Trip back to Malaysia

First of all, I would like to apologize for my lack of blogging for the past month as I had flown back to my home town (Malaysia) to visit my dad, who was very sick and long stories short, I have to be a dietitian to help get my dad get back on track with his health.  It is never easy to have to deal with a sick elderly parent.

Anyhow, I’ve just return a week ago but was really exhausted and have been hibernating for a few days. For those who followed me on Instagram you probably have seen all the delicious food photos that I’ve been posting. For those who doesn’t, I’m going to give you a brief tour of the Malaysia classic food 101. I missed the wide variety of food that I get to choose whenever I go home. It really is a treat since I prefer savory foods more than anything else!

I really hope everyone who had a chance would go visit Malaysia for once in their lifetime. The food is indescribable delicious and there’s plenty of natural wonder to visit. The only downside is HOT weather as it could get as hot as 40+ Celsius or over 100 degree Fahrenheit.  If you go during the monsoon season (Nov – early Jan) it will be a bit cooler but you won’t be able to visit tourist places due to frequent unexpected terrential down pour.

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Roasted Pork with Lo Mein noodles or known as Siew Yuk Kon Low Mein
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Thai Style Beef Noodle Soup
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Curry Noodles (My favorite breakfast item) – Only the culture in my home city (Kuantan) that people eats curry noodles for breakfast. 
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Classic Soft Boiled Eggs with Buttered Toast & Coffee
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Fish Ball Wide Noodle Soup
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Nasi Lemak (Coconut Rice), and Sambal with Kangkung Belacan
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Nasi Kukus (Steamed Rice) with Sambal & Rempah Fried Chicken
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Ondeh Ondeh (Clasic Malay Dessert) It’s like Mochi stuffed with melted brown sugar and coated with shredded coconut

 

 

 

 

Roasted Delicata Squash Breakfast

Fall harvest is over and the winter squash can be seen everywhere you go. I’ve recently picked up a few new winter squash that I don’t normally used from the farm stand and really enjoyed this lesser used Delicata Squash.  I later learned that they often called it sweet potato squash because it has a mild and sweet flavor resembled the regular sweet potato. The skin is thin and is edible as well (which I found out later after i used it because I was lazy to peel the skin off).  So, I come up with this breakfast idea using the squash as an accompaniment.

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Ingredients:

1 1/2 cup sliced thin (1/3 inch) delicate squash (about half of a medium size squash)
2 Tablespoon extra virgin olive oil
¼ teaspoon of freshly ground black pepper
½ teaspoon of salt
3 medium sized eggs
1 tablespoon of Sriracha sauce
1 tablespoon chopped scallion or chives (optional)

Instructions:

  1. Pre-heat oven to 425 degree Fahrenheit.
  2. While waiting for the oven to be preheated, laid the sliced squash on a baking pan, add in olive oil, salt and pepper. Toss to coat evenly.
  3. Place the baking pan in the oven, bake for 15-20 minutes. Remove and let it cool down a little. 1-2 minutes.
  4. In the same baking pan, arrange the sliced squash into a circular shape (about 4 inches wide) using your hand/chopstick/fork and keeping the center hollow. Keep layering the squash on top until you reach about 2 inches thick.
  5. Crack an egg and drop into the hollow center.
  6. Put it back to the 425 degree oven and finish baking for another 15 minutes.
  7. Serve it hot with some chive or scallion sprinkle on top; add with a pinch of freshly ground pepper and Sriracha hot sauce.

Rice Cereal/Rice Product: Yay or Nay ?

Since the Dartmouth college and consumer report published the research and article about arsenic in rice in 2012 and how infant exposure to the inorganic arsenic were among the highest had raised an alarm to the parent groups and pediatric health care providers. To this date, I still hear the same conversation between parents, doctors and dietitians.

As a pediatric dietitian, I’ve yet to see an infant with arsenic poisoning  came my way whether it be in the hospital or outpatient clinics. None the less, there’s some concern about inorganic arsenic in rice cereal/ rice products but since 2012, the infant cereal manufacturer has taken action to uses rice that has the least amount of inorganic arsenic for infant cereal and also provided other options of infant cereal such as Oats, Barley and Multi-grain.

BEWARE – brown rice cereal/brown rice has the highest amount of inorganic arsenic compared to regular rice cereal/ white rice. Same applies to organic baby formula which uses organic brown rice syrup -has also been tested with high level of arsenic content.

*So far, I only found Nature’s One Baby’s Only Toddler organic formula has a disclaimer that took action in filtering their brown rice syrup to an undetectable level of arsenic content.

What exactly is Arsenic ? Why does it matter ?

According to Food and Drug Administration (FDA): Arsenic is an element in the Earth’s crust, and is present in water, air, and soil. It occurs both naturally in the environment and as a result of human activity, including from erosion of arsenic-containing rocks, volcanic eruptions, contamination from mining and smelting ores and previous or current use of arsenic-containing pesticides. Long-term exposure to high levels of arsenic is associated with higher rates of skin, bladder and lung cancers, as well as heart disease. The FDA is currently examining these and other long-term effects.

So is it still safe to provide rice cereal/ rice products to my baby and children?

Short answer is YES.  The latest data analysis conducted by FDA in 2014 shows that majority of the rice cereal averaged about 103 parts per billion and the new proposal to limit the total arsenic content in rice cereal is set at 100 parts per billion (same as the European commission).  If you provide your infant/young children with variety of foods and rice is not the only source of grains, you shouldn’t be worried.

There’s also a few ways to help reduce the exposure to high amount of inorganic arsenic if rice is the main stable (such as Asian communities).

  • Rinse the rice in large quantities of water until the water is clear.  This has been the practice of Asian culture. (As per FDA, rinsing will reduced about 16% of the inorganic arsenic content, but it also rinses off other fortified vitamins and minerals such as iron, thiamine and folate)
  • Cook rice in large quantities of water (6:1 to 10:1 ratio) – as in making rice porridge for the infant. Which is also a practice in Asian culture when they first introduce solids. (This will reduce about 43% of the inorganic arsenic content).
  • Chooses rice that is lower in arsenic content, such as Basmati, Jasmine and Sushi Rice. Here’s a chart published by consumer report on all the rice that they examine:  consumer-reports-arsenic-in-food-november-2012_1

Bottom Line:

  • It is still safe to provide rice cereal to your infant as long as it’s not the only source of solids.  Meat, fruits, vegetables are also a good first food options as well. If you are still worried, then choose Oats, Barley, or Multi-grain infant cereal.
  • Provide a variety of grains for your toddler and rice shouldn’t be the only grain in his/her diet. VARIETY is the key !!
  • Rinse and cook your rice with lots of water.
  • Breastfeeding your baby as long as you can. Recommended exclusive for the first 6 months and then up until one years of age.

Steamed Snapper with Veggies Delight

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You probably can’t see the fish buried underneath all the veggies pile but this is one of my favorite dish to make because it’s easy and I only have to make one dish to get a balance meal for my family of 2+1.

Not only it is simple, quick and enjoyable by even my little tot, you can also substitute with whatever white fish and veggies you like as long as you don’t overcook them and having to time when to add in the vegetables during the steaming process is important.

Ingredients:

6-7 ounces  of white fish fillet (Here I used red snapper)
One large heirloom tomatoes/ or two medium red tomatoes (half then sliced)
1 cup broccoli florets
1/2 cup broccoli stems sticks (remove the outer skin, then julienne)
1/2 tablespoon sliced ginger
One cup chopped cilantro
1/4 cup low sodium chicken stocks
1/4 teaspoon sesame oil
1/2 teaspoon soy sauce
1/4 teaspoon salt
1/4 teaspoon white pepper powder

Instructions:

  • Place the fish fillet in the center of a round deep dish, add in ginger, sprinkle on top the salt, white pepper powder, and pour over the soy sauce and sesame oil.
  • Arrange the tomatoes slices on the side into a fan shape. Add in the chicken stocks
  • Add water to a steamer and bring to a boil, place the dish inside the steamer and steam about 15 minutes.
  • Arrange the broccoli sticks in the middle and broccoli florets on the side using chopstick to prevent being burn by the steam.  Steam for additional 5 minutes
  • Turn of the heat, and add in cilantro in the middle. Cover for another one minute.
  • Garnish with roasted garlic and garlic oil. (optional)

Raising Adventurous Young Eater

A lot of parent appears to be in a lot of constant struggle (including myself) with their children when it comes to eating.  Every day is different, they can be the best eater one day and the next is “NO, NO, NO” for all the foods they used to like before, leaving parent scratching their heads.

I believed that eating is a learned behavior and we can foster that sophisticated palate at a very young age.  What is young you ask?  The answer is infancy (Day 1) You can expose your infant to different flavor through your breast milk. How neat is that?!?!  Mother’s breast milk changes according to the types of food she’s eating. So, the more variety of foods you eat, the more complex taste your milk will be and the baby is less likely to reject new foods later on as they already are familiar with the flavor .

Well, formula mamas don’t get discouraged either, any duration of breastfeeding you can provide still shows good benefits and reduces their risk of becoming a picky eater when they reach pre-school age.  Remember: Any breastfeeding is better than nothing. You can still teach your young child to eat a variety of foods when they are starting complimentary foods (right about 6 months of age).

Here’s a few tips that can get you started:

DINING ATMOSPHERE

The eating environment for your child should be enjoyable.  No distraction of TV, video games, phone and tablet. All electronics to be turn off at meal time. Meal time should be around the same time everyday. Kids does well with routine and it does take about 6-7 weeks to build up a new habit. All family members needs to sit down at the table and eat together. Everyone needs to eat the same food (correct texture and consistency for the young infant), family style. Let the children pick and choose what they wanted, at least all food should be sampled.  No yelling, shouting or force feeding as we don’t want your kid to associate eating with bad experiences.

ROLE MODEL

Baby and toddler are smart, they observe adults behavior and emulate them. They also learn to manipulate the parent so they get what they wanted. So parent needs to be consistent (Both mom and dad) in relaying the same message for their kids when it comes to food and eating. If you are not an adventurous eating, please don’t expect that your child will eat everything you ask them to.  Be a role model for your children, eat and try new food in front of them.

IT TAKES MORE THAN ONE TRY

The key is “Try new food”, it takes repetition of 9-10 tries of introduction of the same food before the kid will accept/like them.  Just because they don’t like it in the beginning, doesn’t mean they wouldn’t try it again. Sometimes is the texture they don’t like, so be in tune with the types of foods your child enjoys.

HAVE FUN WHILE LEARNING

For young children less than 3 years old, let them play with the food.  It’s going to be messy but allowing the children to play with food will reduces their anxiety of eating them later on. Set them up on high chair or booster seat and teach them about the food, play (brush their teeth with it, splash, smash, tear) and then show them how you cook with it in food later on.

Take them to grocery stores and let them pick a new food (preferably fresh foods, not processed) from the isle and both of you can explore together what to make using it. Making food into fun shapes and sizes with cookie cutter would work too.

Educate your young child why the food is good for them, whether it be strong bones, good vision, become a super hero that they admires or becoming strong and tall like the athletes they wanted to become or grow tall enough to get to the rides in adventure parks.

DON’T SKIMP ON FLAVOR

Food doesn’t have to be bland. It can have some flavor.  Infant less than one year old is best to stay away from salt but you can include other herbs and spice (Not spicy) to amp up the flavor of foods. But, if your children prefers bland food, that’s ok too, as long as they are open in trying different foods.

 

NO SNACKING 1 1/2-2 HOURS BEFORE MEAL TIME

Children stomach capacity is small. If they snack too close to meal time, then they wouldn’t be hungry at meal time. Then you’ll be struggling to even get him/her to take a bite of food, but then later at bedtime they will be asking for cereal when they become hungry.  Occasionally that’s ok when you don’t want to deal with power struggle with your stubborn child (we are all human after all).  However, if it continuous, then the children will learn that it’s acceptable for him/her not to eat lunch/dinner because he/she will get to snacks all day and eat their favorite cereal at bedtime.

REWARD SYSTEM

Kids thrive on being praise and feeling proud of themselves. So, if they eat a new food, reward them with things they like to do, whether it be a chocolate/ice cream after meal or 20-30 minutes more play time with his/her favorite activities.

Bottom line:

  • Breastfeeding from Day 1.
  • Let the young kids explore with food, have fun while doing it.
  • Don’t make separate meals to cater to them. Eat together as a family.
  • Be persistent, consistent and patience.  Routine is your best friend !

 

Gestational Diabetes: What Should I do ?

“You have Gestational Diabetes.”  If you hear that statement when you are pregnant, don’t be frightened. Even though it’s not a desirable diagnosis we would like to hear while we are growing a baby, but there’s ways you can do to keep it under control without needing to take insulin.

Diabetes (high blood sugars) that is diagnosed during your pregnancy is called “Gestational Diabetes Mellitus (GDM)”.  According to American Diabetes Association, the prevalence of GDM is as high as 9.2%.  Pregnancy naturally increases your insulin resistance due to the growth hormone releases from the placenta, therefore all expectant mothers are at risk for developing GDM and we all have to go through the gruesome glucose tolerance test around 26-28 weeks of our pregnancy to ensure we don’t develop it.

Gestational diabetes is not to be taken lightly. Uncontrolled blood sugar level will negatively affect your growing baby in vitro and also putting your newborn baby at risk for very low blood sugar at birth, increases their risk for obesity and developing Type 2 diabetes in adulthood.

So, what can you do? Best way to keep your blood sugar in check is to watch the amount of carbohydrate intake daily.  Therefore, knowing what kind of foods contains carbohydrate is the first step.

Carbohydrate Containing Foods:

  • Grains, Rice, Cereals, Pasta, Breads, Crackers, Tortillas, Anything made with flour
  • Starchy Vegetables: Potatoes, Yams, Corn, Peas, Squash (Winter, Pumpkin, Kabocha)
  • Dried beans, Legumes, Lentils
  • Fruits, Dried Fruits, Fruit Juices
  • Milk and Yogurt
  • Carbonated drink, desserts.

Basic Dietary Modification: 

Be mindful of Breakfast

When you have GDM, morning blood sugar is the hardest to predict and control due to the highest concentration of pregnancy hormone during the morning. Therefore, it is recommended to only have 2 carbohydrate choices or 30g of carbohydrate foods during breakfast time and eat a higher protein meal to keep hunger at bay.  In addition, it is advised to avoid fruits and fruit juices in the morning as the simple fruit sugars are easily digested, which in turn raises the blood sugar too quickly.

Eat 3 meals and 2 snacks

One way to keeping blood sugar stable is to avoid the peaks and fall. Having a smaller but frequent meal to provide the body steady supply of glucose to be utilized and distributed to your growing baby. Make sure you include about 15-20 g of complex carbohydrate at snack time.

Pair your carbohydrate with protein

Eating carbohydrate with a protein food will help stabilize your blood glucose level.  The body needs time to digest the food mixture, therefore avoiding the highs and lows when compared to just eating a heavy carbohydrate meal alone.

Eat Complex Carbohydrate

Even though carbohydrate appears to be the bad guy here, but our body still need carbohydrate to function on a daily basis.  So, how can we achieve a balance? Eat complex carbohydrate foods (whole grains, brown rice, legumes, beans, vegetables (both starchy and non-starchy).Try to keep your carbohydrate amount at lunch and dinner in between 60-75 g per meal.

Space you Milk/Milk alternative consumption

Milk/Milk alternative is a healthy beverage and good source of calcium and vitamin D. However, it is a liquid carbohydrate just as similar to juice; it gets absorb very quickly and can raise the blood sugar rather fast. So, it is best to just drink one cup of milk at a time.

Limit Concentrated Sugar:

The moment you are told no sugar allows are the times you crave them the most. Daily intake of cakes, cookies, ice creams, candies and pastries can raises your blood sugar too high that you will require insulin injection to keep it under control. While sweets are hard to resist, but remember, they offer high amount of fats and little nutrition values to you and your baby. Occasional treat once in a while is totally acceptable.

If you can’t curb your sweet tooth. The sugar free products are usually safe in moderation. Here’s a list of sugar substitute that is considered safe during pregnancy:

  • Aspartame (Equal, NutraSweet, Natra Taste)
  • Acesulfame K (Sunett)
  • Sucralose (Splenda)
  • Rebaudioside A (Stevia)

There’s sugar substitute that is not safe which is saccharin (Sweet N’ Low) and cyclamate (Sugar Twin). So, make sure you read the ingredient list.

Don’t try to cut out all the carbohydrates in your diet, which I’ve heard a lot of my patients told me that’s what their doctor instruct them to do (most of the time is a misunderstanding or miscommunication of info”.  Find a local Registered Dietitian in your area, she/he can help with personalized your diet and help you eat a balance diet for pregnancy and keeping the blood sugar in control.

Bottom Line:

  1. Keep carbohydrate consistent at meal time (30g at Breakfast, 60-75g at Lunch/Dinner).
  2. Avoid fruit/fruit juice/yogurt in the morning.
  3.  Limit concentrated sweets and added sugar in foods.
  4. Eat smaller but frequent meals.

Easy Pickled Beets

Beets is a great roots vegetables, not only it is a good source of folate, iron, calcium, potassium, vitamin C and fiber, it is also packed with antioxidant and anti-inflammatory properties that can help reduce the risk of developing heart disease.  If you haven’t tried beets before, maybe now is the time to venture out your comfort zone.

I liked beets but usually after a few bites I can’t help but noticed the earthy taste (other people describe it as dirt taste) becoming more intense in my mouth.  One of my colleague had brought in her pickled beets for us to try and I enjoyed it much better cold and when pairing it with salad, it’s a delightful dish!

She said that most of the recipes online that she found has too much sugar or too much spices so she altered some and added different spice to it and it has since becoming her signature dish. She is kind enough to share her recipes with me and has allowed me to post it here as well. Thank you Susan W.

My daughter doesn’t like this at first but after about the fourth introduction, she started enjoying it and has been asking for it as a snack, *weird* I know, but nonetheless I’m grateful that she’s an adventurous eater after all.

Ingredients:

1 large beet or 2 medium beets = yield about 2 cups when sliced
1/4 cup water
1/3 cup apple cider vinegar (can use regular vinegar)
1/4 cup sugar
1/2 teaspoon ground cinnamon
1/4 teaspoon salt
1/4 teaspoon ground clove (or 1 clove)

Instructions:

  1. Bring a pot of water to boil, put in the whole beets in and cook till tender. About 45 minutes.
  2. Let the beets cool down, peel the skin off, cut the beets in half and slice it.
  3. In a separate pot, add in 1/4 cup water, vinegar, sugar, cinnamon, salt and clove. Mix well and bring to a boil.
  4. Add the sliced beets into the spiced vinegar mixture, stir to evenly coat beets with the spices, cover for 6-8 minutes.
  5. Remove from heat and let it cool down and serve.

Is Probiotic Safe for Babies/Toddler?

You’ve probably heard all the good things about probiotic for adults and then you started wondering if it will benefit your babies and young children as well.  The short answer to this question is YES!  Although the research on safety on probiotics for infants are limited but of all the available research out there, side effects are rarely reported.

What are Probiotic exactly ? Probiotic are the “good bacteria” itself that’s helps with our digestive system and with consumption will enhance the health of the host (a.k.a -human). It may also improve outcome of pregnancy, certain intestinal problem such as irritable bowel problem or antibiotic associated diarrhea.  Probiotic often shows up on food as “live culture” such as yogurt, cheese, kefir, or probiotic drink (such as Yakult). Probiotic also presents in the non-dairy products such as fermented foods – Kimchi, tempeh, miso, natto beans, sauerkraut, Kombucha to name a few.

Of course we don’t anticipate young infants (<6 months of age) to eat all this probiotic foods but guess what ?! Human milk is full of probiotic properties (specifically Bifidobacterium Infantis) that was discovered in the intestinal tract of babies, which is the reason why breastfeeding infant does not get sick as often compared to formula fed babies.

If you are formula feeding your babies, don’t feel guilty. You have done the best you could to provide what you can either first few days, weeks or months of available breast milk to help your baby kick start a better immune system.  There’s also probiotic formula available on the shelf these days, mostly labeled as “Formula for supplementing”.

Also, don’t get confused between prebiotic and probiotic. There’s a big differences.

What are Prebiotic? Prebiotic are non-digestible dietary fibers that fuel the good bacteria in our gut (a.k.a bacteria’s food). The more of prebiotics that we consume, the more gut flora will grow and stays to help keep us healthy.  Prebiotic also helps produces vitamin B, helps with calcium digestion and absorption as well. Good prebiotic sources includes: Artichoke/Jerusalem Artichoke, chicory roots, leeks, garlic, onions, asparagus, banana, whole wheat products, scallions, apples and legumes.

Therefore, once your babies reaches the age to introduce solids. Try to introduce as much prebiotic food sources in their diet to help colonize their little gut with the good bacteria and ward off illness as much as possible. When prebiotic and probiotic combined, they are a dynamic pair to keep the digestive system healthy.

I always recommend to get your probiotic sources from food before opting for the pill forms.

 

 

 

Discover Columbia Gorge/Hood River

Sorry if I’ve been slacking.  It’s been awhile since my husband and I got any alone time since the little one was born couple years ago.  So, he took me away for the weekend and I also have been busy at work too. But, I promised I will slowly get back into my grooves to start updating the blog again.

I just wanted to share the scenery and the food I ate on my trip here, just in case you would like to visit the area someday.

Hood River is along the Columbia River Gorge area (Northwest of Oregon) and you get to enjoy the beautiful scenery and lots of outdoor activities to indulge yourself in such as hiking, rock climbing, biking, kayaking, sailing, para-sailing etc.  There’s a lot of family friendly easy to moderate hikes. We did a short Bridal Veil Falls hike and then a longer Multnomah falls hike (45 mins up 620 feet elevation).

 

If you are not an adventurous outdoor person like myself, no worries, you can go and enjoy the food. Which is exactly we did for the most part🙂

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This spicy squid with tomato sauce over the focacia bread was one of my favorite. Restaurant Solstice @ Hood River.
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Local Zion Farm pear on a pizza….delish.
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Shrimp Caesar Salad🙂
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Assorted Local Cheese & Fresh berries with Vegetable ash crackers
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Slow Roast Lamb with Green Beans and Cauliflower.

Also, if you wanted to relax and get a massage. I do recommend to go to Holistic Massage Hood River and the service was great and the massage therapist is good at taking care of your sore spots and work on the trouble areas.

 

Monthly CSA Updates

It’s been more than a month since I joined the CSA and has been very pleased with my weekly produce that I picked out.  Most of the time is the same type of veggies that I eat all the time but I tried to be a little bit adventurous from time to time to pick a vegetables that I’m don’t usually cook at home such as patty pan squash, lemon cucumbers and swiss chard.

I enjoyed all the seasonal produce that are available weekly at the farm stand where I picked up my small share.  They are fresh, delicious and worth the extra money that I paid for instead of sifting through the produce isle in the store.

One surprised thing was that my daughter even know that each week I will bring home the “goodies bag”. As soon she sees the red bag I brought home, she immediately says “Mama…strawberries !” and start digging through the bag.  I enjoyed letting her discover all the produce and using it as a tool to teach her the fruits and vegetables that are healthy for her.

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Week 3: Strawberries, cucumber, patty pan squash, carrots, plums, italian kale, & garlic.      New Menu Item: Roasted patty pan squash & Asian Cucumber Salad
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Week 4: Swiss Chard, Cauliflower, Lemon Cucumber, Strawberries, Plums, Carrots, Zucchini.           New Menu Item: Swiss Chard with spaghetti & meat sauce,  Lemon Cucumber Salad
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Week 5: Italian Kale, Eggplant, Cauliflower, Plums, Strawberries, Zucchini, Basil                 New Menu Item: Basil Eggplant Stir Fry