necessary fat to make up her ratio. It didn’t spill yesterday–the jar broke! Nora opened her lunch box to cream and broken glass. Yikes.

The school called me, but I was teaching and my phone was off. They called Ted next, who was much more clever than I would have been. When I heard their message I was ready to jump on my bike and get new cream over there. Luckily I called the school back first and found out that it was taken care of.

When Ted got the call, he asked if they had any butter at the school. They did not (really? not part of a healthy school lunch, I guess). The secretary suggested that they have olive oil in the teacher’s break room, so Ted calculated that 2 teaspoons of olive oil would do the trick. Nora wasn’t happy about it, but she took it and no one had to leave work.

On a related note, we still have not made a formal 504 plan with the school. The nurse has not contacted me about it again, and in the rush of daily life I have not pushed it. It is comforting to know that her teacher (who was part of the chain of command) and the school staff were aware of her needs and worked with us to find a solution.

Nora also had her routine blood draw yesterday for Monday’s keto clinic appointment with Dr. Wray. Ted took her in when the lab opened at 7:30, so she was a little late to school. When she came into her classroom some of her friends came over to give her hugs and brought her to the rug where they were singing and dancing their morning songs. Ted left with a warm and happy feeling about Nora’s school. That’s another wonderful kind of peace of mind.

Many thanks and muchas gracias to the wonderful people of Garfield school who take care of Nora every day!

Oregon Keto Kids

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Monthly Archives: December 2013