UCSD Cystine Determination Laboratory

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by Annie Durning-Canty, M.S., R.D.
General Clinical Research Center
UCSD Medical Center

As Presented During the 1997 Cystinosis Conference in San Diego.

What Makes a Meal?
- protein
- bread, cereal or grain
- fruit or vegetable
- dairy

Offer a variety of food at mealtime. A meal could be hamburgers, salad and milk; roast beef, mashed potatoes, vegetables, bread and milk; stirfried chicken with vegetables, rice and milk; spaghetti with meat sauce, french break tossed salad, and milk; burritos with cheese, chopped lettuce, and tomatoes and milk. Even hot dogs, potato chips, carrot sticks and milk make a nutritious meal!

Refer to "Recommended Daily Pattern of Food Selection" below for nutritious patterns of eating for different age groups. Remember serving sizes for children are approximately 1/3 the size of an adult serving.

2 - 10
Milk2 cups4 cups2 cups
Meat, fish, poultry, cooked dried beans, nuts2 - 3 oz4 - 5 oz4 - 5 oz
Breads and cereals4 serv.4 serv.4 serv.
Fruits and vegetables4 serv.4 serv.4 serv.

Easy Entrees

Assemble Yourself:Condiments:
- Tacos- Salt, pepper
- Burritos- Ketchup, mustard
- Pizza- Relish, pickles, olives
- Pasta or Salad BarSalsa
- Deli Sandwiches  

Anytime Meals

Hot Dog*  *
   w/cheese** *
Chili* **

Food Suggestions for Adding Calories

Full fat cheeses     Hot Dogs
Half n Half     Luncheon meats
Full fat ice cream     Sausages/bacon
Milkshakes      Turkey or chicken thigh or leg, with skin
Whole Milk     Fried chicken/fish
Yogurt     Nuts, nut butters
Pudding     Eggs, omelettes

Avocado     Bagels w/cream cheese or jelly
Banana     Chips, popcorn
Olives     Cookies
Mashed Potatoes w/gravy     Crackers
Creamed corn     Flour tortillas
Cooked vegetables w/margarine     Croissants, pastries
French fries, onion rings     Cakes, pies
Fruit smoothies       

Pediasure   Margarines
Ensure Plus, Sustacal   Canola, Olive oil
Scandishake   Cream sauces
Instant Breakfast   Gravies
Nonfat dry milk powder   Salad dressing
Polycose   Mayonnaise

Pizza, tacos, burritos, spaghetti w/meatballs, macaroni and cheese, fettucine alfredo, fast food entrees, soups, stews, quesadillas (flour tortillas w/melted cheese), grilled cheese sandwich, baked potato with melted cheese, waffles, pancakes.

Problems with Swallowing

- Swallowing evaluation
- Modifying food consistency
- Positioning
- Rate of feeding
- Swallowing techniques

Progression of Food Textures

A. Pureed, Strained, Blenderized

B. Semi-lumpy (no discreet lumps)

C. Solids that form easity into mass

D. Foods that are difficult to tolerate

E. To thicken foods:

Division of Feeding Responsibility

- Parents are responsible for what is presented to eat and the manner in which it is presented.
- Children are responsible for how much and even whether they eat.

Parents are responsible for what is presented to eat and the manner in which it is presented.

  • Selecting and buying food
  • Making and presenting meals
  • Regulating timing of meals and snacks
  • Presenting foodin a form a child can handle
  • Allowing eating methods a child can master
  • Making family mealtimes pleasant
  • Helping the child to participate in family meals
  • Maintaining standards of behavior at the table

    Parent are NOT responsible for

  • How much a child eats
  • Whether the child eats
    from How To Get Your Kid To Eat... But Not Too Much, Ellyn Satter

  • Summary

  • Feeding Concerns
  • Feeding Strategies
  • - Food Preferences  - Promote Balance in Food Choices
    - Food Intake  - Optimize Food Intake
       - Establish a Positive Feeding Relationship

    P- Be a Role Model
         Provide Variety - food pyramid, Easy Entrees
         Tolerate Food Jags
         Anytime Meals

    O - Scheduling Meals and Snacks
         Swallowing Problems
         Adding Calories

    E - Division of Responsibility in Feeding