Inspiration and Improvisation

The ability to improvise and construct a dish or meal from limited ingredients comes in handy in real life. I do it all the time. It's a skill you must have and must continue to foster. There is currently a show on the Food Network called Chopped. They give four competing chefs a basket of unlikely ingredients and challenge them to compose a tasty dish with them. There are three rounds making antipasti, a main dish and a dessert. After each round, prepared in a very limited time frame, one of the chefs is Chopped and leaves the show. Chefs do not normally cook this way. They Plan. They get ingredients they need, lay out the basic materials and all the while they are thinking about the basic dish. THEN they see if inspiration hits them. Sometimes it’s pretty inane and silly, and sometimes the creative use of the different ingredients can be inspirational. In fact it is even more important that they be inspirational, since much of our culinary lives revolve around fishing around in the freezer for things to feed a hungry family or just ourselves. We can use all the inspiration we can get.


In today’s blog I want to apply some possibly inspirational elements to dishes to change how they taste, and how they appear. I will use a fig jam to create a sauce for simple grilled pork; an interesting way to cook sea bass, a great smoked salmon and crepe antipasti, fettuccini with pesto and scallops, a frittata and more. Take a nice deep cleansing breath and follow your inspiration.

Roasted Pork with Fig Sauce
This is great served with mashed potatoes and some sautéed green beans on the side.
Ingredients
2 pound pork shoulder roast
2 tablespoons vegetable oil
Fine grain salt and freshly ground pepper
2 tablespoon of butter
1 cup of chopped onions
1 cup of fig jam or preserves
3 tablespoons of apple cider vinegar or wine vinegar
2 tablespoons of brown sugar
1/3 cup of chicken stock

Preheat oven to 375 degrees F. Season the pork well with salt and pepper. Heat a large sauté pan over medium high heat. When hot add the oil and brown the pork roast on all sides (about 2 minutes per side). Remove from heat and place in a roasting pan on a wire rack. Roast in the oven to an internal temperature of 150 degrees. Remove and let the meat rest for at least 20 minutes.

Meanwhile, heat the butter in a medium sauté pan until melted. Add the onions and saute until translucent. Add the fig jam to the pan and cook for 2 minutes, until heated well. Add the vinegar, stock and sugar to the same pan. Bring the mixture to a boil and simmer for 4 to 5 minutes until the sauce has reduced and thickened. Keep warm until ready to serve.
Slice the pork and place on a platter. Spoon fig sauce around pork and pour sauce over and around the pork. Serve.

Roasted Sea Bass Filets with Wild mushrooms.
Use any thick white meat fishes for this dish. Striped bass, rockfish, or halibut make a good substitute if sea bass is not available.

Ingredients
Fish Sauce
8 tbsp. extra-virgin olive oil
1 medium yellow onion, peeled and chopped
1 medium carrot, peeled, trimmed, and chopped
1 rib celery, trimmed and chopped
2 bay leaves
1 cup chardonnay or other white wine
1 tbsp. tomato paste
1 tbsp. flour
Salt and freshly ground black pepper
6 oz. chanterelles, porcini or mixed wild mushrooms, cleaned, trimmed, and quartered. (Unless you are an experienced mushroom hunter, buy the mushrooms from the Farmer’s Market or grocery store).

Directions
Preheat oven to 350°.Heat 2 tbsp. of the olive oil in a heavy-bottomed medium roasting pan on top of stove over medium-high heat. Add onions, carrots, celery, bay leaves, and sprigs of parsley and cook, stirring often, until just softened, 3–5 minutes. Add wine and tomato paste and cook, scraping browned bits stuck to bottom of pan, until alcohol evaporates, about 2 minutes. Whisk flour and 2 cups water together in a bowl until smooth, then stir into pan and bring to a boil. Transfer pan to oven and roast until liquid has reduced by about half, 25–30 minutes.

Strain liquid through a large sieve into a medium bowl, pressing on solids with back of spoon (you should have about 1 cup liquid). Discard solids. Put the liquid into jar of blender. With motor running, gradually add 2 tbsp. of the olive oil through hole in top of blender lid, puréeing until sauce is emulsified. Transfer sauce to a small saucepan, season to taste with salt and pepper, and keep warm over lowest heat.

Lightly chop or slice the mushrooms, season with salt and pepper and saute over medium heat in two tablespoons of good olive oil and a tablespoon of butter until done. Set aside and keep warm.
Marinate fish for 15 minutes in a bit of olive oil, dried oregano and black pepper. Grill fish until just opaque. Plate with the tomato wine sauce and a spoonful of mushrooms on top. Garnish with some chopped parsley. Serve with a lemon wedge.


Crepes with smoked salmon, citrus marmalade and cream cheese
Crepes are always a great go-to dish. They are easy to make and are really good with a wide variety of savory or sweet fillings. I make my crepes with only a bit of sugar to provide a hint of sweetness that doesn’t overpower the fillings. I have filled these with a spiced cream cheese with chives, smoked salmon and a dollop of lemon mostarda. The crepes can be made ahead and stored in plastic bags in the refrigerator or freezer. Be sure to put a sheet of paper towel between the crepes to keep them from sticking together. The beauty of crepes is that they can be served hot or cold, sauced or not.

Ingredients
Spiced Cream cheese
8 ounces of cream cheese softened at room temperature.
3 Tablespoons of chopped fresh chives.
1/8 teaspoon of freshly ground black pepper.
½ teaspoon of seasoning salt or sea salt.

Mix cream cheese and seasonings together (use a bit of milk to thin if necessary).
Set aside in the refrigerator until you assemble the crepes.

Purchase 4-8 ounces of good quality smoked salmon or lox.

Make the crepes
1-2 cups of all purpose flour
2 eggs, beaten
2 tablespoon of sugar
½ teaspoon salt
1-2 cups half and half or cream
3 tablespoons melted butter

Mix the flour, eggs, cream or half and half, salt, and sugar together to make a thick creamy batter. This is not pancake batter and should be the consistency of thick cream and should readily pour out of a measuring cup. Add the melted butter and whisk together. Allow to rest for at least 15 minutes to a half hour before cooking.

Cook the crepes in a good heavy non-stick pan. Add some melted butter to the pan and then a ¼ cup of batter. Rotate the pan to evenly spread the batter over the bottom and pour of the excess. Bake the crepe for about a minute until it is golden and then flip over to cook the other side for 30-45 seconds. Place the crepe on a plate and top with a paper towel. Continue to make crepes until the batter is gone.

Assemble the crepes.
Spread a tablespoon of the seasoned cream cheese on the crepe, drizzle with a little lemon mostarda, and then lay in a slice or two of the smoked salmon. Roll the crepe up and slice in into bite sized pieces and place them on a serving platter. Sprinkle the platter with a light sprinkle of chopped chives and chopped parsley.

Lemon mostarda
I make this condiment specifically for use with fish in antipasti. It pairs well with salmon, smoked trout, baccalà and can also be used as an added element to grilled, roasted or other fish preparations.

Ingredients
Two cups of water
1 1/2 cups of sugar
Rind from 5 lemons, peeled with a vegetable peeler and sliced into fine julienne
Juice from the five lemons
Two tablespoons of yellow or black mustard seeds, toasted and crushed
3-4 tablespoons of apple cider vinegar (to taste)

Directions
Bring water and sugar to a rolling boil and boil for 10 minutes
Add grated lemon peel and juice and return to a boil.
Allow to cook at a simmer for 20 minutes or until it reaches 225 degrees on a candy thermometer.
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 fruit mixture
Taste and add 3-4 tablespoons (or more) vinegar (This is my preferred option)
Simmer for 30 minutes
Ladle into washed canning jars (1/4 pint)
Seal and process for 5 minutes in boiling water bath
Remove from the water bath to a rack and allow to cool.


Crostini with apple mostarda and sausage cheese mixture
I have used a beer bread for this crostini. The recipe for beer bread can be found in the Sept 15th 2009 blog entry “Beer Bread and Fish Stew”. Add garlic powder, onion powder, grated Parmesan cheese and a good pinch of dried pepper flakes to the bread mix before you add the beer and mix it. Slices of sourdough bread or other crispy breads can be grilled and used as well.
Ingredients
Make a loaf of beer bread and allow to cool overnight.
½ pound of Italian sausage
½ cup parmesan or Pecorino cheese
1 cup of grated jack cheese

Directions
Make the sausage mixture:
Saute ½ pound of Italian sausage and break into small crumbles
In a bowl, mix the cooked sausage with ½ cup Parmigiano cheese and 1 Cup of grated jack cheese or equivalent. Mix thoroughly and cheese will melt into the sausage. Set aside.

Slice beer bread into 1/2 inch or thinner slices and then crosswise in half. Brush with a mixture of olive oil and crushed garlic. Place on baking sheet in 325 degree F oven and allow to crisp slightly. Or if you have a stovetop grill pan, grill the slices.

Spread a slice of the crostini with apple mostarda.
Top with the sausage/cheese mixture.
Place a small amount of apple mostarda on top.
Place on a baking sheet and heat in 350o F oven until sausage and cheese are hot.
Serve immediately.

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

Ingredients
Three cups of water
2 cups of sugar
Four Granny Smith apples, grated
Three tablespoons of yellow mustard seeds
3-4 tablespoons of apple cider vinegar (optional)

Directions
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 to thicken.
Set aside overnight to steep.
Reheat, and bottle in sterilized jars, seal and process for 5 minutes in boiling water.
Remove from the water bath to a rack.
Allow to cool.

Artichoke, salami and cheese frittata
Frittatas are great for the Eight Bites diet. They can be made using leftovers from the fridge, are easy to make and provide high nutritional value in the form of protein. Use a good non-stick pan to cook the frittata so it comes out of the oven and out of the pan easily. This one uses “off the shelf ingredients to make a quick dinner. It can easily feed two to four and is great served the next day.

Ingredients
1 Cup of sliced marinated artichoke hearts
½ cup diced salami
¾ C mixed grated cheese (Parmesan, provolone, and Asiago)
3-4 beaten eggs with ½ cup milk
1 Tbs butter

Directions
Preheat oven to 350 degrees F.
Put 1 Tbs butter in an ovenproof, non-stick skillet over medium heat.
After the butter melts, add the artichokes and salami.
Add the egg mixture and cook for about a minute until it starts to set.
Lift the edges of the eggs to allow the uncooked eggs to flow underneath.
Sprinkle the cheese on the top of the eggs.
Remove from the stove and place the skillet in the oven.
Allow to cook for 10-12 minutes or until the top is firm.
Serve it warm or allow it to cool to room temperature.
Can be warmed in the oven the next day for brunch.

Farmer's Market

One of the most difficult things about living alone is cooking for one. Packaging of food in the markets is based upon purchasing larger volumes. Buy two and get one free; buy the family pack, or buy the large loaf of bread. It seems like nothing is packaged with the person who has had weight loss surgery in mind. So you have to buy two and get one free, or buy the big family pack of meat and split it up. These deals do save you money, but you must then figure out what to do with the extra food until you can get around to eating it. Recently the supermarket was having a big sale on high quality steaks, (New York cuts) very tender but you had to buy six of them. So I bought a pack and brought them home. Each steak was about 12-14 ounces so I sectioned each one into three or four pieces, wrapped each pieces in plastic wrap, and then put them in a freezer bag. I could take one out of the freezer and allow it to defrost for dinner and I had a tender 3-4 ounce serving. I grilled them quickly to rare in a grill. Dinner was served. Out of that package of steaks, I got 18 meals of high quality protein for approximately $10.

Yesterday I wanted some country style pork ribs, and a family package of four ribs was on sale for $7. So I bought a package. Last night I placed them in a roasting pan, seasoned them with salt and pepper and baked them at 350 degrees for about an hour. I then coated the meat with Hoisin sauce and let them finish. I had about a ½ of one rib for dinner and then put the others in a package for later. I will make a pork burrito with some of the meat for breakfast this morning. The rest will be in reserve for another time soon.

So why is this entry called Farmer’s Market? Here in Santa Rosa, California, there is a large organic foods Farmer’s Market at the Veteran’s Building on Wednesdays and Saturdays. The Wednesday market has fewer vendors but is still a pleasant place to go. The Saturday market is a lot bigger with quite a few more vendors and therefore more possibilities. The folks in the booths are helpful, friendly and while the produce is not cheap it is of good quality and provides seasonally available fruits and vegetables. Right now peppers, citrus, potatoes and apples are dominating the stands. But you will still also find wonderful greens to braise, or unusual carrots.

Going to the market is really an experience in possibilities. I always make at least two circuits around the market. I don’t but anything on the first pass, just looking to see what is available. Then more slowly, I work my way around the market again. This time looking for those interesting possibilities. I may buy some mushrooms for dinner, or some citrus to make marmalade. Thinking ahead a few days, I might buy some interesting greens to cook and chop, then saute with garlic and olive oil and use to top a garlic-infused crostini, warm from the grill. Put a sprinkle of good Parmigiano Reggiano cheese on the top and serve with a glass of nice white wine. While it is not specifically designed to be a part of the Eight Bites diet, it is very tasty and a way of getting more vegetables into your diet. So go ahead and make some and enjoy it as an antipasti before you eat the protein portion of your meal.

Last Saturday at the market I was shopping with a friend, and found some great oranges, Granny Smith apples and some sweet peppers. I had to hold off on the wild mushrooms, but did order some wonderful butter from an artisan dairy in Petaluma. I also looked at some Muscovy duck breasts. Just thinking about a possible dinner party with grilled duck breast, peppers agrodolce, and apple Tarte Tatin.

At one stand, they were selling smoked olive oil. I spent a few minutes talking with the couple who owned the process and we talked about how we use olive oil and how these flavored ones might provide a different taste. They asked me to develop a recipe or two for them using their oils and I said I would. Before I walked away, they gave me a package containing small bottles of each of their three oils for me to experiment with. I will use the oranges to make some orange marmalade including some with vinegar and red pepper flakes to make it a bit more interesting. I also have some fig jam frozen and will use the Granny Smith apples and some raisins to make some jars of chutney.

So if you have a Farmer’s Market in your town, by all means go and see what is available. The vegetables and fruits are generally fresher and they are often organically raised. So wander around, talk to the vendors. They love to talk about their products and often about using them in your own kitchen. While the market might not provide the meat products we require as part of Eight Bites, they do provide a wonderful gathering of folks with a common outlook. That is the preparation of interesting food with good nutritional characteristics, seasonally and sustainable raised. Support them with your purchases or at least with your presence. Drink an espresso from the stand, buy some bread (even though you can’t eat much of it), and shake their hands. Enjoy the morning adventure and remember that having had bariatric surgery has given you a new life and good health. So celebrate it. Find some interesting foods and use them, even if it requires you to cook just for yourself, and you still have to purchase meats in those big packages.

Thanksgiving 2010

This year I have traveled to San Diego to be with my cousin for Thanksgiving. My kids are having their own celebrations in Albuquerque and Denver. So instead of moping around an empty house or going out to dinner at Denny’s, I decided to take a road trip. I tried to volunteer at the local Senior Center but they were having a catered lunch and didn’t need any assistance.

Thanksgiving is such a food related holiday that most of us look at it as a gluttonous feast day, where we have to unsnap our trouser buttons so we don’t explode. Turkey, mashed potatoes, sweet potatoes, stringbean casserole, pies of all kinds and then there is the gravy. That strangely seductive elixir of turkey drippings, giblets and a thickening agent to tie it all together. Its tradition you know.

But now that I have had WLS, how do I approach both the cooking of Thanksgiving dinner and the consumption of same. What decisions are relevant regarding the foods generally headlining the feast? How do I accommodate my minimal consumptive capacity with the psychological siren song of all that traditional food? And to add another element into the culinary equation, my cousin is both gluten-intolerant and lactose-intolerant. Now we really have to think about the menu. Volume is one thing, intolerance is quite another.

Our plan is to have a roast turkey (sorry you have to have turkey), stuffing, sweet potatoes, mashed potatoes, roasted seasonal vegetables (broccolini, Brussels sprouts and carrots), and a dessert or two. I will make a new antipasto (Medjool dates stuffed with a sausage and cheese mixture and heated in the oven). That is a huge amount of food for two people, so now I am looking at making the dishes so that there are some leftovers (got to have turkey sandwiches) but that we aren’t eating the leftovers for the next week.

So here is the plan including the reduced quantities of ingredients. We purchased a 12 pound turkey which is nicely sized for this application and provides the desired amount of leftovers for turkey sandwiches and turkey tetrazzini. The cornbread stuffing will be made with a gluten-free cornbread mix I will bake and then use half to make the stuffing and the rest kept for another meal. Sweet potatoes (two medium) will be baked and turned into a puree with butter and a bit of cream. The mashed potatoes (4 medium) will be boiled with garlic, mashed and seasoned with salt and pepper, butter and a bit of the cream. The gravy will be a reduction of the pan juices with most of the fat removed. You don’t need to use thickening agents if you use a reduction. 

The Brussels sprouts (10 quartered) and carrots (3 sliced on the diagonal) will be roasted in the oven and tossed with a bit of olive oil, salt and pepper. The broccolini (4-5 small stalks) braised quickly in a saute pan with some garlic and olive oil. The date antipasti are made by sauteing Italian sausage with chopped onions, adding about a half cup of Parmigiano Reggiano cheese, then cooling mixture and crumbling by hand into smaller particles. The dates are placed in a glass baking dish and a mound of the sausage mixture placed in each one. Into the oven for about 10 minutes at 350 degrees and they are served immediately.

All of the tastes of Thanksgiving were retained without the excesses normally seen during the preparation of this meal. There are no gluten filled dishes like rolls or and no significant use of lactose with the exception of the whipped cream which generally has little lactose. For the bariatric surgery patient as well as the gluten and lactose intolerant this meal can easily accommodated.

For the WLS diner, take a single stuffed date, two-three ounces of turkey, a spoonful of stuffing, mashed potatoes and sweet potatoes, a taste of each of the vegetables. Eat slowly and enjoy the traditional flavors. That way you save room for a taste of dessert. This year it will be a flourless chocolate walnut cake with chocolate ganache icing and a pumpkin souffle with whipped cream. It is Thanksgiving after all and on that day we are allowed to eat a little excessively. But the fact that our reduced stomachs provide a restrictive element to our desires, does not mean you cannot enjoy all the tastes and dishes of the holiday table. So eat responsibly and enjoy yourself.

Veal

The most important part of this blog is about the relationship we have with our food, how we deal with the dietary restrictions placed upon us by WLS and how we can still enjoy good and exciting foods as we live our new lower weight life. I have discussed regaining weight after WLS previously and frankly it is more of a problem with the consumptive discipline we need in our lives, not the food choices we have available. So today I want to get back to talking about food again. Exciting, good tasting food that provides adequate sustenance and well as some emotional support. So I am going to give you several recipes for veal. These are high protein dishes with great taste and eye appeal. They can be easily portioned-controlled simply by the creation of the size of the piece of meat. A four ounce serving is just about perfect. They are readily stored and can be rewarmed and eaten as leftovers. I know the arguments regarding how veal is raised and created. That issue is not within the purview of this blog. The meat is available and if you have a problem with how it is raised that is perfectly fine. Don’t use it.



Veal francese

Ingredients:
1/2 pound veal scallops from the leg
Salt to taste
Freshly-ground black pepper to taste
1 Egg well beaten
Flour for dredging
6 tablespoons butter
1 cup Dry white wine

Directions:
Place veal pieces between 2 sheets of waxed paper and pound with a mallet until they're thin. Season with salt and pepper. Place the beaten egg in a wide, shallow bowl. Place the flour on a wide plate.

Dip the pounded veal in the egg. Remove, letting the excess egg drip off. Place each scallop in the flour, and coat lightly. Remove the scallops from the flour, and hold them in a single layer. Add 4 tablespoons of the butter to a saute pan large enough to hold the 6 scallops in a single layer. Melt the butter over medium-high heat.

When it foams, add the veal. Saute, turning once, until the scallops are golden on the outside. Remove the scallops and hold in a single layer. Spill the butter out of the saute pan, and return the pan to high heat. Add the white wine and reduce it to 1/2 cup. Turn heat to very low. Swirl in the butter until the sauce is thickened. Add the reserved veal to the pan, turning them until they are coated with the sauce. Divide scaloppini among 2 plates, pour remaining sauce over them. Serve immediately.

Veal scaloppini

Ingredients:
1 lb veal, scaloppini (1/4 in thick)
1/2 cup flour
3 large eggs
6 tablespoons Parmigiano cheese
1/2 teaspoon salt
1/4 teaspoon black pepper
1 1/2 tablespoons olive oil
1 1/2 tablespoons butter
1 large lemon

Directions:
Preheat oven to 180 degrees F.
Heat olive oil and butter in large skillet over medium high heat.
Dredge veal in flour.
Mix eggs, Parmigiano, salt, pepper.
Dip floured scaloppini into egg batter and place in hot pan.
Cook scaloppini in batches being careful not to crowd the pan.
Cook until nicely browned (1 1/2-2 minutes per side).
Remove to a platter and keep warm in oven.
Repeat, adding more oil and butter to pan as needed until all are cooked.
When done return all to the pan and sprinkle with lemon juice and serve on a warm platter.

Veal with wild mushroom cream sauce

Ingredients:
For the sauce:
2 tablespoons olive oil
2 tablespoons unsalted butter
1/2 cup shallots, minced
8 ounces wild mushrooms (such as chanterelles, shiitake, oyster, or a combination)
1 teaspoon fresh thyme, minced
1/2 teaspoon salt
1/2 teaspoon black pepper
1 large garlic clove minced
1/2 cup dry white wine
1 cup veal demi-glace
1 cup heavy cream

For the veal:
8 veal cutlets, scaloppini style
Flour for dredging
1/4 teaspoon salt
1/4 teaspoon black pepper
2 tablespoons olive oil
2 tablespoons unsalted butter
1 tablespoon lemon juice
1/2 teaspoon fresh chervil, minced

Directions:
Make the sauce:
In a saute pan set over moderately high flame, heat the oil and butter until hot. Add the shallots and cook, stirring, 1 minute. Add the mushrooms, thyme and salt and pepper and cook, stirring occasionally, for 5 minutes, or until mushrooms are soft. Add the garlic and cook, stirring, 1 minute. Add the wine and reduce by half. Add the demi-glace and simmer 5 minutes. Add the cream and reduce until lightly thickened. Cover with a round of buttered wax paper and keep hot.

Make the veal
Dredge the veal scallops in flour, shaking off excess, and season with salt and pepper.
In large skillet set over moderate flame, heat olive oil and butter until hot. Add scallops and saute for 1 minute on each side. Transfer the meat back into the sauce for just a minute and season with fresh lemon juice and chervil.

Small steps

Sometimes it just takes that first small step. Then another, and another. Soon you will find you have progressed quite a distance.

I have been thinking and reading a lot about the obesity dilemma facing the US and considering what is appropriate and necessary to push it backwards. I have talked about thinking big, acting big and eating big and I am sure that is part of the problem, so is the general lack of exercise, particularly with the kids. But also I think we have simply started accepting the fact that we are overweight and not really getting too upset about it. So what if we get Type II diabetes, we have a number of new drugs that work effectively in reducing blood sugar. So our blood pressure is elevated, we have new drugs for that as well. Cholesterol? New drugs. We think in terms of short term health solutions instead of long term health modification. Diet and the associated weight seem to be pushed into the background.

A recent study showed how if we were overweight, our friends and family would be as well. It’s not genetics necessarily; it seems to be primarily perception. What we see we emulate. If our friends are overweight, and we want to be close to them, we gain weight. If we are overweight, our friends and family will think of it as acceptable and move in that direction as well.

A study, titled Obesity is Socially Contagious was published in the July 26, 2007 issue of the New England Journal of Medicine, and suggests that obesity is "socially contagious," as it can spread among individuals in close social circles. The author’s likely explanation is that a person's idea of what is an appropriate body size is affected by the size of his or her friends. This new study finds that when the scale reads "obese" for one individual, the odds that their friends will become obese increase by more than 50 percent. Conversely, the researchers found that thinness is also contagious.

"Social effects, I think, are much stronger than people before realized," said co-author James Fowler, a social-networks expert at the University of California-San Diego. "There's been an intensive effort to find genes that are responsible for obesity and physical processes that are responsible for obesity, and what our paper suggests is that you really should spend time looking at the social side of life as well."

It has been demonstrated in research that peers influence each other's health behaviors. The data for this study was part of the Framingham Heart Study, an ongoing cardiovascular study. The health data was collected between 1971 and 2003 from more than 12,000 adults who participated in the Framingham study. Participants provided contact information for close friends, many of whom were also study participants, resulting in a total of over 38,000 social and family ties.

The most interesting results noted were when the researchers found that if a participant's friend became obese over the course of the study, the chances that the participant also became obese increased by 57 percent. Among mutual friends (both individuals indicate the other is a "friend"), the chances nearly tripled. So it is with friends. Among siblings, if one becomes obese the likelihood of their sister or brother becoming obese increases by 40 percent. Among spouses there is a 37 percent increased risk.

Gender also affected the degree of "obesity contagion." In same-sex friendships, individuals had a 71 percent increased risk of obesity if a friend became obese. If a guy's brother is obese, he's 44 percent more likely to also become obese. Among sisters, the risk was 67 percent.

This phenomenon was apparently was not based upon the potential that fat people hung out with fat people. A direct and causal relationship was determined. If a person had a close friend who was obese they tended to be affected by that person’s obesity. An interesting piece of the puzzle is that if you considered yourself a friend of someone, you were influenced by their weight. Conversely if that person did not consider you a friend, they were not affected by your weight. That is interesting.

So what does all this mean regarding weight gain, weight loss and the relationship to WLS? I feel that the closeness we feel for another can influence how we perceive them physically as well as socially. It can influence whether we discuss weight with them or just accept what and who we are. I feel that it goes to the question of talking to each other honestly about weight issues. Not being judgmental, not being critical, and certainly not making the issue a point of humor. We do not degrade our friends. We want to do what we can to help them look critically at what they are and the implications on their health. I am trying to create a forum where we can talk honestly about these issues. Sometimes it seems almost insurmountable, and sometimes you move a bit forward. Sometimes it just takes that first small step. Then another, and another. Soon you will find you have progressed quite a distance.

Peer to Peer

This is just an idea but please think about it for a moment. If bariatric surgeons could and would connect patients in the post-surgical phase with patients who are investigating the potential for having weight loss surgery, it could prove to be an effective and inexpensive way to provide real-world information to the pre-surgical patient which may be more useful than what can be obtained alone. Pairing people who have gone through weight loss surgery (WLS) with someone thinking about it, can often give them both the support they vitally need to help them. Could weekly support sessions, one on one discussion, email communications, or even an occasional phone call be of assistance?

Success or failure in the post-surgical WLS world is almost totally dependent upon the commitment and will of the patient. The surgeon, given a good surgical outcome can essentially promise weight loss, but they cannot promise that the patient will not have some side-effects or will not regain some weight. They can explain some of the potential side-effects of the surgery on our digestive process, yet they do not discuss the potential change in lifestyles or eating strategies that may be required. There is little if any pre-surgical discussion of the discipline that is required to effectively live with the results of the weight loss surgery.

Group sessions are almost always recommended for patients both before and after weight loss surgery. This peer support does provide value to many patients, but not to all. Sitting in a group of fellow patients sometimes does not support the real and often painful discussions of the effects from the weight loss. This may be where peer to peer personal contact may be useful. Part of the reason I have been writing this blog is to get people who either are contemplating WLS or have had it, to have a place to read about real world experiences with the process, the physiological ups and downs and the potential to live a terrific new life after the weight loss. I don’t feel like some “poster child” for bariatric surgery but I have had a lot of experience with the digestive aspects of this process, with my first wife for 24 years and now for myself for two and a half years.

I have spent a lot of time discussing the process of weight loss surgery, occasionally with someone who has had it, more often with either someone who could use it, or just interested folks. It seems like there are a lot of misconceptions about the various surgeries and they tend to be lumped into the general categories of Lapband or gastric bypass. The same issues are continually brought up. These include: basic misunderstanding about the surgical processes, weight gain after the surgery; complications with the surgery, effects of having to change lifestyles, ability to eat whatever you want, restrictions, insurance support, costs, health issues and the long term implications of both weight loss as well as the psychological and emotional changes the patient goes through. These are all important issues that I believe can be best discussed in a peer to peer setting and not just in a group setting. Real life effects and real life issues are important to those contemplating the surgery.

This proposed effort is not to generate a research proposal but to stimulate thinking on the part of those reading this blog and hopefully physicians dealing with bariatric surgery to assess the level of information transfer to patients and then potentially between new patients and patients who have undergone this surgery. This could include providing the names of peers who have undergone the surgery and are willing to spend the time to discuss it with those contemplating it. Recommending adequate peer support, as well as providing the option of attending group sessions might be appropriate.

In the very personal world of post-surgical weight loss, sometimes we feel a bit adrift as to what we can, should, or need to do. How do we reconcile the demands of our jobs, including dinners with clients and maintaining the discipline we need? How do we enjoy eating with our family and friends when we constantly receive comments about how little we eat or do we want anything more? How can we enjoy eating if we can only eat eight bites? How do we see ourselves in this new world? How many times can you take in the waistband of your favorite pants?

Patients who are contemplating surgery might be better motivated themselves if given the opportunity to both discuss and receive help from another person who has faced the challenges already and has been able to effectively cope.

It appears that study is needed to evaluate which parts of a peer intervention environment are most successful. These could include: face to face discussions between pre- and post-surgical patients; phone calls offering a supportive voice and also a mechanism for answering questions, group meetings and or even one-on-one counseling with professional counselors.

In many medical issues, the time spent with the patient can be directly related to a successful outcome since this time reminds the patient to do something or to be more engaged. It is my contention that this added time provided by peer to peer discussions may be better suited to the understanding of the bariatric process, help allay fears and provide a long term view of where the patient is going. The patient needs to feel empowered and confident, knowing that they are in charge of the ultimate outcome and that it requires personal discipline and will, but also someone to talk to. It's not so much knowing what to eat but how to change behavior and how will this influence your life and lifestyle. That involves problem-solving and goal-setting skills and the evidence shows that the patient may relate better to a peer who might have more similarities than a teacher in the front of the room.

If you want to use this blog to ask questions and maybe get some answers, please feel free.

Coming back to California

On September 29th, 2010 I returned to my home in Santa Rosa after spending over two years in Italy.  I flew from Florence to Frankurt and then to San Francisco. I dragged my four huge suitcases through Customs and I was then met by an old and dear friend who got me to Santa Rosa and my house. The reasons I left Italy are varied and complicated but suffice it to say I wasn't happy there and I am glad to be home. 

In these first days back home I have noted a lot of differences between being in Italy and being in California. The most immediate and obvious difference is not the climate (Mediterranean), or the local vegetative patterns (so like Umbria) or the language (though that is significantly easier for me to understand).  It is the size of things. The cars are bigger. The buildings are bigger.  The distances are greater.  The houses are bigger (and made of wood, mostly). However the most impressive and concerning observation was that people were bigger. 

Weight is an issue in the US and so many people are overweight. I have been observing the scene now for a few days and there are a number of factors that I have noticed that may have led to this issue.  The ads for food are certainly complicating the situation. We are advised to go to an "all you can eat" restaurant. We order the biggest plates to ensure we get our money's worth. Restaurants want to ensure that their patrons feel they are getting full value by having free pie on Wednesday, all you can eat shrimp on Friday and that best of all possible worlds, an all-you-can-eat Sunday brunch. You may never have to eat again.  Our dissatisfaction increases if we don't eat until we are stuffed.

We want to order bigger thicker milk shakes, larger orders of fries, and foot long burgers.  If a two patty hamburger with bacon and cheese is good, wouldn't a three patty hamburger with bacon and cheese be better? It's a bigger slice of pie at the end of the meal or that newest chocolate dessert. The mantra is "Super-size me" and that is exactly what is happening. People are becoming super-sized.

The laws of thermodynamics are immutable. Calories in have to equal calories out, or you gain weight. Slowly or quickly, it is basic physics. As I watch people walk past or eating at a restaurant or buying groceries at the local market I am very concerned about what we are doing to ourselves.  I am not judgemental regarding weight. I have been there at 300 pounds for most of my life. I have suffered the consequences of that weight, including diabetes, high blood pressure, and the inability to move around as quickly as I once did. I had a "friend" ask me once how did I fit into my Porsche.

So today I am reflecting. It is reflections based upon what I have done in my own life to increase the possibility of living longer and healthier. In a recent study, people were asked to determine what the calorie count was for a hamburger and fries. The general consensus was 650 calories. Then a side of broccoli was added to the plate with the burger and fries and the people were asked again what was the calorie count. This time it went down to just above 600 calories. The perception seemed to be that if you have steamed veggies on your plate it must somehow be better for you, and also lower in calories. It is like giving up wine with dinner because you think drinking wine is why you have gained weight. Then you eat three platefuls of food. But have no wine. It might be better to drink the wine and eat less food.

Its time to take some control of your eating habits and determine for yourself what you want your life and health to be.

A busy few months

The last few months have been very busy and I have had little chance to update the blog. This season has been a particularly busy one for Amore Sapore. The daily grind started early at about 5AM, when we got up to start prepping for the meal that evening. I would make up the set ups for the antipasti and check the menu for the day's shopping needs. I might also make a loaf of beer bread or some oatmeal cookies. At 8:30 I would head for the store to get all the things we would need for that evening. Usually this was the fresh things, like fruit, salad materials, meats, gelato or anything else we needed.

The morning was spent getting the preliminary cooking done. If it was a class that evening, we did a relatively minimal prep since the students were going to be doing most of the actual work. We did ensure that all of the materials and foods were there and ready to pack into the car.  I had several carry bags that had cooking implements and a set of pans that I always took. The kitchens in some of these houses were often deficient in some pans and I found it easier just to take everything we would need. Bags were packed and checked and then we took a short nap. It was going to be a long day.

At about 5PM we packed the car and left for the dinner location. We had two spots this summer where we had to make a drive of over an hour. One to Perugia and another to near Montepulcino in Tuscany. The rest of the cooking venues were within 15 to 20 minutes drive.

It was a very busy summer  and we cooked a wide variety of menu items. The following is an annotated list of dishes from the Amore Sapore menus in  August and September:

Bruschetta with artichokes and Pecorino romano
Bruschetta with mushrooms
Ricotta with peperone and flatbread
Salami plate
Chicken Piccata
Insalata Caprese, mozzarella, tomatoes and basil
Panna cotta
Local Pecorino cheese with honey, marmalatta and chutney
Figs stuffed with Gorgonzola and prosciutto
Bruschetta with artichoke pate
Veal scaloppini with Marsala sauce
Grilled porterhouse steaks
Poached pears and sweetened mascarpone
Crostini with caramelized pears and Gorgonzola
Figs with prosciutto
Stuffed peppers with sausage and cheese
Potato and cheese ravioli  with tomato sauce
Roasted sausages and grilled grapes
Flourless chocolate walnut cake with chocolate ganache
Crostini with salmon
Spinach and garlic saute
Tiramisu
Pumpkin ravioli with walnut sauce
Chicken breast with saffron and ginger
Pumpkin gratin
Pears in Chianti with mascarpone
Salmon crostini, cream cheese and lemon marmalatta
Gnocchi with fresh basil pesto
Veal scaloppini with mushrooms
Fettuccine with walnut sauce
Crostini with cannellini beans, onions and marmalatta
Cucumbers and goat cheese and roasted tomatoes
Spinach and cheese ravioli
Roast Quail stuffed with sausage and wrapped in pancetta
Chard sauteed with olive oil and anchovies
Bruschetta with goat cheese and tomatoes
Slow roasted tomatoes with marinated mozzarella
Bruschetta with ricotta and peppers
Marinated cucumbers
Roast Salmon
Wild Rice pilaf
Zucotta
Prosciutto rolls with goat cheese, lemon and rucola
Eggplant Bolognese
Bruschetta with broccoli rabe
Farro and lentil soup
Pear cake with a caramelized pear and ricotta gelato
Bruschetta with spiced sausage
Bruschetta with ricotta, honey and peperoncino
Cucumbers with goat cheese and roasted cherry tomatoes
Gnudi (inside out ravioli)
Braised rabbit with peppers, onions and olives
Frittata with mushrooms, peppers and artichokes

Its been a yummy summer and my weight has stayed constant at 165 pounds. Eating and living Eight Bites at a time can be fun and satisfying and you can still enjoy the wide variety of dishes and items we prepared without gaining weight. Eat well and enjoy your life.

Food is not just about consumption

Eating in the post-weight loss surgery world can be a bit of a dilemma. As we look back at the pre-surgical life we led, we often see consumption being of paramount importance both to our psychological well being and our personal feelings of worth. When we entered into the new life created by our surgically-reduced ability to consume food, the importance of consumption changed. So what has changed? Certainly the ability to eat all the food you “wanted” has been eliminated. But what else has changed? How important to us personally was our ability to consume food? Did it have to be good food? Tasty food? Filling food? Comfort food? Food that was healthy? Or just a lot of food?

Why we got to the place where we had to have weight-reduction surgery is individual to each of us. I got there after thirty years of being heavy, having insulin dependent diabetes, high blood pressure and looking at my wedding picture from March 2008 and comparing it to my wedding picture from July 1966.

I was not healthy, and I felt that my life was being significantly shortened by my obesity. I had tried diets and done a bit of yo-yoing up and down but my job and career did not lend itself to an active physical regimen. The basic laws of thermo-dynamics were conspiring to make me heavier. So I had the surgery. Those first few weeks frankly were pretty easy though the high protein drinks I had were not that appealing. I didn’t feel the urge to eat anything and I started to drop weight quickly. Pants got looser and looser. Shirts got larger. Towels would fit around me easily.

In the fourth week I began to eat semi-solid foods. A scrambled egg was delicious on that first semi-solid Saturday. After a few weeks of yogurt I was ready to chew something. I wanted to taste things but I felt no overwhelming need to over-eat. The flavor and texture of that first scrambled egg with a bit of salt and pepper is stuck indelibly in my mind. It was delicious. So for the next couple of weeks I stuck to a semi-soft diet and started to add new (and old) flavors, textures and foods into my diet. It was not about how much I could consume. My surgery limited that for me. It was about what I ate and how it tasted. What were the things about the dish or food that gave it the character I wanted? 

I was responsible for eating substantive amounts of proteins as part of my weight-loss regimen, and making sometimes bland protein-rich dishes required me to look at aggressive spicing and condiments to accentuate the flavor. I started considering what small things I could add to a dish that would change its flavor, complexity, and composition. A braised pork dish was accentuated by raisins, and some apple cider vinegar. A poached chicken dish was enhanced by the use of chipotle bouillon cubes in the poaching liquid. I added capers and some anchovy fillets to my pureed tuna fish for a tasty sandwich. I didn’t even need to use mayonnaise and used a bit of olive oil instead.

The physical restriction placed on me by the surgery meant that I would never be able to over-consume again. I guess you could live on cheesecake and wash it down with chocolate milkshakes, but that is a bit counter-intuitive. I was really limited to Eight Bites. So I went for small enhancements to the dish rather than large volumes. These small enhancements led to exciting new dishes that in many cases I have turned into antipasti as part of my new career as a chef. I found that I didn’t have to create large amounts of food, just small bites with extraordinary flavors and surprise taste elements.

One example is a pureed cannellini bean spread on a piece of bruschetta or a crostini. This is a standard topping for Italian crostini antipasti and is relatively bland. The basic puree is made by draining and rinsing a can of cannellini beans and put those in a sauce pan with about a half can of chicken stock and three garlic cloves. Add some salt and pepper and let the beans cook at medium low heat for about 20 minutes until the stock is virtually gone. Pour the beans into a food processor and puree. Put in a bowl and into the refrigerator to cool. Saute a medium chopped onion in a small saute pan in a bit of olive oil or butter, add some salt and pepper. Saute until translucent and then add some sugar (teaspoon or so) and a tablespoon of vinegar. Finish caramelizing the onions and set aside in a bowl. Taste it to see if the flavor profile is sufficiently sweet and sour and adjust as necessary. To make the crostini you could spread the bean puree on the crisp bread and top with the caramelized onions. Cut them into serving size pieces and place on a pretty plate. Or change it a bit and give it a surprise taste element. Spread the bread with a thin layer of fig jam or an apple chutney, then top with the bean puree and onions. When your friends bite into this little antipasto they get the crunch of the crisp bread, the smooth textural quality of the beans, and the sweet and sour contribution of the onions. Then they will get a hint of a sweet undertone and you will get questioned as to what you put on this.

It is truly about taste and not just about consumption. Enjoy your weight loss, and enjoy all those extraordinary tastes you can now have as well as create.

Just a note

I was asking my doctor about a piece of information I had received about a delayed weight gain, a number of years after weight loss surgery. I was wondering if this delayed response was a particular issue that I had to watch for and be concerned about. His response was enlightening and yet totally obvious. He stated that in lectures to new patients in group support meetings that he has seen weight regain with all procedures over all periods of time.  His  strongest point during the lecture is always:  A good operation done correctly gets all the weight off, the patient then has to keep it off. 

So it is the patient's responsibility to keep the weight off. How novel. I have discussed previously the problems with regaining weight dearly lost and why. But this statement really puts that issue into perspective. If you have this surgery because you are overweight, you are responsible to yourself and to those who care about you to ensure that you do not regain the weight. It takes a personal responsibility to keep the weight off. The path you took to get to the weight loss was one traveled with some trepidation, some  excitement, and some hope. It was not a SIMPLE solution to your weight problem. It required a substantial commitment, in terms of money, desire, and the willingness to change your life. 

As a cook I hear from customers all the time that all it takes to lose weight is a starvation diet and exercise. Its easy isn't it?  No it is not. A great chef at a restaurant owned by a slender person is told that all he has to do is exercise and diet. All will be well.  Yet he still is heavy, still at risk, and to some degree still looked upon as lacking some will to change. 

Choosing  bariatric surgery is not the choice of a weak-willed person. It is a choice made to better yourself using a tool that is available and safe.  But it is not easy. It changes you. It allows you new freedoms and a new healthy body. It does not make you smarter, more reliable or a better driver. It does make you less heavy. It enhances your life in ways you have no idea about until they happens. It changes not only your waist size but your attitude. But like the doctor said, the surgery can get the weight off, but the patient has to keep it off. You have to decide if you want to go back to the way you were before the surgery. I have thought long and hard about that question and there is NO chance of me returning to that life. I am healthier, stronger, happier and in a better place and will never go back to that persona again. It means that I have taken personal responsibility for maintaining my diet and my exercise. I still eat Eight Bites, not because I have to but because I choose to. I can eat more but choose not to. Choices......

So it is very personal when you decide to have this life-changing surgery. But it is also your decision to ensure that you maintain it. I wish all of you the very best, and a longer and healthier life.  

A week in the life of a cook

This week in the middle of June has been a busy one for us. In June we have 24 dinners to cook and in some cases we have had to split the teams and serve two dinners in one evening. One group of 13 people that we cooked for every evening from Sunday to Friday presented a series of challenges. There were older adults, middle aged adults, teenagers and pre-teenagers. Some didn’t want sauce with their pasta, others didn’t like cheese. Some ate salad, others liked their meat medium while others wanted it rare. The first two days were dominated by vegetarian main dishes like gnocchi and polenta and the last four days were primarily meat meals. We made bread salad, Insalata Caprese and a large number of antipasti. It was a good effort for the cooking team, rewarded by kudos every night. I was happy with the results.

Cooking like this requires a complicated dance to be performed by the cooks. They need to work, often in smallish places with crowds of people sitting in close proximity. They need to perform a variety of tasks from going the refrigerator, back to the counter top, then to the stove. Focusing all of the time on trying not to run into each other, or get in each other’s way. It is a semi-choreographed dance that can end up in a well-presented meal or with the cooks glaring at each other. If care isn’t taken, cooks can get burned, cut and Band-Aids are an essential part of the work sack. To work effectively in these conditions, it is really important that you do not feel that your individual task or cooking responsibility is the most important one. That sometimes is difficult to remember. You must accommodate each person’s needs and requirements. And the phasing of the preparations is really important.


Cooking meat for a crowd, particularly where you have individual preferences for the level of doneness of the meat, is sometimes difficult. Roast pork is easier to cook than individual steaks. But these are challenges that have to be met. Tonight for example I will be preparing Bistecca Fiorintina (essentially grilled Porterhouse steaks) cooked rare. But there will be requests to make them medium rare or medium. Ah, the joys of cooking for 13 people all wanting their food at the same moment.

So here are the primary dishes done this week in June 2010. I hope you enjoy them. Mangia!


Polenta with mozzarella
Cook 1 ½ cups of quick cooking polenta in 6 cups of water. Bring to a boil, and add 1 tsp of salt. Cook stirring frequently over medium heat until the polenta is cooked. Take the pan off the stove and add 125 grams (1/4 pound) of butter and a cup of grated Parmigiano. Stir until the butter has melted and the cheese has disappeared. Stir in 8-10 boconcini (small mozzarella balls. Serve hot with a favorite sauce.


Baked Polenta with mushrooms and sauce
Cook 1 ½ cups of quick cooking polenta in 6 cups of water. Bring to a boil, and add 1 tsp of salt. Cook stirring frequently over medium heat until the polenta is cooked. Take the pan off the stove and add 125 grams (1/4 pound) of butter and a cup of grated Parmigiano. Stir until the butter has melted and the cheese has disappeared. Pour half of the polenta into a 9x13 inch baking dish. Smooth the top with a spatula. Add some fresh mushrooms to your favorite tomato sauce and pour over the polenta. Smooth the sauce, sprinkle on some Parmigiano and top with the rest of the polenta. Smooth the top. Sprinkle about a cup of grated Parmigiano on the top of the polenta. Bake in a medium to hot oven for 20 minutes at 350 degrees. Remove the polenta from the oven and allow to set for 5 minutes. Cut into 4” x 4” squares and serve on warm plates. Pass additional Parmigiano.


Roast Pork with milk (Arista con latte)
This dish is based I believe on an old Roman recipe and is often made on top of the stove. It can however be made in the oven.


1 – 2 tablespoons fat (butter, bacon grease, vegetable oil)
4 – 6 cloves garlic, chopped
2 – 4 pound pork roast (allow about 6 ounces uncooked bone-in, fat-on meat to yield a three-ounce cooked serving)
2 cups of chopped leeks (washed and cleaned)
Seasoned salt (or salt and pepper)
2 cups whole milk
Sprig of fresh rosemary, optional


Directions
Preheat oven to 300F. Remove some of the thick layers of fat from the roast. Pat it dry and rub with a seasoned salt mixture or just salt and pepper.


On medium high, heat the fat in a Dutch oven and sauté the leeks and the chopped garlic until softened. Do not allow to burn. Remove the vegetables to a dish. Leave the flavored oil in the pan.. Brown the meat on all sides until slightly crispy. Add the vegetables, milk and rosemary. Cover and place in the oven. Cook until meat reaches an internal temperature of 150 degrees F, about 1¼-1½ hours, turning over halfway through. For a very tender roast, cook 2-3 hours in the oven or for 6-8 hours in a slow cooker


Lift meat out, transfer to cutting board, cover and let rest for 10 minutes under a tent of foil. Transfer half of the hot braising liquid including the vegetables to a blender and blend until smooth. Repeat with remaining liquid. Slice the meat and serve with the sauce. For a thicker sauce, mix ¼ cup of the hot liquid mixture with 2 tablespoons flour until smooth. Stir slowly into remaining milk mixture and cook, stirring often, until thick.


Veal scaloppini with Marsala and mushrooms
This dish requires some quick cooking so be sure all of the ingredients are in place before starting (Mis en plas).


Veal or tender beef, sliced thin (1/2”) and pounded with a flat surfaced meat tenderizer.
Flour for dredging
Seasoned salt
Vegetable oil for sauteing
2 ounces of dried mushrooms or 8 ounces of fresh (or a combination of both)
½ Cup of Marsala (or more)
2 tablespoons of Butter
Directions
The “veal” used in Italy is often cut from a top round and can be quite tough and even after pounding is not as fork tender as I like. So with my catered dinners, I used a thick Porterhouse steak that I bone out and slice thinly. I then flatten the meat and it is ready to cook. If good veal is available, that is fine.


Heat the oil in a saute pan to 360 degrees F. Dredge the meat slices in seasoned flour and shake off excess. They should not be doughy. Saute the meat quickly (1-2 minutes per side), dip in the sauce, and place on a warm baking pan in a slow oven (250 degrees F). Continue to saute all the slices.


To make the Marsala mushroom sauce, rehydrate the dried mushrooms in hot water for about a half hour. If using fresh mushrooms, slice and saute in butter until golden and the moisture in the pan is reduced. Add 1-2 table spoons of flour to pan and using a spoon thoroughly mix into the mushroom mixture. Check for seasoning. Do not add too much salt. Add about a cup or more of beef stock or the same amount of water with a bouillon cube in it to start the creation of the sauce. Check the seasonings again. Cook to thicken. Add ½ cup of Marsala and a ½ cup of chopped parsley. Add a tablespoon of butter to the sauce just before serving. Put the slices of cooked veal scaloppini in the sauce for a couple of minutes to warm in the oven and then serve with a bit of the sauce and some mushrooms.


Vitello tonnato
This a fairly complicated dish that takes two days of preparation and served thinly sliced cold. It can be used as an antipasto or as a main dinner or lunch course. It is particularly good during the heat of the summer.


For the vitello:
2 1/4 pounds (1 kg) boned veal, cut from the rump (check for gristle)
A bottle of dry white wine
6 salted anchovies (the canned variety, sold by delicatessens)
A rib of celery, thinly sliced crosswise
A few leaves of sage
2 bay leaves
3 cloves (some people omit these)
Salt


For the tonnato:
3/4 pound (320 g) tuna packed in oil (three cans drained)
The juice of a lemon
3 hard boiled egg yolks
A tablespoon of drained, pickled capers
1/2 cup (approx.) olive oil
1 tablespoon white wine vinegar
Cooking stock from veal to finish sauce


To serve:
A handful of perfect capers (look for the smaller ones)
Some thin lemon slices with seeds removed
Sprigs of parsley or some chopped parsley for garnishing


Directions:
Put the meat in a bowl with the bay leaves, cloves, sage and celery, and pour the wine over it. Cover and marinate in the refrigerator for 24 hours, turning the meat occasionally. The next day place the meat in a Dutch oven. Strain the wine and pour it over the meat, then add enough water to cover. Lightly salt the pot and bring the pot to a boil and then reduce the heat to a simmer and cook the meat for an hour.


In the meantime, wash, scale and bone the anchovies. When the hour is up add them to the pot and continue at a high simmer for another half hour; the liquid should be reduced by half. When the meat is fork-tender remove it from the pot and strain the broth into a bowl. Retain the anchovies in the strainer. Allow the veal to cool, and then wrap the veal and place in the refrigerator.


In a food processor, add the anchovy fillets from the strainer, the drained tuna, and the egg yolks. Add in the capers, the vinegar, the lemon juice and the olive oil and process until smooth. Dilute the sauce to a thick but pourable consistency with some of the warm, reserved broth. The sauce should be a pale color, almost white. Sauce can be refrigerated.

Eating Meats

The following dishes are different meat preparations that I have cooked for guests. All of them are suitable for a WLS diet and provide excellent levels of protein. They are relatively easy to prepare with most taking only minutes to cook. In all of the recipes I have added some personal touches that provide distinct flavors and tastes.


Sausages and grapes
Grilled sausage and sautéed grapes are a simple dish here in Umbria and is very popular in the area. The addition of the grapes adds a unique touch to this dish. In general I have found that the sausage preparation here includes a bit too much salt. The seasoning mix they use predominantly here is salt, pepper and garlic. Virtually every meat market has its own sausages stuffed into natural casings and ready to cook. You buy them by the link and often ten or more at a time.


The simplest preparation is to grill the sausages over a hot barbecue. They use a rack here that you put the sausages on and then lock together. All of the sausages are then cooked at one time over the coals. Using that technique, you get a great tasting sausage infused with the smoke of the barbecue, but more often than not, they can be overdone and dry. Ground meats are a bit of a digestive problem for me personally and the dryness of the sausages can make them difficult to eat. I have grilled these sausages a in a grill pan on top of the stove many more times than I have cooked over the coals. I have more control over the doneness when I use the grill pan.


The grapes are removed from the stems, washed and placed in a saute pan with a bit of olive oil. You can use either seedless or seeded grapes for this dish, but I prefer the large reddish globe type grapes with seeds. They have a nice rich flavor that is enhanced by the cooking. Add a sprinkle of salt and pepper and saute them over a medium to hot flame until they start to swell and some will pop open. Take them off the fire and keep them warm. Put the cooked sausages on a heated platter and spoon the grapes over the top.


I have modified this dish by including sautéed yellow and red bell pepper strips, and onion strips to the sausages. I add a bit of water to the pan with the peppers and onions and allow the sausage to steam for a few minutes. I then add a couple of tablespoons of tomato paste, some dried oregano, a bit of black pepper, an ounce of wine vinegar and a tablespoon of sugar. Continue to cook the mixture on top of the stove or put in a baking dish in a medium oven until the dish is warmed through. Makes a great sweet and sour sausage dish that also results in a moist sausage than is easier for me to eat.


Pork shoulder steak with mixed salt
This is a popular grilled pork dish using a shoulder cut pork chop. In Italy the pork is quite good and the shoulder cut is a very popular cut. They also use a center cut pork chop as well. The meat is salted with a salt mixture composed of a mixture of fine and coarse grained salt, paprika, black pepper, crushed and chopped fresh garlic and dried juniper berries. The fresh garlic dries in the salt and infuses the mixture with a great garlicky aroma. Do not over salt the meat. The meat is allowed to sit with the salt on both sides for 15 minutes and is then either grilled in a basket over coals or in the kitchen in a grill pan. Most people like a medium doneness and overcooking the meat tends to dry it out. Serve on a warm platter.


Chicken with lemon, Marsala and capers
Purchase chicken breasts or breast slices and pound each piece in a plastic bag or under plastic wrap with a flat meat mallet until about ½ inch thick. Lightly dust with a seasoned flour mixture, shake off the excess flour and fry quickly in hot oil (not olive oil) at 360-370 degrees F. I normally use sunflower oil. Cook until just barely browned and remove and keep warm in a slow oven (250 degrees F).


Make the lemon Marsala sauce by adding some water in the frying pan after cooking the meat. Cook down to deglaze, add ½ cup Marsala and the juice of 3 lemons. Add a bit of sugar if it too tart. Cook down to thicken. Add a tablespoon of pickled capers. Add a tablespoon of butter to the sauce just before serving and a ½ cup of chopped parsley. Put cooked chicken breast in the sauce for a couple of minutes to warm in the oven and then serve. The key to this dish is to not overcook the chicken. It takes about two minutes in the frying pan to get a nice color to the meat and then it is placed in a warm oven to complete the cooking. Serve with the sauce lightly on top of the meat. Please don’t drown the meat in the sauce.


Grilled chicken with peperone marmalatta and onions
Bone about 1 ½ chicken thighs per person to be served. Place the thighs in a bowl with a bit of olive oil, oregano, basil and ground black pepper. Marinate in the refrigerator up to overnight. Grill in a medium to hot pan and place the pieces in an oven proof dish when done. Saute an onion or two (depends upon how many you want to serve) until golden and caramelized. Add on top of the chicken. Place some sweet and sour pepper marmalatta over the onions. Cover the pan and keep in a low oven until ready to serve. Keep the chicken in a medium oven until done. Do not overcook, though it is difficult to over cook chicken thighs. Check for doneness and serve with the peppers and onions.


Sweet and spicy pepper marmalatta
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 peppers and onions 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)
Place in ½ pint washed jars, seal and process in a water bath for 5-6 minutes
Remove and cool. Keeps for months
Or allow cool and place in a storage container in the refrigerator.


Osso Bucco
Osso bucco is a braised dish that can use beef or veal shanks or lamb shanks as the primary ingredient. It is cooked in the oven for 2 1/2 to 3 hours. There are many versions of this dish and all have certain similarities. Cutting the meat across the bone provides a great deal of bone marrow which melts into the dish and adds a great deal of flavor and texture to the dish. My version follows.


2-3 pounds of veal or beef shanks (sliced across the bone)
1 bottle of red table wine (Chianti, Sangiovese, Merlot)
1 large red or yellow bell peppers cut into 1” squares
2 onions roughly chopped
3-4 good tomatoes chopped into 1/8th
3 cloves of garlic, sliced
Olive oil
1 small can of tomato sauce
1 quart of broth (beef, chicken, bouillon)
Dried oregano
Salt and pepper
In a large oven-proof dish put some olive oil, the chopped peppers, garlic, onions, oregano and tomatoes as a bed for the meat. Dust the shank slices in seasoned flour and brown in hot oil in a saute pan. Put the meat on top of the vegetables and then spoon some of the vegetable mixture over the top of the meat. Pour in the can of tomato sauce and then the broth. The liquid should just barely come up the side of the meat. Add 1 cup of good red wine and cover the pan with aluminum foil. Place in a medium oven 350 degrees F. Cook for at least two hours before you begin checking for doneness. It will probably take about three hours to cook. Be sure to cover it well after checking. The meat should remain cohesive but will be tender and can be cut with a fork.


Serve the shank slices with some of the pan juices and vegetables that have been reduced slightly to thicken. Check for seasonings and add salt and pepper as needed. Serve with a mostarda or more traditionally with gremolata. Gremolata is made with parsley, a couple cloves of garlic and the peeled yellow skin of a lemon. Chop them well together until they are finely minced and serve in a bowl on the side. The gremolata is used as a spicy condiment on top of the meat.


Grilled marinated leg of lamb
For this dish I get a boned leg of lamb from the butcher or bone my own. A single boned leg will feed about four or five people. The meat will be of varying thicknesses and you should pound the thicker areas to thin them a bit. These thicker areas also allow for a variety of doneness for the meat with the thicker portions being a bit rarer. I put the boned leg of lamb into a plastic bag or pan. On top of the lamb pour about ½ cup of good quality olive oil, a tablespoon of dried oregano and three to four chopped cloves of garlic. I do not salt the meat until I cook it. Put the meat in the refrigerator overnight and turn it a couple of times.

Before cooking bring the meat up to room temperature. Grill the meat in a grill pan over fairly high heat to get a nice sear on the outside. I use a heavy steel weight I had made by a local metal worker to hold the meat down in the pan and this allows a uniform grilling. You can use an aluminum foil covered brick. Cook the meat on one side for about 5 minutes then turn and put the weight back on for another 4.5 minutes. Put the meat in a 350 degrees F oven for about 20 minutes to complete the cooking. Check for doneness. Allow the meat to rest under an aluminum foil tent on a cutting board to 10 minutes. Slice into thin slices across the grain and serve on a warmed platter.


I will often serve the meat with a chutney or mostarda accompaniment. Here are a couple of starting recipes. This is a great area to explore culinarily speaking.


Apple mostarda
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.


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


Directions
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 to thicken
Pack 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 Chutney
One pound of dried apricots, chopped into medium dice
Rind of ½ a lemon and the lemon juice
2 cups of water
1 cup sugar
Vinegar
Salt
1 onion, chopped


Directions
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.