Tuesday, October 27, 2009

What about Pasta?

I apologize for the lengthy screed on regaining weight, but I will now return you to the cooking and recipe portion of this blog. It's late October and it is getting into fall and winter here in central Italy and the cold makes it less interesting to sit out on the terrace and drink my morning cappucino. Most of the birds have left for warmer climes and there are times when I would like to go someplace warm as well.

In my on-going search for new and different foods to serve our guests, I have found that I need to develop cooking skills that I have never used before. Yesterday it was making ravioli. I have found that the thicker pasta used to make ravioli does not digest well in my smaller stomach. It tends to just sit there for what seems like a very long time, making me feel full and very uncomfortable. Since starches are not digested well in the stomach, their residence there can be lengthy. Starches are normally digested in the intestinal track where various digestive enzymes called carbohydrases work on breaking down the molecular structure of the starchy foods. This digestion turns the starches into simple sugars that are easily absorbed through the intestinal wall. So when I eat ravioli, I generally eat just one and reserve stomach space for proteins and other foods which are more easily digestible.

OK, back to making ravioli. Here in Italy, pasta making is a way of life. Virtually every house has a manual pasta machine and almost every Italian woman has been taught from an early age how to make the pasta from her region and othere regional specialties. There are basically two types of pasta, northern and southern. Pasta is simply a combination of flour, water, and sometimes an egg. Just combine the flour, water and egg to make the dough. The dough is kneaded until smooth to develop the gluten. The gluten is what gives pasta its texture. Allow the dough to rest before rolling into sheets with a rolling pin or pasta maker.

The traditional method of making and kneading the dough by hand has worked for centuries, although it is a slow method. It is, however, a Zen experience and if you have the time and muscle, do it. On the other hand you can use a food processor and cut the time down significantly, but then you don't get that Zen thing going on.

I put pasta into two categories, northern Italian and southern Italian. While it might be an oversimplification, it makes it easy to understand.

Traditional pasta from northern Italy is normally made with soft wheat (all purpose) flour, eggs and sometimes olive oil to form a tender dough. It is great for making long, flat noodles such as papardelle and tagliatelle as well as ravioli, tortellini and lasagna. Sauces used in the north are highly varied but include Bolognese (a meat sauce which sometimes includes milk as part of the tomato-based sauce), pesto (which is commonly a puree of basil, pine nuts, garlic, olive oil and Parmigiano-Reggiano cheese), or cheese cream sauces which might include the local blue-veined cheese Gorgonzola. Gorgonzola is made in either a dolce (sweet form) or a piccante form (sharper and tangy).

The traditional pasta from southern Italy is often made with semolina flour, a flour made from durum wheat, the hardest of all wheats. It is mixed solely with water to form a stiff dough. To make a lighter dough, half semolina and half all purpose flour can be used. The dough is forced through dyes to create many different shapes including macaroni, penne, fusilli and spaghetti. The pasta sauces of the South are often spicier and use more tomato as in Puttanesca, Amatricana and Tomato. The Internet will direct you to all of these recipes easily.

I made my pasta dough in the northern style with only all purpose flour. I weighed out the flour and added one egg for every 100 grams of flour. This results in a more tender, softer pasta. I mix the eggs into the flour and then I kneaded the mixture into a smooth dough using my hands on a floured board. The dough changes texture as you push it along the board, the graininess gets less and less as the dough hydrates and incorporates the flour. It is simple yet it does require some experience. Try making some pasta dough some Saturday afternoon. Turn on some music you like, weigh out the flour, add the eggs and get to work. Feel how it changes. When it is smooth, wrap it in plastic wrap and put it in the refrigerator to rest for a few hours or even overnight.

When you are ready to work with the dough, let it warm a bit on the table before rolling it out. I use a pasta machine that kneads and rolls the dough into 6" wide strips and is the most common method employed in Italy. Historically in northern Italy women have rolled out the dough using long thin rolling pins. The rolled out dough can be 2-3 feet in diameter and is done on a very large floured board. It is not ready to use until it has been rolled to 2-3 mm in thickness. I watched a young woman roll out her dough very quickly using lots of flour. As the pasta dough got larger, it began slipping around on the board. Then I noticed that she tucked an edge of the pasta over the edge of the board and held it in place with her hip. She could then still used both hands to roll, but the pasta remained still. A neat trick (thanks, Francesca).

To make the ravioli, I need to put something inside it. So the filling becomes a significant element. Perfect ravioli is a combination of the pasta dough, the filling and the sauce. They need to complement each other. Classic fillings here in central Italy include potatoes with two cheeses (mozzarella and pecorino), ricotta with spinach, ricotta with lemon and anisette, and pumpkin with potatoes, spices, amaretto cookies, and Parmigiano-Reggiano or pecorino cheeses. The first three are generally served with a thick tomato and vegetable sauce while the pumpkin is more commonly served with melted butter and fresh sage. As I have explored the ravioli-filling world I have developed several different versions that I like. One was with smoked salmon, some mashed potatoes for structure, chopped spinach, parsley, and some lemon peel; in another I used smoked trout in place of the salmon and without the spinach. Both were great when served in a light butter sauce with a bit of cream and a splash of white wine.

Another filling I worked with was chopped spinach and mushrooms sauteed in butter, seasoned with salt, lots of pepper and Marsala, cooked and pureed. When the spinach was added, the whole became thick and easy to work with. It also had a much different flavor than spinach and ricotta (the classic filling). Yesterday I made the spinach and mushroom filling, a pumpkin filling, and a new one using pureed pears, diced pears, and fresh, soft pecorino cheese.

I had a couple of folks over to lunch and to act as tasters. I had some problems with the preparation of the pasta. It was quite soft and probably needed more flour. It also rolled out a bit thin making the ravioli difficult to fill without tearing. I will probably add more flour when I next make the pasta, and will roll it out a little thicker. The pumpkin ravioli were not all that popular as they did not have a punched-up flavor. I will need to work on that one. On the other hand, the spinach and mushroom pasta was great with a bit of thick tomato sugo under it and on top. I added a sprinkle of grated Parmigiano-Reggiano and it was well received. The pear and pecorino ravioli was also very good. The addition of the chunks of pears took the filling to another level. I served it with a melted butter and sage. Two people liked that sauce, on the other hand my Italian friend was not thrilled with it. As foodies do, we discussed the shortcomings and decided that the ravioli was great but the sauce should have been a mixture of cream seasoned with salt and pepper and olive oil, with maybe some chopped, toasted walnuts on top.

I ate one of the spinach ravioli and one of the pear to see how they were; that was my lunch.
So you see that you can cook interesting exciting foods and serve them to friends, without the overwhelming need to eat them yourself. I think that my experience making pasta was a success and as I learned this new skill I was able to enjoy the process, have others enjoy the results and still keep focused on why I had my surgery in the first place.

From central Italy, the land of a thousand pastas and as many sauces, I bid you good cooking.

Monday, October 26, 2009

Regaining the weight so dearly lost

There is a strong perception out there that people who have bariatric surgery will often regain the weight they lost. It seems that individuals that I talk to about my experience have stories of friends or acquaintances who had the surgery and then regained the weight. I have several of those stories myself. It seems like there are fewer stories about long term successes. A nurse friend said that while the surgery works for some, most people will regain weight and that is why insurance doesn’t often cover the procedures. I would like to discuss in this entry the possible reasons for weight loss failure including the surgical procedure itself, pre- and post –surgical counseling and support, and the emotional side of eating.

The surgical procedures

There are generally four basic surgical procedures available for bariatric patients. There are some significant variations between the surgical procedures, and are based upon individual surgeon’s preferences. The general procedures are all are based upon one basic principle. That is the restriction of food input. How that is accomplished varies with the procedure selected by the surgeon.

The general procedures are the Lap Band, vertical gastrectomy, Roux en Y gastric bypass, and the duodenal switch. The procedures are either mechanical (Lap Band and the vertical gastrectomy) or what I call mechanical/physiological (Roux en Y gastric bypass, and the duodenal switch). Mechanical surgery rather simply reduces the physical capacity of the stomach and restricts the volume of food that can be ingested at one time. The Roux en Y gastric bypass and the duodenal switch are more complex procedures that reroute the movement of food from the esophagus directly into the intestinal tract, and while providing restricted eating also alter the actual physiological processing of the food in the digestive tract where almost all digestion actually takes place.

For the insertion of the Lap Band a small tunnel is made behind the top of the stomach to let the device through and allow it to be wrapped around the upper part of the stomach, like a wristwatch. It is then locked securely in a ring around the stomach. This creates your new, smaller stomach pouch. The rest of the lower stomach will stay in its normal position. A small access port, which is used for band adjustments, is fixed just underneath the skin. The access port is used by the surgeon to inject saline (sterile salt water) into the band when you have an adjustment.

The Duodenal Switch procedure is also called the vertical gastrectomy with duodenal switch, biliopancreatic diversion with duodenal switch, DS or BPD-DS. It generates weight loss by restricting the amount of food that can be eaten (removal of stomach or vertical gastrectomy) and by limiting the amount of food that is absorbed into the body (intestinal bypass or duodenal switch). It is more controversial because it has a significant component of malabsorption (bypass of the intestinal tract), which seems to augment and help maintain long-term weight loss. Of the procedures that are currently performed for the treatment of obesity, it seems to be the most powerful and effective, but may also have more complications associated with it. Most surgeons do not perform this procedure because of the overall concerns about the long term effects of malabsorption.

In the Vertical Gastrectomy (VG) the stomach is divided vertically and more than 85% of it is removed through the small incision in the abdominal wall. This procedure is not reversible. The stomach that remains is shaped like a banana and measures from about 4-7 ounces (120-250cc) in volume depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume. In the Roux-en-Y gastric bypass, the stomach is divided, but not removed, and the pylorus is excluded. The esophagus and a portion of the stomach muscle are then connected to the lower part of the duodenum (first section of the small intestines). The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary as can the Lap Band.

The Roux-en-Y gastric bypass has minimal malabsorption compared to the Duodenal Switch. The design of the duodenal switch was done to reduce the adsorption of nutrients through the intestinal wall and into the body. It was part of the procedure and drives a significant part of the weight loss regimen.

As with any surgery, bariatric surgery does carry some inherent risks and potential complications. These can include: Deep vein thrombophlebitis 0.7%; Non-fatal pulmonary embolus 0.5%; Pneumonia 0.5%; Acute respiratory distress syndrome 0.25%; Splenectomy 0.9%; Gastric leak and fistula 2.0%; Duodenal leak 1.5%; Distal Roux-en-Y leak 0.25%; Postoperative bleeding 0.5%; Duodenal stomal obstruction 0.75%; Small bowel obstruction 2.0%; and possibly death 1.0%. (Surgical risk data from Laparoscopy Associates of San Francisco website LAPSF.com)

Pre-surgical evaluation and support

As part of the pre-operative workup, most patients are required to have a psychological evaluation with a counselor. I believe the need for this evaluation is relatively evident and very significant. The discussion should revolve around the reasons for the weight gain, the time frames, factors influencing it, thinking about the surgery as an option, alternatives to surgery, and the question of what happens next. Frankly the most important part was the analysis of the factors influencing the weight gain. These include emotional eating, compulsive over-eating or other eating disorders, lack of self-esteem or social factors, genetic tendencies, and hormonal imbalances. It is very important to be very honest with the analyst in evaluating the potential for surgery. This is not a frivolous venture and in general is a one way ticket. Do not think of bariatric surgery as just a stop gap procedure to help you lose weight and then you can have it reversed and go back to a normal eating habit. You really can’t go back. The habits and mechanisms that got you to gain weight are likely still there.

During the psychological evaluation the counselor will be assessing a number of elements and trying to determine the answers to these questions:
What is your drug use?
What is your alcohol use?
Do you have untreated depression?
Do you have suicidal tendencies?
Do you have any eating disorders?
Do you understand the surgery and the needed lifestyle changes?
What is your ability to make lifestyle changes?
Can you follow and comply with the dietary demands?
Will you follow the exercise regimen?
Do you understand the importance for post-operative follow-up?
Can the surgeon rely on you to follow their directions?
Do you understand that not following the directions puts you at risk?
Do you have unrealistic expectations about what will happen?
Do you have adequate support in your social circle and at home?

Post Surgery follow-up and support

Many successful gastric bypass weight loss surgery patients say that their support network helped them immensely in maintaining their new healthy lifestyle changes. From family and friends to bariatric program support groups, there are options available for people interested in gastric bypass surgery and for dealing with the rapid weight loss that follows.

Talking to your family and friends about weight loss surgery and your interest in it is very important. They are most often highly supportive; however there are times when they may not be supportive of your decision. They are likely concerned that you might have unrealistic expectations about the outcome, or you will regain the weight lost, or there are risks that they fear. Speak frankly about your feelings, show them the data, and help them understand that while the process is designed to promote better health for you, they will reap the benefits of you being around with them for a longer time. They may also have preconceived notions about weight loss surgery.

If you find that they are unsupportive, it doesn’t mean you are alone. It is important that you follow the path that you decide upon. Many people have had weight loss surgery and have been very successful with the care they received from those outside their normal circle of family and friends. This is your decision and your life. You need to feel comfortable with the decision, understand the potential outcomes, and be willing to work toward a successful outcome.

Weight loss surgery support groups are an excellent resource of weight loss information and support. You’ll find people who share your goals of health and wellness. A support group is a forum for celebrating successes, such as the your weight loss and resolution of health issues. The support group is for people who have common experiences, who can share their feelings in a safe environment, and develop relationships that can contribute to improved physical and emotional health after their weight loss surgeries.

If you are thinking about weight loss surgery, and you want to learn more about the patient’s perspective or help reluctant family and friends to understand, attending a support group meeting can be invaluable.

Reasons for regaining weight

The most significant issue for post surgical patients is to maintain their weight loss, maintain their health and maintain their sense of “why I did this in the first place”. Regaining weight can be due to emotional eating, compulsions, or the simple fact that if you can eat a bit more after awhile (the stomach stretches a bit and accommodates more food), you will. Be careful and keep in mind that while you can stretch the pocket or the pouch to accomodate more food, should you?

People who snack or eat without thinking because they feel depressed, anxious, or afraid are more likely to regain weight than people who may occasionally overeat because of external factors. External factors include the holiday eating season (such as Thanksgiving and Christmas) and celebrations with family and friends. If you concentrate on the dietary requirements for your continued weight loss and then its maintenance the potential to regain is lessened.

Celebrations and parties, spending time with the family watching a favorite show, cook outs on warm summer evenings are social activities that have long been tied together, and you shouldn’t have to give them up. Eating and events are tied together. However after bariatric surgery and with your new healthy habits, you won’t want to eat as much as you used to and, most likely, you won’t be able to. These social occasions and situations can present challenges.

Sometimes even the most well-meaning family and friends may try to push food on you or may have difficulty supporting you. They may be unaware that certain comments they make or things they do are not supportive. You may get frustrated because a family member continues to bring home high-calorie foods, even though you are trying to avoid them. My advice is to take a bite, it won’t kill you and then explain why you can’t eat more. Ask them to bring other types of foods and offer suggestions. You may be upset because a friend who only knows the myths of bariatric surgery thinks it is the easy way out. That is a hard one to get people to understand. It is not an easy way out, it is a lifestyle change and it is for you, your health and well-being. You may never convince them (particularly if they are slender and have never experienced weight issues). Remember why you did what you did.

So with regard to the potential for regaining weight there are a number of things you need to do or understand:

1. Be sure you fully evaluate the reasons for your weight gain and why you are looking at bariatric surgery as an answer. If a single session with the counselor does not resolve your questions or their questions, do another session or more. Get to the bottom of the issues. Be forthright and honest.

2. Select a surgeon you are comfortable with and discuss all of the positive and negative aspects of the surgery, the weight loss potential, other health effects AND the potential to regain the weight. They have the most current data on the successes of the different surgeries and you need to be sure they discuss the known and potentially unknown outcomes and issues with you. Do not be frightened by the risks. Going out to the car and driving to work carries risks. But you need to know the risks.

3. Follow the post operative “rules” to ensure that your weight loss gets off to a good start. It will be amazingly fast at first and you will marvel at the rapid results. But be patient and things actually will get even better. Do not overeat. You need to relearn how to eat and how you feel as the stomach fills and empties. Try to eat to within one bite of full and then stop.

4. Go to group sessions if you feel the need to get that additional support. Your doctor will provide you with locations and times. If you need help with questions ask them, either to your doctor or in the group. If you are still a bit conflicted about the psychological component go seek additional counsel. This is for you and you alone. You have set yourself on this path and you need to be disciplined in its journey.

5. As you move along on your weight loss, add bits of new tastes or maybe old ones you would like to try again. Do not be afraid to taste, just don’t overeat.

And oh yes, do drink plenty of water. Mangia!!!

Saturday, October 17, 2009

Comfort Foods -1

I am not sure why I am following my post on my weight gain issues with one on comfort foods, but it seems appropriate. Comfort foods are familiar, simple foods that are usually home-cooked or eaten at informal restaurants. They are your Blue-plate specials. They are foods that are often emotionally significant and are sometimes related to pleasant associations of childhood or home. While I have tried to give you the gentle familiarity of comfort food, I have also chosen to enhance the flavors and presentations so that while they are familiar, they are not old or staid. Hopefully they will be a new source of comfort, creating new associations.

I have chosen ground meats for my first group of comfort food recipes. The textural qualities of ground meats can be made quite suitable for the bariatric patient. I personally have found that a grilled plain ground beef patty can be difficult for me to digest (there goes the quarter pound burger) but meatloaf, and other dishes textured with soaked bread crumbs are easier for me to handle. The beauty of those dishes is that they can be made exciting and tasty at the same time as they are soul-satisfying and familiar (sort of).

Neapolitan Meat Loaf

This dish is not just reworked meatballs, although the basic meatloaf mixture can easily be made
into excellent meatballs. Due to its unique stuffing and flavors this loaf combines an earthy comfort food taste with an up-scale presentation. This is NOT your mother’s meatloaf. That is not to say hers wasn’t soul satisfying and comforting, but this is different. Mangia!

For the meat loaf
5 slices white bread, crusts removed
1/3 cup milk
2 pounds lean ground beef
3 eggs
2 cloves garlic, chopped
2 tablespoons freshly grated Parmesan cheese
1/4 cup chopped fresh parsley
1/2 teaspoon salt
1/4 pound cooked ham, thinly sliced
1/4 pound fresh mozzarella cheese, sliced
1/3 cup olive oil
1/4 cup white wine

For the omelet
2 eggs
1 teaspoon water
1 tablespoon butter


Preheat the oven to 375 degrees F.

To make the meat loaf
In a large bowl, soak the bread in the milk. Add the ground beef and mix together. Add the eggs, garlic, Parmesan cheese, parsley, and salt. Mix everything together. On a damp cloth or on a lightly buttered piece of aluminum foil, roll or pat the mixture into a large rectangle, approximately 8 x 10 inches and 1-inch thick. Place the ham slices down the middle of the rectangle of meat, then lay the mozzarella cheese on top of the ham. Set aside.

To prepare the omelet
In a small bowl, beat together the eggs and the water. In a 10-inch skillet over medium-low heat, melt the butter. Add the eggs, tilting the pan to coat evenly. Turn the omelet over and cook the second side. Turn the omelet out of the pan on top of the mozzarella cheese that is on the rectangle of meat.

Using the damp cloth or foil, roll the meat loaf into a cylinder. Seal the seam by pressing it together gently with your fingers.

Into a large baking pan, place the olive oil, then put the meat loaf into the baking pan and gently roll it in the olive oil. Sprinkle the meat loaf with the white wine. Bake in the oven for 50 minutes Remove the meat loaf from the oven and allow it to rest for 10 minutes before slicing.

Meatloaf with Roasted Tomato Relish and Roasted Garlic Mashed Potatoes

This dish is a delicious comfort food, but with an interesting twist. It is the loaf shown in the picture at the start of this entry. In this recipe, although we do not pour the relish over the meat when cooking, you can prepare it that way if you (or your guests) prefer. You can also incorporate ½ cup of the relish directly into the meat mixture. The idea of preparing the meatloaf with the bacon on top is because picking the bacon off before eating the meatloaf is a bit decadent and quite yummy. The shape of the loaf will determine the exact baking time; and if you wish, you can reduce the baking time by forming the meatloaf into 4 individual loaves.


For the Relish:
8 medium sized, ripe tomatoes, cored and cut in half lengthwise
1 onion cut in half
1 jalapeno Chile, cut in half lengthwise and seeded (the Jalapeno is a good addition but can be replaced by a bit of Tabasco sauce if less heat is desired)
1 head garlic
3/4 cup vegetable stock
2 tablespoons extra virgin olive oil
2 teaspoons chopped parsley
1 teaspoon chopped oregano
1/4 teaspoon chopped rosemary
1/2 teaspoon chopped thyme

For the Meatloaf
1 cup fresh bread crumbs
1/4 cup milk
1 tablespoon olive oil
1 onion, diced
2 garlic cloves, minced
1 red bell pepper, roasted, peeled, seeded, and diced
1 1/2 pounds lean high-quality ground beef
2 eggs, beaten
/2 cup prepared barbecue sauce
1/4 cup tomato ketchup
2 teaspoons Worcestershire sauce
1/4 cup chopped parsley
1 tablespoon chopped oregano
1 teaspoon chopped rosemary
1 teaspoon dried red pepper flakes
6 slices bacon


For the relish
Preheat the oven to 350 degrees F. To prepare the relish, place the tomatoes, onion, and jalapeno (or not) cut side down on an oiled baking sheet, add the whole head of garlic, and roast in the oven about 1 hour, or until the tomatoes begin to blacken and the onion is soft. Remove four garlic cloves from the head of garlic and squeeze out the pulp; reserve the remaining roasted garlic for the mashed potatoes. Puree the tomatoes, onion, jalapeno (or ¼ teaspoon Tabasco Sauce), and squeezed garlic pulp in a food processor or blender for 2 or 3 minutes, or until smooth, adding about 1/4 cup of the stock if necessary to make pureeing easier. Heat the olive in a sauce pan, add the pureed vegetables, remaining vegetable stock, parsley, oregano, rosemary, and thyme, and cook over medium heat until reduced slightly and thick enough to coat the back of a spoon, about 20 minutes. For an interesting variation, add 3-4 tablespoons of vinegar to the relish and a bit of sugar and make it have a little sweet and sour flavor. Be sure to taste the relish to find what flavor combination you prefer. Season with salt and pepper. Reheat the relish just before serving.

For the meatloaf
Preheat the oven to 350 degrees F. To prepare the meatloaf, soak the bread crumbs in the milk, and then squeeze out and discard the liquid. Heat the olive oil in a small saucepan and sauté the onion over medium heat until softened, about 5 minutes. Add the garlic and sauté for 2 to 3 minutes longer. Transfer to a large mixing bowl and let cool. Add the bread crumbs, bell pepper, beef, eggs, barbecue sauce, ketchup, Worcestershire sauce, parsley, oregano, rosemary, and pepper flakes, and season with salt and pepper. You can add a ½ cup of the relish here to add a bit of a different flavor. Mix gently to combine but do not overwork the meat, as it will become tough. Form the mixture into a loaf and place on an oiled baking sheet. Cover the top of the meatloaf with the bacon slices and bake in the oven for about 1 hour, or until the meatloaf is no longer pink inside and the internal temperature reaches 160 degrees F. Note that the internal temperature of the meatloaf will continue to rise by 5 to 10 degrees F after it has been removed from the oven.

For the mashed potatoes
About 30 minutes before serving, prepare the mashed potatoes from your favorite recipe. Squeeze the roasted garlic from the reserved cloves and mash into the potatoes.
Season the potatoes with salt and pepper to taste, and serve immediately.
Carefully transfer the meatloaf to a warm serving platter.
Spoon the warm relish around the meatloaf and serve the mashed potatoes on the side.

For the bariatric patient, remember to limit your intake of these tasty potatoes so that you have room for the meatloaf and relish.

Albondigas (Meatballs in Garlic-Tomato Sauce)

Albondigas are classic small bites served in a tapas bar. Try to cook these little meatballs just so they are done and not too hard. I have found that overcooked ground meat is difficult for me to digest and I try to cook these until just done. I then put them in the sauce for 10-15 minutes to allow them to absorb the garlic and tomato flavors as well as soften a bit more.

For the Meatballs:
1 large onion, chopped fine
1 large green bell pepper, chopped fine
1/4 cup plus 2 tablespoons olive oil
2 pounds ground beef (not lean)
1/2 pound ground pork (not lean)
2/3 cup fine dry bread crumbs
2 1/2 teaspoons salt
1/4 teaspoon freshly grated nutmeg
1/4 cup minced fresh parsley leaves

In a 9-inch heavy well-seasoned skillet (preferably cast-iron) cook onion and bell pepper in 2 tablespoons oil over moderately low heat, stirring occasionally, until softened. Cool mixture. In a large bowl combine well onion mixture, ground meat, bread crumbs, salt, nutmeg, and parsley. Form tablespoons of mixture into small balls. In a skillet heat 1 tablespoon vegetable oil over moderately high heat until hot but not smoking and brown meatballs in batches, shaking skillet frequently so that meatballs maintain their shape Adding additional oil as necessary. Transfer meatballs with a slotted spoon as browned to a bowl. Serve with the garlicky tomato sauce poured over the meatballs.

Garlic-Tomato Sauce:
4 large garlic cloves, minced
1 tablespoon olive oil
1 (33 1/2-ounce) can whole tomatoes, including juice
3/4 teaspoon dried oregano, crumbled

Mix all of the ingredients together in a food processor and pulse to combine to a smooth consistency. Place in a sauce pan and cook over medium heat for 10-15 minutes. Serve over the Albondigas.

Lamb Meatballs in Almond Sauce

This is a classic ground meat dish with Spanish, northern African and middle eastern influences. It is often served in tapas bars in Spain as part of an afternoon repast.

2 slices fresh white bread, torn into small pieces
3 Tablespoons red wine
1 1/2 pounds ground lamb
1 large egg, lightly beaten
2 garlic cloves, chopped
11/2 tablespoons chopped fresh parsley
1 teaspoon salt
1/2 teaspoon freshly ground black pepper
1 teaspoon mixture of equal parts paprika, garlic powder and onion powder
1/2 cup all-purpose flour
1/4 cup plus 2 tablespoons olive oil
1 1/2 cups diced red onions
1/2 cup dry white wine
3/4 cup chicken stock
6 tablespoons slivered, blanched almonds
1 large garlic clove
1 tablespoon roughly chopped fresh mint leaves

Place bread pieces in a small bowl and drizzle with the red wine. Allow bread mixture to stand for 5 minutes to soften. In a large bowl, combine the lamb, egg, chopped garlic, parsley, and moistened bread. Season with salt, pepper, and the paprika mixture. Roll meat into small bite size balls, about 1 tablespoon each (about 1” in diameter). Cover and refrigerate for 30 minutes or up to overnight.

Place the flour in a small bowl; and then working in batches, dredge the meatballs in the flour. Shake off any excess flour.

Pour 1/4 cup olive oil into a large saute pan with straight sides and heat the oil until almost smoking over high heat. Add the meatballs, in batches, and fry until well browned, gently rolling to brown all sides, about 4 minutes per batch. Remove the meatballs with a slotted spoon and drain on a paper towel-lined plate. Repeat with remaining batches.

Wipe the pan clean and add the remaining 2 tablespoons of olive oil. Place over medium-high heat and, when hot, add the onions. Cook until softened, about 3 minutes. Add the white wine and chicken stock and bring to a boil. Add the reserved meatballs and cover. Reduce the heat to a simmer and cook, covered, for 1 hour and 15 minutes.

While the meatballs are cooking, combine the almonds, garlic clove, and mint in a food processor and pulse until a finely ground paste is formed. Set aside. When the meatballs are tender, uncover and add the almond paste to the broth. Stir to combine and remove from the heat.

To serve, place several meatballs in a small dish and spoon some of the sauce over the tops. Serve with toothpicks or small forks.

Chicken Sausages

I used to make this recipe for my family on Sundays instead of fried or roasted chicken. My granddaughters loved the spicy flavors as well as the apple bits inside. I made a sweet and sour sauce to pour over the patty or if they wanted a sandwich to spread on the bun. I used regular hamburger buns and made up some French fries to go along with the sandwich. Serve the chicken patties with French fries, rice, or macaroni and cheese for the family or friends. The carbohydrates should be only a taste for the bariatric patient. Focus on the meat!

1 ½ pounds of boneless chicken breasts or thighs
Salt and pepper
1 onion chopped in coarse dice
I apple peeled, cored and chopped in medium dice
¼ teaspoon garlic powder and onion powder
¼ teaspoon Tabasco sauce (more if you like a bit spicier)
2 slices fresh white bread, torn into small pieces and soaked in milk to soften

Cut chicken into 1" pieces and place in a food processor.
Pulse the chicken until it is a coarse consistency (8-10 times)
Add ¼ teaspoon salt and ½ teaspoon ground black pepper
Add the chopped onions
Add the garlic and onion powder
Pulse to mix thoroughly (2-3 times)
Squeeze the milk out of the bread and add the bread to the processor
Pulse for 5-10 seconds to combine.
Add the chopped apple and pulse again 2-3 times to incorporate.
Remove chicken mixture to a bowl and refrigerate for 1 hour.

Make into patties about 4 ounces in size.
Dredge the patties in seasoned flour and shake off excess.
In a 9-10 inch saute pan, fry the patties in vegetable oil until brown (4-6 minutes per side).
Place on a heat-proof tray and into the oven at 300 degrees F to keep warm.
Serve with sweet and sour sauce

Sweet and sour sauce
This sauce is a useful one and can be used in a wide variety of applications.

1 large can of pineapple in natural juice, drained and reserve juice

Cut up pineapple into bite sized pieces
1 small onion, chopped and diced fine
½ green Bell pepper, diced into medium ½” pieces
½ Cup ketchup
¼ Cup apple cider vinegar
Sugar (to taste)
1 teaspoon cornstarch or flour in 1 cup water

Place pineapple juice in a medium sauce pan and add onions and Bell pepper
Cook for on medium to high heat for 5 minutes
Add ketchup and vinegar
Add the reserved pineapple, broken into pieces
Taste for sweet and sour balance.
You may need to add some sugar here to counteract the vinegar.
With the sauce simmering gently, add a couple of tablespoons of the cornstarch (flour) mixture
Stir as the sauce thickens.
Keep warm before serving.

Sweet and sour sauce often needs a individual preferential balance between the sweet and the sour, so taste it and
make it to your own preferences

Monday, October 12, 2009

Personal notes about my weight

It’s time for me to talk about my weight. I first became conscious about my weight in 1961. I fell out of my Dad’s car on to the pavement and broke my collarbone. The doctor put me in a cast and after a teenage life full of activity; I was required to not be active. I did however continue to eat. I went from 135 pound to 165 pounds by the time I had the cast removed after one month. There I was in my sophomore year and had gained 30 pounds in a month. I began playing golf that February and the walking daily helped some but I didn’t lose any weight.

Things were never the same after that. I slowly but steadily gained weight all through High School until I weighed 190 pounds in my senior year. I was still in pretty good physical condition, but the weight was starting to affect me, and also affect how others saw me. I spent the summer after graduation working at summer camp and was being quite physically active. I was running and swimming every day.

In September 1963 I decided to go into the US Coast Guard and went to Boot Camp at Base Alameda on September 9th 1963. I weighed about 190 pounds and was very physically fit. I was strong and fast and quite ready to meet the physical requirements that would be placed on me for those 12 weeks of intense physical and mental activity. In that first week, I had to go in for the entrance physical and the doctors wanted to toss me out for being obese. I was 5’7” and weighed 190 pounds. On the weight chart, of course I was obese. I convinced them to allow me to go to the fifth week PE test and if I passed it I could stay in. My company commander, Clem Meredith, made sure that I was VERY physically active and I passed the test easily.

By the time I got out of boot camp I weighed about 175 and was in top physical condition. As I settled in to my more mundane existence at the Base, I started to gain back some of those pounds I had lost. The diet at the Base was fairly high in carbohydrates, and also included high levels of fried foods, as well as fruits, and vegetables (poorly cooked I might add). I was fairly active and stayed in good condition with regular physical training and swimming.

In May 1964 I was transferred to Dental Technician School in San Diego to train for four months. It was summer in San Diego and I spent a lot of time surfing and swimming in the ocean. None of us had cars, so we walked everywhere and that was a plus. We played a lot of volleyball as well. And it was jungle rules, so it was very physical. I stayed pretty much around 195 pounds during this period and things were fine.

In the fall of 1964, I finished DentalTech school and was transferred to the USCG Base in Curtis Bay Maryland near Baltimore. I worked in the dental clinic and every afternoon either played football or softball. Again there was a slight increase in weight to about 200 pounds but I was eating well and was active. I didn’t see the weight as a problem. In the spring of 1965, I was tired of staying on the Base and decided to go into Baltimore most evenings. I started to go dancing at the USO and spent 2-3 hours almost every day dancing vigorously to the rock and roll of the day. I was a good dancer and made a number of friends at the USO in that year. I stayed around 200 pounds during that time. My uniform fit me well and I looked pretty good in civilian clothes.

In December 1965 I met my wife to be. Sandi liked who I was and what I looked like. She was slender and pretty and full of crazy life. We married in July 1966 and moved to Baltimore to our first apartment. I weighed about 210 pounds. Slowly over the first year of marriage, we both gained weight. We didn’t have much money and our diet was dominated by carbohydrates and coupled with a lowered activity level, the pounds started quietly adding on.

I started college in September 1967 at Cal Poly in Biological Sciences. I studied a lot to ensure that I would be able to get through. I also didn’t have too many physical activities outside of the home. Gradually I went up to 225 pounds. I felt a bit loggy but generally fine. But people did comment.

Through graduate school in San Diego and at UC Davis, the weight slowly accumulated. And by the end of the 1970s I was well up into the 200’s. Again it appeared that the combination of calories in and calories out were not matching and thermodynamics were at work. I tried dieting and was successful, as most overweight people are, for short periods of time.

We moved into Tustin, California in the summer of 1982 and I began working for an environmental consulting company. I had slowly but inexorably kept gaining and was now up to 250 pounds. I was not able to do things as I used to and was diagnosed in 1985 with Type 2 diabetes. Control was with pills and diet but that did not stop the slow increase in weight over time. Coupled with my elevated blood pressure, my health was not on a good path.

In 1987 we moved to northern California and the kids started middle and high school, and Sandi and I began a new career running an environmental testing laboratory. I was being required to do a lot of physical work including field work, carrying heavy materials, and doing construction. I felt that I was pretty fit, though in reality I was not. As business increased through 1991 my physical activities decreased as I had staff doing a lot of the heavy work. My weight had gone up to 270 pounds and it was pretty stable there. My diabetes now required heavier medications. Blood sugar control was still difficult and my blood pressure was up in problematical ranges.

In 1993 I began seeing a nutritionist about my diabetes and nutritional control. At one point she told me I could take as much insulin as I needed to get satisfactory control over my blood sugar levels. I began giving myself approximately 300 units or more of insulin daily. Over a period of two months I put on about 30 pounds, going from 280 to 310 pounds. I finally realized that the excess insulin was acting like an anabolic steroid and causing the weight gain. That weight did not come off quickly.

I didn’t feel that my weight was a hindrance to me in business or to my health. I was probably right about the business, but certainly wrong about the health. Sandi was diagnosed with stage 4 pancreatic cancer in late 2004 and died on Valentine’s Day in 2005. Due to the problems my wife had with her bariatric surgery I was not particularly enamoured with having surgery for weight loss.

I reconnected with my future wife Elizabeth on a trip to Italy in the fall of 2005. I had begun having some minor chest pains on exertion. I had a stress EKG in 2006 and had a minor heart attack in the hallway of the hospital, and I quickly realized that things had to change. had a double bypass surgery plus a new laser treatment. My diet was already improved and my cholesterol was excellent. The contributions of the combined risk factors of diabetes, high blood pressure, and cholesterol are what likely caused the attack. Within three months I had gone back to work. I was still at 300 pounds but I felt a lot better and the chest pains had stopped. But I knew that was likely only temporary. There were things that still needed to be done.

Elizabeth and I were married in March of 2008 and while she was very pretty, I looked like an overweight Mafia don. Shortly after the wedding, we watched a 60 Minutes segment on bariatric surgery where all of the patients were also diabetic. The surgery and resulting weight loss apparently eliminated their demand for medications or insulin. As I thought about that, I realized that the long term effects of the diabetes were certainly more problematical than just the weight, but they were interactive and the whole body was involved in the problem. A friend of ours had the bariatric surgery called a vertical gastrectomy in November 2007 and was down about 70 pounds by March 2008 when he took the pictures at our wedding. We had discussed his surgery and I decided to go see his surgeon about possibly me doing the same thing.

In May 2008, I met with my surgeon at our first meeting and spent a lengthy amount of time discussing the various surgical options. He felt that I would be a good candidate for the gastrectomy surgery and gave me about a 92% chance of getting off insulin. At that point, I decided to go forward with the surgery. Since my insurance wouldn’t pay for the surgery, I was required to come up with the money myself. The preoperative process included: endoscopy/colonoscopy, x-rays, blood tests and a psychological evaluation. I had one month to get all this done before my scheduled surgery on June 4, 2008.

On the evening of June 3rd, I took my last long-lasting insulin shot. The next morning my son drove me to the hospital at 10 AM. At 1:30PM, after pre-op meds, I walked into surgery. The surgery took about an hour and a half, and was done using laparoscopic techniques. I awoke at 4PM and was put in a private room. I had ice chips that night, but the next morning, I was offered a high protein liquid breakfast. This was certainly a lot different than in 1981. After a liquid lunch, I was discharged and drove home with the convertible top down. It was certainly a new day.

Over the next few weeks I was kept on a liquid high protein diet. When I went into the hospital I had gone from 300 pounds at out first surgical meeting in May to 292. I began losing weight at an initial rate of 20-30 pounds per month. This lasted for 2 months. I had no pain or discomfort and I felt fine. My blood sugar levels dropped steadily after the surgery with no insulin intervention. My blood pressure was still a bit high but all of my doctors felt that it would come down over time.

The reason I had the surgery was first and foremost to try to eliminate the diabetes. I wasn’t as concerned about how I would look, but more about how I would feel and be health-wise. As I have lost the weight, I have also been able to feel better about how I look. But I am still happier about how I feel. I am now down to 165 pounds. The loss has been 135 pounds since May 2008. I am able to walk for extended periods of time as well as ride the stationary bike for a hour or more. Recently I pushed a wheelbarrow full of 110 pounds of fertilizer up a hill for 100 yards without any discomfort. The net benefits have been increased vitality, decreased fasting blood sugar (now in the normal range), and decreased blood pressure. I am restricted to approximately 8-9 bites per meal and I eat three meals per day. A number of people have expressed concern that I might lose too much weight, but at this point I can adjust my diet by increasing caloric intake to maintain my current weight. I have been steady at 165 pounds since June 2009.

Over the last year I have been acutely aware of how people who have had bariatric surgery deal with their weight loss and in some cases regain the weight. Several of the surgical options tend to leave a bit too much stomach muscle available which can stretch and accommodate potential overeating. I think it is important to understand why you are overweight. If it is because of psychological factors, these should be addressed before you have the surgery. You are truly changing your life and need to clearly understand how that process will transpire. Having lived with Sandi for 24 years after her surgery I found that I understood the problems and processes better than most, and when I decided I was ready, I was ready.

I know that my life has changed for the better. I moved full time to Italy in August 2008. I am no longer taking insulin, and am exercising daily. Extra weight is not just a state of mind. It is neither healthy nor attractive. While society frowns on overweight people, a very large percentage of us are overweight (50-60% in the US). It is very important to understand the health implications of the weight. Acceptance of the weight can be a false acceptance of yourself and it will ultimately affect your long term health. Having been on that side of the fence for so many years and seeing and feeling the real or imagined disapproval, I finally realized that I needed to do this for me. Not for how the public perceived me or how attractive I may become, but for my own survival and the new life I now lead.

Tuesday, October 6, 2009

Foodies, chefs and cookbook authors

This evening I am preparing to serve dinner to 10 folks who represent all of the above title categories. Several are professional chefs, several have written cookbooks, and all just like to eat interesting food.

We know what a chef is and what cook book authors do, but what is a Foodie? Definition of a Foodie: Although the two terms are sometimes used interchangeably, foodies differ from gourmets in that gourmets are epicures of refined taste who may or may not be professionals in the food industry, whereas foodies are generally (but not always) enthusiastic amateurs who simply love food for consumption, study, preparation, and news. They read the publications, try the recipes, and enjoy discussing all things food with other foodies. Gourmets simply want to eat the best food, whereas foodies want to learn everything about food, both the best and the ordinary, and about the science, industry, and personalities surrounding food. For this reason, foodies are sometimes viewed as obsessively interested in all things culinary. I don't think that is totally true. I think they have decided that food is interesting and worthy of appreciation at an intellectual level higher that just nutritional maintenance.

So what do you feed chefs, cookbook authors and sundry foodies? I realized that one of my strengths is in the preparation of antipasti. Those small bits and bites of interesting foods that stimulate the taste buds and prepare you for the meal. For those of us who have had bariatric surgery, the antipasti can often make a meal. So considering that culinary element, I selected four different antipasti to start the meal. Two are served on crostini or bruschetta (bread carriers) and two are served without additional carbohydrates. A combination of the four can provide you with four very different tastes as well as provide adequate protein for the bariatric patient.

So let's start. The first antipasti was Baccala with potatoes. Baccala is salted cod from Europe where salting and drying the cod is a staple preservation method. The salt cod is soaked for a couple of days in successive changes of freshwater until the salt has been removed and the fish has rehydrated and it is then cooked like a fresh piece of fish. In this recipe, I poached the fish in a court bouillion of sliced onions and water with a bit of salt added. The fish had already been de-salted when I bought it. I poached the fish until it started to flake apart, about 25 minutes and removed it from the poaching liquid to cool.
I then put four peeled new potatoes cut into segments into the poaching liquid along with a chopped medium onion and four smashed cloves of garlic and cooked the potatoes until they were done. A sharp knife should insert easily into the potato. The potatoes were drained along with the onion and garlic into a sieve and then mashed coarsely in a bowl. The fish was flaked and checked for bones (there were some, so do check) and then stirred gently into the potatoes. A 1/4 cup of chopped parsley was added along with 1/4 cup of grated Parmesano Reggiano cheese.

To serve, I put the potato mixture in a ramekin and into the oven at 325 degrees F to warm. I grilled some french bread slices, rubbed with olive oil and garlic, in a grill pan on one side only. Serve a portion of the warm potato mixture with a couple of the bruschetta.

The second antipasti was truly a finger-food, Tomatoes with mozzarella. Cherry tomatoes are sliced in half, marinated in olive oil , oregano and basil, then dried in the oven at around 300 degrees F. Put them in the oven for about 45 minutes, then turn the oven off and leave the tomatoes in the oven over night. The next morning they should be soft but with a wonderful smoky flavor. Buy some fresh mozzarella balls, and slice them into thick slices, then into pieces about 1" square. From a small mozzarella ball you should get 12-14 pieces. Put the cheese in a bowl with a bit of olive oil, some of the dried basil and oregano, and a sprinkle of salt and pepper. Allow to sit out for a hour or in the refrigerator overnight. When ready to set up the tray, take a loaf of French bread and slice in half horizontally. With a toothpick, stick through a tomato half and then through a piece of mozzarella. Stick the toothpick into the loaf of bread. Fill the bread loaf with the colorful pieces and serve. Give the guests something to put their toothpicks in.

The third antipasti was a crostini with peperoni agrodolce and Strachinno. I use beer bread (the recipe was provided earlier) grilled and spread with Stracchino (a cream cheese) that has been mixed with chopped chives. The crostini is topped with sweet and sour peppers (recipe provided in an earlier post). Cut the crostini into 2-3 pieces for serving.

The fourth dish was small sweet peppers stuffed with a sausage and cheese mixture. This is an excellent appetizer and is served hot, directly from the broiler. Buy 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); 8 oz of cream cheese; 8 oz of Mascarpone cheese (or another 8 oz of cream cheese); and ½ cup grated Parmesan cheese.

Brown the sausage in a saute pan and crumble into very small pieces when done completely and allow to cool. Mix the cheeses together with a hand mixer and add the sausage. Mix thoroughly and set aside to cool. Slice the peppers lengthwise and remove the seeds and ribs then blanch the peppers for 2 minutes in a small pot of boiling water. Remove and place on a rack cut side down to dry. When dry, place the peppers cut side up on a baking sheet.

Turn oven to broil and preheat. Fill the peppers with the sausage/cheese mixture mounding the mixture slightly and place the baking sheet with the peppers under the broiler to brown (1-2 minutes). Remove from oven and place peppers on a serving platter. Serve immediately.

We have now had our fill (and fun) with the antipasti. The rest of the meal awaits.

The first course was ravioli with a pumpkin filling served with butter and sage sauce. The pumpkin filling is made with spices, crushed biscotti and some mashed potatoes for body and texture. The ravioli are very tender and fragile and are cooked gently. They are then placed on a towel to dry a bit and placed in the butter and sage sauce . Serve three ravioli per person with a bit of the sauce and a good sprinkling of Parmesano-Reggiano.

The second or main meat course was BBQ salmon. I take salmon fillets and place them skin side down on a double layer of aluminum foil. I then fold up the edges to make a sort of tray to hold the fish. The topping is a mixture of brown sugar, seasoning salts, paprika, pepper, and some lemon juice and is applied rather thickly to the fish and is allowed to sit for an hour. The fish are placed in their foil tray skin side down on the barbecue grill over medium heat. The fish cook in about 20 minutes and you will know they are done just when a whitish fluid begins to come out of the fish. Remove the fish and place on a serving platter. Squeeze some lemon juice over the cooked fillets and cut the fillet into serving size segments. Pass the lemon.

The vegetable was braised chard with tomatoes. The chard is braised with a lot of chopped garlic until it is tender and then halved cherry tomatoes are added. A dash of wine vinegar and a bit of fresh olive oil, salt and pepper makes a nice dressing.

The dessert is a Zucotta with a berry coulis. The Zucotta is a dome shaped cake that is constructed in a bowl, The bowl is lined with thin cake strips, and then the cake has rum sprinkled on it. It then is placed in the refrigerator to cool. A chocolate ganache is made and is poured into the cake bowl and is smoothed up the sides to create a chocolate layer . The cake is then filled with gelato (chocolate and vanilla), and the bottom of the cake is replaced. The cake goes into the freezer to harden. Serving is done by inverting the cake onto a serving plate, removing the plastic lining covering the cake and dusting it with cocoa powder and some powdered sugar. It is kept frozen until right before serving and was sliced and served with a mixed berry coulis on the side and some whipped cream.

So there is my version of a dinner for foodies, chefs and cookbook authors. It was colorful, tasty, and had some interesting elements. Dinner was filled with conversation, appreciation, toasts, requests for recipes, and a great level of joy. It was a fun evening with nice people. I like this "job".

Sunday, October 4, 2009

I know! More fish.

I have been considering the types of foods that are easier for me to eat lately and found that fish and other seafoods are easy to cook, infinitely modifiable and easy to eat. They fill our need for spicy, or hot, or savory foods and can be made quickly. I know! I know! I am pushing the envelope a bit with the fish recipes, but they meet all my requirements for bariatric eating with high levels of proteins, simple preparation and excellent market choices. One hint, always smell the fish when you buy it. It should NOT smell fishy. If it does don't buy it. Keep it cool on the trip home and rinse the fish and dry it well before using it.

Baked Fish fillets
This basic recipe is a favorite of mine in that I have used many different species of fish and a number of different combinations of moist coatings and dry crumb mixtures and all of them come out great. Do not overcook the fish but it will be easy to tell when it is done as it starts to gently flake apart. Often people who don’t like fish will eat these dishes with gusto.

Fish selection (for four servings)
4- 4 ounces fish fillets (Tilapia, rockfish, perch, halibut, swordfish, bass, redfish or any of the flounder fillets or other white meat fish)
Preheat the oven at 350 degrees


1 cup Ranch dressing
1/2 cup Parmesano Reggiano cheese

2 cups dried bread crumbs or crushed corn flakes
1 pinch salt1 pinch black pepper
½ cup melted butter

If using corn flakes, grind up into crumbs. Mix Parmesan cheese, salt, pepper in with the corn flake or bread crumbs. Roll the fillets in the ranch dressing (both sides). Coat fish with the crumb mix evenly. Place in a baking pan. Drizzle a bit of melted butter over each fillet. Bake for 15 to 17 minutes.

1 cup barbecue sauce (use whatever bottled brand you like)
2 cup crushed barbecue potato chips
1 pinch black pepper
½ cup melted butter

Roll the fillets in the barbecue sauce (both sides). Coat fish with the potato chip crumbs evenly. Place in a baking pan. Sprinkle with pepper. Drizzle a bit of melted butter over each fillet. Bake for 15 to 17 minutes.

1 cup Italian dressing (the bottled brand you like)
1/2 cup Parmesano Reggiano cheese

2 cups dried seasoned Italian bread crumbs
Black pepper
½ cup melted butter

Mix the Parmesan cheese with the bread crumbs. Roll the fillets in the dressing (both sides). Coat fish with the crumb mix evenly. Place in a baking pan. Sprinkle with black pepper. Drizzle a bit of melted butter over each fillet. Bake for 15 to 17 minutes.

lue cheese or Roquefort
1 cup Blue cheese or Roquefort dressing (the bottled brand you like)
2 cups dried seasoned Italian bread crumbs
Black pepper
½ cup melted butter

Roll the fillets in the dressing (both sides). Coat fish with the crumb mix evenly. Place in a baking pan. Sprinkle with black pepper. Drizzle a bit of melted butter over each fillet. Bake for 15 to 17 minutes.

This recipe can be made with a wide variety of dressings and coatings, but is always received well at the table. Use your imagination to create new combinations. The fish market now has many species of fish fillets that are appropriate for this dish. However salmon, trout, and other species of oily fish may not be appropriate for this method.

I really like the barbecue sauce version. Its spicy (use a hot barbecue sauce) and when served with baked beans, coleslaw and some corn bread makes a great southern dinner. Of course I can't eat too much of the beans, coleslaw, or cornbread but a bite or two provides me what I need, my eight bites.

Saturday, October 3, 2009

Friends for dinner

Last night I cooked dinner for ten friends and made a really good selection of menu items. They were all suitable for me as well as tasty and portion-controlled for the guests.

Two of the three antipasti were perfectly suitable for the bariatric eater. The first was a salmon crostini that I have described in an earlier blog, with spiced cream cheese spread on grilled beer bread flavored with cheese, some shredded smoked salmon and a topping of citrus (lemon and lime) marmalatta. It had a combination of the creamy cheese with chives, the silky, smoked salmon, and the slight sweetness of the marmalatta. I put a small 1/2 inch triangle of fresh lemon on top.

The second was a simple dish with oven-dried tomatoes and marinated mozzarella. The cherry tomatoes were sliced in half and placed in a bowl with some good olive oil, dried basil and some dried oregano. They were allowed to marinate for 1/2 hour and then poured out onto a baking sheet. I turned them cut side up and put them in a 350 degree F oven for about a 1/2 hour. Then I turned off the oven and left the tomatoes in the oven overnight. They should be a bit leathery but not dried out. Put them in a container and into the refrigerator. Then take a couple of fresh mozzarella and slice them into thick slices and then into segments about an inch square. Place them in bowl with some good olive oil, the herbs and a bit of salt. Cover and put in the refrigerator until ready to assemble. To serve, slice a loaf of french bread (stale) in half horizontally, take a toothpick, spear a tomato half, then a section of mozzarella. Stick the toothpick into the loaf. When you have filled up the loaf you have a neat presentation of very healthy little bites.

The third antipasto was a local Italian favorite of stuffed, deep-fried squash blossoms. The batter is a basic tempura batter, though they use a carbonated water here to make the batter lighter. The squash blossoms are stuffed with a small section of mozzarella, dipped in the batter and fried in vegetable oil (not olive oil) at 375 degrees F. They are then placed on paper towels and salted. Serve these hot. They are actually great for the bariatric diet but they will be quite filling with the batter crust so to accommodate other protein-rich foods, eat only one. That will be hard to do. They are really yummy.

We had handmade pumpkin filled ravioli in a sage butter sauce. It was topped with grated Parmesano Reggiano cheese. We will be doing this one again next week for a large group of food writers and chef visiting us here in Umbria. I hope they like it.

The main course was a scaloppini with a Marsala and lemon sauce, served on warm plates. It was topped with pickled capers and a slice of lemon. The meat was actually thinly sliced Porterhouse steak, pounded to 1/4 inch thickness, seasoned and dusted lightly in a seasoned flour. It was fried very quickly in vegetable oil and butter. When cooked, it was set aside to keep warm. I then made the sauce. Pour out the oil and start the sauce using the brown bits on the bottom of the pan. To make a quick roux, pour the oil and butter from the pan into the dish with the dusting flour and blend. Use a tablespoon or more of the created roux in your sauce. The sauce is an amagamation of butter, lemon juice, Marsala wine and some roux made in the same pan as the meat was cooked. I also added a bit of sugar to cut the sourness of the lemons, but that was a personal choice. Use the juice of 2 or 3 lemons, about a 1/2 cup of Marsala wine and about a cup or more of water . Allow the sauce to cook down by half and thicken. Taste it and adjust seasoning as required. The meat goes back into the sauce to heat through and it is then served on the warm plates. With the meat I served a mixed lettuce salad with pears and walnuts in a light vinaigrette. The meat is totally suitable for the bariatric patient, just use a bit of discretion regarding the size of the piece you select. Stay around 3-4 ounces of meat. The salad may be a bit more problematical, but a few pieces of pear which is dressed in a vinaigrette with some acacia honey can be a nice side dish to the meat.

So there is a dinner I fixed for friends with consideration for portion sizes, ingredients, and suitability to my eating habits. It also turned out the people I was serving enjoyed it as well. That is not so bad. It is important to assess these elements of your diet as you think through the menu. Particularly think about ingredients, portion size and cooking techniques. And invite some friends over for dinner.