Wellness Wednesday: A Thousand Small Cures

Not a day goes by that I am not asked about one “cure all” or another. Wellness Wednesday has been a column devoted to just the opposite- the many, sometimes small things, which done repeatedly, amount to the “cure”. The “cure” offered by longstanding attention to wellness is none other than prevention. 

Even when unpreventable illness or injury happens, wellness behaviors can make the difference between a good outcome and a bad one. We have so much power over our health but people scarcely realize it. Some realize it but are not up to taking that responsibility. It feels better to ascribe their poor health to genes, “toxins” in the environment, or something else. Strangely, empathy rather than blame is in order here. Why ? Because empathy is empowering and empowerment works. Once people get the message (though empathy) that they are not alone, they have the courage to begin improving their health related behaviors. 

Taking charge of your health is easy and empowering from day one. That is the secret that popular media and medical professionals alike keep obscuring. It is not so much a matter of discipline as it is of planning. It need not take place all at once. Once people get the message that wellness behaviors are easy, and need not be hard to be helpful, they are more apt to do them. 

How do people get these messages ? There is of course the popular media. To find this material about health maintenance you must be seeking it. These people are already on the right track. But what about others ? Here is where I believe the responsibility falls on all doctors to talk to patients about their health maintenance. Even before that, I believe it behooves all physicians to set a good example in this regard, and keep themselves as healthy and fit as possible. Nobody is perfect, and nobody should be held to an unrealistic or extreme standard. Yet, doctors should practice what they preach and lead by example. 

Physicians offices should be set up to refer liberally to nutritionists, physical therapists, counselors and others who can specifically teach and monitor health maintenance behaviors. Physicians themselves should learn how to discuss sensitive matters like weight. They should ask about life at home and work to screen for interpersonal issues or abuse. 

It is my hope that popular culture will increasingly embrace legitimate ideas about nutrition, fitness, mental health, and health care.  By now, most people know how ideas travel though communities and social media. Good ideas are sticky, and should be circulated. For example, food and workout posts which we love to hate actually bring these ideas to the fore. 

My website is a repository for health information related to Obstetrics, Gynecology and Health Maintenance. However, it has a limited readership. My plan to curtail blogging to Medical Mondays only is an attempt to get "more bang for the buck” and try another format for distributing this information. There are a couple decent books out there in this subject area, but mainly the field is lacking. I will be looking at the possibility of an ebook versus apps to serve as resources for women looking to improve their health. I hope you stay with me along the way. 

Food Friday: Comfort Food

I think we could all use a little comfort food after this week. 

We turn to comfort foods when we are stressed, sad or lonely. I know lots of people felt this way after this week’s presidential election, especially women. So I am here with some ideas for healthy comfort food. 

Comfort foods are traditionally loaded with simple or refined carbohydrates. Classics include baked goods like muffins and pie, heavy savory food like french fries, mashed potatoes and spaghetti and meatballs. They are filling, warm and associated with good memories. How can you make some of your own without going into a carbohydrate coma and feeling worse after you’re done ? 

I suggest starting with some hot tea, dressed nicely with lemon and and a little agave. This might be all you need. A savory alternative is a hot chicken broth, made easily from jarred organic broth mix which is readily available in standard grocery stores these days. 

If you need more, and you need it quickly, consider homemade popcorn with olive oil, salt, herbs, lemon pepper, or nutritional yeast. (The nutritional yeast is something you’ll have to get at your local organic foods store.)

If you can take the time to prepare something, be strategic. We will go with the traditional items, just tweaked for the cause of health. 

Muffins:

Try my fruit muffins 2.0 HERE  and use gluten free flour or whole wheat flour, depending on your tolerances. Try cutting the sugar. 

Pie: 

Try a Paleo nut crust with a fruit that doesn't need much sweetening. Plums come to mind. When I thaw frozen pie fruit out of season, I do so in a large nonstick frying pan, and pretty much get the water poured or boiled off, and the filling made. How about Paleo pumpkin pie made with coconut cream ? 

Here’s some recipes: 

https://elanaspantry.com/paleo-pumpkin-pie/

http://blog.paleohacks.com/pumpkin-pie-recipe/#

These recipes are for YOU. Don’t expect to serve a huge room of extended family these healthy alternative recipes and not get some comments about how they are different. They are different in that the crust is not the same and the fillings are less sweet. But they are treats you can feel good about. A brief search on Pinterest will yield dozens of Paleo pumpkin pie recipes. 

French Fries: 

This is easy: Crispy baked or broiled sweet potato fries made with coconut or olive oil. The key is in the cut. Sharpen your knife. Make them uniform. If you are brushing them with olive oil, make them thin, so high heat is not required. I recommend a large cookie pan lined with parchment. Lay the fries in a single layer brushed with oil and salted with kosher salt. The add pepper or herbs as desired. Bake at 375 in the upper half of oven until they are beginning to crisp. Dip in paleo or home made olive oil mayonnaise instead of sugary ketchup. Aioli sauce would also be nice. You may cook them in a hotter oven if you use coconut oil, but watch them carefully. 

Mashed "potatoes": 

Here you can try the now famous FAUX potatoes which are made with cauliflower. Wash and cut a whole head of cauliflower, cook until fork tender. You may steam, boil, or roast it. Then blend with a tablespoon of healthy fat like olive oil or a little butter, add salt or pepper to taste. Some people add a little garlic puree, but that is optional. Garnish with turkey bacon bits, and maybe chives. 

"Spaghetti" and meatballs: 

This gives you the chance to try Zoodles, or zucchini noodles. Use a peeler, or a special tool widely available in the kitchen gadget section of major stores. They cook quickly, so beware and do them last. Make the marinara sauce and meatballs of your dreams, the simply have them over the well drained Zoodles. 

I hope you have a nice comforting weekend. 

Food Friday: Feeding the Recovering

Last week on Food Friday we looked at "Feeding the Unwell". We talked about patients who were quite ill or in the early post op phases. This week we will go on to pleasanter things and talk about the time frame when patients are feeling better, but still are unable to cook healthy attractive food for themselves. 

Nutritional requirements are increased while recovering. In particular, nutrients and protein needs are particularly increased, similar to that for pregnancy. There are other special needs. For example, the need to avoid constipation is key. Those recovering from surgery or whose mobility has been limited are prone to constipation, and this can be a significant source of discomfort. Strategic food choices can help avoid this. 

Those who are recovering may have had antibiotics. They may benefit from probiotics such as yoghurt, kefir, sauerkraut, and kombucha. 

Appetite is often diminished in the recovery period. Foods need to be especially appealing and tailored to the patient’s preferences. It also is best to foster a small frequent meals type schedule. 

Between all this, you as the caregiver or helpful friend have several options: 

• Bring freshly made food which can be portioned out over time.
• Bring frozen food which can be heated up.
• Bring ziplock freezer bag “ Kits” of food for use in slow cookers or fast cookers ( pressure cookers like InstantPot) which the patient might have. 
• Make sure the patient has enough healthy handy beverages. Consider herb tea, probiotic Kombucha, milk if tolerated and lightly sweetened drinks. 
• Bring frozen “smoothie kits” containing yogurt or kefir, fruits, and veggies. 
• Use the secret weapon of some wholesome sweets, .i.e. dark chocolate, or a slice of fruit pie to kickstart a recovering person’s appetite. 
• Use the secret weapon of salty foods like pickles, salsa or sauerkraut to induce someone to drink more water. 

Here are some of my Pinterest Boards with recipes which may inspire you. 

Instant Pot Tips and Recipes

Paleo Nutrition

Pick dishes with ample protein, fruit, veggies, and fiber. Include healthy fat such as avocado, nuts, olive or coconut oil. For specific information on these, see below: 

Protein

Fiber

Healthy Fat

Smoothies

Here are some tips to make your culinary caregiving experience more manageable and satisfying. 

• Visit your patient first to see how she really is doing. 
• Make sure you know her allergies, intolerances, preferences and level of hunger. 
• Check in regarding who else will be helping, and whether someone else has organized a meal schedule. 
• Organize a meal schedule yourself using Google Docs or another method of your choice. 

Your patient will not just be well fed; She will have the pleasure of seeing you and the knowledge that you care.  

Food Friday: Pre and Post Work Out Food and Drink

This is actually called nutrient timing in the hallowed halls of medicine. When I initially started looking into this, I found a number of sources calling it bunk, and just as many others touting it earnestly. I wanted to get to the truth of the matter. 

To understand the rationale for pre and post workout food and drinks, one must understand the concepts of catabolism and anabolism. These are the two basic metabolic modes that the body can be in. 

Catabolism is the state of breaking down.

Make no mistake, all exercise is, by design, a teardown or at least a strain, on body parts. What makes exercise more than just trauma is that it is done in such a way to be just enough strain to stimulate new growth, or anabolism. Moreover, it is balanced between upper and lower body, as well as between flexor and extensor muscle systems of the body. Exercise is a well designed program of strategic strains on the body so as to stimulate a growth and strengthening of the systems. 

Anabolism is a state of building up that one will hopefully achieve in the aftermath of exercise. 

Clearly this state of anabolism is resource requiring, even resource intensive. We need certain amounts of water, carbohydrates and fats for energy, and protein to build body parts. 

Review of the literature reveals a shortage of good studies on the effectiveness of pre and post exercise supplements. However a number of general insights can be gained. 

• Gains after exercise are greater when exercise is in initiated in a non fasting state. 
• A meal should not be closer than 1.5 to 2 hours before a workout. 
• The so called post exercise window when one can benefit from this supplementation is not as small nor as soon as was previously believed.
• To maximize anabolic effect, pre and post meals should be separated by no more than 4 hours. 
• Good nutrition spread throughout the day also supports continued anabolism. 
• The post exercise interval is more important than the pre-exercise interval, but supplements at both times appears to confer some benefit in optimal anabolic gain and have little risk. 
• Carbohydrate is needed as well in the post exercise interval in order to replace glycogen, but the carbohydrate need is met by meeting the normal daily requirement for carbohydrate distributed throughout the day. 
• Protein supplementation pre and post workout should be about 0.5 g/kg of Lean body mass (LBM) For example, a 50 kg person would consume 25g of protein a couple hours before a workout and a couple of hours after a workout. 
• Pre and post exercise supplements seem to confer a greater percentage gain in the untrained versus the already trained. 
• Pre and post workout supplements need not be expensive or prepackaged. Protein powder in milk will do nicely. 

Good for you if you are interested in both fitness and nutrition. Now you can leverage them both for some serious gains. Ladies, remember, muscles do not make you look big. They make you look toned and sleek. And they burn more calories than fat. Best yet, they let you do fun things like carry backpacks, ride horses and play sports. 

reference: 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577439/

Food Friday: Cookbooks

Todays's post is the last in a series of 4 posts about cooking inspiration. It is about cookbooks. As I survey my wide ranging cookbook collection, I can see that they sort themselves into a few key categories: 

Reference Material- These are books that encyclopedically categorize a small category of foods or ingredients, ie. The Spice Bible.  

Do it Yourself Cookbooks- These are books which have recipes and methods for making that which we commonly think of as " store bought" stuff.  These books often collect food preparing techniques which are in danger of being lost from the general population. How many of you know how to make crackers, cheese, pickles or ice cream ?   i.e The Home Creamery by Farrell Kingsley. 

Cookbook travel- These books explore a region dish by dish. They are often noteworthy for their fabulous photography.  i.e. My Paris Kitchen by David Lebovitz

Health related cookbooks- These are focused on foods, dishes and menus which have health benefits. There are many such books claiming this feature, but not all actually have it. I have included a few which I think have genuine health benefits.  i.e. The Autoimmune Paleo cookbook by Mickey Trescott, NTP. 

Coffee Table Cookbooks-  These books are typically large format, and magnificently photographed. They are sumptuous tomes which are meant to be works of art in and of themselves. Example: Culinaria, eds. Andre Domine, and Michael Ditter

Chef Based Cookbooks- These feature one famous chef who gives presents their unique recipes but also their versions of the classics, i.e. Mastering the Art of French Cooking, by Julia Childs. 

Category Cookbooks- These are cookbooks which focus on a particular category of cooking, i.e. The Essentials of Roasting by Williams Sonoma. 

Comprehensive Cookbooks- These are cookbooks which aspire to cover everything comprehensively, ie. The Best Recipe, by Cooks Illustrated. 

Here are some homegrown photos of my cookbook shelves as they are tonight. 

My personal favorites shift every few months. Right now, I am biased toward the health related cookbooks since I believe more and more that one can make healthy food delicious. We understand more than we ever have about food science and human nutrition, and many well educated and creative writers are producing excellent cookbooks by marrying this information with their skill and taste in cuisine. 

I also believe that once you taste healthy food from well written recipes, that you will not be able to go back to ordinary unhealthy food. 

With this in mind, I am going to plug one cookbook series and two particular books by different authors as my top choices at this time: 

The Jonny Bowden series on The Healthiest Foods

Paleo Takeout by Ross Crandall

Nom Nom Paleo Food for Humans, by Michelle Tam and Henry Fong 

I love all the online recipes and sites. But sometimes, the large glossy photos and thoughtful prose in a traditional paper cookbook is uniquely satisfying. Paper cookbooks also permit annotation. I can tell you all of mine are written in, with dates, who I made the recipe with, and any modifications I saw fit to make. 

Take a walk on the culinary wild side, and read a good cookbook. Better food is pleasant step toward better health. 

Belated Food Friday: Food Movies

We are one day behind, both today and tomorrow. Thursday night I attended an unexpected emergency, and through much ado, all is well. However between that and the birthday parties, family slideshows, and wedding showers this weekend, we are a bit behind. So I am going to release a fun "Food Friday" now, and Tuesday the belated Medical Monday. The rest of the week I will be devoted to by niece's wedding, which will be held at our farm. I may send out some more fun posts. 

Why watch movies about food ? Food is something we must deal with everyday. It can be a chore, but it needn’t be. Movies about food tell the stories of how food came to be as it is today. Food movies remind us about what and who it takes to put it on our table. They also serve to inspire us to make better and healthier food for our families. 

There is a dark side to food in the developed world. There are numerous documentaries which go into this. Here is a site which catalogs and reviews them. 

First we Feast

I would like to focus on a celebration of food, and the people who make it.  Here is a great “beginner’s”  collection of food movies which I have seen. I have tried to provide a little introduction so you can chose mindfully. I have also included viewing source options. Do not be put off by other languages. The subtitles are easy to get used to and it is fascinating to hear the other languages in the setting of what is happening. 

• Haute Cuisine - (French with subtitles) (Netflix)- chronicles the career of one of the personal chef’s of the president of France. 
• Chocolat- (English) (Apple movies) Art House film with a all star cast including Johnny Depp and Juliette Binoche- set in France - about a newcomer whose beautiful bakery inspires the villagers to enjoy life. 
• Chef- (Netflix)- unmissable sweet story about a single dad who is a chef, his young son and their transition to a food truck business
• Like Water for Chocolate - (Netflix) (Spanish with subtitles) - fanciful earthy tale about a family with a daughter who can infuse her feelings into the food she cooks. Great fun. 
• Babette’s Feast (Apple Movies) (Danish and French with English Subtitles)- Period piece movie about a French housekeeper and cook who moves to Denmark two live with two old  puritanical sisters. Her cooking is transformative. 
• Julie and Julia - Delightful account of a New York woman who blogs about cooking every dish is Julia child’s cookbook “Mastering the Art of French Cooking”. 
• Ratatouille- Charming Pixar film about a rat who wants to become a 5 star chef. 
• The Hundred Foot Journey - Must see culture clash tale of an Indian family, their restaurant, and a french chef.  A visual feast. 
• Burnt (Apple Movies) - Drama/Comedy about a narcissistic two star Michelin chef who has to grow up to get his third star. Stars Bradley Cooper. 
• JIRO Dreams of Sushi - (Japanese with English Subtitles) Documentary about the greatest sushi chef in Japan 
• The Ramen Girl- (Amazon video) ( English and Japanese with subtitles) Heartwarming comedy about an young American Woman in Japan who is determined to learn the art of making traditional ramen. 

Series: 

• Giada DiLaurentis (Food Network) glossy production, pretty Giada and simple Italian dishes 
• The Barefoot Contessa, Ina Garten (Food Network) - Beautiful streamlined classic recipes 
• Tastemade - Sourced-(internet and Apple TV) engaging series of shorts by Aussie hostGuy Turland about classic ingredients and how they are sourced. 
• Chef’s Table - series of different chefs and their unique contributions. (Netflix) 
• Cooked - MIchael Pollan - unparalleled photography, food science and delicious food (Netflix) 
• The Mind of a Chef - David Chang; origins of classic dishes and travel to their geographic and cultural origins (Netflix) 

Some of these series are complete and some are ongoing. These are generally much shorter than full length movies and are great to watch if you don’t have much time. 

So I recommend tucking in to these food movies. Just make sure you get out of the theater and into the kitchen yourself, even if your dishes don’t look exactly like the ones on the screen.  

Food Friday: Staple Pantry Goods

As promised, here are my lists of staples for the pantry. You will notice that not everything here is a superfood. That is because there are special occasions like birthdays which require treats. Not only are these events important for family and social life, but it is important to learn how to use restraint and have a small single portion of an indulgent treat made after a healthy meal. Bon appetite ! 

Grains

• Cornmeal for Polenta
• Quinoa
• Oats for baking and hot cereal

Rices

• short or long grain brown ( preferably basmati)
• wild rice
• black forbidden rice
• sushi rice

Pasta

• whole grain and gluten free pasta, i.e. spaghetti or penne
• Oils and fats
• Canola, for higher heat cooking
• olive, extra virgin, for medium heat cooking
• olive, extra virgin, cold pressed, for dipping.
• sesame oil for flavor
• flavored oils
• coconut oil

Some basic spices and herbs

• kosher salt
• pepper, preferably whole peppercorns
• lemon pepper
• rosemary
• thyme
• basil
• sage
• chili
• cumin
• paprika
• garlic, fresh and powdered
• ginger, fresh and powdered
• cinnamon
• cloves

 Canned and jarred goods
 

• tomato sauce
• diced or stewed tomatoes
• tomato paste
• canned olives
• canned pineapple for pizza or stir fry
• various beans, like black, pinto, garbanzo
• pickles
• sauces like soy
• chilis, diced
• canned salmon
• coconut milk
• all the jams, jellies, chutneys, and pickles that you have canned : ) 
• vinegars like apple cider vinegar, balsamic, rice

Dried things

• raisins
• dried cranberries
• sun dried tomatoes in oil

Baking Ingredients

• whole wheat flour, I prefer fine grind for the most protein and the heaviest bread
• whole wheat pastry for pie crust
• unbleached flour if you must have it
• gluten free flour for those who require it
• baking powder
• baking soda
• cream of tartar
• cornstartch or tapioca powder for thickening pies
• sugar, white, brown cubed and powdered
• chocolate chips
• bakers chocolate 2 forms, blocks and powder
• expresso powder
• sweetened coconut
• molasses, agave, honey
• Nuts (see the freezer section in future posts) 

Beverages:

• a complete selection of chai and coffees, including decaffeinated versions of each
• teas: black, green, and herbal
• Soda water, or Perrier or Pellegrino to splurge

Stay tuned for the fridge and freezer sections next week on Food Friday ! 

Food Friday:A New Year's Pantry

It’s time for a fresh start on your nutrition. Here’s an easy way to go beyond intentions and take a SMART (Specific Measurable Attainable Relevant and Time bound) step to better nutrition: 

Clean out your pantry. 

This is a way of taking stock of your eating habits as they really are. I suggest the following plan for success in this endeavor: 

• Put your family on notice so they can prepare.
• Have a simple plan for your healthy meal while you get all this done
• Take everything out of the pantry and sort it into
  • Keep 
  • Donate 
  • Compost 
  • Trash 
• Be ruthless and keep only what fits into the plan of healthy eating. If you are unsure, then review our section on Nutrition. 
• Clean the whole pantry. 
• Replace the good stuff which made the cut.
• Now that you have a detailed overview of what you have and what you lack, make an excellent list of your healthy pantry staples. Keep the list on your phone and make a couple laminated copies for the pantry itself and for your wallet. 

You will feel such a great sense of satisfaction, and you will be on your way to dietary honesty. Stay tuned next week for my preferred list of staple pantry goods. 

Food Friday: Fruit Muffins 2.0

Fruit muffins were originally an attempt to use up borderline fruit and to make regular muffins (Fruit muffins 1.0) more healthy. They have since become a family favorite. 

You may not need to make fruit muffins before Thanksgiving but you will most definitely need to make them afterwards. That is why I am giving you the recipe this week. You see, you will have left over items from Thanksgiving, and most likely you will make soup out of these premium ingredients. It follows therefore that you will need muffins to go with your soup.

Fruit muffins 2.0 is a flexible recipe. You will see a lot of variations and there are a lot of workable substitutions. 

Adjust your shelf to the upper third of the oven and preheat to 350 degrees F. 

Equipment

• Two cupcake tins each holding 12 cupcakes.
• Unbleached cupcake papers, usually available at a natural food store

Ingredients

• 3 1/2 cups whole wheat pastry flour or whole wheat flour fine grind ( use white if you must but the result is less rich.. you may need more flour too) 
• 2 teaspoons baking powder
• One half teaspoon salt
• One and 1/2 half teaspoons baking soda
• 1/2 cup butter, or one half cup coconut oil can be substituted
• 1 1/2 cup sugar, can be cut to 1 1/4 cup
• Two eggs
• 4 tablespoons lemon juice (equals one quarter cup)
• Six bananas
• or 3 bananas +3 cups mixed fruit such as strawberries, diced fresh apple, dried cranberries.
• Zest of one orange if you have it

Most baking recipes like this one proceed along a typical pattern:

• Cream the liquid ingredients first starting with the butter in the sugar by themselves.
• Add eggs at this stage and whip mixture until fluffy. 
• Add the lemon juice and whip again. 
• Mix in all the fruit and the zest. 
• Whisk together the dry ingredients so they are thoroughly mixed. 
• Stir or fold them thoroughly into the wet ingredients. 
• Scoop with a large ice cream scoop into the muffin papers. 
• Bake 19 -24 minutes ( usually 23) until golden and slightly firm, and passing the sharp knife test. 

Transport in their tins to serve warm to happy friends and family, or to crabby ones and watch their mood improve. These are great served with cold milk. 

Have fun cooking this week. Clean , decorate, cook, and forget perfection. Make cooking a fun group activity. Make it healthy with selected treats and family traditions. Get along with everyone as best you can. Most of all, be grateful. 

Food Friday: Cold Desserts

It’s hot and fruit is in season. Here’s a little history of your favorite summer desserts and some tips on how to modify them to make them healthier. 

• Frappes- ice, milk of some sort, flavorings, blended as a drink, originated in Greece  in the 1950s, named with the French word for shake or strike. 
• Smoothies-a thick beverage made of  ice, milk of some sort, yogurt, fruit, blended as a drink. Some include vegetables, nut butters or protein powder. Recipes originated in Brasil, and were popularized with the invention of the blender. These became popular in the US in the 1960s. 
• Ice cream - In the US defined as having 10 % butterfat or more, frozen, with lots of air whipped in. Frozen dairy desserts date back many centuries to many countries. The English first published recipes for ice cream in the 1700s. 
• Gelato- Italian ice cream; must be at least 3.5 % butterfat; comes from Sicily since Sicily is near both mountains with ice and orchards with fruit. 
• Sherbet- frozen blend of milk and fruit flavors about 1-2 % butterfat, An lower fat American version of ice cream.
• Frozen yogurt - yogurt with flavoring like fruit, frozen and whipped. Originated in the Us in the 1980s during the fitness revolution. 
• Granita- water, large ice crystals, sugar and flavorings like fruit juice or coffee; also hails from Sicily. 
• Sorbet - dense frozen confection of water, sugar, flavoring, frozen and blended smooth; folklore dates it back to the Roman emperor Nero. 
• Popsicle- originally was frozen flavored ice on a stick. Patented in Oakland California in the 1920s. Modern versions may contain other ingredients like fruit. 

Cuisinart ICE-21 Frozen Yogurt-Ice Cream & Sorbet Maker, White

$53.51

Cuisinart

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You can find recipes for these in many places. My favorite sources are :

epicurious.com

Food.com

Foodnetwork.com

 Pinterest

Here are some general principles which will help you create desserts that people will enjoy. 

Ben & Jerry's Homemade Ice Cream & Dessert Book

$7.01

By Ben Cohen, Jerry Greenfield, Nancy Stevens

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• Get a good electric ice cream machine. 
• Get a good blender, preferably a Vitamix. 
• Get some popsicle forms and make your own healthy versions. Make icy or dairy versions; consider adding fruit slices. 
• You may use a simple metal pan placed in the freezer, combined with periodic stirring. Granitas work especially well this way. 
• Use sweet ripe fruit if you are omitting or reducing sugar. Consider adding half a banana or a few sweet grapes to certain desserts to sweeten. Those who like stevia may try that, though be sparing. The point is to taste the natural flavors. 
• Choose coconut milk if you are dairy intolerant. 
• Choose dark chocolate flavoring. 
• Choose decaf coffee for flavoring. 

It is a fun summer family activity to make healthy cold desserts. However, you have to have a good attitude if you are going to take conventional recipes and modify them to make them more healthy. You can’t expect them to taste exactly like store brands, and that’s just fine. 

Food Friday: Fast Food

I am loathe to miss a meal and can hardly tolerate missing a snack. My patients know they aren't supposed to either. Metabolism, energy, a bright outlook, ability to exercise, blood sugar control, weight management and sharp thinking all depend on it. So often my patients say they don't have time to eat, especially breakfast. These are the same folks who are struggling with their weight. So instead of repeating this point, I am going to give you my down to earth, personal go to suggestions when you really have next to no time to make and eat food. 

First, however you have to shop correctly. Remember super basic is key, and one real cooking episode is needed: dinner. Most people don't struggle with dinner. Cook extra at dinner so you will have leftover protein rich foods and cooked vegetables. 

Here is my basic grocery shopping list for fast food, by section.

Freezer: 

• Lean meat, chicken, turkey, fish, shredded cheese
• frozen fruits for smoothies: mixed berry, mango, blueberry etc 

Fridge: 

• Milk, cottage cheese, plain yogurt, sour cream, cheese, kefir, eggs
• salsa, condiments like pickles 
• whole grain low carb wraps
• nuts like walnuts and almonds 
• healthy broth mix 

Pantry: 

• whole grain bread, corn tortilla chips, oat bran cereal, healthy cold cereal like muesli 
• canned salmon, canned tomato products, sauce and stewed
• your favorite complete protein powder
• dried fruits like craisins 
• oils - olive and canola 

Produce: 

• cooking greens like chard, kale and spinach
• Salad greens like spinach and lettuces 
• cucumbers, tomatoes, broccoli, green beans, zucchini, carrots, colored peppers, avocados
• Strawberries, watermelon 
• apples, bananas, oranges  
• red and green grapes 
• stone fruits in season 

"Recipes"

Breakfast : 

• bowl of cottage cheese or plain yogurt with any fresh or frozen fruit. optional : nuts, craisins
• healthy cold or hot cereal with dollop of yogurt, and some fruit
• chopped fresh or leftover veggies with a couple scrambled eggs with or without cheese. Dress with salsa, sour cream or avocado. 
• wrap with leftovers 
• 2 cups milk with protein powder 

Snacks: 

• hardboiled egg, cheese, dairy, fish chicken or meat with fruit or veggies like carrot sticks

Lunch: 

• Salad greens with  hardboiled egg, cheese, dairy, fish chicken or meat. Try mixing canned salmon with mayo olives and pickles for a great spread. On a cold day, make soup with broth and leftovers. Make it the blender to speed up the process. 

Dinner: 

• Main protein rich dish, green salad, cooked vegetable and fruit for dessert. Cook extra for wraps later.

Note:

• A hefty blended smoothy with yogurt and protein powder, fruit and even vegetables can substitute for any meal. 

Give some of these fast foods a try. Bon appetite. 

Food Friday: Food Joy and Fat ?

Food joy. Does all this enthusiasm about food contribute to the obesity epidemic ? Consider everything hot now in food : food magazines, the food channel, food trucks, street food, farmer's markets and local food ! Vegan, Paleo, Pegan, organic. 

I say a resounding NO. All this food joy is a great step in the right direction. It does not contribute to the obesity epidemic. I have no data here. I only have 30 years in medicine, most of which is focused on women’s health. 

Those with poor nutrition and problems with obesity are most often those who have not discovered the joys of food. Many times they are those that eat whatever food they can get. This ends up being the stereotypical top ramen, soda pop and boxed mac and cheese, or the iconic white bread. I remember unkind comments from adults I knew as I was growing up, as they wondered how people with so little money could get so much food to get so big. This reflects a profound misunderstanding of nutrition poverty and obesity.

Many times overweight people do not eat very much. They have little and eat little. What they do have is cheap carbohydrate, and they need to eat it as their whole meal since protein sources and fruits and vegetables are or are perceived as less available. Because of this diet, these folks suffer from chronically low metabolism and have low energy. They therefore become less active. Their extra weight compounds their insulin resistance, which results in more fat deposition. It is very hard to get out of this vicious cycle.

Many times I see young women in this predicament while they are pregnant. In this instance they have access to better resources such as food stamps as well as nutrition teaching. I have found that they are as eager and able as anyone else to learn. Once they do learn about the correct composition of meals, as well as the correct timing and quantity, they are astounded about several things. First, they are astounded about how much they enjoy their new diet. The are almost universally shocked at what large quantities they are supposed to eat. And, given this, they are amazed that their pregnancy weight gain levels out appropriately. Finally, they begin to enjoy food preparation, but note that it is a time commitment that they did not have before.

Some have odd reactions from significant others, and find themselves isolated. The partners may not want to change the way they eat. Sometimes partners even make fun of the one trying to be healthy and tease or taunt them back down to their level of poor nutrition. 

Most of the time this change toward nutrition awareness, and eventually toward food joy, is life altering. They never want to go back. Sometimes it becomes a source of pride and accomplishment in the family, and mealtimes become social in a way that they had not been. 

To me, the final stage of food joy is the social and cultural aspect. I took a walk down my own Main Street. I was amazed at what our little town had to offer. We had artisanal breads, real sushi, Thai food, genuine French macarons, and handmade watermelon chili sorbet all on one block. Granted, most of these delicacies were treats. But they were foods that made people appreciate food, other people, and other places. I saw people clustered in cafes, and out on the sidewalls. I saw people working on laptops, socializing, and flirting, all the while over special foods and drinks. They all seemed rather vibrant. 

It appears that people who take the time to walk about to find beautiful food like this are not apt to “ waste” their calories or carbs on junk. They become conoisseurs who are interested in the best for themselves. 

It is always a step in the right direction when people start to focus on quality, in nutrition, food, or even cuisine. When people focus on quality in one dimension of their lives, it tends to spread to others. My favorite part of this whole process is watching patients start to embody quality and enthusiastically take good care of themselves. 

Food Friday: Healthy Substitutions

Eating well is not about dieting or deprivation. It is about understanding food and physiology. It is also about taking a little extra time to obtain and prepare great tasting and healthy food. Some people worry about all the things they would have to give up to eat healthfully. But I’d rather think about all the substitutions that both taste better and are better for you. 

Here are some specific examples to make this easier: 

Drinks: 

• Instead of cheap caffeinated coffee, use water process decaf made strong in a french press. Or, for lower cost, try decaf Earl Grey tea. 
• Instead of sugary or artificially sweetened soda, use club soda, plain Pellegrino or Perrier with a light splash of pure fruit juice and citrus wedges. 
• Instead of a milkshake, have a smoothie with real fruits, plain yogurt, and ice. 

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Snacks: 

• Instead of forgetting snacks for work, bring a week’s worth on Mondays. Include easy things, like raw nuts, cheese, and long lasting vegetables. 
• Ditch the granola bars in favor of sweets like fruits with plain yogurt or cheese. 
• Steer clear of office sweets by having your own vegetables, dips and nuts. 

Breakfasts: 

• Instead of an Egg McMuffin, saute mixed veggies like peppers, onion and tomato then cook with a couple eggs and a little cheese. 
• Instead of a sugary cereal, have a low sugar whole grain high fiber cereal with skim milk and piled with fresh berries or even slivered almond. 
• Instead of no breakfast have the very quick banana and a glass of milk. 

Lunches: 

• Have a breadless sandwich. We call it a salad with meat. 
• Keep things like salad dressing at work so your lunch salads are more appealing. 
• Watch cafeteria soup… it is full of fillers like starch and sugar. Make a big batch from scratch and bring it all week long.

Dinners: 

• Instead of main dish, salad and starch, have main dish, salad and cooked vegetable. 
• Instead of pasta or rice, have Zoodles, meaning noodles made from vegetables such as zucchini. 
• Broil, grill or bake rather than fry. These methods require less tending and cleanup anyway. 

Desserts: 

• Make a crustless or nut crust pie and reduce the sugar. 
• Have plain yogurt or cheese with fruit for dinner. 
• Make a conventional dessert but halve the portion size and make it beautiful. 

To learn more about the principles behind these modifications, see the following sections on our website: 

Nutrition 

Nutrition in Pregnancy 

 

Food Friday: The Joy Lunch Club

Who doesn't look forward to lunch during a busy day tending kids at home or a hard day at work? I look forward to lunch. However, when I interview patients about their eating habits, I find all too often that patients skip meals, especially breakfast and lunch. 

I understand. We're busy. Sometimes we're not even hungry. We think skipping meals will help us lose weight. But as I have mentioned before, skipping meals actually causes us to lose muscle and slow down our metabolism and our thinking, making us feel sluggish and perform poorly. If we skip breakfast we are even less hungry than we would be had we jumpstarted our metabolism with a good breakfast. 

So, I have decided to promote the idea of a homemade workday lunch by issuing a challenge called the Joy Lunch Club. I will give the readers of this blog two weeks to submit a picture of their awesome lunch on a typical busy day. The best workday lunch photo at the end of two weeks will receive a custom "yoga girl" lunch box complete with containers and ice. To qualify, the lunch must be healthy, contain protein and produce like fruit or vegetables, be homemade, and if  brought to work, be in suitable containers. Photos may contain the lunch itself or you with the lunch. They should be posted to my office Facebook page linked to this website. Finally, to be eligible for the prize, you have to be subscribed to the site. (Please see the "Subscribe and Comment" section in the menu.)  At the end of the two weeks I will announce the winning photo, who's owner will then need to Facebook message me for the prize. Unfortunately I need to limit this offer to the US and Canada.

Others can order this unique lunch box through our Zazzle Store found HERE. Have fun, enjoy your lunch and good luck! 

Food Friday: Manage your weight the counterintuitive way !

It seems to make sense that to lose weight we should eat less. On the other hand we all know certain people who seem to eat all day long and are quite slim. Indeed, the French who are known for their small figures, have food as a centerpiece of their culture, a lot of it, and all day long, well into the night. 

How is it possible? It's all about metabolism. It's not about the calories you eat in one sitting, and it's not about the calories you burn in one exercise session. It is about the rate at which you feed calories into your system and your body's ability to utilize them as they come in. 

To have good energy all day, you must have a moderate steady input of calories all day long. If you have a span of time without enough fuel, you body will turn down your metabolic rate and you will feel fatigued and be sluggish. If we eat episodically, then binge, we create a slow metabolism, then overwhelm it with an excess. Such an excess is stored as fat, even though then total number of calories eaten in that day might have been low. This strategy leads to feeling sluggish, losing muscle, and gaining fat all in the course of one day. 

Anyone would rather feel energetic and improve their body composition, but few know how.  Surprisingly, you have to eat more of the right kinds of food, and eat them more often. This produces a steady release of calories. To accomplish a steady release of calories into your system, you need to choose foods which singly, or in combination, release slowly. Unprocessed natural foods tend to release slowly, whereas process foods release quickly. If you combine high quality carbohydrate containing foods like fruits and vegetables with healthy fats or proteins, then you will have energy even longer. 

The rate at which a food digests and release energy in the form of glucose is called the glycemic index. Slow release foods have a low glycemic index, and that is what we should be choosing. If we choose high glycemic foods like sweets or breads, we stimulate a spike in our insulin levels, which leads to cravings. Thus, the less we eat of high glycemic foods, the less we want them. 

Do you want to leverage the system even more? Build up some muscle through a mixture of cardio and resistance. Muscle is lean body mass and has a much higher metabolism than body fat. Either cardio or resistance will increase your metabolism all day long, far beyond your exercise session, but together, they synergize. 

If you are willing to eat three moderate meals and three small snacks composed of some protein, fruits, vegetables, healthy fats and low glycemic grains, you will have more energy and you will drift toward your ideal weight. If you are willing to do a half an hour of cardio and light resistance every day though a gym or a DVD available at any big box store, you will make progress even faster. 

To learn more, see this following section in our website. 

Nutrition 

Bon appetite! 

Food Friday : Party Food

Despite my intense interest in nutrition, I believe the highest and best use of food is to forge bonds between people. Food is a natural centerpiece for social gatherings. It puts people at ease, and makes them feel good. It can, if presented correctly, cause us to slow down and connect with one another. 

I am blessed with a large extended family and group of friends. It has become our tradition to have frequent large gatherings which I think people really appreciate. Here are ten tips about parties and party food which I have learned along the way. 

1. Entertain for traditional and nontraditional occasions. It's great to observe birthdays and holidays, but it is also fun to celebrate different things like graduations, the spring equinox, or the Academy Awards. Do not limit yourself to dinners. Brunch and lunch can be fun too, though a great deal of preparation has to be done the night before. 
2. Partial pot luck is a very successful format. Partial pot luck is, as far as the guests are concerned, pot luck. They are each assigned a dish of your choice and mutual agreement, since you have made sure the menu is balanced. Behind the scenes, you make sure you have a flexible main dish, enough for almost everybody, and good beverages. You may also have your signature dish, which in my case is large fruit platter. That way you have the backbone of the meal covered, in case of no shows and dishes turning out poorly. 
3. Be aware of any special dietary needs or preferences of your guests. I know it is extra work, but if you want to host you are obliged to have something for everyone. This includes vegans, vegetarians, diabetics, the pregnant and those nursing, the gluten intolerant, and those who do not eat pork or shellfish. 
4. Set a beautiful table. Be creative. Check Pinterest. 
5. Serve the meal in stages and take your time.  After you take a guest's coat and introduce them, offer them something to drink. We offer things like Perrier, Pellegrino, and club soda. With a sit down meal you can control how fast the courses come out. With a buffet you can do the same the as the dishes go onto and off the buffet table. 
6. Its a party! Have several courses. Consider appetizers, a fancy salad (with multiple dressings on the side) , main dish, side dish, always a fruit platter with cheese, and at least one dessert. It is fair to have both cake and pie. I usually omit bread, rolls, rice and potatoes. Why ? Because dessert. 
7. Consider a culinary theme like Mexican, Japanese, Italian, you name it. Rehearse your recipes ahead of time if need be. Do not perform culinary experiments on your guests.  
8. Go ahead and have a rich fancy dessert. However, be sure to have something savory to go with it, such as cheese. Many people feel poorly with they have a big serving of sweets without anything to buffer it. Always offer coffee and tea afterwards. Be sure to have attractive decaf coffee and tea options. 
9. Have enough predesignated helpers before, during and afterwards. Make sure no one person is burdened with cleanup. Even a pair of buddies in the kitchen washing dishes can be fun. 
10. Be confident and know that it does not have to be perfect. Send invitations at least two weeks in advance, and plan the details of the event at least one week in advance and you will be fine ! 

Food Friday: Nutrition in Pregnancy

Many things related to food change in pregnancy. What you need changes. What you like changes. Some of these changes have reasons. Some are just plain weird. 

You need to know a few things about nutrition in pregnancy to deal with all of this and to make sure both you and baby are getting the best nutrition possible. Learn more HERE. 

Food Friday: Snacks !

Snacks can be your dietary downfall or your salvation. So often a snack is the easiest thing we can get our hands on, and as such, it is often processed and of poor nutritional quality. (Think granola bars and the like which are full of fat, sugars and refined flours.) But with a little planning, healthy snacks can be a great contribution to your nutrition, fitness and weight optimization plan. 

Learn more here.