I rolled out of bed this morning, threw on some old clothes and headed outside.  It was drizzling, but I couldn’t wait any more; the garden needed some serious weeding, made more serious by two Sundays in a row of commitments when it wasn’t raining, and rain when there weren’t commitments.  The crabgrass was my primary focus today.  I saw some dandelions, which I’ll leave for next week, when I’m looking forward to making another one of those amazing dandelion salads I wrote about a few weeks ago.  I saw, for the first time, a little bit of purslane, too, which I left to spread and grow.  Purslane, which is pleasantly crunchy and extraordinarily high in omega-3 fatty acids, was actually cultivated in gardens once upon a time, though most people consider it a weed these days.  It’s everywhere; if you Google its image, you’ll probably recognize it.  I saw a large patch of it growing near my office last Friday.  Let it be known that I’m planning on reviving purslane-on-purpose.

In my garden, I sprinkled lots of lettuce seed about a month ago, so today I got to pick a huge bowl’s worth of mixed miniature lettuce leaves.  Then I picked a round purple and white striped eggplant, 2 long dark purple eggplants, a long thin red hot pepper, one tomato, a large bunch of basil, and a couple of bunches each of flat and curly parsley.  I carried everything into the kitchen and tossed the lettuce into a bowl of water to get it rinsing right away.   I cut up the eggplants and tomato.

Back outside, I grabbed the wheelbarrow.  The chicken coop was due for a change of straw today.  I filled the wheelbarrow with the old straw, and took it to the garden, where I spread the straw over the areas where the crabgrass had been thicker.  We’ll see whether that works.

In the kitchen, meanwhile, the eggplants, tomato, and hot pepper, along with 3 cloves of garlic, an onion, olive oil, and a couple of zucchini, turned into a lovely ratatouille.  When it was done I sprinkled the top with the fresh parsley and left it to cool to room temperature.

A small head of broccoli from last week’s CSA was cut into florets, steamed until bright green, and then sprinkled with French Thyme.  I cut the woody part of the stems from five gorgeous artichokes, and then steamed them, too, along with two cut up limes, until the leaves separated easily.  I baked a few potatoes.  The lettuce went through a great many water changes until it looked quite clean and all the specks of dirt had been rinsed away.

In the afternoon, my husband left for the supermarket to pick up a few pieces of tilapia.

I stripped the basil leaves (approx 30) from the stalks, and mixed them with olive oil (approx 1/2 c.) and salt (approx 1/2 t.) in a 2-cup pitcher.  Then I blended the mix with an immersion blender until it was smooth and bright green.  This should be amazingly good(!!) anywhere you decide to put it: on the salad, baked potatoes, broccoli, or fish.  Or all of them, as I plan to do.  Maybe the ratatouille, too.  I’ll bet the artichoke leaves will taste delicious dipped in basil-olive oil.

Dinner should be ready soon and, given the number of dishes we prepared, there should be plenty of leftovers.  I am looking forward to eating them for lunch this week.  I am also looking forward to a new batch of vegetables from our CSA on Tuesday.

This past spring, what with the unceasing rain, one of our hens caught a cold and never recovered.  It was a bit sad, but there was a good side:  I figured out how to keep the pen drier so the girls wouldn’t get soaked to the skin every time it rained.  They could easily stay inside the coop whenever it rained, but they were apparently eager, no matter what the weather, to spend time out of doors.  I bought a piece of roofing to cover the open pen; and then, since most of our weather comes from the north/northwest, I fixed a large tarp across the back of the north side of the pen.  It made a big difference, and I was no longer greeted on rainy days by drippy hens.

The girls seem healthier now than ever before.  They are laying large numbers of eggs, and their combs are full and red.  In fact, after a long, dry patch that lasted at least a year, we have seen Nora’s pale pink, wizened comb turn soft, red and fertile again.  She’s laying eggs now at least every other day.  Dora’s comb has grown so big that it covers almost her entire head and makes her look like she’s wearing a red baseball cap.  Nora and Dora are black-and-white Hamburgs, and they lay creamy white, angular, medium-sized eggs.  The five Golden Buffs, Daisy, Maizey, Maggie, Goldie and Glorie, lay extra-large, extra-round, brown eggs.  The two lighter-colored Golden Buffs, Maizey and Maggie, are probably the ones whose eggs are slightly chalky in appearance.

What do our hens eat?  They get approximately 5 cups daily of an organic, grain-based feed that my father obtains from an outfit in Hillsborough, NJ.  Besides that, they get major amounts of leftovers from the cutting board.  On any given day, these might include apple cores, beet greens, stale sunflower seeds, leftover salmon skin (from special dinners), watermelon rinds, the seed mass from inside cantaloupes and honeydews, tops and seeds from sweet peppers, or cucumber ends.  I toss in things like stale bread and moldy muffins.  After Passover this past spring, they ate all the leftover matzah.

The girls are let out of the coop (with its attached pen) every afternoon for 2-3 hours, and that’s when they get their fill of bugs, grubs, greens, weeds, and worms.  They hang around when I garden to grab any worms I unearth in the process of digging and turning the soil.

What do they seem to like best?  The same thing as human beings, oddly enough.  Or not.  They love the sweet stuff.  They fight over strawberry tops and melons, and they look amusingly ghoulish as they cannibalize melons and race away to enjoy their bounty, the long, ragged strings of seeds and fruit dripping from their mouths.  They vie with each other for an ideal spot when grain is being tossed into the pen.  Sometimes somebody gets pecked and lets out a big squawk, but usually they behave well enough.

They are also partial to protein.  They fight with one another to be the lucky recipient of fish skin, and they have behaved similarly on the rare occasions that I have brought them leftover hamburger.  We have a family policy never to feed them leftover chicken, the reasons for which seem obvious.

I know that they need greens, and I’ve seen them eating them, but never with relish.  Maybe greens are an acquired taste, or maybe they just aren’t as delicious as protein or sweet.  All I know is, it reminds me of people.  A friend of mine recently shared that she requires her children to eat their vegetable course (served first) before the rest of the meal.  Her kids are beautiful, healthy and slender.  I’m just saying…  Anyway, sometimes I toss grain on the crabgrass growing around the edges of my fenced garden.  Then the chickens get their greens, and I get some help with the weeding.  They also get plenty of greens from the kitchen in the form of outer lettuce leaves, wilted salads, and fading cole slaw, but they always eat it last.

This brings me to Dr. Niva Shapira, from Tel Aviv University, whose recently published article in the Journal of Agricultural and Food Chemistry explains how a hen’s feed affects the quality of her eggs.  Dr. Shapira’s research indicates that hens fed a diet high in wheat, barley and sorghum (another grain) produce eggs much lower in omega-6’s and with much larger amounts of anti-oxidants than hens fed a cheaper diet consisting mainly of soy- and corn-based products.

Dr. Shapira showed that daily consumption of two standard, commercial eggs increased LDL cholesterol oxidation by 40 percent over eating eggs from hens eating the better quality feed.  In North America (but not in Europe by the way), corn- and soy-based chicken feed usually make up the bulk of commercial hens’ diets.  Looks like your health is on your hen’s plate, too.

For now, many of us are limited to what’s available at the supermarket.  But when you do buy eggs, pick the expensive “high omega-3” eggs.   Even if they cost more than the standard, commercial eggs, they are still some of the cheapest high-quality protein available.  And worth every extra penny.  If you don’t spend it on food now, you’ll spend it on medicine later.

Last week’s blog post was all about your heart.  If you think of the heart as having electricity, carpentry and plumbing, then heart attacks are a plumbing problem, i.e., a blockage in the pipes.  The pipes, of course, are the blood vessels of the heart, and the blockage is called a clot.  If blood can’t pass through a vessel, then all the cells past the blockage quickly become starved for oxygen, and then they die.  That’s a heart attack.  

What does this have to do with diabetes and obesity?  Everything.  High blood sugars cause stiffening of the blood vessel walls.  The higher your blood sugars, the faster the blood vessels harden.  The longer your blood sugars remain high, the faster the hardening occurs.  So the worse your diabetes, and the longer you have it, the harder your arteries become and the worse your circulation gets.

We’`re not just talking here about the arteries in your heart.  Once your arteries start to harden, it’s a problem everywhere.  Each of these complications has its own name.  Blockages in the
heart cause heart attacks.  Blockages in the brain cause strokes. 
Blockages in the legs cause peripheral vascular disease, and then
amputations.  Blockages in the kidney cause renal insufficiency, and
then “end stage renal disease.“   Blockages in the back of the eye, or
retina, cause diabetic retinopathy.  And so on. 

These aren’t all separate diseases.  The fact of the matter is that they
are all caused by the same underlying problem.  If you’ve been reading
this blog for a while, along the way you`ve learned that this problem is
caused by high insulin levels, or “hyperinsulinemia.”

Hyperinsulinemia
is also known as metabolic syndrome.  It`s a pre-diabetic state, and it
is the underlying cause not just of diabetes, but also of high blood
pressure, high triglycerides and low HDL, polycystic ovarian syndrome
(PCOS, a cause of infertility in young women), and obesity.  High
insulin levels stiffen blood vessels, too.

Long before people are diagnosed with diabetes, their bodies try to
cope with the occasional (at first) and then frequent (later) high blood
sugars by releasing loads of extra insulin to catch all the extra blood
sugar.  But the high blood sugar itself causes resistance to the
insulin, and so bodies respond by releasing even more insulin. 
Unfortunately, it’s never enough; the amount of circulating insulin
continues to rise.   When the day finally arrives on which the person can no longer make enough insulin to manage their ever-rising high blood sugars, those blood sugars begin to rise even higher and faster.

Diabetes increases the likelihood of having a stroke (brain arteries), an amputation (leg arteries), kidney disease and dialysis (renal arteries), blindness (retinal arteries), dementia (due to “small vessel ischemic disease“, which means “hardening of the small blood vessels“), and difficulty having an erection (penile arteries).  In case you’ve ever wondered, yes, hardening of the arteries causes erectile dysfunction, too.  That’s why we call erectile dysfunction a “proxy” for heart disease.  Hardening of the arteries anywhere increases the risk of hardening of the arteries everywhere. 

Remember that blood sugar problems start years, even decades, before people are diagnosed with diabetes. For a long time, their blood sugars have been spiking after they eat, and then taking too long to return to normal.  For all that time, damage has been slowly accruing.  That’s why people who are diagnosed with diabetes already have 10 years worth of damage to their blood vessels at the time of their actual diagnosis.  What does that tell you?  It tells me that we diagnose diabetes 10 years after it really starts.  I’d like to change the paradigm so that doctors recognize diabetes before the damage begins.  Even better, I`d like to identify those people who are entering that 10-year period and stop it before it even begins.  We need to start diagnosing people at the beginning of that 10-year period instead of at the end.  It would save patients 10 years of damage to their blood vessels. 

All the while, as the years go by, arteries continue to harden throughout the body.  So if you are ready to decrease your chances of developing hardening of the arteries, I`d like to suggest that you start today by decreasing your consumption of refined carbohydrates, and shifting your diet in the direction of foods that you absorb slowly:  Eat more fruits and vegetables, more healthy oils, more high-quality protein, and less white flour and sugar.   
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I’ll be honest — on my first day of medical school I could not have told you exactly what a heart attack was.  I knew it was due to some kind of blockage, but I didn’t know exactly where, how, or why.  I’m not sure anyone still knows yet exactly why, but research continues to bring us closer to at least some of the answers.  At a certain point though, I did put it together, and that, dear readers, is what I’m going to discuss today.

The heart is a house with four rooms.  Two rooms, the right atrium and left atrium (plural: atria), serve as entryways; and the other two rooms, the right and left ventricles, are the main rooms.  Blood enters the right atrium, moves through the tricuspid valve to the right ventricle, and is then pumped to the lungs, where it receives oxygen.  The blood returns to the heart via the left atrium, passes through the mitral valve to the left ventricle (the largest room), and is then pumped into the aorta (the largest blood vessel in the body), from which it spreads through the entire body, taking oxygenated blood to all the cells.

Think of the heart as having plumbing, electricity, and carpentry.  Diseases of the heart can usually be traced back to some problem in one of these systems.  In other words, some heart problems are due to the plumbing, others to faulty wiring, and still others to either the material itself, or how it is put together.   

Heart attacks happen in the plumbing.  Blood vessels that surround the heart provide it with its very own blood supply.  If blood cannot flow easily through those vessels, the heart muscle will not receive the oxygen it needs to function. 

Just as blood leaves the left ventricle and enters the aorta, some of it is diverted into small arteries that feed the heart itself.   These small arteries are called the coronary arteries.  [“Coronary” means “heart.”]  This efficient system reminds me of an airline’s warning to put on your own oxygen prior to assisting those around you.  The heart makes sure to take blood for itself first.

In most people, the largest of the coronary arteries heads to the front of the left ventricle as the “left main.”  The left main has a large branch, called the “left anterior descending,” that goes straight down to the left ventricle.  A smaller branch, the “circumflex,” wraps leftward around the back.  A second coronary artery is called the “right coronary artery.”  It feeds the right atrium and ventricle, which are smaller because they pump their blood only to the lungs.  The lungs are a lot closer and comparatively easy to reach than the rest of the body, whose blood is pumped by the left ventricle.

What is a heart attack?  A blockage in the coronary arteries.  You could have a heart attack in one of the tiny, last branches of the coronary arteries.  Or you could be extremely unlucky and have a heart attack in the “left main,” or “left anterior descending” arteries.  Cardiologists call these blockages “widow makers.”  Now you know why:  These are likely to be disastrous, because every bit of the heart muscle beyond the blockage suddenly loses its blood supply.  You know how much it hurts to keep your arm up high in the air and compromise its blood supply?  That’s why a heart attack hurts so much. 

The likelihood of developing a blockage rises rapidly if you have diabetes, hypertension, obesity, high insulin levels, low HDL, high triglycerides, or large amounts of small, dense LDL.  Add to these a sedentary lifestyle.  Being physically active markedly decreases your likelihood of developing a blockage.

What else can go wrong?  

Problems in the electrical conduction system affect the timing of heart muscle contractions.  Imagine, just for an instant, how important it is for the atria to contract before the ventricles.  An instant is about how much time your heart has to get this exactly right with each squeeze.

Problems in the “carpentry” affect the valves or muscles of the heart, which is really a specialized pump made mostly from muscle.  The pump has two phases to its function: squeezing and relaxing.  The muscle can become enlarged and floppy.  That makes it hard to squeeze.  Or it can become stiff and shrunken, which makes it hard to relax.  Both affect the heart’s ability to pump efficiently.  We treat these difficulties with different medicines, depending on the exact problem. 

Illnesses of the heart can be congenital, which means you are born with them, or they can be caused by an injury, be it biological (like a virus or bacteria) or chemical (like a vitamin deficiency).  Illnesses can affect a valve, like rheumatic heart disease, which usually damages the mitral valve.  Or, like longstanding alcohol abuse, they can affect the entire heart muscle.
 
Questions?  Ask away!
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