The recipes in this cookbook were extracted from the established science of flavor
creation and my experiences with side effect illnesses. They grew from the deep
sub soils of smell and taste, senses so interactive they are almost impossible
to think about separately. If smell is blocked, about 80% of the ability to taste
is lost. Understanding the dynamics of smell and taste proved essential in drawing
blueprints for assembling the recipes contained in this cookbook.
Some day we will know a great deal more. For now, let’s begin at the beginning.
SMELL
Smell is about 10,000 times more sensitive than taste. It is the least
acknowledged of our sensory tools. Its role in food selection, socialization,
and reproduction, dwarfs the more commonly famous, taste. As a stimulus for pleasure,
smell is unequaled. Real estate agents advise baking brownies before showings.
Grocery stores locate bakeries by entryways.
As a marker for danger, smell is has no match. An aware nose can “smell”
fear. We know to leave a burning building, run away from gas leaks and many, but
not all, life-threatening pollutants. As a culprit in the creation of nausea,
it is our prime suspect.
The outlines of a science of smell begin with a depiction of invisible, vibrating,
gaseous molecules transporting odor fragments from their origins to receptors
in our nasal cavities. Unlike taste, no simple categories exist to organize these
complex sensibilities. All that is known for certain is that smell conveys the
overwhelming majority of the information we process about food. Familiar things
smell “good” and mostly unfamiliar things smell “bad”.
As youngsters, we quickly discovered that by holding our fingers “over”
our noses, we could mask “bad” tastes and eat foods we did not “like”.
The implications of this lead to the first outlines of discovery when considering
the mysteries of appetite and illness.
Food temperatures also have a dramatic influence on olfactory perception and therefore
on tastes. Lukewarm food seems tasteless, no matter how large the seasoning profile.
Elevating the temperatures of food to 165 degrees or more at the point of service
dramatically increases molecular movement and therefore smells. By increasing
smell, taste is “improved”.
For “normal” people, we conclude as follows. Serve food as hot as
possible. It will smell more. Therefore it will taste better. How does that influence
recipe creation for the sick? Keep reading.
Food freshness has a universal influence on food fragrances. Fresher
food seems to smell “better”. Unless they have spoiled, previously
cooked foods smells less, having “lost” some of their fragrances over
time. Food served “buffet-style” often suffers this fate.
What smells “good” and what smells “bad” move unpredictably
around during illness. Previous fragrance attractions may become repellant and
previously unappealing fragrances become obsessions. Sometimes smell simply disappears.
When that happens, a basic sense of connectedness and trust is lost. Taste is
curtailed and appetite upended.
Increasing taste, while reducing smells, is, in the final analysis, what the recipes
in Cooking for Chemo attempt to do. How this is accomplished is highlighted later
in this chapter in the section called Remapping.
TASTE
Taste is a descendent of smell. Although humans talk about it endlessly,
it is a very puny thing compared to smell. The multi billion-dollar flavor and
fragrance manufacturing industry has created innumerable tastes and indescribable
fragrance ìnotesî in multiples of engineered layers into everything from custard
to ketchup. The influence of MSG alone is almost encyclopedic in scope.
Thankfully, much about our sense of taste is known. About 10,000 taste ìbudsî
are located in predictably placed clusters on our tongues. These zones detect
sweet, salt, sour, and bitter and, to a fifth taste, called umami, referred to
as ìsavoryî or ìmeatyî. Umami is universally desired cultures. It is compared
to motherís milk.
Sweetness, as everyone knows, is almost never excessive. We have an axiom
in the food business. If the recipe isnít selling well, add sugar. No one ever
sent a dessert back to the kitchen because it had too much sugar in it. Most of
the truly great food fortunes in America are based, at least primarily, on sweets.
The role of sweetness, in nausea, appears minimal. Our culprit therefore, is unlikely
to be found in the sweet zone.
Nearly the opposite can be said for saltiness. Even though we are mobile saltwater
balloons, and we have an almost zombie-like attraction to saltiness in convenience
food, professional cooks agree that it is brushstrokes of saltiness that stimulate
pleasure. Excessive saltiness has a ìtipping pointî where it is almost universally
disliked.
Sourness, a word not frequently associated with the word delicious, can be eliminated
almost intuitively. Sourness is, like saltiness, a contrast taste, used sparingly
in cooking, almost invariably next to its opposite in cooking, sweetness. Many
are the recipes that join sweet and sour.
Bitterness is the most protective of the taste sensations. It is among the hardest
and most intricate tastes to fuse in a joyful recipe. Chocolates, baked goods
with butter and nuts and a short list of beverages succeed in harnessing bitter
flavors. Bitterness, like saltiness and sourness is a contrast taste, again typically
used with sweetness to create taste pleasures. Neither sweet, salt, sour nor bitter,
are detectable by smell. Since nausea appears, at least partially, an olfactory
phenomenon, all four can be used in recipes in traditional ways when cooking for
the unwell.
The whole array of what are thought of as culinary enhancements: peppers of all
colors and varieties, herbs, barks, leaves, berries roots or extracts will, for
the moment, remain unmentioned. All these happy accessories are instinctively
suspect Their appearance in the recipes will be sparing indeed.
We are left in mysterious contemplation of the final taste, Umami. Referred to
as the ìsavoryî or ìmeatyî taste, it may well, in fact, identify the zone where
food equilibrium resides. It is here where we must look to unlock the secrets
of nausea. Said by food scientists to be a taste of universal appeal, far more
compelling than sweetness, it is the only taste that is firmly linked with smell.
Umami harbors the taste sensibility that detects vegetable and animal fats. Cooks
and food scientists have long known that increasing fats in a recipe enhances
its desirability. If adding sugar to food increases its tastiness, and this is
ineffably the case, adding fat, preferably animal, correspondingly increases taste
and ìmouthfeelî.
d food smells less, ìlostî it fragrances over time. This is not anthropology.
This is just basic chemistry. About the only thing that smells better the second
day is pot roast.
What smells ìgoodî and what smells ìbadî move unpredictably around during illness.
Previous fragrance attractions may become repellant and previously unappealing
fragrances become obsessions. Sometimes smell simply disappears. When that happens,
a basic sense of connectedness and trust is lost. Appetite is upended. And fundamental
equilibrium is disconnected.
Eliminating, or at least diminishing smells initially appears to be an easy, intuitive
solution to the problems of smells. This is to be dismissed. Some things will
smell good. Reconnecting tastes and smells with joy becomes an overriding, culinary
challenge. This subject will be explored in a later section titled Remapping.
TEXTURE
Crunchy, brittle, doughy, gooey, bubbly, silky, crispy, sticky, and crumbly
are just some of the food textures created by cooks to tease us. These stimuli
are what are collectively referred to as “mouth feel”. People generally
seek these texture variations for amusement and pleasure. Hard exteriors frequently
enclose soft interiors. Why these opposites engage the human imagination, no one
really understands. They create mouth “fun”, that’s all we know.
On the other hand, no matter how food starts out, it must eventually be reduced
to a moistened, evenly textured paste in order to be swallowed. To varying degrees,
lips, gums, mouth linings and throat can all be sensitized by illness, treatment
and side effects. The abrasion of toast can be a challenge to chew much less to
swallow. Soup can become the only manageable food.
Cooking for extreme tenderness is referred to as the creation of “soft food”.
It can refer to tastes, smells and textures, all of which, to one degree or another,
are impediments for eating.
Baby food and canned nutritional supplements are the ultimate soft foods. This
rather desperate measure can be minimized by careful food selections and cooking
techniques. Overcooking cereals (pasta, potatoes, rice etc.) helps a texture-impaired
diner. Avoiding skins, seeds and dehydrated items is another.
REMAPPING
In the extremely ill, how can food excitement be recreated? Sensory disabilities
can range from partial or total loss of either smell, which subsequently cripples
taste, or both smell and taste, for which science has no solution whatsoever.
Mouth sensitivity can, in varying degrees, further compromise our recipe selections.
How do we remap this new terrain? How do we redesign meals for diminished appetite,
unpredictable flavors, chaotic fragrance reorientation and tenderness in both
the mouth and throat?
How can we make foods that taste great but, at the same time, don’t smell
a lot? Pulling out our old tools and using them in new ways should help us out.
First we “eat” with our eyes! This often repeated maxim launches our
thinking about recovering the joy of flavors. The first faculty to remap is vision.
It’s time to stop looking at food and rediscover the stunning, visual, miracle
of food.
Open the refrigerator door, pull out a fruit drawer and extract the most attractive
orange, lemon or grapefruit you see. Place it on your kitchen counter, preferably
in front of a sunny window. If your counter is colored or textured, put it down
on a clean white, linen napkin. Turn it slowly and study it in detail. Notice
the side that grew facing the southern sky, dizzy and sunny with intense color.
Now, close your eyes, place the food item under your nose, and inhale, slowly
and repeatedly. 80% of your information gathering is now complete. The nose should
signal what to do next. It is time to move on to taste.
Using what we do know about tastes, smells and textures, we can predict some preliminary,
generalized things. Foods that are exceedingly simple and sweet, reduced in “umami”
smells but high in “umami” tastes, recently made with fresh ingredients,
served at lower temperatures with softer textures are natural candidates for “remapping”
our desire to eat. With these as starting points, our cooking journey can begin.
Conventional, well-made chicken and beef soups can sustain for a long, long time.
They are time consuming to make, they lack living microorganisms and humans crave
diversity. Meal replacement beverages can extend life almost indefinitely. Napoleon
almost conquered the western world marching his men forward on simple, boiled
potatoes. Fortunately, we are not Napoleon’s soldiers!.
These emerge as key prescriptives for soothing foods and appetite recovery:-
-Use the very best ingredients
-Keep portions small
-Emphasize visual details
-Softer is better
-Cool the food down, cold is usually better
-Fresh-made and served
-Increase sugars
-Increase fats
-Reduce fragrance profiles
-Reduce or eliminate all seasonings
-Reduce ambient humidity
How can these criteria be employed in the easiest way? Now that smells, tastes
and textures have been reformatted, let’s revisit home economics and reinvent
it for the unwell. We’ll find ways that commercial cooking practices can
ease the burdens and boost the results for everyone, particularly people coping
with healthcare disruptions.