Health Food

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NHS MenueNo blog at the weekend because I had an unexpected trip to hospital with an attack of my old foe, biliary colic and ended up admitted for four days to make sure it wasn’t anything more serious than some seering pain. Luckily it wasn’t, although since I haven’t had a gallbladder since 1997, it’s a tad alarming that I’m getting pain in the area. I foresee even more medical appointments in my future.

Being a chronically ill person I am a bit of an expert on NHS appointments and by extension, since I think of little else, the food associated with the NHS. I attend no less than four hospitals in South London as an outpatient and have long since jokingly thought about blogging their lunch options for other who will be visiting too.

I haven’t had to be an inpatient since I moved to London and the last few times I was in hospital in Belfast, I’m not sure I was well enough to actually eat anything so I’ve not been sure if the unflattering comments about hospital food are still true.

At one point over the weekend, I wasn’t sure if I’d get to test the theory as I was both nil by mouth for three days and had zero appetite. I studied the five page hospital food menu in the abstract way you might with a guidebook for somewhere you’ll never visit and dreamed of a glass of ice cold Diet Coke with lots of lemon instead to quench my thirst.

However eventually I was allowed to start eating again and I started paying attention. King’s College Hospital offers the above five page menu to all patients, along with halal, kosher, Caribbean, gluten free and dairy free options, low residue and renal safe diets. They feed thousands of people a day, most of whom are homesick, ill and in need of some cheer as well as nutrition.

The menu was surprisingly comprehensive and packed with choice. There were no less than 7 vegetarian options and at least 3 that were vegan. There was curry, roast dinners, lots of fish and a mix of the light and easy to eat and the heartier for building people back up again. They’d tried to sign post everything possible to help you make good choices as they need you to eat no matter what it is.

They’d thought of pretty much everything in fact. Except what to do if someone came in and needed a low fat Fodmap friendly option like I did. Onions and garlic are my current kryptonite and I didn’t wish to aggravate issues further by risking them. But my inner Brit came out and I felt really awkward stopping a busy nurse to ask her to help pick out allium free options.

I need not have worried. The nurse was fantastic and we had a bit of a giggle about my digestive diva-dom and she then took the time to phone catering to ask them about the ingredients. They then went through ALL the options to let me know what was safe. We established all the soups had onions and that the fish dishes were all without and I was able to order cod in parsley sauce with carrot and swede mash with potatoes as my first meal in nearly 4 days and they brought it to me two hours early since I was so faint feeling at this point.

And you know what? It really wasn’t bad. Yes, it was the tiniest piece of fish I’ve seen in a long time, but it was hot, fresh and actually tasted of its component parts. The potato was real mash not reconstituted and the carrot and swede had just enough of that catering texture to be oddly comforting.

Both King’s and St Thomas’s Hospital are distinctly old fashioned these days and don’t have any fast food outlets on the premises, running central kitchens and a daily canteen for staff, visitors and patients where everyone eats the same food. I’ve been attending regular appointments weekly at St Thomas’s and eating lunch in their canteen and the price of a central London sandwich meal deal have been able to have a proper fresh hot meal rather than a limp sarnie.

There’s a touch of the school dinners about it as there’s vast portions of custard and crumble available everyday, but beyond that, it’s actually pretty good. You can have freshly cooked omelettes with your choice of filling, use the salad bar or soup or have one of five hot options which range from Cornish pastie and chips to fish or noodles.

Aside from the food, my favourite bit is that you can sit in the dining room overlooking the Houses of Parliament, Big Ben and the Thames in possibly the finest view in London and watch a vast mix of people eating. Few things sum up London’s multiculturalism better to me than watching people of all races eat jollof rice with baked beans on the side and apple crumble for afters or a halal British roast dinner without batting an eyelid about it. Food here makes everyone the same and the atmosphere in both the dining room and the hospital is calmer than at a hospital like Guy’s where everyone has to go to McDonalds for lunch.

I understand the NHS has had to try and make money from commercial outlets coming to them and there’s many time I’ve been grateful for a branch of AMT or an M&S cafe to grab a coffee or tea when the canteen is shut, compared to the vending machines at the Maudsley. Yet I do worry that by turning food into a business transaction in a hospital or solely a nutritional aim like with the Eatwell plate the NHS promotes, it misses a crucial point of how food nourishes us. We need to combine it with being sociable and comforting and filling for it to have the best effect.

Choice within a structure here actually makes that easier to achieve so that people can seek out what they need at that time. Hospitals can take away independence so the highlight of the day is choosing your own lunch, but there’s something comforting to me about the NHS offering you options within reason like your parents did when you were a kid. Yes, sometimes you could stuff yourself on cake but other times, you had to choose which vegetable you were going to have.

The old fashioned centralised catering idea I’ve been eating at recently provides this caring choice perfectly and made me feel like someone was looking after me. I might have felt less so if I’d been eating poor quality slop dumped on a plate and wheeled round miles of wards before it got to me so it was cold and congealed like much hospital food still is. King’s steams all the food on the wards so it’s hot and fresh and they clearly use identifiable ingredients rather leaving you wondering if you’re eating horse in everything.

I think this style of cooking and eating is healthier in all senses of the word. All but one woman on my ward was very happy to eat the food provided, and frankly I’ve never met anyone so hard to please in my entire life. The nursing and catering staff attempted to answer every question and encourage you to eat, making tea and coffee to exact specifications, offering you several types of jam with your toast and providing biscuits from a local bakery for afternoon tea. They then ate the same things as we did.

I hope this experience wasn’t an outlying one and that more hospitals are starting to see the value rather just the costs of food for both staff and patients rather than simply renting their lobby out to Maccy D’s and Starbucks. I know the staff struggle to find more than lattes and biscuits on nightshifts and welcome the communal spaces with microwaves that St Thomas’s  offers everyone for their use.

Ironically now I’m home, I’m probably not going to be eating quite as well as I’m mainly existing on toast and microwaveable rice as I don’t have much appetite and have to be low fat and bland for a week or so. I think the slow cooker will be pressed into action tomorrow when I feel a bit more like getting out bed. My friends have been terrific, but sadly none of them has an extensive menu of tinned fruit about their person like the NHS offered me thinking it’s still 1972….

Slow Cooker Matchmaking

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slow cookers

So you’ve decided to buy a slow cooker? Welcome to the least time consuming cult in the world. We find time to put our feet up (at least metaphorically) and get on with all the other stuff we love in life and then sit down to a proper meal at the end of it. I particularly love the low washing up levels that accompany it.

But what do you do if you’re still standing on the side of the fence with the stove and saucepans, looking forlornly at a dish needing steeped and don’t know which toe to dip in first to join Club Slow Cooker? I’ve got some advice for you here so you’re ready to start using the recipes in Slow Cooked.

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Creating Slow Cooked

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book cover

I’m not sure I’ve mentioned this before now or anything, but I’ve written a book! You’ll have to forgive me getting meta and writing about writing a book but I’m still in post book writing withdrawal and indulging myself with as many blog posts as possible before Slow Cooked comes out on November 6th.

After people congratulated me on the book deal (and believe me, nothing gets people more excited than a proper paper book even in these days of blogs and e-readers), they generally wanted to know two things. Firstly, how do you get published and secondly, how do you actually write a book from scratch?

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Pork, Plums and Fodmaps

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pork-fillet-plums-tweaked2I have a notoriously delicate constitution. My innards tend to react like an angry toddler needing its bedtime over all kinds of things. Some of it is because I am an expert maker of gallstones (despite having my gallbladder removed when I was 18) leading to my digestive system reacting  angrily to say the least. I’ve done a lot of exclusion diets in my time.

There was the post cholecystectomy low fat diet that meant all I could safely eat without a trip to A&E was bread and jam which in turn meant having to do a candida exclusion diet. Not only am I prone to yeast issues in my gut but because it was the mid 90s and it was the current solve all your internal ills idea at the time. I also dabbled with wheat and dairy free for a while and didn’t achieve much effect apart from sending myself gently bonkers around food. I’m sure I’d have excluded gluten too if I’d heard of it then.

I thought I’d just have to put up with feeling terrible all the time and existing on a heavy routine of peppermint oil capsules and mint tea and then I saw a new and wonderful gastroenterologist about some other gallbladder related issues you don’t want to read about over breakfast. While not denying I had a problem, he mentioned that about 80% of his current caseload is down to three things: poor gut flora, Chorleywood bread and Fodmaps.

The first, I know well. The second makes sense since it relies on underproving yeasts and gluten and making bread much harder to digest. The third? I had no earthly idea what he was on about. But I trusted him (I should, he swears like a sailor on shore leave, keeps a sourdough starter in his office for patients and is Michael Mosley approved, all on the NHS no less) so I went off and looked these Fodmaps up.

Discovered by Monash University in Australia, it identifies that there are certain sugars and carbohydrates that the human body finds hard to digest leading to problems. These are the Fermentable, Oligo, Di and Mono Saccharides and Polyols the diet is named for. Often confusing for people because many healthy foods are an issue, it’s a complicated diet that should only ever be undertaken with the help of a trained medical professional, hopefully via the NHS these days,

However it’s worth looking into doing it if you find you have issues after eating wheat or rye, all dairy products not just lactose based ones, certain fruits and vegetables, especially onions and garlic or pulses beyond the normal response to large amounts. Meat substitutes like Quorn can only be a big Fodmap trigger. People are further confused by Fodmaps because everyone’s tolerance is different. I am absolutely fine with wheat (and other members of the galactan family) and have no issue with lactose.

Yet give me a fructan in the shape of an onion or garlic especially and I am utterly miserable. My problems are compounded by the fact I am also fructose intolerant so react terribly to high fructose fruit, any kind of fruit juice and anything like agave syrup that’s high in it. It’s best to only consume fructose when it comes with the natural fibre of the fruit to prevent overloading your system but for fructose malabsorbers like me, any amount is difficult. A glass of orange juice or a whole apple will be both cause my mouth to swell and break me out in a sweat and itchiness. I suspect many people have this issue these days but have simply never heard of it. Innocent times. Literally.

I have to be incredibly careful in what I eat so that I don’t end up lying down feeling faint and bloated at best or triggering off my more intense bowel issues. Fruit and pulses are occasional treats for me (which is why I become murderously annoyed when people tell me how great lentils are when you are poor) and alliums are to be eaten only when I can’t avoid them and can be alone soon after. I will never eat a Jerusalem artichoke or chicory root or take a prebiotic again as they contain inulin, a form of indigestable fibre that is problematic for everyone but triggers debilitating biliary pain for me. Read more

Dos and Doughnuts in the Kitchen

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beaters

As I’ve mentioned in a few posts this summer, I haven’t been spending huge amounts of time in the kitchen. My cooking mojo seems to have taken the holiday I haven’t and I’ve not been venturing much beyond finally getting my (non cream based) carbonara just right, breaking records for the number of frittatas one person can eat and eating lots of salad and fruit. So when I was invited to a Bank Holiday picnic it seemed like the time had come to start making a bit of an effort again.

In between not cooking very much and buying eggs in such numbers my local shop actually laugh at me, I’ve also joined Instagram. I’ve really been enjoying it, finding it complements Twitter nicely. I expected it to be about 50% photos of cats and kids but surprisingly there are few of either. What there are a lot of are photos of doughnuts.

London is in the grip of doughnut mania. I know they’ve been gradually making their way from cop show cliche to food blogger fascination for a while. St John started their journey from Krispy Kreme kiosk to the current in-thing (with a little help from The Faerietale Foodie) but call them beignets, donuts or gravy rings, they are everywhere this summer.

Inspired by the reverence with which doughnut fiends speak of Justin Gellatly, formerly of St John Bakery and now of Bread Ahead in Borough Market and because he’s a fellow Ebury author, I thought I would make his legendary recipe for doughnuts and fill them with a wonderful this lemon ricotta semolina custard by Ruby Tandoh. Her custard slice recipe with this is peerless and I needed an excuse to make the filling again.

I almost instantly ran into a problem with Justin’s recipe. It called for fresh yeast and at 8pm on a Friday night, that’s not something I could lay my hands on easily. I subbed in half the amount of dried active yeast by adding it to 50ml of the water required in the recipe and allowing it to bubble for 15 minutes before I started mixing.

And there in lay the second problem with the recipe: the mixing. It called for a stand mixer or Kitchen Aid and involved almost 20 minutes of active mixing in stages. Thing is, I don’t have a Kitchen Aid mixer and I have a serious hump about the number of recipes by big name authors and cooks these days that assume the majority of people own a piece of kitchen equipment that start at £300 and are the size of a small Sherman tank.

I’ve lost count of the number of the TV chef recipes (yes, I am looking you Ms Pascale and Mister Oliver. Stay behind after class please) that tell you to buck everything into the mixer bowl, turn it on and come back after a certain amount of time. At risk of sounding decreipt and resistant to change, getting a machine to do it all for you isn’t cooking to me, it’s assembly. Where is the education? The cues to look for? The touch, taste and feel of food? The explaining why you do something? The alchemy when it comes together?

It’s as sanitised as those supermarket ‘just cook’ ready meals that feature a chicken breast, a sachet of sauce and suggest the veg on the side. One step up from simply piercing the plastic, they are cooking at the most basic level of the word. I see nothing wrong with a proper ready meal, but something about simply preparing components with emotional detachment but calling it cooking bothers me. Even with the slow cooker, I avoid this style of just warming ingredients up, making simple, quick dishes that are still actively cooked and created in a method that teaches and engages you with your food and a specific method of cooking.

I’m well aware some of this resentment of Kitchen Aid cooking comes from the fact I can’t afford something that cost more than my washing machine (and that I haven’t had the chance to slip onto a wedding list yet) and that I’ve never really found a time when it would be properly worthe the cost and storage space. But most it comes from the annoyance that as I work hard to learn to write recipes that both work and teach people to cook, many big names take the path of least resistance and education (or effort.) It doesn’t take much to do a Nigella and give non machine methods alongside.

This isn’t to say that I’m a Luddite who does everything by hand and owns a mangle (although my dad owned a car that had to be hand cranked sometimes when I was a kid…) I love my stick blender and its little chopper bowl attachment. Clearly I’m a bit obsessed by slow cookers. I can completely understand why people with limited time, energy or grip use food processors or breadmakers. But I still like to get involved with my food and feel and see the changes rather than let something else take all the strain and responsibility all the time.

So having started making the doughnuts, I mixed mine with my electric hand whisk. The beaters simply created something akin to a dough tornado and did little. I used the dough hooks and mixed and mixed and mixed. I’ve made marshmallows quite a few times and they were as easy as falling off a log in comparison. Standing holding the electric whisk and beating the dough endlessly made me consider trawling Gumtree for any unwanted stand mixers as my arm hurt and my hands cramped.

However all the buzz told me Justin Gellatly’s doughnuts are the best in the world, so I thought it would be worth it. The fact the dough was both sticky and greasy wasn’t worrying me too much. It had to chill overnight after all so that would sort the Copydex texture, wouldn’t it?

Sadly no. Next morning the dough was just as greasily elastic and globular as the night before. The only hint in the recipe was that it should be smooth and elastic and as it was both those things as well I was baffled. This is where I needed the explanation of the sensations of cooking not just an instruction manual on timings. I know Justin is a commercial baker and uses machinery, but if you’re writing books for home cooks, that’s not much use to me.

I stickily rolled them into balls and proved them them again. Instead of looking taut and tight like Justin advised they were slacker and softer than one of my thighs and when I obeyed the instruction to cover them with clingfilm, they stuck to it like a clingy child and had to prised apart.

Getting them off the floured trays and into the oil was a disaster. They expanded into strings like cheap mozzarella, sticking first to me, then to the scraper, then to the side of the pan and finally flopping wetly into the hot oil and puffing up momentarily before subsiding into a lopside comma shape. I tried five of them, each one getting worse and more oil logged than the previous one before I gave up.

I’m genuinely not sure which of us was more deflated by the experience. Despite getting my oil to exactly 180℃ as per the recipe, the shape shifting of the doughnuts meant the outside was Snog Marry Avoid contestant tan while the middle was gluey white. The cooked bits were as bready as Mother’s Pride and even dipped in sugar, tasted bland. I threw the other 15 lumps of squish in the bin and went to M&S to stock up on dulce de leche teacakes instead.

Instinct tells me it was probably the change in yeasts that was the problem, compounded by the inability to mix the dough like instructed, but the whole experience left me frustrated. It’s a complicated recipe but relying on a costly piece of kit and a difficult to obtain type of yeast with no allowance for home cooking, irritated me. Quite simply why write commercial recipes for home kitchens without an attempt to adapt?

Am I being harsh? Or should recipe writers have a duty to cater to the majority of their readers without explicitly explaining why you need a certain piece of equipment? And does it annoy you when only the mechanical version is given or am I the only person in town still doing it the old fashioned way?