Eating for health and wellbeing

Recipes, information and guidance on healthy eating for older people

Visit our website: www.nhsaaa.net All our publications are available in other formats Introduction Healthy eating is always a positive choice to make no matter how old you are. Eating well helps you to maintain a good quality of life. It benefits your health, mental wellbeing and energy levels for as long as possible. By eating well you can minimise the risks of illnesses and better manage health problems. However, it has been identified that older people living at home face a range of barriers to healthy eating which in turn may put them at risk of nutritional deficiencies, diet related disease and reduced quality of life. Inside the booklet you will find information and guidance on healthy eating as well as a selection of healthy recipes that are easy to cook for one. A variety of tips and ideas will help you to use the information provided. There is also a section on malnutrition, poor appetite and chewing difficulties, which you may find useful.

Table of Contents

The Eatwell Plate ...... 2 Salt ...... 9 Food labels ...... 10 Shopping on a budget ...... 11 Store cupboard essentials ...... 12 Fridge and freezer essentials ...... 14 Keeping food safe ...... 15 Hints for healthy cooking ...... 18 Kitchen: Making things easier ...... 22 Malnutrition ...... 23 Restoring your appetite ...... 24 A poor appetite and weight loss ...... 25 Chewing difficulties ...... 26 The importance of breakfast ...... 27 Ideas and recipes ...... 29 Tasty breakfast ideas ...... 30 Snack, lunches and soups ...... 35 Main meals ...... 39 Desserts ...... 54 Meals ideas ...... 57 Freezer storage time ...... 58 How to read food labels guideline ...... 58 The Eatwell Plate

Healthy eating guidelines are as relevant to older people as they are to younger adults. However, these guidelines need to be applied with an element of common sense. Healthy eating is important in the younger age group of 64 – 74 years as long as you remain fit and active, however if you are frail or ill a healthy diet would not be applied too strictly. The Eatwell Plate is a healthy eating model for the UK and it makes healthy eating easier to understand. It is divided into five segments, each one representing the different types and amounts of foods you should be eating to have a healthy, varied and balanced diet. By following the Eatwell Plate advice you make sure your diet is nutrient-dense, i.e. contains foods which are rich in essential nutrients rather than those which supply mainly energy (calories). It is particularly important with age as your energy requirement tends to decline but your need for protein, vitamins and minerals remains unchanged. The balance of the Eatwell Plate doesn’t have to be achieved at every single meal. It can be achieved over a day or several days. The important thing is that you are getting the balance right by eating more food from the larger four food groups and less food from the smallest one.

2 Starchy foods

 Should make up 1/3 of your diet.  Try to include foods from this group in every meal. Breads tatoes Po

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These foods provide your body with:  Carbohydrates for energy.  Fibre for healthy bowels and reduced risk of constipation.

Whole Grain Varieties  The entire grain on its own: Wild and brown rice, oats, popcorn.  Manufactured product: Wholegrain breakfast cereal, whole wheat pasta, oatcakes.  More fibre and other nutrients than in refined starchy foods.  May prevent heart disease, cancers of the stomach or bowel, type 2 diabetes.  Look for word ‘WHOLE’ in a product name e.g. wholemeal bread.  Check for whole grain as the main ingredient if it appears at the top of the ingredients list e.g. whole grain wheat, brown rice, whole rye.

 Remember not too fill up on fibre without eating other foods. Helpful  Drink plenty of fluids to get the best of fibre. Tips  Eat a range of starchy foods to get all the nutrients you need.  Oats are rich in soluble fibre to keep your cholesterol levels low.  For ways to increase fibre content when cooking see page 19.  For ideas on how to include starchy foods across the day see page 57. 3 Fruit and vegetables

 Should make up 1/3 of your diet.  Eat variety of fruit and vegetables every day at every meal. ned Ju an ice C d

F n r ze d esh Fro Drie These foods provide your body with:  Important vitamins and minerals to help your body to function properly.  Fibre to help reduce cholesterol levels and to keep your blood sugar level constant.

Apply the rainbow rule! Different colours of fruit and vegetables offer different health benefits.

Aim for at least FIVE portions of fruits and vegetables per day!

1 Portion = 80grams = = A handful

 A glass of juice only counts for one of your 5 a day no matter how Helpful many you drink!  Frozen or canned varieties are as good as fresh ones. Tips Use more of these if the preparation of raw veg is too difficult.  If you find it difficult to eat raw fruit, try softer canned or cooked fruit.  For tips on reducing vitamin loss from fruit and vegetables see page 20. 4 Milk and dairy products

 Aim for three portions daily (A portion is a glass of milk, a small pot of yogurt or a small matchbox size piece of cheese)  Provide a lot of calcium that is easy for our body to absorb.

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These foods provide your body with:  Calcium for strong, healthy bones and teeth and vitamin D for its absorption.  Vitamin A for good vision, healthy skin and immune system.  Protein for growth, development and repair.

High calcium intake slows down the calcium loss from the bone. Milk and dairy products are the best way to get enough calcium. Vitamin D is needed for calcium absorption. We mainly get vitamin D from the sun on our skin. However, due to age and low sunlight in Scotland you should consult your doctor for advice if you are concerned.

Low fat alternatives:  Suitable if you have a good appetite and have not recently lost any weight.  Have the same calcium content as full fat varieties.

 Non-dairy sources of calcium include soya milk, broccoli, almonds, and kale. However, it is not that easy for your body to absorb calcium from these sources. Helpful  For ideas on how to incorporate dairy products across Tips the day see page 57.

5 Meat, fish and alternatives

 Two to three portions of these foods are needed daily. (A portion is 50g-75g meat, 75-100g fish or 2 eggs)

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A l a n f y f o m , e ry sh at, poult Any fii These foods provide your body with:  Protein for growth, development and repair.  Iron to prevent anaemia. • Meat, fish, offal and its products – iron easily absorbed • Beans and pulses – need vitamin C rich foods for better iron absorption  Zinc (red meat) for wound healing and the functioning of the immune system.  Vitamin B12 (meat, fish, poultry, eggs) to make red blood cells and for healthy nervous system.  Vitamin A (oily fish, eggs) for good vision.  Fibre (beans, pulses, nuts and seeds) for healthy guts and low cholesterol levels.

Aim to eat two portions of fish a week, one of which should be oily.  Oily fish salmon, herring, trout, sardines, pilchards, fresh tuna, mackerel: • Source of omega-3 fatty acids for healthy heart and joints.  Sardines with bones are a good source of calcium and vitamin D.

 For tips on how to keep down the fat content of meat and poultry Helpful see pages 18 – 21.  Beans and pulses are great meat substitutes and can also count Tips towards one of your 5 a day.

6 Fatty and sugary foods

 Not necessary for a healthy diet as they are low in nutrients but high in energy.  Enjoy occasionally, in small amounts as part of balanced diet.

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These foods provide your body with:  Saturated fat which can increase the amount of cholesterol in blood over time.  Sugars which increase risk of dental problems.  Salt which increases the risk of high blood pressure.

Ways to cut down on fats Ways to cut down on sugar  Avoid highly processed,  Drink water or unsweetened fruit juice. take-away foods.  Try currant buns, scones or malt loaf.  Use a moist sandwich filling  Try to reduce the amount of sugar so you can leave out butter. you add.  Compare the labels.  Use dried or fresh fruit to sweeten dishes.  Check hints for healthy cooking  Choose cans of fruit in natural juice. on page 18-21.  Try wholegrain breakfast cereals and sweeten with fruits.

Note: The above advice is not suitable if you are ill, convalescing or have a poor appetite.

7 Keep well hydrated

 To stay healthy and avoid dehydration.  Aim to drink about six to eight glasses (1.5 – 2 litres) of fluid each day.  Don’t wait until you are thirsty to drink.

The best ways to meet your fluid requirements: ed ju ilk en ice M et e w s

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Water Other drinks that also count towards your fluid intake: ting a ilu jui e D ce T / s q

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C offee Remember!  Tea, coffee and fizzy drinks such as cola contain cafeine and sugar.  Consuming too much cafeine means you may need to go to the toilet often.  Tea, coffee & cocoa reduce iron absorption from food. Where possible drink these an hour after eating, and between meals.

Signs of dehydration:  Headache  Feeling thirsty  Lack of concentration  Confusion and irritability  Dark-coloured urine  Feeling sleepy

8 Salt

 No more than 6g (a teaspoon) of salt a day.  Most of us get 70% of the salt we need from our food without adding extra.  Too much salt can contribute to high blood pressure and therefore increase risk of strokes.

Foods high in salt:

Cheese Tinned fish in brine Crisps Cheese products smoked fish Salted nuts

Ham Some baked beans Tomato ketchup Bacon and canned Gravies Processed meat vegetables Stock cubes Soy sauce

Bread and breakfast cereal Although they are an important part of a healthy diet these can and do contain salt. Try to compare labels and choose the ones lower in salt.

Watch out for high salt in food and compare the labels: HIGH is more than 1.5 g of salt (0.6g sodium) per 100g LOW is 0.3g of salt (0.1. sodium) or less per 100g

 Try not to add salt to cooking or at the Helpful table before you try it. Use herbs and spices instead.  Try not to overdo salty foods. Tips  Be sparing with sauces like ketchup and soy sauce.  Go for low salt snacks like dried fruit.  For more helpful tips see pages 18-20. 9 Food labels

Dates you should look for: Use by dates - used on items with a short shelf life that can go off within a few days. Do not use foods after this date. Best before dates - used on items which can be stored for a week or more. They can be eaten after this date but they may not be as tasty as before the date. Foods with no use by date such as fish or meat counter products can be kept in the fridge for up to two days after purchase.

Traffic Light Labeling Many food manufacturers are now adopting the traffic light food labeling system. You can compare food at a glance for their fat, saturated fat, salt and sugar content. The pictures below show the way 3 different manufacturers use the system.

LOW The more green the healthier the food.

MED Choose most of the time but you might want to change to green over time.

HIGH Should be trying to cut down on these foods. Eat occasionally in small amounts but try to keep an eye on how often you choose these foods. Check page 58 for How to read food labels guidelines.

10 Shopping on a budget

Plan ahead and write a shopping list - You will be less likely to buy too much.

Compare diferent brands - Supermarkets ‘own brands’ are usually cheaper than ‘branded’ items and just as nourishing.

Look at your watch - You can catch end-of-day bargains.

Take advantage of reduced items that you can freeze - Freeze food on the day of purchase! (Freezing guide on page 17, 58).

Buy frozen foods - Try swapping fresh for frozen once or twice a week.

Tins - Buy tinned fish once in a while. Choose the one preserved in spring water. Stock up on canned fruit and vegetables. Buy those canned without added salt or sugar.

Fruits and Vegetables - Cheaper when bought in season.

Avoid ‘buy one get one free’ ofers which don’t store easily.

Go shopping with a friend - Take advantage of bulk buy offers, spread the cost and the load and maybe enjoy a cup of tea together after all the work!

Cook in bulk - Consume another day or freeze in portions for a later date.

Meat and fish counters -If there is a special offer on something but you don’t know how to cook it, ask for a recipe.

11 Store cupboard essentials

 Fill your cupboard with the basics. This way only the fresh ingredients need to be bought regularly and meal planning becomes easier.  Keep a reserve for times when illness or bad weather makes shopping difficult.  Many of the items in the list below will store well, so you can buy reasonable quantities without fear of it going off or getting stale, provided it is stored correctly.

Tins  Baked beans. A very good source of protein and great for an instant meal.  Soup. Either for a quick meal or to add to casseroles – for example, adding chicken and mushroom soup to a casserole. Watch out for their salt content.  Pulses. Chick peas, kidney beans, lentils etc. Don’t have to be soaked overnight. Add substance and flavour to soups and stews. Drain and rinse them before use.  Fish. Tuna, mackerel, sardines and salmon. For a quick meal, serve on toast.  Corned beef. Cheap and nutritious source of iron. Goes well with a salad. Be careful because it has a high fat and salt content.  Sweetcorn. Use in any salad, on a jacket potato or in a sandwich.  Tomatoes. The basic ingredient for pasta sauces and soups. Good to mix with meat, fish, lentils and leftover foods.  Rice pudding. A warm and filling pudding for cold evenings.  Fruit in natural juice. Use for a quick pudding with a bit of yoghurt.

Dried goods  Pasta and rice. Rice and pasta are useful for serving with leftover meat, vegetables and cheese.  Dried fruits. Last for months, if sealed. Can be chopped up and added to cereal, curries, and puddings or just eaten on their own as a nutritious snack.  Porridge oats. Perfect for a fibre-rich breakfast.  Flour (plain and self–raising). Essential for sauces and for baking.

12 Bottles, jars and cartons  Oils. A good vegetable or sunflower oil is essential for frying food, olive oil, although more expensive, is worth buying if on offer. Olive Oil adds a good flavour to food and is “healthier oil” (don’t use for frying though).  Vinegar. Useful for making salad dressings.  Tomato puree. Makes any tomato dish richer. The tubes are better for using small quantities.  Long-life fruit juice.  Jam. Always good on toast.  Long-life milk. Can be used to make rice pudding and porridge when you haven’t managed to get out to buy fresh.

Flavourings and gourmet extras  Herbs: mixed herbs, basil, mint, oregano, parsley, rosemary, sage, thyme, majoram.  Spices: cinnamon, ground ginger, ground coriander, nutmeg, paprika, cumin, chilli and curry powder, garlic, pepper.  Stock cubes. Quick and easy to use, great for making simple soups. Vegetable stock cubes help to add flavour to a leftover vegetable soup. Look for low salt options.  Garlic. Enhances savoury dishes - stir fries, sauces, salad dressings. Easily stored in a cool place.  Onions. Essential for any casserole or sauce and will add taste to just about anything. Store them in a dry, cool place and they will last for several weeks.

13 Fridge and freezer essentials

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Milk Eggs

Milk Eggs For your cereal, tea & coffee. For making Always have some on hand for quick white sauces and puddings. scrambled eggs.

Cheese Frozen fruit and vegetables Adds taste and substance to dishes. Green beans, peas, spinach, broccoli, Add to eggs for omelettes, grate onto soups. blueberries ,raspberries etc. Great for an Be aware of its fat and salt content. instant accompaniment.

Yogurt Frozen meat, poultry or fish For a quick dessert poured over fruit. Natural Frozen beef mince, chicken strips or different yogurt can be a substitute for cream in many types of fish. Ideal for a quick and easy meal dishes e.g. curries. like spaghetti bolognese, chicken stir fry or Check the label for sugar content! fish baked in tomato sauce.

Butter or margarine Frozen potato wedges Unsalted butter is better for cooking. or thick cut chips Easy spread butter is ideal for sandwiches An excellent accompaniment to many dishes. or toast. Use sparingly. Watch out for salt in flavoured varieties.

Mayonnaise Goes with chicken, potatoes, tuna, egg and just about anything that fits inside a sandwich. Once opened, it must be refrigerated.

14 Keeping food safe

 Food poisoning is unpleasant at any age, but when you’re older, the effects can be more serious and even life-threatening.  Follow these tips to keep your food fresh and safe to eat.

Food preparation  Always wash your hands thoroughly before handling or preparing food, after handling raw meat, going to the toilet or touching the bin or pets.  Keep utensils and worktops clean. Wash thoroughly before and after preparing any food and after handling any raw foods or eggs.  Separate raw food from cooked/ready to eat food to avoid cross contamination.  Raw meat or fish should not be placed close to other foods, especially foods that are eaten uncooked, such as salads.  Raw eggs can transfer germs so wash your hands after cracking eggs and don’t mix raw eggs with ready-to-eat foods.  Wash tea towels and dish cloths regularly to prevent build of harmful bacteria.

Cooking food  Make sure that food, especially meat and poultry, is cooked thoroughly, until piping hot. Juices should run clear and there should be no pink bits.  Using a microwave oven. Stir the food from time to time to ensure even cooking and heat distribution.  Using an oven. To cook frozen, pre-cooked foods and ready meals, be sure to preheat the oven according to the manufacturer’s instructions to ensure adequate cooking throughout.

15 Food storage  Keep the right fridge temperature: between 1° and 5° C.  Foods should be covered when in the fridge. A good way to do this is to save and wash food containers.  Store raw meat and fish at the bottom of the fridge so that it doesn’t drip on to other food. Keep cooked meat separate from raw meat.  Meat and dairy. Should be stored on separate shelves wherever possible.  Store eggs in the fridge to keep them fresh.  Opened canned foods should be removed to another sealed container and stored in the fridge for not more than two days.  Kitchen foil. For wrapping and covering foods. It is made from aluminum so don’t use it to store highly acidic foods like: tomatoes, rhubarb, cabbage or soft fruit.  Cling film. For protecting food. Check the description on the box to see what foods it can be used with or whether it can be used in the oven or microwave.  Always follow the manufacturer’s instructions on storing bought food and do not use it after the use-by date (see p.10).

16 Leftovers  Don’t leave food out overnight.  Never put hot food in the fridge as it will heat up the refrigerator. Cool leftovers as quickly as possible (within 90 min) and store them covered in the fridge or freezer.  Divide leftovers into smaller portions so that it cools evenly.  Use leftovers within two days. Keep boiled rice ONLY until the next day as bacteria can multiply rapidly in rice given the correct conditions.  When re-heating leftovers, warm up only what you plan to eat. Make sure that it’s piping hot all the way through.  Don’t reheat food more than once.

Freezing and defrosting  Freeze food so you always have some food in stock and avoid waste.  Freeze almost any food, except eggs in shells or unopened cans.  For quality reasons don’t freeze foods such as mayonnaise, cream sauce or lettuce.  Freeze raw or cooked foods before use-by date.  Follow the label instructions for freezing or thawing.  Wrap the meat before freezing to keep it edible and soft after defrosting.  Date and label food in the freezer.  Defrost food before cooking. Thaw in the fridge so it doesn’t get too warm. Use microwave if you want to cook it straightaway.  Defrosting meat and fish. Keep it in a sealed container at the bottom of the fridge to prevent dripping onto other foods.  Eat food within two days after defrosting.  Cook food until it’s steaming hot all the way through.  Never re-freeze foods that have already been frozen and defrosted.  Check page 58 for freezer storage times.

17 Hints for healthy cooking

Use ingredients, preparation and cooking methods that will help you to cut down on fat (especially saturated fat) and salt. At the same time this will allow and enable you to increase fibre, vitamins and minerals.

Note Fat restriction is not appropriate if you have a small appetite due to illness or frailty.

Ingredients

Cutting down on fat and saturated fat Use unsaturated oils such as olive, rapeseed, corn, soya and sunflower oils instead of butter, lard or ghee in cooking. Fish. Choose tinned fish in spring water rather than oil. Lean meat. Choose the leanest meat you can afford and grill, stew or braise it. Replace meat with more vegetables and/or pulses in casseroles, stews and curries. Strong cheeses. Using a stronger cheese will allow you to use less. Dairy. Choose lower-fat dairy products e.g. semi-skimmed milk or reduced fat cream. Lower fat versions. Try those for mayonnaise, salad cream or hummus. Salad dressings. Try making your own with natural yoghurt, herbs, spices, vinegars, lemon juice or tomato juice.

Cutting down on salt Tinned vegetables and pulses. Choose ones marked ‘no added salt’ but still check the label and compare with other brands. Drain off excess juice or brine. Stock cubes and gravy. Buy low salt, use less or replace with herbs and spices.

18 Bought pasta sauces. Watch out for their salt content. Often tomato based sauces are lower in salt than cheesy sauces or those containing olives, bacon or ham. Be sparing with cooking sauces, soy sauce, brown sauce and tomato ketchup as they are all high in salt. Meat and fish. Choose smoked meats and fish less often due to their high salt content.

Ways to increase fibre content  Add beans, peas, and lentils to soups, casseroles, stews and curries.  Vegetables. Include lots of vegetables in your recipes and serve portions of vegetables with your meals.  Wholegrain. Choose brown rice, pasta or wholegrain bread to serve with your food.  Mix wholemeal flour with white flour when baking.

Note Bran should not be added to food: it reduces the absorption of many minerals and can, if consumed without sufficient fluid, cause bowel obstruction. Preparation and cooking

Cutting down on fat and saturated fat  Visible fat. Trim off before cooking.  Chicken skin. Remove skin from chicken before you cook it as a stew or stir fry. Keep it on when grilling to prevent the chicken from drying out and remove skin before serving.  Measure oil. Use a teaspoon, rather than pouring it straight from the container. 1 teaspoon per person is fine to prevent sticking.  Skim fat of from the top of a meat dish or soup before serving.  Mash potato with olive oil and garlic instead of butter and milk.

19 Cutting down on salt  Don’t add salt to cooking.  Marinate meat and fish to add flavour. You can try: • Soy sauce, garlic and lemon juice to marinate fish. • Wholegrain mustard and low fat yoghurt to marinate fish. • Cumin, turmeric, paprika, chilli powder and tomato paste to marinate chicken. • Balsamic vinegar, garlic, pepper, thyme works for steak, pork and chicken.  Roast vegetables. Try roasting red peppers, tomatoes, courgettes, fennel, parsnips and squash to bring out their flavour.  Seafood and fish. Squeeze on lemon juice.  Onion: use brown, red, white, spring onions or shallots for extra flavour without salt.  Herbs: fresh and dried. For pasta dishes, vegetables and meat.  Stir- fry flavourings: use garlic, ginger, chilli and lime.  Black pepper. Use on pasta, scrambled egg, tomatoes etc.

Minimizing vitamin loss from fruit and vegetables  Don’t store fresh fruit and vegetables for a long time.  Use frozen veg. Freezing ‘locks-in’ the vitamins.  Prepare ingredients immediately before cooking.  Don’t chop too small.  If grating food, eat or cook as soon as possible.  Use lemon juice to prevent fruit browning.  Avoid peeling where possible. Fibre and many nutrients are just under the skin.  Cooking time. Use the minimum amount of water, start with boiling water and cover tightly to keep in the steam, or try steaming instead. Don’t overcook.  Don’t add bicarbonate of soda to the cooking water as it affects vitamin content.

20 Healthy cooking methods

Choose ones that don’t require extra fat like:

POACHING Low fat: Poaching requires no extra fat. Variety: Eggs and fish such as salmon are popular foods for poaching but you can also poach light meats such as poultry. The method: Place the food in a container (such as a fish or egg poacher), add the poaching liquid, cover with foil or a close-fitting lid and cook in the oven or on the stove. Liquids for poaching: Add lemon juice or vinegar when poaching eggs in a pan of water. Use milk, water or a light aromatic stock for fish and poultry. The poaching stock can be thickened with cornflour for a sauce.

GRIDDLING Low fat: You hardly need to use any oil or fat, particularly with the non-stick griddle pans. Griddle pans have ridges so that fat can drain away from foods that contain fat. Variety: There are many foods that can be griddled, including vegetables like courgettes and peppers, fish like tuna or salmon, or poultry, chops and steak. The method: Sear your food quickly in the hot pan on both sides to form a crust and seal in the juices. Buy a high quality pan to withstand high temperatures. Flavourings: Griddling food keeps in all the natural flavours, and you can add fresh herbs, spices, lemon or lime juice and balsamic vinegar for variety.

STEAMING Vitamin loss: Reduce vitamin loss in vegetables compared to boiling. This is a low fat cooking method which keeps food moist. Variety: You can steam fish, poultry, puddings, sponges, couscous, custard and dumplings as well as vegetables. The method: Put the food in a steamer or colander and fit over a pan of boiling water. Cover with a close-fitting lid - the steam cooks the food.

21 Kitchen: making things easier

There can be many things in a kitchen that make cooking more difficult. Many food packets can be hard to open and some kitchen utensils can be fiddly and awkward to use. There may be a certain cupboard or shelf in the kitchen that is difficult to reach. Take a look around your kitchen and see if it can be re-arranged to make things easier. It might be helpful to get a friend or a neighbour to help you.

 Try to put things you use everyday in handy and easy-to-reach places. Helpful  See if any heavy utensils (such as mixing bowls, chopping boards, measuring jugs or baking trays) can be replaced with lighter weight Tips versions or, if not, try to keep them within easy reach so you don’t have to reach up or bend down to get them.  It might be worth looking at more specialised equipment if you are finding something particularly difficult. Many cook shops have special styles of utensil to make things easier.

For information call Age Scotland Helpline on 0800 4 70 80 90 from 10am – 4pm, Monday to Friday. On Tuesdays the helpline is open until 7pm. They will provide you with free, confidential information or point you in the direction of other experts who can help.

22 Malnutrition

Malnutrition is a serious health condition. It can be caused by not eating enough, too few nutrients in the diet or by digestive problems related to ageing, or underlying health problems. If your needs for energy and nutrients are not met this can stop your body functioning properly. You are at higher risk of malnutrition if you are over 65’s, socially isolated or recently bereaved.

Symptoms  Unplanned weight loss  Lack of strength or energy to undertake routine activities.  Increased vulnerability to infection and delayed wound healing.  Dizziness and irritability.

Numerous factors can contribute to malnutrition  Poor appetite and problems with chewing food.  Cooking for one and/or limited knowledge about cooking.  Limited knowledge about good nutrition.  Difficulty using kitchen utensils.  A low income and a lack of budgeting skills.

Note Medical conditions i.e. cancer, liver disease, depression, Crohn’s disease, dementia or persistent diarrhoea can also contribute to malnutrition. However, to deal with those factors is beyond the scope of this booklet.

The best way to prevent malnutrition The best way to prevent malnutrition (if not caused by an underlying health condition) is to eat a healthy balanced diet. In the following section are tips on how to make sure your food intake is as good as possible when your appetite is poor, if you have lost some weight or have chewing difficulties.

Note If you are underweight or have lost weight suddenly (without a clear cause) visit your GP to ensure there is no underlying issue.

23 Restoring your appetite

There are different reasons why your appetite may be poor as you get older. First check with your doctor to see if it is due to medication you are taking. Other than that the most common reasons for appetite loss are: decline in sense of smell and taste; being less active; cooking for one, limited knowledge about cooking; being socially isolated.

Simple ways to improve your appetite:  Add herbs, garlic, spices and lemon juice for stronger and more vibrant flavours.  Use different colours i.e. serve a spoonful of berry fruit with plain yogurt.  Use different shapes and textures of food.  Do a small amount of exercise every day. This will be different for everyone - whether it’s a full exercise class, a walk for a pint of milk or a bit of dusting - but it all goes to increasing your appetite. For details about activities to attend near you visit your library.  Experiment and be flexible. Adapt to your mood and what you want and like to eat.  Cook and eat with friends and family.  Go to your local community cafe for a warm and cheap healthy meal every now and then.  Check our healthy, easy to follow recipes for one.  Make use of convenience food. Remember to check the labels (tips on pages 10 and 58).  It is never too late to join a cookery class.  But most of all have fun! Don’t let cooking and eating become a chore: make it something you enjoy.

Note If you are concerned and unsure about reasons why you may be losing your appetite visit your GP to ensure there is no underlying cause.

24 A poor appetite and weight loss

If your appetite is poor and you have lost some weight, below are tips on how to increase your food intake and get all the energy and nutrients your body needs.  Eat smaller meals and frequent snacks.  Snack on good quality food such as breakfast cereal, sandwiches or wholegrain toast. Don’t fill up on biscuits and cakes.  Don’t fill up on fibre without eating other foods as too much fibre can make it difficult for the body to absorb nutrients.

Nutrient Rich Foods Eat foods which provide lots of nutrients in a relatively small volume:

Foods with Full Canned Fish Nuts - go for Cream Milk Meat on Toast unsalted varieties

Soups with Cheese, Creamy Well Cooked Eggs Pulses & Pasta Yoghurts

Add Things - make foods more energy or nutrient dense by adding: butter to vegetables, skimmed milk powder to milk, grated cheese to savoury dishes, cream, cheese, milk or skimmed milk powder to soup, evaporated milk to custard, jelly or milk puddings.

 Try and take some fruit and vegetables with your meals to get the vitamins – for example, chopped banana or dried fruit on cereal.  Consume more nutrient-rich drinks e.g. milk or fruit juice, rather than tea or squash.  Take drinks after meals rather than before so your stomach is not full before you eat.  Prepare food in advance when possible so the appetite is not diminished by the effort of food preparation or prolonged exposure to cooking smells.

Note This advice may not be suitable for some medical conditions e.g. diabetes. If you are not sure whether this applies to you consult your GP or Dietitian. 25 Chewing difficulties

When people experience problems with chewing, eating can be painful and difficult. The following is a list of ways to adapt foods to ensure nutrient intake is adequate.

Meat and poultry Potatoes  All well cooked, tinned and ready cooked  Mash potatoes. Instant mashed potatoes meals can be minced with a sauce. are a useful alternative.  Try cold meats e.g. corned beef and  Bake potatoes and eat with a soft filling. spreads.  Choose softer meals like shepherd’s pie, Pasta spaghetti bolognaise, corned beef hash,  Cook pasta until soft. chicken casserole and stew.  Add creamy sauces and/or grated cheese. Soups Vegetables.  All varieties can be liquidised.  Cook until soft (and mash if necessary).  Remove crust from the bread and break into soup.

Fish  Steam, bake, microwave fish. Flake and serve with sauce. The sauce will help to moisten the fish.  Choose filleted fish.

Cheese  Use grated cheese.

Eggs  Have them boiled, poached, scrambled or as an omelette.

26 Importance of breakfast

Benefits of eating breakfast:  Boosts energy and concentration levels.  Provides the body with essential nutrients and vitamins.  Regulates your appetite.

Top tips to get you started

Make time for breakfast Cannot face eating first thing in the morning?  Try and eat within two hours of getting up.  Start with a piece of fruit to ‘kick start’ your digestion.

Choose porridge or wholegrain varieties of breads and cereals* A high fibre content will help keep your gut healthy and you will feel full for longer. * Many breakfast cereals have minerals and vitamins added.

Go for variety Vary your breakfast by trying other types of bread such as:  Rolls, bagels, fruit loafs, hot cross buns  Crumpets, English muffins, scones  Rice cakes or oatcakes are great alternatives too!

Have some fruit and be well on your way to 5 a day  Add some fruit to you cereal.  Have a glass of juice or a piece of fruit.  Try a mashed banana on toast.  Go for a fruit salad or smoothie. 27 Include dairy products  Great source of calcium, protein and vitamin D.  Have milk on your cereal.  Drink a glass of milk on its own or as a milkshake/smoothie.  Have a pot of yoghurt or cheese on toast.  Choose lower fat versions when watching your fat intake.

Eggs are a good breakfast option  Great source of protein and iron.  Go for boiled, poached or scrambled options.

Vary your sources of protein  Choose lean grilled bacon, grilled sausages or baked beans.  Try smoked mackerel or trout pate on toast or with oatcakes.  Avoid fried options.

Go easy on foods and drinks high in fat, sugar and salt  Croissants, pancakes and pastries can make for a tasty breakfast but only have them occasionally.  Try to be sparing with butter, jam or syrup.  Try to avoid cereals coated in sugar or adding sugar.

Remember to include a drink Water, milk, unsweetened pure juice, tea and coffee all supply vital fluids. Being well hydrated also means you can concentrate better.

28 Ideas and recipes

The following is a selection of ideas and recipes that are quick, simple and nutritious. All the main meals recipes have the traffic light colour-coded nutritional information to inform you at glance whether they are low, medium or high in fat, saturated fat, sugar and salt. All recipes that display the 5 a day stamp count towards at least one of your 5 a day. Most of the recipes provide one portion. However, some recipes provide for two portions when it’s more feasible and better money-wise. Therefore, when appropriate, follow food safety tips for leftovers on page 17.

Ready meals There is no reason why ready meals cannot be included in your diet to make cooking and preparing easier. It is the ingredients that determine whether a meal is healthy or unhealthy, not whether it is bought from a supermarket or prepared at home. There are a number of things you can look out for to make sure you opt for the healthiest choice possible:  For ready meals with traffic lights, try to choose a meal with no reds or only one red.  Compare food labels for the healthiest option.  Look out for the ‘5 A Day’ logo on ready meals, which indicates how it contributes to your daily quota of fruit and veg.  Add some cooked vegetables or a mixed salad of your own if the meal is a bit low in vegetable content.  Be aware of high salt and added sugars.

29 Tasty breakfast ideas – begin your day the healthy way!

Porridge It is a great choice for breakfast. It’s cheap, rich in fibre and has no added salt or sugar. Porridge oats soaked the night before in milk or yoghurt need no cooking.

Topping ideas that can be used both on porridge or cereal:  A pinch of ground cinnamon and fresh apple (you could add some raisins as well).  A sliced banana and honey.  Raisins, sultanas, dried cranberries, dried apricots or blueberries.  Chopped fruits. You can use dried, fresh tinned or frozen. Remember to think about what is in season to keep the cost down.  Raspberries and a spoon of yogurt.  Mixed nuts (but remember they might be difficult to chew).  Add many others, be inventive!

Yogurt  Try to buy yogurts that are low in fat.  Be careful as low fat yogurt can be very high in sugar.  Try different varieties e.g. Greek yogurt, fruit or plain.  Add fruit, nuts and/or seeds.  If there isn’t enough sweetness in the fruit try adding a small amount of honey.  Add yogurt to muesli and fruits.

Eggs  Serve on toast, a bagel, an English muffin, a crumpet or a baguette.  You could try frying some mushrooms and a tomato in a very small amount of sunflower oil to go with eggs. 30 Porridge 7 mins 1

Ingredients Equipment ½ cup porridge oats Measuring jug 1 cup of water/milk Medium Pan The more milk you use the creamier the porridge will be. Wooden Spoon Why not try with a half and half mix for the first time and then in the future you can adapt the recipe to suit you.

Method 1. Put the liquid in a small pan and sprinkle porridge oats on top. 2. Bring to the boil on a medium heat, stirring continuously. 3. Turn the heat down slightly and simmer gently for about five minutes. 4. Pour into a bowl and serve with fruit and maybe a little of extra milk. 5. See topping suggestions.

Apricot porridge 7 mins 1

Ingredients Equipment Measuring 40g (1½ oz) porridge oats jug 200 ml (7 fl oz) semi-skimmed milk Small saucepan 4 ready-to-eat dried apricots Knife 2 teaspoons golden syrup Board Wooden A pinch of ground cinnamon Spoon

Method 1. Simmer the porridge oats and milk together in a small saucepan for four to five minutes until the mixture is slightly thickened and smooth, stirring frequently. 2. If necessary, add a little water to get the texture you prefer. 3. Meanwhile, chop the apricots. 4. Stir the syrup and ground cinnamon into the porridge. 5. Pour the porridge into a bowl, sprinkle with chopped apricots and serve. 31 15 Banana pikelets mins 1

Ingredients Equipment 1 cup flour, preferably wholemeal Bowl Fork 1 teaspoon grated lemon rind (optional) Non-Stick 1 small mashed banana Frying Pan Spatula Lemon juice Semi-skimmed milk Oil, if non-stick pan not available

Method 1. Combine all dry ingredients and add milk until the mixture is of a dropping consistency. 2. Heat a non-stick frying pan. 3. Drop in spoonfuls of the mixture. Turn them over when bubbles appear on the top of each pikelet. 4. Remove the cooked pikelets from pan and continue adding spoonfuls until all the mixture is used. 5. Serve topped with slices of fresh banana.

Fruit smoothie 2 mins 1

Ingredients Equipment 1 small carton fruit yogurt, low fat Blender Splash of semi skimmed milk for smooth texture 1 banana, broken up into pieces 4-6 strawberries Use fresh, canned, frozen or slightly soft or over-ripe fruit

Method 1. Add the fruit, yogurt and milk to the blender. 2. Switch on the blender for 30 seconds - ensure the lid is secure. 3. Check if the fruit is blended. If not, switch on the blender again. 4. Pour the smoothie into glass. 32 Scrambled eggs 5 mins 1

Ingredients Equipment 1-2 eggs Bowl Pan 2 tablespoon of milk per egg Fork Pepper Wooden Spoon Method Small Pan 1. Break one or two eggs into a bowl and whisk lightly with a fork. 2. Add about two tablespoons of milk per egg. 3. Season with a good shake of pepper. You can also add a pinch of herbs or dried parsley if you like. 4. Warm a pan with a little oil in the bottom. 5. Pour in the egg and continue to stir under a low/medium heat. 6. As the egg cooks it will thicken. Take it off the heat when it is still very slightly liquid as it will continue to cook in the warm pan.

Mackerel paté 5 mins 2

Ingredients Equipment 1 medium, smoked mackerel fillet Bowl Fork 50g (2oz) reduced-fat cream cheese Garlic crusher 1 tablespoon lemon juice ½-1 teaspoon Worcestershire sauce Black pepper Crushed chopped one garlic clove (optional)

Method 1. Remove skin from fish. Break in to pieces in a bowl, removing any bones. 2. Add cheese, lemon juice, Worcestershire sauce, pepper and garlic. Mash together using a fork. 3. Cover and keep in a fridge for maximum two days. 4. Serve with oatcakes or wholemeal toast. 33 LOW SALT LOW SUGAR MED FAT MED SATURATES 15 Simple Omelette mins 1

Ingredients Equipment 1 teaspoon oil Oven safe frying pan 1, 2 or 3 eggs, depending on appetite Knife, Fork Chopping Extra ingredients (Choose as you fancy) Board Small Bowl 1 or ½ red pepper, chopped Peeler 2-3 mushrooms, sliced Wooden Some chopped ham Spatula Grater Herbs Grated cheese, to sprinkle (optional) Side salad or some vegetables and bread, to serve

Method 1. Beat the eggs together in a small bowl. Add the extra ingredients and mix. Season to taste with herbs and pepper. 2. Warm the oil on a low heat in the frying pan. Swirl the oil around the pan. 3. Pour the egg mixture into the pan and allow to cook without stirring for five to eight minutes. It is ready once it starts to look golden on the underside. Look at it by carefully lifting it up with the spatula. 4. Meanwhile put the grill on medium. Once the underside has started to go golden put the pan under the grill to set the egg on the top. 5. Serve immediately with a sprinkle of cheese, side salad and bread.

 Omelette is a perfect BREAKFAST meal; you can just make it plain Helpful or add a chopped tomato.  Use leftover vegetables to make your omelette. Tips  Make sure the omelette is completely cooked: raw eggs should not be eaten.  Eggs are relatively inexpensive and make a substantial meal.  Keep eggs in the fridge, away from strong odours. Use the eggs by the ‘best before’ date. Do not use eggs with damaged or broken shells.

34 Snacks, lunches and soups

The following section gives some ideas of things you can have for a quick nutritious meal or snack.

Healthy snack ideas  Carrot, cucumber or pepper sticks with cottage cheese  Plain or fruit scone with jam  Chopped melon or pineapple  A flapjack  Low fat yoghurt or fromage frais  Sandwich or slice of toast with banana and a little honey  Cottage cheese and plain crackers  Handful of rice crackers or a rice cake  Rice cakes with peanut butter or banana  Half a bagel with low fat cheese spread  Small handful of unsalted peanuts  Hot cross bun or two slices of malt loaf  Plain popcorn  Handful of dried fruits

Healthy sandwich, roll or pitta bread fillings  Tuna and sweetcorn  Hummus and tomato or radish slices  Tuna and cucumber  Grated cheese and carrot  Turkey breast with pickle  Tinned mackerel or sardines on toast  Cheese and cucumber  Egg and cress with low fat mayonnaise  Chicken, lettuce and tomato  Peanut butter and grated apple

Healthy lunch ideas  Sandwich, roll or pitta bread with a healthy filling. Banana and fresh orange  Any soup and bread. Fruit salad. juice.  Baked potato with tasty filling. Chocolate  An omelette filled with low fat grated mousse. Cheddar cheese and courgettes.  Greek salad (feta cheese & olives). Sugar-free jelly. Low fat Greek yogurt and fruit.  Poached egg on toast  Sesame crackers and low fat cheese selection. Grapes and yogurt. 35 60 Baked potato mins 1

Ingredients Equipment 1 medium floury baking potato Aluminium Foil (King Edward or Maris Piper is ideal) Metal Skewer (optional) Fill with a filling of your choice: Fork  Mixed salad  Cooked tin of mixed or baked beans  Plain yoghurt, coriander and diced cucumber and/or red onion  Cottage cheese with pineapple or dates  Sliced mushrooms lightly fried in olive oil and garlic  Tuna mixed with sweetcorn and natural yogurt  Leftover chilli con carne or bolognese sauce

Method 1. Pre heat oven to 400F/200C/Gas Mark 6. 2. Wash potato in warm running water and dry carefully. 3. Sit on sheet of aluminum foil and if using metal skewer carefully insert it through the potato length ways (using a skewer will reduce cooking time). 4. Pierce the potato a few times with a fork to allow steam to escape. 5. Wrap whole package loosely in the foil making sure it is sealed. 6. Place directly onto middle oven shelf and bake for about 1 hour and a half. 7. Carefully remove the package with oven gloves and gently squeeze, it should give a little. If it still feels hard place back in oven for a further 10 – 15 minutes. 8. When cooked place on a plate, carefully remove the foil and the skewer and cut along lengthways and crossways most of the way through.

Microwave Option Helpful If you are in a hurry try cooking the potato in the microwave. Wash and pierce the skin several times. Put in the microwave Tips on full power for eight minutes. Test to see if the potato is done by piercing with a skewer.

36 60 Making soup easy mins Variable

Equipment A basic recipe for any soup Chopping board Ingredients Knife 1 teaspoon oil or enough to soften vegetables Peeler 1 onion, sliced, any thickness is fine Wooden spoon 1-2 garlic cloves, chopped thinly (optional) Saucepan Any vegetables of your choice, chopped into small chunks Measuring jug Stock, enough to cover vegetables. 1 stock cube per pint of water Hand blender Milk (optional) if you want a more creamy soup Dry herbs Pepper Bread, to serve

Method 1. Heat the oil in a saucepan. Cook the onion on a medium heat until it’s soft. 2. Add the garlic and cook for another minute. 3. Add all other vegetables and fry until soft (for about 10 minutes). 4. Add stock. If you want a more creamy soup, add milk to the pan. 5. Bring to the boil and simmer for 20 – 30 minutes. 6. Add any dried herbs. Mixed herbs are a good choice for mixed vegetables. 7. Use your hand blender to blend the soup to a consistency that you want. 8. Season the soup and serve hot with some bread.

 Soup can be made for one but it is often useful to make more. Check helpful tips’ box on page 38.  Soup is very adaptable and is a good way of using up Helpful vegetables or throwing in whatever you have leftover. Tips  Ideas for great soups include: Leek & potato; Tomato & basil; Tomato & pepper; Carrot & coriander; Brocolli & cauliflower; Cream of potato; Leek & spinach. 37 MED SALT LOW SUGAR LOW FAT LOW SATURATES 50 Lentil soup mins Variable

Ingredients Equipment 1 teaspoon margarine/oil Chopping board 1 carrot, peeled and chopped Knife 1 onion, peeled and chopped Peeler Wooden 50g (4 tablespoons) red lentils spoon 450ml (2 cups) water Saucepan Kettle 1 vegetable stock cube Measuring Pepper, to season Jug Bowl For extra flavor (optional) Cup 1 slice of bacon, chopped Celery seeds Bread, to serve

Method 1. Boil water in a kettle. Dissolve the stock cube in the boiled water. 2. In a saucepan, heat the margarine/oil on a low heat until melted, then add onion, carrot and bacon (if used) and cook for five minutes until onion softens. 3. Add the lentils and stir for one minute. 4. Pour the vegetable stock into the pot. 5. Bring to the boil, then turn down to a simmer for at least 35 minutes. The longer it cooks the thicker it will get. 6. For smoother soup put it in a blender or through a sieve. 7. Season to taste with some pepper and serve hot with bread.

This recipe makes a generous quantity of soup so you could keep the Helpful other portion in the fridge in a covered container for up to three days. Add a little amount of water and heat through for five to ten minutes, Tips to create another tasty meal.

38 Main meals

LOW SALT LOW SUGAR LOW FAT LOW SATURATES 35 Tomato sauce mins 2

Ingredients Equipment 1 teaspoon oil Frying pan Knife 1 onion, finely chopped Wooden 1 garlic clove, finely chopped spoon Can opener 400g (14oz) can chopped tomatoes 2 tablespoon tomato puree Pinch of mixed dried herbs, to season Black pepper, to season Serve with pasta or spaghetti A variety of raw or cooked vegetables, or cooked meat, is delicious in a tomato sauce. Chorizo or pepperoni will give extra bite to your sauce.

Method 1. Heat the oil in a frying pan. Cook the onion on a medium heat until it’s soft. 2. Add the garlic and cook for another minute. Make sure the pan is not too hot when you add the garlic as it burns easily, causing a bitter taste. 3. Add chopped tomatoes, tomato puree and mixed herbs. Simmer gently for 15 minutes until the sauce is thick and rich. 4. Add pepper to taste. 5. Cook the spaghetti/pasta according to packet instructions.

 This is a very versatile sauce that you can use in many different ways. Helpful  Add a can of tuna or some sliced vegetables to the sauce at step 3. Try mushrooms, peppers or courgettes. Tips  Use the sauce as a pizza topping. Just sprinkle with grated cheese and your favourite vegetables.  Pour the sauce over fish fillet (140g/5oz) and bake in the oven at 180°C or gas mark 4 for 15 – 20 minutes. 39 LOW SALT LOW SUGAR LOW FAT LOW SATURATES 30 Gnocchi and tomato bake mins 1

Ingredients Equipment Gnocchi 120g (4oz) Frying pan made of potato, found near the pasta section in the supermarket* Ovenproof dish 1 teaspoon of oil Chopping board 1 garlic clove, chopped Wooden 3 medium size mushrooms, sliced spoon 1 small courgette, chopped into chunks Knife Can Opener 1 small can (227g) chopped tomatoes Basil, fresh or dried 28g (1oz) Mozzarella cheese, torn or sliced (cheddar cheese is fine as well) Vegetables, to serve * Take enough gnocchi for this recipe and freeze the rest of the pack (check packaging instructions).

Method 1. Heat the grill to high. 2. Heat the oil in the frying pan. Add the mushrooms and courgettes and cook until soft, approximately five minutes. 3. Stir in the garlic for one minute. Add the chopped tomatoes and gnocchi. 4. Stir occasionally until the gnocchi has softened and the sauce has thickened. 5. Stir through the torn basil leaves and transfer all to the ovenproof dish. 6. Scatter with mozzarella and grill for five minutes until the cheese is golden.

 Make a double portion so you can buy a 400g can of chopped tomatoes (usually cheaper than the smaller can). Keep excess Helpful for another day, or freeze for a later date. Simply defrost and bake in a Tips medium oven for 20 – 30 minutes.  Try changing the vegetables according to taste and season – or try with other vegetables in your fridge to use them up.  Try adding fresh chilli or chilli flakes for an extra kick or use goats’ cheese for a different taste.

40 MED SALT LOW SUGAR MED FAT MED SATURATES 30 Macaroni cheese mins 1

Ingredients Equipment 50g (2oz) macaroni Chopping board 50ml of semi-skimmed milk Knife 1 tablespoon plain flour Wooden spoon 1 tablespoon butter/margarine 2 Saucepans 50g (2oz) strong cheddar cheese, grated or diced Scissors Frying pan/ Pepper to taste griddle 1 tomato, sliced Measuring Jug For extra flavor (optional) Sieve 1 slice of bacon, cut with scissors and dry fry on non-stick frying pan until brown Green vegetable and/or salad, to serve

Method 1. Half fill a saucepan with water and bring to the boil, add the macaroni and cook for 10 minutes or as directed on the packet. 2. In the meantime melt the margarine/butter in a small pan, add the flour and stir over a medium heat for a few minutes. Add the milk gradually stirring all the time. When the mixture comes to the boil, turn the heat down and simmer for two minutes. 3. Add two thirds of the cheese and pepper to the sauce, return to the heat to allow the cheese to melt. 4. Mix in bacon if used. 5. Turn the grill on. 6. Drain the macaroni through a sieve and add to the sauce. 7. Pour into an ovenproof dish, arrange the tomato slices on top, and cover with the remaining cheese and brown under the grill.

For a change, can add a chopped hard-boiled egg to the sauce at the same time as the macaroni. Helpful Tips 41 LOW SALT LOW SUGAR MED FAT LOW SATURATES

35 Bowl of biryani mins 1

Ingredients Equipment 100g (3 ½ oz) lamb, beef or chicken, cut into chunks Chopping board 1 teaspoon oil Knife 1 small onion, sliced Frying pan Wooden 1 garlic clove, chopped spoon Pinch of cinnamon Kettle Pinch of cumin Black pepper 1 pepper (any colour), deseeded and cut into strips 1 bay leaf ½ teaspoon medium curry powder Pinch of ginger 1 small chilli, sliced through but added whole 75g (3oz) long grain rice Approx. 150ml boiling water ½ teaspoon vegetable bouillon powder (or half a veggie stock cube) Low fat yoghurt, to serve

Method 1. Heat the oil in frying pan. Add onion and garlic with cumin, cinnamon and a twist of black pepper. Cook to soften the onion and sizzle the spices. Remove half the onion and set aside for later. 2. Add the meat to the pan and brown with the remaining onions, curry powder, ginger, bayleaf and chilli. 3. Add peppers and rice and mix together, 4. Gradually add boiling water with the bouillon powder, stirring occasionally. 5. The rice takes up to 15 minutes to cook so gradually add water until the rice is cooked and the mixture is fairly dry. 6. Serve topped up with the remaining cooked onion and yoghurt.

42 LOW SALT LOW SUGAR LOW FAT LOW SATURATES 25 Chinese stir-fry mins 1

Ingredients Equipment 1 teaspoon oil Large frying pan/wok 1 garlic clove, crushed or chopped Garlic crusher 75-100g (2 ½- 3 ½oz) chicken or turkey portion, diced Chopping board 1 red pepper, sliced Peeler 2 or 3 spring onions, sliced Knife Wooden 1 small carrot, peeled and cut into thin strips spoon 3 mushrooms, sliced Saucepan Small handful mangetout, sliced 2 teaspoon low salt soy sauce 2 tablespoon water 1 tablespoon orange juice Pinch of ground ginger ½ or one block of egg noodles

Method 1. Heat a little oil in a frying pan or wok. Add the garlic and turkey or chicken and cook until meat has gone white. 2. Add pepper, spring onions, carrot and mushrooms. Fry for six to eight minutes until the vegetables start to soften. Keep stirring. 3. Put the noodles into a pan of boiling water for three minutes (or follow instructions on the packet). 4. Make the sauce in a teacup – mix the soy sauce, water, orange juice and ground ginger. 5. Add the mangetout and soy sauce. Mix and cook for another two to three minutes. 6. Drain the noodles. Add to the frying pan, heating for two minutes and serve.

For a vegetarian stir fry, substitute meat with your favourite vegetables - e.g. courgettes, peppers, mushrooms and babycorns. Helpful Tips 43 MED SALT LOW SUGAR MED FAT LOW SATURATES 60 Pork casserole mins 1

Ingredients Equipment 1 teaspoon oil Chopping board 100g (3 ½ oz) diced pork Knife Pinch of ground cinnamon Peeler Wooden Pinch of paprika spoon 1 small leek, trimmed and sliced Frying pan Measuring 1 small red skinned eating apple, cored and thickly sliced jug 50ml apple juice Medium saucepan 50ml pork stock (made with a stock cube) Salt and freshly ground black pepper 1 teaspoon cornflour Rice, to serve Vegetables, to serve

Method 1. Heat the oil in a pan. 2. Add the diced pork and stir fry for five minutes, until sealed on all sides. 3. Sprinkle it with the cinnamon and paprika and toss well. Add the leeks and apple, pour in the apple juice and stock and bring to the boil. 4. Cover and simmer for 30 minutes until the pork is cooked through. Season to taste. 5. Mix the cornflour to a paste with a little cold water and whisk into the casserole then cook, stirring for a few minutes, until the juices thicken a little. 6. Serve hot with rice and vegetables of your choice.

Buy bigger pack of diced pork and freeze the excess on the day of purchase and eat within three months. Helpful Tips

44 LOW SALT LOW SUGAR MED FAT MED SATURATES 30 Chop with an apple and mustard mash mins 1

Ingredients Equipment 1 medium size pork chop (75g/3oz) Medium saucepan 2 medium potatoes, peeled and cut into chunks* Grater 1 small apple, cored and grated Peeler Knife 1 flat teaspoon wholegrain mustard Chopping 1 teaspoon olive oil board Potato masher Steamed or boiled green beans, to serve *When making mash always use a floury potato, such as King Edward or Maris Piper – that way you’re guaranteed a smooth texture.

Method 1. Bring a large pan of water to the boil and cook the potatoes for 15 minutes. 2. Add the grated apple and cook for a further five minutes. 3. Drain well and mash thoroughly with the mustard and olive oil. 4. Meanwhile put the grill on medium. Grill the pork chops for 10 minutes each side, until cooked through. 5. Serve the chops with the apple and mustard mash and vegetables.

 Grilling doesn’t require any extra fat. Use this method as a healthy, low fat alternative to frying. Helpful  Trim any visible fat off meat before cooking. Tips

45 LOW SALT LOW SUGAR MED FAT MED SATURATES 30 Pork with red onion sauce mins 1

Ingredients Equipment 100g (3 ½ oz) pork tenderloin, cut into 3cm (1in) thick slices Chopping board ½ flat teaspoon flour Knife 1 teaspoon oil Wooden spoon 1 red onion, thinly sliced Frying pan 50ml (1 ½ fl oz) vegetable stock Bowls Measuring 1 teaspoon wholegrain mustard jug 2 teaspoon of lemon juice 75g (3oz) rice, to serve Vegetables in season, to serve

Method 1. Put pork slices in the bowl, season, then lightly coat in the flour. 2. Heat the oil in a large non-stick frying pan. 3. Quickly fry the pork until it is browned all over. Remove to a clean bowl and cover. 4. Add the onion to the pan (with a touch more oil, if needed) fry for five minutes until light golden. 5. Add the stock and bring to the boil. Boil hard for a couple of minutes to reduce the stock a little. 6. Stir in the mustard and lemon juice, and then bring back to the boil, stirring. 7. Return the pork to the pan and gently simmer for a further 3-4 minute until it is cooked through. 8. Serve with rice and season vegetables.

This recipe could be easily doubled. Helpful Tips

46 LOW SALT LOW SUGAR LOW FAT LOW SATURATES 50 Spaghetti bolognese mins 2

Ingredients Equipment 100g (3 ½oz) lean beef mince Peeler Sharpe knife 1 small onion, finely chopped Chopping 1 garlic clove, finely chopped board 2 Medium 1 carrot, finely chopped saucepans 400g (14oz) can chopped tomatoes Wooden spoon 1 tablespoon tomato puree Can opener Pinch of basil and oregano, to season Colander Black pepper, to season Spaghetti to serve If you don’t like one of the vegetables, swap it for another. Try adding more vegetables e.g. a handful of sliced mushrooms, chopped pepper.

Method 1. Brown the mince over a gentle heat, stirring to stop it from sticking. 2. Add the onion and garlic to the mince and cook for two to three minutes. 3. Add the remaining ingredients, apart from the pasta. Bring the sauce to the boil, then lower the heat and simmer gently for 15 – 20 minutes. 4. Add a pinch of basil and oregano and season with black pepper. 5. Meanwhile, cook the pasta in a saucepan of boiled water. Drain and transfer to the serving dish. 6. Pour the sauce over the pasta and serve with a mixed crunchy salad.

 Buy a small amount of minced beef from your local Helpful or supermarket butcher.  To save leftover boiled pasta, mix drained pasta with a little oil, Tips cover with cling film and store in the fridge.  Use turkey or chicken mince instead of beef. Heat ½ tbsp. oil at step 1 before adding meat.

47 MED SALT LOW SUGAR LOW FAT LOW SATURATES 50 Mince and tatties mins 1

Ingredients Equipment 100g (3 ½oz) lean beef mince Medium saucepan 1 small onion, peeled and chopped Knife 1 carrot, peeled and chopped Peeler Wooden spoon Handful frozen peas (optional) Measuring jug 1 tablespoon beef gravy granules Masher 2 potatoes for the mash, boiled and mashed Chopping board A bit of margarine and milk for the mash potatoes ALTERNATIVELY for mashed potatoes use olive oil and crushed garlic clove. Boiled cabbage or brussels sprouts, to serve

Method 1. Brown the mince over a gentle heat along with the chopped onion. Stir to stop it from sticking. 2. Remove from heat and drain any excess oil. 3. Make up the gravy. Put 300ml of boiling water on the gravy granules and stir. 4. Add carrots, peas and gravy mix and return to the heat. 5. Bring to the boil and then turn down the heat and gently simmer for about 30 minutes. 6. In the meantime boil potatoes for about 20 minutes, until tender. Drain and mash with a small amount of milk and margarine or butter. 7. Serve mince and tatties immediately with vegetables of your choice.

 Try using lean mince or draining off as much of the mince fat as Helpful possible after browning.  Serve with neep purry (turnip puree). Boil one to two small turnips in Tips water, then drain them and mash them into puree. Put mashed turnip back in the saucepan with some butter, white pepper and a good pinch of ginger, mix and it’s ready to serve.

48 LOW SALT LOW SUGAR LOW FAT LOW SATURATES 50 Chilli con carne mins 2

Ingredients Equipment 100g (3 ½oz) lean beef mince 2 Medium saucepans 1 onion, peeled and finely chopped Wooden 1 clove garlic, finely chopped spoon Can opener 400g (14oz) can of chopped tomatoes Knife 1 tablespoon tomato puree Chopping board ½ teaspoon chilli powder ¼ teaspoon cumin ¼ teaspoon coriander 1 red pepper, chopped 100g (3 ½oz) mushrooms, sliced Can of kidney beans, drained and rinsed Rice to serve

Method 1. Brown the mince over a gentle heat, stirring to stop it from sticking. 2. Add the onion and garlic and cook for two to three minutes until soft. 3. Add the chopped tomatoes, tomato puree, and spices. Bring the sauce to the boil then lower the heat and simmer gently for 10 – 15 minutes. 4. Meanwhile, cook the rice according to the packet instructions. 5. Add the chopped pepper and sliced mushrooms and simmer for five minutes. 6. Add the kidney beans and simmer for another five minutes. 7. Season with pepper and serve with boiled rice.

 Serve any leftover sauce with baked potato for a quick, tasty meal. Helpful  Buy a bigger pack of minced beef, use the amount required and freeze the rest for another recipe. Tips  For a vegetarian alternative substitute meat with 100g mixed vegetables e.g. courgette, sweet potato, butternut squash. Use ½ tablespoon oil at step 2 to cook onion and garlic. Add all the vegetables at step 5.

49 MED SALT LOW SUGAR LOW FAT LOW SATURATES 35 Moroccan spiced rice with Lamb mins 1

Ingredients Equipment 75g (3oz) lean lamb mince Chopping board 1 small onion, sliced Knife 1 clove of garlic, crushed (optional) Wooden spoon Pinch ground ginger Cup Pinch ground cinnamon Non-stick fry- ing pan with a ¼ teaspoon paprika lid/saucepan with a lid 1 small aubergine, diced Measuring 1 small courgette, diced Jug 75g (3oz) long grain rice 120ml (½ cup) stock made with a half a stock cube 1 medium tomato, skinned, deseeded and diced 2 tablespoons chopped fresh mint, plus a few extra leaves to garnish

Method 1. Heat a non-stick frying pan, dry-fry the lamb for five minutes, and then drain off any excess fat. 2. Add the onion, garlic, ginger, cinnamon and paprika and stir well. 3. Add the aubergine, courgettes, rice and stock then bring to the boil. Cover and simmer for 20 minutes until the stock has been absorbed and the rice is tender. 4. Add the tomatoes and mint and then heat through. Spoon the pilaff into a warmed serving dish and scatter with a few extra mint leaves to serve.

 An easy dish to use up vegetables to boost your 5-a-day.  For a cheaper alternative use mince pork instead of lamb. Helpful Tips

50 LOW SALT LOW SUGAR MED FAT LOW SATURATES 20 Cod with tomato sauce mins 1

Ingredients Equipment 140g (5oz) thick cod fillet or other white fish Frying pan Knife, 1 teaspoon oil Scissors* 1 garlic clove, sliced Chopping board 2 thin slices of chorizo cut into thin strips Can opener (other types of salami will work just as well)* Grilling pan Pinch of chilli powder (optional) Wooden spoon 227g (8oz) can chopped tomatoes 75g (2 ½oz) brown rice, to serve Green beans, to serve * You may find it easier to use scissors to cut the chorizo slices instead of a knife.

Method 1. Heat oil in a pan then cook the garlic and chorizo for a few minutes. 2. Add the chilli and tomatoes and simmer for 10 minutes until thickened, then season. 3. In the meantime cook the rice according to the packet instruction. 4. Heat the grilling pan. 5. Rub the fish with a little more oil, season and grill until cooked through - about four to six minutes. 6. Serve the fish with the tomato sauce spooned over, rice and cooked green beans.

 Alternatively, you can steam the fish until cooked through.  A 500g bag of frozen green beans can be stored in freezer and some Helpful taken out when needed. Tips

51 LOW SALT LOW SUGAR MED FAT LOW SATURATES 25 Peppered salmon mins 1

Ingredients Equipment 140g (5oz) salmon fillet Baking tray Baking foil 1 teaspoon lemon juice Medium Pepper saucepan Colander 3 heaped tablespoon peas Wooden 2 medium size new potatoes, boiled spoon/masher Sieve 1 teaspoon olive oil

Method 1. Pre-heat oven to 190°C OR put grill on medium heat. 2. Cook the potatoes in boiling water for 10 – 25 minutes, until tender. 3. Lay the fillet on a foil-lined baking tray. Squeeze lemon juice over the salmon and sprinkle with pepper. 4. Bake/grill the salmon for about six minutes. The flesh is cooked when the salmon is opaque and flakes easily with fork. 5. When the potatoes are nearly cooked, add the peas and cook for a couple of minutes. Drain through a sieve and return to the pan. 6. Season the potato and pea mixture with pepper, and then add oil. Crush roughly with a wooden spoon/masher. 7. Serve the salmon on top of the crushed potato mixture.

 Ingredients could be easily doubled Helpful  Oily fish like salmon, trout, mackerel, sardines and herring are a good source of omega-3 fatty acids which could reduce your Tips risk of heart disease, if consumed as part of a healthy diet. Choose oily fish once a week.  Buy frozen salmon fillets as they are cheaper than fresh.  Thaw frozen fish in the fridge, not on the countertop.  Refrigerate fish immediately when returning home from shopping.

52 LOW SALT LOW SUGAR LOW FAT LOW SATURATES 20 Mackerel and cauliflower salad mins 1

Ingredients Equipment 1 large or 2 small mackerel fillets Chopping board 150g (5oz) cauliflower, cut into florets Knife 1 lemon Grater (for lemon Parsley, chopped zest) Garlic crusher 2 teaspoons olive oil Small pan 1 garlic clove, crushed or chopped Baking tray Salad bowl Method 1. Heat the grill and bring a pan of water to the boil. 2. Drop the cauliflower into the water and then cook for four to five minutes until just tender. Zest and juice half the lemon, then mix with parsley olive oil and garlic in a salad bowl. 3. When the cauliflower is cooked, drain and then stir into the herby dressing with some seasoning while still hot. 4. Put the mackerel on a baking tray and grill for a couple of minutes on each side. Cut half the lemon into wedges. Serve alongside the mackerel and cauliflower salad.

You can swap half the cauliflower for diced boiled potatoes if you’d like to make the salad more substantial. Helpful Tips

53 Desserts

Fruit dessert 5 mins 1

Ingredients Equipment 1 small pot (125 ml) natural yoghurt Tumbler Bowl 5ml (1 teaspoon) runny honey Knife 1 banana, sliced Chopping board Approximately 1 tablespoon muesli/or wholemeal breakfast cereal Measuring Try any fruit you like, either fresh or tinned in natural juice jug

Method 1. In a small bowl blend the yoghurt and honey. 2. Place a spoonful of the banana in the bottom of a tumbler. 3. Place a spoonful of the yoghurt mixture on top of the banana and scatter with a little muesli. 4. Repeat to form layers ending with a scattering of muesli and sliced banana.

Fruit salad 5 mins 1

Ingredients Equipment Banana, sliced Chopping board 4 strawberries Knife 10 grapes, halved Bowl 1 kiwi fruit, sliced 50ml unsweetened orange juice Use fruit in season or tinned fruit in natural juice

Method 1. Wash the fruit. 2. Prepare the fruit and place into a large serving dish. 3. Add orange juice. 54 Stewed apple 6 mins 1

Ingredients Equipment 1 apple - peeled, cored and sliced. Saucepan Chopping 1 Dessertspoon of water board This can be served with yogurt as a healthy and warm pudding Knife or it can be put on top of cereal and porridge in the morning.

Method 1. Put the apple and water into a saucepan over a medium heat. 2. The apple will soften into a puree in about four minutes. Stir to make sure it doesn’t stick. 3. If you use a cooking apple you may need to add a small amount (about a teaspoon) of sugar.

10 Plum crunchies mins 1

Ingredients Equipment 2 ripe plums, washed, halved and stoned Fork Knife 1-2 wholemeal digestive biscuits, crushed Ramekin/ 30g (1oz) fromage frais - try to choose reduced fat small dish

Method 1. Place plum halves in a small pan with one tablespoon of water. Simmer for five minutes until soft but still holding their shape. 2. Put the crushed biscuits into a ramekin/small dish. Press down with the back of a spoon. 3. Spread fromage frais carefully over crushed biscuits with knife. 4. Top with plum halves and drizzle with the juice.

55 LOW SALT MED SUGAR MED FAT MED SATURATES 40 Bread and butter pudding mins 2

Ingredients Equipment 3 slices white bread Chopping board 1 tablespoon butter/margarine to spread the bread Knife 1 dessertspoon of raisins or mixed dried fruit Fork Bowl 1 dessertspoon of sugar Cup 1 egg Small ovenproof ½ cup of semi-skimmed milk dish Method 1. Remove crusts from bread and spread with butter/margarine. Cut each slice into four squares or triangles. 2. Grease a small ovenproof dish and arrange half of the bread over the bottom of dish and sprinkle with half the fruit and half the sugar. 3. Place the remaining bread on top followed by the rest of the dried fruit and sugar. 4. Beat the egg in a bowl with a fork and beat in the milk. 5. Pour over the bread pudding and leave to stand for a few minutes until the bread has absorbed the milk. 6. Bake for 20 minutes until set and the top is golden.

 Add some cocoa powder to the milk mixture and sliced banana Helpful instead of dried fruits for an interesting alternative.  Foods high in fat and sugar should only form a small part Tips of your diet.

56 Breakfast Lunch Snacks Dinner

How to incorporate STARCHY FOODS across the day.

Cereal Sandwich Popcorn Wild rice Toast with spread Pitta with filling Oatcakes with curry Bowl of porridge Rice or pasta salad Rye crisp bread Noodles with stir Soup with whole Whole grain fried vegetables grain roll cereal bar Pasta with sauce Casserole with couscous Filled tortilla wraps Aim to get at least half your starchy foods as wholegrains

How to incorporate FRUIT AND VEGETABLES across the day.

Fruit juice or Vegetables sticks Piece of fruit Wild rice smoothie with dip Fruit salad with curry Chopped or dried Vegetable soup Dried fruits Noodles with stir fruit on cereal Pitta, jacket potato Smoothie fried vegetables Grilled tomatoes or with vegetable Pasta with sauce mushrooms filling Casserole with Rice or pasta salad couscous with vegetables Filled tortilla wraps Aim to get at least 5 portions of fruit and vegetables a day

How to incorporate DAIRY PRODUCTS across the day.

Yogurt with fruit Cheese and salad Smoothie Natural yogurt and seeds sandwich Yogurt added to soups, Milk on cereal Drink a glass of milk Crackers with cream stews, curries and Milk or yogurt Have a pot of cheese casseroles smoothie fromage frais Cottage cheese in Milk in tea or coffee jacked potato

How to incorporate MEAT, FISH AND ALTERNATIVES across the day.

Cereal with seeds Sandwich with ham; Nuts Check our recipes for and nuts tuna and sweetcorn meat and fish dishes Toast with mackerel Tinned fish on toast pate Beans on toast 57 Freezer advice and facts

Freezers are a great way to make the most of your food. Here are the four golden rules to follow. 1. You can freeze pretty much everything! The only exception is soft cheese as the texture goes very strange! 2. The freezer acts like a pause button on food and so you can freeze it right up to the use by date. It also stores safely for years - it's just that the quality will start to deteriorate after three months. Ideally use within six months 3. Always wrap the food well in the freezer and don't forget to label everything with the date and what it is. 4. When you want to make use of it defrost overnight in the fridge, use within 24 hours and cook till piping hot. If you need it quickly food can be defrosted safely in the microwave. Love Food Hate Waste's website is full of practical food saving tips, simple recipes and more to help you start wasting less and saving money.

How to read food labels guideline

What is a lot per 100g? 22.5g sugars 17.5g fat 5g saturates 1.5g salt 0.6g sodium

What is a little per 100g? 5g sugars 3g fat 1.5g saturates 0.3g salt 0.1g sodium

58 Notes For further information and useful resources contact: http://www.healthinfoshop.scot.nhs.uk/ Health Information & Resources Service Afton House Ailsa Hospital Campus Dalmellington Road Ayr KA6 6AB Telephone: 01292 885927

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Reproduced with kind permission of Edinburgh Community Food Initiative

ND16-004-CC