Monthly Archives: February 2018

Should Cauliflower Be the Main Course at a Vegetarian Wedding?

I could have chosen the fish entrée at the wedding we went to a few weeks ago. But since we eat fish several times a week, and since the caterer was known for creative healthy main courses, I opted for the vegetarian choice. Maybe I would discover a novel way of preparing non-animal protein to add to my cooking repertoire.

But alas it was not to be. The mix of vegetables, grains, and lentils that were described in the printed menu was like a bait and switch. The plate arrived containing a mound of steamed cauliflower surrounded by two tiny pieces of sautéed mushrooms. I looked wistfully at the perfectly grilled fish my spouse was eating. Next time I will know better.

But why? Why shouldn’t a caterer prepare a vegetarian entrée with the same balance of protein, vegetables and starch that would appear on a traditional meat or fish dish? Why do caterers or chefs in general assume that vegetarians eat only vegetables? People who identify themselves as meat and potato eaters surely must eat other foods for breakfast or lunch. And why do caterers and chefs conflate vegetarian and vegan? They are not the same.

Indeed, the menu said “ vegetarian” entrée, not vegan. This meant that protein from dairy products and eggs could have been incorporated into a main course, thus allowing for a large variety of possible dishes. Moreover, if the entrée had been listed as vegan—meaning no dairy or eggs—then other protein sources such as beans, lentils, soy, and quinoa could have been used.
It is not necessary for the chef preparing a vegetarian meal to reinvent the wheel. Because animal protein has always been expensive and out of reach for much of the population, each culture has developed signature non-animal protein dishes from cheese blintzes to bok choy stir-fry with crispy tofu. Moreover, the Lenten season restricts the consumption of animal protein, and over the centuries many vegetarian dishes have also been developed to feed families unable to eat meat or chicken.

But none of this seems to be considered when the catering kitchen or many restaurants plans the components of a vegetarian meal. Unfortunately, despite the protein sources that could be incorporated into a vegetarian dish, the protein is usually omitted. Sometimes this is because the caterer simply takes the vegetables from other entrées and dumps them on the plate for the token vegetarian. But protein is often left off of the plate because the chef doesn’t take the time to learn how to include it.

Ironically, eating a vegetarian entrée at a catered affair that serves the main course often hours after one normally eats is a wise choice. Ingesting a slab of filet mignon or heavily sauced chicken at 9 or even 10 pm does not make for a sound sleep a few hours later. Digesting the fat in these animal protein dishes sometimes causes sleep disturbances or a lighter sleep than normal as well as a feeling of heaviness upon awakening the next morning. Vegetarian options tend to contain less fat (unless substantial amounts of cheese are used) and are less likely to demand heroic digestive function late at night.

Until the education of chefs at well-known culinary institutes includes an intensive education in preparing protein-rich vegetarian dishes, there is little hope that vegetarian entrée options at catered affairs will improve. And until cooking shows feature vegetarian dishes that provide at least 25-30 grams of protein and which seem “yummy” enough to be reproduced in the viewer’s kitchen, there is little hope that home cooks will find making a well-balanced vegetarian meal as desirable as grilling chicken or a hamburger. Fortunately, there are many excellent cookbooks and some gourmet cooking magazines that provide ample recipes for the vegetarian home chef. And in fairness to the caterers and restaurant chefs who have developed nourishing vegetarian main courses that look and taste good, it is hoped that they will be able to stimulate others to provide nourishing meals for those who abstain from animal protein.

However, until this occurs, it may be necessary to plan on eating before going to a catered event or bringing protein bars to nibble, discreetly, along with that cauliflower. And if there is any benefit to being denied a substantial vegetarian meal at a catered affair… it is that you will be one of the few who don’t feel your wedding finery is getting snug.

Night Eating Syndrome: Is It Just Sleep That Is Disturbed?

Waking up in the middle of the night is an annoying event that most of us experience. Usually we are able to fall asleep again quickly, perhaps after drinking some water and/or making a trip to the bathroom. But for some, waking up is a signal to go into the kitchen and eat: a bowl of cereal, a peanut butter sandwich, or a dish of ice cream. And unhappily, going back to bed after the night time snack does not ensure that the remainder of the night will be restful. Waking may occur once again, or even several times during the rest of the night, and is always accompanied by eating. The next morning, the night time eater has no appetite for breakfast and may not eat for hours.

When the pattern of awakening and eating occurs regularly, it is defined as a type of eating disorder called Night Eating Syndrome (“NES”) described first by Albert Stunkard in l955. Dr. Stunkard was a professor of psychiatry at the University of Pennsylvania when he first put forth the criteria for diagnosing this poorly understood behavior. Simply eating leftover pie or pizza at midnight is not sufficient to meet the diagnosis, because people with NES consume about 25% of their total daily calories after the evening meal. The food can be consumed in the evening before sleep and/or during nocturnal awakenings. Those with NES suffer from insomnia at least four or five times a week and believe that they will not be able to go back to sleep unless they eat. Finally, if they have mood disturbances like depression and anxiety, their moods will worsen as the evening progresses.

Interestingly, as Stunkard points out in a paper he wrote on the subject almost fifty years later, people who engage in frequent night time eating are not necessarily obese, although it is a risk factor for obesity. Because they are unlikely to eat during the early part of the day, (skipping breakfast and delaying lunch) their total daily intake may be appropriate. On the other hand, many who are seeking help for their obesity often fail to report nighttime eating episodes. Plus, they are rarely asked about it, so it is not known to what extent this type of eating contributes to weight gain.

The inability to sleep through the night, or to do so with only infrequent awakenings of short duration, is certainly associated with NES, but is it the cause? Many people have insomnia, but they do not eat their way through every period of nighttime wakefulness. If the food eaten helps put the eater back to sleep, this would explain their seeking food once they wake up. But it is hard to find studies that test whether the foods chosen in order to put the insomniac to sleep actually work. Moreover, in a study that examined sleep cycles of NES subjects and controls, no difference was found in the duration of sleep, although the former did awaken earlier in the night and more often.

Perhaps the syndrome is not caused by disordered sleep, but by something else. Current research suggests someone with NES is not eating to go back to sleep, but rather waking up because of hunger. The “hunger” hormone ghrelin, which normally is secreted during the day when we normally feel hungry, seems to peak late in the evening and into the night in NES sufferers. Thus they may be awakening because of ghrelin-potentiated hunger.

A solution has been to reset the pattern of ghrelin secretion back to normal by exposing the patient to light very early in the morning. Anyone who has traveled east across enough time zones to feel out of sync and out of sorts during the first couple of days, knows the feeling of being forced to sleep and eat on another time zone’s timetable. It is hard to be hungry for breakfast when it is only 3 am back home, and it is hard to find food when you wake up hungry at 2 am because it is now 7 pm back home. If you stay in the new time zone long enough, your eating and sleeping hormones adjust. This is what researchers hope to accomplish for the night eaters using bright lights to make ghrelin levels high during daylight rather than at night.

Melatonin is also being tried because some studies have found that this sleep hormone is not as high as it should be in the late evening, and perhaps this is why it is so easy for the night eaters to wake up. There is a time-released melatonin preparation containing the low recommended dose of melatonin (0.3 mg); whether it might prevent frequent awakenings has not yet been tested. Anxiety and depression are also linked with NES, but it is unclear if they are the cause or consequence of disrupted sleep.

It is not unusual to wake up at 3 am and be assaulted with the worries that were successfully repressed 12 hours earlier. If one were prone to depression and anxiety, would these mood disorders cause sleep disturbances leading to frequent awakenings or, if awake, prevent the individual from falling back asleep unless something is eaten? Stunkard recommended antidepressants that increase serotonin activity to decrease anxiety and depression and calm the individual back into sleep. But a remedy that would help the sleep, as well as hunger and mood disturbances, is more simple and natural: a cup of low-fat, mildly sweet breakfast cereal eaten upon nighttime awakening. The carbohydrate will increase serotonin thus inducing relaxation, satiety and a more tranquil mood.

If the cereal is in a cup by the bed, it can be eaten without leaving it (as long as there are no crumbs.)


“The night-eating syndrome; a pattern of food intake among certain obese patients,” Stunkard, A.J.; Grace, W.; Wolff, H.,The American Journal of Medicine. 1955: 19: 78–86

“Two forms of disordered eating in obesity: binge eating and night eating,” Stunkard, A. and Allison, K.. Int J Obes Relat Metab Disord 2003, 27: 1-12

“Circadian eating and sleeping patterns in the night eating syndrome,” O”Reardon, J., Ringel, B., Dinges, D., et al, Obes Res. 2004; 12:1789-96

If Your Valentine Sweetheart is on a Diet, Should You Gift Chocolates?

Valentine ‘s Day is a sweet (pun intended) holiday. It comes in the middle of the winter doldrums; Christmas is long past and spring is nowhere to be seen. But the problem is that it also comes about six weeks into the weight-loss program many started after New Year’s Day.

“Give something to show your love,” we are told in a doughnut shop advertisement featuring heart- shaped pink doughnuts covered with white icing and pink sprinkles. Shelves in gourmet chocolate stores are filled with pinky-red, heart-shaped boxes decorated with tiny flowers; the boxes contain melt-in-your-mouth creamy chocolate that should be guaranteed to melt the heart of the recipient.  Russell Stover chocolates that are filed with hidden flavors revealed only when bitten into are waiting to be bought and sent to the relatives who remember the candy with fondness. M&M’s sport pink chocolate shells, while heart-shaped sugar candies waiting to cause instant tooth decay call to the drug store shopper who came in only looking for shampoo.

Not to be left out, bakeries feature several-layered heart-shaped cakes to be consumed with a glass or two of champagne.

To be sure, commercial romance for Valentine’s Day is not limited to food. Flowers are a welcome brightness in the gloom of early February and jewelry, especially diamond engagement rings, do not contain calories. Gifts of self-indulgence that the recipient may not get for her or himself, such as a massage, spa treatments, pedicures, and/or manicures, are also calorie-free and thoughtful.

However, sweet foods, especially chocolate, seem to be the most persistent symbol of romantic thoughts or intentions. Perhaps because for centuries chocolate has been considered an aphrodisiac. There is no scientific evidence for this, and even if it were true, there would be no reason to assume that chocolate consumed on Valentine’s Day has a greater impact on sexual arousal than if it were consumed on any other day. Perhaps if chocolate is wrapped in a heart-shaped box, it has more of an impact; nonetheless, this certainly has not been tested.

Giving a gift of chocolate also has its perils. What if the message it conveys has less to do with romantic intentions and more to do with the body image of the recipient? Give a pound of chocolate to someone skinny and it may convey the thought, “You need to gain some weight.”  Present that heart-shaped box to a chubby recipient and it can unintentionally convey the thought that, “You are fat already, so what difference does another pound of chocolate make?” instead of, “I like you the way you are.” Can you give chocolate to someone in the older generation who may be overweight, developing diabetes, or dealing with orthopedic problems because of excess weight?

Then there is the dieter. The continuing popularity of low or zero carbohydrate diets puts chocolate on the forbidden food list. The butterfat would be fine, and the more expensive the chocolate, the more butterfat it contains. But the sugar content that makes chocolate edible (otherwise it would taste like bitter cooking chocolate) would ruin the diet of anyone who is following a ketogenic diet in which fat, not carbohydrate, is used by the brain and body for energy.

But for those who are counting calories or the equivalent in food exchanges, there is good news. Small amounts of chocolate have fewer calories than they seem to have, given their luxurious taste and mouthfeel. A quick scan of Godiva, a popular gourmet brand of chocolate, reveals a lower calorie count for their chocolate than one would assume. Admittedly the actual pieces of chocolate are not large, maybe one or two bites. Still, you can eat four dark chocolate truffles for about 180 calories, and three pieces of assorted Belgian chocolates for 190 calories. A Lindt chocolate ball has 75 calories. To put this in perspective, a glass of champagne has 95 calories, an eight-ounce serving of fat-free yogurt around 80-90 calories, and 10 almonds, 70 calories. So certainly presenting your Valentine gift of chocolate to a dieter should not be a problem; one or two pieces of chocolate will not retard weight loss or cause the diet to fail.

But of course that is the problem. You can’t buy prepackaged chocolates wrapped in the colors of Valentine’s Day in amounts smaller than twenty or so pieces. Thus the recipient has to confront the problem of how to manage the consumption of the rest of the chocolate after February 14.  A highly disciplined dieter will be able to restrict consumption of a luscious piece of chocolate to one or possibly two a day. But this kind of restriction is not easy to accomplish, especially in the middle of the diet. And the romantic associations with the chocolate will be quickly dissipated when the dieter finds a “gift” of pounds after devouring the rest of the package.

One solution is to buy only one or two pieces of gourmet chocolate from the store; the chocolate can be boxed in the same fancy wrapping as would be used for a larger amount. But in this time of online rather than in person shopping, locating such shops and having the time to go to one seems much too inconvenient. Moreover, the dieter may misinterpret intentions behind the gift thinking that the giver:

1) Is cheap;

2) Thinks I am fat;

3) Thinks I will gobble everything in a bigger box; and therefore

4) Wants me to stay fat.

Maybe people should stick to flowers or diamonds.




Will the Bacteria in Sauerkraut Make You Thin?

Most of us pay less attention to the many colonies of bacteria living in our intestinal tract than we do to the possibility that there may be colonies living on Mars. Recent research suggests it is time to do so. Our gut contains densely packed colonies of bacteria that affect not only digestion and diseases of the intestinal tract, but also our immune system and, according to some research, perhaps hunger, weight, mood, and athletic performance as well.

According to an article by Drs. Zhang and Yang, our intestinal tract contains more than 1000 or more bacterial species. These varieties of bacteria, of which we are usually unaware unless we have “tummy troubles,” function to assist in digestion,  particularly of high fiber fruits and vegetables. They break down the chemical composition of fiber, thus transforming the indigestible carbohydrate to substances, as well as short chain fatty acids, which are used for energy. Our bacteria are also gatekeepers, helping the intestinal immune system deal with foreign antigens or proteins when they enter our body. Intestinal bacteria contain enzymes that make vitamin K, a critical component in the formation of blood clots. Intestinal bacteria also synthesize other vitamins: biotin, vitamin B12, folic acid, and thiamine.

That the bacterial flora can change is well known to anyone who has taken antibiotics for several days, and then confronted with less than optimal intestinal functioning. The antibiotic wipes out so-called healthy bacteria, and sometimes it takes several days or longer to restore normal functioning.

Zhang and Yang’s report asserts that diet also causes significant changes in gut bacteria. Consumption of a high-fat, high-sugar diet causes unhealthy bacteria to flourish. Conversely, diets low in those nutrients, but high in fiber, bring back a better class of bacteria. For somewhat obvious reasons, most of these studies are done on laboratory animals, since they require samples of intestinal bacteria found in the feces, and it is hard to find human volunteers for these studies.

Is it possible that our bacteria can affect our mood? Some scientists suggest that we can reduce anxiety and depression if we have the good kind of bacteria. This is based on evidence that intestinal bacteria make neurotransmitters, the chemicals that transmit messages in the brain. But it seems unlikely that our gut will control our mood since neurotransmitters made in the gut never get into the brain. (But interestingly, we do talk about our gut having feelings, i.e., our language is full of expressions that suggest our gut has moods: a feeling in my gut, gut response, gut reaction, etc…)

Intestinal microbes may affect the amount of ghrelin, a hormone that tells the brain whether we are hungry. But if so, no one has figured out what species of intestinal bacteria may do this—or whether they will make us feel so full we will eat less. Now athletes are allowing their intestinal bacteria to be analyzed to see if they differ from those of sedentary folk. According to an article in a recent issue of Outside magazine, some super-fit athletes do have varieties of bacteria not found in non-athletes. However, since they tend to follow extremely healthy, low-fat diets, is it their diets or their incredible athletic feats that change the bacteria? (Or, do the bacteria contribute to their athletic success?)

Much more research has to be carried out to show that intestinal bacteria are having a direct effect on hunger, athletic performance, or obesity before we can start manipulating our bacterial colonies to bring about certain desirable health effects.  To be sure, there are some studies now gaining interest, that have tested the effects of fecal transplants in which bacteria from healthy volunteers may be transplanted to the intestines of those suffering from an intestinal disease like irritable bowel syndrome. These studies are showing promise in helping people whose intestinal disorders do not respond to conventional therapies.

In the meantime, while we are waiting for more science to support some of the claims that our gut bacteria can alter our heath for better or for worse, we are told to load our intestinal tract with good bacteria. Supposedly, these good bacteria can be eaten if we consume fermented foods such as sauerkraut (fermented cabbage), miso and tempeh (fermented soybeans), kimchi (a Korean dish of fermented cabbage with hot spices), kombucha tea (a fermented drink made with tea, sugar, bacteria, and yeast). and kefir (a fermented yogurt drink). These foods contain probioticsor living bacteria, that when ingested populate our intestinal tract with good microbes. Pasteurization will kill the microbes, both good and bad, which is why many yogurts and canned sauerkraut are not on the list.

But there is a problem. Although scientists can identify many of the species of good intestinal bacteria, they are not listed on a package of tempeh or a bottle of kombucha. Moreover, how many bacteria are we actually eating? Probiotics may differ in their content of something called CFUs, or colony-forming units. CFUs describe the density of viable bacteria in a product. According to Dr. Shekhar K. Challa, a gastroenterologist who wrote Probiotics For Dummies, quantitating the CFUs of probiotics in most food products is almost impossible. CFUs are not listed under calories or any other place on the food label.

So will eating unpasteurized sauerkraut make enough good bacteria to make you thin (that is, if good bacteria will make you thin)? Probably not. But sauerkraut contains almost no calories, and chopping a cabbage, mixing it with salt and watching it turn into sauerkraut is something to do on a snowy afternoon. And after you eat it, its bacteria will have a happy home in you.


(“Effects of a high fat diet on intestinal microbiota and gastrointestinal diseases,” World Journal of Gastroenterology 2016, Oct 28; 22(40): 8905–8909)