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Any recipes for low Vitamin K casseroles for a neighbor on blood thinner?

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  • Rasam Dec 26, 2012 09:22 AM

Hi:
My elderly neighbors who are good people and good friends, one of them is now on blood thinners. So she has to eat very low Vit K. Green leafy vegetables, or any green ingredient (including parsley), seem to be out, as apparently are cauliflowers.

I was thinking of taking them a casserole, which is a dish I have almost no experience making, but I can deal with that.

I am more worried about making sure that I don't inadvertently include any high Vitamin K ingredient in the dish. One of the difficulties is that online resources, including those from reputable places like University Hospitals, sometimes disagree on ingredients' levels of Vitamin K, or leave out some ingredients I might think of including.

So, I was thinking of making a casserole containing:
chicken, artichokes, corn, embedded in a cream "sauce" of some kind, maybe including pasta (elbows or shells or orzo?), and topped with breadcrumbs. These ingredients (depending on the specifics of the sauce) should be OK.

Are there any hounds with experience with this diet, and can someone share with me a good casserole recipe that a) contains safe ingredients, b) likely to please elderly persons whose tastes are probably conventional, and c) not extremely complicated?

Thanks in advance

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  1. Here's a selection of recipes to give you some ideas:

    http://www.drgourmet.com/warfarin/war...

    1 Reply
    1. re: Jeri L

      Thank you, that's a helpful site. There is not much on it that resembles a 'casserole', but I don't have a very good grasp of what a casserole is, anyway.
      I will be able to figure something out from this I think, but if anyone reading this can tell me more about 'casseroles', I would be grateful.
      Thanks!

    2. That is a nice link that Jeri gave you. I took a look since I've cooked for special diets before, although not low Vitamin K.

      A casserole is usually a protein (although you can make them totally vegetarian), a starch, vegetables, and enough sauce to keep the dish juicy and not dried out in the final bake.

      I saw a Cream of Mushroom soup recipe under the soup category that might work for you for the cream sauce. I would definitely add a pasta to your ingredients and skip the corn (save for another time...too starchy, I find). But if you think they'd go for it, leave it in!

      I notice that several recipes call for tarragon which is a pretty strong herb, licorice flavor, so you might want to find out if your friends would mind this flavor. Also, I noticed that goat cheese is also mentioned a lot. That also might be something you would want to reconsider because you mentioned conservative tastes. But cheese doesn't have to go on everything.

      They list a tomato sauce which could be a sauce for your next casserole. There's a Chicken Parmesan recipe that looks good and a Chicken Pot Pie that uses cornmeal rounds (polenta) as a topper instead of pie crust. But you could totally cheat and add some gluten-free noodles. It wouldn't be pot pie, but it would come close to a casserole, and isn't that the whole point of this?

      Sounds like you're doing your homework. You'e a good friend and neighbor. Come back and report. I'm sure others can benefit from your knowledge.

      1. That's so sweet of you to cook for them. :)

        If I were cooking for a friend/neighbor, I'd probably make a dish I was familiar with; that way I'd know it came out as expected and taste correct. For example, the dish you suggest sounds like it could be tasty, but you'd need to know how the pasta added will cook up so that it won't end up a mush.

        Another pitfall is that many casserole recipes involve ingredients that add a great deal of salt -- and many elderly folks try to watch sodium intake. So keep an eye out for those.

        A reliable source for nutrient values is the Nutrient Database Lab, just plug in a food/amount:
        http://ndb.nal.usda.gov/ndb/foods/list

        And thanks for mentioning parsley and teaching me something today!.... seriously, I never thought of parsley as a green leafy and I guess I thought it was made of air. I certainly use plenty without thinking. :)

        1. Thanks for all the replies. Also, thanks to some Chow site tracking software, I found a slideshow to the right, titled "19 Casseroles for Cold-Weather Dining". I'll start with something from there (maybe Creamy Carrot Casserole), tweak it (e.g. make it much lower fat, add chicken), cross check the ingredients against the site Jeri L provided, substituting as necessary, and go from there.

          Instead of adding the pasta to the casserole, I may make the Cheesy Baked Rice as a side (again adjusted as needed). As suggested, I will lose the corn.

          There is also a Chicken and Artichoke Casserole recipe.

          Yes, DuchessN, parsley is an issue, as are thyme and sage (alas, as I had planned to rely on thyme for flavor but wont do that now). Spring/green onions are out, though regular onions are OK. Garlic seems fine. So I will stay with garlic, onions, salt and pepper.

          The low Vit K web sites say that it is important to be consistent in the amount of Vit K, and be low Vit K rather than zero Vit K, but I don't want to add anything iffy for the recipients to worry about.

          1 Reply
          1. re: Rasam

            Just FYI, the Coumadin-safe recipes in that slideshow are Root Vegetable Shepherd's Pie, Butternut Squash Lasagne, Cheesy Baked Rice, Creamy Carrot Casserole, Baked Ziti with Prosciutto, Chicken & Wild Rice Casserole, Bockwurst & Mushroom Noodle Bake, and Baked Chicken & Artichoke Casserole.

            Obviously if sodium or fat is a concern you'll have to choose or adjust accordingly, but in terms of vitamin K content they're fine.

          2. OK: urgent question, I hope someone sees this in time.

            I am making something like the Chicken and Artichoke casserole from the list of casseroles. I have a glass baking dish that is 6 cups, aka 1.6 liter capacity. It is 7X7 inches square, by about 2.5 in deep.

            It is now filled about 2/3 full with poached chicken pieces (I poached this myself, so there is no added salt here and it is flavored with onion, carrot, 1 clove garlic, 1 bay leaf, and a few peppercorns), artichoke hearts quartered (from a can), and a little carrot and onion.

            I now need to fill this baking dish up with the "background material" and then bake.

            I have 1 can Campbell cream of mushroom soup concentrate to hand. Shall I just add that in? Do I need to dilute this? Is the sodium content here just too much (I am sure my neighbors don't need a sodium bomb dish either) or is canned soup acceptable?

            If I don't use the canned soup, do I fry some butter + flour and add milk? I have read how to do this, but don't have a good idea of what the finished product should look like in terms of color and consistency (how brown? how thick?)

            Also, given the size of the baking dish described above, what quantity of butter+flour+milk should I use? Should I season this also with salt and pepper (the chicken has no salt, the canned artichokes have some, though drained).

            Thanks in advance!

            2 Replies
            1. re: Rasam

              Here's what I would do: Skip the canned soup. Make a little sauce (this is kind of a veloute): Melt 2 T butter, add 2 T flour, cook for 2 minutes while stirring constantly. Slowly add 1 cup chicken broth and 1 cup milk. Stir a lot and let simmer. Add a bit of lemon juice (or vinegar) and salt & pepper. Taste! This ought to do it. Hope this is in time and works for you!

              1. re: monfrancisco

                Thanks MonF: I did see this now.

                I can make what you say, and I assume this will give enough background filler for the dish I described?

                Will it thicken up further as I bake? Should I bake uncovered or covered? Since all the ingredients are cooked, I think I will need to bake only for about 20 minutes or thereabouts so that everything gets integrated?

                I have panko to cover the top. Should I toast the panko in a little butter before putting on top? I assume I will put the topping just before taking it to their house, i.e. not while baking.

                Thank you all so much!

            2. OK thanks everybody. I made the casserole (chicken+artichoke), with the steps described by MonF. The slurry thickened up really well.

              I think the recipients liked it.

              I think the next endeavour after a few days will be meatloaf, another item I have no experience eating or making, but what the heck. How hard can it be?

              Thanks again to all!

              2 Replies
              1. re: Rasam

                Plenty of help for you on the meatloaf front ;)

                http://www.chow.com/search?query=meat...

                1. re: Rasam

                  Well, you're more than welcome! Glad to hear it worked. People are so scared of gravy and sauce, but they're not such a big deal if you pay a bit of attention. (I made, broke, and fixed a Hollandaise this AM for example.) On to the meatloaf project! And all good thoughts to you for taking care of neighbors. Happy new year, M

                2. OK friends: meatloaf update.

                  I read the links provided and looked at a couple of youtubes and blogs. Head whirled.
                  Manged to distill the following principles:

                  1. Ground meat, must have a good percent of fat, not lean.
                  2. Mix ins: chopped vegetables (onions, carrots, mushrooms in this case).
                  3. Seasonings (salt, pepper, garlic other options ruled out due to recipients' health needs)
                  4. Eggs
                  5. Bread/breadcrumbs. Based on one recipe I used oatmeal powdered in the FP.
                  6. Glaze: begin with ketchup or tomato paste, and gussy with seasonings.

                  I used 1.3 lbs of what the supermarket called "meatloaf mix" - beef, pork, and veal.
                  I used 1 C oatmeal, then powdered it for breadcrumbs
                  1 medium-small onion, fine diced
                  Handful of carrots, ditto.
                  1 pkg (forgot to look at the weight) mushrooms, minced them.
                  3 cloves garlic, 1.5 tsp salt, 1 tsp pepper.
                  2 eggs whisked.

                  Mixed the above taking care not to overmix. Formed it into a loaf on a foil lined flat baking sheet, cooked at 350deg F for 30 mins, then painted with a tomato glaze (ketchup+veg approximation of Worcestershire sauce) and baked for another 20 minutes.

                  Well, I don't know. It was kind of loose still at the end.

                  Why do you think that was? Too much egg? Too little oatmeal? Loaf not firmly pressed enough? Too many mixins? Other ideas?

                  We delivered it to the neighbors and told them that it didn't look great but tasted good (brave husband tasted a few crumbs).

                  Odd thing I noticed: I have never made or eaten meatloaf before, and have not cooked or eaten meat for >15 years, and when I did before this, it was usually Indian food where the masala smell predominates and mostly chicken.

                  The smell of this meatloaf cooking was INTENSE. Just smelled like an ANIMAL. I knew enough to know it was not a smell of food-gone-bad, just the nature of the dish. Our poor dog almost went nuts with wanting (not getting because of the onion+garlic = bad for dogs, she has her own dog food). I left the hood fan running, but the kitchen and that part of the house still REEKS and I fear my clothes and hair may smell too.

                  This reminds me of people who cannot tolerate office or apt bldg food smells and usually complain (in the US) about Indian or SE Asian or Filipino neighbors. I found myself reacting in the same way to this meatloaf smell. Cooking the chicken based dishes for the neighbors was much easier.

                  In Indian cities there are some neighborhoods/apt bldgs where people try and forbid "non vegetarians" from renting/owning saying they want to be free from the smells of cooking meat, bones in the garbage etc (an issue in areas where solid waste disposal is not well done and rats, dogs, etc congregate around food scraps).
                  I do not approve of those ideas because those are code words for people of different religion and caste, leading to ugly forms of segregation. But just for a few minutes I can say I understand how awfully the smell of cooking red meat can strike a person who a) is not accustomed to it and b) has negative associations with meat eating.

                  I am surprised by this as I didn't expect this reaction in me.

                  ETA: my hand still smells, though I washed well afterwards.

                  I hope the neighbors like it however, as DH who knows American food said, it doesn't look like much but the taste is OK: about 7 on a scale where 1=dreadful and 10=delicious.

                  1 Reply
                  1. re: Rasam

                    wow! i never thought of this as a problem in another country - but i totally get it!! i used to stage homes for sale, and we were told to always warn people about cooking "ethnic" (spicy) foods and bacon as the smells can permeate the house and give a potential buyer a negative feeling. Cinnamon is apparently the only "internationally" acceptable smell LOL!

                  2. Rasam,
                    I think you're great. My DH is also on blood thinners, and as a reassurance, know that s/he is likely on a sliding scale of coumadin (warfarin sodium) and gettng it tweaked as needed to make sure the INR is at the right spot. So if you added spinach inadvertently---a ton of it--it would show in the test and be compensated for. Vitamin K hangs out in weird spots...like mayo, pickles, and the usual suspects like broccoli, etc.

                    I'm not a vegetarian, but my mother, who quit smoking, always had a similar, visceral reaction when she smelled smoke in the house (if an aunt visited and snuck one in the house), similar to your sensing the meat smell--it was a negative reaction, not a wistful"oh that's nice" reaction.