Monthly Archives: July 2015

Is There an App to Tell Me How to Cook Strange-Looking Vegetables?

“What am I eating?” my spouse asked, poking at the roasted wedges of an orange vegetable on the dinner plate. “They look and taste like beets, but I thought beets were, well, red.”

“They are beets. I got them at the Farmer’s Market,” I explained. “They were next to the red beets so I knew what they were. But I wish all the vegetables came with nametags. I have no idea of what at least of third of them are.”

That is the problem. Every Tuesday and Friday, I walk over to the outdoor market with my cloth shopping bags planning to buy vegetables for supper. And every Tuesday and Friday, I leave with pretty much the same assortment although fresher and younger than what is available in the supermarket down the street: spring onions with dirt still clinging to their long green leaves, delicate lettuces, pale pink radishes, misshapen tomatoes (the more misshapen, the more expensive), just picked corn and, of course, beets.

But the stands are also filled with mysterious greens whose long tough stalks look inedible. What are the funny looking lumpy peapods that look like pregnant green worms and those purply round root-like vegetables that vaguely resemble turnips? Maybe they are turnips. Next to the conventional zucchini and yellow summer squash, there’s a pile of squash-like looking vegetables with either stripes or scalloped edges. They look like models in a still-life painting and, if I could paint, I would take them home and make art of them. I want to ask the nice people selling the produce what these squash-like vegetables are called, if I should I peel them before cooking and how should they be cooked. But the stands are always crowded, and this being a city where people rush about, not too many would be happy if I were given a cooking lesson while they are behind me in line.

So even though I should be more adventuresome and attempt to wrestle those aggressive greens into submission in a shopping bag and then figure out how to prepare them, or throw the squash-like vegetables in the oven and hope for the best, I walk away with the my predictable purchases.

But as I trudge home, filled with frustration about my ignorance of those nutritious-looking but nameless vegetables, I wonder why there isn’t some way of giving shoppers like myself information about what is being sold. Obviously I don’t expect the squash-like vegetables to come with food labels or the greens packaged with a machete so they can be cut into mouth-size pieces. But think how useful it would be to see pictures of these vegetables on a large poster with their names and a brief description of how to prepare them. Many shoppers might buy new to them vegetables to try at home, at least once, if they know their names when family members ask what they are eating. It would be really helpful to see instructions on whether the vegetable is to be eaten raw, or cooked and if the latter, how? Doing so would keep us from serving something hot that was meant to be eaten cold, or baked if it should have been boiled.

Why stop with the Farmer’s market? How useful it would be to go into an ethnic supermarket and know how to prepare the many vegetables and fruits that are unfamiliar? I live near several Asian supermarkets but, as with the Farmer’s Market, rarely do I deviate from purchasing only the vegetables that are familiar. Should I buy bitter melon? What if it is bitter? What do I do with lemongrass? Does it taste like grass or lemon? Are those red berry-like fruits covered with little spines meant to be peeled? Plantains look like bananas but I know they have to be cooked not eaten raw. But how? What do I do with yucca, or other tubers that look sort of like potatoes? Is a Japanese sweet potato sweet?

Some adult education classes take their students on field trips to ethnic supermarkets so the students can learn from an expert the names of produce sold in such stores, and how to prepare them. But what about the rest of us? Why do we have to sign up and pay for a course to learn how to shop for exotic vegetables, and then be taught how to cook them correctly?

Almost all packaged processed foods that cannot be eaten straight out of the box or pouch come with detailed instructions on how to steam, microwave, bake, or roast the food inside the package. The irony is that the foods we should be eating, i.e. the unprocessed, fresh vegetables and fruits, are information orphans.

Maybe the answer will be an app. The shopper will take a picture of a weedy-looking vegetable that might or might not resemble a stalk of broccoli, or a green-skinned pear-shaped vegetable that can’t be a pear (it is in the vegetable section) and send it to a virtual nutritionist. Then instantly, the shopper will receive its name, nutrient content, instructions on preparation, and maybe even a hint of what it tastes like (chicken?). Could we have this app by August, please?

Can You Be Too Fat to Lose Weight?

Several years ago, Mary, a young professional woman, came to see me for help in losing weight. She was about 40 pounds overweight, gained in large part because of the sedentary nature of her job; she endured a long commute that gave her little time to go to a gym or even jogging before or after work. A decreased calorie intake more compatible with her decreased level of physical activity and a health club opening in the office complex where she worked made weight loss relatively effortless.

A few weeks ago, she came to see me. I did not recognize her; she now weighed considerably more than 300 pounds. A perfect storm of family tragedies, job loss because of her firm’s bankruptcy, and two years of treatment for anxiety and depression with a medication known to cause weight gain had left her morbidly obese. Each time she went on a program such as Weight Watchers or dieting with calorie-controlled shakes, she lost 50 or so pounds, but gained them back as soon as she stopped the diet. She told me, “I am heavier than I have ever been, and I am still gaining weight.”

Bariatric surgery had been recommended but the stumbling block was the requirement to lose 30 pounds before she would be considered eligible. This is pretty standard procedure: The group caring for her prior to and following the surgery wanted to make sure that she would be able to stick to the rigorous diet plan she would have to follow for months after the surgery. She wanted me to help her lose the weight as I had many years earlier.

But now it was going to be so much harder. Mary was no longer a healthy young woman. Her obesity had spawned a cluster of health problems: type 2 diabetes, high cholesterol, high blood pressure, sleep apnea, chronic back and knee pain, and difficulty walking. And, she told me, she was horrified at the way she looked. “The doctors said not to worry about my weight gain. It was more important to get rid of my depression. But how can anyone not be depressed if they look in the mirror and see a fat body staring back at them? And now I can’t get a job! Sometimes I find part-time employment, but my weight makes it too hard for me to take any job that requires standing. And when I apply for a job that I know I can do, I don’t get hired, probably because employers don’t want to hire someone who is so fat.”

Isolation from not working, along with an extremely limited social life, contributed to her difficulty in losing weight. “I am alone all the time. Since I rarely work, I stay at home during the day, and I never go out at night or on weekends. No guy is going to date someone looking like me, and most of my girlfriends are married. I don’t know what to do. There aren’t any support groups to help people like me, who become obese on antidepressants and, as a result, have our lives fall apart.”

She was right.

Helping her lose weight now was not merely a matter of having her eat more salads, fewer pizza slices, and getting to the gym more often. Now losing weight meant dislodging her from the lifestyle self-imposed by her morbid obesity.

She already had a diet given to her by a clinical dietician and if she followed it, she would lose weight and her diabetes would be in control. But as she told me, she cheated after less than a week on the diet, and did not think she was capable of staying on it long enough to be eligible for bariatric surgery.

We discussed ways to make small changes in her life that might positively affect her weight loss. Her physical inertness from chronic back pain and fatigue from her medication had to be overcome. I urged her to move, even if it meant going from one chair to another, at least once an hour and to walk for five or ten minutes, twice a day.  She knew from exercising years ago that physical activity would make her feel more, not less, energetic and perhaps even less depressed. And as she lost weight, walking, climbing stairs, and even getting up from a chair would become easier.

Volunteering seemed a good way of getting her out of the house and might generate a paid position, or at least recommendations that she could use in applying for a permanent job. Her acute loneliness on weekends might be diminished by volunteer activities that took place on Saturday and Sunday afternoons and early evenings.  Educational workshops scheduled for weekends could also decrease her isolation, and she lived close to an adult education center that offered such courses.

We both knew that her progress in losing weight would not be without setbacks. Unraveling the complicated reasons for her weight gain cannot be undone by a few workshops or 10-minute walks. Progress would depend on resolving them with a therapist whom she was already seeing, a post-bariatric surgery body that was no longer a visual and physical liability, a job and, hopefully, a better social situation.

Mary may not be too fat to lose weight, but her situation demonstrates how hard it is for the morbidly obese to become thinner. It is a heroic undertaking.





The Inedible Food Diet

Having recently returned from a weeklong conference, I noted, happily, that I had lost a couple of pounds. This was surprising, since so much of the day was spent sitting in seminar rooms or large lecture halls, with a large buffet lunch and dinner served each day. Moreover, the meeting took place in Jerusalem, where hotels traditionally served breakfasts whose variety and abundance of food rival that of any cruise ship.

But when I considered why I had lost weight, I realized that the cause was frustration with the foods served at lunch and dinner. At breakfast I ate the foods I usually eat at home, probably because in my jet-lagged state, making decisions about what to eat so early in the morning was beyond my cognitive ability. But by lunch, I was hungry and dinnertime corresponded to lunchtime back in my home time zone, so I was even more hungry. However, I found I could not eat the food served beyond what it took to minimally satisfy my hunger.

The food was abundant and looked attractive, but it was more or less inedible. The salads were limp and watery, the bread stale, the pasta overcooked and underseasoned, and the fish, chicken and beef tasted as if they had been cooked several days earlier and reheated. Fortunately, fresh fruit was always served for dessert, but the small cubes of cake served along with it tasted like leftovers from a long ago party. No one complained about the food; we were not at the conference to eat and conversation at meals offered enough “food for the mind” so that we didn’t pay much attention to the food for the body. But I did notice that no one went back to the buffet table for second helpings. The one meal we had away from the conference, in the home of a friend, made me anticipate eating a well-cooked meal. Alas, I had forgotten that she hates to cook and her food actually competed with that of the conference for its inedibility index. Thankfully, the company made up for the absence of culinary pleasure.

My unanticipated weight loss made me wonder if an inedible diet plan might work in a weight loss program. Some diet plans answer this question by eliminating the consumption of normal foods altogether, offering instead complete nutrition shakes or food bars. But many others advertise themselves as offering reduced-calorie foods that have been engineered to make them as tasty as foods with traditional ingredients. Other weight loss plans teach their clients how to substitute ingredients in baked foods to make them taste like food with more fat, sugar or salt so they won’t miss their favorite dishes while they are losing weight.

Could it be that this is the wrong approach? Could it be that manipulating ingredients so that a lasagna or sausage and egg patty with engineered ingredients to make it less caloric than its original version is the wrong way to get people to lose weight? Could it be that putting people into a residential facility like Canyon Ranch and presenting guests with flavorful and attractively prepared foods is sending the wrong message?

The diet industry is telling people that they can continue to enjoy eating and lose weight at the same time. Maybe this is one reason why diets are so unsuccessful. The dieter and indeed the non-dieter are rarely taught that the reason we eat is to provide nutrients and calories to keep us alive and healthy. We accept this premise when feeding our pets and quarrel with ourselves when we give in to the demands of our pets to feed them tasty but not particularly nutritious foods. “Don’t feed your dog table food!” we are admonished. The dog must eat only foods that are designed for its own nutritional and caloric needs. If you don’t give him cheese, chicken, hamburgers, etc., then he will learn to eat only dog food.

But we don’t apply this advice to ourselves. Like some pets, we want to eat only foods that taste good and when we get those foods, we often overeat them. Perhaps just as we try to get our pudgy Labrador or Dachshund to lose weight by restricting tasty foods, we can help ourselves lose weight by eating only foods with a low taste quotient.

It is well known that dieters and non-dieters use food as a substitute for whatever is missing in their lives. For many, eating is rarely done to nourish or take away hunger. Indeed, we eat when we are not hungry or continue to eat after hunger is satisfied for the pleasure of putting food in our mouths. Food is consumed as a source of gratification, a substitute for loneliness, a recreational and social activity, a stress reliever, as a symbol of celebration and ritual and because it tastes good. There is nothing wrong with using food for these objectives, unless and until, consuming them for these reasons causes weight gain or prevents weight loss.

It might be interesting to do a study in which dieters are given palatable but not particularly tasty foods and their meals are accompanied by pleasurable social interactions. Might they find it easier to eat less? If we can be weaned from thinking that life’s pleasures are found in an ice cream bar coated with chocolate, or a sandwich dripping with melted cheese and bacon, might we begin to look for non-edible pleasures and find them? This is not to say that eating delicious food is not one of life’s pleasures. But clearly it should not be the only one we seek.

Should You Be Eating High Fat Before a Endurance Events?

As with every aspect of the high/low carbohydrate diet argument, there is now some controversy about whether eating fat, as opposed to carbohydrate, is better for endurance sports.  Although lard has not become the preferred pre-Marathon Dinner menu item, there are some whom are promulgating for credit, even, that avoiding carbohydrates and eating fat will make you run or bike longer and faster. 1 Obviously if the only running you may do is after your spouse who is making off with the last pint of ice cream in the freezer, your response may be, “Who cares?” And if you are following a high protein, low carbohydrate diet, you may feel that exercising is irrelevant since you are losing weight without it. (The benefits of exercise on longevity, reduction of muscle loss, and delay in cognitive decline are something you will think about when you are much older).

But maybe you have a personal trainer who tells you to avoid carbohydrates; she read that you will lose more weight exercising if you eat only fat and protein.  Or you play golf with a friend who eats six strips of bacon before a game, convinced it improves his drive.  You begin to question something you learned decades ago: that muscles use carbohydrate for fuel. Do marathoners now chow down on lard rather than pasta before a race? You begin to wonder whether eating fat before exercising will allow you to losemore weight, because it will be burned for energy. Or maybe you can exercise even better if you just eat protein. After all aren’t muscle made of protein?

The answer is that despite what books and blogs are telling you, your body still depends on carbohydrates as its basic source of energy.

A tiny bit of biochemistry to show you why:

Adenosine triphosphate or ATP is the energy compound inside the cells.  It is metabolized to release the energy to allow you to pick up the remote if it fall off the sofa or to run a 100 mile ultra marathon. 2 Carbohydrates, fat and even protein can be converted to ATP with varying degrees of rapidity and efficiency. Protein is rarely used to fuel muscle movement because it has to be converted to glucose first; but it is needed to repair used muscle fibers after exercise and build new muscle. 3

What happens when we begin to exercise? Let’s say you are walking the dog, slowly until suddenly he  jerks the leash out of your hand and races off to catch a squirrel (a futile endeavor). For the first 2 or 3 seconds, your muscles move rapidly, using  tiny amounts of stored ATP. Then, at second 4 and beyond there is no more ATP. Your muscles begin to convert  stored glucose, called glycogen, to ATP and you and your dog can happily  run for several more minutes without the need for additional oxygen. At this point, unless you supply more oxygen to your muscles, you will hurt. Lactic acid builds up causing a burning sensation and your muscles  feel tired. You need to breathe.

In this scenario, if the squirrel runs to the next town, you have enough stored carbohydrate to run after the dog and the squirrel for about two more hours. But then you run out of stored carbohydrates and,  “hit the wall, “ or “bonk,” in athletic parlance, i.e. you run out of steam.

So now assuming you and your dog have several miles to run to get back home, your body must switch to fat as its backup energy source.  It might be a good idea to sit down on a park bench and talk to your dog about the futility of chasing squirrels, because it takes a little time for your body to mobilize fat from your fat stores.  Unlike carbohydrate, which is readily converted to ATP, fat has to be dragged out of your fat cells (the bacon you ate for breakfast is not going to be used up on the jog home) and broken down so that  one component, the  free fatty acids, are transported to muscle cells .There they are   converted to ATP with the help of lots of oxygen. You and your dog are going to be doing a lot of  panting on the way home. 4

Athletes who do endurance sports such as 100 mile ultra-marathons , day long mountain hikes, or long distance bike rides  can transition from carbs to fats as an energy source very quickly.  According to the sports nutritionist, Sunny Blende who writes for UltraRunning magazine, during a six hour or longer run, about 90% of energy will come from fat. 5 (My pudgy dachshund should read this Blende article).

So does this mean that if we plan on going on for a six hour run with our dog and squirrel, we should eat lots of melted butter the night before, or at least a pint of ice cream? Well according to Ms. Blende, and I quote, “…Even the leanest ultrarunner has about 800 miles worth of fat stored within their skinny-little self.”6  Presumably the rest of us have more than  enough fat for any energy requiring endeavor,  and do not have to eat more in order to move.

So if we can use fat for exercise, why do we need carbohydrates?  According to Matt Fitzgerald, author of Diet Cults, research done long before Dr Atkins promoted chicken fat for dieters, showed that carbohydrate is needed both for high intensity performance and endurance. He cites the diet of the Kenyan marathoners whose diet is about 78 percent carbohydrate. (They are clearly not obese). He says, “If you want to go fast, your body needs carbs for fuel.” This is true if you are running after your dog, or after a tennis ball.

Avoiding carbohydrates in the pursuit of leanness makes sense only if you want to avoid exercising. And if that is the case, you may need a dog that can pull you in a wagon.