Thursday, November 25, 2010

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.

Monday, November 8, 2010


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

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

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

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

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

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

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.