So many things happen within a ten year span of time. A quote attributed to Bill Gates speaks to this: “Most people underestimate what they can do in one year and underestimate what they can do in ten years.” For most of us, when we look back at where we were ten years prior, we see tremendous growth. It is harder to see change in just one year.
I turned twenty-one years old in 2000. I lived at quite a few different addresses and with a rotation of roommates in my twenties. At the start of the decade, I was still living in Pennsylvania and my go-to meals at restaurants were salads and fries. My blood phe levels in my early twenties bounced all over the place. When I had better access to a kitchen, medical foods, and a stable schedule, I was in pretty good control of PKU. During other periods of time, my schedule would become very busy and I mostly just manage to drink formula and eat a vegetarian diet. When I was doing the latter, my relationships and academics would suffer.
Being away from home is a big change, and early twenties are a time of huge transition for almost everyone. Diet management takes adjustment as living situations might change most frequently when a person is in their twenties than any other decade. Costs of medical food are prohibitive during college and early career, when income is less. Once, when I was determined to be in strict control but had no budget for medical food, I ate tons of raw veggies and salads and little else. Even though it was difficult, a roommate commented how much happier and more energetic I seemed. We need to continue to advocate for the passage of the Medical Equity Nutrition Act.
I could easily write pages about each phase of my twenties. By my late twenties, diet management was beginning to stabilize. When I started working for a small business at age twenty-six, I also started making my formula at work. I found it easier to work for small companies because everyone gets to know your PKU story fairly quickly. In larger organizations, PKU needs to be explained to more people, and accommodations may be more likely to be overlooked without persistence. When I started my MBA at age twenty-eight, I committed to being careful with my diet. Quantitative work was significantly harder for me with high levels, and I wanted to finish the program.
However, my introduction to foods from other ethnicities and cultures was one of the more substantial discoveries. During this decade, it was the biggest factor in improved diet management. I moved to Chicago when I was twenty-three and began an internship downtown. A co-intern self-identified as a foodie, and when I explained my diet, he said “no problem, I’m sure we can find you veggies anywhere!” He introduced me to Thai food and Korean food. When I finished the internship, I began doing in-home respite work for an East Asian family. Although the family did not understand my diet well, they encouraged me to partake in Indian vegetable dishes. I soon realized that other cultures had seasonings and spices for preparing common foods that fit within my diet in ways made them feel like entirely different foods.
Enjoying foods from other cultures can be tricky, because not every dish will fit each tolerance level. Also, you might be less likely to be able to identify a hidden ingredient such as egg or dairy if you are unfamiliar with traditional preparation methods. When ordering from a restaurant, there might also be a good chance of overeating phe because portion sizes are large. I know many places around the country are still fairly limited to standard American fare and ingredients. But if foods prepared in ways other than traditionally American are available, it is an excellent way to expand dietary choices. Food items such as yucca, plantain, nopales (cactus), jicama, or papaya feel less common, but are a healthy way to enjoy the low protein diet.
If you can’t find anything in a restaurant that is appropriate for your phe tolerance, search for PKU recipes online or adapt a regular recipe with low protein ingredients. The Apples to Zucchini cookbook has a handful of low-protein recipes from other cultures that are delicious. This PKU blog does not appear to be active but does still have a few great Indian and Korean recipes that are live. Cook for Love has also expanded some of their menu to include foods from other cultures.
Drop a favorite non-American PKU recipe link below as well!
Here are some of my favorite suggestions and modifications when dining out. As always, be careful to ask about ingredients and adjust to fit appropriate phe tolerances.
Columbian: Yucca fries are amazing. Cambrooke foods provides a packaged version of yucca fries, but nothing beats fresh yucca straight from the deep fryer. Yucca is hearty and lower in phe than potatoes, and can be found fried or mashed at many Columbian restaurants.
Puerto Rican: Chicago Puerto Ricans invented an amazing sandwich called the jibarto, which substitutes fried plantains for bread. While delicious, it also is not the healthiest choice. Most restaurants will substitute the meat for extra veggies, stir-fried peppers or mushrooms.
Indian: Indian food is my absolute favorite, but it can be much higher in phe, especially when eaten with rice. Be careful because many veggie dishes are made with legumes or dairy, but those will usually be listed on the menu. My favorites are Aloo Gobi or Aloo Palak – the former being potatoes & cauliflower in a tomato sauce, and the latter being potatoes & spinach in a tomato sauce. This is likely more appropriate for those with higher tolerances or as a special treat.
Mediterranean: Most Mediterranean restaurants will have a good selection of vegetables on the menu. Some dishes might require slight modifications, but there is a good chance you can find a veggie kabob, a ratatouille, or cold veggie plate.
This is definitely not a comprehensive list! Most every culture has dishes that can be modified to become PKU appropriate. Common food items prepared in different ways can go a long way to making the PKU diet more diverse and more manageable. Adjust as necessary – for example, when you get Thai takeout for the family, combine the veggie dishes with low protein rather than regular rice for the person with PKU. Pull some recipes online from other cultures and experiment! Vegetables can be delicious and surprising when prepared in new ways.