Rice-topped Shepherd's Pie (dialysis diet)

This one is mostly for me. I originally started this blog as an easy way to share the couple dozen recipes I recommended frequently to people who needed to prepare meals in advance, but it's also been useful for me to document how I've changed recipes that I want to make again.

So this is one of those recipes.  It's from a cookbook called Cooking for David that provides recipes for folks on dialysis.  I'm cooking for a loved one who has been experiencing worsening chronic kidney disease (CKD) and is now receiving dialysis treatments.  Side note...Boy, have I learned about food and the kidneys lately.  Lemme tell you, if you've been diagnosed with diabetes (and CKD is likely in your future if you have poorly managed diabetes) and think the diabetic diet is restrictive, that's NOTHING compared to the CKD/dialysis diet.  Keep your kidneys (and pancreas) healthy people...life is not fun when they don't work.

So back to the recipe...you don't futz with dialysis recipes.  This is so hard for me.  There's a pretty strict limit on potassium and phosphorus intake, in addition to sodium, protein and liquid limits and it's different for each patient.  Unfortunately, potassium and phosphorus are nutrients that aren't required to be listed on nutrition labels the way sodium, carbohydrates, protein and fat grams are so it's hard to know just how much you're getting unless you follow a tested recipe very closely or use a renal diet food analyzer like this one: http://www.davita.com/food-analyzer/

Also unfortunately, the foods that are high in potassium and phosphorus are healthy foods...whole grains, many fruits and veggies, nuts and beans, dairy products.  "Low sodium" products are also a minefield as most aren't simply made with less salt, but with a potassium salt substitute (not necessarily a bad thing for those of us with functioning kidneys...in fact here is a report of a study suggesting that more than high sodium intake alone, a combination of high sodium and low potassium puts you at higher risk for cardiac problems... but it's problematic for renal patients. Also a reminder that when buying packaged foods, "low" anything oftens means "substitute" rather than just "less" of whatever the reduced ingredient is).  So again, the takeaway is that you follow the recipe, don't add extra veggies (crazy, right?), don't substitute whole grain products and read labels.

Shepherd's Pie is a family fave here.  I was excited to see a kidney-friendly recipe that substituted low-potassium/phosphorus white rice for the usual high-potassium/phosphorus potato-cheese crust (did you know that a potato has more potassium than a banana...my dance teacher always said that, but I thought she was full of it).  It did use a lot of high-sodium sauce additions though..."no salt added" beef stock, additional beef bouillon granules, Worcestershire sauce, Kitchen Bouquet (who even has this any more anyway?).  I checked the labels on all my stock/bouillon/sauce options and settled on a vegetable base bouillon made without potassium salts and a healthy slug of red wine (which I also checked on the Davita food analyzer) instead of all that other stuff.  I made it with long grain white rice...I might try arborio rice next time for a creamier, more potato-y texture.

And so to bring it all back to where I started...my husband requested that I make a note of what I did so I can make this recipe again in the future...soon, preferably.  No pictures because I prepped it ahead for my family to cook on my late night at work.

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Risotto

I used shallots and celery for aromatics, tilapia for protein,
seafood stock, chopped fresh spinach for veggies, savory
for flavoring

I've worked with a delicious seafood risotto recipe for many years.  It's from a fundraiser cookbook called Dewey or Don't We published by the Dubuque Public Library.

I used to follow it to the T, and finally understood that really, it was more like guidelines (as so many recipes truly are).

And then I started being able to use the technique given in that recipe and substitute my own flavors and ingredients, depending on what was in season and available.

No matter what ingredients you use, this is definitely a prep-ahead-friendly recipe.  Chop and measure everything ahead of time, combining ingredients by category.  You can also freeze this as a meal kit...combine ingredients by category, put them in vacuseal bags or ziptop bags, and freeze.  Thaw before cooking.

The use-what-you-have components are:

• fat for sauteing: use butter, olive oil, canola oil, lard, mojo de ajo
• aromatics: use onions, shallots, celery, carrots, leeks or any combo thereof
• stock: chicken, seafood, veggie (not so much beef here)
• protein: fish, chicken, shrimp, scallops, crab (again, not so much beef)
• veggies: chopped bell pepper, snow peas, chopped greens, broccoli, peas, corn kernels, pre-cooked squash cubes
• flavoring: citrus zest, minced herbs

Some favorite combinations are shallots with shrimp, green peas and thyme; celery/onion/carrot with chicken, pepper and savory; crab, leeks, spinach and lemon zest.

Chop, measure, and fridge everything in advance for next-day or same-day cooking.  You can also freeze the components ahead.  To save space with liquids, either freeze wine and stock in ice cube trays beforehand to include in the freezer kit or pour the liquid into a ziptop bag, carefully press air out of the bag, seal and lay flat on a tray to freeze.

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Creole Risotto and How Your Christmas Lights Help You Prep Ahead

Finished dish with chicken and peas

I have a new cookbook (my Mother's Day gift to myself)!  It's a vintage cookbook called Scientific Cooking with Scientific Methods by Sarah E. Woodworth Craig, published in 1911 by Ellis Publishing Co (Battle Creek, MI).

It's chock-full of adverts for Vonnegut Hardware in Indianapolis (yes, *that* Vonnegut, though Vonnegut grandpère rather than Vonnegut grand-fils) and "scientific" culinary gems like, "Brain workers want to take easily digested foods, such as eggs, fish, etc. The laborer needs quantity, and can eat of corned beef, cabbage, corn bread and brown bread, and not overtax his digestion..."

As always, I wonder what of our current "known scientific truths" will seem quaint and outmoded in a few decades.

Outmoded though their musings on digestion are, I LOVE recipes from the pre-processed foods era.  In this instance, I'm combining one of the recipes with a previous Mother's Day gift (my rice cooker) and streamlining the recipe.

Rice cooker in foreground,
Christmas lights timer in background

I've been really into using my rice cooker lately as a prep-ahead tool in combination with...wait for it...my Christmas light timer.  Most rice recipes (the vegetarian ones) can sit out at room temp for a few hours before cooking without ill effects, but really can't sit around on "warm" all day without getting burned.  Enter the timer...  Rice cookers will generally cook white rice in 15-20 minutes, plus a few minutes cool-down time or brown rice in about 45 minutes with the same cool-down period.  Count backwards from your preferred meal time, and set your timer to start at the appropriate time.  Don't forget to set the rice cooker itself to "cook" even though it won't be kicking on for awhile.

Now the recipe...the original recipe calls for making a sauce of onions, pepper, mushrooms, sherry and tomatoes separate from the rice.  I sauteed the veg, added a splash of wine and added all this to the rice cooking liquid.  I used all mushrooms rather than a mixture of onion/pepper/mushroom because that's what I had on hand.  Use more veggies, less veggies, whatever works for you.

Also, be sure to use all the liquid called for even if it doesn't seem to jive with the rice cooker's notion of appropriate rice-to-liquid ratio...the volume of the sauteed veggies throws things off.

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Pumpkin Gnocchi

Gnocchi are sturdy little bite-size dumplings that are often made with mashed potatoes, but other veggies can form the basis for them too.  They usually have an egg as a binder, and I like that this recipe uses an alternate (therefore allergy-free and vegan) binder that takes advantage of leftovers, if you have leftover rice.  There original recipe comes from a PBS vegan cooking show called Christina Cooks.  I choose to serve mine with a non-vegan browned butter and sage sauce.

The tricky thing about this recipe is controlling for moisture content...you can't.  Your pumpkin may have more or less water than average, and even how soon you puree and use your cooked rice alters its moisture content.  I made rice special for this recipe and (as usual) made too much.  I pureed all the rice immediately (thinking I'd freeze some as "rice cereal" for the baby) and clouds of steam poured out of the food processor.  By the time I finished the gnocchi dough, the rice left in the processor was dry and sticky...I suspect that if I'd used the rice at that stage, I would have needed less semolina in my gnocchi dough.  I also suspect using leftover rice rather than freshly prepared hot rice would have had the same effect.  So the amount of semolina you use is very approximate...keep adding until it's the right consistency.

Which, by the way, is like a soft cookie dough.  You want the dough to hold together when you boil the dumplings but you don't want the dough so stiff that the dumplings are like concrete when you cook them.  So you want a dough that can be controlled with a light dusting of flour on your hands and work surface when you roll it out, but not as stiff as, say, a pie dough or cutout cookie dough.

And the semolina...I don't know if you could easily substitute regular wheat flour for the semolina flour.  They're both wheat products, but the semolina feels like cornmeal.  It's also a higher-gluten flour than regular all purpose flour.  You can't substitute cornmeal either because cornmeal doesn't form gluten bonds and therefore won't bind properly.  I didn't have a hard time at all finding semolina flour...it was on the baking aisle at my decidedly non-fancy grocery store with "specialty" flours.  Bob's Red Mill was the brand available.  For what it's worth, I've made other gnocchi-type dumplings before from different recipes that used regular flour and I thought they were heavier and chewier than the gnocchi I made with the semolina.

Lastly, this recipe calls for 1 cup pureed pumpkin.  I used canned pumpkin.  1 cup is about 1/2 a 15 oz. can.  I HATE having half-a-can of stuff leftover.  You could double up the recipe (especially since you can freeze the uncooked gnocchi!) or make pumpkin muffins, pumpkin seafood chowder, or pumpkin pancakes.  You can use homemade pureed pumpkin or I bet even other types of pureed squash though, again, these changes will affect the moisture content of the dough and change how much semolina you need.


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Broccoli Rice Salad

I spent part of a summer in France many, many moons ago, and to be expected, my culinary world was transformed by the exposure to French foods and French cooks.  However, not so expectedly, my favorite foods from this trip are the French gastronomic equivalents of PB&J (which they do NOT have in France)...ham and butter sandwiches, grilled sausage served in split baguettes instead of hot dog buns, salads made of a single perfectly ripe and lightly dressed vegetable, fresh-picked plums (oh the plums!), and rice salads. 

I was one of about a dozen volunteers, both French and de l'étranger , and we took it in turns to cook for the group.  Several times we had salads composed of rice mixed with leftover meats, black olives, chopped fresh onion and peppers, summer corn, and just about anything else that needed using up.  Like I said, it's not fancy food, but it was revelatory for me.  I had no idea leftovers could be, well, delicious!  It holds at room temperature very well, too, so it's an excellent potluck/pitch-in/picnic dish.

The transition between the tough, outer
layers and the tender, light green "meat"
is clearly delineated.

As implied, you can make a rice salad out of just about anything on hand.  A few cups of rice (even that can be a leftover), a couple cups of cooked chicken, beef, pork, canned tuna, salmon mixed with a couple cups of vegetables (fresh or leftover), any herbs that are handy, some olives or pimiento and a little bit of salad dressing is all you need. 

The following salad uses up raw broccoli stems and is a vegetarian/vegan (depending on the exact ingredients of your salad dressing) dish.  To peel the broccoli, cut the bottom inch or so of stem off.  Stand the stem on its "floret" end (after removing the florets for another use), and use a knife to slice the woody peel away.  Then shred the broccoli using a food processor or hand grater. 

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Rice Custard Pie

I read in a cookbook somewhere that you're not supposed to freeze custard pies.  Balderdash.  This pie freezes gorgeously, and doesn't require cooking once it's thawed.  You can also make the fruit spread and freeze that ahead of time to prepare the pie later which can in turn be frozen, in the event you need a really long time to make a pie...in which case I'd make two ;-) 

And for today's episode of "I Screw Up So You Don't Have To"...don't try to use brown rice here.  Just don't.  Even with extended cooking times, it won't absorb quite as much of the milk as white rice does, and you'll just get milk custard with little hard kernels of rice bran instead of the glorious creamy goodness that is rice custard.  Also use a deep die pie pan or a 10" pie pan.  This makes a BIG pie.  And if you forget to put the prune filling in the crust before pouring the custard, don't worry!  It's delicious spread on top of the pie as well.  I screwed up a lot.

Also of note, I am not a pie crust purist ::gasp::  Pillsbury makes a better crust than I do, so I let them do the work.  Feel free to make your own crust if you are a pie crust master and/or have something to prove.  Adapted from America's Best Lost Recipes.

Rice Custard Pie

Makes 8-10 servings

Prune spread:

1 cup pitted prunes

1/2  cup sugar

1 tbsp brandy, triple sec, bourbon, apple juice

3 tbsp water

2 tbsp brandy, triple sec, bourbon, apple juice

Place the prunes, sugar, 1 tbsp brandy in a small saucepan.  Bring to a simmer over medium-low heat and cook until prunes are very soft, about 20-25 minutes.  Transfer mixture to a food processor, and add 2 tbsp brandy.  Process until smooth.  Set aside or put in a freezer container to freeze for later use.

Filling:

1/2 cup medium grain or Arborio rice (WHITE ONLY)

1/2 tsp salt

1 3/4 cup water

4 cups milk

1 cup sugar

1 tsp ground cinnamon

4 large eggs (see American Egg Board size substitution chart if you have another size egg)

2 tsp vanilla extract

Bring water to a boil.  Add rice and salt, cover and reduce heat to medium-low.  Cook covered until rice is tender, about 20 minutes. 

Stir in milk, sugar and cinnamon and cook, stirring frequently, until rice is thickened and very soft, about 45-50 minutes. 



Properly thickened custard



Beat eggs and vanilla in a medium bowl.  Ladle 1 cup of hot rice mixture into egg mixture, whisking as you pour to avoid scrambling the eggs (this is called tempering).  Pour the rice-egg mixture back into the saucepan and cook 1 minute. 



Adding tempered eggs to custard



 

Pie:

Thawed prune spread

Custard

Single crust pie dough

Roll out pie dough to fit a deep dish pie pan or a 10" pie pan (if you're using store-bought crust, you'll need to roll it out a bit).  Spread room-temperature prune filling on bottom and sides of crust.  Pour custard into the pie crust.  Bake at 350F for 1 hour, until the custard is set in the center.  Refrigerate until chilled, at least 2 hours, before serving.  If planning to freeze, freeze pie uncovered for 1 hour.  Remove from freezer to wrap in a double layer of plastic wrap and foil, then return to the freezer to completely freeze.

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