Swallowing can be difficult after a stroke, making some foods that were once favorites nearly impossible to eat.

However, if you or a loved one are experiencing difficulty swallowing, that doesn’t mean you have to sit Thanksgiving or other holiday meals out this season, according to Angie Nyp, Encompass Health’s national senior manager of nutrition services. It doesn’t mean you have to fix an entirely different meal either.

By modifying some of your family favorites, stroke survivors experiencing dysphagia, a swallowing disorder that is a common side effect of stroke, can enjoy their meal alongside their family during the holidays.

Swallowing ability and eating

Stroke affects everyone differently, and people’s ability to swallow safely after a stroke can differ as well.

Depending on the swallowing ability, food may need to be prepared slightly differently. The International Dysphagia Diet Standardization Initiative framework has eight levels of texture, with levels zero through four addressing liquids and four through seven addressing food.

The food texture levels are:

  • Level 4 – pureed
  • Level 5 – minced and moist
  • Level 6 – soft and bite-size
  • Level 7 – regular/easy to chew

What’s good about most holiday dishes, Nyp said, is that many already meet Level 4 and 5.

For example, “Stuffing is already soft; just make sure the pieces are small enough,” she said. “Then you have mashed potatoes, which are also a good option.”

Serving up healthier holiday favorites

Diet and nutrition are also important after a stroke, as foods high in sodium and saturated fat increase blood pressure, which could lead to another stroke.

To make sure you’re serving up heart healthy recipes, the American Heart Association/American Stroke Association offers these holiday recipes:

Mom’s Roasted Turkey with Butternut Squash and Asparagus

Ingredients:

For the Asparagus

  • 1 pound fresh asparagus, trimmed
  • 2 medium garlic cloves, minced

OR

  • 2 teaspoons bottled minced garlic
  • 2 teaspoons extra-virgin olive oil
  • 1 tablespoon fresh lemon juice
  • 1/2 teaspoon pepper

For the Butternut Squash

  • 1 medium butternut squash, peeled and cut into 1-inch cubes
  • 2 teaspoons honey
  • 1 teaspoon ground cinnamon
  • 1 teaspoon dried thyme
  • Cooking spray
  • 2 teaspoons extra-virgin olive oil
  • 1/2 teaspoon pepper

For the Roasted Turkey

  • 1 12-pound fresh or frozen turkey, thawed if frozen
  • 2 tablespoons dried Italian seasoning, crumbled
  • 1 tablespoon canola or corn oil
  • 1 teaspoon pepper
  • 2 to 3 medium ribs of celery, coarsely chopped
  • 2 medium carrots (about 1 cup)
  • 1 small onion (coarsely chopped)
  • 3 sprigs fresh thyme

OR

  • 1 tablespoon dried thyme
  • 3 sprigs fresh rosemary

OR

  • 1 tablespoon dried rosemary
  • 3 medium garlic cloves, minced

OR

  • 1 tablespoon bottled minced garlic
  • Cooking spray

Directions:

For the Asparagus

  1. Preheat the oven to 350˚F. Line a baking sheet with aluminum foil.
  2. In a small bowl, whisk together the lemon juice, oil, garlic, and pepper.
  3. Arrange the asparagus in a single layer on the baking sheet. Drizzle the lemon juice mixture over the asparagus.
  4. Bake for 12 to 15 minutes, or until the asparagus is tender-crisp.

For the Butternut Squash

  1. Preheat the oven to 350˚F. Lightly spray a baking sheet with cooking spray.
  2. In a medium bowl, stir together all the ingredients until the squash cubes are evenly coated. Transfer to the baking sheet. Bake for 45 to 50 minutes, or until the squash is fork-tender.

For the Roasted Turkey

  1. Preheat the oven to 425°F.
  2. Place the turkey on a cutting board. Using kitchen shears, remove any loose or hanging skin around the neck cavity of the turkey. Pat the turkey dry with paper towels. Loosen the turkey skin away from the meat by inserting your hand between the meat and the skin and gently pushing down. Pull the wing tips up and back and tuck them under the turkey.
  3. In a small bowl, whisk together the Italian seasoning and oil. Rub the mixture on the turkey breast and drumsticks, underneath the skin. Sprinkle the pepper over the entire turkey.
  4. Fill the turkey cavity with the celery, carrots, onion, thyme, rosemary, and garlic. Tie the legs together with kitchen twine. Lightly spray a roasting pan and rack with cooking spray. Place the turkey with the breast side up on the rack. Roast for 30 minutes.
  5. Reduce the oven temperature to 325°F. Loosely cover the turkey with aluminum foil. Roast for 1 hour and 45 minutes, or until the turkey reaches an internal temperature of 165°F on an instant-read thermometer. (The total roasting time may be up to 3½ hours to reach 165°F.) Remove from the oven.
  6. Remove the foil and spoon the pan juices over the turkey to baste it. Re-cover the turkey and let it stand for 15 minutes at room temperature. Baste two to three times during the standing time (removing and replacing the foil each time). Discard the skin and any visible fat before slicing the turkey.

Green bean casserole

Ingredients:

  • 1 pound frozen green beans (French cut is best), thawed
  • 1 10.5-ounce can reduced-fat, low-sodium cream of mushroom soup
  • 1/2 cup low-fat sour cream
  • 1/2 teaspoon pepper
  • 1 small onion (cut into thin strips)
  • Cooking spray
  • 1/4 cup whole-wheat flour

Directions:

  1. Preheat the oven to 350˚F.
  2. In a 13 x 9 x 2-inch glass baking dish, stir together the green beans, soup, sour cream, and pepper until well blended. Bake for 20 minutes.
  3. Meanwhile, spread out the onion strips on a baking sheet. Lightly spray the onion strips with cooking spray.
  4. Sprinkle the flour over the onion strips, tossing to coat.
  5. Lightly spray a medium-large skillet with cooking spray. Cook the onions on medium-high heat for 3 to 4 minutes, or until crispy, stirring occasionally.
  6. When the casserole is done baking, remove it from the oven. Stir half of the onions into the green bean mixture.
  7. Top with the remaining onions. Bake for 5 minutes, or until the onions on top are browned.

For more information on meal preparation and cooking after stroke, download a free copy of the AHA/ASA cookbook, “Simply Good: A cookbook for stroke survivors and their families.” Encompass Health, a leading provider of rehabilitation care for stroke survivors, supported the AHA/ASA in developing this new cookbook.

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