When in doubt, start with chicken.
That's the lesson Danielle Cook Navidi learned after her 11-year-old son, Fabien Navidi-Kasmai, was told he had cancer, and the only nutrition advice she received was, "Let him eat McDonald's. He needs the calories."
Navidi, an avid cook with a love of farmers markets and a background in catering, was appalled. But she was also at a loss.
Fabien's body, his digestive system, his taste buds and even his cravings were being ravaged by his illness, stage 3 Hodgkin's lymphoma, and by his medical treatments. He would go for days without eating. When he did, he had trouble keeping down even his favorite foods. Navidi didn't know how to feed him anymore, but she was convinced fast food was not the answer.
"So I started with the basics," said Navidi, a Washington resident. "I grabbed a pot, put a chicken in, added some vegetables. There were days when he'd have chicken soup at 10 a.m. because it worked for him. Now that's what I tell other parents: Start with the chicken."
That back-to-basics approach is the backbone of Navidi's free Cooking for Cancer classes at MedStar Georgetown University Hospital and her cookbook, "Happily Hungry: Smart Recipes for Kids With Cancer."
"I never thought I'd be here," Navidi said, stirring a pot of red beans and rice soup with kielbasa, which is simmering on a hot plate in a corner of the hospital's kitchen-less pediatric oncology waiting area. The room, filled with art projects and board games and now, thanks to Navidi, the smell of simmering sausage is a place where children pass the time between checkups and treatments. Eight years have passed since her own son was here, undergoing surgery, chemotherapy, radiation and blood transfusions.
Navidi is no longer the worried mother 19-year-old Fabien's cancer is in remission but there are plenty of other parents in that position. Navidi's job is to share recipes that might lighten their burden or, at the very least, distract them during the long hours spent waiting.
A holistic nutritionist, Navidi began volunteering at MedStar Georgetown in 2008. "I pretty much just asked, 'Can I take a little spot and make smoothies?' " She would do prep at home, pre-cooking anything that required a stove or oven, and showed up at the hospital with bags of groceries.
Navidi's commitment and willingness to pay for food and supplies out of her own pocket drew the attention of Aziza Shad, chief of MedStar Georgetown's pediatric hematology-oncology program. Shad helped find grant money to fund the program and encouraged Navidi to compile her recipes into a book.
"As an oncologist, you have to make sure your patients are in good shape nutritionally," Shad said. "If a child doesn't eat well, he can't handle chemotherapy well. Nutrition is medicine. It's all connected."
Shad said cancer treatment has a major effect on appetite. Sores can develop in the mouth, throat and gastrointestinal tract. Foods that are raw, acidic or greasy become hard to digest. Food, even water, can begin to taste metallic due to changes in the lining of the mouth. Stress on the body leads to new cravings.
"Everything gets really out of whack," Navidi said. "Fabien used to crave burritos, and it just made him so sick." Recognizing that what he really wanted was salt and fat, Navidi encouraged him to eat olives and feta cheese instead.
Through the cooking classes and the book, Navidi said, she tries to show parents that real, whole foods don't have to be inconvenient.
"Food and health can be a very sensitive topic. Families know that their food choices are not always the best," she said. "They will come in with bags of fried chicken that they munch on (while waiting). I try not to be judgmental. We sit. We talk."
The cooking classes are free, informal presentations open to patients and their families. They're held once each week from 10:30 a.m. until around 1:30 p.m. The classes are appropriate for the whole family; parents learn practical tips, such as how to peel squash and grate ginger, while kid-friendly steps such as mixing ingredients and pressing buttons on a blender allow children to participate.
For Tanikka Cunningham's family, the classes are as much a distraction from the reality of childhood cancer as they are a lesson in cooking. In July 2010, doctors told the Virginia resident that her 3-year-old son, Sekhu, had leukemia. He is now 6 and in recovery; he visits his doctors twice a month and often sees Navidi on those occasions.
"When your child is sick, your time is just focused on trying to keep your family going," Cunningham said. "Everything else," including healthful eating, "takes a back seat." She said the classes are a reminder to make nutrition a priority, and they provide a creative outlet for her son.
Sekhu sidles up to Navidi, who asks if he would like to help make a cranberry-pear smoothie. Sekhu looks from Navidi to his mom and back again, nodding excitedly. Navidi shows him how to add the ingredients to the blender. He giggles, successfully pouring everything in without spilling. Behind him, his mother is smiling.
In addition to soups and smoothies, the 43 recipes in "Happily Hungry" include comfort foods such as warm potato salad with black olive and mint pesto, and hazelnut-chocolate chip brownies. They're focused on flavor, digestibility and easing side effects of cancer treatment, such as nausea, fatigue, dehydration and compromised immune function.
Navidi is toying with the idea of writing a second cookbook this year and dreams of expanding the Cooking for Cancer program. She hopes someday to install a full kitchen in the hospital, but her larger goal is to help parents beyond the walls of MedStar Georgetown.
"There's a feeling of not being in control of the situation when your child is sick," Navidi said. "And when you're cooking something they like, when you feel that you're helping. That's everything."
"Happily Hungry: Smart Recipes for Kids With Cancer" cookbook (Walsworth Print Group, $19.95, 80 pages) is available online at Amazon.com.