Saturday, September 26, 2009

It's some more fish

The bariatric diet has a very soft spot for fish as I have described previously. I am including in this group of recipes a deconstructed tuna salad. blackened grilled fish seemingly straight from New Orleans; and a grilled fish with a Hollandaise sauce which has a blend of herbs making it a bit unique.

Two of these recipes call for grilled fish which should be in 4 ounce fillets. I have set these recipes to serve four people so invite some friends over to dinner or lunch. Use a grill pan if you have one to reduce the need for a lot of oil. Use a bit of olive oil in the pan before you put the fillets in to cook. Try not to overcook the fish. When it is done correctly it is moist and tender, gently flaking. Overdone and it’s a bit rubbery. Keep the heat to medium high.

The tuna salad undone is a interesting change from the standard tuna and mayonnaise mixture. However do use the very best quality canned tuna you can find. Italian tuna packed in olive oil is delicious and the high nutritional quality of the dish as well as the interesting ingredients makes it more than a typical tuna salad for lunch.

Tuna Salad undone

6 to 8 ounces quality canned tuna, packed in olive oil
4 leaves butter lettuce, rinsed and patted dry
2 tablespoons finely chopped shallot
2 tablespoons finely chopped red or orange bell pepper
1 tablespoon nonpareil capers
2 tablespoons chopped hard-boiled egg
1 tablespoon micro greens
1/4 teaspoon sea salt
1/2 lemon

Carefully remove the tuna from the can, leaving the loin pieces intact. Reserve the olive oil. Place the tuna in the refrigerator while you prepare the remaining ingredients.
Divide the lettuce between 2 plates and carefully lay the tuna atop the leaves. Top with the shallot, bell pepper, capers, hard-boiled egg and micro greens. Sprinkle with sea salt. Drizzle the salad with the reserved olive oil and a squeeze of lemon.

Blackened spicy fish

Blackened fish is a staple item in the restaurants in New Orleans. The normal method is to sear the spiced fillets in a white-hot frying pan. This causes the spice seasoning to smoke heavily and when you hot cook something with pepper in it, be sure to have your exhaust fan on in the kitchen. Or do it the way we like do it here, and grill the spiced fish over an open barbecue. Same great flavor from all the spices without all the inside smoke and coughing, and sneezing, and hacking.

4- 4 ounce fillets of white fleshed fish (halibut, rockfish, seabass)
1 Cup Crab boil mix
¾ Cup Paprika
¼ Teaspoon Garlic powder
½ Cup Catsup
½ Cup Mango chutney
¼ Cup Hot sauce

To make the Blackened spice mix
1 Cup Crab boil mix
¾ Cup Paprika
1 Teaspoon Garlic powder
Mix ingredients together and store in an air-tight container

Spicy sauce mix
½ Cup Catsup
½ Cup Mango chutney
¼ Cup Hot sauce
Mix ingredients together and store in an air-tight container

Sprinkle fish fillets with spice mix, and then dredge in the spicy sauce
Let stand for 5 minutes to dry slightly
Grill at medium high until done.

Grilled fish with Spring Herb Hollandaise Sauce

Fish served with Hollandaise makes a wonderful lunch or dinner entree. This dish sautes the fish and dresses it with the herbed Hollandaise. The recipe uses four ounce fillets. and provides a substantial amount of protein as well as a fair amount of fats (butter and eggs). As in all dishes, think wisely before eating and eat what is not only good for you but tastes good too.

4 - 4oz fish fillets (sea bass, rockfish, or other 1” thick fillets)

Make a quick Hollandaise
Break two eggs into a blender jar
And add the following:
1 teaspoon dry mustard
A pinch of salt and white pepper
½ tablespoon of grated lemon zest
1/2 tablespoon minced fresh mint
1/2 tablespoon minced fresh basil
1/2 tablespoon minced fresh tarragon
3 tablespoons of fresh lemon juice
Melt 1 ½ cubes of butter until it starts to foam
Start blender; pour melted butter in very slowly
The mixture will form an emulsion.
Keep warm but do not let it boil.
Reserve some of the chopped herbs to sprinkle over the fish before serving.

To serve
Saute fish fillets in 2 tablespoons of melted butter
Serve topped with the warm Hollandaise and a sprinkle of the mixed fresh herbs
Add a slice of lemon.

Friday, September 25, 2009

Condiments that add excitement

Interesting condiments can take sometimes bland and possibly unappetizing foods and turn them into truly delicious dishes. The trick here is to understand the combinations of flavors that go with a dish and then accent one or more of those flavors. It can be a simple reduction of the juices left over after roasting a chicken. Just add a bit of water, scrape up the brown bits in the bottom of the roaster and let the liquid evaporate over medium heat until it is thick and rich. Taste it before adding any seasonings. Salt and other flavors will concentrate in the reduction so season just before serving.

Here in Italy we use these types of condiments all the time in antipasti, served on cheese slices, or with hot or cold meats. Their unique characteristics make them a worthy part of the bariatric diet and when left in the refrigerator can be quickly used to enhance any dish. Use the fruits and vegetables that are in season and make these up for long term storage. They are easy to water process can and keep for extended periods. If you have some apples, make an apple mostarda; likewise with pears, figs or peppers. Have fun learning to can your own condiments and enjoy them all the time.

For the bariatric patient, condiments should be used lightly as they tend to be fairly high in calories, but when used sparingly can truly enhance the flavor of the dish. Of particular interest to the bariatric cook is the development of flavors that are slightly acidic (made with vinegars) or a combination of sweet and sour flavors. I have includes several recipes condiments that I have made here in Italy and have stored down in the pantry for ready use or to be given away as house gifts.marinades.

Making chutneys, marmalattas, and mostarda here in Italy is a lot of fun and takes advantage of the fall and summer largesse of fruits and vegetables. They provide wonderful additional flavors and depths to the basic recipes. I have used chutneys and marmalattas to make up a plate of sliced cheese pieces and either top the pieces with one of the condiments or pass a small bowl with a demitasse spoon to serve yourself. Mostarda is a uniquely northern Italian dish that combines the sweetness of fruits and syrups with the taste of vinegars and toasted mustard seeds. Use them on the smoked salmon antipasti as well as on a wide variety of other antipasti. It gives them a slightly different taste and I usually get the same comment from those people consuming the item. “What is it??”

I have included several recipes for mostarda and marmalattas and conserves, and if you have a favorite recipe for chutney, make it up and try it with cheeses. A few chutney recipes will follow in another posting. I came up with the recipes for mostarda while experimenting with different tastes and fruits and I have use apples, pears, and various citrus fruits as well as dried fruits. You can make them is smaller amounts and put them in the pantry. When you need one for a party, take it out and use it, then refrigerate.

Mostarda can be made with just the mustard seeds and the sugar syrup, but I prefer to add some vinegar to make the preserves sweet and sour.

Apple or Pear mostarda

Three cups of water
2 cups of sugar
Four Granny Smith apples, grated or the same amount of grated firm pears
Three tablespoons of yellow mustard seeds
3-4 tablespoons of apple cider vinegar (optional)

Bring water and sugar to a rolling boil and boil for 10 minutes.
Add grated apples and return to a boil.
Toast mustard seeds in a dry frying pan until they start to pop.
Grind in a mortar or spice mill to a coarse texture.
Add to apples and sugar.
Taste and add 3-4 tablespoons vinegar. (This is my preferred option)
Simmer for 30 minutes.
Set aside overnight to steep.
Bottle in sterilized jars, seal and process for 5 minutes in boiling water.
Remove from the water bath to a rack.
Allow to cool.

Lemon or citrus mostarda

I like this one made with tangerine or lemon rind. Makes a great condiment for crostini with cream cheese and smoked salmon.

2 cups of sugar
2 cups of water
2 tablespoons of yellow or black mustard seeds
1 Tablespoon of powdered mustard (Coleman’s)
1 cup of citrus peels (tangerine, lemon, orange or mixture)
All the juice from the peeled fruits
3-4 Tablespoons of white wine vinegar (more to taste)

Mix water and sugar together and bring to a boil.
Boil for 10 minutes, and then add the citrus peels and juice.
Add the powdered mustard.
Continue boiling the sugar mixture until it thickens, and the bubbles are small.
Toast the mustard seeds in a small frying pan until they start to pop.
Transfer the seeds to a mortar and pestle or a spice grinder.
Grind to a coarse grind and add to fruit mixture.
Bring to a boil and cook for 20 minutes.
Transfer to clean canning jars (1/2 pint or less).
Cap and process in boiling water bath for 10 minutes.
Transfer to rack and allow to cool.

Pear and Ginger mostarda

This can be made with just the mustard seeds and the sugar syrup, but I prefer to add some vinegar to make the preserves sweet and sour. Mustard seeds can be increased according to taste.

Two cups of water
2 cups of sugar
Four firm pears, peeled and grated
3 Tablespoons grated ginger
Three tablespoons of yellow mustard seeds
3-4 tablespoons of white wine vinegar (optional)

Bring water and sugar to a rolling boil and boil for 10 minutes.
Add grated pears and return to a boil.
Add ginger.
Toast mustard seeds in a dry frying pan until they start to pop.
Grind in a mortar or spice mill to a coarse texture.
Add to pears and sugar.
Taste and add 3-4 tablespoons vinegar. (This is my preferred option)
Simmer for 30 minutes.
Bottle in sterilized jars, seal and process for 5 minutes in boiling water.
Remove from the water bath to a rack.
Allow to cool.

Dried Apricot and Onion Conserve

1 pound of dried apricots, chopped into medium dice
Rind of ½ lemon and the juice from the whole lemon
2 onions chopped in medium dice
2 cups of water
1 cup sugar
1 onion, chopped

Boil water and sugar together to dissolve.
Add the lemon rind and juice.
When boiling, add apricots and return to a boil.
Simmer mixture for 30 minutes.
Add 3-4 Tablespoons of vinegar.
Add a pinch of salt.
Add the chopped onion and continue cooking for another 30 minutes.
Mixture will thicken as the apricots hydrate.
Remove from heat and allow to cool slightly.
Puree the mixture with an immersion blender to a coarse consistency.
Return to boil.
Taste and correct seasonings (add vinegar, sugar).
Fill ½ pint bottles and lid.
Process in boiling water for 5-6 minutes.

Can be made with fresh apricots.
Use 3-4 cups fresh with the stones removed.
Simmer for 30 minutes to cook the apricots. They will start to fall apart.

Fig marmalata

1 dozen large ripe Mission or green figs
I onion, chopped (more if desired)
3 cloves of garlic, chopped
Sugar (to taste)
Red pepper flakes (to taste)
Apple cider or wine vinegar (to taste)

Make the fig puree:
Place a dozen large figs cut into quarters in a large saucepan.
Add a chopped onion and 3 cloves of garlic
Add water to cover and cool over medium heart for approximately 1 hour until figs are very soft.
The mixture should be reduced by about ½.
Place the fruits in a food processor or using a stick blender, puree till smooth.
Put back over low heat and continue to cook to thicken the puree.
Stir at frequent intervals.
Check for seasonings and add salt and pepper.
I found a couple of tablespoons of vinegar made a great difference in sharpening the flavors.
Add 2-3 tablespoons of sugar if you want it sweeter and to balance the vinegar.
Pack in ½ pint clean jars and refrigerate or water process for 10 minutes to can for longer term storage.
Keeps about three weeks fresh or they can be stored for longer periods if canned.

Pepper marmalatta

Ingredients and directions
1 yellow bell pepper, remove the stem, seeds and interior ribs and slice lengthwise into thin slices.
1 red bell pepper, remove the stem, seeds and interior ribs and slice lengthwise into thin slices.
2 large onions, peeled, cut into half and sliced into thin slices (should be approximately 2 cup).
3 cloves of fresh garlic, peeled and sliced thinly.
Place vegetables in a deep saute pan and add ¼ cup olive oil.
Add ½ teaspoon salt.
Add ½ teaspoon red pepper flakes (this can vary with your tolerance for the heat)
On medium heat, saute for approximately 20 minutes, stirring frequently.
Add 2 cups of water and return to a simmer.
Add ¾ cup of vinegar (wine vinegar, apple cider vinegar, or rice wine vinegar, not Balsamic).
Add 3/4 cup of sugar to the vegetables and continue to simmer.
Taste the mixture to determine the balance between the vinegar and the sugar.
Add either as appropriate.
Continue to cook the vegetables down until they are quite thick.
Taste and adjust seasonings (it should be a balanced sweet and sour and not overpowered by either).
Allow to cool and place in a storage container in the refrigerator or can be water processed for 10 minutes for long term storage.
Can keep in the refrigerator for several weeks

Thursday, September 24, 2009

Today its Eggs

The egg is a nutrient-dense food, containing high quality protein and a wide range of essential vitamins, minerals and trace elements. Eggs can make a significant contribution to a healthy diet for the bariatric patient.

I know. I know about the cholesterol scare tactics of the anti-egg groups. But eggs have not been shown to be that excessive a provider of cholesterol and the fact that they are so versatile makes them perfect components in the bariatric diet. If there is concern regarding your LDL and total cholesterol I encourage you to talk to your doctor about adding more eggs to your diet and maybe reducing other dietary components?

Eggs are an excellent source of protein. The egg contains all the essential amino acids needed by the human body. They then complement other foods of lower biological value by providing the amino acids that are in short supply in those foods. The weight of the egg is approximately 12.5% protein and it is found in both the yolk and the albumen. Although protein is more concentrated around the yolk, there is in fact more protein in the albumen. On the scale most commonly used for assessing protein, egg are used as the base reference (with a value of 100) and are the standard against which all other foods are assessed, So now that we know about the nutritional aspects of the egg (commonly the chicken egg), lets find some ways to cook them and incorporate their goodness into the bariatric diet.

I will provide some complex egg dishes here but also remember to just fry a couple up for breakfast when you want. Add a bit of salt and freshly ground pepper, and maybe a splash of Tabasco sauce. Put them on a nice little plate (makes the meal look bigger than it is). Pour yourself a cup of good coffee and go sit out on the patio. (Oh, that’s what I do most mornings, sorry) Use the patio, terrace, or breakfast nook, but give yourself a place to quietly enjoy your nutritional repast.

An easy technique for excellent egg dishes is to bake them. They can be cooked with vegetables, a bit of wine, or some cheese . You can stick the eggs in the oven, make the coffee and pour a bit of juice. When they are ready so are you.

Baked eggs with Spinach

1/2 medium onion, finely chopped .
2 tablespoons unsalted butter.
1/4 pounds spinach, coarse stems discarded and leaves coarsely chopped
1/3 cup heavy cream
1/2 teaspoon salt
1/8 teaspoon black pepper.
4 large eggs.

Preheat oven to 400 degrees F.
Cook onion in butter in a 10-inch heavy skillet over moderate heat, stirring, until softened, about 5 minutes.
Add spinach and cook, covered, stirring 2 or 3 times, until wilted, 2 to 3 minutes.
Remove lid and cook, stirring, until excess liquid is evaporated, 2 to 4 minutes.
Add cream, salt, and pepper and simmer, stirring occasionally, until slightly thickened, 3 to 4 minutes.
Arrange buttered ramekins in a shallow baking pan and divide spinach among them.
Make an indentation in center of each and carefully crack an egg into each indentation.
Bake in middle of oven until whites are just set, about 15 minutes.
Serve eggs in ramekins with bacon and toast.

Baked eggs with wine and Asiago cheese and chicken and apple sausage

4 eggs
Salt and freshly ground pepper
2 tablespoons of butter
4 tablespoons white wine
4 tablespoons of grated Asiago cheese
2 Chicken and apple sausages

Preheat oven to 400 degrees F
Take two ramekins and place a tablespoon of melted butter in each.
Break two eggs into the ramekin
Pour 2 tablespoons of white wine over the eggs,
Put 2 tablespoons of grated Asiago cheese on top of the eggs.
Put the dish in the oven
Put on the middle rack in the oven and bake until whites are set, about 15 minutes
Served with grilled chicken and apple sausages.

A frittata is quite easy to make and creates a nice dish that can serve several people for brunch. In effect they are crust-less quiches. They have the same creamy custardy egg mixture without all the bother of creating that perfect crust. You do need a good, non-stick, oven proof pan though. I happen to use a 9”Calphalon anodized aluminum frying pan and it has created some great frittatas for brunches we have prepared here in Umbria.

This one was consumed rapidly by at least 20 guests at a recent afternoon party.

Artichoke and mushroom frittata

6 eggs
One small jar of marinated artichoke hearts (drained) and chopped coarsely
One jar of marinated mushrooms, drained and chopped coarsely
3 tablespoons of butter
¼ cup whipping cream
½ cup grated sharp cheese (Pecorino, white chedder, Parmesano Reggiano)

Preheat oven to 350 degrees F.
On top of the stove, heat the butter in the frying pan.
Thoroughly mix the eggs in a bowl with whisk.
Add the cream and mix well.
Saute the artichoke hearts and mushrooms in the melted butter for 1-2 minutes at moderate heat.
Pour in the egg mixture and stir to ensure the eggs are starting to set.
Sprinkle the cheese over the top of the eggs.
Place in the oven for 12-15 minutes until it is puffy and slightly browned on top.
Slice into wedges and serve hot or warm.

The following dish is one we serve a lot during the early part of the summer when we have wild asparagus available. Our chef picks the asparagus during its spring growing period, blanches it and freezes it until it is needed. We serve this with moistened Sardinian flat bread in a type of wrap. It can also stand alone as a semi-poached egg and asparagus dish. Since wild asparagus is generally not available everywhere, commercial asparagus is a fine substitute.

Asparagus and steamed eggs (alone or wrapped)

10-15 stalks of asparagus, sliced into thin julienned strips or chopped into thin slices crosswise
4-6 eggs
2-3 tablespoons of good olive oil
Salt and pepper

Cook the asparagus in a frying pan or saute pan with a good fitting lid.
Start the asparagus in the frying pan with the olive oil over medium heat.
When the asparagus has wilted, break the eggs into the pan on top of the asparagus and add 2-3 tablespoons of water. Salt judiciously. A lot of cracked pepper is great.
Put the lid on and cook gently covered until the whites are set and the yolks are cooked (4-5 minutes on medium heat).
For the Sardinian bread recipe, the egg yolks are done to a hard state; the eggs and asparagus are sectioned and then rolled up in slightly moistened cracker bread or in warmed commercially available wraps or even flour tortillas. Sort of a healthy burrito.
Alternatively you can just cook the eggs to whatever level of doneness you prefer. This would likely be the method of serving for the bariatric patient. Veggies and eggs!

Cheddar Cheese Egg Casserole

3 tablespoons butter, melted
5 large eggs, beaten
1 cup cottage cheese
1/2 cup shredded Cheddar cheese
1 (4 ounce) can diced green chiles
1/4 cup flour
1/2 teaspoon baking powder

Preheat the oven to 350 degrees F.
Brush an 8-inch square baking dish with 1 tablespoon butter and set aside.
In a medium bowl, whisk together the eggs, cottage cheese, cheddar cheese, chiles, flour, baking powder, 1/2 teaspoon salt and the remaining 2 tablespoons butter.
Pour into the prepared dish and bake until set, about 35 minutes.
Serve hot

Not all tortillas are made from flour or corn. A tortilla in Spain is more like a frittata and is made with ham, potatoes, and eggs. It is served with a quick and easy Aioli and is a terrific brunch or dinner dish. This dish takes some time but is worth the effort.

Tortilla Espanola with Aioli


1/2 cup plus 2 tablespoons good quality olive oil
6 cups thinly sliced brown onions
1 1/2 teaspoons salt (kosher preferable)
3/4 teaspoon freshly ground black pepper
1/4 teaspoon sugar
3 baking potatoes, (about 2 pounds), peeled and sliced into 1/8-inch thick rounds
8 eggs, lightly beaten
1/2 cup julienned good quality ham
Chopped fresh chives, for garnish


In a blender add
1 egg,
3 cloves of garlic,
Salt and pepper,
Lemon juice from 1 large lemon.
Blend thoroughly and then slowly add olive oil in a thin stream until the aioli forms a thick consistency

Heat 1/4 cup of the oil in a large 12-inch non-stick skillet over medium heat. When the oil is hot, add the onions and cook, stirring occasionally. Season with 1/4 teaspoon each of salt, pepper, and sugar. Continue cooking, stirring occasionally, until onions are golden, and well caramelized, about 45 to 50 minutes. Remove the onions from the pan and set aside. Wipe the skillet clean.

Pour an additional 1/4 cup of oil into the skillet and heat over medium heat. Season the potatoes with 1/2 teaspoon of salt and 1/4 teaspoon of freshly ground black pepper. Add the potatoes to the hot oil and cook, stirring and gently turning, until tender and slightly golden, 15 to 20 minutes. Remove the potatoes from the skillet and wipe the skillet clean.

Heat the remaining 2 tablespoons of oil in the skillet over medium heat. Combine the reserved onions, potatoes, beaten eggs, and ham pieces in a large bowl. Season with the remaining 3/4 teaspoon of salt and 1/4 teaspoon of freshly ground black pepper. Add the entire mixture to the hot oil and cook until the bottom is set and the top is still runny, about 12 minutes. As the bottom of the tortilla is cooking, use a rubber spatula to run around the edge of the eggs, lifting slightly to allow the eggs to run to the bottom and cook.

Place a large plate or serving platter on top of the skillet and invert the tortilla onto the plate. Carefully slide the tortilla back into the skillet so that the browned side is facing upward. Cook until the bottom is golden brown, about 10 to 12 minutes longer. Remove the tortilla from the skillet and serve hot, or cool to room temperature, and serve. To serve, cut tortilla into thin slices and spoon 1 or 2 tablespoons of the Aioli onto the side of the tortilla. Garnish with fresh chopped chives.

Wednesday, September 23, 2009

Antipasti, Parties and some new clothes

I have decided to include a few antipasti that can be made as a light meal or taken to parties and get-togethers as your contribution. They are not necessarily high in protein but they do taste good. A problem for bariatric patients when going to parties is how to ensure they get a sufficient amount of protein without monopolizing all the barbequed mini-hot dogs, the chicken liver pate, or the cheese platter. People want to bring interesting dishes when asked to a cocktail party, but they usually don’t want to spend a lot of money buying proteins. Unless it is catered, you generally won't find steak tartare, skewered teriyaki chicken, or a big bowl of boiled shrimp. You invariably get tabbouleh, hummus, a veggie platter or some other vegetarian dish. These are all great to eat and quite tasty but are limited nutritionally for the bariatric patient.

Pre-party planning: If necessary, eat a bit of protein before going out. Then if you have the opportunity to have some interesting bites, do so with no guilt. Many dishes that are served as antipasti are flavorful but somewhat devoid of protein. So prepare yourself and don’t get to crazy if you can’t get your normal amount of protein for that meal. You will live. Relax and enjoy the convivial time with friends. Tell them your story about how you made such a big decision and why you are doing so well. Then walk away in that slinky new little black dress or that Armani suit. Giggling to yourself!

Sautéed mushrooms and Marsala

Sautéed mushrooms have a complex flavor that is easily accentuated by the addition of Marsala. However for the bariatric patient this dish has little protein. You might wish to spread some of the basic cream cheese spread on the bread before placing the mushroom mixture. This will increase the level of protein.

3 Cup sliced button mushrooms
Olive oil
Red pepper flakes
Marsala fortified wine

Saute 3 cups of sliced mushroom in 2 Tablespoon olive oil and 2 ounces of butter.
Saute over medium-low heat until they start to brown and caramelize.
They will shrink down in volume.
Add 2 cloves finely chopped garlic and another 1 Tablespoon of butter.
Use a teaspoon of red pepper flakes if you want more “heat”.
Add some ¼ Cup chopped onion for additional flavor.
Add ½ cup Marsala wine and allow it to cook down until there is no liquid left.
Taste and correct seasonings (salt and pepper).
Serve on crostini or bruschetta. (I have served these on beer bread that is slightly sweet).
Can be served at room temperature or warmed slightly. Do not serve this antipasto cold.

Stuffed peppers

This dish was initially made using Jalapeno peppers however I found that fresh Jalapeno peppers can vary significantly in their heat, and range from Bell Pepper mild to very hot. Without tasting each one prior to preparation there is a potential for highly variable results. To reduce the potential of varying heat levels, I have chosen to use small mild green pepper and fill them with a spicy cheese mixture, over which I have some control.

This is an excellent appetizer and is served hot, fresh from the broiler.

1-2 dozen sweet green peppers approximately 3” long and about 1 ½” wide
1 pound of fresh Italian sausage (you can use spicy hot or mild)
1 medium onion
8 oz of cream cheese
8 oz of Mascarpone cheese (or another 8 oz of cream cheese)
½ Cup grated Parmesano/Reggiano cheese

Brown the sausage, and the chopped onion in a saute pan and when done completely crumble into very small pieces and allow to cool.
Mix cheeses together with a hand mixer or in a food processor with the steel blade.
Add sausage and mix thoroughly to a coarse mix.
Set aside to cool or put in a container in the refrigerator.
Slice the peppers lengthwise and remove the seeds and ribs.
Rinse the peppers and allow them to drain on a rack.
Parboil them in a pan of boiling water for 1 minute and then allow them to drain.
When dry, place cut side up on a baking sheet.
Turn oven to 400 degrees F and preheat.
Fill the peppers with the sausage/cheese mixture mounding the mixture slightly.
Place the baking sheet with the peppers in the oven to brown and melt the cheese (3-4 minutes).
Remove from oven, remove from baking sheet and place on a serving platter.
Serve immediately. People will serve themselves using their fingers and a napkin.

Fresh mozzarella slices with olive oil and salt

This is a simple but exquisite dish so use the very best fresh mozzarella you can find. It has a subtle taste that can be overwhelmed by strong flavors, so go lightly with the herbs and salt.

1 pound of fresh mozzarella
Fresh basil and oregano (dried would be acceptable, but use less)

Slice mozzarella into ½” slices
Place slices in a bowl with ½ cup of olive oil
Add 1 tsp chopped basil and oregano.
Toss gently to distribute oil.
Allow to marinate for 30 minutes
Drain the cheese pieces
Place on a small plate and sprinkle with bit of salt

Tuesday, September 22, 2009

Thoughts from the Front

The reasons why people gain weight vary as much as the people themselves. Some eat too much pie, while others have an endocrine problem. When my first wife had a hysterectomy in 1975, she also started to aggressively gain weight. She had all of the endocrine tests, took thyroid tablets and the rest. She continued to gain inexorably up to 300 pounds. Her back went bad, she was not able to deal with the kids as effectively, and she was quite unhappy. She was not a significant over-eater and she enjoyed food (Chesapeake Bay background). But she was terribly unsatisfied with her life.

When she finally had the stomach stapling in 1981, even though she had to go through a huge effort, the weight loss thrilled her no end. She felt better. She looked better and she thought better of herself. She eventually reentered the workforce, training in the commercial insurance field, found new friends and became a new person. That made me happy for her. I was never sure how much she felt she gave up not being able to eat everything, but she was a very happy person with who she became.

I realize there are rules. The "rules" that my surgeon gave me in his handout before the surgery helped me get through that initial phase of weight loss. The "rules" are really most important during that first year and have been designed to minimize potential but very serious post-surgical problem. Not drinking fluids during eating is important as you really need to heal the stomach. The extra volume of material can distend the stomach and you can become very uncomfortable. After a year I now eat and drink at the same time with no difficulties. It is very important to follow your doctor' advice and counsel. Vitamins are an essential part of the process. You simply can not get all the vitamins you need from your food. This regimen is not for the vegetarians among us. So the "rules", while not made to be broken, do restrict us a bit early on. They are not as significant later. However fluid intake is an important part of the maintenance of a healthy body. To me three things are critical to your success. Drink plenty of fluids (notice I didn't say 8 glasses), take the multi-vitamins and some B12, and eat slowly, savoring the food.

I have had my ups and downs during my weight loss, but I am much happier and certainly much healthier after losing the weight. I get to wear nice suits, slim cut pants, and walk around with renewed confidence in how I look. While that was not my goal it is a nice unintended consequence. I have not weighed this amount since I was 16 years old. Over the years I saw myself and my weight as fine because I was fairly smart and pushed myself through my degrees with alacrity. I spent a career with people who didn't seem to mind my weight and were more concerned with the information I provided them in my consulting business. It wasn't until I decided to do something for myself that things changed. I am not like a reformed alcoholic, spending my time proselytizing about weight loss. It is truly an individual decision not to be taken lightly. I hope that the reader understands that. You must do what you feel you need to do for YOU and no one else. Its your life, your health, and your view of yourself in that big picture.

Saturday, September 19, 2009

Shrimp, Scallops, and Squid

Shrimp, scallops, and squid or calamari are great dietary elements in the bariatric diet. They are easy to cook, and very easy to eat. They are highly nutritious and provide a substantial amount of proteins. I often fix these dishes for a quick lunch on a busy day. I particularly like the squid or calamari. I had this dish at a small restaurant in San Francisco, down in the industrial section of the city. Sitting on the deck with a friend, looking over at the shipyards and the marine activity, with the sun shining and a big plate of fried squid and vinegar dipping sauce was the perfect lunch. I think the vinegar dipping sauce made the dish special.

The ginger scallops and the two shrimp dishes provide an Asian flavor and when combined with a bit of steamed rice make excellent dinners. Sometimes rice for the bariatric patient may be a problem, so try eating small amounts first. Remember it is a carbohydrate and it is expected to be at a reduced level in the diet. Due to the size of the portions and the ease of cooking, these items these make great meals for one. Frankly eating alone with a plate of shrimp or scallops or calamari in front of you isn't too bad.

Bacon-Wrapped Ginger Soy Scallops

1/4 cup soy sauce
1 Tbs. dark brown sugar
1-1/2 tsp. minced fresh ginger
6 very large “dry” sea scallops (8 to 10 oz. total)
8 oz. can sliced water chestnuts, drained
12 slices bacon, cut in half crosswise

Set a rack in the upper third of the oven.
Line the bottom of a broiler pan with foil, replace the perforated top part of the pan, and put the whole pan on the oven rack.
Heat the oven to 450°F.
In a medium bowl, combine the soy sauce, brown sugar, and ginger.
If the muscle tabs from the sides of the scallops are still attached, peel them off and discard them.
Cut each scallop into quarters.
Marinate the scallop pieces in the soy mixture for 15 minutes.
Reserve the marinade.

To assemble, stack 2 slices of water chestnut in the center of a piece of the bacon. Put a piece of scallop on top of the water chestnuts. Wrap each end of the bacon over the scallop and secure with a toothpick. Repeat with the remaining bacon, water chestnuts, and scallops (you may not use all of the water chestnuts). Remove the broiler pan from the oven and quickly arrange the bacon-wrapped scallops on the hot pan so that an exposed side of each scallop faces up. Drizzle the scallops with the reserved marinade. Bake, turning the scallops over once after 10 minutes, until the bacon is browned around the edges and the scallops are cooked through, about 15 minutes total.

Spicy Shrimp with Mangos and Snow Peas

2 red onions, sliced
1 tablespoon ginger, julienne
1 1/2 teaspoons to tablespoons of sambal to taste (or if it is not available, spicy hot pepper paste).
1 1/2 pounds large shrimp, peeled and deveined
Juice of 2 limes 2 ripe mangoes, diced
1/2 pound blanched snow peas
1 tablespoon Dijon mustard
1/8 cup rice wine vinegar
1/4 cup canola oil
Salt and black pepper to taste

Coat hot wok with oil and caramelize onions with the ginger.
Season with salt and pepper.
Add sambal and shrimp and stir fry until just cooked through.
Deglaze with lime juice and add mangoes.
Check for seasoning.
In a mixing bowl, whisk together Dijon mustard, vinegar and oil.
Toss with the snow peas.
Place a pile of snow peas in the middle of the plate and surround with the stir fry.
Garnish with mango slices.

Scarred Squid

1 lb of fresh or frozen whole market squid, cleaned with mantles left whole and tentacles removed

Vinegar dipping sauce:
½ cup apple cider vinegar or rice wine vinegar
1 Tsp of sugar
Pinch of red pepper flakes
Bring to a boil and simmer for 2 minutes.
Let cool
Serve in a side bowl

Clean whole squid and rinse out the body cavity.
Remove the tentacles and cut the tentacles below the beak (the hard structure below the eyes).
Put a knife blade inside the squid mantle and then slice through the mantle on one side down to the knife blade. T
he blade limits the cut to just one side of the squid- the scar.
Lightly dredge the squid in seasoned flour and dust off the excess.
Heat approximately 1 cup of light oil (canola, peanut) to 360-375 degrees F in a deep saute pan.
Quickly fry tentacles first, then the mantles for 1 minute or less.
Add salt and pepper.
Serve with lemon or lime or the spicy vinegar dipping sauce.

Marinated shrimp

1/4 Cup fresh lime juice
1Tbs honey
1 Tsp dried thyme
1 lb jumbo shrimp
3 cherry tomatoes
4 green onions cut into 1-2” pieces
1 green bell pepper, cut into 1” squares
1 lime cut into wedges
6 bamboo skewers, soaked for ½ hour

Mix lime juice, honey, and thyme together in a Ziploc bag.
Add shrimp and allow to marinate in the refrigerator for ½ hour.
Skewer the shrimp, cherry tomatoes, onions and peppers on to bamboo or metal skewers.
Grill for three to four minutes over hot grill (can be done in a grill pan indoors).
Brush with reserved marinade.
Squeeze lime over the skewer and serve.

If it swims, it's probably good for you.

Fish is an excellent ingredient for the bariatric patient. It can be cooked in a wide variety of dishes, and retains a moist texture making it easy to eat. I have includes four recipes. One for a poached fish in a tomato sugo or sauce, one for salmon cakes made with canned salmon, the third is for a slow cooked tuna dish that is quite unusual, and the fourth is spicy fish kebabs cooked on the grill. Accompanying sauces or marinades make them exciting to eat. The recipes serve four people. Use approximately 4 ounces of fish per person.

Fish poached in sugo

Sugo is an Italian tomato-based sauce that can be made quickly.
Use firm-fleshed fish that is fresh, or if frozen, slowly defrosted in the refrigerator.
For four persons use 4-4 ounce pieces of fish.

Ingredients for sugo
1 red bell pepper, chopped
1 medium onion, chopped
2 cloves crushed garlic, minced
Dried pepper flakes
Dried oregano
Dried basil
1 28 oz can of crushed tomatoes
Olive oil to saute vegetables
Salt and pepper

Saute the peppers and onions and minced garlic in ¼ cup of olive oil until onions are translucent.
Saute gently so you don’t burn the garlic.
Add a pinch each of dried oregano, dried pepper flakes (to taste), and dried basil.
Stir to mix and add the can of tomatoes. Bring to a simmer.
This will thicken somewhat so be prepared to put ½ to 1 can of added water.
Simmer gently for about ½ hour.

Use fillets of fish for this dish, although swordfish steaks would also be good. Use four ounce fillets per person for adequate portion control. A wide range of fish can be used in this manner, just be sure that the bones are removed. Perch, tilapia, sea bass, and cod will all work nicely. Buy the freshest fish you can. If it smells fishy put it back and buy some pork chops.

In the saute pan, place the fillets into the sugo and with a deep spoon ladle the hot sauce over the fish. Cover and let simmer. Depending upon the thickness of the fish, it will take about 20 minutes to cook the fish to a moist doneness. Squeeze a half of a lemon over the dish and add a handful of chopped parsley as a garnish.

For the bariatric patient, the fish will probably be enough, however the dish would go well with rice and a side dish of braised spinach or chard. Any leftover fish is good as a cold lunch dish the next day.

Salmon Patties

If you are trying to boost your intake of omega-3 fatty acids (the healthy ones), try this simple favorite. It is a great way to use convenient canned (or leftover) salmon. A tangy dill sauce or a good tartar sauce can provide a nice balance.

Make Ahead Tip: Prepare the patties then cover and refrigerate for up to 8 hours.

3 teaspoons extra-virgin olive oil, divided
1 small onion, finely chopped
1 stalk celery, finely diced
2 tablespoons chopped fresh parsley
15 ounces canned salmon, drained, or 1 1/2 cups cooked salmon
1 large egg, lightly beaten
1 1/2 teaspoons Dijon mustard
1 3/4 cups fresh whole-wheat breadcrumbs (see Tip)
1/2 teaspoon freshly ground pepper
1 lemon, cut into wedges Tip:

Preheat oven to 450 degrees F. Coat a baking sheet with cooking spray
Trim crusts from firm sandwich bread. Tear the bread into pieces and process in a food processor until coarse crumbs form. One slice makes about 1/3 cup.

Make the salmon patties
Heat 1 1/2 teaspoons oil in a large non-stick skillet over medium-high heat.
Add onion and celery; cook, stirring, until softened, about 3 minutes.
Stir in parsley; remove from the heat.
Place salmon in a medium bowl.
Flake apart with a fork; remove any bones and skin.
Add egg and mustard; mix well.
Add the onion mixture, breadcrumbs and pepper; mix well.
Shape the mixture into 8 small patties, about 2 1/2 inches wide.
Heat remaining 1 1/2 teaspoons oil in the pan over medium heat.
Add 4 patties and cook until the undersides are golden, 2 to 3 minutes.
Using a wide spatula, turn them over onto the prepared baking sheet.
Repeat with the remaining patties.
Bake the salmon cakes until golden on top and heated through, 15 to 20 minutes.
Serve salmon cakes with lemon wedges and tartar sauce.

Slow cooked tuna

4- 1” thick tuna steaks about 4 ounces each
Tomato salsa

Make the Tomato salsa
1 Cup chopped ripe tomato
½ C Chopped basil
2 Tbs capers
1/2 cup Olive oil
Salt and pepper
½ cup Parsley

Place tuna on an oven-proof plate
Season with salt and pepper
Drizzle with a little olive oil
Place in 200 degree oven for 20 minutes
Make tomato salsa and mix thoroughly in a bowl
Add a squeeze of lemon at last minute just before serving
Serve fish with tomato salsa on the warm plate

Grilled fish kebabs

1 lb of fish (select dense fish such as halibut, swordfish, mahi mahi or fresh shark)
½ cup soy sauce
2 Tbs honey
½ tsp dry mustard
½ cup dry sherry

Make a marinade:
½ cup soy sauce
2 Tbs honey
½ tsp dry mustard
½ cup dry sherry

Cut fish into 3” squares.
Slide marinated fish on to metal or bamboo skewers skewers and place in a glass casserole dish.
If using the bamboo skewers, be sure to soak them in water for a 1/2 hour before using them.
Mix marinade and pour over fish, allow to marinate for 30 minutes.
Grill fish in a lightly oiled grill pan over medium to high heat.
Turn once.
Boil remaining marinade for 2 minutes.
Drizzle marinade over fish.

Wednesday, September 16, 2009

Its just chicken

Today it’s chicken. I have found that chicken thighs work best for me and have more moisture and are easier to eat than chicken breasts. Breasts can be overcooked quickly and tend to dry out. This makes them a bit more problematical to eat. Thighs tend to just get more succulent as they cook and stay quite moist. The chicken breasts and thighs can be boned or not. The first dish is quite spicy and can be made even spicier with the addition of dried pepper flakes. If you have not tried spicy food yet, I would not add the pepper flakes the first time you make this dish. To add foods for guests or family make some steamed or boiled rice, add a salad and a light dessert. The second dish is a grilled chicken in a flavorful orange glaze. It works well on the grill and has lots of sweetness and spice.

Chicken and Sausages with peppers

This dish is a terrific dish that takes a while to cook. Makes a great buffet addition or serves a dinner party. The small size portions of the different meats make it fit easily into your eight bites. Take a little bit of chicken and a small piece of sausage, add some sauce. Enjoy.

12 Italian sausages, depending upon your tolerance can be hot or mild
8 Chicken thighs
3 bell peppers (2 red and 1 yellow)
2 large onions (yellow or white)
Olive oil
White wine vinegar
Dried hot peppers, crushed
Large can of crushed tomatoes

Trim the stems and seeds from the peppers
Slice the bell peppers into ¼” slices
Slice the onions in half and then into ¼” slices
Sauté the peppers and onions in olive oil until soft in a large sauté pan
Add dried hot peppers during the sauté (1/2 teaspoon)
Add 2 tablespoon sugar
Add ½ cup white wine vinegar
Salt and pepper to taste.

Remove cooked peppers and onions to a bowl.
Clean the pan and add ¼ cup olive oil
Sauté sausages until brown, remove
Salt and pepper chicken thighs
Sauté until browned and nearly done, remove

In a large baking dish, place a layer of peppers and onions on the bottom.
Add the sausages, then another layer of peppers
Add the chicken
Pour the crushed tomatoes over the mixture
Bake for 1 hour covered with aluminium foil in the oven at 350o
Remove foil and allow cook for 20 minutes longer
Stir the casserole and serve hot

Grilled Chicken in orange mustard marinade

This grilled chicken is a quick and easy recipe that provides excellent flavor as well as the taste of the grilling experience. It is sufficiently high in protein and can meet the meal requirement.

1 pound boneless, skinless chicken breasts or thighs, trimmed of fat
1 1/2 tablespoons Dijon mustard
1 1/2 tablespoons frozen orange-juice concentrate, thawed
1 1/2 tablespoons honey
1 teaspoon sesame oil
1/2 teaspoon freshly ground pepper
1/8 teaspoon red pepper flakes
Salt to taste

Cut chicken crosswise into 3/4-inch-wide strips. Whisk together mustard, orange-juice concentrate, honey, sesame oil, pepper, and red pepper flakes in a medium bowl until smooth. Add the chicken and toss to combine. Cover and marinate in the refrigerator for 15 minutes.

Preheat the grill or broiler. Oil the grill rack or spray with a non-stick cooking spray. Remove the chicken strips from the marinade, and discard the remaining marinade. Grill or broil until the chicken is no longer pink in the center, 2 to 3 minutes per side for breast meat and about 5 minutes for thighs. Season with salt and serve.

Tuesday, September 15, 2009

Beer Bread and Fish Stew

Today I want to give you my basic recipe for beer bread which I almost always use for creating crostini for our catering guests. It has density, flavor, and body and it holds up well to a wide variety of toppings. I may have several loaves in the refrigerator at one time that have different additions in them. I can then pick and choose which ones I want for the crostini that I am preparing. The loaves are inexpensive to make and last in the refrigerator for a week or more wrapped in a plastic bag. The basic recipe is similar to all of the other beer bread recipes out there and I make no claim on developing it as a new recipe. However it is the additions that I incorporate that make it more distinctive and tasty.

Beer Bread

This recipe makes one loaf of bread. It takes about 5 minutes to mix up and bakes in under an hour. The basic recipe is simple:

3 cups of self-rising flour or three cups all purpose flour plus 1 1/2 tablespoons of baking powder
¼ to ½ cup of sugar (depending how sweet you want it to be)
A pinch of salt
1 12 oz beer (the type of beer will alter the flavor, dark-richer, light-less beery)

Now is the fun part. These are some of the added ingredients I have used before baking. Mix in one or more different ingredients into the dry flour mixture to vary the taste.
I have used:
Garlic powder ½ tsp
Raisins- 3/4 cup plumped
Onion powder ½ tsp
Cinnamon 1/8 tsp
Sautéed onions ¾ cup
Chopped salami ¾ cup
Chopped sun dried tomatoes ¾ cup
Grated Pecorino cheese ½ cup
Parmesano/Reggiano cheese ½ cup
Dried chili peppers 1/8 tsp
Grated Asiago cheese ½ cup
Dill weed 1 Tbs

Mix the dry ingredients together; pour the beer into the center of the flour mix.
Stir to make a thick, sticky dough.
If it appears too thick and not moist enough, add a a little bit of water.
Place in a greased 1 pound loaf pan.
Bake in a pre-heated 375o oven for 55 minutes or until it sounds hollow when tapped.
Five minutes before the time is up pour a bit of melted butter over the top and return to the oven.

Make up your own flavor or try them all. Just not too many different things in one loaf.

Kurt’s Fish Stew

A savory fish stew is an excellent dish to prepare for the bariatric patient, particularly after the healing has been completed and foods are again interesting. I have made this stew for a large dinner party and when served with some crusty bread and salad makes a great convivial meal and a spontaneous dinner party. Just invite some friends and pass the aioli.

Fish stews are made throughout the world and live under a wide variety of names including bouillabaisse, cioppino, as others. I make this stew using locally available ingredients and fish found here in the markets of Umbria. However, the ingredients are easily found in markets just about anywhere. It makes a fairly large quantity and can be shared with friends as an impromptu dinner (or frozen for later). Just slice some French bread, make a green salad, open some good (but not great) wine, and add a light dessert for those who can eat it. This is not haute cuisine, but it is fun to call your friends at the spur of the moment and have a wonderful evening. For the bariatric patient, the stew will probably be enough; however the dish would also go well with rice and a side dish of braised spinach or chard. Pour a glass of wine and enjoy the conversation swirling around you.

2 red bell pepper, chopped
3 small or 2 medium onions, chopped
1 cup chopped celery
2 cloves crushed garlic, minced
¾ cup of white wine
Dried pepper flakes
Dried oregano
Dried basil
1 28 oz can of crushed tomatoes
1 28 oz can of tomato sauce
Olive oil to saute vegetables
Salt and pepper
Chopped parsley
Quick Aioli (see below)

Fish choices
Use fillets of fish for this dish, although swordfish steaks would also be good. Use 4-6 oz fillets per person for adequate portion control. A wide range of fish can be used in this manner, just be sure that there are no bones. Use firm fleshed fish that can hold up to the cooking, such as sea bass, grouper, redfish, monkfish, striped bass, freshwater bass, perch or other heartier fishes. Purchase a pound of pre-cooked large shrimp (frozen). Cut the fillets into 1” to 2” squares.
Buy the freshest fish you can. If it smells fishy put it back and buy some pork chops.
A total of 2 ½ pounds of fish and shellfish should be adequate for 6 people.

Sauté the peppers, celery, onions and the minced garlic in ¼ cup of olive oil until onions are translucent and the vegetables are soft.
Sauté gently so you don’t burn the garlic.
Add a good pinch each of dried oregano and dried basil. Add dried pepper flakes (to taste).
Stir to mix and add the cans of tomatoes and the wine. Bring to a simmer.
This will thicken somewhat so be prepared to put ½ to 1 whole can of added water
Simmer gently for about ½ hour.
15 minutes before seating your dinner guests,
In the saute pan, place the fillets into the sauce and stir the fish into the sauce to cover. Cover and simmer gently for 15 to 20 minutes. Depending upon the thickness of the fish, it will take about 20 minutes to cook the fish to a moist doneness. Add the frozen shrimp in the last five minutes and allow them to warm through. Ladle the stew into warm bowls and provide lemon wedges. the aioli, and warmed baguettes.

Quick Aioli
In a blender add:
1 egg
3 cloves of garlic,
Salt and pepper,
Juice from 1 large lemon.
Blend thoroughly to a fine puree

Then slowly add 1 cup of a vegetable oil (sunflower, corn, mixed) in a thin stream until the aioli forms a thick consistency. Using olive oil will make this sauce very thick and some people prefer the use of the lighter weight oils. Use whichever oil suits your fancy. Just add it slowly in a stream. Store refrigerated and it keeps for about a week. Use it on sandwiches as well.

Saturday, September 12, 2009

Braised Pork and a Smoked Salmon antipasto

Today I want to provide you with a couple of my favorite dishes. I made the braised pork for a dinner party we had in August 2008. I had just arrived in Italy to live and my wife invited her chef and a few others over for dinner. Pork in Italy is terrific, is well-marbled and cooks beautifully. Melchiorre had never eaten a dish like this and most Italians are not particularly adventurous eater. “If it doesn’t taste like Mom’s sauce I don’t want to eat it”. But Melchiorre as a chef has a much more adventurous palate and I waited to find out how he liked the dish. He tasted a small bite, chewed it slowly, and then turned to me and said “Molto buono”. We had a winner.

Braised Pork with onions and raisins

This is a stove top braising recipe that makes a wonderful stew-like dish. It takes a bit of time to cook on top of the stove and can easily be done in the oven using a low temperature setting and prolonged cooking. It is best to use pork cuts from the shoulder, which are rich in fat and connective tissue that slowly is released into the braise resulting in a succulent dish.

2 pounds of pork shoulder
1/4 cup flour
Salt, black pepper
Mild paprika
Onion powder
Garlic powder
Olive oil of light cooking oil
2 -3 onions
Liquid for braising (stock, boiling water, wine)

Cut 2 pounds of pork shoulder into 2” x 2” cubes.
Sprinkle all sides with a mixture of salt, black pepper, paprika, onion powder and garlic powder.
Dust in flour and shake off excess.
Brown in olive oil, in a heavy skillet or braising pan until brown on all sides.
Add 2-3 medium onions, sliced.

Cook to start caramelization of the onions and then add the braising liquid. This can be boiling water, beef stock, or wine or a mixture of all three. The liquid should go up approximately ½ ways up the meat. Bring to a boil and then reduce to a simmer. Cover. Cook for approximately 2 hours on the stove until pork is tender. This can be cooked in the oven at 325 degrees for 2-2 ½ hours. In the last 20 minutes of cooking add a ½ cup of wine vinegar and ¾ cup of raisins.

This dish can be served hot or warm, but not cold. A small serving (3-4 oz) will provide an adequate level of protein. Serving pilaf or mashed potatoes with this dish will provide the carbohydrates guests might want. Serving a soft vegetable such as spinach sautéed with garlic will also add an interesting accompaniment to the pork.

One of my favorite appetizers uses smoked salmon, cream cheese, chives and a condiment called mostarda (recipe to follow). I make a beer bread with cheese grated into it, slice it thinly and lightly grill it. I then spread a bit of mostarda on the bread, top with the cream cheese and then a slice of smoked salmon. I then put a dollop more of mostarda on top.

Smoked salmon and crema with chives

Smoked salmon
Creamed cheese and chopped chives
Beer bread crostini

If you purchase smoked salmon it can be chopped into dice and added directly to the creamed cheese and chives, and then spread on crostini. Or make the creamed cheese and spread on the crostini and then topped with a small piece of salmon. Whip 8 oz of Mascarpone cheese and 8 oz cream cheese (or 16 oz of cream cheese) until light and creamy. Add 1/4 cup chopped chives and 1 Tbs of lemon juice. Taste and add salt and pepper to taste

Spread on crostini and top with the smoked salmon. Try a bit of lemon or citrus mostarda on the crostini, then some cream cheese, then the salmon then a bit more mostarda.

Lemon or citrus mostarda

I like this one made with tangerine rind or lemon. Makes a great condiment for crostini with cream cheese and smoked salmon.

2 cups of sugar
2 cups of water
2 Tablespoons of yellow or black mustard seeds
1 Tablespoon of powdered mustard (Coleman’s)
1 cup of citrus peels (tangerine, lemon, orange or mixture)
All the juice from the peeled fruits
2 Tablespoons of white wine vinegar (more to taste)

Mix water and sugar together and bring to a boil.
Boil for 10 minutes, and then add the citrus peels and juice.
Add the powdered mustard.
Continue boiling the sugar mixture until it thickens, and the bubbles are small.
Toast the mustard seeds in a small frying pan until they start to pop.
Transfer the seeds to a mortar and pestle or a spice grinder.
Grind to a coarse grind and add to fruit mixture.
Bring to a boil and cook for 20 minutes.
Transfer to clean canning jars (1/2 pint or less).
Cap and process in boiling water bath for 10 minutes.
Transfer to rack and allow to cool.

Daily Sustenance

When people find out that I have had bariatric or weight-loss surgery (WLS), they often ask what I eat during the day. Am I hungry and how do I know when I am full? So let me tell you what I had to eat yesterday (9/11/2009).

I got up Friday morning early since I am still suffering a bit from jet lag, having just returned from California after a 12 day working trip. At 4:00AM it is quite beautiful here in Umbria and I made myself a cappuccino and sat out on the terrace. It was a tranquil morning and the birds weren’t even up yet. At about 5:30AM I decided to fix myself another “capuch” and cook some eggs. They have very fresh eggs here in Italy and they are extremely good. So I lightly fried a couple of medium eggs in a bit of butter in a non-stick pan. I seasoned them with a salt mixture that I have put together here as my “house” seasoning (salt, pepper, garlic and onion powder, and paprika), put them on a small hand- painted ceramic plate and went back out to the terrace to eat. It is a very nice way to greet the day.

At lunch, my wife returned from gardening up at the rental houses and was hungry. I had made a tuna salad that could be used on a sandwich, in a sliced tomato or on some crackers. The tuna salad was made with tuna in olive oil and drained, ¼ cup of giardiniera mix (pickled vegetables including cauliflower, onions, peppers, and carrots), ½ cup of marinated artichoke hearts, and 2 tablespoons of mayonnaise. I then added a teaspoon of pickled capers and put everything in the food processor with the steel blade and mixed it thoroughly until it was mostly smooth but with some texture. Into a bowl it went and then into the refrigerator until ready to eat. Elizabeth likes her tuna with some tomatoes from our garden. I prefer mine on saltine crackers. We get saltines here in packets of 4 or 5 (depending upon the brand) and they are exactly how much I can eat. Portion control done for you. So I had four cracker sandwiches made with a total of about 3-4 ounces of tuna salad and some bottled water for lunch.

For dinner, we went out with friends to a local trattoria to participate in a city festival or festa celebrating Festa 1800. The center of our little 13th century town was crowded and everyone seemed to be eating and drinking, sometimes at the same time. There was music, crowds, dancing, and people in costume. We sat down and ordered from an extensive menu. In Italy the menu items are divided in antipasti, primo piatto, secondo, contorno, and dolci. This works out to be the antipasti, the first plate as pasta or soup, the second plate which is the meat course, contorno are the side dishes like vegetables, potatoes, and of course dolci are the desserts. Obviously I cannot eat a full meal like that so I looked over the menu starting with the antipasti (generally the perfect sized dishes) and finally selected a fish stew dish made with baccala or dried salt cod. Everyone else at the table had at least a primo piatto, a secondo, a salad or vegetable, wine and several had a caffe macchiato. No dessert!

My fish was a small serving of three pieces of salt cod (4 ounces or so) that had been stewed in a wonderful tomatoey sauce. Lots of great flavor and the fish was succulent. A small piece of bread was used to sop up the sauce and I was done. My recipe for fish stew is remarkably similar in flavor and that recipe will be coming soon. The conversation at the table was lively and then we headed off to see the rest of the festa.

So there is my eating for one day in September. It is similar to most other days and the varied tastes and foods that I enjoy make up easily for the volume of food I no longer need or can eat. All of the meals provide good levels of proteins, exciting flavors and manageable portions. That is what this story is about.

Friday, September 11, 2009

The little bites- Antipasti and Tapas

I live in Italy now and cook for a living. My current position is as a chef for my wife's catering company, Amore Sapore. Amore Sapore means to love flavors. Our primary chef is a Sardinian man who has experience with the regional foods and dishes of Tuscany, Umbria and Sardinia. He generally does the pasta (ravioli, penne, tagliatelle, and gnocchi), as well as grilling the lamb, pork, and fish over a wood fire in front of the guests. Elizabeth, my wife, manages the dinner, makes the salads and many of the desserts. I generally assist Melchiorre with the pasta, sauces, and meats and also make the antipasti for our catered dinners and cocktail parties. I am also responsible for grilling the chicken and making a number of side dishes such as Eggplant bolognese. I even make desserts including lemon curd with shortbread and berries, and a variety of sorbets and gelato. I have found that combining my love for cooking, my dietary requirements after my surgery and my attention to taste and presentation details provides me an artistic as well as a culinary outlet.

Antipasti and tapas (and dim sum) are all excellent-sized dishes for the person who has had weight loss surgery. They can be nicely spiced, in small bite-sized portions, and you can have a variety from which to select. They can also be quite pretty and eye-appealing. This makes them even better.

I will be providing some recipes as well as some ideas for these beautiful dishes. Some may not be for you, for example if you don't like chicken liver pate, don't make it. But my recipe is quite good and I have served it to a lot of my catering customers with no complaints. Most of the antipasti that I will be providing recipes and descriptions for have been prepared for our catering clients. Some can be made in advance and stored in the refrigerator, others need to be made immediately before serving.

Several small serving of appetizers can be used effectively as a meal for the bariatric patient. They can be very flavorful and also provide the bite and the crunch that many people need and deserve. Over the years I have created a wide variety of appetizers and toppings which can be placed on crackers, lettuce leaves, on crunchy bruschetta (thick grilled bread slices) and on crostini (crispier small, thinner bread slices). They can be stand alone pieces such as the stuffed peppers, or artisan cheese slices with flavorful toppings and eaten with your fingers.

One of the foods that can cause you difficulties after surgery is breads. They are high in carbohydrates and because of their texture can cause pain and a sense of fullness. Breads are often a significant problem in the bariatric diet since they can add a lot of calories and can result in weight gain in the post-surgery period. Which if you have gone this far, you would rather not experience. That is not to say you shouldn't eat bread. A slice of bread as a carrier for a high protein topping can be a wonderful way to enjoy appetizers and provide you with the nutrition you need. Many of the recipes are really just toppings that are applied judiciously to a crispy bread slice.

Bruschetta and crostini

The difference between bruschetta and crostini is whether you want a thicker, chewy piece of bread that has been grilled to support the topping (bruschetta) or a smaller, thinner, and crispier piece (crostini). As a bariatric patient I prefer the smaller crostini to the larger bruschetta (frankly while bruschetta tastes great, the crostini provides fewer carbohydrates and still provides a healthy platform for the toppings). I usually take a composite approach in making the bread base. I cut ½” slices on the diagonal through a baguette, and then lightly brush the slices with olive oil and mashed garlic. I toast them in the oven at 375 degrees until they are done as you wish (crispy, soft, crunchy). A shorter time in the oven yield a softer slice with crispy crust, while a slightly longer time will result in a crispier base. I think you need to consider the toppings to be applied and plan the oven time accordingly.

Many appetizers are made without a bread base and can be a terrific addition to the bariatric menu providing unusual flavors and textures. The preparation of many of these will be self-explanatory based upon the ingredients. These bites are normally intended to whet the appetite prior to a meal, but in the case of the bariatric patient they are designed to provide a sufficient amount of protein and make the meal. I also want to provide some basic toppings that can be made easily and then mixed and matched with other toppings to create new taste sensations.

Basic tomato topping for bruschetta or crostini:

This topping while very flavorful, does not have any significant level of protein in it. It makes a great addition to an appetizer platter for a party, but the bariatric patient will require a more substantial topping to ensure they get the protein levels they need. Think about adding cream cheese or a slice of rare roast beef, or some cooked shrimp to the crostini when you prepare it.

Carefully chop 1 ½ cups of tomatoes into ½” dice, place in a bowl
Chop three cloves of garlic very finely, add to the tomatoes
Chop 1 cup flat leaf parsley finely and add to the bowl
Add 1/3 cup wine vinegar or lemon juice
Add 2/3 cup olive oil
Add 1/2 teaspoon salt and ¼ teaspoon black pepper
Mix thoroughly and allow it to sit for 30 minutes or more

Interesting modifications to the basic mixture:
Add ½ cup chopped basil to basic mixture
Add ½ cup finely chopped rucola, (arugola or rocket) and omit parsley
Drain the basic or modified mixtures to consolidate the topping and remove some of the accumulated fluids. This reduces soaking through the bread, on the other hand I like the soaked bread.

The topping should be served at room temperature. Place a tablespoon full of topping on a crispy slice of crostini and top with a sprinkle of Parmesan or Pecorino cheese and a bit of chopped parsley. This also goes well with some smoked fish (salmon or swordfish).

Basic cream cheese topping

This is an infinitely modifiable topping that can be used as the base for a wide variety of crostini. It can provide a significant amount of protein to the meal.

Mix 8 ounces of cream cheese with 8 ounces of Mascarpone cheese with a hand mixer
Add a few drops of milk if it is too thick
Add ¼ teaspoon of salt, ½ teaspoon of garlic powder, and ½ teaspoon onion powder
Add ½ teaspoon paprika
If you wish, a few drops of Tabasco can be added here
Mix thoroughly, cover with plastic wrap and refrigerate for 30 minutes

Spread on a piece of crostini and top with a slice of roast beef, smoked salmon or some cooked shrimp.

Its time to eat

The development of this blog was initially to publish recipes that I have found or created to provide adequate levels of protein, exciting flavors, and to add some fun dishes you can use to vary your diet. In future posts I will try to provide recipes for an appetizer or antipasti and a main dish item (or two). I hope you will use these recipe ideas as jumping off points and not as absolutes. Make the recipe as described the first time and taste it. If it suits your tastes, great. If you feel that it needs a little something, add it. Let me know what your changes are and I will try to incorporate them into the recipes. Use your imagination and create your own dishes using these as models. Have fun deciding what you want to eat and then go for it.

Thursday, September 10, 2009

Figuring out what your body needs

The bariatric patient has undergone major changes in their digestive systems and as a result their nutritional needs and requirements have changed substantially. The active process of weight loss includes the metabolism of carbohydrates stored in the liver, metabolism of fats stored as body reserves, and the metabolism of proteins which make up our muscles and other tissues. The loss of carbohydrates from the liver leads ultimately to a reduction in blood sugar levels and in my case the virtual elimination of my Type 2 diabetes. I have been insulin-dependent since 1992 and was taking three meal-associated short-term insulin injections and a single long term insulin injection at night. I had my last insulin shot the night before my surgery on June 3, 2008. My fasting blood sugar in the morning has gone from 180 immediately after surgery to a current daily level of less than 100 without any supplemental insulin. This phenomenon is observed in many bariatric patients and as an “unintended” consequence of the surgery can lead to the elimination of type 2 diabetes and all of its negative health effects as we age.

It is important to eat a high protein diet as you heal and start losing weight. The loss of muscle mass is common in bariatric patients and a combination of exercise and a high protein diet can reduce the effects from this loss. Taking multi-vitamins and other vitamin supplements is also important. Your vitamin intake has been reduced significantly and you need to replace those vitamins. I take a full multi-vitamin and a vitamin B complex daily. In my first annual blood analysis, all of the vitamin levels were within normal limits. In consultation with your doctor, it may be necessary to add vitamins if you find that blood levels are inadequate. Eating a lot of vegetables, especially in the beginning phases of your recovery is not normally an option. As much as I like spinach and chard I am only able to eat small amounts and still maintain the adequate levels of proteins I need. I still like the vegetables, its just that I have to reduce their intake

Wednesday, September 9, 2009

Cooking Small

Cooking as a bariatric patient can be an exercise in frustration. Most cookbooks don’t think in the portion sizes that we require so we must learn to think differently about cooking. One of the most difficult things in the world to do is to just cook for a single person. So if possible, don't. Try to eat with someone. Cook for them or better yet, with them.

Foods are generally sold in packages that are three to four times larger than we can eat. So a bit of planning is necessary before going to the store. If you are cooking for one, think of the dishes you want to prepare and then purchase what you need. I have found that when you buy in large lots (pork chops spring to mind), you often bag them and stick them in the freezer. Which is where you might find them a year from now, probably freezer-burned. Limit your food purchases to what you need for a few meals or a few days.

Be sure you keep protein-rich foods available in the refrigerator. Breakfast can be some yogurt and fruit or granola,or a couple of poached, fried or boil eggs. Lunch can include a nice tuna salad or egg salad. Some cheese like Monterey jack or mild cheddar can be incorporated into a high protein lunch or breakfast. The high fat cheeses, like Brie or Gorgonzola should be eaten in moderation.

Eating after bariatric surgery does not mean that the potential for cholesterol issues is substantially reduced. If you have high cholesterol, maintain the medications and dietary elements that are part of that treatment process. It is likely that cholesterol levels will go down as well as blood sugar and probably blood pressure, but until your doctor specifically eliminates your medications, continue them.

Tapas and Social Eating

Tapas are little dishes of food often served in bars with a glass of sherry in the afternoon in Spain and are served as part of the social scene. They were served before lunch and dinner in bars and taverns. There are as many variations of tapas as there are cooks in Spain, or maybe more. They are generally small portions of food. Tapas in Spain are rarely eaten in lieu of a main meal, but dinner is often served after 9PM and there is a large time gap after lunch. A bit of sustenance is important.

For this book however the concept of tapas is really very much in line with the nutritional needs of the bariatric patient. This type of eating provides for the nutritional requirements as well as fulfills the need for the inclusion of delicious ingredients and flavors. It can also contribute to the social connectivity that we all require. Eating with others makes the bariatric patient less self-conscious. There is no reason to have to continue explaining why we can only eat a small amount. Our friends know and understand.

In the tapas bars the patrons line up at the bar, and call their orders to the bartender. You are immediately exposed to the aromas of garlic, olive oil, shellfish, ham, cheese, saffron, and a host of other aromas coming from a spread of hand-made pottery bowls brimming with tapas. You make your choices, and then carry your wine glass and tapas outside to the tables. You might end up with: Chickpeas and Spinach, Clams in Sherry Sauce, Octopus & Paprika, Meatballs in Almond Sauce, Fried Cheese, Quail and Onions, Dried Cod & potatoes, Sole with Raisins & Pine Nuts, and some pieces of grilled pork.

As you can see, tapas are a ready-made eating solution for the bariatric patient. The portions are small, well-seasoned, and when selected correctly can be high in protein. However, it’s not necessary to dine out when craving these bite-sized eats. Just gather some friends, whip up a pitcher of sangria, and serve some of Spain’s tastiest treats. Use tea saucers as plates, and encourage your guests to use toothpicks or their fingers when eating (as is the tradition in Spain) – no silverware necessary.