Thanksgiving in Umbria

This is my first Thanksgiving since moving to Italy a year ago in August of 2008. In November last year I had to go back to California and get my long term visa to stay in Italy with my new wife. So last Thanksgiving I made dinner in my old house for my youngest son, his wife and two children. We had all the basic trappings of a traditional Thanksgiving meal, turkey, mashed and sweet potatoes, vegetables, cranberry sauce and pumpkin pie with whipped cream. In the time in California, I was able to visit some friends and family and to finally get my visa (stamped into my passport with a misspelled middle name). I returned to Italy the day after Christmas and so this year I will be having Thanksgiving dinner here.

Thanksgiving is a uniquely American event. In Italy it is just another day of working, shopping, working in winter gardens, pressing olives for oil, and tending to the myriad number of mundane things that are required to live here. But there is no celebration, no turkey, no stuffing, and certainly no pumpkin pies. The evening meal is the same as normal. This year, a group of Americans and a Brit will be coming together at one of the rental country houses my wife manages and will be having a communal dinner combining Italian and American characteristics. There will be eight people in our group and the food tasks have been divided up among us all. I will be making four different antipasti including: sausage and cheese crostini, mushroom pate crostini, melon and prosciutto, and sliced pecorino cheese and salame. I included a bit of apricot mostarda to put on the cheese slices. My wife and Anne made about 80 pumpkin ravioli Tuesday and they are ready to quickly cook and finish. OK, Paul (Ann's husband) made a few ravioli, but mostly he wandered through the kitchen smelling things on the stove and in the oven and asking questions. I like him.

 We will probably serve possibly three ravioli per person so we won't take them all. I will likely only eat one ravioli since pasta is difficult for me to digest after my surgery. I will make a light bechamel sauce with walnuts for the ravioli. Then David will roast some marinated lamb and make some braised mustard greens with garlic from Kathy's recipe, and we will have some dessert which this year will be grape pie with Greek yogurt from Mara. I am sure there will be plenty of wine poured and stories told around the inviting fire set in the big fireplace.  This will be a good Thanksgiving held in the spirit that it should be. One of a gathering of friends and family, good foods lovingly prepared, good wine generously poured, and good fellowship gratefully shared.

I will eat only what I can accommodate. A few bites of antipasti, a single ravioli, some grilled lamb, possibly a bite or two of mustard greens and a small slice or a few bites of pie. A lengthened dinner allows me the consumption of a few more "bites" that I will gratefully savor. We will try the new olive oil pressed Thanksgiving morning. I will get all of the tastes of the seasonal dishes that I love and still not overeat.

Happy Thanksgiving.

Post script to Thanksgiving: The grape pie was quite something, made with Concord grapes picked from the pergola outside our guest house in September this year and served with a thick Greek yogurt. The freshly pressed olive oil had a peppery flavor, and when drizzled on the lamb and vegetables was excellent.  It was a satisfying dinner and an entertaining evening. kfk

Eating during the holidaze

The winter holidays are some of the most difficult times of the year for those of us who have had bariatric surgery. It is a time of family, friends, gifts, parties and FOOD. To cope with this period of potential excess, it is important to remember why you had the surgery and what you hope to gain (or lose actually) from the process. If this time comes early in your surgical healing period, it is important to be very careful about what and how much you eat. The limits placed on you for those first six months means that your intake is very restricted. Don't let pressure from friends or family push you to eat excessively.

There is a lot of temptation regarding foods during the holidays. Candy, cookies, cakes and other sweets can sabotage your weight loss quickly. They are physically filling and full of carbohydrates, thus limiting the amount of important foods you need to eat. Be extremely careful, but do enjoy that piece of chocolate or a butter cookie, or a few bites of your aunt's apple spice cake. You will notice I said a piece of chocolate, a butter cookie and a few bites of the spice cake. Eating that whole pound of See's chocolate can be a real problem. You can enjoy the wonderful tastes of the holidays without stuffing yourself. Love those eight bites. Especially early in the healing process it is important to be sure you do not over-extend the surgical site.

Parties are the biggest problem you can encounter during the holidays. Most of the people attending will not know the effort you have spent in losing the weight, but may comment on how little you eat. To deflect questions, take a little plate, put a couple of nibbly little things on it and carry it around with you. (A side note: with a wine glass in one hand and a plate in the other, no one will be able to shake hands with you and pass on that ugly flu we are experiencing). People will stop asking you to eat something as long as you have something in your hand. My father used to avoid the issue of drinking too much during the holidays by carrying around a glass with ginger-ale in it. It looked like a high ball and since he already had a "drink", no one asked him if he wanted another. Just keep slowly refilling that glass with ginger-ale or that small plate will small bites. It is the safest way to get through the party intact.

Thanksgiving has come to mean eating to excess with loving friends and family and you need to carefully consider what you are about on that day. Today I will be having Thanksgiving dinner wih nine friends at one of the rental properties my wife manages in the hills of Umbria. We are all bringing things to share for dinner. I will be making antipasti (more about that in a minute), there will be pumpkin ravioli with bechamel and walnut sauce, grilled marinated lamb (hard to get good turkeys here), a variety of vegetable dishes and the usual plethora of desserts. The olive oil from our trees is being pressed this morning so thoughts are not strictly on food, though I guess here in Italy, olive oil is a major food group.

Thanksgiving antipasti will include sausage and cheese crostini with chutney, sliced pecorino cheese, and some winter melon and prosciutto. I will make them in small bites, and will plate them on holiday platters.

The sausage and cheese crostini will be made with sautéed local sausage (seasoned with fresh garlic, salt and pepper only) mixed with a generous amounts of Parmigiano-Reggiano and Cacciota (a cow's milk cheese that is soft and mild). I will puree it in the food processor until smooth. The crostini will be made from fresh local artisan bread that I will grill to toast, rub with garlic, sprinkle with a bit of the fresh olive oil and a sprinkle of salt. I 'll assemble the crostini just before serving so it is warm. A bit of pear or plum chutney will top the sausage mixture on the crostini. Wine will be passed and the air will be filled with stories of past Thanksgivings, stories of friends, and plans for the future. Especially for that olive oil, just pressed this morning.

Enjoy the holidays, but remember the limits we have placed upon ourselves. Eat those delicious bites on that small plate and toast your friends well. Mangia!

Working as a cook in Italy

Part of the experience of working as a cook in Italy is making interesting foods, using creative and locally available ingredients and combining them in different ways. While much of the cooking I do has an Italian base, I try to incorporate some new tastes for the people I serve. I make pasta including ravioli using classic fillings such as potatoes and two cheeses, ricotta and spinach, ricotta and lemon sauced with a vegetable tomato sauce. But then I try some new tastes such as a spicy pumpkin and Parmesan cheese filled ravioli in a bechamel sauce with walnuts, or smoked salmon ravioli with grated lemon peel, mashed potatoes and spinach and parsley in a white wine sauce.  I realize these dishes are not strictly for the bariatric patient but they are interesting and contribute to a great dining experience.

A note about parmesan cheese please. In Italy, the more correct and preferred spelling is Parmigiano-Reggiano for cheese made from cow's milk in the specific region around Bologna. If it is a generic version, it is spelled Parmesan(o). Parmigiano-Reggiano is a beautifully made cheese with a great flavor and is normally aged for many months. The producers of this cheese are justly proud of their product and it deserves the credit. Generic parmesan cheeses used in recipes will probably not have the richness of flavor that using Parmigiano-Reggiano would impart, but still will be suitable. When I use Parmigiano-Reggiano in a recipe, the generic version would be acceptable in the event you can not obtain the real thing.

Tonight my wife brought home a whole turkey breast and asked for it for dinner. Using turkey breast meat is a good substitute for too much beef or pork and you can use it in a wide variety of ways. So I prepared it in thin slices which I pounded flat with a mallet. I made a flour mixture with seasoned salt, pepper and some Cajun spice. Then I dredged the turkey slices in the flour and sautéed them quickly in hot vegetable oil until they were brown, and almost done. I poured out the oil and added a cup of water to the hot pan to deglaze it. I then squeezed in about a 1/4 cup of fresh lemon juice, added a 1/2 cup of cured olives and 1/4 cup of marinated artichoke hearts. The sauce was a bit tart so I added a couple of teaspoons of sugar to reduce the sharp flavor. The sauce thickened and I then put the turkey slices back in the pan to heat and finish cooking. I served it with a green salad simple dressed with vinaigrette.

So you see that you can adapt. Last Tuesday, I was to make dinner for some friends and decided to do a simple dinner that was quick and easy to prepare. It included Umbrian chicken liver pate on beer bread crostini, some slices of pecorino cheese with a couple of chutneys, beer bread crostini with smoked salmon, strachinno, chives with citrus marmalatta (described in an earlier post), tagliatelle with pesto and grilled fish, black cabbage with oven dried tomatoes and pancetta, sweet and sour cipollini and for dessert vanilla gelato with brandied cherries. I served the antipasti attractively on beautiful plates with some good wine; while the pasta and fish went into heated bowls as a one dish meal. The vegetables were eaten on the side with a green salad. I used a commercial gelato, and my own brandied cherries. I had put up the cherries earlier this year during the cherry harvest. They were terrific.

Umbrian chicken liver pate.

This is a simple and a fairly inexpensive antipasti. The pate is made primarily in the food processor. Place 1/2 cup of pickled vegetables (giardineri) in the food processor, add 1/4 pound (125 grams) of cold butter cut into bits. The giardineri includes pickled cauliflower, carrots, dill pickles, and red peppers in a vinegar solution and is easily found in your local market. Rinse and drain 1/2 pound of fresh chicken livers. Saute a medium chopped onion in some olive oil over medium heat; add a bit of crushed dried hot pepper and some salt. Add the chicken livers and saute until no longer reddish inside, but still pink. Don't overcook the livers. Add 1/4 cup of Marsala to the pan and deglaze. Pour the entire pan of livers and onions into the food processor and process until smooth. Put the mixture in a covered bowl and refrigerate for two hours until firm. Spread on garlicky crostini, bruschetta, or even spread on crackers.

Tagliatelle with pesto and grilled fish

This dish combines the creaminess of the basil pesto with the crispy heat of the grilled fish. It is a good lunch dish or as part of a larger dinner. It also is not too bad for the bariatric patient as long as they do not overdo on the pasta. Get the lovely basil flavor and eat the fish.

Purchase 4 ounces of fish (look for firm white fleshed fish like halibut, swordfish, tilapia, and rockfish) per person. Cut into 1” chunks and set aside in a bowl. Make a seasoned flour with seasonings you like (can be spicy, mild etc). Mix well and set aside.

Make the basil pesto: In a blender place 2 cups of fresh basil, two garlic cloves, a bit of salt and freshly ground black pepper, ¼ cup of pine nuts (substitute toasted almonds or walnuts, if pine nuts are not available), then add about ¼ cup of olive oil and start to blend. Add additional olive oil in a stream slowly as the emulsion forms. If you are serving the pesto immediately add ½ cup of grated Parmigiano-Reggiano cheese and continue to blend until smooth. Set aside. If you want to make a larger volume, add additional ingredient but do not add the cheese if it is going to be frozen. That can be added when you defrost the sauce.

For four or five servings make up 1 pound of dried tagliatelle or linguine. Cook the pasta, drain and add the pesto. Mix thoroughly and keep warm. Dredge the fish pieces in the flour mixture and saute in a good amount of vegetable oil at 370 degrees F. Brown and cook the fish and put on a warm platter to hold until all pieces are cooked. Don’t use olive oil here. Portion out the pasta into warm bowls and top with 5-6 pieces of fish. Pass lemon wedges.

Black cabbage with oven dried tomatoes and pancetta

Black cabbage (a local Italian vegetable), chard, or spinach can be braised in water with some added garlic cloves. To complete the dish, pancetta or thick bacon is cut into small chunks and sautéed in a bit of olive oil. Add the vegetables and saute quickly. Serve hot.

Sweet and sour cipollini

The little onions that are available in Italy are quite sweet and delicious. They are however a bit of a problem to peel. To solve that problem, drop the onions into boiling water for a minutes and then drain then and cool quickly in cold water. Trim the end off and the onion slips right out of the skin.

To make them agrodolce (sweet and sour), add 1 cup of sugar to 2 cups of water and bring to a boil. Put some salt and crushed dried red pepper in the solution to taste. Cook for at least 10 minutes at a good boil to reduce the water. Add about 1/4 cup to 1/2 cup of apple or white wine vinegar, return to a boil and then start to taste it. You are looking for a balance between the sweet and the sour. When you have reached the taste you want, dump the onions into the solution and cook for 20 minutes until they are tender. These can be canned in sterile jars in a water bath for 10 minutes or simply placed in a covered bowl in the refrigerator. Use them from the fridge in a week of two. Canned, they will store well for months if they seal well.

Cooking is fun and when you treat it as an on-going taste and ingredient experiment, it can be quite rewarding and delicious. Besides you don't have to serve your failures. So cook with confidence, and never let them see you sweat. There are always omelets if all else fails.

Some different takes on fish

I keep returning to fish dishes, but frankly they are easy to digest, can be quite elegantly presented, and are excellent at dinner parties. These four recipes from the Mediterranean region represent a variety of different cuisines, flavors and presentations. They appear to be complicated but in reality are relatively easy. Work through them slowly and you will be rewarded with some great flavors.


Spanish Salt Cod Fritters with Spicy Tomato Sauce

4 ounces salt cod
1/4 cup (1/2 stick) plus 1 tablespoon unsalted butter
1/2 cup diced Spanish onion
3/4 cup water
1/4 teaspoon kosher salt
1/4 teaspoon cayenne pepper
3/4 cup all-purpose flour
Vegetable oil, for frying
3 eggs
Spicy Tomato Sauce

Directions
Place the salt cod in a bowl, cover with cold water, and refrigerate for 24 to 36 hours, changing the water often. Press all of the excess water out of the salt cod and finely chop.

Heat 1 tablespoon of the butter in a medium skillet over medium-high heat. Add the onions and cook until softened, about 3 minutes. Add the chopped cod and cook for 3 to 4 more minutes. Drain any excess liquid and discard liquid. Place cod-onion mixture in the bowl of a food processor and pulse until finely chopped, stopping to scrape down the sides as needed. Set aside.

In a heavy bottomed 2 1/2-quart saucepan, combine the water, remaining 1/4 cup butter, salt, and the cayenne. Bring to a rolling boil. Remove from the heat and add the flour, all at once, to the pan and quickly stir vigorously with a wooden spoon to incorporate the flour into the liquid. Return the pan to the stove, and over a medium-low heat, continue to cook and stir the dough over the fire. Do this until the dough pulls away from the sides of the pan and forms a ball. Remove from the heat and cool dough to 140 degrees F, about 5 minutes.

Put the vegetable oil into a heavy stockpot or deep fryer to a depth of 3 inches and heat oil to 360 degrees F.

To the dough mixture add 1 egg and beat well with a wooden spoon until completely incorporated. Continue adding the remaining eggs, 1 at a time, waiting until each egg is incorporated before adding the next egg. Stir the cod mixture into the dough. This panade is the basis for the fritters

Spoon tablespoon-sized balls of dough into the preheated oil. Fry until cooked through and golden brown, about 4 minutes per batch. Using a slotted spoon, remove fritters from the oil and drain on a paper towel-lined plate. Season generously with seasoned salt and pepper.
Serve hot with Spicy Tomato Sauce.

Spicy Tomato Sauce:

2 tablespoons olive oil
2/3 cup chopped onions
3/4 teaspoon kosher salt
1/4 teaspoon freshly ground black pepper
2 tablespoons minced garlic
1/2 teaspoon crushed red pepper flakes
2 tablespoons tomato paste
3 cups peeled, seeded, and chopped tomatoes
1 bay leaf
3 cups chicken stock
1 1/2 tablespoons chopped fresh basil leaves
1 1/2 teaspoons chopped fresh oregano leaves

Heat the oil in a medium saucepan over medium-high heat. Add the onions, salt, and black pepper and saute until the onions are translucent, about 2 minutes.
Add the garlic, crushed red pepper, and tomato paste, and cook, stirring, for 1 minute. Stir in the tomatoes, bay leaf, and chicken stock, and bring to a boil. Reduce the heat and simmer, stirring occasionally, for 30 minutes. Add the basil and oregano the last 5 minutes of simmering.
Remove from the heat, remove and discard the bay leaf, and pulse the mixture in a food processor or blender until pureed but still slightly chunky. Serve immediately or store, refrigerated, in an airtight container for up to 2 days. Reheat in a saucepan over low heat.
Makes about 2 1/2 cups


Sea bass with pesto, zucchini and carrots cooked en papillote

Cooking en papillote (in a pocket) is an easy and quick way to make delicious fish dishes. Normally these are made with parchment paper, but the use of aluminum foil is an easy and always-available alternative to the parchment paper traditionally used. Cooking with parchment is also quite easy, but often it is not part of our kitchen “toolkit”. As the fish and vegetables bake in their packets, they render a delicious broth that is then poured over the fish at serving time. For the bariatric patient, the 8 oz portion size would likely be too much, however this fish makes a superb leftover meal when served the next day, flaked cold in a salad. Or simply buy smaller portions of fish.

Ingredients
4 sea bass fillets, about 1 inch thick (about 2 pounds in all)
3/4 teaspoon salt
1/2 teaspoon fresh-ground black pepper
1/4 cup pesto, homemade is preferable (recipe follows)
1 zucchini, grated
3 carrots, grated
2 tablespoons extra virgin olive oil
1/4 cup dry white wine
Heat the oven to 450 degrees F.

Directions
Make four 12-inch squares of aluminum foil
Place on a work surface and brush lightly with cooking oil
Put a fish fillet in the center of each square of foil.
Sprinkle the fillets with 1/4 teaspoon of the salt and 1/4 teaspoon of the pepper.
Spread the fish with the pesto.
Cover the pesto with the carrots and top with the zucchini.
Sprinkle with the remaining 1/2 teaspoon salt and 1/4 teaspoon pepper.
Gather the foil around the fish and drizzle the fish with the oil and wine.
Fold the edges of the foil to make a sealed package.
And place on a baking sheet
Bake the fish until just done, about 10-12 minutes.
Open the foil packages and transfer the fillets with their vegetable topping to warm plates.
Pour the juices over the top.

You can use other small, flat, white fish fillets, with or without the skin, such as red snapper, pompano, or striped bass. A four ounce fish fillet will give you about 22 grams of protein and about 200 calories.

Pesto
To make pesto at home is very easy. It requires a blender, a good bunch of fresh basil, garlic, pine nuts, olive oil and grated Parmesano-Reggiano cheese.
Put two cups of fresh basil leaves in a blender
Add 2 cloves of fresh peeled garlic
Add about ½ cup of olive oil and start the blender and puree the mixture
Add the pine nuts as the blender is going
Continue to stream the olive oil in slowly, you will probably use about a cup of a bit more
Add a bit of salt
At the last moment, add about ½ cup of grated Parmesano-Reggiano. It’s done.

If you wish to freeze some, do not add the cheese until you defrost the sauce. Freeze the sauce in small amounts (1/4 cup) in air-tight containers or plastic bags.


Moroccan Grilled Salmon

Tangy plain yogurt mixed with the classic ingredients for chermoula—a Moroccan spice mix—serves as both the marinade and the sauce in this salmon dish. If you like your food on the spicy side, add a pinch of cayenne to the mixture.

Ingredients
2 tablespoons low-fat or nonfat plain yogurt
2 tablespoons chopped fresh parsley
2 tablespoons chopped fresh cilantro
1 tablespoon lemon juice
1 1/2 teaspoons extra-virgin olive oil
1 clove garlic, minced
3/4 teaspoon paprika
1/2 teaspoon ground cumin
1/8 teaspoon salt
Freshly ground pepper to taste
8 ounces center-cut salmon fillet, skinned and cut into 2 portions
2 lemon wedges

Tip: To skin a salmon fillet: Place a fish fillet on a clean cutting board, skin side down. Starting at the tail end, slip the blade of a long, sharp knife between the fish flesh and the skin, holding the skin down firmly with your other hand. Gently push the blade along at a 30° angle, separating the fillet from the skin without cutting through either.

Directions
Combine yogurt, parsley, cilantro, lemon juice, oil, garlic, paprika, cumin, salt and pepper in a small bowl. Reserve 2 tablespoons of the sauce; cover and refrigerate. Place salmon in a medium sealable plastic bag. Pour in the remaining yogurt mixture, seal the bag and turn to coat. Refrigerate for 10 (or up to 30) minutes.

Meanwhile, preheat grill to medium-high.

Oil the grill rack. Remove the salmon from the marinade, blotting any excess. Grill the salmon until it is browned and just cooked through, 4 to 5 minutes per side. Top the salmon with the reserved sauce and garnish with lemon wedges.


Grouper Poached in Olive Oil With Grape Leaves

This dish is served with rice cakes and is certainly of Mediterranean origin. Serves 2. Grape leaves can be fun. Use them for dolmas and other Greek dishes.

Ingredients:
2 grouper fillets (4-6 ounces each)
Salt and pepper
Jar of preserved grape vine leaves
Chives, left long and blanched for 1 minute in boiling water
Olive oil enough to cover the fish bundles

Rice Cakes
1 cup of cold cooked rice (preferably Arborio)
1 egg, beaten
Some grated Romano or Parmesan cheese
Salt and pepper to taste
All-purpose flour for dredging
Oil for frying

Green Pea and Caper Sauce
1 cup of green peas (fresh or frozen)
1/4 cup extra-virgin olive oil
1 tsp. Dijon mustard
2 Tbsp. of fresh lemon juice
1 Tbsp. of finely chopped capers
1/4 cup chopped fresh dill
1/4 cup chopped fresh chives
Salt and pepper to taste

Directions
Take the preserved grape leaves out of the jar and briefly rinse them to remove excess salt. Remove any stems from the leaves and place them vein-side up on your work surface. Place two long stems of blanched chives on your work surface in cross (+) formation. Set one grape leaf where the chives intersect, then begin to lay enough grape leaves just overlapping each other in an outward circular pattern. The number of grape leaves required to bundle your fillet depends on how large your leaves are and the size of the fish fillet.

Lightly season your fillet with salt and pepper and place in the center of your grape leaves. Now carefully bring the other edges of the grape leaves (with the chive stems) up towards the top of the fish fillet and wrap your bundle. Carefully tie the bundle up with the chive stems.
Place a pot large enough to hold both bundles on your stove-top and add some olive oil (eyeball it). Gently heat up your olive oil (medium heat) to an approximate temperature of 250-300F. Your olive oil should be just “quivering”. Gently drop your bundles into the olive oil know side down and poach for 20 minutes. Keep the oil quivering.

Mix the rice, cheese, beaten egg, and salt and pepper for your rice cakes and form the mixture into patties. Dredge lightly in flour and reserve. Add about 1/2 inch of cooking oil into a large skillet bring to about a temperature of 350-360F. Carefully place your rice cakes in the hot oil and fry for about 3 minutes per side or until golden brown. Place on a paper-towel covered plate and keep warm.
Carefully remove your fish bundles and place on a paper-towel covered platter. Reserve.

Make your pea and caper sauce. You can use either fresh or frozen (thawed) peas, place in a small pot of salted boiling water for a couple of minutes. Drain and blanch in cold water (peas should be slightly warm). Add the peas to a food processor with a bit of the cooking water and puree. Now add the mustard, lemon juice and with the processor running, add a slow stream of olive oil (you may use the olive oil used to poach the fish). Add the capers, chives and dill and pulse a few times to blend in. Adjust seasoning with salt and pepper.

Spoon some sauce onto the bottom of each warmed plate. Place your poached grouper bundle (tied-side down) on top of the sauce. Place a rice cake on the side of the plate and garnish with chives and chopped fresh dill. Serve warm.

What about Pasta?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regaining the weight so dearly lost

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

The surgical procedures

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

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


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


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

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

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

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

Pre-surgical evaluation and support

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

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

Post Surgery follow-up and support

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

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

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

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

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

Reasons for regaining weight

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

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

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

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

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

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

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

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

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

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

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

Comfort Foods -1

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

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

Neapolitan Meat Loaf

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

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

For the omelet
2 eggs
1 teaspoon water
1 tablespoon butter

Directions

Preheat the oven to 375 degrees F.

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

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

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

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


Meatloaf with Roasted Tomato Relish and Roasted Garlic Mashed Potatoes

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

Ingredients

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

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

Directions

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

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

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

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


Albondigas (Meatballs in Garlic-Tomato Sauce)

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

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

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

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

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


Lamb Meatballs in Almond Sauce

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

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

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

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

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

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

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

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


Chicken Sausages

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

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

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

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

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

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

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

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