Practice Makes Progress

A few years ago, the computer guy showed up at my office for the first time in a long while. Let’s call him Gene. Right away, I knew something had changed. I said, “Gene, how are you? You’re looking very well!” He responded with an uncharacteristic grin, and answered with a statement that all of us know, but few believe. He said, “Diets don’t work.” I sat up quick.

Gene motioned to a small machine on his belt that I had assumed was a cell phone, or perhaps even an insulin pump. It was a pedometer. He said he had started slowly, satisfied at first with even 8,000 steps per day. That was then. Now he was walking close to 20,000 steps a day and sometimes even more. His pants were getting loose, and he was proud to say that he had taken in his belt a notch.

Change begets change, and health begets health. Before long, Gene had decided to stop eating the fast food lunches he had bought for years. He decided to try eating a piece of fruit and a bag of nuts instead and discovered, to his amazement, that they satisfied his hunger. He took in his belt two more notches.

Tip O’Neill, former Speaker of the House, once said, “All politics is local,” meaning that the issues we consider most important are the ones that affect us most personally. In a parallel statement, I would say that good health is personal. One size never fits all, and I should know: I’m barely 5 feet tall, so “one size fits all” never fits me! 

Some people enjoy the taste of cilantro whereas others despise it. Some people carry their water in gallon jugs, whereas others carry small bottles. Some folks thrive on a vegan diet, and others are unable to manage their weight unless they cut their intake of grains to just about nil. 

The same goes for exercise. Good health is not just about food. If you live near a track, or in a safe neighborhood with sidewalks in good repair, and you enjoy walking, then maybe you’re ready to buy a pedometer. But if your knees give you the blues, and you have always loved the water, maybe you’ll check the schedule at the community pool. Or maybe you’ll download a youtube video of a yoga or tai chi class. Do what appeals. Work with, not against, your inclinations.

What is the secret to Gene’s success? First, he understands that diets don’t work. You can’t build a system on deprivation. Secondly, Gene figured out which lifestyle choices were most easily achievable, and he started working on just those. One step at a time. Literally. And then one meal at a time. Small changes.

Thirdly, Gene increased his activity in a way that was pleasurable. When he was ready, he substituted a high-quality nutrition source for the low-quality fast food he had eaten for so long. And lastly, he stopped drinking soda. That was really all it took. He didn’t stop eating every last speck of processed food, and he didn’t say that he will never again drink a soda. He just decided that he will no longer drink it every day. What keeps him going? The fact that he feels so much better.  And his son.

Many patients have told me that the changes they start to make on behalf of their own health often become reflected in the health of their entire families. Gene drinks only water or milk now, and that’s what he offers his 6-year-old son, too. He says, “If you’re thirsty, you’ll drink water. If you want something sweet, eat a banana.” I’ve heard plenty of people complain that they don’t like water, but this is a learned response, and that means it can also be an unlearned one. You can make small changes by diluting drinks by 1/2 for a while, then 1/4, then 1/8, and so on, down to zero. Small changes, always. Gene is right: if you’re really thirsty, water should do the trick.

Change is reflected first in our thinking, and later in our actions. As our conversation came to a close, Gene surprised me by saying, “I still have a long way to go.” He must be referring to the distance he intends to walk, because mentally, as far as I’m concerned, he’s already there.

Practice makes progress. Perfection is the enemy of progress.

YOUR HEALTHY PLATE: Hazelnut Spread (Not-tella)

A group of us went out for breakfast this past Sunday morning at one of my favorite spots, a great local place called Cafe Avalaun, and a plate of their heavenly pancakes with “not-tella” arrived at our table in short order. Not nutella, whose first ingredient is sugar and second ingredient is modified palm oil, but not-tella, which the folks at Cafe Avalaun make with real food ingredients, all of which you can find at the grocery store. 

I went on line to look for a homemade “not-tella” recipe that I could make at home, and was very happy to find this one, from the Coconut Mama.

1 cup hazelnuts, roasted
1 1/2 Tbsp. coconut oil
3 Tbsp. cocoa powder
1/3 cup maple syrup
1 1/2 tsp. vanilla extract
1/4 tsp. nutmeg (my addition)
1/4 cup (plus 1/4 cup more to hold) coconut milk
a pinch of salt

Blend the hazelnuts in a high-speed food processor (Vitamix, Blend-tec) to form the hazelnut butter. Add coconut oil, cocoa butter, maple syrup, vanilla extract and 1/4 cup coconut milk. Blend until mixture is creamy and smooth. Add salt, and then, if necessary, additional coconut milk, just one teaspoon at a time, to obtain desired smooth texture.

Bon appetit!

Body Maps: Do You Know What Yours Looks Like?

Early one morning, decades ago, I looked down a long hallway and saw two obese women walking toward me. Backlit by the rising sun, the two women appeared in outline; all I could see of them was the dark shapes of two bodies, surrounded by golden rays. I stood, transfixed, watching their movements as they walked, their arms swinging far out from their shoulders like ribbons on a maypole. Instead of moving easily, to and fro, with each step, their arms flew back and forth like propeller blades. The force of these arm rotations supplied energy to fling their hips and torsos forward, while their legs, stiff and straight, worked to catch up with each step. Frankly, it looked like hard work, and I forced myself to look away.

Then, a few years ago, having arrived early to a large celebration, I saw a woman, clearly an organizer of the event, distractedly crossing the soon-to-be-filled party room on some urgent last-minute mission. What I saw astounded me: Though of normal weight, she was flinging her arms back and forth like propeller blades. Immediately, I knew that she had not always been this size. I also knew something else, and it troubled me greatly: there was a part of her brain that still thought she was heavy. Despite the many hours invested in her health and recovery, and despite her obvious success, not all of her had healed.

Last year I saw it once again, this time in a young woman walking briskly along on the sidewalk.

Gastric bypass operations have become commonplace, and many individuals who thought they were consigned to a life of obesity, diabetes and knee pain have found a way out. It’s not enough, though.  We may be making some headway treating the physical part of the disease, but we need to do a much better job treating the mental and emotional part. I’m sure that my friend and colleague, Dr. Sara Stein, a bariatric psychiatrist and author of Obese from the Heart, would agree.

I recently had the pleasure of reading The Body Has a Mind of Its Own, by the mother-and-son neuroscience writing team of Sandra Blakeslee and Matthew Blakeslee. Rated one of the top science books of 2007 by the Washington Post, the team of Blakeslee & Blakeslee explain that our minds create networks of body maps exquisitely related to how our bodies interact with the environment. Like trees that grow new limbs while others are pruned, body maps also change over time, shrinking and expanding in response to changes in your body and the environments within which you function.

Doctors, and occupational and physical therapists, are using this new research about body maps to develop methods to heal phantom limb pain, anorexia nervosa, and other body map distortions. I am looking forward to learning how they begin to use it in people whose minds need help learning that the bodies they inhabit are no longer obese.

YOUR HEALTHY PLATE: Fresh Herbs with Cannellini Beans

What makes this an unusual salad is that the herbs in this recipe play a leading role, complementing the cannellini (small white) beans as equal partners instead of minor players. Think of the herbs in this recipe more as greens than flavor enhancers. It’s a great way to use large amounts of fresh herbs from the garden. It’s super easy, super delicious, and super nutritious; herbs are known to have extremely high levels of phytonutrients.

If you don’t have access to fresh, you have three options: plant some now, beg some from a friend, or check to see if your local grocery store carries any. They are usually in the produce section.

Early this past Friday evening, I went outside with a pair of scissors and a large bowl, and cut:
two big bunches of chives (each about 1 inch diameter)
two long sprigs of oregano
one sprig of rosemary
8 leaves each of mint and basil.

Rinse the herbs, pull off the leaves, and remove any brown bits. Lay the chives parallel in one large bunch, and slice them into very small (1/4 inch) pieces. Chop up the other herbs into one little mound until their fragrance fills the air. Scrape everything back into the bowl, and add:
2 Tbsp. olive oil
1 tsp. salt
Stir until the herbs are well coated.

Empty one 15-ounce can of cannellini beans into a strainer, and rinse well until the water runs clear. Add to the herbs, and mix well. Allow the salad to sit at room temperature for a little while (30-60 min) to blend the flavors. Serves 6.

Can a Simple Bowl of Fruit Help Heal Us?

“We must learn to live together as brothers and sisters. If not, we will perish as fools.”  —Congressman John Lewis on July 8, 2016.

The events of the past week have shaken me, like many, and I don’t feel much like talking about food. Today I want to talk about something else. Like most important lessons, I have learned this one the hard way. 

I know for a fact that hate enslaves the hater as surely and thoroughly as it does the hated. As long as you continue to rage against a person or experience that has hurt you, you define yourself in relation to it. Even as you maintain — loudly and emphatically — that you want no part of it, it remains the yes! to your no!, the outside to your inside, the bad to your good, the war to your peace. Yes, it really hurts. But it is not until you are able to give up defining yourself in relation to it that you begin, finally, to heal. 

I am not saying it’s easy. But the alternative is unacceptable. I said something like this once not very long ago, and I find myself saying it here again: Conflict is inevitable, but patience and kindness are a choice.

In the months before 9/11, a young family moved onto our small street from their former home in the Middle East. On that terrible day, I worried that they might fear for their safety. I wondered if they were worried that they would feel forever like strangers in their new home. When evening came after that very long day, and my children were tucked in, I baked a batch of cookies, and then walked, alone, up the dark, silent street to their home. I knocked on the door. They peeked out from behind the curtains, and then invited me in. We had a nice visit. Their children and mine grew up together. They live there still.

Food has the power to connect people around the world. The simple act of sharing a bowl of peaches with your neighbor can bring you together. So go take a bowl of peaches or grapes or something over to your neighbor. I think it’ll be good.  #enough


YOUR HEALTHY PLATE: Early Tomato Salad

This is not the time of year to turn on the oven or stove. But that’s not going to stop me. The tomatoes are starting to ripen, and it’s time to celebrate. You don’t need more than a knife and a cutting board for this recipe. It’s simple, and it’s oh-so-much-more than the sum of its ingredients. Continue reading

YOUR HEALTHY PLATE: The Barefoot Gypsy’s Tabouli

Here is an absolutely fantastic recipe for tabouli from my lucky friend Judith, who got it from her mom, who got it from her mom, who got it from her mom, and so on, which is why my friend Judith is so lucky. Pick up what you need next time you go shopping, so you can make it in time for next weekend’s celebrations!  Continue reading

The Glycemic Index

Many people have heard of the glycemic index (GI), but they are not exactly sure what it means, or how it works. A low glycemic index diet is thought to significantly lower your risk of type 2 diabetes, obesity, coronary heart disease and even certain cancers. This is probably true, but not for the reasons people think. Continue reading


If you’ve been looking for a way to branch out and eat more different vegetables, this is it. Every color in your diet represents a different phytonutrient, and every phytonutrient is like a building block for your good health. That’s why it’s important to eat the rainbow, to maximize the number of different colors on your plate, to spread your bets. If you have been feeling like you could use a little more on the red side of the spectrum, make this.
It takes just a few minutes to whip up this Red Pepper Bisque and IT IS GOOD. The original version comes from Food Babe, who has been generating terrific buzz on the subject of cleaning up our food supply and putting pressure on BIG COMMODITY FOOD to do the same. She has got it all figured out, and she’s on your side.

Continue reading

Eat the Orange, Skip the Juice

Juice is not a great choice unless you need to raise your sugars rapidly. Do you want to spike your blood sugars? Probably not. Not if you want to conserve your insulin and reduce your risk of developing diabetes. When I was a kid, my doctor used to keep orange juice in the office to treat patients with low blood sugar.  Continue reading