Thursday, February 27, 2014

Fish and Potatoes

It's been several weeks since I've put a recipe on the blog, my time having been consumed with medical topics, and so I'm returning today with a recipe, a simple one that reveals the natural goodness of the ingredients used. Simplicity is undervalued in cooking, especially in modern American with its fetish for complicated flavors and heavily spiced foods. Simple foods, prepared well are often the most delicious because they allow us to really pay attention to what we are eating.

As is well documented, fish can be a tough sell. We know we should eat more, but we don't know how to prepare it. I've offered recipes in the past, but it's been a while since then, so I'm returning with a guaranteed sell. If the prior recipes were strongly flavored, this one is far, far from it. It's simple and allows the natural flavors of the fish to be presented - I recommend a mild, meaty white fish for this, like mahi mahi or corvina.

2 medium onions, sliced thin
3 tbsp olive oil
2 lbs waxy potatoes (such as Yukon gold), peeled and sliced in thin rounds
1/4 cup water
1 tsp salt
1 lb white fish fillets
1 tbsp lemon juice

Use a large, oven-worthy pan for this. Saute the onions in 2 tbsp olive oil until very soft and caramelized. Add the potatoes, the water, 1/2 tsp salt and gently stir to mix. Cover and cook at medium low temperature for 10 minutes, until the potatoes begin to soften.
Meanwhile, drizzle the fish with the remaining 1 tbsp olive oil and sprinkle on 1/2 tsp salt.
Add the fish to the cooking potato/onion mixture, along with the lemon juice - don't mix, just place it on top. Cook covered for at least 20 minutes, until the fish is fully cooked.
Finish the dish by putting the pan in the oven to broil for 3-4 minutes. The broiler will put a nice brown on the fish and potatoes.


Thursday, February 20, 2014

Naturopathic Medicine Saves Money

Last summer, a landmark study was published in the Canadian Medical Association Journal. It found that naturopathic medicine reduced the risk of cardiovascular disease when added to conventional medical care. In the study, the group that received naturopathic care saw its incidence of metabolic syndrome fall nearly 50%, and their likelihood of suffering a cardiovascular event (a fancy word meaning heart attack, stroke, clot, or other issue) was about a third lower than the group that received only conventional care. To put this in plain English, Naturopathic Medicine makes people healthier and saves lives.

However, the study authors weren't done there. In addition to investigating the healthcare benefit, the authors wanted to answer the question: Does naturopathic medicine save money?

Specifically, the researchers were asking this question: If an employer invests in naturopathic medicine, do they see a return on their investment? To find out, the full cost of the naturopathic program was assessed, and this was then compared against total per employee healthcare spending and differences in employee productivity.

The results were published recently, and they are clear: Employers who invest in naturopathic medical care for their employees see significant healthcare cost savings, as well as increases in productivity. You can read the exact figures in the article itself, but the rough findings were that naturopathic care helped employers save about $1000 dollars per employee in healthcare costs, and that those employees were more productive, to the tune of about $1400 per year. As a per-employee benefit, that's notable, and it scales up very quickly into even more significant cost savings in a large company.

While this is only one study, it does accord with earlier unpublished findings that naturopathic medicine reduced healthcare costs and improved productivity at the Vermont Auto Dealers' Association (VADA). The findings were so significant in Vermont, in fact, that the VADA changed its position on insurance coverage for naturopathic services, and helped Vermont to pass legislation that mandated insurance coverage for naturopathic care.

Whether the new study will push insurance coverage in any states is not clear, but in any case, employers should strongly consider providing naturopathic care to their employees, not only to help their employees live healthier lives, but to save money as well. I'm even imagining a slogan: Go Green To Save Green With Naturopathic Medicine.

Let's get out there and make this happen.

Thursday, February 13, 2014

How Many Mets Is That?

About a month ago, the Freakonomics radio show asked the question "What's The 'Best' Exercise?" in their weekly episode. This is a tough question, because there are many criteria you could use to assess this question. Does "Best" mean the one that works the largest variety of muscles? The one that we can do starting when we are young and continue until we are very old? Is it the one that provides the most cardiovascular benefit? Is it the one that provides optimal health benefit for the least input? Or is it the most enjoyable? As you can see, this is a hard question to answer.

In some ways, the answer to this question is: The "Best" form of exercise is the one that you will do regularly. Exercise is a habit, and hard work and persistence are more important than scientifically proven results. A "beach-ready" body that you have one summer when you are 24 is less valuable than the more moderately toned one you maintain for decades. Thus, the exercise that you find enjoyable enough to engage in regularly is the "Best" one. By far.

That said, there is some interesting research out there on the "value" of some forms of exercise as opposed to others, and the best way to quantify this is by using the MET as a unit of measure. MET stands for Metabolic Equivalent, and is a way to quantify the amount of energy burned by a given activity. 1 MET, for example, is roughly equivalent to sitting quietly, whereas walking at a slow pace has a MET value of 2, or twice that of sitting quietly. The higher the MET value, the greater the energy expenditure for a given activity.

But how do we use this information? What are various activities "worth"?

Well, Freakonomics would direct you to this document, produced by the CDC, which gives some examples of moderate and vigorous activity. You might find this helpful, or you may find it a bit difficult to navigate. I'd refer you instead to this website, which provides lists of all kinds of activities, grouped into categories such as Bicycling, Dancing, Home Repair, and Sports. Just about any activity you can think of has been measured and updated over the past 20 years.

While some of this information is what you already know - e.g. basketball requires more energy than billiards - it's still helpful for those who are considering picking up a sport for health benefits. But again we come back to the important question of what kind of exercise you will stick with. Running at a 10 minute/mile pace has a higher MET value than basketball, but the social reinforcement of a team sport is likely to keep you engaged over a long period of time. So take the information with a grain of salt. One form of exercise may burn more calories than another, but if you won't do it, is it worth investing in?

After all, what do you want to do to keep active?

Thursday, February 6, 2014

Old Wive's Tales?

The legislative effort continues in Maryland, and in the past week, I have testified to both the Maryland Senate Education, Health, and Environmental Affairs Committee, and the Maryland House Health and Government Operations Committee on the topic of naturopathic licensure. What a week it's been! If you're a Maryland resident and are interested in contacting your representatives about naturopathic licensure, click this link and you'll be brought to a page with simple instructions.

Meanwhile, I was sent this charming infographic by a friend of mine. I can't say I agree with everything it presents (the lack of citations makes it hard to verify info), but this is a great starting point for a conversation. Naturopathic medicine is often maligned as a collection of "old wives' tales," but nothing could be further from the truth. Naturopathic doctors are actively involved in research efforts, and of course pay attention to the latest news from around the scientific world. So which of the following are old wives' tales? Ask a naturopathic doctor to find out!