When we first met Lottie Barnett, a lively 84-year-old, she was dredging pieces of liver in flour and frying them in canola oil for her supper. I was with Robin Spence, the registered dietitian from Union Memorial Hospital who helps with our monthly Make Over My Meal series. About five months ago, Barnett moved into one of the low-income senior apartments in the Stadium Place development on 33rd Street.
Barnett is lucky because she has a 67-year-old daughter with an apartment three doors down the hall who keeps an eye on her. But Barnett is proud of her independence and enjoys shopping and cooking for herself, even though when the dietitian asked her how often she cooked, she said jokingly, "Just as less as I can."
Her nephew drives her to the supermarket -- "about once a month," she said -- so she hasn't yet had to take the apartment-complex bus that transports residents to and from the food store. (Her daughter makes sure she gets one hot meal a day if she isn't cooking for herself.)
On the evening of our visit, Barnett planned to fix canned peas and creamed potatoes with her liver.
Spence started off praising her for using canola oil. "It's a really healthy oil," she said.
The nutritionist wasn't so thrilled with the liver, though, in spite of the fact that it contains all the iron, protein and vitamin A Barnett would need in a day.
"It really is high in cholesterol and high in saturated fat, which increases your chance of a heart attack," Spence told her. She said she recommends liver to her patients no more than once a month.
"My personal bias is that it's the filtering organ," the dietitian added. Liver, in other words, may contain byproducts of the animal's feed and medications as well as cholesterol and saturated fat.
Barnett turned the liver pieces, which were now a nice golden brown, and continued to fry them in the hot, bubbling oil; but she listened intently.
Spence asked about her health, which is pretty good for someone her age; she does, however, have asthma, arthritis and high blood pressure. Cholesterol isn't a problem, and Spence encouraged her to keep it that way by eating less saturated fat and more fruit and green vegetables.
"I'm always looking to make sure people eat their fruit and vegetables," she said with a laugh, pointing out that they were also good for intestinal regularity.
Barnett retorted that at her age, "You could eat a whole mule if it was green, and it would still bind you."
Fresh vegetables would be best, of course, but Spence understood Barnett's dependence on canned because of her infrequent trips to the grocery store. She urged her to drain the can of peas and rinse them off before she heated them to cut down on the amount of sodium she was getting in her diet -- and in the future to buy frozen peas that have no salt added. Canned fruit would be good to have on hand because there would be no worries about salt, and it wouldn't go bad if it didn't get eaten right away.
With high blood pressure, the 84-year-old needs to watch her sodium intake.
"That's what they say?" Barnett asked skeptically.
"They say it because it's true," Spence told her.
When Barnett told her she made her creamed potatoes with milk, margarine, salt and pepper, Spence said, "That's a chance where you get to control the amount of sodium."
She approved of the 2-percent milk but pointed out, when Barnett complained that milk sometimes spoiled before she could finish the carton, that milk can easily be frozen in the carton without changing the taste significantly.
"Instead of getting a half gallon, buy two quarts and freeze one."
As an alternative to the liver, Spence asked Barnett if she ate fish.
"You want to know the truth about fish?" she said. "Since they found the snakehead fish, I haven't eaten much fish. You can't tell what kind of fish you're really getting in the store, can you?"
How about crabs?
She was emphatic. "No, no, no, no."
Barnett likes chicken, but a breast is too big for her. The boneless, skinless strips of chicken would be too pricey on her limited budget, Spence decided. Boneless, skinless thighs would be a good alternative.
Barnett prefers wings, which Spence felt had too much skin and fat to make them nutritionally worthwhile.
Would she eat salads? No, she told the dietitian, she likes her vegetables cooked.
"I had a whole menu for you," Spence said with a laugh, "but so far nothing's working."
Knowing that Barnett likes beans and would eat vegetables if they were well cooked, Spence suggested for her "after" meal a simple variation on minestrone, using low-sodium chicken broth and canned vegetables. It would be good with corn bread, which could be made with a mix and which would have more nutritional value than the crackers Barnett usually has with soup.
Dessert could be fresh seasonal fruit like apples or pears, or if necessary canned fruit. Leftover soup could be frozen in individual portions to be reheated in the microwave for another meal.
Barnett's apartment includes a tiny but fully equipped kitchen. She has managed to fit in a separate small freezer where a little table might have gone. Spence zeroed in on this as a way to have healthful meals at her fingertips. For some reason, Barnett never freezes part of what she cooks for another meal. Spence encouraged her to do so, even going so far as to say we would bring her some plastic containers for leftovers.
I gave Barnett a call a week later to see what she thought of our after meal.
"The soup was a little greasy," she told me, "but it was real nice. The corn bread was delicious, and the pears were nice."
We were afraid that she might mind the fact that there wasn't much salt in the soup, but that wasn't the case. The "grease" problem is easily solved. If the amount of oil is more than you want, simply simmer the onion and carrots in the chicken broth until they are tender, then add the other ingredients.
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Makes 3 to 4 servings
4 teaspoons canola oil
1 small onion, chopped
1 carrot, peeled and sliced thin
3 cups fresh kale, coarsely chopped
3 cups low-sodium chicken broth
one 15-ounce can diced tomatoes, no-salt-added if possible
1/4 cup broken-up fine pasta
one 15-ounce can Great Northern beans, drained and rinsed
Heat the oil in a pot and saute the onions, carrots and kale for a few minutes. Add the chicken broth and bring to a simmer.
Drain the tomatoes, add and bring to a boil. Add the pasta and simmer 15 minutes. Drain and rinse the canned beans, add and bring back to a simmer. If sodium is not a concern, serve with grated parmesan cheese.
Leftovers can be kept in the refrigerator a day or two, or frozen in individual containers.
Courtesy of Elizabeth Large
Per serving (based on 4 servings): 241 calories, 11 grams protein, 17 grams fat, 1 gram saturated fat, 35 grams carbohydrate, 8 grams fiber, 19 milligrams cholesterol, 207 milligrams sodium
ROBIN SAYS ...
SKIP THE CRACKERS
Corn bread adds more nutritional pop to the meal than crackers.
A FRUITY BOOST
Fresh seasonal fruit is a light but vitamin-packed dessert. Canned fruit is an accept-able alternative.
Vegetables and beans in the soup provide vitamins and roughage.
Low-sodium chicken stock and low-sodium canned vegetables are more healthful but still convenient.