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.
Thursday, November 25, 2010
Monday, November 8, 2010
Veal
The most important part of this blog is about the relationship we have with our food, how we deal with the dietary restrictions placed upon us by WLS and how we can still enjoy good and exciting foods as we live our new lower weight life. I have discussed regaining weight after WLS previously and frankly it is more of a problem with the consumptive discipline we need in our lives, not the food choices we have available. So today I want to get back to talking about food again. Exciting, good tasting food that provides adequate sustenance and well as some emotional support. So I am going to give you several recipes for veal. These are high protein dishes with great taste and eye appeal. They can be easily portioned-controlled simply by the creation of the size of the piece of meat. A four ounce serving is just about perfect. They are readily stored and can be rewarmed and eaten as leftovers. I know the arguments regarding how veal is raised and created. That issue is not within the purview of this blog. The meat is available and if you have a problem with how it is raised that is perfectly fine. Don’t use it.
Veal francese
Ingredients:
1/2 pound veal scallops from the leg
Salt to taste
Freshly-ground black pepper to taste
1 Egg well beaten
Flour for dredging
6 tablespoons butter
1 cup Dry white wine
Directions:
Place veal pieces between 2 sheets of waxed paper and pound with a mallet until they're thin. Season with salt and pepper. Place the beaten egg in a wide, shallow bowl. Place the flour on a wide plate.
Dip the pounded veal in the egg. Remove, letting the excess egg drip off. Place each scallop in the flour, and coat lightly. Remove the scallops from the flour, and hold them in a single layer. Add 4 tablespoons of the butter to a saute pan large enough to hold the 6 scallops in a single layer. Melt the butter over medium-high heat.
When it foams, add the veal. Saute, turning once, until the scallops are golden on the outside. Remove the scallops and hold in a single layer. Spill the butter out of the saute pan, and return the pan to high heat. Add the white wine and reduce it to 1/2 cup. Turn heat to very low. Swirl in the butter until the sauce is thickened. Add the reserved veal to the pan, turning them until they are coated with the sauce. Divide scaloppini among 2 plates, pour remaining sauce over them. Serve immediately.
Veal scaloppini
Ingredients:
1 lb veal, scaloppini (1/4 in thick)
1/2 cup flour
3 large eggs
6 tablespoons Parmigiano cheese
1/2 teaspoon salt
1/4 teaspoon black pepper
1 1/2 tablespoons olive oil
1 1/2 tablespoons butter
1 large lemon
Directions:
Preheat oven to 180 degrees F.
Heat olive oil and butter in large skillet over medium high heat.
Dredge veal in flour.
Mix eggs, Parmigiano, salt, pepper.
Dip floured scaloppini into egg batter and place in hot pan.
Cook scaloppini in batches being careful not to crowd the pan.
Cook until nicely browned (1 1/2-2 minutes per side).
Remove to a platter and keep warm in oven.
Repeat, adding more oil and butter to pan as needed until all are cooked.
When done return all to the pan and sprinkle with lemon juice and serve on a warm platter.
Veal with wild mushroom cream sauce
Ingredients:
For the sauce:
2 tablespoons olive oil
2 tablespoons unsalted butter
1/2 cup shallots, minced
8 ounces wild mushrooms (such as chanterelles, shiitake, oyster, or a combination)
1 teaspoon fresh thyme, minced
1/2 teaspoon salt
1/2 teaspoon black pepper
1 large garlic clove minced
1/2 cup dry white wine
1 cup veal demi-glace
1 cup heavy cream
For the veal:
8 veal cutlets, scaloppini style
Flour for dredging
1/4 teaspoon salt
1/4 teaspoon black pepper
2 tablespoons olive oil
2 tablespoons unsalted butter
1 tablespoon lemon juice
1/2 teaspoon fresh chervil, minced
Directions:
Make the sauce:
In a saute pan set over moderately high flame, heat the oil and butter until hot. Add the shallots and cook, stirring, 1 minute. Add the mushrooms, thyme and salt and pepper and cook, stirring occasionally, for 5 minutes, or until mushrooms are soft. Add the garlic and cook, stirring, 1 minute. Add the wine and reduce by half. Add the demi-glace and simmer 5 minutes. Add the cream and reduce until lightly thickened. Cover with a round of buttered wax paper and keep hot.
Make the veal
Dredge the veal scallops in flour, shaking off excess, and season with salt and pepper.
In large skillet set over moderate flame, heat olive oil and butter until hot. Add scallops and saute for 1 minute on each side. Transfer the meat back into the sauce for just a minute and season with fresh lemon juice and chervil.
Veal francese
Ingredients:
1/2 pound veal scallops from the leg
Salt to taste
Freshly-ground black pepper to taste
1 Egg well beaten
Flour for dredging
6 tablespoons butter
1 cup Dry white wine
Directions:
Place veal pieces between 2 sheets of waxed paper and pound with a mallet until they're thin. Season with salt and pepper. Place the beaten egg in a wide, shallow bowl. Place the flour on a wide plate.
Dip the pounded veal in the egg. Remove, letting the excess egg drip off. Place each scallop in the flour, and coat lightly. Remove the scallops from the flour, and hold them in a single layer. Add 4 tablespoons of the butter to a saute pan large enough to hold the 6 scallops in a single layer. Melt the butter over medium-high heat.
When it foams, add the veal. Saute, turning once, until the scallops are golden on the outside. Remove the scallops and hold in a single layer. Spill the butter out of the saute pan, and return the pan to high heat. Add the white wine and reduce it to 1/2 cup. Turn heat to very low. Swirl in the butter until the sauce is thickened. Add the reserved veal to the pan, turning them until they are coated with the sauce. Divide scaloppini among 2 plates, pour remaining sauce over them. Serve immediately.
Veal scaloppini
Ingredients:
1 lb veal, scaloppini (1/4 in thick)
1/2 cup flour
3 large eggs
6 tablespoons Parmigiano cheese
1/2 teaspoon salt
1/4 teaspoon black pepper
1 1/2 tablespoons olive oil
1 1/2 tablespoons butter
1 large lemon
Directions:
Preheat oven to 180 degrees F.
Heat olive oil and butter in large skillet over medium high heat.
Dredge veal in flour.
Mix eggs, Parmigiano, salt, pepper.
Dip floured scaloppini into egg batter and place in hot pan.
Cook scaloppini in batches being careful not to crowd the pan.
Cook until nicely browned (1 1/2-2 minutes per side).
Remove to a platter and keep warm in oven.
Repeat, adding more oil and butter to pan as needed until all are cooked.
When done return all to the pan and sprinkle with lemon juice and serve on a warm platter.
Veal with wild mushroom cream sauce
Ingredients:
For the sauce:
2 tablespoons olive oil
2 tablespoons unsalted butter
1/2 cup shallots, minced
8 ounces wild mushrooms (such as chanterelles, shiitake, oyster, or a combination)
1 teaspoon fresh thyme, minced
1/2 teaspoon salt
1/2 teaspoon black pepper
1 large garlic clove minced
1/2 cup dry white wine
1 cup veal demi-glace
1 cup heavy cream
For the veal:
8 veal cutlets, scaloppini style
Flour for dredging
1/4 teaspoon salt
1/4 teaspoon black pepper
2 tablespoons olive oil
2 tablespoons unsalted butter
1 tablespoon lemon juice
1/2 teaspoon fresh chervil, minced
Directions:
Make the sauce:
In a saute pan set over moderately high flame, heat the oil and butter until hot. Add the shallots and cook, stirring, 1 minute. Add the mushrooms, thyme and salt and pepper and cook, stirring occasionally, for 5 minutes, or until mushrooms are soft. Add the garlic and cook, stirring, 1 minute. Add the wine and reduce by half. Add the demi-glace and simmer 5 minutes. Add the cream and reduce until lightly thickened. Cover with a round of buttered wax paper and keep hot.
Make the veal
Dredge the veal scallops in flour, shaking off excess, and season with salt and pepper.
In large skillet set over moderate flame, heat olive oil and butter until hot. Add scallops and saute for 1 minute on each side. Transfer the meat back into the sauce for just a minute and season with fresh lemon juice and chervil.
Small steps
Sometimes it just takes that first small step. Then another, and another. Soon you will find you have progressed quite a distance.
I have been thinking and reading a lot about the obesity dilemma facing the US and considering what is appropriate and necessary to push it backwards. I have talked about thinking big, acting big and eating big and I am sure that is part of the problem, so is the general lack of exercise, particularly with the kids. But also I think we have simply started accepting the fact that we are overweight and not really getting too upset about it. So what if we get Type II diabetes, we have a number of new drugs that work effectively in reducing blood sugar. So our blood pressure is elevated, we have new drugs for that as well. Cholesterol? New drugs. We think in terms of short term health solutions instead of long term health modification. Diet and the associated weight seem to be pushed into the background.
A recent study showed how if we were overweight, our friends and family would be as well. It’s not genetics necessarily; it seems to be primarily perception. What we see we emulate. If our friends are overweight, and we want to be close to them, we gain weight. If we are overweight, our friends and family will think of it as acceptable and move in that direction as well.
A study, titled Obesity is Socially Contagious was published in the July 26, 2007 issue of the New England Journal of Medicine, and suggests that obesity is "socially contagious," as it can spread among individuals in close social circles. The author’s likely explanation is that a person's idea of what is an appropriate body size is affected by the size of his or her friends. This new study finds that when the scale reads "obese" for one individual, the odds that their friends will become obese increase by more than 50 percent. Conversely, the researchers found that thinness is also contagious.
"Social effects, I think, are much stronger than people before realized," said co-author James Fowler, a social-networks expert at the University of California-San Diego. "There's been an intensive effort to find genes that are responsible for obesity and physical processes that are responsible for obesity, and what our paper suggests is that you really should spend time looking at the social side of life as well."
It has been demonstrated in research that peers influence each other's health behaviors. The data for this study was part of the Framingham Heart Study, an ongoing cardiovascular study. The health data was collected between 1971 and 2003 from more than 12,000 adults who participated in the Framingham study. Participants provided contact information for close friends, many of whom were also study participants, resulting in a total of over 38,000 social and family ties.
The most interesting results noted were when the researchers found that if a participant's friend became obese over the course of the study, the chances that the participant also became obese increased by 57 percent. Among mutual friends (both individuals indicate the other is a "friend"), the chances nearly tripled. So it is with friends. Among siblings, if one becomes obese the likelihood of their sister or brother becoming obese increases by 40 percent. Among spouses there is a 37 percent increased risk.
Gender also affected the degree of "obesity contagion." In same-sex friendships, individuals had a 71 percent increased risk of obesity if a friend became obese. If a guy's brother is obese, he's 44 percent more likely to also become obese. Among sisters, the risk was 67 percent.
This phenomenon was apparently was not based upon the potential that fat people hung out with fat people. A direct and causal relationship was determined. If a person had a close friend who was obese they tended to be affected by that person’s obesity. An interesting piece of the puzzle is that if you considered yourself a friend of someone, you were influenced by their weight. Conversely if that person did not consider you a friend, they were not affected by your weight. That is interesting.
So what does all this mean regarding weight gain, weight loss and the relationship to WLS? I feel that the closeness we feel for another can influence how we perceive them physically as well as socially. It can influence whether we discuss weight with them or just accept what and who we are. I feel that it goes to the question of talking to each other honestly about weight issues. Not being judgmental, not being critical, and certainly not making the issue a point of humor. We do not degrade our friends. We want to do what we can to help them look critically at what they are and the implications on their health. I am trying to create a forum where we can talk honestly about these issues. Sometimes it seems almost insurmountable, and sometimes you move a bit forward. Sometimes it just takes that first small step. Then another, and another. Soon you will find you have progressed quite a distance.
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.
Thursday, October 21, 2010
Peer to Peer
Success or failure in the post-surgical WLS world is almost totally dependent upon the commitment and will of the patient. The surgeon, given a good surgical outcome can essentially promise weight loss, but they cannot promise that the patient will not have some side-effects or will not regain some weight. They can explain some of the potential side-effects of the surgery on our digestive process, yet they do not discuss the potential change in lifestyles or eating strategies that may be required. There is little if any pre-surgical discussion of the discipline that is required to effectively live with the results of the weight loss surgery.
Group sessions are almost always recommended for patients both before and after weight loss surgery. This peer support does provide value to many patients, but not to all. Sitting in a group of fellow patients sometimes does not support the real and often painful discussions of the effects from the weight loss. This may be where peer to peer personal contact may be useful. Part of the reason I have been writing this blog is to get people who either are contemplating WLS or have had it, to have a place to read about real world experiences with the process, the physiological ups and downs and the potential to live a terrific new life after the weight loss. I don’t feel like some “poster child” for bariatric surgery but I have had a lot of experience with the digestive aspects of this process, with my first wife for 24 years and now for myself for two and a half years.
I have spent a lot of time discussing the process of weight loss surgery, occasionally with someone who has had it, more often with either someone who could use it, or just interested folks. It seems like there are a lot of misconceptions about the various surgeries and they tend to be lumped into the general categories of Lapband or gastric bypass. The same issues are continually brought up. These include: basic misunderstanding about the surgical processes, weight gain after the surgery; complications with the surgery, effects of having to change lifestyles, ability to eat whatever you want, restrictions, insurance support, costs, health issues and the long term implications of both weight loss as well as the psychological and emotional changes the patient goes through. These are all important issues that I believe can be best discussed in a peer to peer setting and not just in a group setting. Real life effects and real life issues are important to those contemplating the surgery.
This proposed effort is not to generate a research proposal but to stimulate thinking on the part of those reading this blog and hopefully physicians dealing with bariatric surgery to assess the level of information transfer to patients and then potentially between new patients and patients who have undergone this surgery. This could include providing the names of peers who have undergone the surgery and are willing to spend the time to discuss it with those contemplating it. Recommending adequate peer support, as well as providing the option of attending group sessions might be appropriate.
In the very personal world of post-surgical weight loss, sometimes we feel a bit adrift as to what we can, should, or need to do. How do we reconcile the demands of our jobs, including dinners with clients and maintaining the discipline we need? How do we enjoy eating with our family and friends when we constantly receive comments about how little we eat or do we want anything more? How can we enjoy eating if we can only eat eight bites? How do we see ourselves in this new world? How many times can you take in the waistband of your favorite pants?
Patients who are contemplating surgery might be better motivated themselves if given the opportunity to both discuss and receive help from another person who has faced the challenges already and has been able to effectively cope.
It appears that study is needed to evaluate which parts of a peer intervention environment are most successful. These could include: face to face discussions between pre- and post-surgical patients; phone calls offering a supportive voice and also a mechanism for answering questions, group meetings and or even one-on-one counseling with professional counselors.
In many medical issues, the time spent with the patient can be directly related to a successful outcome since this time reminds the patient to do something or to be more engaged. It is my contention that this added time provided by peer to peer discussions may be better suited to the understanding of the bariatric process, help allay fears and provide a long term view of where the patient is going. The patient needs to feel empowered and confident, knowing that they are in charge of the ultimate outcome and that it requires personal discipline and will, but also someone to talk to. It's not so much knowing what to eat but how to change behavior and how will this influence your life and lifestyle. That involves problem-solving and goal-setting skills and the evidence shows that the patient may relate better to a peer who might have more similarities than a teacher in the front of the room.
If you want to use this blog to ask questions and maybe get some answers, please feel free.
Sunday, October 10, 2010
Coming back to California
On September 29th, 2010 I returned to my home in Santa Rosa after spending over two years in Italy. I flew from Florence to Frankurt and then to San Francisco. I dragged my four huge suitcases through Customs and I was then met by an old and dear friend who got me to Santa Rosa and my house. The reasons I left Italy are varied and complicated but suffice it to say I wasn't happy there and I am glad to be home.
In these first days back home I have noted a lot of differences between being in Italy and being in California. The most immediate and obvious difference is not the climate (Mediterranean), or the local vegetative patterns (so like Umbria) or the language (though that is significantly easier for me to understand). It is the size of things. The cars are bigger. The buildings are bigger. The distances are greater. The houses are bigger (and made of wood, mostly). However the most impressive and concerning observation was that people were bigger.
Weight is an issue in the US and so many people are overweight. I have been observing the scene now for a few days and there are a number of factors that I have noticed that may have led to this issue. The ads for food are certainly complicating the situation. We are advised to go to an "all you can eat" restaurant. We order the biggest plates to ensure we get our money's worth. Restaurants want to ensure that their patrons feel they are getting full value by having free pie on Wednesday, all you can eat shrimp on Friday and that best of all possible worlds, an all-you-can-eat Sunday brunch. You may never have to eat again. Our dissatisfaction increases if we don't eat until we are stuffed.
We want to order bigger thicker milk shakes, larger orders of fries, and foot long burgers. If a two patty hamburger with bacon and cheese is good, wouldn't a three patty hamburger with bacon and cheese be better? It's a bigger slice of pie at the end of the meal or that newest chocolate dessert. The mantra is "Super-size me" and that is exactly what is happening. People are becoming super-sized.
The laws of thermodynamics are immutable. Calories in have to equal calories out, or you gain weight. Slowly or quickly, it is basic physics. As I watch people walk past or eating at a restaurant or buying groceries at the local market I am very concerned about what we are doing to ourselves. I am not judgemental regarding weight. I have been there at 300 pounds for most of my life. I have suffered the consequences of that weight, including diabetes, high blood pressure, and the inability to move around as quickly as I once did. I had a "friend" ask me once how did I fit into my Porsche.
So today I am reflecting. It is reflections based upon what I have done in my own life to increase the possibility of living longer and healthier. In a recent study, people were asked to determine what the calorie count was for a hamburger and fries. The general consensus was 650 calories. Then a side of broccoli was added to the plate with the burger and fries and the people were asked again what was the calorie count. This time it went down to just above 600 calories. The perception seemed to be that if you have steamed veggies on your plate it must somehow be better for you, and also lower in calories. It is like giving up wine with dinner because you think drinking wine is why you have gained weight. Then you eat three platefuls of food. But have no wine. It might be better to drink the wine and eat less food.
Its time to take some control of your eating habits and determine for yourself what you want your life and health to be.
In these first days back home I have noted a lot of differences between being in Italy and being in California. The most immediate and obvious difference is not the climate (Mediterranean), or the local vegetative patterns (so like Umbria) or the language (though that is significantly easier for me to understand). It is the size of things. The cars are bigger. The buildings are bigger. The distances are greater. The houses are bigger (and made of wood, mostly). However the most impressive and concerning observation was that people were bigger.
Weight is an issue in the US and so many people are overweight. I have been observing the scene now for a few days and there are a number of factors that I have noticed that may have led to this issue. The ads for food are certainly complicating the situation. We are advised to go to an "all you can eat" restaurant. We order the biggest plates to ensure we get our money's worth. Restaurants want to ensure that their patrons feel they are getting full value by having free pie on Wednesday, all you can eat shrimp on Friday and that best of all possible worlds, an all-you-can-eat Sunday brunch. You may never have to eat again. Our dissatisfaction increases if we don't eat until we are stuffed.
We want to order bigger thicker milk shakes, larger orders of fries, and foot long burgers. If a two patty hamburger with bacon and cheese is good, wouldn't a three patty hamburger with bacon and cheese be better? It's a bigger slice of pie at the end of the meal or that newest chocolate dessert. The mantra is "Super-size me" and that is exactly what is happening. People are becoming super-sized.
The laws of thermodynamics are immutable. Calories in have to equal calories out, or you gain weight. Slowly or quickly, it is basic physics. As I watch people walk past or eating at a restaurant or buying groceries at the local market I am very concerned about what we are doing to ourselves. I am not judgemental regarding weight. I have been there at 300 pounds for most of my life. I have suffered the consequences of that weight, including diabetes, high blood pressure, and the inability to move around as quickly as I once did. I had a "friend" ask me once how did I fit into my Porsche.
So today I am reflecting. It is reflections based upon what I have done in my own life to increase the possibility of living longer and healthier. In a recent study, people were asked to determine what the calorie count was for a hamburger and fries. The general consensus was 650 calories. Then a side of broccoli was added to the plate with the burger and fries and the people were asked again what was the calorie count. This time it went down to just above 600 calories. The perception seemed to be that if you have steamed veggies on your plate it must somehow be better for you, and also lower in calories. It is like giving up wine with dinner because you think drinking wine is why you have gained weight. Then you eat three platefuls of food. But have no wine. It might be better to drink the wine and eat less food.
Its time to take some control of your eating habits and determine for yourself what you want your life and health to be.
Friday, October 8, 2010
A busy few months
The morning was spent getting the preliminary cooking done. If it was a class that evening, we did a relatively minimal prep since the students were going to be doing most of the actual work. We did ensure that all of the materials and foods were there and ready to pack into the car. I had several carry bags that had cooking implements and a set of pans that I always took. The kitchens in some of these houses were often deficient in some pans and I found it easier just to take everything we would need. Bags were packed and checked and then we took a short nap. It was going to be a long day.
At about 5PM we packed the car and left for the dinner location. We had two spots this summer where we had to make a drive of over an hour. One to Perugia and another to near Montepulcino in Tuscany. The rest of the cooking venues were within 15 to 20 minutes drive.
It was a very busy summer and we cooked a wide variety of menu items. The following is an annotated list of dishes from the Amore Sapore menus in August and September:
Bruschetta with artichokes and Pecorino romano
Bruschetta with mushrooms
Ricotta with peperone and flatbread
Salami plate
Chicken Piccata
Insalata Caprese, mozzarella, tomatoes and basil
Panna cotta
Local Pecorino cheese with honey, marmalatta and chutney
Figs stuffed with Gorgonzola and prosciutto
Bruschetta with artichoke pate
Veal scaloppini with Marsala sauce
Grilled porterhouse steaks
Poached pears and sweetened mascarpone
Crostini with caramelized pears and Gorgonzola
Figs with prosciutto
Stuffed peppers with sausage and cheese
Potato and cheese ravioli with tomato sauce
Roasted sausages and grilled grapes
Flourless chocolate walnut cake with chocolate ganache
Crostini with salmon
Spinach and garlic saute
Tiramisu
Pumpkin ravioli with walnut sauce
Chicken breast with saffron and ginger
Pumpkin gratin
Pears in Chianti with mascarpone
Salmon crostini, cream cheese and lemon marmalatta
Gnocchi with fresh basil pesto
Veal scaloppini with mushrooms
Fettuccine with walnut sauce
Crostini with cannellini beans, onions and marmalatta
Cucumbers and goat cheese and roasted tomatoes
Spinach and cheese ravioli
Roast Quail stuffed with sausage and wrapped in pancetta
Chard sauteed with olive oil and anchovies
Bruschetta with goat cheese and tomatoes
Slow roasted tomatoes with marinated mozzarella
Bruschetta with ricotta and peppers
Marinated cucumbers
Roast Salmon
Wild Rice pilaf
Zucotta
Prosciutto rolls with goat cheese, lemon and rucola
Eggplant Bolognese
Bruschetta with broccoli rabe
Farro and lentil soup
Pear cake with a caramelized pear and ricotta gelato
Bruschetta with spiced sausage
Bruschetta with ricotta, honey and peperoncino
Cucumbers with goat cheese and roasted cherry tomatoes
Gnudi (inside out ravioli)
Braised rabbit with peppers, onions and olives
Frittata with mushrooms, peppers and artichokes
Its been a yummy summer and my weight has stayed constant at 165 pounds. Eating and living Eight Bites at a time can be fun and satisfying and you can still enjoy the wide variety of dishes and items we prepared without gaining weight. Eat well and enjoy your life.
Sunday, July 4, 2010
Food is not just about consumption
Eating in the post-weight loss surgery world can be a bit of a dilemma. As we look back at the pre-surgical life we led, we often see consumption being of paramount importance both to our psychological well being and our personal feelings of worth. When we entered into the new life created by our surgically-reduced ability to consume food, the importance of consumption changed. So what has changed? Certainly the ability to eat all the food you “wanted” has been eliminated. But what else has changed? How important to us personally was our ability to consume food? Did it have to be good food? Tasty food? Filling food? Comfort food? Food that was healthy? Or just a lot of food?
Why we got to the place where we had to have weight-reduction surgery is individual to each of us. I got there after thirty years of being heavy, having insulin dependent diabetes, high blood pressure and looking at my wedding picture from March 2008 and comparing it to my wedding picture from July 1966.
I was not healthy, and I felt that my life was being significantly shortened by my obesity. I had tried diets and done a bit of yo-yoing up and down but my job and career did not lend itself to an active physical regimen. The basic laws of thermo-dynamics were conspiring to make me heavier. So I had the surgery. Those first few weeks frankly were pretty easy though the high protein drinks I had were not that appealing. I didn’t feel the urge to eat anything and I started to drop weight quickly. Pants got looser and looser. Shirts got larger. Towels would fit around me easily.
I was responsible for eating substantive amounts of proteins as part of my weight-loss regimen, and making sometimes bland protein-rich dishes required me to look at aggressive spicing and condiments to accentuate the flavor. I started considering what small things I could add to a dish that would change its flavor, complexity, and composition. A braised pork dish was accentuated by raisins, and some apple cider vinegar. A poached chicken dish was enhanced by the use of chipotle bouillon cubes in the poaching liquid. I added capers and some anchovy fillets to my pureed tuna fish for a tasty sandwich. I didn’t even need to use mayonnaise and used a bit of olive oil instead.
The physical restriction placed on me by the surgery meant that I would never be able to over-consume again. I guess you could live on cheesecake and wash it down with chocolate milkshakes, but that is a bit counter-intuitive. I was really limited to Eight Bites. So I went for small enhancements to the dish rather than large volumes. These small enhancements led to exciting new dishes that in many cases I have turned into antipasti as part of my new career as a chef. I found that I didn’t have to create large amounts of food, just small bites with extraordinary flavors and surprise taste elements.
One example is a pureed cannellini bean spread on a piece of bruschetta or a crostini. This is a standard topping for Italian crostini antipasti and is relatively bland. The basic puree is made by draining and rinsing a can of cannellini beans and put those in a sauce pan with about a half can of chicken stock and three garlic cloves. Add some salt and pepper and let the beans cook at medium low heat for about 20 minutes until the stock is virtually gone. Pour the beans into a food processor and puree. Put in a bowl and into the refrigerator to cool. Saute a medium chopped onion in a small saute pan in a bit of olive oil or butter, add some salt and pepper. Saute until translucent and then add some sugar (teaspoon or so) and a tablespoon of vinegar. Finish caramelizing the onions and set aside in a bowl. Taste it to see if the flavor profile is sufficiently sweet and sour and adjust as necessary. To make the crostini you could spread the bean puree on the crisp bread and top with the caramelized onions. Cut them into serving size pieces and place on a pretty plate. Or change it a bit and give it a surprise taste element. Spread the bread with a thin layer of fig jam or an apple chutney, then top with the bean puree and onions. When your friends bite into this little antipasto they get the crunch of the crisp bread, the smooth textural quality of the beans, and the sweet and sour contribution of the onions. Then they will get a hint of a sweet undertone and you will get questioned as to what you put on this.
It is truly about taste and not just about consumption. Enjoy your weight loss, and enjoy all those extraordinary tastes you can now have as well as create.
I was not healthy, and I felt that my life was being significantly shortened by my obesity. I had tried diets and done a bit of yo-yoing up and down but my job and career did not lend itself to an active physical regimen. The basic laws of thermo-dynamics were conspiring to make me heavier. So I had the surgery. Those first few weeks frankly were pretty easy though the high protein drinks I had were not that appealing. I didn’t feel the urge to eat anything and I started to drop weight quickly. Pants got looser and looser. Shirts got larger. Towels would fit around me easily.
In the fourth week I began to eat semi-solid foods. A scrambled egg was delicious on that first semi-solid Saturday. After a few weeks of yogurt I was ready to chew something. I wanted to taste things but I felt no overwhelming need to over-eat. The flavor and texture of that first scrambled egg with a bit of salt and pepper is stuck indelibly in my mind. It was delicious. So for the next couple of weeks I stuck to a semi-soft diet and started to add new (and old) flavors, textures and foods into my diet. It was not about how much I could consume. My surgery limited that for me. It was about what I ate and how it tasted. What were the things about the dish or food that gave it the character I wanted?
I was responsible for eating substantive amounts of proteins as part of my weight-loss regimen, and making sometimes bland protein-rich dishes required me to look at aggressive spicing and condiments to accentuate the flavor. I started considering what small things I could add to a dish that would change its flavor, complexity, and composition. A braised pork dish was accentuated by raisins, and some apple cider vinegar. A poached chicken dish was enhanced by the use of chipotle bouillon cubes in the poaching liquid. I added capers and some anchovy fillets to my pureed tuna fish for a tasty sandwich. I didn’t even need to use mayonnaise and used a bit of olive oil instead.
The physical restriction placed on me by the surgery meant that I would never be able to over-consume again. I guess you could live on cheesecake and wash it down with chocolate milkshakes, but that is a bit counter-intuitive. I was really limited to Eight Bites. So I went for small enhancements to the dish rather than large volumes. These small enhancements led to exciting new dishes that in many cases I have turned into antipasti as part of my new career as a chef. I found that I didn’t have to create large amounts of food, just small bites with extraordinary flavors and surprise taste elements.
One example is a pureed cannellini bean spread on a piece of bruschetta or a crostini. This is a standard topping for Italian crostini antipasti and is relatively bland. The basic puree is made by draining and rinsing a can of cannellini beans and put those in a sauce pan with about a half can of chicken stock and three garlic cloves. Add some salt and pepper and let the beans cook at medium low heat for about 20 minutes until the stock is virtually gone. Pour the beans into a food processor and puree. Put in a bowl and into the refrigerator to cool. Saute a medium chopped onion in a small saute pan in a bit of olive oil or butter, add some salt and pepper. Saute until translucent and then add some sugar (teaspoon or so) and a tablespoon of vinegar. Finish caramelizing the onions and set aside in a bowl. Taste it to see if the flavor profile is sufficiently sweet and sour and adjust as necessary. To make the crostini you could spread the bean puree on the crisp bread and top with the caramelized onions. Cut them into serving size pieces and place on a pretty plate. Or change it a bit and give it a surprise taste element. Spread the bread with a thin layer of fig jam or an apple chutney, then top with the bean puree and onions. When your friends bite into this little antipasto they get the crunch of the crisp bread, the smooth textural quality of the beans, and the sweet and sour contribution of the onions. Then they will get a hint of a sweet undertone and you will get questioned as to what you put on this.
It is truly about taste and not just about consumption. Enjoy your weight loss, and enjoy all those extraordinary tastes you can now have as well as create.
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