Food Friday: Passover Food, Part One

This year the first night of Passover falls on Friday night April 22nd. This means the upcoming week will be one of preparing. Observant households are cleaned and cleared of all leavened (yeasted or raised) bread and grains, since for the entire 8 days of the holiday, they are not eaten. 

Passover is the biblical holiday of the Feast of Unleavened Bread. It commemorates the Exodus of the Hebrews from slavery in Egypt. It is celebrated by both Jews and Christians. Jesus famously celebrated the Feast of Passover at what is now called The Last Supper. It is important to me as Jew among Christians to highlight the fact that we share this common narrative of liberation and redemption. Passover is always fresh, modern and relevant. It is one of my favorite holidays because of these themes, and since it involves food and family. 

Passover is celebrated over an eight day period not at a synagogue, but at the dinner table. The story of the Exodus is retold at the table though the reading of a work of liturgy called the Haggadah, which is essentially a narrative recounting of the portion of the book of Exodus which chronicles the event.

Here is the real genius of the observance in my opinion: The series of dishes in the meal serve as illustrations for the major points in the story ! This serves to keep the attendants engaged and makes the elements of the story unforgettable. Our ancestors felt so strongly about instilling within us this story of freedom that they enshrined it in a festive meal. 

This post will cover the elements of the festive meal, in order, and their meanings. Next week we will look at modern recipes for the same. 

Historical Culinary Elements of the Passover Seder: 

 

1st cup of wine or grape juice              

To sanctify the day 

Karpas (green herbs)    

To announce spring 

Salt water for dipping     

To signify the tears of the people 

Matzah (unleavened flat bread)                          

made in haste for an urgent departure

Maror ( Bitter herbs) traditionally horseradish,

to symbolize the bitterness of slavery    

Charoset (chopped fruit, nut and spice mixture)

to signify the mortar with which the slaves built the cities 

2nd cup to signify redemption 

3rd cup to signify blessing

The festive meal beginning with a roasted egg to symbolize new life. A roasted lamb shank is included and lamb is often served to symbolize the sacrificial Paschal lamb. Typically potatoes are served since they are in season, and they are not a leavened grain. 

4th cup to commemorate acceptance

of the Covenant of Law 

The historical ingredients of the meal are a bit peculiar to work with but are imbued with meaning. Stay tuned next week for the delicious modern adaptations of these ancient dishes.

Wellness Wednesday: The Art of Preparation

Why discuss preparation in a health blog ? Preparation is an antidote to what ails us. 

Preparation is key to overcoming health challenges like obesity, poor nutrition, lack of fitness, chronic disease, and bad habits.

Tax day is April 15th and tax season has prompted my focus on preparation. There is a lot of stress going around associated with tax preparation, and not just because money needs to be paid. There is stress because some people leave their preparations for taxes for the last minute. 

The opposite of preparation is procrastination. Check out this older post on procrastination: 

Curing Procrastination

Procrastination increases stress, undermines self - confidence, and undermines relationships at home and work. 

It decreases performance and effectiveness at completing any goals, including those associated with health. 

There is a common misconception that preparation and goal meeting is about will power and discipline. On the contrary, preparation is about the realization that goal meeting is hard. Because goal meeting is hard, we need preparation which is easy. Said better, preparation is what makes it manageable. Preparation, not will power, is the key to success. 

Let’s dissect or “ unpack" preparation, so you can see what it really is:

• Having optimism that your goal can be achieved.
• Taking the time to fully define your goal. 
• Frankly assessing where you are at the present moment, so that you can see how far you have to go.  
• Breaking down your goal down into parts. These subsections of the main goal, and not the whole goal, get divided according to the SMART goal criteria. Each of these subgoals must be: 
  • specific 
  • measurable
  • attainable
  • relevant 
  • and time bound. 

That is what will make them, if not easy, then attainable.

To learn more about SMART goals, read here : 

New Years Resolutions

Three Ways to get Ready for the Week

The Importance of Inspiration

Sometimes preparation itself is daunting. However, when the ask of preparation itself is broken down into segments, it is easier to face. And, crucially, starting with plenty of time ahead will take enable you to spread the segments out so you don’t have to do too much at one time. With preparation the hard becomes easy and the stressful becomes empowering. Try some today !  

Food Friday: Skin Food- Cocoa Butter and Coconut Oil Body Cream

You all know how I love chocolate. What if you could indulge in chocolate without a single calorie ? That wonderful smell of cocoa butter is the answer. I make my own body cream out of cocoa butter and coconut oil. I have very dry and very sensitive skin due to my lupus. I have found this is well tolerated and very helpful. 

The internet abounds with recipes for homemade cream such as this. I will provide a no frills version PLUS some extra tips to ensure the process is hassle free. 

Prepare all your supplies first:

• Cocoa butter and coconut oil in 1:1 ratio
• powerful mixer with whisk attachment 
• glass bowl for microwave
• spatula and ladle
• final containers such as mason jars with lids 
• roll of paper towels for covering the work surface, covering the mixer and for cleanup
• a handy garbage bag
• Stovetop with good ventilation
• shallow metal pan or bowl for cooling 

Steps: 

Place equal volumes of each fat in a microwave bowl. Warm as little as possible to get it all completely melted and mixed. You can do the same on a stovetop with a double boiler or simply a bowl over a pot of hot water. Stir. Ensure good ventilation. 

Cool in metal pan until solids are just beginning to reform. While still mostly liquid beat mixture in powerful mixer, covering mixer with paper towel to avoid spray. Stop at the yellow slightly thickened stage for a product that is like butter. Whip to stiffer white peaks for a creamy body spread. Work quickly at this stage since it will harden on your utensils. 

Spoon or pour into mason jars or other decorative containers and place lids. 

Clean up all thick material with the paper towels. Hot water will dissolve this stuff, but when it gets cool again in your drain, it will clog it. Get as much off with your paper towels and then wash up the faint residue with hot soapy water. 

This stuff smells wonderful and would be great for pregnant bellies, healing scars, or dry winter skin. I hope you like it. 

Food Friday: Easter Lunch Planning

Sorry, for some reason this did not go out as planned.... so here it is ! 

Every year we have a sizable party for friends and family. Every year I try to include some traditional dishes, but also some things to surprise and delight. Right now I am letting you in on the menu planning process. 

This year, Passover does not coincide with Easter. Most years, it seems like it does. Since I am Jewish we do not have leavened bread on those years. However, this year, we will be able to. 

Last week’s Food Friday went over many of the traditional foods from around the world. Because Easter occurs so early in the spring, it is before crops are really coming in. Thus even the festive menus include foods made from preserved things, like cured meats and fish. But, when you think about it, dried wheat ground into flour is a preserved thing, and so breads are among the traditional dishes, especially if they contain dried fruits and candied citrus peel.

For our bread this year, I am looking forward to a traditional Russian Easter Bread made by one of my Russian friends. My mother in law usually brings lamb, which is herb encrusted. My daughter is quite the chocolatiere, and I am going to try to persuade her to make a batch of handmade chocolates in fanciful shapes on Saturday. We like to make bugs and butterflies from molds. Her husband is the salad expert and produces an extraordinary spinach salad with candied walnuts and sliced strawberries. I will handle the new potatoes, smoked salmon with cream cheese and pickles, and new asparagus. Also I cannot resist making a meringue cookie in honor of one of the great grandmothers in the family. For them I will use only the whites of the egg, and so will liberate numerous yolks. To utilize these, I will make lemon curd. I have discovered that just about everyone in my family loves it. Few here in the states eat it. It is more popular in Britain. It is a rich lemony spread made with butter, sugar, yolks and lemon juice. You can even make it with lime juice. People use it like jam. It is a beautiful sunny color. 

And that is quite enough for the cooked sweets, since there will be the egg hunt in the nearby forest. There will be lots of treasures, such as spools of thread, coins, buttons, ribbon and more, but there will also be candy. Some of the eggs will be wooden and painted, and some will even be stone. In the past I found some that rang like bells. They went to the permanent egg collection. 

Make no mistake these gatherings are for more than fun and food. They forge the social bonds we need to be happy and healthy. So regardless of your religious , political, familial or cultural affiliations,  get together and make something nice. Renew old bonds and forge new friendships. 

Welcome to my spring holiday table. I would love to hear about yours. 

Wellness Wednesday: Wellness While Gardening

Gardening does not strike anyone as a particularly dangerous pastime. However there are a few tips and one critical point I’d like to share on the subject. 

I have been a committed gardener ever since I got married 33 years ago. It has been a soul feeding pastime for me. Gardening has gone hand in hand with family time, from the hands on science education for our kids to our present day culinary pursuits. 

I have gotten sunburns, rashes, cuts, scrapes, slivers and mosquito bites.  I have gotten dirty and dehydrated. I have lifted too much. I have risked heat stroke and frostbite. Thank goodness I have not gotten any ticks. But these are the concerns at hand. If you check the CDC (Centers for disease control ,they cover the list of precautions that would have prevented all these ills, and I will recoup them dutifully here. But there are a couple surprises, and at the end, one BIG POINT. 

• Your clothing and hat should protect against weather, insects, chemicals (even organic ones) sun and yes, dirt. Dirt is full of pathogens like various fungi, tetanus and toxoplasmosis. This is of special concern to those who are pregnant or have compromised immunity. Play in the dirt with gloves.  
• Make sure your every ten year tetanus shot is up to date. 
• Your skin should be protected by sunscreen or insect repellant as indicated. 
• Your hands should be gloved no matter what. Did I mention the gloves ? 
• Your eyes should be protected from flying debris and dirt. You are not pulling enough weeds if you do not have dirt flying toward your face. 
• Have water with you and hydrate throughout the day. Dehydration happens faster than you think. 
• Know the fertilizers and supplements you are dealing with. Read all labels and follow all directions. 
• Know your equipment, and make sure it is in good working order. If you are using sharp objects or powered equipment, keep your attention on what you are doing and keep small children out of harm's way. 

Here is the BIG POINT, and I will plead with you on this. Use organic methods. Please. The whole point of gardening is to get closer to nature and to produce something wholesome you can eat. Please do a little reading, and welcome yourself into the immensely gratifying world of organic gardening. If there is one thing that will save the world, it might be this. 

I am not even going to begin to address all the safety concerns of gardening any other way, such as with conventional herbicides, pesticides, or fertilizers. It would take too long and it would be depressing. So, get yourself one of the many excellent organic gardening resources, like maybe a book, the internet, or maybe your grandmother.  It doesn’t matter if you do container gardening in the middle of a cityscape, or if you have a farm. Chose this life affirming hobby, and do it in a life affirming way. 

Stay tuned next week for another Wellness Wednesday. 

Food Friday: Planning the Easter Feast

I am fascinated by traditional holiday foods from around the world. Each dish has a fantastic story that embodies the history, agriculture and joy of the people who produce it. Let’s check into some of the lovely choices. Every holiday table should have the tried and true family favorites. But there should also be some well rehearsed culinary adventures to sample as well. 

I have noticed that many traditional Easter foods involve a sweetened and decorated yeast bread. Examples would be Kulich, from Eastern Europe. This baked in a tall tin and decorated with icing. The Mexican Easter Bread is called Capirotada, and is a baked bread pudding flavored with raisins, cinnamon cloves and cheese. England of course is famous for its hot crossed buns.

There are a couple of versions of sweet yeast breads which are decorated with colored eggs. They are Mona de Pascua from Spain and Tsoureki from Greece. The first looks like a donut topped with a hardboiled egg. In the second case, the eggs are dyed red to symbolize the blood of Christ. Columba di Pascua ( The dove of Easter) is a Italian bread with candied citrus peel much like Pannetone eaten for Christmas. 

It is important to remember that Easter occurs in spring. Historically, one would have to rely on the pantry or garden to make meals. Greens would barely be beginning to come into gardens. Perhaps there were new potatoes, peas or onions ifone were lucky and Easter was late. Thus breads from stored wheat, eggs from chickens just starting to lay again, and meat, either fresh or cured was accessible, and figured prominently in the Easter menu. Accordingly we see the observance of “ Gründonnerstag” in Germany on Maundy Thursday, when a soup of greens is eaten. In Naples, bread, cured meats and cheese were combined in a tortano for Easter day picnics. In Greece, lamb was traditional, cooked as a stew, with greens and an egg and lemon sauce.

Eggs of course, figure strongly into Easter menus throughout Christendom. Most traditions provide for them to be decorated. Did you know that this tradition of egg decoration predates Christianity by thousands of years? The custom was sanctioned early on by the early Christian church as the egg was declared a symbol of the risen Jesus. This custom was raised to high art in the Eastern European arts of Pysanka, with complex deeply colored geometric patterns, and ultimately to the jeweled eggs of Fabergé. While I would love to see and touch a Fabergé egg, I would prefer to have a fanciful design made in chocolate. 

Did you know even the making of Easter baskets has roots in the church ? In Poland decorated baskets are filled with decorated eggs and special foods, and are blessed collectively by the town priests. Modern children whose baskets are filled with toys should remember that in days gone by, the special foods given in baskets were a great luxury. 

I hope this gives you a little inspiration as you prepare your celebration. Remember to plan ahead and involve every one in the preparations for the festivities. 

Wellness Wednesday: Menstrual Wellness

At first I thought the #freethetampon movement was a bunch of hooey. However, now I am giving it a second look. What got me thinking was a Tedx talk given by Nancy Kramer featured here on this website:

http://freethetampons.org

This site has some hard numbers about how many girls and women have to interrupt their school or work day to improvise a solution to an unanticipated period (86 % of us !) This is because restrooms the world over are stocked with toilet tissue, soap and something to dry hands, but there are scarcely ever any tampons or pads.

Granted there is an additional cost to providing these supplies, but in terms of school or professional environments, there are also benefits: less time away, less workplace stress, etc. Supporters of the #freethetampon movement advocate that tampons and pads should become freely available in every public bathroom, much like toilet tissue or soap. They view it as a public good and standard of decency in consideration for the everyday realities of normal body functions in women. Most women prepare as best they can and carry adequate menstrual supplies most of the time. But, as a Gynecologist I can assure you that irregular cycles and uncontrolled menstrual flow happen once in a while to most women. Even the best prepared among us has most likely struggled with an out of control period at one time or another.

Back to the cost of menstrual supplies. Did you know that in most places there is sales tax on tampons and other menstrual hygiene materials ? Sales tax criteria vary by state. Montana, Alaska, Oregon and New Hampshire have no sales tax on anything. Beyond that, Minnesota, Pennsylvania and Maine tax the customary items of “ tangible personal property” excluding necessities like food and medicine. Most notably these states also exclude menstrual hygiene products from sales taxation! In these states menstrual hygiene products are classified as necessities rather than “ luxury” or “ tangible personal property” items. Every other state taxes menstrual hygiene products. Every other state has what is being called the “ tampon tax.” Critics of the tampon tax say that it unfairly discriminates against women. They point out that it is a tax that women have to pay solely by virtue of being women, which is sex discrimination.

The tampon tax issue together with the #freethetampon movement has catapulted the menstrual cycle into the public limelight. For most of history however, the subject has been totally taboo. Most generally menstruation has been looked upon as an “unclean" state. In many cases menstruating women have been set apart from their family during this time. Even until recently it has been considered a topic not fit for polite conversation. And for reasons which are still not clear to me, menstruation has been a source of embarrassment or shame.

Many contemporary women are interested in removing the stigma of shame associated with this normal body function. To do so, they have taken several tacts. If you search the web on such matters, you will find all kinds of art from posters, pins and jewelry which flaunt these taboos, and demonstrate menstrual pride. There are references to “shark week”, “riding the cotton pony” and visits from “Aunt Flo”, normalizing and humorizing the subject. In one instance at one American high school

(https://en.wikipedia.org/wiki/Tri-Valley_Central_School,)

a security guard’s public search of a girl’s purse also included questions about whether she was on her period. The incident was considered intrusive. The next day, boys at the school came to class with sanitary pads taped to their shirts in a show of solidarity for the girl. Girls wore tampon necklaces. Finally, most of you have heard by now how Kiran Gandi, a Harvard business school student, ran the 26 mile London Marathon on her period, without a tampon and with visible bleeding, to “ transcend oppression” and to publicize the plight of those women who lack adequate menstrual products.

You get to decide how you feel about your period. But you should know a few things about it. No period is comfortable or convenient, but some get downright bad. If you meet certain objective criteria, you should call your doctor and get checked. Abnormal periods are not healthy, and should be treated.

Here is a section from our page on on adolescent and childhood Gynecology which describes the beginnings of periods :

The mean age of menarche (first menses) is approximately 12 1/2 years of age, with a range of about 11 to 14. Menarche typically occurs 2 to 3 years after thelarche after the breasts are fully developed. Ninety eight percent of females will have had menarche by age 15. Any adolescent girl who has not reached menarche by 15, or within 3 years of thelarche should be evaluated. Additionally, any vaginal bleeding before the age of 8 is a concern and should be evaluated by a a gynecologist.

- See more at: http://drginanelson.com/childhood-gyn-concerns#sthash.ykiQ4Hoh.dpuf

More menstrual facts you need to know:

Periods should not last longer than a week.

Period intervals ( time from day 1 of one period to day 1 of the next period ) should not be less than 21 days or greater than 35 days.

Total flow should not exceed 80 cc (1/3 cup) in one cycle.

Period flow should not make you lightheaded or anemic.

Period pain should not keep you from school, work or exercise.

You can get pregnant on your period.

If you experience any of these things, you should call your doctor. Depending on your age and medical history, an evaluation may be done. Depending on the results, a treatment can be planned.

Tips for menstrual management:

You may pick from either pads, tampons or both. You may use menstrual cups as long as you wash them as instructions indicate. None of the internal methods should be left in longer than needed, or they can foster infection. Apparently there are now unisex tampon necklaces you can wear, to use yourself or to “help a sister". There is even an app, developed by a Harvard freshman, Olenka Polak, called “ Code Red” which alerts sympathetic users in your area that you are caught in a “ periodic emergency”.

Menstrual health is a physical and psychological challenge. Don’t feel like you have to meet this challenge alone. 

Wellness Wednesday: Following up on Serious Injury: the Role of Physical Therapy

When you are injured badly, you are in pain and you are shaken up, sometimes literally. You lose perspective. You may have temporary alteration of your memory mood and judgment. You need guidance on how to recover, and your instincts aren’t a good guide. That is why in good medical care environments, you have a team of people, from family and friends, to doctors and nurses who help you get better.

In the very best of medical care environments, you have those, plus the group of therapists: physical therapists, cognitive therapists, occupational therapists, and family therapists. These are the people who take you from healing and back into high functioning. We underutilize them. I write today to make you aware of all this by sharing what our experience has been thus far with my son Vale and his physical therapy.

As those of you who have been reading this blog know, our son Vale had a serious ski injury on Saturday February 6th. He sustained a comminuted (broken to pieces) fractured femur, a mild concussion, a broken rib and a mild pulmonary contusion. That evening he had a long emergency surgery requiring a great deal of internal fixation. The next day he was discharged home as per is customary. He required pain meds, and still had memory deficits, though he was basically himself. Appetite was slow to come and he was quite discouraged. 

Much to our surprise, they requested his first physical therapy visit the very next day, or post operative day two, Monday the 8th. I couldn’t imagine what they would be doing with him at that early stage, despite my familiarity with surgical recovery in general.

When we arrived, they informed us they had spoken with his surgeon and were appraised of his hospital course. They proceeded to perform consultation much like we doctors do, beginning with a history and then proceeding with a physical exam. However, this exam was precise, detailed and recorded, covering all neurological aspects, range of motion, and strength. 

I expected all this. What I didn’t expect was the best part. The facility was beautiful and open, and all the staff were fit and upbeat. There was even a freshly shampooed dog randomly going from area to area to cheer people up. The whole encounter brightened our son’s spirits, and renewed his hope. They told him all about the typical post op course with injuries like this. This showed him a light at the end of the tunnel. It gave him some tasks to do and milestones for progress, thereby dispelling feelings of powerlessness.

There were so many more things to do to help his recovery than we had anticipated. I often recommend that patients enter physical therapy. Not uncommonly they ask me, “ What could they possibly do that would help ? “ The answer is, go and see. Since Vale has entered PT, he has gotten serial cognitive testing, passive range of motion exercises, strength exercises, electrical stimulation and deep oil massage of the muscles near the fracture. Soon, when the incision is better healed, he will have water therapy. 

His sessions are not necessarily comfortable. Nonetheless he looks forward to them. He can see his own progress because it is actually measured. Thus he is consistently encouraged. They tell me this is typical. Today is post op day ten and it was his first day back to his University classes. He felt himself, and did not notice any problems in following the material or using his crutches. I credit his ongoing PT for his speedy recovery.

I encourage all of you to look into physical therapy if you have chronic pain, injury, or problems getting around. There are many other conditions which can benefit from physical therapy. Discuss this with your doctor at your next appointment to see if you might stand to benefit. 

Wellness Wednesday: Recovering from a Serious Injury

This last weekend my son Vale had a major skiing accident. He broke his femur, had a pulmonary contusion, a broken rib, and a mild concussion.  He had to have emergency surgery. We quickly travelled to attend him, and since then we have been making arrangements for his recovery care. 

Though he will be off school for a time he will stay at college and we will return home. Therefore, I have been working with a team of friends and relatives to accomplish his care. This will, of course, consist of a series of wound checks, physical therapy appointments and post op appointments. It will also consist of a calendar of people doing shopping, making meals and doing laundry. When he returns to school in two or three weeks, it will mean getting driven to campus and wheelchairing around. It will mean seeing how it goes.

It has also meant getting correspondence passed back and forth between the doctors, physical therapists and the university faculty. To coordinate all this, I have had to send no end of contact information. I have had to create shared calendars and documents in the cloud, and distribute them to all his friends and family who have stepped forward to help.

Vale has had to deal with pain, disappointment and disruption. It is taking all of us together to shore him up during this trying time. It is taking everything from favorite foods to ice packs, but it is worth it. Even though it has been only four days, we can see distinct and major improvements every day.

 I am in awe of his caregivers. The surgeon and anesthesiologist spent significant time on the phone with me both before and after the case. It was easy to tell they were top notch, but they were also genuinely invested in my son, and empathized with me having to be so far away during the surgery.  I will be forever grateful for the time and energy they spent. I later leaned that that they spent this kind of energy during the entire weekend, since Vale's hip fracture was one of five such cases. The winds in the mountains had been high, and had swept the ski slopes to a hard shiny gloss. It took its toll.

Vale's physical therapist was a ray of hope. She came from both academic and clinical practice backgrounds, and was deeply invested in her field. She was immediately able to put us at ease and to identify all kinds of helpful strategies. Vale felt 100 percent better after one appointment, from a combination of the physical treatments, but also the encouragement of knowing his prognosis.

All this touched me as a mother and as a physician. It sheds renewed light on what I do.

Food Friday: Setting the Table

When I was growing up, my parents had a sit down dinner since that’s how they had been raised. My mother had nice china and table linens, but we rarely saw them since she used them only for special occasions. Instead we had everyday plates and cups, often plastic. The margarine was set out in its own tub. (Remember that this was the 70s, when margarine was thought to be healthier than butter. )

My father had business contacts from all over the world and they would come to visit us. In one case, a German guest showed me a photo of his daughter. She was sitting at their table. I would never have thought to take such a picture of a person at a table since our table was nothing special to look at. But their table was beautiful even though they had already finished their meal. Each plate was white glass, and crowded round each plate were clear glasses of various deep jewel tone colors and shapes, some cylindrical and thin, some globular, and yet others like cones. A light went on in my mind, and ever since then I started to see table settings differently. I began to notice the beautiful dishes and table settings in my friends' houses. 

Fast forward to college, when freshman year and dorm food banished all thoughts of table settings. Then came second year, when I moved into a campus co-op named Synergy. The house was organic and vegetarian way back in 1981. We had a big hippie kitchen in a huge hippie house right on campus. Since we were a co-op we cooked all our own food in a big kitchen in rotating teams. There would be no chefs or housekeepers for us.

The ethic of this house also required a communal sit down dinner as a deliberate act of culture. However the table settings in Synergy were like none I had ever seen. Since we were all about conservation, with reuse happening before recycling, our cups, plates, and serving utensils were a motley collection of all that had come through the kitchen. We drank from a selection of old jars, such as those from sauces or jam. Our plates were all completely mismatched. Bowls were just old plastic containers from things like bulk peanut butter. Most wonderfully, the center of the table held as many as a dozen great steaming loaves of bread: home made whole wheat bread. It was the signature of the house. We would cut slices or tear chunks, and slather it with butter, jam, hummus, or whatever mystery stew the cooks happened to create. Kids from other dorms would come by just for the bread. There is a reason for the expression, “breaking of bread”. It seems to bring people together.

Greg and I bonded while making this bread since it literally took all four of our hands to knead it. We had met while cleaning the kitchen at Synergy. We took it upon ourselves to clean this hippie kitchen, since he and I seemed to be the only ones who noticed how dirty it was. We met over a filthy sink, and there was something about me turning on the garbage disposal at the wrong time. No one was hurt, but he did have to take a shower after the incident. 

Greg sometimes ate a couple of houses down the row where there was a clean kitchen, a chef, and of course, meat. His sister lived there and she had made friends with the chef. I think they had an arrangement since not uncommonly Greg would go there and use their massive Hobart mixer which would hold a 16 batch of his mother’s chocolate chip cookies. As you could smell the bread of Synergy wafting down the row, you could smell the chocolate chip cookies coming from the other direction. From then on, our collective memory would be infused with the aroma of bread and cookies. 

After graduation, we married and lived in a little farmhouse far away from University life. It was a bit run down, so we repaired and decorated it. Happily, among our wedding gifts were many table linens and pretty dishes, so it followed that the table got set very nicely. The cutting boards were set with bread and platters filled with cookies. When our daughter and the boys came along, they helped with all of this. Ever since then we have set the table and had a sit down dinner. 

Today I believe in the power of the sit down dinner more than ever, to promote communication, coordination and peace in the family. And for me, all my best dishware is out all the time. I think it sets a festive mood and makes people feel valued.

What would I do if I were just starting out, of modest means, and wanted to bring some inspiration to meals ? There are two possibilities. First, I could go minimalist and get all clear glass dinnerware from the dollar store. Everything would match, and design interest would come from the food itself, the table, or the table linens.

A more colorful and more ecological choice would be to thrift. I would have a fantastic set of non matching antique plates. I would shoot for a reasonably common size, and perhaps a common theme, say a color scheme or a design element like birds. A physician friend of mine did it complete with mismatched silverware, and mismatched but coordinating goblets. It was nothing short of magnificent. It was all thrifted, very inexpensive, and truly delightful.

And that is the point: to delight. Making the food and setting the table is a gift to others, and a joy for you. 

Wellness Wednesday: Time and Goals

We each have goals. What would it be like to accomplish them ? What would it be like to accomplish a lot of them ? Some people do. These are people with good time management. 

It occurred to me that before I discuss exercise on this Wellness Wednesday blog, I should discuss the one thing my patients say they need before they can exercise: more time. We all have one lifetime of time. What matters is how we use it. Everyone knows this, so what is the problem ? 

Most people are not fully aware of how they spend their own time.

They are not as factually familiar with how they spend each hour as the think they are. I have found that everyone thinks they’re busy, and everyone thinks they're active. People are less sure if they are efficient in their day. This is the territory I suggest we explore at this point in the New Year. 

We are talking about time management. Have you ever had a class in this ? Few people have. It seems like it would be a good idea right at the beginning of high school. Or how about right now, in the blog post ? 

Here is your mini class on time management, complete with some handouts and homework. 

• Obtain a notebook to document this process. 
• Record your present schedule, down to the hour, for one week. Include everything from housework to Facebook. Wear a watch all week so you will have realistic estimates of time. 
• Make a list of goals, for the week, month, quarter, year and five years. 
• Order the goals by priority.
• Assess your week long log and see where you are misdirecting or wasting your time. 
• Realign your schedule with your priorities. Include a spot for 30 minutes of exercise 6 days per week. 
• Record what happens the next week and repeat. 

Now this is a VERY simplified version of a time management class. It is, however, the essence of the process. It only works however, if you are absolutely truthful with yourself about how you spend you day’s time and absolutely truthful about what you really want. 

I hear so much about not “ having enough time” to exercise, or to shop for healthy food, or to prepare healthy meals, that I decided to address it head on. 

For those interested in more, there are really so many great resources on the web, from Lifehack.org, to books by Harvard Business Review. 

Here is a one page handout on the subject. Click on the title below to download. 

"Time Management" from the Stanford Center for Teaching and Learning

For extra credit, here is an awesome self assessment and time management tool from University of Kentucky. Click on the title to download. 

"The Successful Person's Guide to Time Management"

This should be be printed, filled out and used. 

Class is dismissed. Homework is due next week! I’d love to hear how you do. 

Wellness Wednesday: New Year’s Resolutions

I have always been skeptical of the idea of  New Year’s resolutions. Did you know that only 8% of them succeed ? I am more in favor of a New Year’s PLAN. Plans can change things. 

I am all for establishing intentions and all for making lists. A resolution however, is more like wishing for something and expecting that the strength of your wish will make it come true. Research shows the desire or willpower alone is insufficient. If you are ready and willing to make changes, bring out the power tools. They are called SMART goals. 

SMART is an acronym for Specific, Measurable, Attainable, Relevant, and Time bound.

See more at:

Structure Sunday: Three Ways to Get Ready for the Week

So make a New Year’s list of the goals you would like to achieve, but apply this metric to each one. 

Here is more on exactly how this works : 

The Importance of Inspiration

For example, if you want to exercise daily, you must know what exercise you will do, and where. You should make a record of what you do. It should be something that is realistic at the present moment. You should know exactly when in the day and week it will take place and give yourself a date to reassess your progress. If you do not do these things for your exercise plan, then you are not serious about this goal. If you actually set yourself up this way, you will almost certainly be successful. It’s like Dorothy and the ruby slippers. You had the power all along. 

Meanwhile here is some additional fun and illuminating reading on New Year’s Resolutions : 

LIfehack: 50 New Year's Resolutions and How to Achieve Each of Them

Happy New Year ! 

Wellness Wednesday: Holiday Wellness Collection

Here is a little collection of holiday wellness quick reads from my past blog posts. I hope they help the next week or two be merry and bright. 

Holidays, the Happy Disruption

Holiday Wellness

Gratitude is at the Center of Wellness

Look forward to more post collections during the holiday week while I take a little time off from writing and just highlight the “ need to know “ stuff. 

Merry Christmas and Happy New Year. 

May the light of the season be within you. 

Food Friday: Holiday Menu Planning

I don't know about you, but right now I am trying to figure out the menu for not one but several holiday dinners to come in the fairly near future. To try and minimize stress with these events which are supposed to be fun, I've decided to do a little advance planning and let you in on it too.

Sometimes it's best to stick to tradition, and include menu items you know are family favorites. But particularly when you have more than one meal to present during the holiday season, you can afford to be a little bit creative. Let's take a quick look at four different cuisines which you might consider. Christmas is really big in each of the five countries which I will present, but you can probably think of many more countries that cherish the holiday as well. You can explore their cuisines too. Suddenly there is no shortage of menu ideas when you consider it in this framework. The challenge will be choosing what to leave out ! 

A Mexican inspired Christmas “ Navidad” 

• Virgin Margaritas
• Quesadillas with fresh salsa for starters 
• Ponche - a hot fruit and cider punch 
• Mexican Christmas Eve Salad _ this is colorful salad mixture of lettuce, beets, apple carrot, pineapple, jicama, pecans and pomegranate seeds. 
• Tamales with a chocolate chili mole sauce. 
• Rosca dee Reyes- A sweet spicy fruity bread containing assorted dried  or candied fruits. 

A French Inspired Christmas “Noel” 

• Champagne, Perrier
• Amuse bouche ( hor d’oeuvres) - olives, seasoned nuts, vegetable platters with dips etc. 
• Boeuf (beef) Bourguignon ( A thick stew made all day with red wine and meat cooked until fork tender eaten with crusty baguettes. ) 
• Haricots Verts ( green beans roasted with olive oil) served with lemon 
• Salade Nicoise - Tomatoes, boiled eggs, and tuna on a bed of greens 
• Diverse fruit and cheese platter 
• Buche de Noel- An amazing rolled chocolate sponge cake filled with mocha cream, frosted with chocolate buttercream to look like a log and garnished with meringue mushrooms
• Sorbet 

An Italian Christmas “ Natale” 

• Pellegrino 
• Antipasti- tuna, fresh salmon, cured meats, olives, cheeses, bruschetta, crostini, Caprese salad- with fresh mozzarella, basil and tomatoes
• Pasta, such as ravioli filled with extravagant fillings, such as meat, spinach, ricotta, figs, and even chocolate and candied citron. 
• Parmesan chicken in red sauce 
• Lemon tart 
• Gelati

 

Scandinavian Christmas recipes “ Yul” 

Glogg- spiced mulled wine 

• A “ julbord” , meaning a smorgasbord especially for Christmas
• Cold foods like Gravlax ( salmon cured in sugar, salt and dill), cured meats, cheeses, pickles, beet salad, breads and butters
• Warm foods like meatballs in berry sauce, potato dishes and cabbage dishes. 
• Desserts like Pepparkakor ( gingerbread cookies) and saffransbullar ( sweet buns)

One traditional Christmas in America, with some twists

• Turkey
• Mash potatoes
• Cranberry sauce
• Green salad 
• Asparagus
• Pie À la mode

Turkeys is front and center at Christmas time as well as at Thanksgiving. But this time give it a little twist. Consider encrusting the bird with herbs, or having it smoked. For the stuffing, go beyond simple breadcrumbs and try wild rice stuffing. Try a twist on traditional cranberry sauce and add orange. For your salad, add every favorite salad ingredient you can think of from olives to capers, dried cranberries, two colors of tomatoes, and even candied nuts. For the mashed potatoes, consider the very exotic purple potato, or for a very healthy twist, sweet potatoes. If you really want some color on your table try all three. And whatever you do with the potatoes, flavor them well with olive oil, butter, sour cream, salt, pepper and even herbs, garlic, or cheese. Regarding your traditional pie, consider one two fruits not one. Great combinations are apple raspberry, or rhubarb strawberry.

Warning: Each of these menus require several days preparation and several people to accomplish. But, as I read through all my material about holiday and meal traditions the world over, I realized that the affectionate time and extra effort spent preparing these magnificent celebratory meals together is the essence of the holiday. 

Merry Christmas all week long to all the cooks ! 

Wellness Wednesday: Body image

Hello Angels. Did everybody watch the Victoria’s Secret Fashion show last week ? I did. It is a provocative female fest of the first order and boy does it provoke a lot of conversation. So thank you VS for stimulating conversation around the world. 

I am a doctor and am first and foremost interested in health: physical health and mental health. So that is my filter. And through that filter, this is what I see, and it isn’t all pretty. 

I see that many women of all types and sizes have poor body image. I have seen umpteen conversations in the blogosphere running along the following lines: “ The VS show made me feel bad about myself.” I wonder if these women feel the same way after watching the Olympics or the Cirque du Soleil ? I wonder if they are aware that these models train like professional athletes, boosting their calorie and protein intake way up to build muscle and compensate for the long hard workouts that they must do. Many women are 5’10 or more and have pretty faces, but few can achieve this level of discipline and training.

I am not so unsophisticated that I do not realize that the VS show is essentially marketing and that it sends mixed messages to and about women. Yet, it would be nice if we could all watch Olympics, gymnastics, or even the VS show and be inspired to be our best selves. 

I am certain this chronic problem with poor body image is something we inherit from our culture, and that we are retaught every generation. Historically, we women have been property, and most generally utilized for our physical attributes. Is it any wonder this is still how we define ourselves ? Although the problem of our self worth came from without, the problem is now within us. Likewise,the solution can only come from within each of us. It is for each of us take a hard look at ourselves and count our own strengths. We need to learn to define ourselves in our own terms, and value ourselves as whole people. We all know none of us is perfect, mentally or physically. However, we must learn to celebrate what we are and to learn to enjoy the process of making ourselves better all the time.

Through my filter, I see that women of all descriptions hurt one another with fat shaming and thin shaming. Women already have to deal with objectification, abuse, unequal pay, glass ceilings, and sexism. The last thing they need to be doing is undermining each other.

I see people outside the health profession mistake all sorts of things: slim for anorexic, obese for “ big boned”, obese for "womanly" and muscular for unfeminine. I even hear some of these things from people in the health sciences. None of these analyses are helpful to the cause of the physical or mental health of women.  None of these critiques allows for the fact that there are many body types. None of them asks the right questions about fat percent, muscle mass, bone density, strength, nutritional status, menstrual health and other truly relevant parameters. 

I am very concerned about eating disorders in young women. However, I see them very rarely. But, numbers wise, prevalence wise, I am profoundly more concerned about the obesity epidemic. This will end up causing no end of disease related suffering as women of this generation come into middle age and older. We as women have to come to terms with the need for good nutrition and regular fitness. We need to get back in touch with strong female physicality.  If we cannot get in touch with our physicality, we become oblivious to our bodies and avoid them outright and they get less and less healthy with each passing year. 

Strong healthy physicality in women, and I mean mature adult women as well as young women, lends confidence to the mind as well as the body. What does physicality mean ? To me it means, being in touch with your body. This means being able to honestly assess your bodies strengths and weaknesses with the help of your doctor and maybe even a trainer. It means standing in front of a mirror without clothes. It means getting on a scale and doing a waistline measurement. It means accepting where you are at the present moment and knowing you have the power to better yourself.

Physicality means having the courage to try new things with your body, new exercises, new sports. Sports ! Yes… I believe all women need sports and competition in their life. It builds confidence in all things, because sports teaches you how to try and try again. Sports teaches you how to practice, even how to train, however modestly. 

Your physicality extends to other people. It asks you to acknowledge your own sexuality, and to ask whether it is in a reasonable state. 

Physicality bears on how you present yourself to the world. You may not wish to become a materialistic fashion slave. But….. do you neglect your own appearance and present yourself poorly to the world ? Do you neglect your hygiene ? Do you dress down or to be invisible ? Is your posture poor ? Think about these things and take responsibility for yourself. Love what is, shower it, brush it, put some cream on it, then dress it up to show your best self. 

Physicality extends to the natural world. It asks that you get out in it and feel it with all your senses. When learn to use your body in the natural world, the natural world will, in return, sculpt you into a better adapted creature. 

It is good to embrace health and beauty in all forms. True beauty is health. You have the power to make some of your own. 

Food Friday: Special Holiday Food

Holiday food is not just the food on the holiday table. It is two weeks from Christmas and in many families and in many workplaces it is like one long holiday. Food is front and central in many places at this time of year. Make yours special. 

Here are are some categories of holiday food to think about: 

• Office food
• Cookie exchanges 
• Food Gifts
• Hospitality Gifts to bring to a party
• Potluck food to bring to a party 
• Foods for the stocking 
• Foods for the holiday table. 

Office Food

Office food at the holidays can be overwhelming. From deli and cheese plates to commercial thank you baskets to homemade confections and baked goods, it can really pack on the pounds. The best thing to do is to make sure to keep a good list to write thank you notes, have a small sample of one or two treats, then cover the rest up and put it in the office fridge until the end of the day when the food can be taken home to someone’s hungry adolescent horde. 

Cookie exchanges

These take the advance planning of someone with an MBA. The key is a good freezer. The other key is a source of good freezer friendly cookie recipes. For example, anything based in shortbread is good, whereas meringue cookies are right out, unless they are baked same day and carefully transported. Remember that there is good gluten free flour that is widely available that will bake up just like regular wheat flour. You may not know who you are feeding, and you want to be inclusive.

The idea is this: You bake a good sized batch of cookies every couple days starting a couple weeks before Christmas. You freeze each batch. You do at least 3 types of cookies but 5 is better. You make sure to vary the flavors and form factors, so they will look interesting on a gift platter. On the day before the exchange, or whatever activity demands batches of festive cookies, you bring them out and arrange assorted cookies on said gift platter, making sure to package and decorate them well. Voila, now you know you could run at least a small company. 

Food gifts

These have been addressed previously HERE.

Hospitality Gifts

When you are choosing your party outfit, chose your party gift. Some people call them hostess gifts. Think of it as an accessory to your outfit. It’s good form, breaks the ice, and makes everybody feel good right away at the front door.

If you are attending a potluck and are bringing a dish, it does NOT count as your hostess gift. Classic gifts are a wrapped bottle of wine or champagne, but can just as easily be Pellegrino, Perrier, or sparkling cider. Another route is cut flowers, but I myself prefer a live plant such as an orchid. 

Potluck food 

First rule is to ask the host what they would like you to bring, smile, say yes and do it. Second rule, is make an extra special version of whatever it is. Third rule: try to steer clear of common dietary intolerances. Fourth rule: make enough. Fifth rule: present it well. Sixth rule: observe standard food safety practices. 

Foods for the stocking

Filling stockings is one of my favorite things to do. I bet if you thought about it, you could list the favorite treats of everyone in your family, and maybe a few of your friends. Think a bit more broadly and cover spices and condiments; then consider food related items like pretty toothpicks, and soon your “ foodie “ stockings will be overflowing. Here are some ideas: Hard candy in pretty small tins, actual high end natural cough drops, favorite gum, of course chocolates, but make sure they are not crushed, candy canes or licorice (but only if people actually like them), bottles of culinary extracts for cooking like vanilla or lemon, exotics like pomegranates, star fruit, cumquats, fancy nuts, and their nutcrackers. Capers, tiny jars of indian chili paste, colored peppercorns, teas, tea infusers, jams, and hot sauces. You get the idea. Just troll through a nice organic store and santa’s little helper will find lots of stocking sized treasures. 

Foods for the holiday table

I have covered this a bit before, but the essence is this: Bring people together in a spirit of wonder, gratefulness and congeniality. If your cherry pie can help with this, by all means make it. As far as healthfulness is concerned, yes, there is a healthy hack to every traditional recipe. I would like to write a bit more about this, and so this will be my topic for next’s week’s Food Friday. 

My best wishes to all the busy elves. 

Wellness Wednesday: Wellness Gifts

Still searching for that perfect gift ? Why not give something that promotes health and wellness ? I propose considering a “ wellness gift”. Here are some useful categories: 

1. Books on health and wellness. These could be books on mental or physical health. 

The Seven Habits books by Stephen Covey are some of my favorites. 

2. DVDs for exercise, yoga or meditation- Try those by Gaiam or Jillian Michaels. 

3. Basket of healthy drinks: herb teas, decaf coffees, matcha, or chai

4. Basket of healthy foods 

5. Healthy cookbooks ! - Try the Mayo clinic cookbooks, as well as the series by Jonny Bowden PhD, CNS. 

6. Tuition for a series of health classes, but only if you are sure they want them. 

7. Cool workout gear, or a gift certificate for it. 

8. Certificates for spa treatments, massage, or even a personal trainer session.

Spread cheer this season with some of these worthwhile wellness gifts. 

Food Friday: Food Gifts

Tis the season to start firming up your holiday gift plans. To do this, remember that gift giving is supposed to be fun. It shouldn’t stress you out, or be unduly expensive. It should be personal. Finally, we all know the best gifts are home made. 

Here’s a list of ideas that should get you cooking on some fun food projects that will make great gifts. For more ideas, think of what you are really good at preparing. And, if you are still at a loss, then just consider what you might like to get ! 

Holiday food gifts divide themselves nicely into several categories: 

1. Baked goods, from cookies and cakes to fancy breads. You can even leave your cookie dough uncooked in a roll of waxed paper, and package them nicely for refrigeration. This is the so called “ refrigerator cookie “ which you can slice off as needed and “ bake” in the toaster oven. 

2. “Kits" for baked goods, cleverly packaged in, for example, a mason jar. Decorative recipe cards are included. 

3. Homemade candy, since it is a project to make. Brittles and toffees are classic, but truffles are highly prized. 

4. Candied or spiced nuts, since they are festive and because they are handy for entertaining. 

5. Other mason jar “ kits”, for soup, spiced hot drinks like chocolate, coffee, or chai. 

6. Spice mixes in nice containers. 

7. Preserved goods such as jam, jelly, and pickles. Of course if you live in the northern hemisphere it is not summer at Christmastime. Thus you will not have fresh fruit and vegetables to preserve. But you can still make preserves from other things, like wine ! You can make jelly from wine and even from balsamic vinegar. Plus, it only takes a few hot peppers to make some colorful hot pepper jelly. 

8. You can make infused oils and vinegars and use pretty bottles. 

9. Food kits can become more elaborate if you include equipment and table dressings. Consider a sushi themed basket with rice, seaweed, sushi rollers, pickled ginger, horseradish, chopsticks and dipping bowls. 

10. If you are super short on time, you can present someone a “ coupon “ for a dinner catered by you, or even just a batch of brownies. 

Food gifts are really fun to receive. This is especially true is you package them artfully and with care. Craft, fabric and even grocery stores have great materials for wrapping. I am partial  to unbleached parchment paper and plain brown cooking twine. You can add natural embellishments like pine cones, or evergreen twigs. You could even tie in a small wooden spoon. 

Whatever kind of gift you chose to give, just make sure that there is a little of you in it. 

Wellness Wednesday: Cold Weather Workouts

Now that the temperatures are dropping and the outdoors is frosty, there are a few cold weather tips you need for working out outside. 

• Chose safe routes. Avoid iced over rivers of uncertain stability. Winter roads can be icy. One winter run of mine a few years ago landed me in a CT scanner, since I slipped, fell and hit my head on the ice. All was well, but it was no fun and showcased my imprudence to all my friends in the emergency room. Plowed roads or snowpack can work well, but you still have to be on your guard for black ice. Despite your best efforts, you may fall and injure yourself, so always carry your cell phone or go with a buddy. Some have suggested a loop close to home so you are are never far if you have to limp back. 
• In your first excursions of the cold season, go for less time than you usually do, to see how you adapt. You can always work up gradually later. This is especially good advice if you have asthma or other medical conditions. 
• Don’t forget sunscreen, especially in bright snow white conditions. Likewise wear appropriate eye protection for sun, snow and ice .
• Warm up and cool down as always. However, in the case of cold weather, do it inside. 
• Dress in layers, so you can stay warm but not overheat and sweat too much. Start with a wicking layer, followed by insulation, and then a shell. Always include a hat, which adds warmth without bulk and can help prevent frostbitten ears if it has earflaps. Consider a neck gaiter to keep the mouth and nose warm. Absolutely wear gloves to prevent frostbite. 
• Check the forecast before you go, factoring in not only temperature but precipitation and windchill. Tell someone where you are going and when. 
• Have an indoors workout alternative if it is just too challenging out of doors, preferably an indoor alternative at home, such as a workout DVD you can do in your living room or basement. 
• Do not mix alcohol with any workout. Be aware that alcohol degrades decision making, and masks symptoms of hypothermia. 
• Know and recognize the symptoms of frostbite, whiteness, tingling and pain. Know, recognize and heed the signs and symptoms of hypothermia: shivering, confusion, fatigue and slurred speech. Hypothermia is medical emergency and must be corrected right away. 
• Avoid cold weather exercise in the face of dehydration, inadequate calories or sleep deprivation. These can limit your bodies ability to thermoregulate. 

Working out outdoors in the winter requires extra preparation and mindfulness. However, there are some major benefits: Winter workouts produces a bigger endorphin boost than working out in warm weather. You burn more calories in the winter and train a bit harder. And it is invigorating to be out in the weather, and the landscape is often stunningly beautiful. Getting outside in the winter is important for fitness, but it also improves attitude and mood as well. All in all, is it something you should add to this season’s workout mix. 

Food Friday: After Thanksgiving

How was your thanksgiving ? Not flawless ? That's ok. Take this time to decide how to make the rest of this weekend worthwhile. 

Our family and friend group has a leftover party every Thanksgiving Friday. Pies are featured as well. Turkey soup and turkey pot pie are great options. 

Consider this time, your leftovers, your pies, friends and family and be grateful.