Wired Jaw Diet - Kaiser Permanente jaw diet... · Wired Jaw Diet 2014, The Permanente ... eneral...

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Wired Jaw Diet

© 2014, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Department of Maxillofacial Surgery. RL 7

After jaw surgery, you many need to stick to a special diet (liquid or semi liquid) for 1 to 6 weeks based on your surgeon’s recommendations. This may be a challenge for you to get enough nutrition during this time as your jaws are wired or rubber banded together. It is important to eat a variety of foods to get all of the nutrients your body needs during this time to help wound healing and to lower weight loss.

General guidelines

- Eat at least 6 small meals to meet nutritional needs. Eat every 2-3 hours.

- Prepare all foods to a very smooth and thin consistency. Use a blender or food processor.

Strain the blended food if it has lumps or chunks. Thin with varied liquids to preferred

consistency.

- Include a variety of foods from each of the food groups (protein, carbohydrate, fat, fruit and

vegetables) to achieve a balanced diet.

- Most foods can be blended.

- Prepare foods and freeze in 1-2 cup containers before surgery if possible.

- Drink plenty of liquids (choose liquids with calories).

- Take a liquid multivitamin daily.

- If you are losing weight, increase calories (see chart below)

- Eat the same foods that your family eat but in a liquid consistency.

- Use a thermos to bring prepared food from home if microwave is unavailable.

- Commercial nutritional supplements can be used for convenience and to increase calorie

and protein intake.

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Wired Jaw Diet


Suggested liquid supplements

- Boost Plus – 8 ozs (350 calories/14 gms protein) - Boost High Protein – 8 ozs (240 calories/15 gms protein) - Boost High Protein powder mix (270 calories/14 gms protein when mixed with 1 cup 2% milk) - Carnation Instant breakfast – 1 packet (280 calories/13 gms protein when mixed with 1 cup

whole milk) - Komplete – vegan meal replacement (1 carton = ~320 calories/18 gms protein) - Orgain – protein shake (1 carton = ~250 calories/17 gms protein) - Ovaltine – 4 Tbls (170 calories/9 gms protein) when mixed with 1 cup whole milk - Ensure – 8 ozs (240 calories/10 gms protein) - Ensure Plus – 8 ozs (355 calories/14 gms protein) - Hot cocoa mix – 8 ozs (260 calores/12 gms protein when mixed with 1 cup whole milk) - Chocolate milk – 8 ozs (240 calories/8 gms protein) - Sustacal – 8 ozs (240 calories/14.5 gms protein) - ProMod protein powder (1 oz = 100 calories/10 gms protein) - Scandishake – 3 oz envelope (600 calories, 14 gms protein when mixed with, 8 ozs whole

milk) - Meritene Vanilla drink – 8 ozs (280 calories/17 gms protein when mixed with 8 ozs whole milk) - Resource 2.0 drink – 8 ozs (480 calories, 20 gms protein) ** Check ingredients for Vegan, Vegetarian, Lactose Intolerance and Gluten sensitivities.

Most above supplements powders can be mixed with soy, rice, or almond milk.

Calorie Boosters:

- 1 Tablespoon smooth peanut butter (~100 calories) - 1 Tablespoon vegetable oil - avocado, hemp, grape seed, canola or olive oil (~120

calories) - 2 Tablespoons avocado (~45 calories) - 1 Tablespoon dried milk powder (~50 calories) - 28 gms (1 oz) Whey protein powder (~ 50 calories) - 28 gms (1 oz) Soy protein powder (~96 calories) - 1 Tablespoon flaxseed meal powder (~45 calories) - 1 Tablespoon smart balance margarine (~45 calories) - 2 Tablespoons cream (~45 calories) - 1 Tablespoon coconut milk (~45 calories) - 1 Tablespoon butter (~120 calories) - Fortified milk – 1 quart of milk, 1 cup NF milk powder (blend together for 5 mins in food

processor (12 gms protein per cup)

of 16 © 2014, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Department of Maxillofacial Surgery. RL 7

Wired Jaw Diet

Food Chart GuideFood Recommended

FoodsPreparation Consistency

OptionsHow to Optimize Calories and Protein

Special Diet Considerations

Milk1 serving = 8 ozs = 1 dairy

Whole Milk& Soy, Rice, or Almond Milk

n/a n/a Add dried milk powder, Carnation Instant Breakfast

Vegan: Rice, Soy, or Almond milkVegetarian: cows milk & rice, soy, or almond milkGF: No restrictions

Yogurt1 serving = 2/3 cup = 1 dairy

Sweetened, plain or Greek yogurt

Blend fruit yogurt, strain out large pieces

Thin with milk as needed

Full fat yogurtKefir

Vegan: soy yogurt,coconut yogurtLactose Intolerance: use soy or lactose-free yogurt Vegetarian: No restriction

Cottage Cheese1 serving = ¼ cup = 1 protein

Full fat Cottage Cheese

Blend until smooth, strain as needed

Thin with milk Add dry powdered milk

Vegan: restrictedLactose Intolerance: use lactose-freecottage cheeseVegetarian: No restriction

Soups1 serving = 1 cup = 2 veggies, 1 starch

Any soup of choice Blend all soups and strain to remove any solid

Thin with milk, cream, or chicken/vegetable broth to desired consistency

Add healthy oils(Olive, Canola, & Avocado Oils)

Vegan: use vegetable brothLactose Intolerance: use lactose-free milkVegetarian: use vegetable stockGF: thicken with potato or tapioca starch

of 16 © 2014, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Department of Maxillofacial Surgery. RL 7

Wired Jaw Diet

Meats, Fish, Poultry, Eggs, Tofu1 serving = 1 oz = 1 protein

Chicken, Fish, Turkey, Pork, Egg (without skin or bones)

Cook until tender, blend, strain to remove large pieces

Thin with broth, sauces, gravies

Add healthy oils Vegan: Tofu Vegetarian: Tofu & Eggs GF: no restrictionsLactose Intolerance: no restrictions

Fruit1 serving = 1 small fruit , ½ cup canned or ½ cup juice = 1 fruit

Fruit skins and seeds removed,fresh, canned, frozen, or cooked

Cooked or raw. Blend until desired consistency and strain.

Thin with fruit juice or milk

Add honey, syrup, sweetened juice, ice cream, sorbet, sherbet

Vegan: no restrictionsVegetarian: no restrictionsGF: no restrictionsLactose Intolerance: no restrictions

Vegetables1 serving = ½ cup cooked, 1 cup raw = 1 vegetable

Vegetables skins and seeds removed,fresh, canned, frozen, or cooked

Cooked or raw. Blend until desired consistency and strain.

Thin with V-8, tomato juice, broth, or cream

Add healthy oils Vegan: no restrictionsVegetarian: no restrictionsGF: no restrictionsLactose Intolerance: no restrictions

Starches1 serving = ½ cup cooked cereal, ½ cup dry cereal, ½ cup mashed potatoes = 1 starch

Hot cereals: Cream of Wheat, Rice, Millet, & QuinoaCold cereals

Potatoes: all types mashed

Cook hot cereal with milk. Blend & strainSoak cold cereal in milk, blend & strain

Cook potatoes, mash/blend with milkor broth

Thin with milk

Thin with broth or milk

Add powdered milk, honey, syrup, butter, cream, pureed fruit

Add cream and milk

Vegan: Rice, Soy, or Almond milkVegetarian: no restrictions Lactose Intolerance: Soy, rice, or almond milk GF: use GF cereals

Desserts 1 serving = ½ cup = ~2-4 fats, ~1-2 starch

Ice cream, Frozen Yogurt, Sherbet, Popsicles, Puddings, Custards, Jello

No nuts, seeds, fruit chunks or candies.

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Blend if needed

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Vegan: use dairy-free Vegetarian: no restriction Lactose Intolerance: use lactose free GF: check ingredients

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Wired Jaw Diet


Sample Menus

Day 1 Calories (approx)

Protein (gms)

Breakfast: ½ cup cooked Oatmeal with 1 cup milk, 1 tbsp melted butter, blend and thin to desired consistency

350 11

Snack: 1 cup milk (almond, soy or rice milk), 2 tbsp smooth peanut butter, blended

350 16

Lunch: Raspberry Smoothie

450 16

Snack: ½ cup frozen yogurt, softened

130 2

Dinner: 2 cups Chicken and vegetable soup, blended and thinned to desired consistency

250 10


Protein (gms)

Breakfast: ½ cup cooked cream of wheat with 1 cup milk, 1 tbsp Flaxseed meal, 1 tbsp melted butter, blend and thin to desired consistency

400 11

Snack: 1 cup pulp-free orange juice

120

Lunch: Strawberry and Banana Smoothie

500 16

Snack: 8 ozs Carnation Instant breakfast made with whole milk

320 15

Dinner: 2 cups Cream of broccoli soup, blended and thinned to desired consistency

400 10

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Wired Jaw Diet-Nutritional Booklet



Protein (gms)

Breakfast: Mango and Peach Smoothie

600 14

Snack: 1 cup almond milk with 1 tbsp almond butter, blend

250 12

Lunch: 1 cup cottage cheese, ½ cup canned peaches, blend, thin with milk to desired consistency

350 16

Snack: 1 can V-8 juice

100 4

Dinner: 2 cups Chicken, vegetable and potato stew, blended and thinned with broth

400 26


Protein (gms)

Breakfast: ½ cup cooked quinoa made with 1 cup milk of choice, 1 tbsp Flaxseed meal, 1 tbsp melted butter/oil, blend and thin to desired consistency

420 18

Snack: 1 cup fruit yogurt, blended and thinned with milk of choice

230 18

Lunch: Banana and Broccoli Smoothie

400 12

Snack: 1 can chocolate boost with ½ cup vanilla ice cream, blended

400 12

Dinner: 2 cups Lentil and vegetable soup blended and thinned with vegetable or chicken broth

420 16

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Wired Jaw Diet



Protein (gms)

Breakfast: 2 scrambled eggs, 1 tbsp oil, thinned with milk of choice

330 20

Snack: 1 can strawberry ensure plus with ½ cup sorbet, blend

470 12

Lunch: Kale and Banana Smoothie

275 4

Snack: 1 cup cottage cheese, ½ cup canned fruit cocktail, blended with milk of choice

350 16

Dinner: 2 cups split pea soup blended and thinned with vegetable or chicken broth

375 20


Protein (gms)

Breakfast: ½ cup cooked cream of millet with 1 cup milk choice, 1 tbsp flaxseed meal, 1 tbsp oil, blend and thin to desired consistency

400 11

Snack: 1 can apricot nectar

200

Lunch: Banana and Spinach Smoothie

375 4

Snack: 1 cup vanilla yogurt, ½ cup apple sauce, blended and thinned

220 10

Dinner: 2 cups fish soup with vegetables, blended and strained

350 20

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Wired Jaw Diet



Protein (gms)

Breakfast:½ cup cooked cream of rice with 1 cup milk of choice, 1 tbspflaxseed meal, 1 tbsp oil, blend and thin to desired consistency

400 11

Snack:1 cup sorbet, softened

300

Lunch:Soy Smoothie

430 18

Snack: 1 can carnation instant breakfast, 1 cup milk of choice, 1 cup

strawberries

380 15

Dinner:2 cups beef stew with mashed potatoes, blended, thinned with broth and strained

500 25

The above meal choices are suggestions only. Please feel free to mix and match based on your appetite and caloric needs. Make substitutions when needed – for example, use almond milk, tofu, vegetable broth etc. if vegan. For extra protein, add protein powder from soy or non fat milk powder.

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Wired Jaw Diet-Recipes

© 2014, The Permanente Medical Group, Inc. All rights reserved. Santa Clara Health Education. Department of Pediatrics. RL 7

Banana Peanut Butter Shake (~ 600 calories, 17 gms protein ) ¼ cup whole milk, soy, almond, rice, or coconut milk 1 cup sliced banana (1 large banana) 1 ½ cups ice cream (sorbet, sherbet, non-dairy ice cream) ¼ cup smooth peanut butter 3 Tbsp chocolate malted milk powder Place all ingredients in a blender, blend until completely smooth. Thin to preferred consistency with soy milk or juice. Strain if needed. Soy Smoothie (~430 calories, 18 gms protein) ¾ cup vanilla soy milk, almond, rice or coconut milk ½ cup apple juice 1 Tbsp honey 1 cup blueberries 1 banana 1 cup strawberries 1 cup non-dairy frozen frozen yogurt 1 scoop (10 gms soy protein powder or tofu) Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with milk or juice. Strain if needed. Strawberry Smoothie (~ 300 calories, 15 gms protein.) 1 cup vanilla soy milk, rice, almond, cow or coconut milk) 1 cup sliced strawberries 1 banana 1 packets of carnation instant breakfast or 1 scoop protein powder of choice) Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with milk or juice. Strain to remove seeds. Raspberry Smoothie (~450 calories, 16 gms protein) ¾ c apple juice 1 Tbsp honey 1 ½ cups diced cantaloupe 1 ½ cups diced raspberries (strained to remove seeds) 1 cup vanilla ice cream (frozen yogurt or non-dairy ice cream) 1 scoop (10 gms protein powder of choice) Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with milk or juice. Strain if needed.

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Strawberry and Banana Smoothie (~ 500 calories, 16 gms protein) 1 cup vanilla soy milk, rice, almond cow’s or coconut milk) ½ cup orange juice 1 Tbsp agave syrup 1 ½ cups strawberries 1 banana 1 carton strawberry banana yogurt (or soy yogurt) Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with milk or juice. Strain if needed. Fruit Smoothie: (~ 450 calories, 18 gms protein.) ¾ cup apple juice 1 Tbsp maple syrup 1 banana 1 cup peeled, diced peaches 1 cup peach yogurt (or soy yogurt) 1 scoop (10 gms )protein powder of choice Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with milk or juice. Strain if needed. Mango and Peach Smoothie: (~600 calories/14 gms protein) ½ can (8 ozs) peach nectar 1 Tbsp agave syrup 1 cup peeled and diced peaches ½ cup mango sorbet ½ cup vanilla yogurt 1 scoop (10 gms) protein powder of choice ½ cup crushed ice Place all ingredients in a blender. Blend until smooth. Thin to preferred consistency with V-8 juice. Strain. Vegetable Smoothie (~170 calories/4 gms protein) 1 small cucumber (seeds removed) 1 cup (packed) spinach 1 apple, cored 1 inch fresh ginger, peeled and minced (~1 Tbsp) Juice of 1 lime 1 Tbsp honey Ice cubes Place all ingredients in a blender. Blend until smooth. Thin to desired consistency with V-8 juice. Strain.

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Banana and Broccoli Smoothie: (~400 calories/12 gms protein) 1½ cups almond milk (rice or soy) 1 ripe banana 1 cup broccoli florets (stems removed) 1 Tbsp ground flaxseed meal 1 Tbsp agave syrup Place all ingredients in a blender, blend until smooth. Strain. Kale and Banana Smoothie: (~275 calories) ½ cup packed flat-leaf parsley 1 cup Kale (center ribs removed) 1 cup mixed berries (fresh or frozen) 1 ripe banana 1 Tbsp flaxseed meal or 1Tbsp smooth peanut butter Ice cubes Place all ingredients in blender, blend until smooth, strain. Banana and Spinach Smoothie: (~375 calories) 1 ripe banana ½ ripe avocado 1 cup (packed) spinach) ½ Tbsp honey 1 cup ice Place all ingredients in a blender, blend until smooth, strain.

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Soup Recipes:

Lightly Curried Butternut Squash Soup: (adapted from “ A Snap cookbook, Good and Cheap” by Leanne Brown)

1 butternut squash or other winter squash

3 Tbsp olive oil

1 medium onion, diced

1 green pepper, diced

3 cloves garlic, finely chopped

1 tsp cumin

1 tsp coriander powder

1 tsp turmeric powder

1 tsp cayenne pepper

1 can coconut milk

3 cups vegetable stock

Salt and pepper

To prepare squash, peel off the tough skin with a potato peeler. Cut the squash in half lengthwise with a sharp knife, scoop out the insides. Slice off the stem and very bottom of the squash and discard. Slice the squash into thick slices and dice roughly. Heat olive oil in large pot or dutch oven on medium heat, add the onion, pepper and garlic and sauté for 2 minutes.

Add the diced squash and spices and stir it all together. Cover and cook for another 2 minutes. Add the coconut milk and vegetable stock and stir.

Bring the soup to a boil then turn down the heat and simmer for about 30 minutes until squash is tender. Taste and correct seasoning as needed. Blend and strain.

To add extra calories stir in cream or sour cream.

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Creamy Broccoli Soup with Cheddar: (adapted from “For the love of Soups” by Jeanelle Mitchell)

1 Tbsp olive oil

1 onion, chopped

2 garlic cloves, minced

1 stalk celery, chopped

1 carrot, peeled and chopped

2 cups chicken or vegetable stock

1 cup water

3 cups chopped broccoli

1 large potato, peeled and cubed

1 Tbsp chopped fresh oregano or 1 tsp dried oregano

1 cup low-fat milk

1 Tbsp Dijon mustard

½ cup grated cheddar cheese

Sea salt and freshly ground pepper

In a large saucepan, heat oil over medium heat. Add onion, garlic, celery and carrot and sauté for 4 minutes.

Add stock, water, broccoli, potato and oregano and bring to a boil. Lower heat, cover and simmer for 15 minutes or until vegetables are tender. Remove from heat and let cool slightly.

Puree soup in the saucepan using an immersion blender or transfer in batches to a blender or food processor and blend until smooth, then return soup to the saucepan. Stir in the milk (leave out if vegan), mustard, and cheddar; simmer until cheese melts and soup is heated. Do not boil. Season with salt and pepper to taste. Strain and thin to preferred consistency.

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Creamy Chickpea Soup: (adapted from “For the love of Soups” by Jeanelle Mitchell)

1 Tbsp olive oil

1 large leek, white and light partly only, cut in half lengthwise and thinly slices

4 large garlic cloves, minced

1 large sweet red pepper, diced

2 cups chicken broth or vegetable stock

2 cups water

Two 19 oz cans chickpeas, drained and rinsed

1 tsp chopped fresh thyme, or ¼ tsp dried thyme

1 bay leaf

2 Tbsp fresh lemon juice

2 Tbsp chopped fresh cilantro or flat-leaf parsley

Freshly ground pepper

In a large saucepan, heat oil over medium heat. Add leek, garlic, and red pepper and sauté for 4 minutes.

Add stock, water, chickpeas, thyme, bay leaf, lemon juice and cilantro or parsley and bring to a boil. Lower heat, cover, and simmer for 15 minutes. Remove from heat, let cool slightly, and discard bay leaf.

Puree soup in the saucepan using an immersion blender, or transfer to a blender or food processor and blend until smooth, strain, and then return pureed soup to the saucepan and simmer until heated. Season with pepper to taste.

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Ginger Orange Carrot soup: (adapted from “For the love of Soups” by Jeanelle Mitchell)

1 Tbsp unsalted butter

1 Tbsp olive oil

1 large sweet onion, chopped

4 cups peeled and chopped carrots

2 tsp grated ginger

2 cups chicken or vegetable soup

2 cups water

1 cup orange juice

Sea salt and freshly ground pepper

½ cup low-fat yogurt or sour cream, or more to taste (optional)

2 Tbsp chopped fresh chives or flat-leaf parsley.

In a large saucepan, melt butter with oil over medium heat. Add onion and carrots and sauté for 4 minutes. Stir in ginger and cook for 2 minutes longer.

Add stock, water and orange juice, parsley and chives, and bring to a boil. Lower heat, cover, and simmer for 20 minutes or until carrots are tender. Remove from heat and let cool slightly.

Puree soup in the saucepan using an immersion blender, or transfer soup in batches to a blender or food processor and blend until smooth, strain, then return soup to the saucepan. Season with salt and pepper to taste. Simmer until heated through. Stir in optional yogurt, cream or sour cream.

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Velvety Red Lentil Dahl: (adapted from “the cancer-fighting kitchen” by Rebecca Katz)

2 Tbsp extra-virgin olive oil

1 ½ tsp cumin seeds

1 ½ tsp black or brown mustard seeds

1 onion, diced small

1 Tbsp minced fresh ginger

2 tsp turmeric

2 tsp ground cumin

Sea salt

2 cups chopped tomatoes, or 1-14-oz can diced tomatoes, drained

8 cups vegetable broth

2 cups red lentils, rinsed well

1 cinnamon stick

1 tsp freshly squeezed lime juice

½ tsp agave nectar or maple syrup

¼ cup finely chopped fresh cilantro or mint

Heat the oil in a soup pot over medium heat. Add the cumin and mustard seeds and sauté for 3 minutes, add the tomatoes and ¼ tsp of salt and sauté for 2 minutes more. Pour in ½ cup of the broth to deglaze the pan and cook until the liquid is lowered by half.

Add the red lentils and stir well, then add the remaining 7 ½ cups broth and the cinnamon stick and stir in the lime juice and agave nectar.

In a blender, puree the soup in batches until very smooth, strain and thin with more broth if needed.

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