The Cost of Your Burger and Fries

I  had intended to write about crackers this week, but crackers will wait while I share the news that Food, Inc., an Academy-award nominee for Best Documentary, will be available on line, for free, now through April 29th only, at Food, Inc.  Billed by Variety as a “civilized horror movie for the socially conscious, the nutritionally curious and the hungry,” I urge you to find 94 minutes this week to watch it.

This news about Food, Inc. comes at a good time for “Your Health is on Your Plate,” because it was just last week that a reader named Julia commented on the higher cost of meat from pastured and grass-fed chickens relative to lower-priced, mass-produced meats.  She expressed the concerns of many when she said that it’s a difficult choice to make when you are purchasing and cooking for a large family.  But is it really true that mass-produced meat is cheaper?  It is not.  Food, Inc. explains why.

The money that we remove from our wallets turns out to be just one small part of the total cost of mass-produced, manufactured food products.  The actual costs, a great deal higher, are transferred to three other sectors: health, the environment, and society as a whole.  As a physician with a background in environmental studies, I stand at the crossroads where the three arenas intersect, and I state with authority that the costs are unacceptable and unsustainable.  Health effects are reflected in the absolutely unbelievable rates of obesity and diabetes, and the skyrocketing medical costs of caring for those with these diseases.  Environmental effects are made visible in the rivers of animal waste spewing from feedlots.  And the parallel between the inhumane treatment of animals that become our food and the workers (without whom these artificially suppressed prices are not possible) who process that food is not coincidental.

In Food, Inc., I heard a family choose dollar-menu sandwiches, fries, and shakes over fresh produce, all while spending $70/month on the father’s diabetes medication.  I saw photographs of feed lots filled with thousands of animals knee deep in their own excrement.  I learned that the number of slaughter houses in the United States has dropped from several thousand to just 13 over the past several decades, effectively concentrating and destabilizing the meat processing industry.  I was introduced to a woman who has campaigned, so far unsuccessfully, for safer cattle feeding and butchering practices ever since her 2-year-old son contracted hemorrhagic colitis that was caused by the E. coli 0157:H7 bacteria in the burger he ate 10 days before he died.  Feeding animals a grain-based diet, which they did not evolve to eat, increases the risk of illness to both the animals and the people who consume them.

Eating well doesn’t have to be expensive.  Eating meat every day is expensive, but eating different things, such as lentils, chickpeas, salads, whole grains (especially when purchased in bulk), and greens, is not.  A few years ago, one of my patients, a janitor in a local high school, dropped 50 pounds and half of his medications over the course of a year or so.  “How did you do it?,” I asked.  “Beans and greens,” he said with a grin as he pounded on his chest and then opened both arms wide.  “It’s the secret to my success.”

Jamie Oliver, the cook who transformed England’s school lunch program, has now decided to tackle Huntington, WV, with the highest rates of obesity in the nation.  His goal is to teach families to prepare meals in their own homes by using real ingredients in place of pre-processed, manufactured products.  I’ve been watching episodes of “Jamie Oliver’s Food Revolution” as he wins over school cafeteria workers, a local disc jockey, and the many obese residents of a town filled with optimistic families.  Jamie Oliver understands that teaching people to enjoy and cherish their food is key to teaching them to prepare it.  And learning to prepare one’s own meals with fresh ingredients is the crucial first step to preventing obesity and diabetes.

Simple-food guru Alice Waters says that good food is a good investment. “You either pay up front, or you pay out back…in your health and your way of life and the health of the planet…”  Jamie Oliver says that Alice Waters’s books “…bring her recipes to everyone.  There’s nothing elitist about that.”  For more on affordability, check out Dawn Viola’s post at Wicked Good Dinner, voted one of the 10 best food blogs of 2009.

In the current environment, a burger has become a better buy than a bunch of broccoli.  Chips are cheaper than carrots.  Easy down-payment, lifetime to pay.  It reminds me of subprime, variable-rate mortgages.  The actual price is untenable, unthinkable, and, actually, unaffordable.

According to Michael Pollan, this is precisely why change is required at the policy level.  The “Farm Bill,” ignored for decades by most of us who assumed that it was irrelevant to those who don’t farm, is actually the heart of the American food system, and we will become more familiar with its content as we begin to make the standard American diet our own business.

Here’s more good news:  We remain complicit only as long as we continue to purchase cheaply manufactured calories.  The fact is, our purchasing power is substantial.  We vote each and every time we open our wallets.  So let’s get out there and vote.


Grass-fed Beef, Wild Salmon, Organic Tomatoes, and Whole-grain Wheat

Our food supply has undergone an unprecedented change in the past century; the drive to decrease consumer costs while maximizing profits has compromised the quality of our food supply to an astonishing degree. This phenomenon is reflected in the actual words we use to talk about food. Words that describe food have come to mean something quite different than what they meant just a few generations ago.

Despite the country meadow scene on the cartons, you can be sure that the dozens of eggs for sale at conventional supermarkets were laid by chickens that never saw a sunny day.  If you’re looking for eggs from chickens raised the old-fashioned way, you’re looking for “free-range” chickens. Inasmuch as our fragile, centralized food industry depends heavily on fertilizers and pesticides to increase crop yield and protect against insects and other predators, strawberries and potatoes grown without such interventions are “organic” or “pesticide-free.” “Wild” salmon are the kind that swim upstream and grow strong and healthy, not to mention nutritious, on what salmon have always eaten. Plain old milk, without any of the butterfat removed, is now “whole” milk.

The list goes on and on. Old-fashioned oats, pastured lamb, whole-wheat flour, hormone-free milk. These are retronyms, objects or concepts whose original names are now used for something else. If the more typical examples of retronyms (e.g., rotary phone, analog watch, black-and-white TV, cloth diaper, biological parent, tap water) reflect a century of explosive technological change, what are they doing in our food?

Steaks at conventional supermarkets come from steer raised in a feedlot, or confined animal feeding operation [CAFO], on grain, growth hormones, and antibiotics. If that’s not the kind of beef you want, you have to go to a different type of store and specify “grass-fed” beef. One hundred years ago my great-grandfather, who made his living as a butcher, had no reason to advertise his beef as grass-fed. All cows ate grass, and none of them received antibiotics or steroids. That’s what he meant when he advertised “Beef for Sale” in the front window of his store.

Although we continue to describe foods with the same words we have always used, the words no longer mean what they once did. “Wheat,” the staff of life, no longer refers to the entire grain, with its bran fiber coat, starch core, and wheat germ intact. Now it means only the starch core of the grain, the “endosperm.” The intact wheat, including its fiber and germ, is “whole-grain,” a retronym.

Before the industrial revolution changed the American landscape, most goats, cows, hogs and chickens lived in the barn, or alongside the house. Vegetables grew out back by the kitchen door. Families fertilized vegetables with compost, and leftover vegetables found themselves back in the animal feed. That world, in which people lived within an endless chain of recycled biomass, is virtually extinct in the United States. Our food supply has been redefined.


Use the Glycemic Index to Conserve Your Insulin

This week’s post is about the glycemic index (GI).  Many people have heard of the GI, but they are not sure what it means, or how to apply it for their own benefit.  Several lines of scientific evidence have shown that individuals who followed a low-GI diet over many years significantly lowered their risk of developing type 2 diabetes, obesity, coronary heart disease and even certain kinds of cancer, compared with those who did not.

The glycemic index was developed at the University of Toronto (my daughter’s alma mater) to provide researchers with a way to compare the rates at which various foods, primarily carbohydrates, raise blood sugar.  Because the GI measures how quickly a fixed portion of food is absorbed into the bloodstream, it therefore correlates with the amount of insulin required.  As we have discussed, the faster you absorb a food, the more insulin you need to catch it and escort it to the cells.  So if your goal is to conserve insulin to the greatest extent possible, the glycemic index provides a way to compare foods, and to select ones with lower ratings.  I would arbitrarily rate a low glycemic index value as below 40, a high GI value as above 70, and 40-70 as mid-range.

Let’s look at some actual ratings at http://www.glycemicedge.com/glycemic-index-chart/.  In the “beans & vegetables” category, most beans are rated low.  No beans are rated higher than 48.  Baked beans are rated that high only because they are prepared with a lot of sugar.  So it isn’t the beans themselves that raise the glycemic index to 48.

Most green (broccoli, celery) and white (cauliflower, mushrooms) vegetables are rated below 25.  Red, yellow and orange vegetables are generally in or near the mid-range.  Instant mashed potatoes are a whopping 74.  Why?  Mashing potatoes begins the mechanical process of breaking down food in preparation for its absorption.  Any time we decrease our body’s work of digestion, we increase the rate of absorption.  The more broken down a food prior to eating it, the less work the stomach has to do, and so the more rapidly the food is absorbed. 

In the breads category, whole-grain breads are the lowest (40) and white breads range around 60-70.  French baguettes are extremely high (94).  Most cereals are in the 70-80 range, except for a few whole-grain products in the 50’s.  Rice chex are 89.  Among grains, instant rice is rated as 87 (consider it pre-digested).  Most pasta is in the low mid-range.  Why is steamed brown rice rated at 50, and boiled brown rice at 72?  I suspect that the increased mechanical action of boiling causes more fiber to break down during the cooking process.  I’d be interested to hear from other readers with ideas about this. 

Crackers (67-82) and cookies (vanilla wafers and graham crackers-mid 70’s) are high because they are generally made from white flour with little or no fiber to decrease absorption.  Oatmeal cookies (55) are better.  Most fruits are in the 30-50 range, with a few higher and a few lower. 

It is very interesting to note that the section with the highest glycemic index values overall is “Snacks & Chips,” including poptarts (72) and french fries (75), neither of which, by the way, would be classified as a snack or chip by me.  I thought poptarts were marketed as a breakfast substitute.  More truth in advertising.   Substitutes are not food.  That makes me wonder if perhaps it is the types of snacks, more than snacking itself, that contribute to our obesity epidemic.  Drinks, predictably, range from tomato juice (38) to gatorade (78).  Overall, the lowest glycemic index sections are dairy, beans, and vegetables.  The worst surprises on the list are the tofu frozen dessert (115) and pretzels (83).  The best surprise is the dairy section in general, and yogurt in particular (14).  Here is more evidence that, in fact, Grains are not Beans are not Fruit are not Vegetables: All Carbohydrates are not Created Equal .

The GI depends not only on the particular food being consumed, nor on associated foods eaten at the same time, but on preparation methods as well.  We can manipulate, to a certain extent, the rate at which we absorb various foods, even those with a higher GI.  Basically, whatever increases the work of breaking down food will lower the GI and, conversely, whatever decreases the work of breaking down food will raise the GI.  The longer it takes to break down food, whether mechanically or chemically, the longer it takes to absorb that food.  It takes time to tease apart the strands of a fiber-rich food to get at what’s inside.  This is why whole-grain breads, with higher amounts of fiber, generally have a lower GI value than white breads.  But, as usual, the buyer must beware.  Many brown breads are treated with enzymes that break down fiber and soften the crust.  This has the effect of raising the GI to levels comparable to those of white bread.  So don’t assume simply that switching to brown-colored bread is worth it.  First, check to be sure that the first ingredient is whole-grain flour.  Secondly, check to see if there are 3 grams of fiber per serving.  It’s no guarantee, but it certainly improves your chances of getting what you think you are paying for.

What else lowers the GI?  Fiber, fat and protein all slow gastric emptying (which means that they make a meal sit in the stomach longer), which reduces a food’s GI.  What else?  Acids like vinegar and lemon juice appear to lower gastric emptying.  And, according to one study, alcohol (though not beer), reduced the GI of a meal by 15%.  

So how best to use this information?  Compare the glycemic indexes of the foods you are considering, and choose the lower.  This approach is similar to that of  “Eat This, Not That,” by David Zinczenko, editor-in-chief of Men’s Health magazine and author of the Abs Diet series, and Matt Goulding, the magazine’s food and nutrition editor.  If you compare the GI values of the recommendations, you will see that in virtually all cases, a lower GI food is recommended as the preferred choice.  It’s not just about calories. 

What are the limitations of the glycemic index?  First, it measures only glucose, and not fructose, a major cause of insulin resistance, high triglycerides, and non-alcoholic hepatitis.  (See Fructose, Fiber, and High Fructose Corn Syrup .)  Secondly, the GI measures the intake of a 50-gram load of a food, even if the usual serving of that food is much smaller.  Despite these two major limitations, it is useful for our purposes. 

 

    


The DASH Diet (a Dietary Approach to Stop Hypertension)

From time to time, I get to recommend to a motivated new patient with mildly elevated blood pressure that he or she try the “DASH” diet prior to considering medication.  The DASH diet, which stands for “Dietary Approaches to Stop Hypertension,” and has been recommended by the National Institutes for Health, the National Heart, Lung, and Blood Institute, and the American Heart Association, lowers blood pressure within 2 weeks.  You can check it out yourself at dashdiet.org.

The DASH diet is based on 1) increasing fruits and vegetables, whole grains, nuts, and dairy; and 2) decreasing fat and sugar.  Specifically recommended for lowering blood pressure, it also lowers weight, and the risk of stroke and heart disease.  Combined with exercise, it improves insulin resistance, which decreases your risk of developing diabetes.  The benefits have been seen in people of all ages, from teens to the elderly.

You can see that there is significant crossover between my four recommendations and the DASH diet, although we do part company on the amount of grain it recommends and the preference for low-fat dairy.  Let’s just say I respect the fact that everyone is different, and that some folks seem to tolerate grain (whole-grain only) better than others.  If the low-fat dairy recommendation confuses you, I recommend that you do your own little experiment:  Follow the DASH diet as written for a month or two, and then switch to full-fat dairy.  If your pants get tight or your weight (or blood pressure) rises, then you’ll have your answer.  But just for the record, I don’t believe that will happen.  I don’t believe that the fat in dairy and meats is unhealthy.  In fact, I believe those fats are nutritious.  It’s the fats in fast food, snack foods, and commercial baked goods that are the big problem.  All fats are not the same (see “Butter is better.”)

A new study shows that the DASH diet plus regular exercise improves not only blood pressure, but brain power as well.  In a March 2010 study published in Hypertension: Journal of the American Heart Association, 124 men and women were divided into 3 groups.  Over 4 months, one group followed the DASH diet and exercised for 30 minutes three times a week, a second group followed the DASH diet without exercise, and a third group changed neither their eating patterns nor their level of activity. At the beginning and end of the study, participants underwent a series of tests that assessed mental skills such as manipulation of ideas, concepts, and planning.  The people who combined aerobic exercise with the DASH diet experienced a 30% improvement in brain function, improved their cardiovascular fitness, lost 19 pounds on average, and lowered their systolic blood pressure (top number) by 16 points and diastolic blood pressure (bottom number) by 10 points.  Wow.  That’s the group I want to be in.

High blood pressure is epidemic in our country.  It affects at least one-half of adults aged 60 and older and increases the risk of heart attacks, strokes, kidney disease, and dementia.  So why don’t we all eat the DASH diet?  Why don’t all newly diagnosed hypertension patients get referred to a nutritionist to learn to eat this way?  Come to think of it, why should you have to wait until you’re diagnosed with high blood pressure?  Why aren’t school lunch programs based on the DASH diet?  And why don’t children learn these basics in their science and nutrition classes?  I am more than ready to spend my days teaching people how not to become hypertensive and diabetic.  Any takers?

How to start improving your nutrition?  Since the average American gets only 2-3 servings of fruits and vegetables each day in total, the DASH diet involves a significant increase in the amount of produce consumed.  As usual, I don’t recommend jumping in all at once.  Instead, pick something from the list below.  In a few weeks, add another choice, and then another a few weeks later.  At some point, you will notice that you feel a lot better.  Then, if you’re like most people, you’ll go back to your old habits.  Don’t worry, it’s temporary.  You just need to see if it’s really the dietary changes that are responsible for the fact that you feel better.  That’s human nature, and it’s how we convince ourselves which investments are worth it.  Don’t take my word for it — take all the time you need, and figure it out for yourself.

Here are some ways to get started:
.Add a serving of vegetables to lunch and dinner.
.Bring a piece of fresh fruit to work for midday snack.
.Switch to butter, and make your own salad dressing (see “What’s in that salad dressing?”).
.Use vinegar, herbs, and spices instead of salt.
.Have a glass of milk or a piece of cheese or a serving of yogurt three times a day.
.Limit meat to 6 ounces a day.  Be aware of portion size; we all need to know what an appropriate serving size looks like.
.Change from white rice and conventional pasta to brown rice and whole-grain pasta.
.Eat more beans (see “The Lovely but Lowly Bean“).
.Choose cheese sticks, nuts and nut butters, raisins and other dried fruits, yogurt (see “Everything You Always Wanted to Know About Yogurt But Were Afraid to Ask“), fresh fruits and vegetables for snacks.

Bon appetit!


Potatoes, Horseradish, and Gifts from the Compost Pile

Almost exactly one year ago, when winter was coming to an end and spring was still soggy and cold, I discovered a lone organic* potato in my kitchen.  [*It is important to specify organic here because conventionally grown potatoes are much less likely to root and generate offspring.]  It was dried out and wrinkled, way past edible.  At least six baby roots were beginning to form on the skin.  I decided to try an experiment.  I cut up that potato into six pieces, each containing a rootlet.  I dug a trench in the garden on the far side of my backyard, and dropped in the pieces about 1 foot apart.  I covered them with dirt and waited.  A few weeks later, when potato buds began to push up through the mud, I covered them with more dirt and waited again.  I kept covering the buds until I got busy with more urgent projects, at which point I forgot about the potatoes.  Then, later that summer, I discovered a group of straggly potato plants in my backyard.  When I finally got around to digging up those potato plants to see what was hiding below, I found many beautiful, golden-skinned, new potatoes, perfect in every way. 

I know I shouldn’t have been surprised, but to be honest, I was.  It’s not that I never did anything like this before.  Yet it still created a sense of wonder.  All that stood between me and those new little potatoes was a bit of effort.  I already had the potato (such as it was) and, despite the fact that it was no longer edible, it still contained all the raw materials necessary to create new food, sustenance, satisfaction and joy.  The whole experience reminded me of the children’s folktale, “Something from Nothing,” about a little boy whose tailor grandfather continues to craft for him progressively smaller articles of clothing from the remains of other, cast-off pieces.

Our family has an exquisite Passover seder plate, a treasured gift of blue-and-white porcelain.  After seder, I don’t clear it from the table; it stays as a sort of centerpiece for days afterward.  It’s obviously not its appearance that keeps it there, but rather what it means to us.  And so it remains, in fading glory, long after the parsley, horseradish and charoset [a mixture of apples & walnuts] become dehydrated and unappealing.  A few years ago, when I finally removed the plate to the kitchen sink to be cleaned, I got the idea to plant the dry chunk of horseradish in the backyard garden.  I really had no idea what I was doing, but I remembered that friends where we once lived in Athens, Ohio, would always arrive days before Passover with a large jar of homemade horseradish, the most fiery I ever tasted, and prepared from horseradish that they themselves had grown.  Well, if they could do it… 

Sure enough, a few years later, by which time that undisturbed horseradish root had given rise to dozens of 2-foot long leaves, I dug up a huge clump of root, cleaned it well, tossed it into the food processor with vinegar and salt, and stood back.  Suffice to say the horseradish stimulated penetrating conversation that year, and every year since. 

Like my mother, I have maintained a compost pile wherever I have lived.  All the coffee grounds, egg shells, corn husks, apple cores, leftover green beans, nut shells, used tea bags, fruit pits and seeds, carrot peels, old refrigerator-drawer oranges, and other food waste go into it.  Leaves and grass would be okay, too, but I happen to put those in a different place.  Because the pile contains absolutely no meat, dairy or egg products (other than calcium-rich egg shells), there is never a problem with pests or rodents.  It is located out back, behind a particularly lucky spruce, in a spot initially demarcated by shiny chicken wire wrapped around four 4-ft-tall metal posts, each sticking a couple of feet out of the ground.  After 14 years, the rusty chicken wire is sagging and disappearing, and the spot is identified mainly by habit. 

A few words about that spruce:  When we arrived at our new home late in the summer of 1996, it did not look well.  It appeared to be fading, and I made a mental note to have it taken down the following spring.  Much to my delight and amazement, the new growth on each branch the following spring registered more than a foot.  It wasn’t dying; it was hungry!  The compost pile saved it.

In the spring, and at other times when I am planting, I push my shovel down deep into the pile to pull up a shovelful of rich, black dirt.  This is as fertile as soil can be.  I’ll toss some in a hole before I add a new bulb, or seed, or planting.  I’ll spread it around on the surface of my herb garden and dig it into the top few inches to enrich the soil and increase its organic content.  Then, as happens every year, nature takes over and the magic begins.  Some forgotten seed, lying dormant in the compost, germinates and begins to grow.  Two years ago, we got grape tomatoes, green beans and gourds.  This past year it was zucchini and roma tomatoes.  Once a gorgeous broccoli plant grew.  A few years ago, incredibly, a tiny date palm began to grow, oblivious to the fact that the weather in Cleveland, Ohio, would not be kind.  I recently learned that there is a name for this annual experiment.  My friend Amalia, newly the mother of twins, tells me that it is called “compost gardening.” 

Life may be found hiding in all kinds of unexpected places: a wizened old potato, a dry piece of horseradish, a spadeful of soil from deep within the compost pile.  You never know exactly what surprises are hiding within, but you can be guaranteee that, whatever they turn out to be, they will be flavorful and bountiful.  Some sun, some rain, and a little effort.  All free for the taking. 

 


What’s in that salad dressing?

Many commercial salad dressings drown your fresh, delicious and nutritious food in water and corn syrup.  Not only do they waste your money, but they convert your salad to a wolf in sheep’s clothing. 

This morning, I stopped at the local supermarket to look at the ingredient lists on four popular brands of salad dressing.  You will be very interested to learn what I discovered.  The first product I picked up was Wishbone Italian dressing.  Its first ingredient is water.  Seems like a very expensive way to buy water.  And surprising, too, given that Italian dressing is traditionally made from olive oil and vinegar.  Not this Italian dressing, though.  After the water, its ingredient list contains soybean and canola oil, distilled vinegar, sugar, salt, dehydrated garlic and onion and red bell pepper, maltodextrin, xantham gum, spices, autolyzed yeast extract, EDTA, natural flavor, lemon juice concentrate, caramel color, and annatto, which colors the dressing yellow, more like olive oil, which it does not contain.

The second product I picked up was Hidden Valley Fat-Free Ranch.  Like the Wishbone Italian, the ingredient list starts with water, followed by corn syrup, maltodextrin, sugar, and modified food starch (usually made from corn or wheat, whichever is cheaper at the time of purchase).  These are four different ways to say “sugar,” which, of course, significantly raises the amount of insulin required to metabolize your food.  The 6th ingredient is protein-rich buttermilk, of which there must be very little since the nutrition information lists 0 grams of protein.

Next I checked Kraft Catalina, a sweet, French-style dressing.  The first ingredient was high-fructose corn syrup, followed by water and tomato paste (called “tomato puree”), soybean oil, vinegar, salt and 12 more ingredients that constitute less than 2% of the total.  These include red dye 40, yellow dye 6, and blue dye 1, which probably account for the unusually deep orange color of the product.  Two tablespoons of Catalina salad dressing contain 10 grams of carbohydrate, most of which (9 grams) is sugar.  It’s a lot like pouring pancake syrup on your salad.

The last dressing I examined was Kraft Balsamic Vinegar.  Once again, the first ingredient was water.  Then came “vegetable oils” (further defined as “canola, soybean, extra virgin olive oil”),  followed by “balsamic vinegar” (wine vinegar, grape juice, water), and the usual long list of ingredients each of which constitutes less than 2% of the total.  I  have a much better, simpler recipe.  Mix 3 tbsp. of olive oil with 2 tbsp. balsamic vinegar.  Toss over washed lettuce greens just before serving.

So what’s the alternative?  I picked out a few of my favorite salad dressing recipes for you to try.  The directions for all of them are the same:  Combine ingredients in a small bowl, mix or whisk until blended, and refrigerate.  All of these dressings are flavorful and nutritious.  If you are sensitive to salt, just skip it.  There is plenty of flavor with or without the salt.

1) Balsamic Vinaigrette (a bit more involved than the very simple recipe above) is made with 1/4 cup balsamic vinegar, 1/4 cup extra-virgin olive oil, 2 tbsp lemon juice, 2 tsp soy sauce, and 3 garlic cloves mashed to a pulp with 1/2 tsp coarse salt (use a fork or a mortar & pestle), and fresh ground pepper to taste.

2) Tahini Salad Dressing (one of my long-time favorite salad dressings, and really delicious on a Lebanese salad composed of 2 small diced cucumbers, 2 small diced tomatoes, 3 diced radishes, 1 sliced green onion, 10 sliced mint leaves, and 1/3 bunch parsley, chopped) is made with 1 minced clove of garlic, 3/4 cup tahini (sesame seed paste, available everywhere), 1/4 cup lemon juice, and 2 tbsp olive oil, with salt to taste.  This dressing will only stay fresh for a few days.

3) Classic French Vinaigrette is made with 1/2 cup white vinegar, 1 tbsp honey, 1 tbsp prepared Dijon-style mustard, 1/2 tsp ground black pepper, 1 tsp salt, 2 tsp minced garlic, and 1 cup olive oil.  Adding 2-4 drops hot sauce is also an option, although it will no longer be a classic french vinaigrette.

Try one or more of these and let me know what you think.

 


Scoop at the Coop 2

Last summer, egg production was way down.  Soon after our 3 beautiful Hamburg chickens arrived, we went from 1 or 2 eggs a day to maybe 1 egg a day to sometimes no eggs.  Then a whole week went by without a single egg.  It soon became clear that something was not right.  They looked okay, at least at first.  Friendly, healthy, happy.  The dappled sun shone down through the leaves of the oak tree under which their coop was situated, and flattered their beautiful black and white feathers.  Every morning they looked forward to the delivery of their breakfast, and they chirped eagerly as I crossed the lawn to the coop.  But there were no eggs. 

I checked the inventory:  fresh water, laying mash, oyster shell, plenty of leftover fresh produce.  What was missing?  The girls’ feathers were starting to fall out.  And their bright red combs were starting to fade.  They were starting to look a little drawn.  Now what?

Whereas I usually take to the books for answers, my husband takes to the road.  Sure enough, in short order he had made a new friend, an elderly gentleman who had spent decades raising racing pigeons in, of all places, the same town we live in!  His flock had once numbered upwards of 300 birds, and he had had ducks and chickens as well.  He knew his birds, and he was pleased to help.  He emphasized that he would have to see the coop. 

The following Sunday the birdman and his young assistant pulled up in a small truck.  The assistant hopped out, leaving the knowledgeable birder in the driver’s seat.  From his truck’s location at the bottom of our driveway, the birder could just barely see the corner of the coop peaking out from behind the great oak.  He explained that the weather had kicked his arthritis into high gear, so he would have to stay put while his assistant took a look around.  The assistant returned to report that the coop itself looked great.  Our carpenter’s father-in-law’s old clothes pole made a perfect roosting post.  The nesting boxes were just right.  The water was clean.  So what was the problem?

The birder listened to his assistant, nodding carefully, and then leaned forward.  He raised up his nose, and drew his eyes in toward the center of his face as he focused in the direction of the birds.  He could not actually see them from where he sat.  We waited.  I didn’t breathe for a few seconds.  Then he delivered the verdict :  There’s not enough light.  That perfectly protected little spot under the oak was not so perfect after all. 

We spent a few days assessing our options.  We let the girls out to run around and hoped they would stay near the coop.  They did not.  We admitted the obvious, and drove to Lowe’s.  Twenty-one metal stakes and 150 feet of chicken wire later, we had expanded the girls’ playground into the bright sun.  We flung open the coop door, and they jumped out, eager to explore their newly extended surroundings.

So here is what we learned:  Chickens need sunlight.  This makes me think about the epidemic of Vitamin D deficiency in Cleveland and elsewhere.  I read once that Nordic moms bundle their infants and place their carriages outside while they sleep so their tiny pink faces are exposed to the sun.  I already knew that people and vegetables need sun to grow.  I didn’t realize that birds need sun, too.  Vitamin D isn’t just good for your bones.  It strengthens your immune system.  It makes your insulin work more efficiently.  Make your insulin work better, and you will lower your risk of becoming diabetic.

I belong to a terrific gym, and I really enjoy going there with my family.  But it does not take the place of a walk in the light of the day, even if it isn’t exactly sunny.  Barring blizzards, floods, tornadoes, and temperatures in the single digits, I try to get out for a walk every day.  It makes an enormous difference in my waistline, my outlook, and my overall health. 

I encourage patients to commit to a 5-minute walk every day, outside if at all possible.  Maybe 10 minutes, depending on how sedentary they are — the last thing I want is for folks to start walking 30 minutes a day, get shin splints, and then have to sit still and heal for 3 months.  So I say, “Start slow.”  Maybe in a month or two you can increase to 7 minutes, or 15, depending.  If the weather is not to your liking, walk in hallways, or at the mall, if there is one nearby.  The closest mall to where I live is filled with brisk walkers every morning. 

The key to exercising is to do it at the same time every day.  To illustrate why, allow me to ask you a couple of silly questions:  “Do you brush your teeth?”  Of course you do.  “What time?”  “In the morning,” or “Morning and night.”  So now we’ve established that you brush your teeth every day at the same time. 

What if I were to tell you that the research now shows that you get the same benefit if you brush your teeth just 3 times a week (not true, but stick with me…)?  But here’s the rub — it has to be on Tuesdays at 10 am, Thursdays at 7:30 pm, and Saturdays at 4 pm.  We would never brush our teeth!  But that’s how we expect ourselves to exercise, and then we get frustrated with ourselves when we don’t.  So the key is to exercise at the same time every day, seven days a week.  Then you don’t have to think about it.  You just do it. 

Next scoop:  Golden Buffs arrive to share the coop, grow up, and start laying eggs.

 


Eat When You’re Hungry, Stop Just Before You’re Full

     Recently, my old friends and neighbors, Marc & Suzanne, sent me this note about the blog:  “We love it!  Thank you for sending it.  We are not doing so well, weight wise.  We cook the healthy food, eat it, eat it again, eat it all, and then have dessert.”  This week’s post is about portion control.

     Yesterday I sat on a cozy couch with a group of friends, and we worked on a few recommendations to help people with portion control.  The first recommendation was to divide food into single-size portions right when you bring it home from the store.  In my house, I empty 2 large bags of peanuts into a bowl, then measure 1/4 cup of peanuts into each of about 18 baggies, knot each one, and then toss them all into a tin can for retrieval later, one at a time.  I am not a big fan of pre-portioned foods like granola bars and cereal bars, because they contain way too much refined carbohydrate and way too little nutrition.  If the ingredient list contains items not normally found in my kitchen, it’s not really food.  If it’s something my great-grandparents would not have recognized as food, it’s not.  But slicing up an apple or a grapefruit in advance, or grabbing a bag of nuts, ready to eat, is a great idea.

     Recommendation #2 was to serve meals on smaller plates.  Dinner plates, like our expectations about the size of a normal portion, have gotten larger over the past few decades.  You can fix that simply by using plates that are called “salad size.”  Or you can cover that large dinner plate (formerly the size of a typical serving plate) with a large amount of greens or salad, and place your other delights on top.  Of all the commercial diet programs, Weight Watchers does the best job helping adherents to learn to eat appropriate amounts of food.  In part, this is because they teach people to eat real food, and not prepackaged foods and supplements.  Teaching portion control is Weight Watchers’ greatest strength.

     Recommendation #3 was to serve food plated instead of family-style, and even to place the leftovers in the refrigerator before the meal begins.  A related recommendation, one that I’ve seen in action especially in my skinny friends’ homes, is to serve buffet style in the kitchen while guests eat in the dining room, necessitating that the diner rise and leave the table to get a second or third helping.  One variation on this theme would be to bring items like salad, pickles, and olives and so forth to the table, but to keep the other foods on the buffet. 

     Recommendation #4 was to savor the flavor, let chocolate melt on our tongues, eat at the table instead of in front of the television set, and be “in the moment.”  My friend Joe calls this “food consciousness.”  This morning for breakfast, I cracked a golden-orange yolked egg into hot butter, cooked it “sunny-side-upside-down,” slid it onto a small plate, and carried it to the kitchen table to be eaten in the light of the early morning sun.  I made sure to appreciate and enjoy the flavor of each bite.  I allowed nothing to disturb my concentration.  The egg was delicious.  How do I know?  I tasted every bit.   

     Recommendation #5 was to serve soup first.  It’s satisfying and flavorful, fills the belly with a volume of liquid, and gives the brain time to receive the message of satisfaction.  That way, hopefully, you will be less likely to overeat the next course.

    There are any number of reasons why people overeat.  The first and most obvious reason is hunger.  After we eat, it takes about 20 minutes for the signal to reach our brains.  So that’s how much time you need to wait to know if you are satisfied.  Before 20 minutes goes by, you can’t tell if you have had enough to eat.  So if you keep eating during those 20 minutes, you will end up feeling uncomfortably full.  Assuming your insulin levels are normal, that is.  Remember that high insulin levels coat the satiety centers in your brain and make it very difficult to tell whether or not you are full. 

     All kinds of cultural rules have evolved to help individuals regulate their appetites.  The French generally do not take seconds, nor do they snack between meals.  That’s much easier when you’ve eaten a tasty, satisfying, and enjoyable meal.  Parents in a community in the southeast Pacific teach their children to stop eating when they are 80% full.  That gives their brains time to catch up with their stomachs. 
 
     My friend asked me to talk about emotional eating, especially after dinner.  Oprah says that stopping eating at 7 p.m. each night was the single most constructive improvement she made to her eating patterns.  The importance of eating breakfast in this situation cannot be overemphasized.  If you have not eaten the amount of fuel (i.e., food) you need by the time you get up from the dinner table, you will eat the rest after dinner.  And then you won’t be hungry when you wake up in the morning.  To help you out of this vicious cycle, eat some protein for breakfast.  Cereal does not count.  This may not solve the problem entirely, but it will help.  For more help with emotional eating, read Dr. Sara Stein’s very special new book, Obese From The Heart.

     We are programmed to eat when there is food.  Only recently, evolutionarily speaking, have we become absolutely sure when we will be eating our next meal.  Only recently have large numbers of people found themselves in the midst of endless plenty.  So only recently have we needed to learn how to stop eating.  It goes against our natures, and this is why it is so challenging.  Nevertheless, I strongly believe that if we work WITH our metabolism, instead of AGAINST it, we will find it much easier to defer that second helping until it’s time for our next meal.  Then it won’t be a second helping.  It will be dinner.
 
     At the end of the meal comes dessert.  Dessert in our home consists of fruit.  Not fruit cups, or fruit roll-ups, or Fig Newtons.  Fruit.  A bowl of blueberries or strawberries.  Sliced kiwi or oranges.  Sometimes with a few squares of dark chocolate.  When company comes, we may go all out and serve ice cream, or my husband’s delicious banana-chocolate-chip cake.  Or both.  One serving, for special occasions.  Eaten slowly and savored for its unbelievably satisfying flavor.  Then I carefully wrap and freeze the remainder for another special day.  There will always be another special day, and another opportunity to enjoy a treat.  I promise.

 


The Lovely but Lowly Bean

“We know there is a deep reservoir of food wisdom out there, or else humans would not have survived to the extent we have.  Much of this food wisdom is worth preserving and reviving and heeding.”  
                                   —
Michael Pollan in
Food Rules: An Eater’s Manual 

    It occurs to me that there is a great deal of wisdom in the advice we receive at the dinner table, and I’ve been collecting it for years.  I heard some of these aphorisms at home, and I heard others elsewhere: “Eat your vegetables,”  “Chew your food,”  “Breakfast is the most important meal of the day,” “Eat slowly,” “Don’t eat standing up,” and — my favorite —  “The more colors on your plate, the better.” 

 

    There is more to these sayings than meets the eye.  We have a lot of innate knowledge about food.  For example, it now appears that chicken fat has antiviral properties.  That makes a lot of sense to me.  Why else would my medical school classmate, Xenia, have brought me chicken soup when I had a cold?  Everyone knows that you’re supposed to drink chicken soup when you’re sick.  Now it turns out that it’s not just about the steam. 

 

    Then there are beans.  Beans are the only food in the universe that are high in both protein and fiber, and that makes them delicious, nutritious, and satisfying.  We teach our children that beans are magic.  Every culture has its “Jack & the Beanstalk” story.  Beans are on the list of foods that prevent diabetes and obesity.  Yet considering they’re so good for us, we don’t eat very many.  People aren’t even sure what to do with them anymore.  Over the past 100 years, home-based food wisdom has been a major casualty of the industrialization of food, and beans are a good example.  

 

    Recently, I found a 1991 article from the NYTimes, “To Reclaim Their Health and Heritage, Arizona Indians Reclaim Ancient Foods,”  http://www.nytimes.com/1991/05/21/science/to-preserve-their-health-and-heritage-arizona-indians-reclaim-ancient-foods.html?scp=2&sq=chia+seeds&st=nyt about native Americans learning methods of food preparation traditionally used by their ancestors.  A return to a diet consisting primarily of beans, greens, whole grains, and high-fiber plant foods will normalize digestion, hunger, blood sugar, and weight.  For all of us.  Beans can be grown, soaked, sprouted, slow-cooked, and dried. 


    I’ve collected a few beanpot recipes for you to try.  They all have in common the same approach.  Collect a bunch of ingredients, throw them into a covered pot, and cook them over low heat for a pretty long time.  You will not be sorry.  These recipes are delicious.  If you’d like to add a meat bone or a piece of flank steak as well, then go right ahead.  And if you have another favorite recipe, please send it in.  We can start a collection.

1. Black-eyed peas with vegetables and pasta

Ingredients:  1/2 lb. dry black-eyed peas; 1 large onion, finely chopped; 2 large carrots, finely chopped; 1 red bell pepper, seeded and chopped; 1/4 c. tomato paste dissolved in 1/2 c. water; 4 garlic cloves, minced; 1 bay leaf; 1 dried hot pepper or 1/2 teaspoon hot pepper flakes; 1/4 c. extra virgin olive oil; 1/2 c. elbow macaroni or small square Greek egg noodles; 1 c. chopped cooked spinach or greens; 2 tbsp. red wine vinegar.

Directions:  On the stove, boil the black-eyed peas in a large soup pot for 5 minutes, and drain.  Add onion, carrots, pepper, pasta, tomato paste, garlic, bay leaf, hot pepper and 1/4 cup olive oil to soup pot.  Cover with water by 2 inches, cover the pot, and place it in a 300 degree oven for 2-3 hours.  Taste and adjust seasoning.  Stir in the greens, 2 more tbsp. olive oil if desired, and vinegar.  Allow to cool for about 10 minutes before serving.


2. White baked beans

 

Ingredients: 1 heaping c. dry white navy beans, 1/4 c. dry chick peas, 1 large onion, chopped; 4 carrots, peeled and sliced in small rounds; 3 tbsp. hot sauce; 2 tbsp. brown sugar, 1 t. salt, 4-5 c. water, and  4 whole raw eggs, in the shell.

Directions:  Start this the night before, if you plan to eat it for lunch.  Or before 8 a.m. if it’s going to be dinner.  Place ingredients in a deep casserole dish.  Add enough water to cover the ingredients by two or three inches.  Cover the bean pot and place into a 250 degree oven.  Turn it down to 200 degrees after a few hours.  Check it a few times to make sure there is enough water just to cover the beans.  The eggs absorb flavor across the shell and become the most amazing hard-boiled eggs you’ve ever eaten. 

 

3. Exotic white beans (Thank you, Jean!)

 

Ingredients: 1 c. dry white beans; 1 large red onion, chopped; ¼ c. sundried tomatoes; 2 tbsp. brown sugar; 1 t. salt, 1 tbsp. thai roasted red chili paste, 5 c. water.  Directions identical to #2, although Jean said that somehow she cooked the beans at 350 for 3 hours, and then 250 for a couple more hours, and then accidentally turned off the oven overnight.  The beans were soft and delicious anyway.  These recipes are very forgiving.

 

4. Black beans

 

Ingredients: 1 c. dry black beans; 1 large onion, chopped; 4 cloves garlic; 3 tomatoes; 2 oranges, peeled and chopped into small pieces; 1/2 t. red pepper flakes; 3 tbsp. molasses; 1 t. salt; 5 c. water.  Directions identical to #2.

 

    Many years ago, my then-vegetarian sister had a boyfriend whose mother served her “bean loaf” on her first visit to their home.  Its dreadfully unappetizing name was nothing like its flavor.  We renamed it “chickpea pie,” and it stuck around for much longer than the vegetarianism (and the boyfriend).  Here’s to the lowly but lovely bean.  And here are a few more of my favorite sayings.  Eat close to the garden.”  “Don’t buy products whose ingredients you can’t pronounce.”  “Don’t buy products with more than four ingredients.”  “Choose foods that have been through as few machines as possible.”  These are all different ways of saying the same thing: Eat food, not manufactured calories. 

 


Grains aren’t Beans aren’t Fruit aren’t Vegetables: All Carbs are not Created Equal

People tend to consider the category of “carbohydrates” as a single entity.  You hear people say, “I’m a carboholic,” or “I’m trying out this new, low-carb diet,” as if all carbohydrates are the same, which they are not.

One person who strongly influenced the way people think about carbohydrates was Dr. Robert Atkins, who was famous for having invented the Atkins Diet.  Dr. Atkins was on the right track, but he had a few of the details wrong.  He thought that all carbohydrates were the same, and that they were all bad for you.  He didn’t differentiate between the various kinds of carbohydrates.  He just said not to eat them.

People had no trouble losing weight, impressive amounts of weight, on the Atkins diet.  They ran into trouble only when they go to the maintenance phase of the diet.  Here, Dr. Atkins recommended that carbohydrates be reintroduced slowly.  But he provided no guidance.  He didn’t know that a slice of white bread is entirely different than an artichoke.  So that’s where people got into trouble.  Now their weight ballooned, and they deemed the entire experiment a failure.  It’s probably the main reason that people were unable to sustain their weight loss on the Atkins diet.

So how should we be thinking about carbohydrates?  In terms of the amount of insulin they require.  If you’d like to reacquaint yourself with how insulin works, take a minute to go back and read my post on “Eating Toast and Jelly for Breakfast Wastes Your Insulin.”  Remember that foods which are broken down into sugar and absorbed quickly require a large bolus of insulin to catch them.  The faster they are broken down, the more insulin they need.

The four categories of carbohydrate-rich foods, in order of increasing insulin requirement, are vegetables, beans, fruit, and grains.  Vegetables, especially green vegetables, require the least insulin.  Veggies are usually permissible in unlimited amounts on most diets.  I’m sure you have noticed that vegetables, as a rule, do not seem to cause people to put on pounds.  Now you know why.

Beans are a very special food.  They are pretty much the only food on Earth that is rich in both fiber and protein at the same time.  The research shows that they decrease the risk of developing diabetes.  That makes sense.  They use comparatively little insulin.  Remember to categorize green peas, green beans, and peanuts (also known as goober peas!) as beans, not vegetables.

There are zillions of different types of beans, and they all have their own very special flavors, colors, sizes, and other properties.  Adzukis, a tiny, dark red/purple bean from Japan, are one of my favorites.  I like chickpeas, too, which are also known as garbanzo beans.  Last summer I forgot about a jar of chickpeas that I’d set out to sprout.  I found the smelly mess a few days later, tossed it on an empty patch of dirt outside and forgot about it.  Until, that is, I found several plants hanging full with fresh chick peas.  They were so great!  I am looking forward to repeating the experiment again this year.

Fruit is a gift.  The variety of profoundly complex flavors, coupled with their sweetness, provides so much joy and satisfaction.  I remember, as a child, watching my mom methodically peel a beautiful, red pomegranate, and share its tart, jewel-like seeds among my brother, sister, and me.  Another time, there was a silky, smooth-textured, jelly-soft, orange persimmon.  Melon, kiwis, dates, gala apples and navel oranges.  They certainly contain a significant amount of sugar.  But fruit yields up its sugar molecules only reluctantly, as they are slowly released from the fiber matrix within which they lie.  So they do not overburden our insulin production.

By far, grains require the most insulin of each of the four categories.  But grains (whole grains that is), like all the other sources of carbohydrate listed here, carry a significant amount of fiber, and that slows the absorption of the sugar within.  That’s one reason why whole grains are so much more nutritious than “refined” flour.  Speaking of which, what exactly is refined flour?  To “refine” is to purify, to remove coarse or extraneous impurities.  So what makes flour “refined”?  The fact that it’s been stripped of fiber and germ, its so-called coarse impurities.

Flour made from whole, intact grains is darker than flour made from grains that have been stripped of their bran layer.  Also, the germ is rich in polyunsaturated oils, which are highly reactive.  So whole-grain flour becomes rancid much more quickly than white flour.  That’s why white flour has such a long shelf life.  Decades ago, it was easy for manufacturers and advertisers to convince people that flour stripped of the bran and germ was more pure.  It looked cleaner and lasted longer.  It could be stored for months without refrigeration, transported far distances, and still smell fresh when it reached its destination.  The coarse impurities had been removed.  It was new and improved.  It was “refined” flour.

If we recall that fiber, fat and protein slow food absorption, then we can conclude that removing the bran (fiber) and the germ (fat) will significantly increase the rate of absorption, and will result in the need for a great deal more insulin.  So not only do we use more insulin to eat grains, we use even more when we eat the refined white flour of the standard American diet.  Not good.  We aren’t meant to eat a diet that is high in refined flour.  We are meant to eat a diet that is high in vegetables, beans, fruits and whole grains.

A special note about potatoes and corn.  Although these plants are usually considered vegetables, they function more like grains.  In fact, corn meal and potato flour can be used to make baked goods or to thicken gravies, in other words, to use as one would use wheat flour.  So treat them like grains, and don’t eat them in unlimited quantities.

Therefore, to summarize, if you think that you may be using too much insulin, the first thing I would recommend is to decrease the amount of white flour (and sugar) that you eat on a daily basis.  Give it a couple of weeks, and see if you notice that your pants fit better.  If not, then the next step would be to decrease the amount of all the grains you eat, both whole and stripped (refined).  It’s not an all-or-nothing proposition.  You don’t have to remove all the grains.  You could start with fifty percent, and see if that does the trick.  Now wait a couple of weeks again, and see whether your pants are looser.  I would be very surprised if there was still no improvement.  Finally, in the unlikely event that you are still seeing no change, you could cut down on fruit, maybe just the sweeter, tropical fruits like banana and mango.  And that should definitely do it.