Archive for the ‘Dietary Fiber’ Category

A Mediterranean Interlude

Posted: November 28, 2011 in Dietary Fiber, Greek food, Italian food, low-carbohydrate diet, Mediterranean Diet, The Nutrition Story
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I thought that, for a change of pace, I would take a Mediterranean perspective.  The Mediterranean Diet is widely considered as an ideal diet since it is not explicitly low-fat (most of the time) while still allowing people to avoid saying low-carbohydrate which is not fashionable in many circles.  At the end of this post, however, I have included a couple of recipes from Judy Barnes Baker’s new cookbook, Nourished; a Cookbook for Health, Weight Loss, and Metabolic Balance.  For general health, Mediterranean diets have the advantage that nobody is really sure what they are and hence there are no long term trials of the type that makes low-fat diets look so bad, as in the Women’s Health Initiative.

Tournedos Rossini

Start with Giochino Rossini.  It is generally known that his life as a composer included significant time for food. He retired in his forties and devoted the rest of his life to cooking and eating. (William Tell was his last opera). Rossini said that he had only cried twice as an adult. The first time was when he heard Paganini play the violin and the second, when a truffled turkey fell in the water at a boating party.

 

Because his later life was more or less in seclusion, there is some confusion about his gastronomic experiences.  It is not even clear whether Tournedos Rossini was made for him or by him.  In fact it is not even clear where the name Tournedos comes from.  Derived from tourner en dos, turning to the back, it may refer to the method of cooking or possibly that somebody had to turn their back during the preparation so as not to let anyone see the secret of the final sauce.  The recipe, although simple in outline, has expensive ingredients and the final sauce will determine the quality of the chef. It simply involves frying a steak and then putting a slab of pate de foie gras with truffles on top. The sauce is based on a beef reduction. More at Global Gourmet.

  1. Sauté the 4 center-cut filets mignons, chain muscle removed, 6 ounces in the 2 tablespoons (30 milliliters) clarified butter or vegetable oil on both sides until rare.
  2. Remove excess fat with with paper towel and place on heated plates.
  3. Place warm pate de foie gras slices on each tournedo.
  4. Cover with Périgueux Sauce:

Bring 1-1/2 cups (375 milliliters) of demi-glace to slow simmer. Add 5 tablespoons (75 milliliters) of truffle essence and 2 ounces (50 grams) of either chopped or sliced truffles. Off heat and cover with tight-fitting lid, allow truffles to infuse into the sauce for at least 15 minutes. (The sauce using truffles sliced into shapes rather than pieces is called Périgourdine).

5. Finish with a little truffle butter.

Lardo di Colonnata

Not really a make-at-home item, this traditional creation from Tuscany captures the care in processing  that makes Italian food famous.  The original curing method supposedly goes back to the year 1000, and has been handed down from generation to generation.  The lard, of course, comes from pigs that have not undergone the genetic transformation that American pigs have.  In any case, you will need marble tubs which you should keep in the basement assuming that there are no caves in your neighborhood.  You rub the tubs with garlic and then layer the pork lard and cover with brine, add sea salt and spices and herbs. You continue with additional layers until the tub is full and then cover with a wooden lid. Curing time is about 6 to 10 months.

Greek Barbecue

As described on one of the Greek food sites “anyone visiting Greece would wonder exactly what is meant by the Mediterranean diet for while those of us outside the Med have been eating more whole grains, extra virgin olive oil and fresh vegetables…. as the Greeks become more affluent they eat more meat.” I haven’t been in Greece for many years but I remember quite a bit of meat then. Of course, in Greece, as elsewhere, affluence is a sometime thing but the trend is for festive holiday foods to be increasingly available all year round.  The most popular food for Easter is whole lamb roasted on a spit  The recipe is simple, if not convenient for the small family “You will need 1 whole lamb, skinned and gutted…”  Seasoning can be simple salt and pepper or basted with ladolemono, mixture of lemon juice, olive oil and oregano.

As the site points out, Lamb on the spit “is especially popular [at Easter] because it follows 40 days of fasting for lent and people are definitely ready for some meat, though not everyone fasts the entire forty days.” This reminds me of little known angle on the Seven Countries study.

Ancel Keys auf Naxos

The idea of a Mediterranean diet derives, in some way, from Ancel Keys’s Seven Countries study. He discovered that the two countries with the highest consumption of fat, had the lowest incidence of cardiovascular disease (Crete) and the highest (Finland), and he attributed this to the type of fat, olive oil for Crete and animal fat for Finland.  It was later pointed out that there were large differences in CVD between different areas of Finland that had the same diet.  This information was ignored by Keys who was also a pioneer in this approach to conflicting data.  Another of the rarely cited responses to the Seven Countries study was a letter written by Katerina Sarri and Anthony Kafatos of the University of Crete and published in the journal Public Health Nutrition: 8(6), 666 (2005):

“In the December 2004 issue of your journal…Geoffrey Cannon referred to … the fact that Keys and his colleagues seemed to have ignored the possibility that Greek Orthodox Christian fasting practices could have influenced the dietary habits of male Cretans in the 1960s. For this reason, we had a personal communication with Professor Christos Aravanis, who was responsible for carrying out and following up the Seven Countries Study in Greece. Professor Aravanis confirmed that, in the 1960s, 60% of the study participants were fasting during the 40 days of Lent, and strictly followed all fasting periods of the church according to the Greek Orthodox Church dietary doctrines. These mainly prescribe the periodic abstention from meat, fish, dairy products, eggs and cheese, as well as abstention from olive oil consumption on certain Wednesdays and Fridays….”

“this was not noted in the study, and no attempt was made to differentiate between fasters and non-fasters. In our view this was a remarkable and troublesome omission.”

Kokoretsi.

Leopold Bloom ate with relish the inner organs of beasts and fowls. He liked thick giblet soup, nutty gizzards, a stuffed roast heart, liver slices fried with crustcrumbs, fried hencod’s roes. Most of all he liked grilled mutton kidneys which gave to his palate a fine tang of faintly scented urine.

— James Joyce, Ulysses.

Along with Greek Barbecue, it is traditional at Easter to serve kokoretsi which is  made from the internal organs of the lamb. Liver, spleen, heart, glands are threaded onto skewers along with  the fatty membrane from the lamb intestines. When the skewer is full, the lamb intestines are wrapped around the whole creation. It is then barbecued over low heat for about 3-5 hours.

 

One of the regrettable aspects of the decline in food quality in the United States is the general disappearance of organ meats although the Paleo movement may help with this.  Organ meats were once very popular; the quotation above is probably the second most widely quoted passage from James Joyce’s Ulysses. Because of various ethnic influences, they were probably more popular in New York than in America (which begins somewhere in New Jersey).  I found Jimmy Moore’s confrontation with beef tongue  quite remarkable in that (in its corned form (like corned beef)), tongue was once a staple of my diet.  When I was in grade school, there were many weeks where I would bring tongue sandwiches on Silvercup bread for lunch every day.  Silvercup, made in Queens was the New York version of Wonder Bread. The Silvercup sign is still a fixture of the New York landscape — it is now the site of Silvercup Studios, the major film and television production company that kept the name (and the sign) when the Bakery folded and the studio bought the building in 1983. (You name the TV show, it was probably produced at Silvercup).

Of course, everybody draws the line somewhere. Although I used to eat with my friends at Puglia, the Little Italy restaurant that specialized in whole sheep’s head, I passed on this delicacy mostly because of the eyeballs.  Also, although you gotta’ love the euphemism Rocky Mountain Oysters, bull testicles don’t do it for me, at least if I know for sure in advance. (I don’t really mind, in retrospect, if the folk-myths about the tacos that I ate outside the bullring in Mexico City were really true).

Etymology of Food Words

Whether it is the steak or the cook whose back is turned in Tournedos, it is generally difficult to find the etymology of food words, although some are obvious. The conversion of Welsh Rabbit to Welsh Rarebit is surely an attempt to be more politically correct and avoid Welsh profiling.  One disagreement that I remember from way back when I was in college is now settled. There used to be many ideas about the origin of the word pumpernickel.  One of my favorites at the time was that Napoleon had said that it was “pain pour Nicole” (his horse). Great but not true, it is now agreed that it comes from the German, pampern, to fart and Nickel meaning goblin, along the lines of Saint Nick for Santa Claus.  So pumpernickel means Devil’s Fart presumably due to the effect of the unprocessed grain that gives it its earthy quality.  Which reminds me of the ADA’s take on fiber that I quoted in an earlier post: “it is important that you increase your fiber intake gradually, to prevent stomach irritation, and that you increase your intake of water and other liquids, to prevent constipation.”  foods with fiber “have a wealth of nutrition, containing many important vitamins and minerals.” In fact, fiber “may contain nutrients that haven’t even been discovered yet!” (their exclamation point).

In Brooklyn, the Mediterranean diet means Italian sausage, largely from Southern Italy.  I had always assumed that Soppresata (pronounced, as in Naples, without the final vowel) was so-called because it was super-saturated with fat, but I have been unable to confirm this; since first writing this post, Italian friends have suggested that it comes from Sop-pressata, that is “pressed on,” but this is also unconfirmed.  There are many varieties but supposedly the best is from Calabria.  For something like this, with so many varieties which each cook is sure is the best, there is no exact recipe, but you can get started with this from About.com Italian Food.

 6.6 pounds (3 k) of pork meat — a combination of loin and other lean cuts

1 pound (500 g) lard (a block of fat)

1 pound (500 g) pork side, the cut used to make bacon

Salt, pepper

Cloves, garlic and herbs (rosemary, lemon peel, parsley etc

1/2 cup grappa (I think you could also use brandy if you want)

The basic ideas is to remove all the gristle, and chop it with the lard and the pork side. About.com recommends a meat grinder but I suspect that the knife blade of a food processor is better.  Then, wash the casing well in vinegar, dry it thoroughly, and rub with a mixture of well ground salt and pepper. “Shake away the excess, fill the casing, pressing down so as to expel all air, close the casing, and tie the salami with string. Hang for 2-3 days in a warm place, and then for a couple of months in a cool, dry, drafty spot and the sopressata is ready.”

At exactly what moment these simple, natural ingredients turn into processed red meat is unknown.

Simple Mediterranean

I’ve included two recipes from Judy Barnes Baker’s new book, Nourished; a Cookbook for Health, Weight Loss, and Metabolic Balance.  Currently in press, publication will be announced on her website.  For very simple Mediterranean, she suggested the following from the The Silver Spoon. Translated from  Il cucchiaio d’argento, published in 1950 by Editoriale Domas, the back cover describes it as “the bible of authentic Italian cooking and Italy’s best-selling cookbook for the last fifty years.”

Eggs En Cocotte with Bacon Fat

Serves 4

4 small slices bacon fat

4 tablespoons heavy cream

4 eggs

2 tablespoons Parmesan cheese, freshly grated

 Preheat the oven to 350º, if you wish to bake the eggs. Parboil the bacon fat in boiling water for about 1 minute, then drain. Put 1 tablespoon cream and a slice of bacon fat in each of four ramekins, break an egg into each and sprinkle with the Parmesan. Place the ramekins in a roasting pan, add boiling water to come about halfway up the sides and bake for 6-8 minutes or until the egg whites are lightly set. Alternatively, place the roasting pan over low heat for 6-8 minutes. The combination of bacon fat and cream—a strong savory taste and a milder flavor—gives the eggs a very delicate flavor.

Recipes from: Nourished; a Cookbook for Health, Weight Loss, and Metabolic Balance  (Judy Barnes Baker is the author although I and others are mistakenly listed by Amazon as co-authors).

Καλή όρεξη

MedicineBall*: Harvard School of Public Health steps up to the Plate.

Posted: October 3, 2011 in Dietary Fiber, Evidence Based Medicine, Lipophobes, low-carbohydrate diet, Observational Studies, Protein, The Nutrition Story, Uncategorized, USDA Dietary Guidelines
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First published in October of 2011, this post announced a Q&A on line with Harvard’s Eric Rimm to answer question about the School of Public Health’s new  “Healthy Eating Plate,” its own version of nutritional recommendations to compete with the USDA’s MyPlate. A rather  limited window of one hour  was allotted for the entire country to phone in our questions.  Unfortunately HSPH was not as good at telecommunications as it is at epidemiology and the connection did not start working for a while.  The questions that I wanted to ask, however, still stand and this post is a duplicate of the original with the notice about the Q&A removed.  Harvard has been invited to participate in a panel discussion at the Ancestral Health Symposium, and we will see how these questions can be answered.

— adopted from Pops (at Louder and Smarter), the anonymous brilliant artist and admitted ne’er do well.

One of the questions surrounding USDA Nutrition Guidelines for Americans was whether so-called “sunshine laws,” like the Freedom of Information Act, were adhered to. Whereas hearings were recorded, and input from the public was solicited, there is the sense that if the letter of the law was followed, the spirit was weak.  When I and colleagues testified at the USDA hearings, there was little evidence that their representatives were listening; there was no discussion. We said our piece and then were heard no more.  In fact, at the break, when I tried to speak to one of the panel, somebody came out from backstage, I believe unarmed, to tell me that I could not discuss anything with the committee.

Harvard School of Public Health, home of  “odds ratio = 1.22,” last month published their own implementation of the one size-fits-all approach to public nutrition, the”Healthy Eating Plate.”  Their advice is full of  “healthy,” “packed with” and other self-praise that makes this mostly an infomercial for HSPH’s point of view. Supposedly a correction of the errors in MyPlate from the USDA, it seems to be more similar than different. The major similarity is the disdain for the intelligence of the American public. Comparing the two plates (below), they have exchanged the positions of fruits and vegetables.  “Grains” on MyPlate is now called “Whole Grains,” and “Protein” has been brilliantly changed to “Healthy Proteins.”  How many NIH grants were required to think of this is unknown.  Harvard will, of course, tell you what “healthy” is:, no red meat and, of course watch out for the Seventh Egg.

 

 

 

 

 

 

 

So here are the  questions that I wanted to ask:

  1. Dr. Rimm, you are recommending a diet for all Americans but even within the pattern of general recommendations, I don’t know of any experimental trial that has tested it.  Aren’t you just recommending another grand experiment like the original USDA recommendations which you are supposedly improving on?
  2. Dr. Rimm, given that half the population is overweight or obese shouldn’t there be at least two plates?
  3. Dr. Rimm, I think the American public expects a scientific document.  Don’t you think continued use of the words “healthy,” “packed with nutrients,” makes the Plate more of  an informercial for your point of view?
  4. Dr. Rimm, the Plate site says “The contents of this Web site are not intended to offer personal medical advice,” but it seems that is exactly what it is doing. If you say that you are recommending a diet that will “Lower blood pressure; reduced risk of heart disease, stroke, and probably some cancers; lower risk of eye and digestive problems,” how is that not medical advice?  Are you disowning responsibility for the outcome in advance?
  5. Dr. Rimm, more generally, how will you judge if these recommendations are successful? Is there a null hypothesis? The USDA recommendations continue from year to year without any considerations of past successes or failures.
  6. Dr. Rimm, “healthy” implies general consensus but there are many scientists and physicians with good credentials and experience who hold to different opinions. Have you considered these opinions in formulating the plate? Is there any room for dissent or alternatives?
  7. Dr. Rimm, the major alternative point of view is that low-carbohydrate diets offer benefits for weight loss and maintenance and, obviously, for diabetes and metabolic syndrome. Although your recommendations continually refer to regulation of blood sugar, it is not incorporated in the Plate.
  8. Dr. Rimm, nutritionally, fruits have more sugar, more calories, less potassium, fewer antioxidants than vegetables.  Why are they lumped together? And how can you equate beans, nuts and meat as a source of protein?
  9. Dr. Rimm, looking at the comparison of MyPlate and your Plate, it seems that all that is changed is that “healthy” has been added to proteins and “whole” has been added to grains.  If people know what “healthy” is, why is there an obesity epidemic? Or are you blaming the patient?
  10. Dr. Rimm, you are famous for disagreeing on lipids with the DGAC committee yet your name is on their report as well as on this document is supposed to be an alternative.  Do we know where you stand?
  11. Dr. Rimm, the Healthy Plate “differences” page says “The Healthy Eating Plate is based exclusively on the best available science and was not subjected to political and commercial pressures from food industry lobbyists.” This implies that the USDA recommendations are subject to such pressures.  What is the evidence for this? You were a member of the USDA panel. What pressures were brought to bear on you and how did you deal with them
  12. Dr. Rimm, the Healthy Plate still limits saturated fat even though a study from your department showed that there was, in fact, no effect of dietary saturated fat on cardiovascular disease.  That study, moreover, was an analysis of numerous previous trials, the great majority of which individually showed no risk from saturated fat. What was wrong with that study that allows you to ignore it?

*Medicineball, (colloq) a game that derives from Moneyball, in which an “unscientific culture responds, or fails to respond, to the scientific method ” in order  to stay funded.

Portion Control and the Language of Food.

Posted: September 5, 2011 in Dietary Fiber, Intention to Treat, low-carbohydrate diet, The Nutrition Story, USDA Dietary Guidelines
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“Portion Control” is a popular buzz-word in nutrition. It has a serious and somewhat quantitative sound as if it were recently discovered and transcends what it really means which is, of course, self-control. Self-control has been around for long time and has a poor history as a dieting strategy.  Lip service is paid to how we no longer think that overeating means that you are a bad person but “portion control” is just the latest version of the moralistic approach to dieting; the sense of deprivation that accompanies traditional diets may be one of the greatest barriers to success. Getting away from this attitude is probably the main psychological benefit of low-carbohydrate diets.  “Eat all the meat you want” sounds scary to the blue-stockings at the USDA but most people who actually use such diets know that the emphasis is on “want” and by removing the nagging, people usually find that they have very little desire to clean their plate and don’t eat any more meat than they ever did.  Coupled with the satiety of fat and protein compared to carbohydrate, this is surely a major factor in the success of carbohydrate restriction.  In the big comparison trials, the low-fat trials are constrained to fix calories while the low-carbohydrate group is allowed to eat ad-libitum, and the two groups usually come out about the same total calories.

On the other hand, there is an obvious benefit to having a lean and hungry feel if not look and, as Woody Allen might have put it: eating less is good if only for caloric reasons.  So, one tactic in a low carbohydrate diet is to eat a small portion — say, one fried egg, a small hamburger — and then see if you are still hungry before having the second or third portion which while not forbidden, is also not required. The longer you wait between portions, the more satiety sets in.

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Fair and Foul on the Diabetes Scene. Diabetes Health beats Jay Leno but the ADA takes the Cake.

Posted: July 14, 2011 in American Diabetes Association, Dietary Fiber, The Nutrition Story
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“Headlines” is one of Jay Leno’s routines on The Tonight Show. While low on production values, it provides amusing typos, odd juxtapositions of text and inappropriate couplings from real notices and newspapers. The headlines are frequently very funny since, like fiction in general, authored comedy has to be plausible. There have been many other versions of the same idea including items in the New Yorker but Jay Leno’s audience rapport adds to the impact. Expert as he is, though, Jay seemed a little off guard when nobody laughed at the headline: “The Diabetes Discussion Group will meet at 10 AM right after the pancake breakfast.” It’s probably generational. After 30 or so years having the American Diabetes Association tell you that sugar is Ok as long as you “cover it with insulin” and that diabetes, a disease of carbohydrate intolerance, is best treated by adding carbohydrate and reducing fat, who knows what anybody believes.

One of the headlines on a previous show that did get a laugh said: “To increase gas mileage, drive less.”  (If Jay only knew how much we spent to get the USDA committee to come up with the advice that if you want to lose weight, you should eat less).

“.. Have we eaten on the insane root,
That takes the reason prisoner?”
— William Shakespeare, Macbeth.

For tragic humor in the bizarre field of diabetes information, it is really hard to compete. About the same time as the headlines sequence on the Tonight Show, DiabetesHealth  an organization and website that is intended to “investigate, inform, inspire” produced an inspiring investigation from the literature. The story is entitled “Maple Syrup – A Sweet Surprise.”  You gotta’ read this:

 “Meet the latest superfood: maple syrup.  Wait a minute…maple syrup? The super-sugary stuff poured on pancakes and waffles and used to glaze hams? That maple syrup? That’s right. Researchers from the University of Rhode Island have discovered that the syrup-produced in the northeastern United States and Canada–contains numerous compounds with real health benefits.”

So how did people with diabetes fare on the maple syrup? Well, there were no people. Or animals. The researchers did not test the effect of consumed maple syrup but only chemically analyzed samples of the stuff.

“‘In our laboratory research, we found that several of these compounds possess anti-oxidant and anti-inflammatory properties, which have been shown to fight cancer, diabetes, and bacterial illnesses,’ said Navindra Seeram, an assistant professor of pharmacognosy (the study of medicines derived from natural sources) at the university and the study’s lead author”

“Pharmacognosy,” incidentally, is the only English word correctly pronounced through the nose.  The article indicates that “a paper describing their results will appear in the Journal of Functional Foods. Scientists hope that these discoveries could lead to innovative treatments as the beneficial substances are synthesized to create new kinds of medicine.”  The article, however, is nothing if not circumspect:

“You might want to pause for a moment before rushing out and buying jug after jug of Canada’s finest maple syrup, though. It still contains plenty of sugar,…” In fact, by far the major ingredient in maple syrup is sucrose which, again, only has to be “covered” with insulin. So, with all those beneficial compounds, we will need less insulin per gram of sucrose with maple syrup, right?    Would Jay Leno have gotten a laugh if the diabetes meeting followed the pancakes and maple syrup breakfast?  How about if they were whole grain pancakes?

“If you can look into the seeds of time,
And say which grain will grow, and which will not…”
— William Shakespeare, Macbeth.

Not to be outdone, the American Diabetes Association website offers the lowdown on just how good grain is. Fiber, in general, is so good for you that you should be careful not to snarf it up too fast. As they point out, it is “important that you increase your fiber intake gradually, to prevent stomach irritation, and that you increase your intake of water and other liquids, to prevent constipation.” Doesn’t really sound all that healthy but foods with fiber “have a wealth of nutrition, containing many important vitamins and minerals.” Now, vitamin deficiency has always seemed to me to be the least of our nutritional problems but there’s more: “In fact,” using fact in its non-traditional meaning, fiber “may contain nutrients that haven’t even been discovered yet!” (their exclamation point). Not to belabor all the metaphors here, the ADA, long telling us that people with diabetes deserve to have their carbs, are surely offering pie in the sky.