The Medical Minute: Swapping in healthier ingredients can be a taste-ful solution

Chocolate cupcakes made with black beans. Tuna salad mixed without mayo. Mashed cauliflower instead of potatoes.

They may sound strange, but healthy swaps such as these are becoming more common not only in restaurants and cookbooks, but also in Food Services at Penn State Hershey Medical Center.

In 2013, the department introduced a “Great Living” menu for patients that focuses on heart-healthy options with minimal fat and sodium and no trans fats.

Brian Ulshafer, executive chef for Morrison Healthcare, Penn State Hershey's food service provider, said that of the 650 accounts his company manages nationwide, the Medical Center's Rotunda Café is one of only 80 healthcare retail venues to be named a center for excellence. “There is a lot of pressure to maintain wellness criteria,” he said.

Subbing whole-wheat hamburger buns for white bread is one thing, but replacing rice and potatoes with items like quinoa, couscous and bulgur wheat can be tricky in the heart of Pennsylvania Dutch Country, known for its stick-to-your-ribs homestyle meals.

“If we take pot pie, shepherd's pie and mashed potatoes off our menu, it's not going to be a good thing,” Ulshafer said. Instead, the department has found ways to cut down on fats, sugar, sodium and carbohydrates in such recipes. “We don't want to remove the unhealthy items, but rather we deemphasize them while promoting the healthier ones.”

“We'll mix broccoli and cheese into the mashed potatoes to add vitamins and nutrients, and we use all raw vegetables, not frozen,” he said. “All our soups are made from scratch and we always have wraps, fresh fruit and salads available.”

Ulshafer said the changes have been well-received. “I think people are becoming more intelligent about what they eat.”

But parsnip puree? A salad made from feta cheese, garbanzo beans, shallots and cucumber? The concoctions may look pretty, but for some, unfamiliar combinations and flavors can seem frightening. Retail staff members engage in active sampling and suggestive selling, offering tastes to customers who want to see if they like an item before purchasing it.

“Nine times out of 10, they think it's delicious and they buy it,” Ulshafer said. “It's about letting them educate themselves and enjoy things they would never have thought they would eat.”

Chelsea Miller, a certified dietary manager in Food Services, said the changes focus on lowering the amount of carbs, sodium, sugar and fats, while adding protein and fiber to keep you full longer. “One way in which we do this for patients is by serving all sandwiches on whole wheat thins instead of white bread or rolls which offer little to no nutritional value,” she said.

Ulshafer said the emphasis is not just on getting rid of the bad stuff, but also adding fresh items for layers of flavor. “We might take the mayo out of our ready-to-eat tuna or chicken salads, but then we add fresh herbs or citrus juices, maybe jazz them up with apples or raisins. It keeps us creative and on our toes.”

Here are some healthy substitutes that anyone can try: (Credit: Greatist.com)

• Canned Black Beans for Flour: Swapping out flour for a can of black beans (drained and rinsed) in brownies and cupcakes is a great way to cut out the gluten and add an extra dose of protein.
• Unsweetened applesauce for sugar: Using applesauce in place of sugar can give the necessary sweetness without the extra calories and, well, sugar. While one cup of unsweetened applesauce contains only about 100 calories, a cup of sugar can pack in more than 770 calories. This swap is perfect for oatmeal raisin cookies. Pro tip: You can sub sugar for apple sauce in a 1:1 ratio, but for every cup of applesauce you use, reduce the amount of liquid in the recipe by 1/4 cup.
• Avocado puree for butter: They're both fats (albeit very different fats) and have nearly the same consistency at room temperature. The creaminess and subtle flavor of the avocado lends itself well to the texture of fudge brownies and dark chocolate flavorings. It can take some experimenting to get this swap perfect, but generally, using 1 cup of avocado puree per cup of butter works.
• Vanilla for sugar: Cutting sugar in half and adding a teaspoon of vanilla as a replacement can give just as much flavor with significantly fewer calories. Assuming the recipe originally calls for one cup of sugar, that's already almost 400 calories cut out. You can’t sub this one in equal ratios, but next time you’re whipping up some cookies, try cutting 2 tablespoons of sugar and adding an extra 1/2 teaspoon of vanilla extract.
• Mashed bananas for fats: The creamy, thickening-power of mashed ripe banana acts the same as avocado in terms of replacing fat in baking recipes. The consistency is ideal, and the bananas add nutrients like potassium, fiber, and vitamin B6. One cup of mashed banana works perfectly in place of 1 cup or butter or oil.
• Greek yogurt for sour cream: Half the fat and calories, yet the taste and texture are virtually identical. Plus, nonfat Greek yogurt offers an extra dose of lean protein.
• Greek yogurt for mayo (in tuna/chicken salad): Add some herbs and a squeeze of lemon juice, and they'll taste almost identical. Plus, this swap will save on calories and fat, and provide an extra dose of protein.

Read more:
The Medical Minute: Trying to cut salt? Try herbs and spices instead

The Medical Minute is a weekly health news feature produced by Penn State Milton S. Hershey Medical Center. Articles feature the expertise of Penn State Hershey faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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