LUNCHES

grapes

School has started again and I was reminded of my sense of inadequacy over lunch food when my brother in law was complaining about his daughter not eating her lunch.  It reminded me of when I had the same complaint.  But my complaint included a rant about the contents of my daughter's lunch.
You see, I hate to pack school lunch.  This dislike goes back to when I was a child.  I never wanted to do it the night before, and everyone knows you can only do a good job in the morning if you get up early.  So I always foist  the job on anyone I can get to do it.
When my daughter was little, I had the babysitter make her lunch.  I would explain, in excruciating detail, what should be included in a nutritious lunch.  And each evening I would empty her lunch box with a complete untouched lunch.  This lunch would always contain food that did not meet my standards.  After listening to me complain about this for weeks, my husband, instead of telling me to make the lunch myself (a very good call on his part, I might add) stated "what does it matter if she doesn't eat a non-nutritious lunch, or she doesn't eat a nutritious lunch?  She doesn't eat it!"
This got me to thinking about what and how much a lunch should contain.  Obviously, the caloric intake varies depending on the age of the child, and whether or not you are packing mid-morning and after school snacks also, as so many parents do.  I think the best way to think about it is how many calories does your child need in 24 hours, and how many of those will he eat away from home.
A child should always start their morning with breakfast.  In general, they should have some protein and complex carbohydrates.  I'm a big fan of oatmeal, but my daughter isn't.  It doesn't have to be typical breakfast fare, either.  A big favorite in my family is cold pizza.  That meets my requirements and can be eaten on the run.
But this is really about lunches.  I've always thought that lunches should have a variety of things because you never know what you are going to feel like eating.  If you are planning lunch with snacks, that allows you to increase the choices and calories for your child.  Plan on giving them half their daily calories.  Include a fruit, a vegetable, carbohydrate and protein.  Include your child in menu planning.  Not necessarily on a daily basis, but in grocery-shopping.  If they have more say in what goes in their lunch, they are more likely to eat it.
Do you need to include a "treat"?  And if so, what kind?  Some people think of treats as dessert and sweet, others think of treats as salty and savory.  I think of treats as junk food and should not be a daily part of eating.  So my answer is treats are not a daily part of lunch.  Even if they are not eaten!  Because what we are trying to teach with what we send to school for lunch is what is good food.
Next blog will have ideas for the lunch itself!

FROZEN TREATS

 In my last blog, I mentioned that I was off to make gelato, which I did.  And then I made some more.  And then I made some ice cream.  And finally I had a bunch of people over to taste them and figure out what they liked better.
The big question on everyone's lips mixed in with cream, sugar and eggs was what was the difference between the two.  So here is a treatise on gelato and ice cream.

Gelato came first, although ice cream and gelato are essentially made from many of the same ingredients.  Gelato has a lower butterfat content which is usually 4-8% and in the United States ice cream usually has about 14% butterfat, but some of the rich ice creams can go up to 20-25% butterfat.  After 25% the texture because almost waxy and is actually unpleasant.

Gelato also has more sugar than ice cream, usually running about 16-24% to ice cream's  12-16% depending on the amount of fat.  It is this increase in sugar that combines with the water to prevent the gelato from forming large ice crystals as it freezes.  Also, gelato requires "a stabilizer" which  most often are the egg yolks (although in the mascapone ice cream I made, the stabilizer was a milk solid commonly known as cheese.)  It is important that the milk proteins are heated, as well as the egg yolks and then the whole mixture ages so that the milk proteins bind with the water so that the ice crystals that form will be smaller giving a smoother texture.

Gelato is always made quickly in small batches, and the churning is slower.  Slow slow churning minimizes the amount of air incorporated into the finished product which is a denser product than ice cream with more intense flavours.  It can only be stored for a few days at consistent, low temperatures.

Ice cream
Standard ice cream is made from cream, milk and sugar.  There are usually no eggs in it.  When eggs are added, it is called French, or custard ice cream, and then it is really more gelato-styled, although usually has siginificantly more fat than gelato.  During the churning of ice cream, there is more whipping during the process whichs incorporates more air which gives it a lighter texture.

There are many ice cream makers out there.  There are commercial gelato makers and many discussions about the availability of good home gelato makers.  I am pleased with the one I bought.  It has gotten great reviews from many others and I can say that the crema gelato I produced was as a good as a remembered from the last time I was in Italy.

Neither gelato nor ice cream is what I call a healthy snack. Calorie-wise, though, per 1/2 cup serving homemade gelato is about 150-200 calories and ice cream is 250-350.  But place it on top of fresh summer fruit and I think for an occasional treat, there is no reason not to give it to your kids.  And there are some sorbettos that I am going to try and I will report in on their ease of making in my new machine.  Because those will be  a lot healthier on top of those summer fruits.

Gelato - Lucky For Me I Don't Live in Italy!

On occasion I write on another blog, Bytes of Food, where the writers talk about is "all things food".  My latest blog there is about the Santa Monica Farmers Market, one of my favorite places to hang out.  Since it is summer and I am feeling lazy, this is going to be a short blog.  I would suggest you read that entry for the background.

Ice cream is a favorite food for everyone in my family.  When I think about what I would NEED on a deserted island, ice cream would definitely be up there.  I sometimes think I could eat it 3 meals a day.  And I know how unhealthy that would be.  So one of the ways I make sure that ice cream is not continuously in my house is that I do not buy it.  The way I satisfy my craving for it is that when I really want it I make it from scratch.  I can assure you that minimizes how often I eat it.

I prefer gelato to ice cream.  The difference is that gelato is made from eggs and whole milk, not light cream.  It has 5-7% fat (by law for something to carry the label ice cream it must have at least 10% fat).  Because it is churned at a slower speed it gets less air in it and is more dense.  It is also is served slighter warmer.  My favorite flavor is crema.  Most Americans think of it as vanilla, but it isn't.  It is more delicate, and I have never seen it in the grocery stores.   The only way to enjoy it in the United States is to make it yourself.  So here is a recipe for it.  You can serve it with the fruit recipe that is in my blog in Bytes of Food. 

Crema (or custard) Gelato

2 1/4 cups whole milk
6 egg yolks
2/3 c. heavy cream
pinch of salt

Combine milk and salt in medium saucepan and heat slowly until bubbles form around the edges.  Take off heat. 
Blend the sugar and egg yolks until very thick and smooth.  Add the hot milk gradually, and then put mixture into the saucepan and cook over medium heat, stirring constantly until the mixture thickens.  Remove from heat and put in a bowl of ice water and stir for 2 minutes until cool.  Cover and refrigerate until chilled.
Beat the cream until soft beaks form.  Add to custard mixture.  Put into your ice cream maker.
Makes 1 1/2 quarts.

IMPORTANT NOTES
1. Since no flavoring is added, the fresher the ingredients the better this will taste.
2. I like using free-range chicken eggs.  The yolks are usually more yellow which gives the gelato a color with more depth.
3. Patience is the key word.  If you don't take your time stirring you will overcook the eggs.  If that happens, just strain your mixture to get out the egg lumps.
4. If you want to add to this, you can mix in pieces of fresh fruits or candies after it is made.  If you put it in while making the ice cream, they tend to freeze.

And now I am off to the kitchen to make gelato.............

AS USUAL, THE KIDS PREFER MOM'S!



Fitz, the "fruit guy"



Not only did Ashna try out the food, but one of her friends participated.  I'm always one to encourage kids to to put their "two cents" in, so even though it is summer, I asked Sydney to give her opinion by writing an essay.  Here  is what she had to say.   

                                                                                      

Easy Fruity Recipes

With the new summer heat, refreshing fruit is beginning to make its way to the top of our snacking list. Since sweet, fresh fruit is now in season, making summer specialties like fruit salad, frulatti, and banana frappes are easy-to-make summer treats. I had a chance to critique different versions of each of these recipes.



"B"                     "A"



First I tried two different bowls of fruit salad and was told to evaluate all aspects of both. I tried “Bowl A” first. Even before scooping up a generous serving, I noticed that the fruit was bright, and seems artfully cut and arranged. However, upon eating the fruit, I found that it was slightly mushy and not as brightly flavored as the colors made it seem. When I tried the “Bowl B”, I was instantly gratified with a fresh, sweet burst of flavor from firmer, juicier fruit than found in the “Bowl A”. However, the fruit of the “Bowl B” was less carefully presented than its counterpart; it seemed to be thrown in haphazardly, and the fruit was cut into uneven chunks. Upon careful examination of the pros and cons of each fruit salad, I found that I liked the “Bowl B” better. Although presentation is important for any dish, flavor is the critical tipping point for any taste testing. Before going into this tasting, I didn’t think that the two fruit salads would be any different; after all, it was the same fruit for both! But I surprised myself by noticing distinct differences between the two.

Now, everybody has had fruit salad before, but have you ever heard of a frulatto? No? Well, neither had I, before this. But I was glad that I got to try it. I tried various frulatti with different types of dairy product. We started out with two frulatti made with milk—one with nonfat and one with whole. Both frulatti made with milk had a slightly gritty texture from the ice and the fruit. The frulatto with skim milk was more watery and not very rich, while the one with whole milk was more full-bodied, but still not creamy and smooth. I then tried frulatti made with yogurt. All of these frulatti were smooth and thicker than the ones made with milk. I first tried one made with a plain, slightly sour yogurt, which was much creamier and smooth than the ones made with milk, but the tang of the yogurt did not go well with the sweetness of the fruit. Next, I tried one made with vanilla yogurt. This one was my favorite frulatto at this point in the tasting. It was rich creamy and smooth, and was sweeter than the one made with plain yogurt. Because I complained about the tanginess of the plain yogurt and praised the sweetness of the vanilla yogurt, I then tried one more; the final frulatto we tried had plain yogurt, and extra sugar added in. This was my favorite of all of the frulatti: it didn’t have the vanilla flavor to distract from the flavor of the fruit; it was rich, smooth, and creamy; and the intense flavor of the fruit was enhanced by the creamy sweetness of the yogurt.

Finally I got to try the banana frappes. My reviews of the different versions were very similar to the ones of the frulatti. The frappes made with milk were thinner and less full bodied than the ones made with yogurt. They were not as smooth, especially the one made with nonfat milk, which seemed slightly chunky and not well-incorporated. The sourness of the plain yogurt did not go well with the banana, much like the frulatti. However, the vanilla flavor of the vanilla yogurt complimented the banana rather than detract from it. It was sweet, creamy, and smooth, with lots of fruit flavor. My favorite frappe was the one made with vanilla yogurt.

Dr. Vicki Again. 

So there you have it.  For you parents out there who are letting fast food joints and restaurants intimidate you from cooking for your kids, GET BACK IN THE KITCHEN!!  You don't have to spend a lot of time or money.  The more time I spend with Carla and her family, the less time I'M going to spend in the kitchen.  (Except when my daughter comes home.  I know she prefers my fancy cooking, because her Mom Knows Best!)

PS  A special thanks to Ashna and Sydney for taking the time to eat and then write up their incredible (with no editing by me) reviews.  And a thanks to Marlborough School.  This is where these girls will be entering 10th grade in the fall and learned to write so beautifully and where my daughter graduated from a few years ago and also got a wonderful education.



FUN, DELICIOUS PRE AND PROBIOTIC FOOD!

Much to my dismay, Carla has not made a single quiche since the one we made together.  So I decided to try something different.  With summer approaching and knowing her younger daughter, Ashna, would be out of school, I decided to teach Carla a number of yummy,  easy healthy snacks that she could do with little effort.  I figured I would do this with her kid around so there would be more pressure for her to "whip" these up in the future.  So here are the recipes, with Ashna's reviews to follow.

FRUIT SALAD
Fruit salad is easy to make but it can be time consuming.  It is, however, used for the next recipe, so from a time point of view, it counts for more than one meal.
Anyone can make a fruit salad.  BUT, there are a few techniques that can make your fruit salad stand out next to your neighbors.  Although not necessary, having good tools does make it easier.

  Here are the tricks:
1.  I tend to only make it in the summer.  I think summer fruits elevate a fruit salad from nothing special to an incredible treat.
2.  Vary tastes, colors,  fruits and textures
3.  As as general rule, cut the fruit to follow how it looks like in nature; don't chop it up into little squares or pieces.  You want to be able to recognize the fruit.
4.  Put the fruit that is going to brown on the bottom.  That means bananas, peaches, nectarines, plums, apricots and pitted cherries go on the bottom.
5.  Use only ripe fruit in season locally.
6.  Always cut an orange and squeeze the juice over the top of the finished salad.  It minimizes browning and gives it a nice flavor.
7.  Make an artistic decoration on top.  Presentation is important.


My fruit salads always have the following put in in the order listed:
Banana at the bottom
Peach or nectarine cut in slices
Apricots or plums (or if you can get them, pluots or apriums) cut in slices
A variety of melons (whatever is available) that is sweet and ripe.  I like to get at least 2 that are different colors, but usually I will get 3.  You can cut these in square pieces but I like to use melon ballers and make them in 3 different sizes based on the size of the melon.
Mango and/or Hawaiian papaya (I live in California so these are almost always available)
A variety of berries
Kiwi
Oranges


FRULATTI
The first time I remember having a frulatto was when I was in Italy as a teenager.  I fell in love with them.  Although Americans know them as smoothies, for some reason, I think that the ones that I have had in Italy seem so much better.  As you can tell from the fruit salads I make, I usually have some leftover.  That enables me to make my beloved frulatti.  They are very easy.


Take equal amounts of fruit, ice and dairy.  Blend.  You can add sugar.  (1 1/2 tsp)
See Ashna's review to figure out which kind of dairy you think you might like.


BANANA FRAPPE
The original recipe is from my college roommate, Katherine Dorfman.  It's a great way to use up those really ripe bananas that you imagine that you are going to use to make banana bread, but never do.  (I've made banana bread once in my life.  I prefer to do this.)

Cut up 2 large bananas and freeze them
Blend frozen bananas with
1/2 c nonfat milk
1 t vanilla
1/8 t nutmeg
Optional:  stir in chopped walnuts after bananas are pureed.

Serve immediately.

The problem with making it with nonfat milk is that it melts really fast.  So I decided to tweak it a little to see what I could get Carla to make that would appeal to kids as a healthy alternative to ice cream.  Here are the different recipes, with Ashna's reviews to follow:

2 cut up large frozen banana pieces

1/2 cup whole milk
OR 1/2 cup whole milk with  1 tsp added sugar
OR 1/2 cup nonfat yogurt
OR 1/2 cup nonfat yogurt with 1-2 tsp added sugar
OR 1/2 cup low fat vanilla yogurt

And for those of you who have little ones, you can see the blog I wrote for EcoMom that uses baby food:  Babies and Toddler Recipes.

"B"                  "A"

                       

Fruity Summer Treats (Ashna's Review)

            Now that summer is approaching, fruity treats are becoming more desirable. I was given an interesting opportunity to evaluate different versions of multiple summer treats, including fruit salad, frulatti, and banana frappes.

            First, I was told to try two different bowls of fruit salad and give my opinion on which I liked better. Fruit Salad “A” tasted like it consisted of many fresh fruits. The fruit was firm, juicy, and sweet. Fruit Salad “B” was also quite delicious. However, it tasted a bit “mushier” than Fruit Salad A. I was later told that Fruit Salad A was just chopped up and Fruit Salad B used various fruit slicing devices, for example the melon baller. Fruit Salad B looked much more appealing, however, I liked Fruit Salad A better. I was surprised that I enjoyed Fruit Salad A more, since the same fruit was used.

            Next, I tried different recipes of a berry frulatto. (NB - Actually, I just took the fruit salad - it took on the color of berries because the purple is so overwhelming!   Dr. Vicki)  The first ones were made with nonfat milk and whole milk. I enjoyed the frulatto made with whole milk more so than the nonfat milk. The one made with nonfat milk seemed a bit more diluted than the one made with whole milk. Then, the milk was replaced by yogurt. I first tried the one with nonfat yogurt and I enjoyed it a bit more than the ones made with milk. It had a thicker consistency, however, the frulatti made with milk tasted a little sweeter. Next, I tried the frulatto with vanilla yogurt. Personally, I liked this version the best so far because it was thick, creamy, and sweet at the same time. After this one, I was given a frulatto made with nonfat yogurt and sugar. I enjoyed this frulatto the most because it was similar to the one made with vanilla yogurt but the sugar brought out the fruity flavors more so than the vanilla, which is what a frulatto is all about. This frulatto was the happy medium between the original frulatto made with milk and a berry smoothie.

            Now it was time to taste the banana frappe. The first ones, like the frulatti, were made with nonfat and whole milk. The nonfat frappe tasted a bit too thin and runny. However, the whole milk frappe tasted frothy and sweet and I noticed the flavor of the banana more so than in the nonfat frappe. Next, we tried the frappes with nonfat yogurt, then vanilla yogurt. The frappe made with nonfat yogurt lost the sweetness and had more of a tart flavor. It was also much thicker than the ones made with milk. The one made with vanilla yogurt, however, was thick and sweet, and the banana flavor came through. It tasted kind of like melted frozen yogurt.  Now I was torn between the whole milk banana frappe and the vanilla yogurt banana frappe. I eventually decided on the one made with whole milk because the consistency came across as that of a frappe more so than the one with vanilla yogurt. They were both strong contenders, but eventually my taste buds chose the whole milk banana frappe.

            Later, I was told that all three of these recipes were easy to make. I love knowing that I can just whip up a delicious frulatto every now and then without doing too much work.



Dr.  Vicki again!  So here you have it.  Even if Carla never makes these again, I know that Ashna will.  So I've converted one person into spending some time in the kitchen.  How about you?

MOM vs HEALTH FOOD INDUSTRY: You Pick!



88 year old Mom who eats a Mediterranean diet

 Many Americans, occasionally even myself, believe that our regulatory systems protect us from false claims. 
Let's look at the Health Food Industry.  There is a whole gamut - from supplements, to buying prepared meals to junk food.  Are all aspects cut from the same cloth?  What can you do to maximize health if you want to increase the good bacteria in your gut particularly if you do not have infinite time and/or money.

The food industry is regulated by the Food and Drug Industry (FDA).  In 1990 Congress passed a law that required "significant scientific consensus" and "a preponderance of  scientific evidence" for food companies to make scientific claims about their foods.  With a lot of controversy, in 2003 the FDA loosened these regulations for the food industry claims about the health benefits of their products.  Perhaps that explains why I see commercials on TV trying to convince me that cocoa cereals boost immunity, sugary cereals will help my child succeed in school and other breakfast cereals fight heart disease!  In 2010 however, Dannon did settled a lawsuit for $45 million because they claimed that their yogurts were "scientifically" and "clinically" proven to boost immunity and regulate the digestive system and had not proven it.  So what does their label say now?  Just "Helps regulate your digestive system"!  My mother still buys it because she believes that it does.  Advertising works.

I decided to look at a number of yogurts on the market that all had  "probiotic" on their label and all implied, although did not state, that their yogurt met the definition of a probiotic.  I looked at their websites. They all were careful NOT to say that their yogurt was a probiotic food but all IMPLIED that it was and that it had all the health benefits that one finds with probiotics.  Which one of these is the best?  Beats me.   Since the food companies are not going to go through the necessary testing to prove theirs have actual health benefits (ie double blind studies) I can't tell you which is the best. I can tell you what the standards are and how many colony counts are required for them to claim that their food is a probiotic.  And the fact that they are careful not to make the claim assures me that theirs is not a true "probiotic". (If they make the claim the FDA, if it has the funding, will go after them like they did Dannon.)  But they do want you to think that they will deliver on promises of health benefits.

I do believe that dairy products are an important part of a healthy diet.  And I do believe, after all my reading, that there are very specific health benefits to a real probiotic. (Probiotics) I just don't know where to find one, except in a lab.  And I don't think I'm going to get my yogurt from my local bio chem lab.  So how do you pick?  This is what I'm going to tell my daughter who has been asking me.  (Actually, I'm just going to tell her to read this, which she does anyway.)  I would go for ones that have live cultures and I would choose one that has the highest colony counts.  (Good luck finding that out!)  So  pick ones that have a bigger variety of organisms.  Then  pick ones based on taste because then you are more likely to actually eat them.  And finally I would go for the nonfat or the low fat  yogurt.  This is almost all I have to say on yogurt, except I just bought a yogurt maker.  I'll let you know in a future blog if it's worth the effort.

Although at a future date there may be be other probiotic foods for purchase, right now there are none. The only other possible way to increase your probiotics is to buy supplements.  However, again buyer beware.  There is no data that the organisms actually get to your gut. (All of them have the same wording "Statements and claims on this site have not been reviewed or evaluated by the FDA")

Prebiotics are a little more confusing in how you get them in your diet. Clearly they are good for you.  They are present in many fruits and vegetables.  Depending on what you want the prebiotic to do for you and what kind it is, you need anywhere from 5-15 grams per day in your diet.  (A 6 gram serving is about 1/4 lb of raw asparagus; 1 1/3 lbs of bananas, 1/4 lb of cooked onions or 2-3 raw onions)  But do you need to take a supplement?  How about snack foods?

Prebiotic supplements are fiber pills.  Most of their products have inulin or fructo-olisaccharides in them.  The many company advertisements state that that their claims have not been evaluated by the FDA. They, too, all use the same wording as above.  Most of their products have inulin or fructo-olisaccharides in them.  PepsiCo is working on "functional food snacks" (Snacks for a Fat Planet, The New Yorker, 5/16/2011) but they are still not available.

 If a diet rich in fruit and vegetables, ( as now recommended by the new USDA nutritional guidelines Choose My Plate), would need a supplement to reach 5-15 grams of prebiotics a day depends on whether or not the choices you make also are ones that have a high percentage of the types of dietary fiber that are considered functional.

What do I get from all of this reading and analysis of functional foods?  First of all, you can look at this from one of two ways - you can either say that functional foods have additional health benefits beyond their nutritional values OR you could say that the other foods have detrimental health benefits beyond their nutritional values!  What I mean is that perhaps poor food choices can encourage the growth of toxin-producing bacteria that lead to ill health.  If you stop eating foods that cause toxins, you improve your health.  Hence, you have increased your health benefit.  This is different than getting additional health benefits from the other foods - you are getting additional health benefits because you stopped doing something negative (like people who stopped smoking).  But either way you look at it, it is a good thing.

You have to eat something.  You can eat food that leads to bacteria that produce toxins.  Or you can eat food that is good for you.  Like Mom always said, EAT YOUR VEGETABLES!  Do you need to pay extra to get it in pill form?  Your choice. 

My next blog will  be back to food and will feature recipes for those of you who want "functional food" that tastes good!!!

PREBIOTICS - A HOLISTIC APPROACH TO HEALTH?

 Prebiotics work not only in the gut, but also have been proposed to play an important role in a large range of health benefits from reducing disease risk to possibly curing disease.  (As I write this, the words from Stephen Sondheim's "Pirelli's Miracle Elixir" from  Sweeney Todd are stuck in my brain.)  The claims are long but I will try to put them in large categories.

Prebiotics work on a limited number of gut microorganisms.  As a result of prebiotics' ability to change the growth OR the activities of certain gut organisms prebiotics are claimed to do the following:
1.  Improve the gut composition which leads to improved gut functions including stool regularity.
2.  Improve immune function
3.  Decrease the risk of colon cancer
4.  Improve mineral absorption
5.  Decrease GI infections
6.  Decreases obesity, metabolic syndrome and its related problems

This then leads to the myriad of health benefits that are all over the Internet.

I will again look at good studies in humans, explain results that have only occurred in labs, and what is theory.  The majority of studies have been done using food ingredients which belong to two groups - inulin-type fructans (ITF) and galacto-oligosaccharides (GOS).  These have been shown to stimulate lactobacilli and bifidobacteria, which are good bacteria.  To be classified as a prebiotic, it has to be resistant to hydrolysis and GI absorption before the colon, must be fermented by the intestinal micro flora and stimulate the intestinal bacteria associated with health of humans.

IMPROVE GUT COMPOSITION
In a normal gut, things go through the small intestine more quickly compared to the large intestine so there are more bacteria in the large intestine as well as more undigested food.  This is where the prebiotics work.  The food that we are unable to digest (fiber, complex sugars and proteins) as well lining substances of the gut are fermented by the bacteria and used as their energy source with metabolites left over.  These products influence the gut motility.
In only 2 studies were they able to show a positive effect in gut motility with patients that had Irritable Bowel Syndrome.  Those patients took 5-7 grams/day of a prebiotic to have an improvement in symptoms.  All the other well designed studies showed less good outcomes and they used lower or higher doses.

IMPROVE IMMUNE FUNCTION
There are some very good theories that prebiotics ought to influence the immune system because the gut, through the gut-associated lymphoid tissue (GALT) is significantly involved in both preventing and modifying disease.  The problem is that the human GI system is not easily accessible for study.  So far the best studies are done in the lab and none have been confirmed with well-designed human studies.
A number of clinical studies are being done in Inflammatory Bowel Disease (IBD).  The problems with the studies are many but the ingredients are safe and some of the early results deserve further investigation.
Prebiotics have been added to infant formula to make it more like breast milk, which does improve babies' immunity.  The stools do show an increase of bifidobacteria, but whether that translates to improved human health has yet to be proved.

COLON CANCER
The bacteria in your gut manufacture chemicals and some of them can be carcinogens and toxic.  Good bacteria produce a low number of carcinogens and bad bacteria produce a large number of toxins by comparison.  In theory, if you have good bacteria, you should have less production of toxic waste products in your gut and less risk of cancer.  In animals there is a a reduction in colon cancer and in humans, there seems to be a decrease in bio markers in patients at risk for colon cancer who were given symbionics (pre and probiotics.)  It has not been proven that there is a decrease risk of cancer in humans, but again, this is a difficult study to do.

MINERAL ABSORPTION
A number of well-designed studies have shown an increase absorption of calcium in prepubertal girls and boys and late post menopausal women.  In healthy infants, prebiotics increased iron and magnesium absorption; and in early menopause there is increased copper absorption.  In the studies that showed the best mineral absorption, it appears not only is the dose important, but that also using a combination of prebiotics made the mineral absorption more effective.

Whether or not increased absorption leads to improved health has only been proved in lab animals.  Although it seems reasonable, the bone metabolism of post-menopausal women is more complex and much of the previous dogma that we have taught women  to do (like take high dose calcium) is now being questioned. So far no decrease in the risk of osteoporosis has been shown with prebiotics.

DECREASED GI INFECTIONS
The studies show some effect in rats, and some moderate success in prevention of traveler's diarrhea in humans, but otherwise this has not been as successful as probiotics.

OBESITY AND METABOLIC DISORDERS
Most of the studies on this subject have been done in animals.  They have shown a decrease in fat mass, but not a decrease in weight.  Also, there is better glucose, lipid, triglyceride,  and cholesterol metabolism in the rats. The few human studies available seem to show that prebiotics work by producing a peptide that regulates appetite. But so far whether or not this will actually work in humans has not be shown. What the importance of the actual microbes in the gut are in humans has not been explored because the studies have all sorts of difficulties in trying to devise double blind studies with good placebos



AVAILABILITY OF FOOD
Many regular foods contain prebiotics.  These include leeks, onions, Jerusalem artichoke, garlic, asparagus and bananas, to name a few.  The quantity of what you have to eat of them to achieve a prebiotic effect differs with the food.  Also, the caloric quantity of the food changes which will modify the health benefits of the prebiotic.
SIDE EFFECTS of PREBIOTICS
Prebiotics are fermented in the large intestine, which means gas is produced.  The more prebiotics, the more flatulence, cramping and diarrhea.  Most people can handle 10-20 grams/meal, but some people complain of side effects with that amount.

So where does that leave us?  See my final blog as I try to summarize the health benefits of these topics and try to make sense on what you can do on a daily basis.

PROBIOTICS - do they make the GRADE?

There are books on this topic.  I am going to just give you an overview
1.  Making the Grade
2.  The probiotic microorganisms
3.  Important health effects of probiotics
4.  Safety of probiotics
5.  Types of foods with probiotics

MAKING THE GRADE
For an organism to be considered a probiotic (and by extension, a probiotic food), it needs to have a positive effective on health in humans (not just rats!).  In addition, it should be safe and nontoxic.  The studies done have to be on the specific organism, not on a related species, because close "relatives" do not always have the same physiologic effect in humans.  Other values that have to be taken into consideration include the number of viable organisms ingested to have the health effects and are they still effective at the end of the expiration date.  And don't forget the age, health, gender and race of the person taking the probiotic can affect whether or not something works.

PROBIOTIC MICROORGANISMS

These organisms meet the following criteria:  they are are not toxic or pathogenic, are originally from the guts of healthy people, and can pass through the stomach without losing their effectiveness before they get to the intestines.

Lactobacilli -bacteria found in abundance in the gut of humans
Bifidobacteria - another group of bacteria found in abundance in the normal human gut.

Other probiotic organisms that are found in normal humans but in smaller amounts include some forms of enterococci, streptococci, lactococci,  and some yeast.

HEALTH EFFECTS
The intestine is extremely involved in the immune system both through how it breaks down the foreign bodies that enter into it (food included) as well as its extensive lymphoid system.  The balance of the different organisms in the intestine will change the pH, the production of substances that kill or allow the growth of different types of bacteria and weaken or strengthen the barrier of the intestinal mucosa.  This is where the probiotics are able to enhance health.
There are many scientific studies that try to measure the health benefits.  Some are done well, some are poorly done, some are difficult to do, and some are waiting to be done.  As it now stands, based on the good studies, the scientific community generally accepts that probiotics do the following:
1.  Decrease the symptoms of lactose intolerance
2.  Prevent or reduce both rota virus and antibiotic-caused diarrhea.
3.  Increase remission periods in people with inflammatory bowel disease

There are some studies that show conflicting reports, and the effects are only in certain groups:
1.  Some regulation in gut motility (improvement in some groups with irritable bowel syndrome)
2.  Improvement or resolution of allergies and atopy in infants, but not older patients

And then in some studies things work in the lab, but so far not in people
1.  Cancer prevention
2.  Decrease cholesterol and protection for heart disease

SAFETY
Probably the best way to think about this is that lactic acid bacteria and bifidobacteria have been used for millenia and have been safe.  Also, when they have actually been looked at, there is no evidence that probiotic products are riskier than are similar products that do not have probiotics added to them.  Also, studies done on patients with leukemia and HIV who were taking probiotics did not have increase infections with lactobacilli.

TYPES OF FOODS
Probiotic foods are different from probiotics in that that have to continue to maintain their efficacy throughout production and shelf life.  They also have to be something that you want to buy which means that they look and taste good for most people.

Fermented Milk Products
Yogurt is the most popular type of probiotic food.  Many yogurts on the market actually do not fit the criteria of being a probiotic.  They do not have live cultures, or do not have the organisms that qualify as probiotics.
Hard cheese is difficult to produce as a probiotic, although fresh cheese is easier.  Unfortunately, the manufacturing process of any cheese tends to kill off the bacteria.  To date all the studies testing the effects of the cheese were done in animals and there are no  marketable cheeses so far.

Other potential foods include ice cream and other sweets, but that kind of defeats the purpose in my mind.  Vegetables have not been tested.  There is some talk about spraying probiotics on salami, but no testing so far.  There have been some studies of probiotic milk powder, but no information on its stability and efficacy.  It could be used in powdered milk, formula etc. if it is successful.


BOTTOM LINE ON PROBIOTICS
Probiotics have scientifically been shown to be safe and have a positive health effect, but not as extensively as what has been claimed in the lay press.  At this point, the only way to get it in food is through yogurt.

On to PREBIOTICS in the next blog.

Buyer Beware: Health Promises of Functional Food

"Let food by thy medicine and medicine be thy food" so said Hippocrates.  If you search this phrase on the Internet you will find thousands of claims of how foods can cure you of everything.  It reminds me of the days when men would travel around with magic potions that could cure whatever ails you. Literature and theatre abound with tales and songs of miracle elixirs.  And there is an even longer history of the health-promoting aspects of certain foods.

For thousands of years fermented foods have been eaten throughout the world.  Abraham's long life is attributed to eating sour milk.    The Romans treated gastroenteritis with fermented milk products.  But I am still a sceptic as I look at all the claims on the Internet.  I decided to review the medical literature where there are more and more articles looking at food, and this topic specifically, and what it can do for health.  I will try and summarize the many studies that I reviewed to make some sense out of all that's out there so that you can decide what, if anything, you what to spend your money on. 

So today's blog will be an overview on what is a functional food and how scientists define prebiotics, probiotics and synbiotics.   The next blogs will go into specifics about them and what the studies have shown and haven't shown about their effects on health.  If there are a lot of comments and/or questions I will address them further.

FUNCTIONAL FOODS
When you look at the label on packaged food it gives you the nutritional value of the food (calories, vitamins, proteins, etc.) but it won't tell you its wellness-maintaining properties.  It doesn't address issues of its potential medicinal benefits.  But for a food to make the claim of being "functional" it should have some enhancement of health beyond its nutritional value.

I plan to focus this discussion on foods that have their effect on the gut.  In a normal gut, you would want the organisms that promote good health to predominate over the organisms that are potentially harmful.  Basically, the whole point of functional food is that after you eat this stuff, you will promote an increase number of healthy bacteria.  Therefore the food has a function "beyond nutrition".

PREBIOTIC
A prebiotic was first defined in 1995 and then further refined over the years.  Presently the accepted definition from the International Scientific Scientific Association for Probiotics and Prebiotics (ISAPP) meeting in 2008 is "A dietary prebiotic is a selectively fermented ingredient that results in specific changes, in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host well being and health."  This means that certain functional foods are not digested by the person but will actually be fermented by selective intestinal bacteria and promote their growth.  These bacteria are beneficial to the person's health.

PROBIOTIC
Although there are some variations in the definitions on what makes up a probiotic, they all agree that the probiotic microorganisms must be living and that scientifically there needs to be proven health effects.  Probiotics are defined as actual microorganisms which get to the intestines in an active form and in a large enough quantity so that the can exert a positive effect on health.  Although many people will use the term probiotics interchangeably with probiotic foods they are not the same thing.  Probiotic foods are foods that also contain organisms (probiotics) that will give an additional health benefit beyond that of the nutritional content of the food.

SYNBIOTICS
Symbiotics are a mixture of probiotics and prebiotics which when added together are supposed to act "synergistically" by promoting the implantation of the live organism (probiotic) and improve its survival (prebiotic).  For a food to be classified as a prebiotic or a probiotic, it has to be in certain quantities or concentrations.  Food companies have been launching more and more products and want to promote the health benefits of their foods, but they cannot classify them in either category because they do not meet criteria.  So what they are doing is putting both pre and pro biotics in their foods and labeling them as "synbiotics".   Often these foods do not have enough pre and pro biotics in them to act in the synergistic way the companies state to have the claimed health benefits.

In the next blogs I will address the myriad of potential health benefits and look at what has been proved, disproved, shown in animals only and thought to be possible from food.

Quiche Review

I decided to have Carla's middle school-aged daughter, who is thinking about a career as a food critic, be the judge of our quiches.  She did not know whose was whose.  Since she does go to school and that is her first priority, the tasting and notes were done the day of the baking, but the actual writing was done later.  Here is her review.  (In both pictures the quiche on the left is A and the quiche on the right is B)

Top Quiche!
            Food—there are no words to describe how I feel about it. I lead a very busy life and always look forward to enjoying a nice meal at home. It’s common knowledge in my home that when I’m not doing homework I’m watching Food Network or the Cooking Channel. I was given an interesting opportunity to evaluate two slices of quiche, made using the same recipe, prepared in different ways. The main ingredients included spinach, onion, and mild cheddar cheese. I was asked to compare and contrast the two slices of quiche.  My real life opportunity to be a Top Chef judge!
I blindly tasted each slice, not knowing the differences between them. As I observed the two quiches, I was taken aback by their inviting and welcoming features. They were both beautifully baked and presented nicely on the plate. However, Quiche “A” appeared like it would be tastier than Quiche “B” because it looked more moist and creamier. I watched as the cheese slowly melted out and I was eager to try it. Quiche B looked a bit crispier and didn’t have as much of an inviting appearance. I sunk my fork into Quiche A first. It had a comforting, fresh aroma. As I tasted the quiche it was quite delicious, I must say; however, I felt that it was a bit too mushy. It left a creamy residue in my mouth that was a little too much for my liking. Immediately after I ate the bite of Quiche A, I was excited to try Quiche B because the creaminess of Quiche A made me want to try something crisper. This slice had a bit more crunch when I cut into it than Quiche A did, and although I don’t think of “crunchy” when I think of a quiche, I was intrigued by this characteristic. I sniffed the bite of quiche on my fork, and the ingredients smelled quite fresh -- more so than Quiche A. I took a bite and I sensed an uncharted combination of flavors I hadn’t ever tried before. The ingredients tasted fresher than the other one. Although, it tasted a little crunchier, I found it refreshing and it did not leave my mouth with a creamy residue. It was love at first bite! I slowly enjoyed Quiche B, thinking of nothing other than the delightful flavors and texture. Before I knew it, the crumbs of the perfectly cooked crust were the only remnants of the quiche on my plate.
Although Quiche A was a mighty contender to Quiche B, I felt the flavors in Quiche B were more prominent and resonated freshness. Overall, I felt that both quiches were lovely, but it all came down to the texture and the distinction between flavors. Since I enjoyed both of the slices, I feel lucky to have been asked to participate in this momentous test!  I was later told that Quiche B was made with frozen spinach and ordinary onions (not the special ones from the Farmer’s Market). I was surprised that I chose it over the one with fresh spinach and sweet onions. But I was happy to know that it’s a recipe that I could easily follow myself.

There were some differences in technique as the reviewer alluded to which I will now elaborate on. Since Carla and I were making dinner for our families I changed my quiche to cater to my family's tastes.  I used fresh, spring onions which have a sweeter, milder taste.  I also used fresh, baby spinach which also is less bitter.  As you can see by the slices, quiche A (my quiche) has less spinach and the onion is more finely chopped.  I also took greater care to mix in the cheddar cheese.  Carla has hers layered on top, giving it the less creamy, more crunch to it.  Clearly, technique changes the outcome.

This whole "project" brings up some interesting, and important points for all parents.

1.  Children prefer what they are used to.

This is extremely interesting and shows what an important influence you have on what your children eat.  You can tell from the review that the flavors in our quiches were different.  And in a previous post (Nana's Vegetable Soup), the kids again preferred what they were used to, not what would be considered the more sophisticated, gourmet-type cooking.  Luckily, I have a thick skin, or about now I would be questioning my cooking skills.
2.  The sooner you introduce your child to varied and healthy foods, the better and more nutritious their diet will be. (When my daughter was 3 we ordered her an appetizer of mussels for her dinner.  The waiter was amazed as she worked her way through the whole thing.  But she had been eating them since she was little and it was (and is) one of her favorite foods.)
3.  Get the kids in the kitchen.
4.  Cooking is more fun when done with others.  Carla said she enjoyed our afternoon together and would like to do it again.  As she reads this she will now find out I have decided to make this an on-going project of the blog entitled "COOKING WITH CARLA".

We'll try to do this once a month, Julia Child style.  For those of you who remember her PBS cooking show, she had a REAL reality TV show and would record everything; including mistakes. We will describe what happens to real people who don't cook, so that you can see what happens and see that everything can (usually) still be edible.  Maybe we can even get our judge back.  (Although at the rate I'm going, I may get kicked off the blog!)

Quiche for the Over-Extended Parent

I think that quiche is a quick, easy, nutritious meal that everyone can make.  I also think it takes no more time to make than going to a take-out place and waiting for them to make your food.  (Every time we go to a "quick" Chinese place, or order a pizza, we always have to wait.)  But I also realize that since I cook all the time, what I think is easy, may not be so for some one else.  I also know that many times I will make a recipe that takes me twice as long as what the recipe calls for.

So, I want to introduce you to Carla (her real name).  Carla is my friend.  She is a typical working mother of  today.  She helps run a small business, has two daughters for whom she chauffeurs around to their various activities, and helps take care of her extended family which includes her step-daughter and grandson as well as her husband's mother.   Rarely does she cook and cooking is not one of her many fine skills.  And I can tell you, she has NOTHING in her refrigerator or her pantry.  When she broke her foot I went to her house to make her some lunch.  It was not easy, and I can whip up something out of practically nothing.  (But it is hard to make something out of nothing.)    So if she can do this, anyone can.

Here is the recipe that I provided her.  We then went to the grocery store.  She prefers Whole Foods, just like in Top Chef.  I did not limit her time; however I did time her.  She got the ingredients and did her general food shopping in 30 minutes with no list.  (That gives you an idea of how much food there is in her house.  I spend an hour each week at the Farmer's Market alone.)

It took her an hour to assemble this.  (It took me 15-20 minutes.)  But she thinks that the next time she does it it will take her less time.  We made 4 quiches and fed 2 families for under $30!  My quiches are enough for 2 dinners, or 1 dinner and a few lunches or breakfast.

If you look at the time and think about it as 2 dinners, then even for Carla, it was efficient because it came out to 30 minutes per dinner.  Check out the next blog for pictures and our guest blogger who will be critiquing blindly the 2 vegetarian quiches.


Basic Recipe for QUICHE  (Read the recipe completely before starting.)

1.  Preheat oven to 450 degrees

2.  Assemble all your ingredients.  (see details below)
     a.  Frozen pie crust -  you find frozen, deep dish pie crust in the freezer section of grocery store where the frozen pies are (comes in package of two).  Check to make sure you get ones that are not broken in pieces.
     b.  Filling 
     c.  Any additions you chose to do
 
3.  Pre bake pie crust
Prick frozen pie crust all over with a fork about one inch apart.  Tightly mold the tin foil over pie crust .  Cook in preheated  450 degree  in lower-middle oven for 8 minutes. 

4.  Start making the filling until the timer goes off.

5.  When the timer goes off, take off tin foil.  Prick bottom again, particularly any bubbles..  If anything has sunk, push it up.  (use spatula if too hot for fingers.)  Bake another 3 minutes without the foil until just beginning to change color.  Take out of oven to cool down as you are doing the rest.

6.  FILLING for one pie crust (double to use both pie crusts)
5 large eggs
Add half and half or whole milk to make 2 cups
1/8 tsp of nutmeg and pepper
Beat with a fork or a whisk

ADDITIONS (choose one, or make up your own)
1.  Traditional quiche Lorraine - 6 slices of bacon cooked crisp
2.  Optional - 3 ozs coarsely grated Swiss or Gruyere cheese to your Quiche Lorraine
3.  Cheese - Whatever flavors you like - add about 3/4 - 1 cup
4.  Fish - Add 1/4 c. smoked (very flavorful) or 3/4 cup mild cooked fish with 1 tsp fresh parsley or dill
5.  Vegetarian - take whatever leftover vegetables you have in the refrigerator, saute 3/4 cup in butter (melt some butter in a pan and heat the vegetables in them)
6.  Frozen vegetables quiche - buy  a package of frozen vegetables.  Defrost in microwave.  Saute 1/2 chopped onion then add microwaved 1 cup of  vegetables.  You can also throw in cheese if you want. (1/2 cup)
7.  Ethnic Quiche - Use flavors and spices that are typical for a particular cuisine that you like.
    for example "Chile rellenos" quiche - 1-2 chiles (poblano or anaheim) and 1 cup jack cheese

 HOW TO ASSEMBLE
Take cooled crust.  Put "additions" in bottom of crust.  Add egg/cream mixture.  Put in oven.  Cook in 375 degree oven for 40 minutes until puffed up and brown.  Serve with french bread and packaged salad.

Bon Appetit!

Sugar Primer

It's that time of year when sugar is everywhere and is also getting its share of bad press. (Sugar Hype) What's a parent to do?  To make an informed decision, it is important to understand that sugars, although simple, are actually  complex. I will give you the basics so you can make an informed decision about what to do with that chocolate Easter bunny (or chocolate-covered matzoh) the grandparents gave the kids. 

There are three main kinds of sugars:  polysaccharides, disaccharides, and monosaccharides.
1.  Carbohydrates (polysaccharides and oligosaccharides):
Many people do not think about carbohydrates as being sugar.  But carbohydrates are sugar molecules that attached to form large molecules.  That means rice, beans, potatoes, pasta, (including whole wheat), cereals, and breads are made from sugar molecules attached together.  Depending on how these bonds form, these complex sugar molecules can be used in many ways, including food (starch) or  fiber(cellulose).

2.  The most common disaccharides in food are:
Lactose (milk sugar) which breaks down into galactose and glucose.
Sucrose (sugar cane or beet sugar) which breaks down into glucose and fructose.
 In breast milk, also known as "The Perfect Food", 50% of the calories come from lactose.

3.  The monosaccharides (the smallest sugar molecules):
Are the final breakdown product in our bodies from carbohydrates and  disaccharides.  In nature, most commonly  found in:
  a.  honey -  a combination primarily of fructose and glucose, but also has complex carbohydrates, trace minerals, vitamins, and antioxidants (depending on the flowers used by the bees).
  b.  fructose (fruit sugar).

 4.  Manufactured sugars are the sugars that are manufactured.  They include:
   a.  Syrups - usually the sugar is sucrose, including maple syrup.
   b.  High fructose corn syrup which is usually about 55% fructose and 42% glucose.
   c.  Corn syrup - primarily glucose.

Only monosaccharides are absorbed through our guts.  That means only galactose, fructose and glucose get into the blood stream, assuming you have a normal, functioning gastrointestinal system.

One way to look at sugars is where they are primarily utilized and metabolized.  You don't have to eat any particular sugar.  The body is capable of making and storing the different sugars from food.  It is made and stored primarily in our liver and muscles.  Glucose, galactose and fructose are used and metabolized throughout the body.  We know this because there are people that have different genetic diseases that make it impossible for them to digest a sugar.  They then accumulate that sugar throughout the body, not just in the liver.  But glucose is the human's primary energy source.  Although we use the other two for energy, our bodies mostly use fructose and galactose to make them into other compounds that we need, and then will convert the extra into glucose, which becomes glycogen.  If you have an excess of glycogen, the body makes fat.

If you think about it, that means if you are a vegetarian, your diet is primarily glucose, fructose and galactose.
Yet, who (except for a few carnivores that I know) would declare that an adult who eats a vegetarian diet is eating unhealthily?  What makes a diet of refined sugar, or for that matter, high fructose corn syrup unhealthy?  By the time it gets to your blood stream it is all the same stuff as what the vegetarians are eating.

I don't have a definitive answer for you.  I do have some thoughts. 

Food is more than calories.  There is how those nutrients are delivered.  Diabetics are aware of the glycemic index.  A newer refinement of that is what is called the insulin index which may be a better measurement of the multiple factors that affect how those same sugars are seen by the body and how the conversion from one sugar to another occurs.  There is, of course, the whole issue of soluble and insoluble fibers, which do not come with a diet of refined sugar.  And finally, there is the interaction of micro nutrients.

There are also my whole idea about food and the research on it.  When people do research, they try to hold all the variables the same but one.  Humans are more complex than that.  The more research I read about food, the more convinced I am that it is rare that 1 "truth" will be learned.  We get small pieces of the puzzle and we get hints and on rare occasions, we get truths.  It goes back to my blog on Girl Scout cookies.  And my whole approach to food.  A little won't hurt you.  Moderation in all things.

Principal Misses Principle

A principal in Chicago has banned home lunches (home) because she wants to encourage healthy eating.  There is a better way to motivate kids and teach them long term healthy habits and you would think an educator would know how to do it.  Here is what I would do.

They now have a situation that lends itself to science, government, math and social science at a minimum.  They have a natural leader at that school, Fernando.  Get him to form a committee with his fellow students.  Obviously, with guidance from adults, they need to come up with recommendations on acceptable foods that can be brought from home.  Their first task will be a governmental one - get a task force.  It is not enough to protest;  if you complain that you don't like something, then you need to come up with an answer that works.

The next task is to learn some science and nutrition.  The students will have to come up with a list of what is acceptable.  They will have to justify why they think a food or drink is healthy.  They will solicit foods from their fellow students and then will decide if those foods are healthy and nutritious.

They will have to have an ongoing committee.  Because every year some student will come up with something new.  The students will have to continually research these new foods and then justify to adults  that their decision is a correct one.  If the adult on the committee disagrees then they bring it to a judge.   But that adult should make the decision based on the facts, not her/his own biases.  There should be  an appeals court outside of the school if someone on the committee is not happy with the judge's decision.  The appeals courts is THE final decision. The students will have to police themselves.    And then they can't complain.  And if the principal wanted to go one step further - she could have a science fair based on the science of nutrition.

This could also work in your school.  If you get kids involved in the decision-making it is more effective on many different levels.  They learn, obviously, but it tends to stay with them longer.  Because if you understand the why you are more likely to do something.  And children, like adults, prefer to do something because they decide, not because they are told to do something.


Finally, everyone loves rewards and parties.  So every once in awhile, for no reason at all, or just because, or to say what a great group of kids I got to work with, if I were the principal, I would declare that a particular day would be "Free Food Day" with no restrictions!

We can't always build the future for our youth, but we can build our youth for the future. - FDR

CHOCOLATE!

-

When we were growing up in the 50's and 60's we were taught there were four food groups.  My husband maintains to this day that all the experts were wrong and that there are actually 5 food groups -  dairy, grains, fruits and veggies, proteins and CHOCOLATE!  Some recent studies are backing him up.

As a pediatrician I routinely advise others on how to feed their children.  I also know that my advice is just that:  advice.  Some of it is followed, and some of it is not.  When it comes to raising my own child, however, I feel strongly that my opinion should not be dismissed out of hand and there needs to be some discussion if my food "rules" are not going to be followed.

For many years, the pediatric party line was not to give a baby foods that were likely to cause allergies until after their first birthday; and more recently if you had a highly allergic child you should avoid the most allergic ones until the age of two.  Chocolate was one of those foods to avoid only until one year of age.  Allergies are rampant on both sides of the family.  Because of this, I did not want chocolate given to my daughter before the age of 1.  I do not think of it as a necessary food group.  At my daughter's first birthday I found out that she had been eating chocolate since 6 months of age.  My husband thought that chocolate chips made a "perfect" finger food.  I was not happy.

 In Dec, 2010, the recommendations about allergy foods changed.  Chocolate, as well as all fruits and vegetables, are no longer listed as allergy foods  to avoid.  And there seems to be no benefit to avoiding any allergy foods past 6 months of age.  One of my basic food beliefs has been challenged.  But I've looked at the studies, and they are good.  I am used to reading the literature and learning new things but rarely do I have to change my whole way of looking at a subject.  That is what has happened with my advice on allergy foods.  It is always difficult to change what one has done for years and recommend something different.   Yet, I always try to put it in perspective by thinking about leeches and how doctors of yesteryear would be amazed if they so how I practiced medicine.  So I now have to eat crow and state that there was no harm done that my daughter got chocolate from an early age.  I still, however, do not believe that chocolate is a basic food group and that babies should use it as a finger food!

There are some interesting studies about chocolate as a health food.  First thing to remember is that chocolate is made from the seeds of the fruit of the cacao tree.  Gram for gram, the antioxidant content of cacao bean powder is higher than acai, blueberry or cranberry powder.  Thus, it can be classified as a "super fruit".  It looks like a daily consumption of a small amount (1 oz) of dark chocolate decreases the risk of inflammation which is associated with many diseases, including heart disease.  It also decreases high blood pressure as well as helps insulin resistance in pre-diabetics.   It improves mood (no great surprise there), but also helps mental processing during sustained intellectual effort.  I particularly like that last finding.  To make standardized testing something that my daughter would look forward to (!), we would always give her dark (her preference) chocolate bars to have during the breaks between tests.  We felt that they gave her a "boost" of energy and helped her concentrate.  I loved finding a study that supported our unscientific beliefs.

There can be too much of a good thing.  And this can happen with chocolate.  As Easter approaches, a holiday that places an undue commercial emphasis on chocolate, it is everything else that is added to the dark chocolate that takes away its label as a health food and gets it into the unhealthy column.  There are many things that you can do with chocolate to keep it in the good column.  Eat small amounts.  Make sure it is dark.  Drink it as cocoa without the excess sugar.  And here is a recipe:

                                CHOCOLATE-COVERED
                                     STRAWBERRIES

Ingredients:  strawberries, molding chocolate.
Melt chocolate over double boiler.  Dip strawberries.  Let dry on parchment paper (or waxed paper).  Eat.

One of the most elegant and easy desserts to make.  I use 70% dark chocolate.   If you are going to any functions you can bring these and actually feel virtuous!

Food Dyes and Hyperactivity

I have been hearing about food dyes causing all sorts of problems in children since my training days, chief among them hyperactivity.  I have read myriad of studies on this subject.   The studies that show a relationship suffer from poor study design, small sample size, subjectivity and atypical intervention protocols.  As a result, the vast majority of the medical community does not accept their conclusions.  I also have heard from a number of my parents that swear that diet intervention has made a tremendous difference with their children's behavior. 

Now, this topic has again come to the forefront because a consumer group, the Center for Science in the Public Interest, wants the government to ban artificial dyes.  Manufacturers state the dyes are safe.  A government advisory panel, after reviewing the available studies, stated that at this time the foods do not need any special warning labels.  They also recommended that the  FDA should further study the issue because it appears that there may be some problems in children who already have hyperactivity.  The ball is now in the FDA's court.   To mix my sports metaphors, I find this topic more controversial than getting in the middle of a discussion between two fans on who has a better team: the NY Yankees or the Boston Red Sox.  I do know that until well-designed, double-blinded studies are done, it is hard to make scientific justifications for taking certain positions on the dyes (and that this LA girl will always be a Dodger fan!)

That does not mean I cannot take a reasonable position.  I try to be practical in my approach to life.  I don't feel I have the answer on whether or not artificial dyes cause children to be hyperactive.  But looking at food with the dyes objectively, I know that I don't want to give children many of those foods.  If we look at the blog I posted on Experimental Eating, I doubt anyone would give their children to eat, never mind spend money on, dirt.  It just does not seem like a natural foodstuff to me.  I do understand why a child would put some of the things I have pictured here in their mouths - that is what they do.  But is there a reason you are serving those worms or yellow "sticks" to your kid?

There are alternatives to artificial dyes.  Sure, kids like snacks.  And yes, I did buy my kid snacks.  I didn't always have time to make them.  (although see below for a story about a snack I made and the dye I put in!)  Yesterday, I went to the grocery store and I scoured the shelves.  I found a number of things that fit into the criteria of junk food and no artificial dyes.  In each picture I have one with no artificial dyes and one with artificial dyes.  I recommend that if you are going to buy this stuff, get the one without the dyes.   If we all start doing this, then whether or not the studies are ever funded, perhaps the manufacturers will have a financial incentive to stop using artificial dyes.  It can be done. 

I don't need the FDA to ban dirt to tell me not to feed dirt children.  If I find things that look unnatural, I do not need the FDA to tell me it is not food.  So how did we start believing that these things were edible?  Why have we lost our common sense?  Any ideas out there?


Halloween Frosting
One Halloween I did not buy an artificial, chemical black dye in time to frost the cookies I had made.  All the stores were out.  So I ended up with a natural substitute that worked better.  I have given toddlers activated charcoal for years for all the poisons that they have eaten.  It is tasteless, but it turns everything black.  I put a small amount in my sugar cream frosting (much less than I would give a baby at one sitting).  I frosted 60 cookies.  It worked great and was much safer than what I had done in the past.

Nana's Vegetable Soup

   We have comfort foods - those foods  we want to eat to feel better.  They often are the foods we had when we were young and our parents (usually our mothers) gave us.  This often means there is a strong cultural element to a comfort food.  Also, as humans are programmed to prefer sweets (breast milk is incredibly sweet) it is not too surprising that many comfort foods are often sweets.

When I was an intern in pediatrics I often worked for 40 days in a row, and was up for 36 hours every 4 days.  Some of those nights I would feel VERY sorry for myself and found myself reaching back to my childhood for a favorite comfort food.  Since I worked on a pediatric ward, we kept snacks that kids would like.  Many a night around 3 AM I would find myself raiding the kitchen for whole milk (which I had stopped drinking years ago) and graham crackers.  I would break up the crackers, pour the milk over them, eat them like cereal and go back to work, feeling energized.  (The adult wards had coffee and saltines; definitely not comfort foods in my book.)

Another huge category of comfort foods for me is soups, which is healthier and the comfort food category I passed on to my daughter; the one I would recommend over graham crackers and milk for your children.  Whenever it is raining, as it has been in LA, I start to want to make and eat soup.  My first choice is chicken soup.  (I found out as a married woman that my chicken soup isn't really chicken soup, but that is a story for another blog.)  But all my mother's grand kids love her vegetable soup so I decided to make minestrone this weekend.

I don't remember my mother making vegetable soup for me as child.  But for some reason, every time one of her grand kids comes over, she got into the habit of making them vegetable soup.  So they all see Nana's Vegetable Soup as a special treat.  Since my mother is Milanese by birth, I assumed she made a minestrone.  When my daughter was in elementary school I decided to make a minestrone soup, something I hadn't made before.  I went to the Farmer's Market, got fresh vegetables and served it for dinner that night.  I was informed it was not as good as Nana's.

 For years I bugged my mom to give me her recipe.  I finally got it and it is below.   I have also included mine.  I (of course!) think my is far superior.  It is also a lot more work.  All the grandchildren think hers is the better of the two.  My suggestion would be to start giving your infants hers from an early age instead of mine.  It's easy to make, good for them and a great comfort food for them to continue to want to eat, and make,  when they are adults.  However, the picture above is my recipe which is what we had this weekend.

                                                      NANA'S VEGETABLE SOUP
Put the following ingredients in a pot:
1 cup raw rice
1 can small, white beans
1 package frozen broccoli and cauliflower
1/2 package frozen green beans
1 package frozen carrots and peas
!/2 head of cabbage sliced
2 diced zucchini
1 cubed potato
                                                      1 stalk of celery, sliced
                                                      1 tomato, diced

Add 2 quart cans of chicken broth, 1 quart can of beef broth.  Cook for about 1 hour and serve.  If there is any left over, you can put it in the freezer where the frozen foods were.


MY MINESTRONE
(It takes about 1 hour to prepare and then 3-4 hours to cook with occasional stirring.)  I make a huge pot and then freeze the extra so this recipe makes about 2 gallons.
Add the following ingredients.  I add them in the order listed; as the one I added is cooking, I  prepare the next one.  It saves time.

Coat the bottom of your largest soup pot with olive oil and add 2 tbsp butter to it.  Add:
2 thinly sliced onions
1 leek, white part only (if available)
1 cup sliced celery
1 cup diced carrots
1 parsnip (if available)
1/2 cup diced green beans
1 bunch bok choy sliced thin (if available)
3 zucchini, sliced
2 lbs waxy potatoes, diced (liked red potatoes or Yukon)
3 tomatoes
1 cabbage (savoy or Napa)
1 cup peas
1 cup cannellini (white) beans

You can add or subtract vegetables as you like.   The amounts are all approximations.   I only use fresh vegetables available at the Farmers Market.  Because you cook it for so long, the flavors blend together.  There are a few things that are important.  You do need some form of cabbage and potatoes. It gives the soup substance.  And I recommend beans and/or rice which then makes it a meal.  You can use canned beans which you add towards the end, or if you can remember, soak them the night before and cook with the soup.   If the vegetable has a strong taste, use if sparingly.

Add chicken pieces, beef soup bones, salt to taste (start with 1 tbsp) and cover with water.  If you have the rind of a piece of Parmesan cheese, throw it in now.
Cook for 3-4 hours.  You can serve it the day it is made, but it tastes even better the next day.