Thursday, October 25, 2012

Cabbage Done Savory

Cabbage is one of my favorite winter vegetables, in part because it's surprisingly versatile. The next three recipes will feature cabbage prepared three different ways. It's not everyone's favorite vegetable, but it deserves to be in everyone's diet, so hopefully you'll find you enjoy one of these three recipes.

Throughout these next few recipes, we'll be using different types of cabbage as well, and today's type is red cabbage. Though all types of cabbage are rich in cancer-fighting compounds, such as sulphoraphanes, indole-3-carbinol, and a variety of vitamins and minerals, red cabbage is unique in containing anthocyanidins, compounds which give the cabbage its unique color, and which also are potent antioxidants.

The first recipe is designed to accompany the roast chicken recipe from earlier this week, and features a savory, but mild take on cabbage that won't steal the show from that fantastic chicken.

1 red cabbage
4 tbsp olive oil
1/2 cup water
2 garlic cloves, crushed
2 sweet apples peeled, cored and chopped
1/4 cup raisins
5 tbsp wine vinegar
1 tsp salt
1/4 tsp black pepper
1/4 cup pine nuts

As always, peel off the outer leaves of the cabbage, and remove the core. Shred the tender leaves of the cabbage.
Add all ingredients except pine nuts to a large pot, and simmer over low heat for about an hour, until the cabbage is quite soft. You'll want to initially bring the mixture to a simmer and then reduce the heat, so that the cabbage steams.
Toast the pine nuts in a small skillet or pan until lightly browned on all sides, and stir into cabbage before serving. Even over low heat, this requires close attention to avoid burning the pine nuts (which can be quite expensive).

(Recipe adapted from Claudia Roden's The Food of Spain)

Tuesday, October 23, 2012

A Podcast About Medicine Done Badly

A few weeks ago, I posted a link to an article by Ben Goldacre, a columnist at the Guardian who's just published a book called Bad Pharma. Soon thereafter, Ben was interviewed for the Guardian's Science Weekly Podcast, and an abbreviated version of the interview was featured in their weekly podcast a few weeks ago. Just yesterday, the full version was released, and let me tell you, it's excellent. While Ben has been a harsh critic of complementary medicine (and so he and I don't agree on everything), his critique of the pharmaceutical industry and the effect they have had on both debasing science, as well as putting patients at risk, is excellent. The interview is about an hour long, but is well worth your time. I hope you enjoy it.

Monday, October 22, 2012

A Roast Chicken Recipe

Roast chicken is probably one of my favorite dishes. Over the years, I've come to think of it as something of a benchmark for quality cooking - while it's not too hard to slather the chicken in sauce, stick it in the oven, and then emerge with something that's fully cooked and doesn't taste too bad, it's a lot more difficult to gently highlight the rich flavor of the chicken itself.

Here's the main takeaway message - the key to a properly roasted chicken is salt. Lots of salt. Many folks worry that salt will raise their blood pressure, and avoid salt religiously. While it is true that salt does raise blood pressure, for most people, the main culprit here is processed food, which is far saltier than home-cooked food, even heavily salted home-cooked food. Salt may raise your blood pressure by a point or two, but the enjoyment of a delicious roast chicken dinner will lower it back down again.

Have I mentioned skin? When chicken is properly roasted, the skin becomes the primary repository of flavor - a crispy flavor conveyor, not a layer of slimy goo to be peeled off. Again, a lot of folks remove chicken skin in the belief that it makes their diet healthier. It's true that chicken skin contains more saturated fat than the rest of the bird, but removing it isn't the solution - adding vegetables to your diet makes it healthier, removing chicken skin just makes it less enjoyable.

So here are the ingredients:

1 whole chicken
Approx 1 tbsp sea salt
1/4 cup olive oil
1 tsp assorted herbs and spices

Pretty minimal and vague, isn't it? Approximately 1 tbsp sea salt? And what are assorted spices? Read on to find out.

A good roast chicken starts in the store. Avoid chicken that has been injected with water to make it appear fuller. The water weight will inflate the price of the chicken, and won't add to flavor. Look for natural or organic birds, but be clear about what organic means - sometimes, the only difference between an organic and natural bird is that the organic one was fed organic feed, while the natural one (which costs less) was also free range and spared excessive antibiotics.

Once you bring it home and have removed it from the packing, it is very important to pat the bird dry, both inside and out. When it comes to meat, water is the enemy of flavor. This step is overlooked by most home cooks, and it makes a real difference. No matter what recipe you're using, dry the bird first.

While you're doing that first thing, have some herbs and spices soaking in the olive oil. Which herbs and spices? Assorted herbs and spices. Pick a few and add them to the oil in small quantities - I usually recommend 1/4 tsp each. Favorites include black pepper, paprika, thyme, oregano, rosemary, coriander, and others. Pick ones you like and have them soak/infuse slightly in the oil.

Think also about the kind of oil you're using. Most recipes call for extra virgin olive oil, but that's not always the best for roasting. Extra virgin olive oil has a very delicate flavor, as well as a fragile fat and antioxidant profile that is easily destroyed by heat. Extra virgin oils are largely suitable for dressing salads and very low heat cooking, not roasting. Consider instead using a semi-refined oil that can take the high heats we use in roasting. Refined oils often get a bad rap, but a high quality, heat-stable refined oil is less likely to form dangerous oxidized fats during roasting. I don't like to plug products here, but I will say that, after reading the olive oil exposé Extra Virginity, I favor Bertolli olive oils - they offer an extra virgin olive oil, semi-refined olive oil, and fully-refined olive oil.

Once you've fully dried the bird and have your oil ready, you're ready to oil it up. Rub that chicken down with the oil, making sure that you get it everywhere.

When the bird is fully oiled, salt it, making sure to hit every exposed surface. You don't need to cake it in salt, but you'll want to use about a tablespoon or more of salt to cover the whole thing. The salt should be clearly visible on the bird by the time you're done.

Next step. Many recipes will say to start the bird on it's breast and to flip it onto it's back halfway through the process. You can do this if you like, but I find that it's an unnecessary step that results in the pain in the butt of having to flip an oven hot bird while trying not to tear the skin. Instead, just put the bird on it's back and leave it there the whole time. Most of the skin you'll want to be crispy and browned is on the legs and breast, so leave that part exposed while cooking.

And finally, temperature. Chicken can be roasted at a variety of temperatures for varying lengths of time. To get a tender, juicy chicken with a crispy, flavor-packed skin, I recommend roasting at 450 for 50-60 minutes. And of course, always remember to fully pre-heat the oven.

Bon Appétit!

Thursday, October 18, 2012

A Carrot Recipe

It's rare that you eat carrots and think, 'Wow! Those are amazing carrots!' but that's exactly what I'm hoping you say after you try this dish.

This recipe comes again from one of my favorite cookbooks, Claudia Roden's The New Book of Middle Eastern Food, and it's a guaranteed crowd-pleaser. I'm including it today because we're now in the grips of fall, and good, hearty dishes like this one are finally returning to our tables.

Though this is Tunisian dish, it will always remind me of the bags of dirty carrots I'd get from Lindentree Farm in Lincoln, MA when I had a farm share there. I'd come home after picking up my weekly veggies, and one of the first things I'd do would be to wash the carrots and make this tasty salad.

1 1/2 pounds carrots (peeled or scrubbed clean)
Salt to taste
4 tbsp of oil (olive, sesame or walnut)
3 tbsp red wine vinegar
2 garlic cloves, crushed (or an equivalent portion of garlic powder)
1 tsp paprika
1/4 tsp chipotle powder
1 1/2 tsp ground cumin
1/4 tsp galangal or ginger

Slice the carrots into large pieces and either boil or steam until easily pierced by a fork.
When cooked, drain the carrots and place in a large mixing bowl. Add the other ingredients and mix thoroughly. Allow to sit 10-15 minutes so that the flavors can marry.
Mash thoroughly or puree.
When mashed coarsely, this can be eaten as a salad, but when pureed can be eaten on bread much like hummus.

A few notes: The original recipe calls for the carrots to be peeled, but leaving the skins on retains more beta-carotene. Similarly, steaming the carrots, rather than boiling them, also retains more nutrients.
I prefer sesame oil for this dish, as it gives the dish a slightly nutty flavor that I prefer over olive oil in this case.
Ground galangal can be hard to find, but is uniquely good in this dish. It is similar to ginger, but imparts a slightly camphor-y, mustard-y taste. Use it sparingly, and it really makes the flavor pop.

Monday, October 8, 2012

A Link to A Colleague's Blog

John Weeks is not a naturopathic physician. Even so, he was honored by the American Association of Naturopathic Physicians this year for his lifelong commitment to promoting the profession, largely through his work as the publisher and editor of The Integrator Blog, though this is only the latest of his contributions to the profession. John also periodically contributes to The Huffington Post, and last week, he commented on a great article recently published by Patricia Herman, ND, and Michael Eisenberg, MD, which assessed the cost benefits of complementary and integrative medical therapies in a variety of conditions, populations, and settings. I had the pleasure of seeing this paper presented at the AANP's annual conference this August, and while I will admit that much of it went over my head (it being economic research, rather than medical), I was encouraged by the core finding of the study, which is that complementary and integrative therapies can offer both clinical effectiveness and cost savings in a variety of medical conditions. I've read a number of individual studies that have shown that naturopathic medicine offers considerable cost savings, including a great study done in Vermont, where one naturopathic physician saved the Vermont Automobile Dealers Association approximately $1.5 million dollars in direct and indirect healthcare costs over 12 months, but this new cost benefits study is especially exciting because it has compiled data from a number of other studies, and in doing so has established a larger pattern. Next Monday, I'll be posting some recipes, which have been missing from the blog for several months, but this week, I'd urge you to read John Weeks' article.

Thursday, October 4, 2012

Omega-3s and Traumatic Brain Injury

This past weekend, I went to Hershey Park and spent the entire day going on roller coasters, or, as they were called by the medical advisory signs posted throughout the park, Aggressive Thrill Rides. Over the course of the day, I was tossed, shaken, rattled, and accelerated within an inch of my life, confirming my suspicion that I’m not a huge fan of roller coasters. By the end of they day, I felt pretty sick and had a headache.

While it wasn’t exactly like having a concussion, I spent a lot of the next day wondering whether modern roller coasters are designed to prevent brain injuries in the same way they’re now designed to prevent whiplash injuries. I don’t have any clear answers, but allow me to explain my concerns. As most of us know, whiplash injuries happen due to rapid deceleration, frequently because of some kind of impact, which causes the head to move rapidly forward and then backward. Fortunately, roller coasters decelerate a bit more gradually, so that whiplash injuries don’t happen. Additionally, the simple use of headrests means that whiplash injuries are less common.

However, the brain is also injured by rapid deceleration. Of course, many brain injuries happen because the head itself comes into collision with a solid object, such as a windshield, the ground, a tree limb, etc. but many other injuries happen because of the motion of the brain inside the bony skull. This type of brain injury happens when, for example, a car stops suddenly – the skeletal body stops quickly, but the brain, resting in a liquid environment inside the skull, doesn’t stop at the same time as the skeleton. Instead, the brain keeps moving forward after the skull has stopped moving, and collides with the skull. This is referred to as a coup injury. What happens next is that the brain ‘bounces’ off of the interior surface of the skull, and then hits the opposite side of the skull. This second impact is called a contrecoup injury. In both cases, the brain is bruised where it came into contact with the skull. So, as you can imagine, with all of this rapid deceleration and changing of direction on the roller coasters, at speeds in excess of 50-70 mph, I was concerned about how my poor old brain was doing.

One of the most concerning things about brain injury is that there are no established therapies for recovery after an injury, be they from car accidents, collisions on the football field, or IEDs in Afghanistan. To be sure, a lot can be done to medically manage acute trauma, and there are physical and occupational therapy treatments to help patients recover function, but there is little that can be done to help conserve or repair brain tissue. If you break a leg really badly, you treat the acute injury, you put a cast on it, and then you go to physical therapy to regain function – when it comes to the brain, there is no cast to use, so this crucial repair phase is lost.

However, there may be some hope for preserving brain tissue when it comes to traumatic brain injury. A number of interesting animal studies have suggested that the omega-3 fatty acid DHA, which comes from fish oil, reduces inflammation in the brain following brain injury (1, 2, 3), and at least one of them also indicates that DHA also helps preserve brain function. In addition, there is a published case study in the American Journal of Emergency Medicine of a case in which a teenager was able to progress from an injury-induced vegetative state to near-normal functioning after use of extremely high doses of DHA and EPA. This is all extremely exciting information, and prompted two authors to suggest in the journal Military Medicine that the Department ofDefense seriously investigate the prevention and treatment of traumatic braininjury using omega-3 fatty acids. This isn’t quite time to start jumping up and down giving one another high fives, but, should human trials pan out, this could be a great treatment for a very serious problem.

So what does all of this mean to a consumer? First of all, do what you can to prevent injuries in the first place. This means wearing proper protective equipment when playing contact sports like football and hockey, wearing a seatbelt when driving or riding in a car, and, possibly, limiting your use of roller coasters. An ounce or prevention is worth a pound of cure, and when the cure is experimental, that ounce is worth much more than a pound of it. Second, this is yet another reason to take fish oil for preventive health. While the effects of omega-3 fats as treatment for brain injuries are questionable, these studies have demonstrated that fish oil seems to exert a protective effect when taken in advance, and hopefully you’re already taking fish oil for cardiovascular health.

Before I sign off for the day, here are a few notes about omega-3s, separate from their use in brain or heart health. The first is that quality does matter when it comes to fish oil, and it’s worth investing in ‘the good stuff’. While mercury, dioxins and other contaminants are of some concern with fish oil (and high quality oils will have removed these substances), the greater concern is freshness – fish oil spoils easily in processing, and taking spoiled fish oil is as good as not taking any. You may pay less in buying a low price fish oil, but if the fish oil has spoiled, you’re losing money.

Secondly, it’s now becoming clearer that relatively high doses of fish oil are necessary to achieve true benefit both in the cardiovascular and neurological realms, so consume your fish oil or cod liver oil with some liberty. A number of companies are now selling concentrated EPA/DHA products that allow you to get relatively high doses of these active compounds without taking massive amounts of capsules.

Finally, we are now, at long last, seeing the emergence of vegetarian EPA/DHA formulas. Previously, these were completely nonexistent, and vegetarian consumers were left with the choice of either taking non-vegetarian fish oil, or taking flax oil, whose benefits on cardiovascular health were largely hypothetical. Now, finally, we are seeing oils containing EPA and DHA that are derived from algae. These oils offer patients the ability to gain important nutrients, while maintaining their dietary preferences.