Working in partnership with:

Dorset County Hospital

THE PEASANT EVOLUTION RENAL FRIENDLY RECIPES

Jyoti Fernandes & Renuka Coghlan

Kevin likes bread, cakes and craves cherry tomatoes and melon.

David chose his favourite foods; multi seeded breads, cherry tomatoes, pickled anchovies and parmesan cheese.

Denise’s favourite foods were chicken, bacon, oatmeal and nutty bread. She also likes mushrooms.

Chris craves bananas but has not eaten any since starting dialysis which was many years ago. He also loves rhubarb crumble, dumplings, stewing steak, carrots and onions.

Gary too loves bananas, steak and kidney pudding and not forgetting Cornish pasties which serves as a tasty snack when on dialysis.

This recipe book is the culmination of the ideas and suggestions made as part of “Blood Makes Noise”, a film by Peter Snelling and a cooking project where people on dialysis worked with Jyoti Fernandes, a local chef and one of the founders of the Peasant Evolution (who grow local organic food in Dorset).

A group on twilight dialysis at Dorset County Hospital came up with a list of their favourite foods and of course some on their ‘wish list’ were high in the potassium, phosphate or salt that they believed they should avoid completely. However Jyoti used her culinary skills to come up with some tasty recipes and together with the specialist knowledge of Renuka Coghlan, renal dietitian, ensured they were suitable for all renal patients.

In the end everyone involved in the project was invited with their family to join Jyoti and the project team in a ‘Cooking with Jyoti’ evening where we all cooked some of the dishes you see in this book. At the end of the evening we all sat down to a sumptuous meal.

The recipes allow you to make a range of meals and snacks that are tasty, flavoursome, fit in with dietary prescriptions and hopefully inspire you to make your own renal friendly recipes.

“I would advise people starting dialysis not to worry too much because it is not as bad as you assume. It becomes a way of life.” Dialysis patient

Introduction

Watch Blood Makes Noise online at www.mypockets.co.uk/bloodmakesnoise

Snacks

Bruschetta page 1

Baba ganoush page 1

Mains

Beef stew & dumplings page 2

Goan pan fried mackerel with lime, mint & cucumber page 3

Pasties page 4

Risotto with peas and parmesan page 5

Salads

Tabouli page 6

Carrot salad page 6

Leek vinaigrette salad page 7

DessertsDorset apple cake page 8

Eton mess page 9

Pear tart page 10

Quick banoffee pie page 11

The recipesAll recipes are suitable for renal patients.

Salt: The savoury recipes are reduced in salt with no salt added in cooking. The flavour of the dish has been enhanced by using fresh herbs, spices and low salt stock cube if needed. Renal patients are advised to reduce their salt intake to 5 grams daily. The recipes are all low to medium in salt.

Potassium: It is important to keep to your allowance of potassium as advised by your dietitian. The recipes are analysed to show the amount of potassium per portion. The savoury dishes can be served with a portion of vegetables.

Phosphate: The total amount of phosphate per portion is provided for each recipe. If you have been prescribed a phosphate binder, remember to take this. You may also need to take a binder with some of the snacks. As a rule if the recipe contains more than 50mg of phosphate it requires a binder.

Protein: Your protein intake is individual for you and calculated by your dietitian. The recipes included can be a main meal or snack.

Please see the table on page 12 for a breakdown of all the recipe’s nutritional content (salt, potassium, phosphate, protein and energy).

page 1

Ingredients 2 thick slices French stick / Ciabatta bread1 teaspoon olive oil

For the tapenade:2 marinated or tinned anchovies (5 grams)4 cherry tomatoes (40 grams)Freshly ground black pepper to tasteFresh thyme or marjoram leaves to garnish

Bruschetta Servings 2 Servings 12

Ingredients 650 grams auberginesJuice of 1 lemon2 garlic cloves

3 tablespoons chopped mint or flat-leaf parsley2 tablespoons extra virgin olive oil

Method• Cut the aubergines in half lengthways, drizzle with olive oil and

roast in the oven or on a gas hob until soft.

• Allow to cool then scoop out the flesh in long strands, discarding the skins.

• Add the lemon juice, garlic and two-thirds of the chopped herbs.

• Mash the aubergines gently with a fork until it is a little creamy.

• Top with the remaining herbs.

• Pour a moat of oil around the edge and serve with the flatbreads.

Method• Drizzle the olive on the bread.

• Finely chop the tapenade ingredients together.

• Lightly spread the tapenade on each slice of bread and bake on a low setting in the oven until crispy. Remove from the oven and garnish with thyme or marjoram.

*Note; This tapenade mixture with a pinch of saffron or turmeric can be added to a serving of boiled cauliflower or courgettes to give it extra flavour.

Baba ganoush, aubergine dip

page 2

Ingredients 100 grams raw onions diced125 grams green pepper1 tablespoon olive oil1 tablespoon flour400 grams diced beef4 garlic cloves finely chopped1 teaspoon redcurrant jelly2 bay leaves5 juniper berries125 grams of boiled sliced carrot 125 grams of boiled green beans

For the Dumplings:50 grams vegetable suet 100 grams flour1 teaspoon thyme and rosemary

Method• Sauté onions and green pepper in the olive oil.

• Toss the beef in flour and spices and then add to the onions and pepper. Brown the meat well.

• Add enough water to cover the beef and cook on low heat at 140°C/275°F until beef is tender.

• In a separate pan boil the carrots and green beans.

• Drain and then add to the stew.

For the Dumplings

• Mix all ingredients and form into balls the size a golf ball.

• Place the dumplings on top of the stew, put the lid back on and allow to cook until the beef is ready.

Beef stew and dumplings Servings 4

page 3

Ingredients 300 grams fresh mackerel fillets1 tablespoon vegetable oil1 teaspoon lime juice¼ teaspoon ground roasted cumin½ teaspoon brown sugar5 grams chopped fresh mintPinch of dried chilli or a little fresh chilli to taste50 grams of cucumber

For the spice mixture:2 teaspoons white vinegar¼ teaspoon red chilli powder1 teaspoon black peppercorns1 teaspoon coriander seeds½ teaspoon cumin seeds6 cloves of garlic¼ teaspoon turmeric powder

Method• Blend the spices and vinegar to a smooth paste.

• Marinate the fish in this mixture overnight or for a few hours.

• Pan fry the fish in the oil until the skin is crispy and the flesh turns white.

• Grate the cucumber and remaining ingredients for the garnish. Sprinkle on the cooked mackerel and serve.

Goan pan fried mackerel with lime, mint and cucumber garnish Servings 2

page 4

Ingredients Making pastry is very simple, but if you prefer you can use ready made short crust pastry, however this is higher in phosphate.

For the filling:100 grams raw onion diced1 tablespoon vegetable oil250 grams minced beef125 grams boiled diced carrot125 grams boiled diced swede 125 grams boiled peasdash of Worcestershire sauceMixed herbsBlack pepper to tastePinch of nutmeg

For the pastry:110 grams plain white flour.55 grams vegetable margarineCold water to mix

Method• Heat the oil and sauté the chopped onions.

• Add the minced beef and brown well.

• Boil the diced carrots, swede and peas and add to the minced beef.

• Divide the pastry (see recipe below) into 4 equal balls. Roll each ball into rounds the size of a saucer.

• Divide the meat mixture between each pastry round putting the filling in the middle.

• Fold the other half of the pastry over, crimping the edges together to form a tight seal.

• Place on a greased baking sheet of grease proof paper and bake at 220°C /425°F for 45 minutes until golden brown.

For the pastry

• Place the flour and vegetable margarine in a bowl. Rub the fat into the flour until the mixture resembles fine bread crumbs.

• Add 2 teaspoons of cold water to the mixture and mix to form a dough, adding more water if needed.

• Wrap the dough in cling film and chill for at least 15 minutes before using.

Pasties Servings 4

page 5

Ingredients 100 grams raw onion diced1 teaspoon olive oil250 grams risotto rice - Arborio rice1 low salt stock cube600 millilitres water20 millilitres white wine100 grams boiled peasBlack pepper Wedge of lemon20 grams fresh parsley or basil for a garnish20 grams parmesan cheeseThyme Rosemary

Method• Sauté the chopped onion in olive oil. Add the rice

and stir so the grains are well coated with oil.

• Dissolve the stock cube in the water. Add this very slowly to the rice stirring continuously to prevent the rice from sticking.

• Add the white wine towards the end when most of the liquid is absorbed.

• In a separate pan boil the peas and add to the rice at the end.

• Garnish with black pepper to taste, a squeeze of lemon juice, parmesan cheese and fresh herbs.

This dish can be served with roast meat or fish. The risotto is a good alternative to potatoes as it is lower in potassium.

Risotto with peas and parmesan Servings 4

page 6

Method• Pour the boiling water over the bulgur wheat. Stir well and leave

until the water is completely absorbed.

• Mix in finely chopped herbs, lemon juice, oil, pepper, cucumber and tomato.

Ingredients 200 grams fine bulgur wheat200 millilitres boiling water150 grams fresh parsley50 grams fresh mint4 tablespoons lemon juice1 tablespoon olive oil

4 cloves of garlic – crushed100 grams finely chopped cucumber50 grams finely chopped tomatoBlack pepper to taste

Ingredients 225 grams of raw carrots grated75 grams finely chopped apple10 grams currants1 tablespoon lemon juice or cardamom infused white wine vinegar

Method• Mix the grated carrots, chopped apples and sultanas in a bowl.

• Add the lemon juice or the cardamom infused white wine vinegar. Add pepper and fresh herbs to taste.

Tabouli Carrot saladServings 6 Servings 4

page 7

Ingredients 400 grams boiled baby leeks - cut into long strips1 teaspoon olive oil1 teaspoon white wine vinegar½ teaspoon French mustard

Method• Cut the leeks into long slices and wash well.

• Boil in unsalted water for a few minutes until al-dente. Drain.

• Mix the olive oil, vinegar and French mustard. Drizzle onto the leeks and serve while still warm.

Leek vinaigrette salad Servings 4

page 8

Ingredients 175 grams plain flour125 grams sugar1 teaspoon baking powder1 teaspoon cinnamon powder125 grams grated raw carrots250 grams chopped cooking apple1 egg3 tablespoons sunflower oil1 teaspoon vanilla essence

Method• Mix flour, sugar, baking powder and cinnamon

into a bowl.

• Stir in the grated carrots and chopped cooking apple, mix well.

• Stir in the egg, oil and vanilla essence.

• Line an 8 inch baking tin with grease proof paper

• Spoon the cake mix in and bake at 225°C /440°F for approximately an hour.

• The cake is ready when a clean skewer inserted in the centre of the cake comes out clean or the cake feels springy to touch.

Dorset apple cake Servings 6

page 9

Ingredients 175 grams caster sugar3 large eggs whites200 grams strawberries 130 grams raspberries120 grams tinned peaches drained570 millilitres double cream

Method• Pre heat the oven to 150°C or 300°F .

• Have the caster sugar measured and ready in a bowl.

• Place the egg whites in a scrupulously clean bowl and whisk until they form soft peaks that slightly tip over when you lift the whisk.

• Next, add the caster sugar, about a tablespoon at a time, and continue to whisk until each table-spoon of sugar has been thoroughly whisked in.

• Take rounded dessert spoonfuls of the mixture and place them in rows on the lined baking tray (lined with greaseproof paper). Place the baking tray in the oven on the centre shelf, turn the heat down to 140°C /275°F and leave the meringues there for 1 hour.

• Turn the oven off and leave the meringues in the oven to dry out overnight, or until the oven is completely cold.

• Whip the double cream, mash the meringues, add the fruit and serve in sundae dish. Garnish with a few berries.

Eton mess Servings 6

page 10

Ingredients 500 grams puff pastry800 grams tinned pears in light syrup drained100 grams sugar1 vanilla pod halved lengthways with seeds scrapped out50 grams butter

Method• Roll out the puff pastry into a rectangle or circle to

fit on top of the dish you are using for the pears.

• Boil together the sugar, vanilla and butter to make a caramel sauce.

• Butter the base of the oven proof dish. Pour the caramel sauce to cover the base. Place the tinned pears on top of the sauce, overlapping the pears if necessary.

• Drape the pastry over the pears, then tuck the edges down the sides and under the fruit.

• Bake in an oven at 180°C/ 356°F for 15 mins. If a lot of juice bubbles up the side of the pan, pour it off.

• Reduce the temperature to 160°C/ 320°F and bake for 15 mins more until the pastry is golden brown.

• Leave the tart to stand for 10 mins, and then invert it carefully onto a serving dish. Serve with cream or fromage frais.

Pear tart Servings 6

page 11

Ingredients 125 grams crushed digestive biscuits50 grams butter melted200 grams custard120 grams sliced banana150 grams whipping cream1 teaspoon of finely grated chocolate to decorate

Method• Tip the biscuit crumbs into a bowl add the melted

butter and mix well.

• Spoon the crumbs in a buttered tin or a ramekin dish. Chill for 10 minutes.

• Mash of the banana and mix with the custard. Spread on the biscuit base.

• Add the whipped cream on top of the custard.

• Garnish with the left over banana and a light dusting of grated chocolate.

Quick banoffee pie Servings 6

page 12

’Blood makes Noise’ was a project undertaken by the Arts in Hospital programme at Dorset County Hospital which worked with patients on dialysis in Dorchester. The project was funded by the Welcome Trust and British Kidney Patients Association (BPKA). The project had a special focus on the relationship between diet and kidney disease. The arts were seen as a way of engaging patients in self expression as well as addressing the difficulty around maintaining diet and fluid restrictions.

Nutritional analysis of recipes

Portion grams

Recipe per portion

Protein grams

Potassium millimoles (mmols)

Salt grams

Phosphate milligrams/millimols

Energy kcals

108 Quick banoffee pie 3 4 0.5 69/1.7 310

242 Pear tart 5 4 0.6 60/1.5 483

215 Eton mess 4 5 0.1 72/1.8 617

130 Dorset apple cake 4 4 0.2 115/2.8 269

103 Leek vinaigrette salad nil 4 negligible 33/0.8 34

80 Carrot salad nil 4 negligible 12/0.3 34

107 Tabouli 5 10 negligible 149/4 153

124 Risotto with peas & parmesan 7 5 0.1 168/4 303

Pasties 16 9 0.3 152/4 385

184 Goan pan fried mackerel 28 12 0.2 319/8 351

233 Beef stew & dumplings 26 15 0.2 258/8 407

30 Baba ganoush neg 2 negligible negligible 5

145g Bruschetta 12 3 2 (high) 134/3.3 338

Photography by Peter Snelling, Renuka Coghlan, Jyoti Fernandes and Alex Murdin.

25 YEA

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25 YEA

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Arts in Hospital is a charity dedicated enhancing the healing environment. Find out more and get involved at www.dchft.nhs.uk/about/arts.html

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Charity registration no. 1056479