Q&A with Project Angel Heart’s Registered Dietitian

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Making sure every Project Angel Heart meal fits the unique nutritional needs of our clients is a difficult job. Each meal is not only tasty, but has to be able to be modified to meet a wide variety of dietary needs. Ensuring that happens is a collaborative effort between our chefs and registered dietitian, Meghan.

Meghan measures the nutritional value of each meal and works with our chefs to provide recommendations and adjust recipes as needed. She also educates staff, clients, and the community on the power of food as medicine.

Meghan Perkins, Project Angel Heart’s registered dietitian.

For National Nutrition Month, we sat down with Meghan to learn about everything that goes into making sure 1,200 clients receive meals fit to their specific nutrition needs every week.

What does a typical day week look like for you? What are you usually doing?

I work with the Executive Chef, Brandon, on making sure the menus he’s planned are going to meet our client’s nutrition needs. One of the main objectives is to make sure what we prepare is delicious, but I leave that up to the chefs. What I look for is that we are able to medically tailor [a meal] so it meets the evidence-based nutrition standards I have set to address the conditions and life-threatening illnesses our clients are living with.

From there, I make the production sheets for our chefs so they can weigh, measure, and record everything that they put into our meals. Once the food has been cooked I take those production sheets and enter the ingredients into our nutrition analysis software to then further ensure our meals are meeting our nutrition standards.

Outside of that, I do nutrition education for our clients. I am available to answer any nutrition or food or health-related questions — if it’s within my scope of practice — that our clients may have.

Evidence-based nutrition standards. What does that mean?

The Academy of Nutrition and Dietetics has compiled all of the research available to us on how we can best serve people’s nutrition needs when they’re living with specific illnesses. Essentially, there are nutrition prescriptions for the diseases we serve, and I based Project Angel Heart nutrition standards off of those from a variety of evidence-based resources like the Academy of Nutrition and Dietetics, National Kidney Association, National Cancer Society. Then I mold that nutrition prescription to what best serves our average client based on the diseases they’re living with. I have set standards for how many calories and grams of protein, carbohydrates, fiber, fat, saturated fat, sodium, potassium, and phosphorus should go into our meals.

Can you give us an example of how a certain meal is altered for the different diets we accommodate?

We make a really great turkey chili, so let’s use that as the example. Our regular meal — which is our standard healthy diet for people who might be going through treatment or living with a life-threatening illness and just really need nutritious calories– would have ground turkey, seasonings, garlic, onions, peppers, diced tomatoes, and tomato paste. Then we would tailor that for our renal diet by replacing those tomato products with roasted red bell peppers. Those are lower in potassium, but they provide a very similar product — a turkey chili that’s still delicious but is more appropriate for people living with end-stage renal disease. In addition to that, the turkey chili is going to be served over beans, so for our renal clients, we would serve it over rice to further reduce the potassium and phosphorous content of that meal.

Using the same example; our regular meal has a set amount of salt and low-sodium chicken base in it. However, that amount is going to be higher than our heart-healthy meals. Those are meals that need to be very low-sodium. So while the meal ingredients might look very similar, there will be less chicken base added and no salt to make it appropriate for our clients living with heart failure.

How many variations of one meal are there?

There are anywhere from 18 to 20 different ways that we make a meal. That is from cooking it all the way through dish-up. That means we might make a chicken Marsala dish served over barley and has cabbage as the side vegetable, and we have to do a whole stream of restrictions for that meal. We remove the mushrooms, we do a vegetable other than cabbage for our GI-friendly group, we chop up the chicken breast for our soft group, and serve it over a different starch to make it gluten-free. We make three or four different versions of the sauce to make sure none of them are too high in potassium, none are too high in sodium, that there’s a gluten-free and dairy-free version, et cetera.

Do you have a meal that we serve that’s a favorite for you?

We make a pesto sauce that goes on a few of our chicken, fish, and even some of our scramble meals. We put a lot of spinach in it, which isn’t a typical ingredient for pesto, so I like that one because it’s a great way we’re “sneaking” extra veggies into our clients’ meals. We’re also able to make it nut-free and dairy-free or tailor it in a few other ways so it meets all of our restrictions while still being delicious.

What are some of the notable changes have you seen in ingredients that we use at Project Angel Heart since you’ve been here? What were the reasons behind those changes?

When I started, I had an eagle eye for items that might have contained ingredients we weren’t expecting. A few of the things I found were some products had hidden salt in them like tomatoes and peas, so we switched to no salt added items to keep the sodium content of our meals appropriate. Most recently, we started buying all whole grains. We were able to switch over to whole grain penne and whole-grain couscous, which provide a lot more micronutrients and fiber to our clients as opposed to processed grains. Finally, we also started serving salmon once a month which has been an exciting addition to provide more heart-healthy fats to our clients.

Read more about how Meghan has found and reduced salt content in Project Angel Heart meals

What is your favorite part of your job?

First, I love working with the staff and volunteers here, they’re wonderful people. But my favorite part of my actual job duties is getting to provide nutrition education to our clients. I really enjoy being able to provide them with help outside of just our meals for how they can eat healthier in the things that they’re getting and preparing at home. I also love teaching the staff at Project Angel Heart about what we do, answering nutrition-related questions, why we tailor things the way that we do and doing “lunch and learns” for them as well. But the nutrition education for clients is surely one of my favorite things. It’s very rewarding.

If you are a Project Angel Heart client and have nutrition-related questions or would like more information, please contact Meghan at 303.407.9439.