Saturday, May 22, 2010

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)

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
1 onion, chopped

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

Wednesday, May 19, 2010

Vegetarian dishes

In this entry I want to discuss how eating as a vegetarian can be accomplished even after WLS. It is important to remember that the protein component of the vegetarian diet is different than eating the high quality protein of meats, fish, eggs and cheese. It is probable that you cannot be a true vegetarian or on a vegan diet after WLS because of the lower proportion of protein inherent in those foods. However is is sometimes nice to move away from the strictly protein diet and have some other flavors, textures and taste. That is what this blog is about: Eating interesting and exciting food after weight loss surgery.

The following recipes are from dinners we created this month (May 2010) and served to our guests. They are interesting items. Some are relatively low in protein and are not really intended to be a major element of the WLS diet while others are high in protein and could be incorporated as a common element into a WLS diet easily,

Pumpkin ravioli with walnut sauce
Make the pumpkin filling before making the pasta and store it in the refrigerator until you are ready to use it. I have previously given the recipe for pasta dough so you should refer to that or use your own recipe. Make the dough and set aside to rest. After resting you can roll out the dough into sheets and make the ravioli using a folding technique or with the ravioli attachment on your pasta machine.

The pumpkin filling: The pumpkin is cut and peeled, then cut into 1” chunks. Use about 1-2 pounds of uncooked pumpkin to start. It is cooked in butter and some water in a large saute pan until it is tender. It is necessary to cook out as much water as possible otherwise the filling is too moist. If there is still a lot of moisture in the pumpkin put in a sieve and allow to drain, even over night. Put it in a food processor and process until smooth. It should be very thick and rich. Add a good amount (1/2 tsp) of grated nutmeg, 4 or 5 ounces of crushed amaretto cookies, and a bit of salt and pepper. Peel and boil a potato, mash it, and add it to the pumpkin puree then process to smooth. Add 4 ounces of grated Parmigiano Reggiano cheese and set mixture aside to cool until ready to make the ravioli. This filling should be savory with a sweetish undertone and definitely not too sweet. Taste it and be sure it has a good solid pumpkin flavor. It should not taste like pumpkin pie. Salt and pepper are important additions. Taste!

The walnut sauce: Toast 1 cup of walnuts in the oven at 350 degrees F for about 6-8 minutes. Be careful to not burn the nuts. Cool them and chop them coarsely. Set aside. The walnut sauce uses a basic bechamel base. The bechamel is made with 2-3 tablespoons of butter, melted in a 2 quart saucepan. Add the walnuts and allow to cook in the melted butter for 2 minutes. Add a bit of salt and pepper. Then stir in 2-3 tablespoons of flour and stir to mix the flour and butter. Cook for 1-2 minutes to eliminate the floury flavor. Add 2 cups of warm milk and stir. Bring to a boil and the sauce will thicken. Add more milk if the sauce is too thick. Taste the sauce and see if it needs a bit more salt or pepper. I also add a teaspoon or so of sugar. The added sweetness really brings out the flavor of the toasted nuts. The sauce should be of a medium thickness. It will be used to lightly sauce the cooked ravioli.

Polenta with fresh tomato/vegetable sauce
This dish can also use a meat sauce to increase the protein levels and also to add a interesting element to a family dinner.

To make polenta: To 1 ½ cups of polenta (corn meal) add 6 cups of broth (chicken, vegetable) and bring to a boil in a 4 quart saucepan on medium to high heat. Stir often to keep from sticking. I use a whisk in the beginning to eliminate lumps then switch to a wooden spoon. Cook the polenta for about 20 minutes until it is very thick and creamy. Add 1/4 pound of butter and a cup of grated Parmigiano Reggiano cheese and stir until well mixed. It can be served hot like mashed potatoes or poured into a loaf pan and allowed to cool (my favorite technique). From there it can be sliced easily and placed on a baking sheet in a medium oven (350 degrees F) for 20 minutes to warm. Serve a slice with your favorite sauce. These can include tomato vegetable sauce (next recipe), a meat sauce, or a basil pesto. Sprinkle on extra Parmigiano and add a bit of grilled meat for a great dinner.

Basic Tomato and Vegetable Sauce
This sauce is at its best when our local tomatoes are at their peak during the summer. It can be used for pasta or polenta, or whenever a rich tomato sauce is called for. This recipes makes a good quantity of sauce sofreeze any leftovers in serving sized containers.

¼ cup olive oil
2 stalks celery
1 white or yellow onion
6 unpeeled carrots
Handful flat-leafed Italian parsley
2 cloves garlic
¼ teaspoon hot red pepper flakes (optional)
A few leaves of fresh basil
2 pounds fresh cherry tomatoes
2 teaspoons salt
1 quart tomato puree (called passata di pomodori—look for the Pomi brand in the U.S.)
2 cups water (or more)
1 cup dry white wine (or more)
1 cup grated pecorino Romano cheese, to be added at the end.

Pour enough olive oil into a heavy frying pan (11 inches diameter, 2 inches tall) to cover its bottom, and place it over medium heat.
After washing the vegetables, chop the celery and onion coarsely, mince the parsley and garlic together, and grate the carrots on the largest holes of the grater. Add to hot oil, stir, and cover pot.
When the vegetables have softened, add the pepper flakes, basil and the washed cherry tomatoes. Sprinkle with the salt and cover.
In 20 minutes, add the tomato puree and stir. Continue to cook, covered, for 15 minutes more, stirring regularly with a flat-bottomed wooden spatula to assure that the sauce is not sticking to the bottom of the pot.
Remove the cover and add water as needed, continuing to cook uncovered on low heat for another thirty minutes, stirring regularly. The sauce will reduce and thicken as it cooks.
When the sauce is thick, remove it from the burner and set aside, covered, to keep it warm. Add to the pasta or polenta, then top with grated cheese and serve.

Lasagna with vegetables and cheeses
The cheese added to this dish enhances the protein level and may actually serve as an adequate meal. Try to cook the pasta until it is quite soft and not too al dente. It will be easier to digest in that new smaller stomach for those WLS patients.

Using dry lasagna noodles or fresh lasagna cook the pasta until nearly done and set aside laid flat on towels to dry slightly. The filling of the lasagna includes your choice of vegetables including grilled eggplant, grilled zucchini, lightly sauteed onion slices, basil leaves, grilled asparagus, slices of tomatoes, mushrooms, or even cooked filed greens like chard, spinach, chicory or mustard greens. All of the vegetables should be cooked until they are almost done before constructing the lasagna.

To construct the lasagna: Slice or grate 1 ½ pounds of good mozzarella cheese grated, have a cup of grated Parmigiano Reggiano cheese in a bowl, and the vegetable mix you are going to use. Two sauces can be used and are often used together. A bechamel or white sauce and a red sauce dominated by vegetables and tomatoes. The bechamel should have grated Parmigiano cheese mixed into it as well as a teaspoon of garlic powder. Add a ¼ teaspoon of grated nutmeg. It should be thick but not over thick. Add a bit of milk if it is too thick to spread or pour easily. Use your favorite pasta sauce made from tomatoes or even commercially pre-made in a jar. Heat the sauce before using.

Place a bit of the tomato sauce on the bottom of the baking dish and add a layer of pasta sheets. Put vegetables on top of the pasta, some grated Mozzarella, and some Parmigiano, then add a bit of the red sauce to the center. Put a border of Bechamel around the edge and place another layer of pasta. Repeat. When you get to the last layer of past, put the tomato sauce in the middle, the bechamel around the edge, top with the mozzarella and Parmigiano. Baker in a moderate oven for 35-45 minutes at 350 degrees F until the lasagna is bubbling and the cheese has melted. Allow to cool for a few minutes and cut into squares and serve.

Insalata Caprese
This dish is actually a salad or can be used as an antipasti. It is simple to put together and is quite good. Use the best quality of mozzarella cheese and fresh vine-ripened tomatoes you can find. If you wish cut some fresh basil from your herb garden or use fresh basil purchased at the market. Slice the tomatoes and the mozzarella into ½ inch thick slices. Lay a slice of cheese down on a nice platter, and then overlap a slice of tomato. Add a leaf of basil and continue the overlapping around the platter. Sprinkle the cheese and tomatoes with a really good quality olive oil and a sprinkle of salt and pepper. Keep cool until serving. This dish provides a beautiful presentation of red, white and bright green but is also quite high in protein and makes a great lunch.

Frittata with artichokes, mushrooms, peppers and pecorino
This dish has one of the highest levels of protein in this recipe group because of the eggs and cheese used to make the frittata. Pre-heat the oven to 350 degrees F
In a 10 inch non-stick saute pan over medium to high heat, put in about 3-4 tablespoons of good olive oil. Add 1 cup of chopped marinated artichoke hearts, a cup of sliced mushrooms, and a cup of sliced yellow or red bell peppers. Stir to keep from burning and allow to saute until softened. Mix 4 eggs with a cup of milk and a ½ cup cream. Add to the pan, stir gently and allow the eggs to begin to cook on the bottom. Sprinkle the top of the frittata with a good quantity of grated pecorino or Monterey jack cheese. Place in the oven for about 15 minutes until it is golden and puffy. Remove and slide the frittata onto a plate, slice into segments and serve.

There you have a number of non-meat recipes that can be easily incorporated into an interesting post-WLS diet and they will provide maximum flavor and tastes at relatively low cost and effort.

Monday, May 17, 2010

Back to recipes and eating

It is time to get back to the basic reason I began writing this blog and that is creating and eating exciting food after weight loss surgery. The month of May has been a busy one with lots of dinner catering here in Italy. We have cooked a number of different meals for groups of visitors. We have had to cook meals dominated by meats, and other meals that were predominantly vegetarian in nature. Cooking for vegetarians and lactose or gluten intolerant visitors provides a challenge to creating interesting meals acceptable to all the guests but meet the nutritional and dietary requirements often for only one person.

So here are some recipes from our May 2010 menus. I will comment on each one in light of their suitability as part of EightBites thinking, but they are all quite nice and while some may not be suitable for EightBites, they can be useful and important to creating exciting dishes for your families and friends. So enjoy the dishes and eat together at the table. These are primarily antipasti, but subsequent blogs will include pasta and meats.

Crostini with smoked salmon (or other smoked fish), crema with chives and lemon mostarda
This crostini uses toasted slices of homemade beer bread as the crostini base. The recipe for my beer bread follows. I like making the beer bread for the smoked fish crostini using toasted dill seeds and crushed dill weed. I also add some onion powder and some grated Parmigiano Reggiano cheese to the bread for flavor. Bread in the EightBites diets can be a bit of a problem since it fills the stomach but does not add much nutritionally. But sometimes you just have to have some bread. When I make this crostini I eat one of the pieces (just to test it to be sure it’s good). Quality control you know.

There are a wide variety of options available for this crostini. If you purchase smoked salmon it can be chopped into dice and added directly to the cream cheese and chives, and then spread on crostini. Or the cream cheese can be made, and spread on the crostini and then topped with a small piece of salmon.

Cheese (crema) topping:
Whip 8 oz of mascarpone cheese and 8 oz cream cheese (or 16 oz of cream cheese)
Add 1/4 cup chopped chives and 1 Tbs of lemon juice
Taste and add salt and pepper to taste
Spread on crostini and top with a small dollop of lemon mostarda.

This dish will work well with other types of smoked fish such as swordfish. Or if you have a stovetop smoker, smoke your own.

Lemon mostarda
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
Slice another lemon into eighths and slice crosswise into very thin lemon wedges, remove seeds
Two tablespoons of yellow or black mustard seeds toasted
3-4 tablespoons of apple cider vinegar (to taste)

Bring water and sugar to a rolling boil and boil for 10 minutes
Add grated lemon peel and juice and return to a boil.
Add small slices of lemon, and allow to cook at a simmer for 20 minutes
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
Chop coarsely in a food processor
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
Allow to cool.

Beer Bread
This recipe makes one loaf of bread. It takes about 5 minutes to mix up and bakes in under an hour. Turn the oven on to 375 degrees F and grease a 1 pound loaf pan with olive oil or butter. Use self-rising flour if you have it available, but a good substitute can be made easily using flour and baking powder (1 ½ teaspoons of baking powder to 1 cup of flour).

The basic bread recipe is simple:

3 cups of self-rising flour or three cups all purpose flour plus 1 1/2 tablespoons of baking powder
¼ to ½ cup of sugar (depending how sweet you want it to be)
A pinch of salt
1 12 oz beer (the type of beer will alter the flavor, dark-richer, light-less beery)
Now is the fun part. Before adding the beer, this flour mixture can be flavored by the addition of a wide variety of items before baking. Mix in one or more different ingredients into the dry flour mixture to vary the taste. Mix in the dry or additional ingredients well before adding the beer.

I have used:
Garlic powder 1/2 tsp
Onion powder 1/2 tsp
Sautéed onions ¾ cup
Chopped salami ¾ cup
Chopped sun dried tomatoes ¾ cup
Grated pecorino cheese ½ cup
Parmesano/Reggiano cheese ½ cup
Dried chili peppers 1/8 tsp
Grated Asiago cheese ½ cup
Dill weed 1 Tbs
Mix the dry ingredients together; pour the beer into the center of the flour mix.
Stir to make thick, sticky dough.
If it appears too thick and not moist enough, add a tablespoon or two of water.
Place in a greased 1 pound loaf pan
Bake in a pre-heated 375o oven for 55 minutes or until it sounds hollow when tapped.
Five minutes before the time is up pour a bit of melted butter over the top and return to the oven.
Make up your own flavor or try them all. Just not too many different things in one loaf.

Crostini with cream cheese and peperone agrodolce
This crostini again uses toasted beer bread and either seasoned or unseasoned cream cheese. I toast the crostini in a grill pan until ther are crisp but still soft in the middle. Then I spread the bread with the cream cheese and top with a spoonful of the peperone agrodolce. Cut into three pieces and serve.

Sweet and spicy pepper marmalatta (Peperone agrodolce)

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 cups)
3 cloves of fresh garlic, peeled and sliced thinly

Place vegetables in a deep sauté 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, sauté 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 to cool and place in a storage container in the refrigerator
Can keep for several weeks

Crostini with sautéed mushrooms or mushroom pate
Sauté 3 cups of sliced mushroom in 2 Tbs olive oil and an ounce of butter.
Cook over medium-low heat until they start to caramelize and shrink in volume.
Add 2 cloves finely chopped garlic and another tablespoon of butter.
Add ½ cup Marsala wine and allow it to cook down until there is almost no liquid left.

At this point they can be placed in a food processor and pureed with three tablespoons of cold butter into a pate. This should be placed in a sealed container and in the refrigerator.

The sautéed mushrooms can also be served directly on toasted crostini. You might consider using a small spread of fig marmalatta on the bread before putting the mushrooms on. It adds a nice surprise flavor. Can be served at room temperature or warm.

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

Directions to make the fig puree:
Place a dozen large figs cut into quarters in a large saucepan.
Add a chopped onion and 3 cloves of garlic.
Add water to cover and cook over medium heat for approximately 1 hour until figs are very soft.
The mixture should be reduced by about ½.
Place the fruits in a food processor or using a stick blender, puree till smooth.
Put back over low heat and continue to cook to thicken the puree.
Stir at frequent intervals.
Check for seasonings and add salt and pepper.

I found a couple of tablespoons of vinegar made a great difference in sharpening the flavors.
Add 2 tablespoons of sugar if you want it sweeter and to balance the vinegar
Pack in ½ pint clean jars and refrigerate or water process to can for longer term storage.
Keeps about three weeks fresh or they can be stored for longer periods if canned

Bruschetta with sautéed broccoli rabe, garlic and anchovies
This is an excellent and unusual antipasti and can be made with green field vegetables other than broccoli rabe. I have also used chard, mustard greens and a vegetable they call cavolo nero here in Italy. I use the rustic Italian salt-less bread toasted in a grill pan as the base for this. Rub the bruschetta with a raw clove of garlic, brush with good olive poil and add a sprinkle of salt, before adding the sautéed vegetables. It is not strictly for EightBites consumption but it’s so good it is worth the lack of protein.

The greens are cleaned under running cold water and if the stems are tough, they are trimmed off. I like to cook the stems, roughly chopped in the boiling water before I cook the leafy portion of the greens which are also coarsely chopped.

In boiling salted water, cook the greens plus 4 or 5 peeled cloves of garlic until they are done and soft. Drain the greens and refresh under cold water, then allow to drain well. Squeeze the greens to remove excess water and place the greens in a bowl in the refrigerator. Pour a bit of olive oil over them before putting them away covered with plastic wrap.

To prepare the bruschetta topping, first grill slices of French or Italian bread to a nice toasty color, rub with a clove of raw garlic, brush with olive oil and sprinkle on a bit of salt. Chop the greens into a fine dice. Add three more chopped cloves of garlic to the greens. Using a 10” sauté pan, put 3 tablespoons of olive oil into the pan and heat over moderate heat. Add the greens and the garlic and stir the mixture while it sautés. Add 4 anchovy fillets (in oil) and allow the anchovies to cook into the greens and disappear. Continue to cook the greens until they start to dry slightly. Remove from the heat. Place a small pile of greens on the bruschetta, spread it to cover and top with grated pecorino or Parmigiano cheese. Put on a baking sheet and into a 350 degree oven for ten minutes (or less) to bring the bruschetta to temperature. Cut the bruschetta into two or three pieces and place on a serving platter. The greens can be kept under refrigeration for several days. Just heat on the bruschetta and serve.

Cucumbers with goat cheese and slow-roasted tomatoes
This dish uses the wonderful fresh goat cheese available here locally. It is high in protein but does tend to fill the stomach with the cucumber slices. One or two of these are a nice addition to your dinner.

Peel and slice cucumbers into ½ inch slices
Mix 4 ounces of goat cheese with a bit of milk to soften if necessary
Add 1 or 2 crushed chopped clove of garlic and a tablespoon of chopped chives
Season with salt and pepper to taste
Roll a small ball of the goat cheese and place on top of the cucumber slice
Top with a half of a slow-roasted cherry tomato

An alternative is to just top the cucumber with the spiced goat cheese and serve.
Slow oven-roasted tomatoes
Cut 25 to 30 cherry tomatoes in half and place in a bowl. Add ¼ cup of olive oil, a teaspoon of dried oregano, a teaspoon of sugar and a bit of salt and pepper. Allow the tomatoes to marinate for an hour. Place the tomatoes on a baking sheet and turn them all over so the cut sides are up. Place in a 350 degree oven for 40 minutes then turn the oven off, open the oven door slightly and allow the tomatoes to remain in the oven overnight. The next morning they should be shrunken and dried but still moist and tasty. Store in a plastic container in the refrigerator for a week or more. ‘

Stuffed peppers with sausage and cheeses
This is a nice addition to the antipasti selections. It is high in protein, has a nice spicy flavor and is served hot directly out of the oven. I eat two or three of these whenever I make them for guests. They can be made with sweet peppers with you controlling the spiciness of the filling or using Jalapeno peppers if you want a lot more heat. Jalapenos can be quite variable in their heat intensity

1-2 dozen sweet peppers approximately 3” long and about 1 ½” wide
1 pound of fresh Italian sausage (you can use spicy hot or mild)
1 medium onion
4 ounces of cream cheese
1 Cup grated Parmigiano/Reggiano cheese (or pecorino or a combination of the two)
Brown the sausage, and the chopped onion in a sauté pan and crumble into very small pieces when done completely and allow to cool.
Mix cheeses together with a hand mixer or in a food processor with the steel blade.
Add sausage and mix thoroughly.
Set aside to cool or put in a container in the refrigerator.
Slice the peppers lengthwise and remove the seeds and ribs.
Rinse the peppers and allow them to drain on a rack.
When dry, place cut side up on a baking sheet.

Turn oven to 400oF and preheat

Fill the peppers with the sausage/cheese mixture mounding the mixture slightly.
Place the baking sheet with the peppers in the oven to brown and melt the cheese (3-4 minutes).
Remove from oven, remove from baking sheet and place on a serving platter.
Serve immediately

Friday, May 7, 2010

An assessment

Next month will be the second anniversary of my bariatric surgery and I think it is time to assess where I have come from, where I am right now, and where I am going in the future. I had a heart attack and double bypass surgery in 2006 and while I recovered nicely, my weight, the major factor in the heart problem still existed. I went back to work in environmental consulting and tried to reconcile what I did, what I wanted to do and how all of the physical factors coalesced into a cohesive whole. I realized that after all those years working with my first wife’s issues and her weight that I really needed some help in getting the weight off. When I saw the 60 Minutes program on weight loss surgery in the spring of 2008 and its obvious associated effects on diabetes I knew that I really needed to do this. My insulin-dependent diabetes required four insulin shots per day to keep my blood sugar under control. The associated physical and medical effects from the diabetes were also weighing heavily on me. I really knew that my life would be shortened substantially unless I could get control of the diabetes.

I was remarried and was trying to deal with a new wife, a new life and soon a new culture living in Italy. Elizabeth’s support was important in the consideration to have the weight loss surgery. So in May 2008 I discussed the options with my surgeon and began the relatively rapid pre-operative run up to the surgery scheduled for June 4, 2008 at California Pacific Hospital in San Francisco, California. Dr. Jossart did asked me to see if I could lose a bit of weight before the surgery since I weighed in at 300 pounds (137 kg) at that first appointment in May. That small loss would help make the surgery a bit easier. I began to get all of the pro-operative testing and assessments done including an endoscopy, colonoscopy, heart assessment, blood work, and most importantly the pre-assessment psychological evaluation. By June 1 all of the information had been provided Dr. Jossart and I was ready both physically and psychologically to have the surgery.

My son drove me to the hospital on the morning of June 4, 2008 and I checked in at 10AM. At the time of my surgery I had lost about 8 pounds and I weighed 292 pounds. They dressed me in an over sized surgical gown and Garth and I sat talking for an hour or so. At noon they came in to pre-op me and I walked over to the preoperative area where I was given some medications to ready me for surgery. At 1PM I walked into the surgical suite and met the anesthesiologist, the surgical nurse and Dr. Jossart. All was ready, as was I. I climbed up on the operating table and laid back. The anesthesiologist set up an IV and the next thing I was aware of was being back in my room at 430PM. The nurse gave me a cup of ice chips to wet my mouth and I fell back to sleep. I had no significant pain or discomfort. The surgery had taken one hour and twenty minutes and had gone well (at least according to the surgical report Dr., Jossart gave me). The morning of the 5th, I was offered a small liquid breakfast of a protein drink, some juice and some Jell-O. I ate a little bit but was not particularly hungry. Dr. Jossart came in that morning to check on me and told me that after lunch (?) I could go home. Garth had stayed overnight in the city and was with me later in the morning. They served me another light liquid lunch which I ate some of and then they discharged me. Garth went and got his car, put the top down, and drove me back to Santa Rosa in the afternoon of June 5, 2008. Things were ready to change in my life. Elizabeth had returned to Italy in April to resume her seasonal responsibilities and I was alone in the house on Powderhorn.

Those first days seemed go by quite slowly. I was drinking high protein drinks and walking around a bit. I was keeping as active as possible. I had no pain or discomfort. My small abdominal incisions were healing nicely and I felt quite well. I was not hungry. At the time of my surgery I wore a size 54 jacket, had a 46 inch waist and wore a 3XXL shirt (19 to 20 inch collar). I stayed on the liquid diet for about three weeks, then I started eating soft solid foods. At six weeks I was eating solid foods and was losing weight quickly. It was the middle of July and I was preparing to move to Italy in early August.

I took my last long acting insulin shot the evening before my surgery on the 3rd of June and my last short term shot in July 2008. I have not given myself an insulin injection since that time. My blood sugar level in the morning is now at 70 which is a terrific level (100 or less is normal). My blood pressure was down. I had stopped snoring and I had no sleep apnea.

At the end of my first year post-surgery I weighed 168 pounds (71 kg). I felt good and when I had my annual blood work and vitamin analyses, things seemed to be going in the right direction. I was down in physical size to a 42 jacket, a 32 inch waist and a size 16 shirt (large in Italy sizes). I was getting up earlier in the mornings and had a good amount of energy. I was exercising regularly and felt wonderful. I had begun cooking with the AmoreSapore team in August 2008 when I got to Italy and was rapidly learning the recipes we used in our dinner catering and service. I was learning a “new” trade and felt great about it. Working was the best thing I could do for myself.

So that is where I have come from. And here at the start of my third year after surgery is where I am right now. I have maintained my weight with no difficulty at 165 pounds (70 kg), and I feel that the weight I have is being redistributed a little better on my body. For the first time in my life I have been able to wear a double-breasted sport coat. I had never had a double breasted sport coat body before. I weigh 30 pounds less than I weighed in high school. I feel and look pretty good.

I have been able to eat anything I want to without restrictions other than I can only Eight Bites per meal. That has been OK. I love to taste the tastes now, not necessarily to consume the volume. The only food that is a still a bit problematical is red wine. The tannins cause me some stomach pain so I avoid them and stick to small amounts of white wine when I want to have a bit with dinner. I have become well-known in local dining circles for my antipasti which to me are the perfect food, since they are small, tasty bites that are pretty to the eye and bring excitement to the dining experience. I often make my meal of several antipasti and will often order a plate of antipasti if we go out to eat. The transition from heavy to lighter has been an easy one. Both in terms of the eating side as well as the living side. I feel that I have a new lease on life and expect to live a long and healthy life.

So where do I go from here? For one thing I will never go back to being heavy again. The surgery I had was a one-way ticket, and there is no turning back. Why should I? I was unhappy heavy and am happier weighing less. Why go through all this just to return to being heavy again? Having maintained my weight loss for one year I know that it can be done. Dr. Jossart has asked me to counsel pre-surgical patients about what to expect in their new lives. And I have been able through this blog to provide clear information and advice to several patients who are considering the surgery. These include those folks referred to me by my surgeon, as well as former classmates and friends. The one significant issue I see with this process is the lack of sufficient pre- operative psychological counseling and evaluations. I have seen where the desire to lose weight can override a person’s problems with eating issues or disorders but those problems don't just go away. When they feel better having lost weight (100 pounds or more often) the “treat” themselves to more and higher calorie foods and can begin an inexorable weight regain. I have discussed this area before and the reader may wish to reread that blog entry.

This blog is being written to assist those who are heavy or who have had weight loss surgery to come to grips with the issues involved in good life choices. Weight loss surgery is not for everyone. But it can change your life.

So now I will get back to why I started this blog last year, food and how to enjoy it. New recipes and food ideas are in the works. Stay tuned. The best is yet to come.

So Happy Re-birthday Kurt. And to all of you reading this blog, thanks and stay with me. Life is just getting better by the day. Mangia!