Crackers and cheese

There is a commonly held belief in our weight-conscious society that eating slowly will help you lose weight. This belief has been around for a long time and has attained the level of “truth.” But is it “truth”? The hard science behind this “truth” is generally lacking. As a scientist, I believe in the scientific method. This method moves from a question, to testing, to an answer, and then to another question. Science moves forward on the development of a sound hypothesis or question. The next phase is the design of rigorous experiments and the testing of that hypothesis to determine if it can be disproved. It is inherently difficult to disprove an idea so it is imperative that we attempt to do so. If we cannot rigorously disprove a hypothesis, it becomes a theory and therefore simply another question. A lot of the weight loss documentation in the field seems to be based upon proving a hypothesis or justifying the specific question or idea that is posed. It often appears that many of these research efforts are designed ultimately to sell some diet plan, diet pill or quick fix program to those of us out there struggling with weight issues.


Back to the issue of eating quickly or slowly. Dieters are counseled to eat slowly and chew their food many times, and put their fork down between bites. This enforced slowing of the consumptive process is theoretically intended to trick the body into sending messages to the brain that you are full and then this tells you to stop eating, before you eat too much. Fast eating may overwhelm the body’s intrinsic hormonal and psychological systems and allow you to eat more, because the message to the brain that you are full is delayed. I have also said that eating your Eight Bites slowly can be incorporated into a active social process which includes eating with friends and family who have not had bariatric surgery, may not be heavy, and may not be on a diet. So what do we do? Eat fast or eat slowly?

After WLS, your body processes eating inputs differently than before. Eating fast or slow was relevant to the information inputs from the stomach to the brain. After WLS when you are physically restricted from eating too much, a different set of conditions occurs. You are now responsible for how much food is put into your body (stomach or what is left of it). The hormonal and neural inputs have been altered and no longer function at the same level. After WLS, you have to learn to feel that you are full, or preferably one bite less than full and stop eating. Overeating after WLS has a variety of effects. It can be painful from over-distending the stomach or pouch; and it can in the early period immediately after surgery cause the surgical site to rupture causing a serious infection (peritonitis) that is often life-threatening. So after WLS you have to learn to know your body better than you did before. After WLS you have to feel and know when to stop eating.

This knowledge is a combination of stomach capacity and your own ability to look at what you are eating and say that is enough. Enough? That is probably the most difficult thing we have to understand after we have undergone the surgical procedures to lose the weight. How do we know what enough is? If you have lived your life never limiting your capacity to eat, this is a difficult thing to understand. First you have to know how much food you can physically put into that newly altered physical environment called your digestive storage system (previously known as your stomach). Your doctor’s instructions are very clear on how that early period post-surgery should be handled. You are likely drinking high protein liquids, which do not put excessive pressure on your surgical site and also provide you with the nutrition your body needs. It is actually pretty easy in those first weeks and months as you rapidly see yourself losing weight, and losing inches. It is easy to succeed when you are succeeding easily. When you switch to a more normal diet is when things get more difficult. Over time as the weight falls off you start to get back into a more “normal” mode of eating. Breakfast, lunch, dinner, and snacks all become part of your normal life. In a year or more post-surgery you will reach a point where you will not lose any more weight. If you are near your ultimate goal you may be satisfied. If you are not, it may be time to critically evaluate the factors in your nutritional world.

This is the time you need to look clearly at what you are eating, when you are eating, and how you are eating in this new environment. This is a time for total honesty with yourself. You went into this weight loss regimen for a reason. What was it? Was it for your health and the desire to increase the potential for a longer healthier life? An honest appraisal of your motives is critical at this point. It may make the difference between your successful weight loss and the potential to put weight back on.

In the last few months I have put approximately 12 pounds back on and I contacted my doctor. His response was because I had been having my heart issues in January and February, I had cut back on my exercise and also probably was retaining fluid as well. So I increased my exercise after the angioplasty. But I also started to examine what and when and how I was eating. After you have WLS you tend to think that calories don’t really count anymore because you can only eat a small amount of food. It can be a very slippery slope if you stop considering what caloric values foods have. And can be even more slippery, if you neglect the exercise so fundamental to the maintenance of the weight loss.

You need to examine what you are eating in light of both the volume and caloric values. I realize that you are eating much smaller amounts than you used to but it is time to examine the true nutritional value of the food you are eating. The first thing is to make a list of what you ate today. Include the estimated amounts in your list. I created spreadsheet that had one worksheet that was a list of foods, their caloric values per unit, and the total grams of proteins, fats and carbohydrates. A second sheet held a calculation sheet. To start I input the foods I ate the day I created the spread sheet, and I found out my day’s intake was 1600 calories instead of the 800-900 calories I thought I was eating. Wow! In my case I found I was snacking on too many crackers and cheese. Ten crackers were about 100 calories, an ounce of cheese is about 100-120 calories, and a tablespoon of butter is 100 calories. So snacking on crackers and cheese at intervals during the day can add 400-600 calories to your diet. That can take you from 900 calories per day to 1500 calories per day, and gradually put on a few of those unwelcome pounds again. If anyone wants a copy of my spreadsheet just email me at kfk125@yahoo.com and I will send it to you.

Now back to the original question that started this entry, should you eat fast or slow? A recent research study published by a group of Dutch scientists suggested that eating slowly doesn't make you eat less than if you eat more quickly. The researchers compared what happens to meal size and appetite by having a group of volunteers eat a leisurely two-hour lunch, and at another time, eat the same lunch in just 30 minutes. They found that the volunteers did indeed feel fuller after the leisurely meal, and were still satiated several hours later. But despite feeling full, when presented with an offering of traditional snacks several hours after lunch, the group who ate the slow meal snacked on as many calories as they did following their 30-minute meal. What this means is that regardless of whether they ate quickly or slowly, it did not translate into an unwillingness to snack on post lunch snacks. So in terms of dieting, snacking is a potentially big problem. As I have personally seen, eating typical post WLS meals is not a difficult proposition. However eating snacks between those meals can almost double the total caloric input for a day.

Reference: http://www.nytimes.com/2011/03/08/health/nutrition/08eat.html

What does this mean for those who have gone through the process of some version of weight loss surgery? The physical restrictions placed upon our eating habits at first keeps you satisfied as the pounds come off. Calories are irrelevant and unimportant. But when you get to the flattened out spot on your weight loss chart, the physical restrictions begin to play a less significant role. It then is up to you. You need to decide what you want to eat, and how often you want to eat. There are three directions you can go here: 1) You can remain at the weight you achieved by balancing the calories you consume with the calories you expend on a daily basis; 2) you can continue to lose weight by increasing your caloric output through exercise; and 3) you can gain weight back by consuming more calories that you expend. Thermodynamics rules this decision making. Snacking defeats the objective to maintain your weight unless you increase the calories expended (exercise). Your doctor can give the mechanism to lose weight, but it will be up to you to maintain that weight. The discipline necessary to effectively make it through this journey can be difficult. Sometimes you just have to sit down and give yourself a good talking to and realize that if your weight is to be what you have sought, it will be up to you. In my case I have given up eating so many crackers and cheese.

Fried Potatoes and Eggs with Cinnamon Toast

A friend was going to be here on Sunday and I wanted to do their favorite breakfast. Potatoes and eggs, with cinnamon toast. I cut up several good sized Yukon gold potatoes into about 1 inch cubes and put them in some cold water to get rid of a little of the starchiness. The potatoes are not peeled as the skins when sautéed are quite good. Three or four potatoes are about the right amount for two breakfast servings. I always keep in mind how much carbohydrates I could eat as well as my guest. If you do make more than can be eaten that morning, put the remaining potatoes in a bowl and reheat the next day. They are not as crispy but still make for a nice addition for breakfast.

To make the potatoes, I drain the potatoes well and chopped a medium onion into a coarse dice. Into a non-stick saute pan I put about ¼ cup of canola oil and brought it to a temperature of about 330 degrees. At that temperature the potatoes will cook relatively quickly and will not absorb too much oil. I then add the chopped onions and the potatoes and start to quickly saute the vegetables. As they begin to brown, I pour in about ½ cup of water and immediately put a lid on the pan. The water quickly steams the potatoes and when it is evaporated you will hear the potatoes starting to sizzle in the remaining oil. The onions should not burn when using this combination oil and water technique. The vegetables will cook nicely together. When the potatoes are golden and crisp, put them in the oven at 350 degrees to hold until you make the eggs.

Eggs are the salvation of the WLS diner. They are so versatile and nutritious that they should be an integral and important part of your high protein diet. They provide a very high quality protein source and can be served in hundreds of ways. In Larousse Gastronomique, an early compendium of French cooking methods and dishes, there are many pages of egg preparations ranging from the simple to the extraordinarily complicated.

My guest liked their eggs sunny side up and I like mine over easy. To cook a beautifully fried egg sunny-side up, you need to start with a non-stick saute pan set over medium-low heat. You really don’t want to overcook the eggs and want the whites set but the yolks still slightly runny.

Put a pat of good butter in the warm pan to provide rich flavor and break two eggs into a bowl. When the butter has melted and has stopped foaming, slide the eggs from the bowl into the pan and start to cook them gently. The whites will start to cook first and then you can add a pinch of pepper. When the whites are fully cooked but still a bit soft, give the pan a little shake to free the eggs from the pan and slide them out on to a warm plate. Over easy is a bit trickier but you start using the same technique. After you shake the pan to release the eggs you can gently flip the eggs in the pan so they cook for 20-30 seconds on the other side.

Plate the potatoes on a warm plate and place the eggs next to them to serve.

Now to the cinnamon toast. I like using a baguette sliced in half horizontally and opened up flat. Spread the bread with butter and sprinkle on a mixture of sugar (1/2 cup), cinnamon (1 teaspoon) and a small pinch of nutmeg. Place on a baking sheet and then into the oven with the potatoes. Allow the toast to get a light brown and the sugar topping is a bit melted.

Thinking in Eight Bite increments

This breakfast provides a good level of protein in the eggs, complementing flavors in the potatoes and onions, and then a little sweetness and crunch with the cinnamon toast. However you still have to think about the volume you should eat. My estimate of the breakfast portion size is the two eggs, about ½ cup of the potatoes, and a 3” piece of the cinnamon toast. This will give you the nutrition you are looking for as well as a sense of eating a nicely flavored breakfast. Don’t be afraid to indulge your tastes every once in awhile with things like cinnamon toast. There is just no need to eat to excess. Thomas Keller at the famous restaurant The French Laundry in Yountville, California says that he serves small portions because we really only remember the taste of that first bite or two. So tastes and those small bites are important.

Tomorrow I will make a couple of nice espressos, plate the eggs and potatoes, portion out the cinnamon toast and call my buddy to breakfast. It will be a nice way for me to start their day. And it will be the start of a good day for me as well.  So invite your friends to visit and make a simple breakfast to start their day.

A new resolve

The other day I wrote about how I have taken responsibility to make myself healthier through the WLS weight loss and other life modifications that I have made. I talked about the heart catheterization I was going to have last Monday and what that meant to me both physically and mentally. I went into that procedure two days ago with a positive attitude and little apprehension. Some cardiac emergencies came in while I waited and my schedule got pushed backwards an hour and a half. But finally it was my turn. A few needle sticks and I was asleep, sort of. When I awoke an hour later it was over and they slid me over on to my bed again and said they were taking me over to the hospital so I could stay overnight, That meant they had put in a stent. The nurses and the doctor were all quite positive about the procedure so I was too. No pain or discomfort and I got a private room, because there were no more rooms available.

I was starving since I had not eaten in almost 24 hours, so they brought me a turkey sandwich (actually very good). I got a phone call from a friend checking to see how I was doing and then a second call asking if I was going home that night and needed a ride. The nurses kept a check on me all night so there was actually little sleep, but I was not in any discomfort, and felt pretty well. The doctor had told me that if everything was okay he would discharge me in the morning so I just dozed off until he came in. He told me about my stent and how it had gone well. Then he told me about the other problems that they had found. Apparently the blood vessels downstream from my bypasses done in 2006 showed signs of heart disease. They were in locations that apparently could not be stented or bypassed. This meant that the only recourse I had was medical therapy. So we discussed the long term issues and options and while they were not determined to be of immediate concern I would have to deal with at some point in the future.

Needless to say that was not the news I wanted to hear. I was a bit down the rest of the day and when I got home to the empty house, it was awfully quiet. But then I started to consider all of the things that have happened in my life and I realized that while I had done everything I could do to change the health status of my life there were still things created many years before that were hanging over my head like Damocles’ sword. Thirty to forty years of poor diets, lack of exercise, diabetes, and the weight gain were superimposed on top of that my family genetics. It was an equation that did not balance well. And frankly I should have realized that a long time ago. But I thought that all I had to do to become healthy is lose the weight and get rid of the diabetes.

So as I sit here this morning thinking about the message I received from my doctor and drinking a cup of coffee I realized that I had gotten up this morning just so that I could start all over again, again. I try to think that way every day. Each day is a new beginning. The problematical stuff with my heart will likely become an issue in a few years. But also will be managed medically. There are apparently no surgical options available at this time. I stress the "at this time" as this may change with our changing technology. I am not expecting medical technology to make my life perfect, but I do expect that technology may very well change how they treat this problem. But until they do, I am pushing forward doing what I have to do.

These back side health problems almost always started many years earlier and to me that meant that your healthy life’s choices need to be made better and earlier than we think now. I guess any special insight I may have is based upon accepting who I was and why I was where I was; and doing what was necessary to change as many risk factors as I could. After that, I then have to deal effectively with those factors that are either genetic (and to some degree out of our control, though not totally) and/or self-driven. There is a lot to be said about looking critically at yourself and your life and evaluating these things.

Accepting some responsibility for changing the front side is very important. I have only watched the Biggest Loser a few times and didn’t particularly like the way the heavy people were treated by the trainers and to a more significant degree by the public. We applauded their successes and seemed to almost gloat in their failures, almost like we expected them to. And as a heavy person, we sometimes start to look at ourselves as a failure. That perception causes us to spiral downwards. Weight does not affect your intelligence and yet many people perceive heavy people as not that smart. “If you were smart, you can change.” To me the biggest perceptual problem with people who are getting heavier is their general unwillingness to critically look at their life simply from the point of health maintenance. It can be said as an excuse, “Since everyone is heavier, what is so wrong with me?”

Now as I look down the path I am on I realize that issues created many years ago under conditions where I was not particularly responsible for my health are going to cause me problems in the future. The weight loss was a positive step; and the elimination of diabetes was also a positive step. But they were probably insufficient to make up for all those years prior. In reality, what other choice did I have? If I had not done what I did to improve my health, I probably would not be writing this or anything, ever again. I probably would not have made it to this point. But I have, and now I know I have some more work to do to ensure that I live as long as possible.

So in ending this entry, I would ask you that if you are considering weight loss surgery or have had it and are moving along, do not be surprised if more health problems are encountered. The WLS is not a total health “fix”. It is really just a reduction or elimination of one risk factor for heart disease. The additional elimination of diabetes also reduces the risks. But other risks are not going to go away. A family history and genetics is an important element and will never go away. Be sure you stay active and exercise as much as you can. Eat as well as you can, given the limitations the Eight Bites life will allow you. And do not fear the future, for it is the only one you will ever have. Your future will last as long as you do. You can do some things to influence it though. You have taken or may be preparing to take your health into your own hands. Handle it with courage, care, and gentleness, but look back at where you were and then do the things you need to do to reduce as many health risks as possible. You also must look forward to dealing with more health issues in the future. Just don’t let them freeze you in place or make you hesitant to act now to reduce your risks.

People do respond to a rational discourse in this increasingly irrational world and I guess that is what I am trying to do. If I manage to get people to think differently about their own health, that is an admirable goal. Maybe I can get some to realize that detection and action, when there is a problem, may simply not early enough. You almost always have to think a long ways back and then a long ways forward, don’t you?

A test of character

As we confront ourselves each day in the mirror we begin the daily testing of the character that we are, and what we hope to be. It is not a simple matter of doing something. It is the matter of doing the right thing. The reasons we give ourselves tests our honesty and personal integrity; and above all else we have to be honest with ourselves. Every day we pick the path we will walk that day. Sometimes it is the same path we were on yesterday and the day before; sometimes it is a new path with unknown pitfalls, hazards and potential rewards. Do the satisfactions from walking the same path you have been on still make your life a good one? Or is truly time for a change?


When I decided to have my weight loss surgery in 2006, I had been involved with the process for 24 years with my first wife, and truly understood the limits that would be placed upon me after my surgery. There were many elements that had to be considered. The most important was my overall health and its attendant risk factors. At 300 pounds on a 5’9” frame I was entirely too heavy. I was on daily insulin support (four injections daily), and I was hypertensive and could not effectively bring my blood pressure down. I had a family history of high blood pressure, diabetes, and heart disease. My father died of a heart attack, significantly influenced by his diabetes. My mother died from a sudden heart attack at the age of 83, when she developed congestive heart failure. Many of my siblings were overweight, and were experiencing many of the same medical issues faced by our parents.

So the primary reason I had the weight loss surgery was to gain some semblance of control over my health, my life and to some degree in my own longevity. It retrospect it was a good decision. I have lost the weight I needed. I have eliminated the diabetes that scared me so with its long term prognoses of neuropathy, blindness, circulation problems, and cardiac risks. But my blood pressure was still higher than I wanted it to be. I was still taking medications for control, and while they were at lower dosages, they were apparently still needed. In 2006 I had a heart attack and double bypass surgery and in general, my heart was in pretty good shape. There is always a bit of paranoia about the artificially altered circulation in your heart after bypass surgery. You want the bypasses to last forever and most of the time they do. But the paranoia still is there.

Last summer I started having some tightness in my chest when I carried heavy loads to and from the houses where we catered meals in Italy. The tightness went away quickly but it did cause me some concern. It was not constant and didn’t always occur when I worked; but it did occur often enough to raise the hair on the back of my neck and start that paranoia again. After leaving Italy, and returning to California (and being eligible for Medicare) I decided to have a stress test to see if the bypasses were still okay and functioning. So on my 65th birthday I went in for that test. They injected, probed, prodded, and I walked faster and faster. Then I felt that twinge of pain and tightness again. But it was apparently not the bypasses, it was something new.

Tomorrow I will go into the hospital for a cardiac catheterization with three possible outcomes. First they may find nothing of significance and I will go home with new medications. Or they will find some minor blockages and put in a balloon stent to open up the artery. Or they might find that I need another bypass. The doctor felt that the need for a bypass was a 1% probability, while the stent was about 99%. At first I was angry after all the work I had done to lose the weight, but that quickly went away as I realized that a lifetime lived heavy was the likely cause of this issue. I reconciled my actions taken to improve my health with the retained potential for problems into the future. So this has been the test of my character for today. As I looked in the mirror this morning I saw a changed man, who has taken charge of his life and yet still suffered the consequences of what he was before.

How does this fit into Eight Bites today?  The combined effects of our past health issues, what we do about them, and where we go has to be considered in our decisions. Weight is the most easily changed of the risk factors that we have had. Doing something about that brought me a great deal of personal satisfaction and eliminated my diabetes. Two factors have been reduced to relative insignificance.  But the heart is another factor. The weight loss has helped but it has not solved the long term problems. Now I must deal with those issues and move on. The path beckons. It is still into an unknown future, it still may be difficult and include new problems, but I have done something to change it. Do not expect the weight loss surgery to solve everything in your life. Take responsibility for changing the things you can, deal with the things you can’t change intelligently and calmly, and continue to live. Eight Bites at a time. Live on!

My 65th Birthday

This picture is me when I was 5 years old, in Antioch, California.  Last Tuesday was my 65th birthday and I decided to have a party. So Friday night, I had a group of old friends over for a buffet of lots of different foods, some good laughs, some quiet conversations and a peaceful beginning to my 65th year. This has been a year of substantial changes and I look forward to the new year with confidence and anticipation.
As to Eight Bites and my thinking and status, this is where I am. I have retained my weight loss at about 140 pounds and weight 160-165 right now. I have been able to stay at this weight for a year and a half now and feel that it is unlikely that I will allow myself to put weight back on. At times I do want something more than I should eat, but I have found that with the gastrectomy, I feel uncomfortable when I eat a couple of bites too much. It is an auto-regulating mechanism. It hurts if I overeat and since I am not a big fan of pain, I have learned to stop eating before I reach that point. Calories are automatically restricted and I don’t have to do anything austere or drastic to prevent my weight from going up. It is why I feel so confident that I will not regain that weight so dearly lost. Besides what would I do with all the clothes I have purchased that fit me so nicely now?

Party food or how to have a good time at a party and not over eat. The menu for the party was pretty extensive but was focused on small individual bites of things. The Eight Bites component of the food for the birthday party was:
• Crostini with turkey spread, crisp bacon, and chipotle cranberry sauce
• Deviled eggs
• Barbecued chicken crepe stack
• Stuffed peppers with sausage
• Crostini with mushroom pate
• Crostini with black beans, chipotle orange sauce
• Cheese plate with Gouda, Havarti and provolone
• Brie with spiced walnuts
• Salami and smoked Gouda
• Vegetable plate with grape tomatoes, celery and bocconcini
• Rigatoni with vegetable sauce
• Squash ravioli with a white herb sauce
• Tortellini gorgonzola
• Flourless chocolate cake with ganache
• Lemon tart
• Chocolate truffles

The following description of four of these dishes shows how you can have a number of different tastes, and enjoy the party without eating too much. As the cook, I tasted everything to be sure that the food items were what I wanted them to be, but these four items are what I had as my dinner. The balance of the dinner was designed for guests who had not had weight loss surgery. The dishes included pastas and desserts.

Crostini with turkey spread, crisp bacon, and chipotle cranberry sauce
For all the crostini, I sliced French bread baguettes into ½ slices, brushed them with olive oil and a light sprinkle of salt and toasted them in the oven at 350 degrees until they were barely crisp.

I used a ½ pound of a good quality of smoked turkey breast from the deli, put it in the food processor with a couple of tablespoons of sweet, hot mustard, a tablespoon of the chipotle sauce, and a couple of tablespoons of softened butter and processed it into a smooth puree. I cooked the thick sliced bacon in the oven with a small amount of brown sugar on each slice and a few drops of the chipotle cranberry sauce then cut each slice into 1” long pieces. To make the crostini, put a little of the chipotle sauce on the bread, spread a layer of the turkey spread and top with a piece of crisp bacon and a few drops of the chipotle sauce. These antipasti provide a fair amount of protein from the turkey and bacon, and a single piece can be a nice addition to your Eight Bites plate. Nutritionally, a 1 ounce serving of the smoked turkey breast is approximately 8 grams of protein.

Deviled eggs
Just make your favorite deviled egg recipe. One or two halves provide a nice amount of protein and pleasant change from the bread crostini. One egg consists of 6 grams of protein content and at least 9 amino acids. Proteins constitute nearly 13% of the weight of an egg. Eating an egg as part of the Eight Bites meal will give you almost 10 percent of the protein required for post-bariatric surgery patients and is also a very high quality protein source.

Barbecued chicken crepe stack
These antipasti are easily made using simple crepes and chopped barbequed chicken and some cheddar cheese. Make crepes from your favorite recipe and add couple of teaspoons of dried chives to the batter before cooking. To create the stack, place a crepe on a baking sheet, top with ¼ cup of chopped chicken mixed with barbecue sauce, then top with cou[ple of tablespoons of grated cheddar cheese. Put another crepe on top of the first, and repeat until you have about 7 or eight crepes in the stack. Finish with a layer of chicken and cheese. Bake in the oven until the cheese is melted and serve hot in wedges. A serving wedge should have about an ounce of chicken and 7 grams of protein.

Stuffed peppers with sausage
This dish is simply made using mild sweet peppers, available fresh in most grocery stores. Slit the peppers in half lengthwise and remove the seeds, rinse and allow to drain and ry. Make the stuffing from 12 ounces of sausage (use your favorite type of hot, or sage, or Italian), a medium chopped onion and a cup of grated Parmigiano=Reggiano cheese. Cook the sausage with the onions until the meat is no longer pink. Put the meat in a food processor and add the cheese. Process using pulses to obtain a coarse mix. Stuff the mixture into the pepper halves and place on a baking sheet. Heat under the broiler until the top is bubbly and golden. Serve warm or hot. The amount of sausage in each pepper is approximately ½ ounce and provides about 6-8 grams of protein per serving.

From the perspective of Eight Bites, having a single piece of the smoked turkey crostini, two deviled egg halves, a wedge of barbecue chicken crepe stack and two stuffed peppers was enough to give me approximately 35 grams of protein or about 50% of the protein required for the day and I didn’t have to eat a lot. And happily, I also have the opportunity to taste a lot of different dishes.

Think Eight Bites, think interesting flavors, think positively about your weight loss and think positively about your new life. Enjoy the day. So, Happy Birthday to me. May there be many more in my healthy new life. There is no good alternative to another birthday.

Focusing today

I have been reading some of my blog entries and I feel that it is time to take a big step back and think through what was my original intent and have I been true to that intent. Have I provided you some answers or have I just caused you to have more questions. Frankly, I hope I have done both.

The time after WLS is a complex period in your life. Your body is changing rapidly. Often faster than you think and almost always faster than you can have the waistband of your pants taken in. You have to get new clothes, but what size? It can be an ongoing mystery as your body changes. But it also can be a lot of fun especially if you have been heavy for quite awhile. Seeing a different you in the mirror virtually every day can be life-changing. However, at the same time your body is changing on the outside it is also changing on the inside. You go through those first few healing weeks, thinking will I ever enjoy food again, as you sip those protein drinks that sometimes are not so yummy? I remember how incredibly good that scrambled egg tasted at week three as I transitioned on to soft foods and away from liquids.

It is really important during those first few weeks that you really begin to think seriously about your eating habits. Why did you have the surgery? What were you expecting to happen after the weight loss? Did you think it would be easy and effortless? Actually in all honesty these questions should have been seriously thought out before you had the surgery. Once you have committed to it, it changes everything, hopefully. And I meant hopefully. Too many people I have talked to in the last year are absolutely convinced that all people who have WLS will regain a lot of the weight lost. Insurance companies deny coverage because of the apparently high percentage of people regaining the weight. It really does come down to you and your personal reasons for having the surgery and losing the weight. Are the reasons you used to justify the surgery sufficient to carry you through to the successful weight loss and much more importantly, to the continued maintenance of that lost weight?

My intentions in the upcoming blog entries is to develop a more specific focus on the individual, and how much they eat. I will be looking at any recipes I provide and show you how to make them just for you. To provide you that defined amount of food that will help you maintain the weight loss. My suggestions for portion size and cooking techniques will be directed toward just the individual who has had WLS. I want to clearly show that you can maintain the weight loss by eating carefully managed portions, knowing when to stop, and knowing when you are eating to excess. You can regain weight if you expand the “pouch” the surgeon created to accommodate more food. More food means more calories. More calories goes to the laws of thermodynamics where calories in must equal calories out. You have a restricted input after surgery, but you can still sabotage the results by eating cheesecake and washing it down with a chocolate milkshake, or pureeing strawberry pancakes so they can go down easier, or just gradually eating a bit more than your stomach was redesigned to hold and allowing the stomach musculature to expand and accommodate more food. Again this goes to the reasons you had surgery in the first place. Were you over-eating because of stress or dealing with life’s issues? Did you eat too much simply because you enjoyed the tastes and flavors, and felt you needed to clean your plate? Did you just not balance the thermodynamics by getting sufficient exercise to balance off the calorie taken in? Did you eat a whole pumpkin pie with whipped cream just because it tasted so good?

My objective in these following blogs is to redirect you eating away from what you could eat to what you should be eating. I will describe dishes in light of the adequate levels of proteins you need and put the ancillary food items such as carbohydrates to the side. I am going to give you information on maintaining the portion controls you need to maintain your weight loss. I am not your keeper, but as a WLS patient I have seen the good and the bad that can result if you don’t take full control of your eating and your thinking about food. I am going to try to give you the tools you can use every day to meet not only your physiological and caloric demands but your demands for tasty, interesting, and exciting foods.

Portion control will be the emphasis that I will be working with. Portions are easily over-ridden if you wish, but I want my objective to be to give you sufficient good tasting food that provide you what your body needs and not to provide excess. This will force you to look at how you are eating, how much you are eating and maybe why you are eating more than you need in your after-surgery life.

So starting today I will focus on giving you the information I think you might need to make your new life satisfying.

New Year’s Eve 2010

This New Years is quite a bit different from last year. Last year I was in Italy and I helped cook for a group of 6 diners, at a very nice house near us. This year I am back in California and starting a personal chef and cooking class business on the north coast above San Francisco.

This New Year's Eve I catered the biggest dinner I have ever done by myself. I cooked for 30 diners at a friend’s beautiful home. It was a fancy party with good music, pretty clothes, and good food. The dinner was served buffet style which made it pretty simple to do. On the other hand, the person who was supposed to assist me backed out at the last minute. So the strategy to prepare and serve the dinner changed. I decided to do a lot of the prep work and some of the precooking at home. Of course that makes it important that the food still taste and look fresh when it is served.

Since this is Eight Bites I want to focus on portions and the food. I also want to show that you can entertain and serve good food to your friends and guests without feeling the least bit deprived of being part of the celebration. New Year’s Eve is a serious party evening. It’s when people want to get out, end the year on a festive note and let their hair down a bit. So this is about making good food, and having fun. It is however not about excess.

The special dinner started with four antipasti dishes.
Crepes with smoked salmon, citrus marmalade and cream cheese
I made a simple crepe batter out of flour, milk, cream, a bit of baking powder, a small amount of sugar, eggs, and melted butter. I then added a good amount of chopped chives to the mixture and let it rest for an hour. It was pretty thick so I thinned it a bit with some more cream. I baked them in a non-stick skillet until there were brown and then flipped them over. When they were done I stacked them separated by paper towels. I made about 35 crepes and put them in the refrigerator overnight.

To make the filling, I took cream cheese and mixed it with a small amount of seasoning salt and lots of black pepper. I then crumbled in the smoked salmon, a couple of tablespoons of chopped chives, a couple of teaspoons of lemon zest, and some chopped parsley and mixed it well. I added about two tablespoons of my lemon mostarda to the cheese. The cheese mixture was allowed to sit for an hour and the flavors combine. At room temperature the cheese was also easier to spread. I spread the cheese mixture on the crepes and then drizzled a small amount of the lemon mostarda on the top. I rolled up the crepes and placed them in a pan to hold in the refrigerator until I finished the prep at the party. All of this prep work was done at home and all I had to do at the party was to cut the crepes into serving size pieces and then plate them on a pretty platter.

Crostini with wild mushroom pate
These wild mushroom crostini were made with a mixture of wild mushrooms and cultivated mushrooms purchased at the local Farmer’s Market. I used dried Shitake and porcini mushrooms, a couple of chanterelles and morels, and commercially grown Portobello mushrooms to make the mushroom pate. The dried mushrooms were soaked to reconstitute them and then were added to the sliced fresh mushrooms. All of the mushrooms were sautéed in a mixture of butter and olive oil. The liquid from the the dried mushrooms was added to enhance the flavor and then the liquid reduced. I added about a ¼ cup of Marsala as well to add more flavor and then added a couple of tablespoons of chopped parsley and they were reduced again to evaporate most of the liquid. The mushrooms were placed in a food processor with a cube of butter and mixed to achieve a relatively fine puree, placed in a container and allowed to cool and solidify in the refrigerator. I made this pate two days before the party.

A beer bread was used as the base of the crostini. I have given the recipe for this bread before and have shown how you can vary the flavor of it by the addition of different ingredients. This time since I was putting a mushroom pate on the bread I decided to make the bread with dried Porcini mushrooms. I had brought back from Italy a lot of packages of the dried porcini which has an intense mushroom aroma, particularly in its dried form. I reconstituted the mushrooms in a little water and then chopped them coarsely. They went into the bread mixture along with some seasoning salt, garlic powder and pepper. The resulting loaf was a very aromatic bread that I was able to make a couple of days before the party. After it cooled, I put it in a plastic bag and into the refrigerator. The night of the party I sliced the bread into ½ inch thick slices and painted one side with olive oil. I then grilled the bread in a stove top grill pan, topped it with a small amount of a fig jam I had made and then spread on the mushroom pate. I cut each slice into two pieces and plated them on a nice plate and out it went to the buffet.

Cucumbers with herbed, garlic goat cheese and roasted cherry tomatoes
This antipasti was quite simple and yet a very tasty “finger food”, it is also colorful and is an attractive addition to the buffet. I sliced four large peeled cucumbers into ½ in slices and held them cold in a bowl in the refrigerator. The fresh goat cheese was mixed with three or four cloves of minced garlic, some seasoning salt and pepper. Oven-dried tomatoes were made by slicing cherry tomatoes in half, mixing them with olive oil and dried oregano and a tablespoon of sugar and allowing them to marinate for about an hour. Then I placed them on a baking sheet and turned them all so they were cut side up. Into a 350 degree oven for about 45-50 minutes and then I turned the oven off and allowed them to dry for another hour or so. They were soft yet they had a concentrated tomato flavor. The serving was done by topping a slice of cucumber with a scant teaspoon of the goat cheese and then this was topped with a tomato half.

Grilled eggplant and zucchini dressed with olive oil and balsamic vinegar
Grilling vegetables was a technique I learned in Italy and there we grilled lots of different vegetables, depending upon their seasonal abundance. Eggplant and zucchini are available all year around here in California so I decided to use them in a simple grilled dish as a starter. The eggplant were sliced into ½ inch thick slices and sprinkled with salt and allowed to drain in the sink for a hour or more. This causes the eggplant to release a lot of the bitterness they possess. I sliced the zucchini into ¼ inch slices lengthwise. After rinsing of the eggplant and zucchini, I sprinkled good olive oil over them and added a bit of pepper and dried oregano. I would add salt later after I tasted the final cooked vegetable. In my stove top grill pan I grilled the vegetables just until al dente, giving them good grill marks and then placed them on a baking dish to cool. When I served them I arranged them on an attractive platter and drizzled some olive oil and a bit of balsamic vinegar over them. They were served at room temperature.

The first course was a terrific dish I had for the first time in a restaurant in Tiburon, California in 1987. I was building a laboratory and I came in for the first time wearing jeans and a t-shirt with paint on it. Jose the chef took one look at my tired face and said “Let me fix you something.” I was served a simple dish of fettuccini tossed in a basil pesto with fried halibut pieces on it. It was absolutely outstanding. I have served that dish many times, substituting different fish and shellfish for the halibut and it has always been well-received by diners. So for this New Year’s Eve party I decided to up the ante a bit and use fresh scallops as the seafood.

Fettuccini with basil pesto and grilled scallops
The fettuccini was a dried commercial pasta made in Italy. It cooks up nicely and stays al dente. I made the pesto some time ago and froze it. Basil in December is not terrific and it is better to have good basil and the pesto made and frozen than to make an inferior sauce today. I do not add the Parmigiano-Reggiano cheese to the pesto until I am ready to serve it. I cook the pasta and then toss it with the pesto, adding a little more olive oil and possibly a bit of the water the pasta was cooked in. I kept the pasta warm and prepared the fresh scallops. Lightly dredging the scallops in a mixture of flour, cornstarch and seasoning salt, I fried them in about ¾ inch of vegetable oil heated to approximately 360-370 degrees. The scallops were dropped carefully into the oil and fried for about 2 minutes, turning once. They remained soft and succulent, with a crispy exterior crust. I then drained them and placed them on top of the pasta, and took the large platter out to the buffet.

The main dish was Roasted Salmon with a spicy rub. I had the salmon cut and portioned by the fish monger into 5 ounce pieces. This provided a nice serving size that was perfect for the meal. I put the cut fillets on a foil-covered baking sheet skin side down and brushed them with a mixture of clarified butter and lemon juice. The skin sticks to the foil and when you take them out to serve them, the skin stays behind. I then sprinkled on the sweet and spicy rub. This is a mixture of brown sugar, cayenne pepper, paprika, seasoning salt, black pepper, garlic powder and onion powder. I mixed the components together completely and then just sprinkled it on to the fish. I squeezed lemon juice over each piece and then drizzled a little more butter and lemon on top. The fish went into the 350 degree oven and took about 15-20 minutes to cook. I don’t like overcooked salmon so this came out while it was still moist and tender and still a bit pink. The fillets were placed in a chafing dish to keep them warm and put out on the buffet. I served a side dish of a sauce made from chipotle peppers in adobo sauce, honey and orange juice. It was quite spicy and I told the guests that it had bite so use it sparingly. Many of them used it and loved its addition to the fish.

With the fish I made a rice pilaf using chicken broth and sautéing the rice with onions before adding the liquid. It’s a simple dish that while adding nice flavor, does not detract from the fish. The vegetable side dish was sautéed chard with anchovies, garlic and olive oil. I cooked the chopped vegetables in boiling water with four cloves of garlic until tender, then drained them. At the party I sautéed them in a large pan with 10 small oil-packed anchovy fillets that I cooked in a couple of tablespoons of olive oil before adding the chard. All I had to do was get the vegetables hot and I served them in a chafing dish. This vegetable dish was a big hit and we actually ran out before everyone got some. I will have to rethink the amount I cook from now on.

Dessert was a flourless chocolate cake with ganache icing. I have made this cake a number of times. It is made from chopped toasted walnuts, chopped chocolate, some sugar and vanilla, egg yolks, and whipped egg whites. It is like a soufflé that is allowed to fall. I iced it with a chocolate ganache made from bittersweet dark chocolate melted in hot cream and allowed to cool. I served it with whipped cream and a sauce I created from cranberries and mangos.

Dinner ended with espressos and chocolate truffles. Using the same ganache as for the icing, I added a bit of brandy to one batch of chocolate and left the other plain. When they were cool, I rolled walnut sized balls of each type and then rolled the brandied chocolate in crushed walnuts and the plain one in a classic unsweetened cocoa powder. They were a big hit and all of them, disappeared, including at least two into one guest’s purse. A bit of post-New Year’s partying? She didn’t know I was watching.

How does this tie into Eight Bites? The best that I can do with that question is to look at what I ate during the evening. I had such fun cooking the dishes, (and giving mini-classes on salmon preparation and fettucciniwith scallops) and wanted them all to come out great. So I tasted each one to be sure it was what I wanted it to be. I think that is what a good chef does. I had a rolled up salmon crepe, a small crostini with mushrooms, a cucumber slice with goat cheese, two scallops, two bites of salmon and a few bites of the cake. Sorry, I had already eaten a truffle before I got there. I tasted everything. And that was enough. Over the three hours I cooked I actually ate a reasonable amount of food. I was happy with the cooking, happy with the dishes and I didn’t get overwhelmed by my inability to eat more.

So there is New Year’s Eve 2010. It gave me an opportunity to show people what and how I could cook. And I did it all staying with the basic premise of my Eight Bites thinking. It is important that celebrations do not become times for over-eating, because they can become that easily. The discipline you show at these times of excess is what really determines if your weight loss will be successful or not. But it is also very important to celebrate as well. Have fun at these celebrations and do not deprive yourself of that enjoyment. Just keep in mind why you did have that weight loss surgery and what you have accomplished. So Happy New Year’s everyone and may there be many more celebrations and opportunities for you in this year. Eat tasty dishes and celebrate what you have accomplished. Mangia!