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!!!

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!

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.

Experimental Eating

As I started to become more serious about cooking, I wondered why humans tried some of the ingredients that they did.  Was it hunger?  Was it fortuitous?  I mean really, who in their right mind would follow a pig who is grubbing through the dirt for truffles and take something that smells that musky and pungent from that pig and put it in his mouth?  Well, now that I have been both a pediatrician and a mother I no longer wonder - we eat what we do because of toddlers.
What got me thinking about this, again, is the recent posting of a friend of mine on Facebook.  His child decided to eat not one, but SIX laxative strips.
Over the years, I'm not sure if I have had more phone calls from parents because their children have eaten something inappropriate or because they refuse to eat at all.  I have never been able to figure out why this is so. But I know that in the picture above the last thing thing most toddlers would eat is the broccoli.  (I think the first thing would be a toss-up between the pills and the rocks in the dirt, but that is not an experiment I will try.)
Can parents take advantage of their children's natural curiosity to put odd things in their mouths to get them to try different foods?  I'm not sure.  I have noticed that they do tend to try things that are bland,  like dirt and paper, and usually spit out "spicy" leaves that they find in the garden.  For some reason they prefer their non-food items to be muted in color.  (I base these observations on the calls I get from parents about what their children have eaten.)
One of the things I used to do with my daughter and her friend Mollie is to let them experiment in the kitchen, with close supervision.  They would invent their own concoctions of edible items taken from all drawers and shelves.  Of course, because my daughter was raised with the  understanding that she always had to take "one bite", she insisted that I try everything she made: "Just take one bite, Mama!" she ordered.  Lucky for all of us, this is before the two of them could write, so none of their recipes were kept for posterity.  (I will say her cooking skills today are great and Mollie is no slouch in the kitchen either.)
Can you take advantage of children's love of non-food products?  Again, I'm not sure.  But I do know that I am not a believer in the recent fad of "hiding" foods found in a number of cookbooks on how to get kids to eat.  My reasoning is:  1)  I don't have time to cook a separate dish for each family member  2)  It is important to learn about different tastes and textures  3)  Most importantly, my job as a parent is to teach my child how to eat properly and hiding food is a cop-out.
Which is not to say that I do not take into consideration different likes and palates.  My daughter hates asparagus.  I love them. I did make my daughter take "one bite" multiple times when she was young because I cook them frequently.  But I was finally convinced that she really does not like them and because she eats so many other vegetables when I make them for me I am willing to make something else for her.  And then we are both happy.

Here is a recipe that I've found that most ages, including toddlers eat.  It is easy to make.  It is not spicy, not identifiable as a specific food to a toddler and is versatile.  You can eat it hot or cold.  You can send it in a lunch.  You can bring it to a potluck.  And you can change some of the herbs depending on your family's preference.  Your toddler may even choose it over rocks and other non-foods!.

ZUCCHINI PIE

Ingredients
4 c. grated zucchini
4 large eggs, slightly beaten (or 7 egg whites or 5 oz of egg whites)
1 c. Bisquick
1/2 c. grated parmesan cheese
1 small onion chopped
1/2 c. oil (preferably olive)
1/4 cup fresh herbs (parsley or cilantro) or 2 tbsp fresh basil or rosemary (stronger flavors)

Mix together in a bowl.
Grease a 9x9 inch pan.  Put in pan.  Cook in 375 degree oven until brown (about 50 min.)

Serve hot, warm, cool or the next day!  I hope you try it and your family and friends enjoy it as much as the many people I've given this to, both already made, and as a recipe.

Does Baby Gaga Ruin a Child's Love of Vegetables?

We are programmed to prefer sweets and fats. However, there are ways to get children to like vegetables. Common knowledge states that you should start babies on vegetables first because if you start them on the sweeter fruits they will never like or at least prefer their vegetables. That never made sense to me. Anyone who has ever tasted breast milk knows that breast milk is incredibly sweet. (If you haven't tasted breast milk you can now go to Convent Garden, London and get a Baby Gaga ice cream cone which is breast milk, vanilla and lemon zest.) So a breastfed baby essentially starts out life drinking warm, melted ice cream. Then I noticed that most of the Asian babies in my practice preferred vegetables over fruits and the Caucasian babies preferred fruits over vegetables and it made NO difference which order the foods were started. So I thought, maybe, there was a genetic preference for taste.

Well, it turns out I was wrong. (At least no one has found a gene to get us to prefer vegetables over fruits.) What has been shown though, is what a mother eats during her pregnancy and while she is breast feeding makes a difference in the acceptance of certain foods by the infant. Certain aromatic chemicals found in vegetables can get into the amniotic fluid and breast milk. And what I was noticing was that the Asian mothers of my patients loved and ate their veggies and their children were accepting those flavors when those foods were introduced. My Caucasian babies were eating the diets that their mothers had been eating - more fruits and less vegetables, which is a typical American diet.

That does not mean all is lost. I have tasted most formulas and to my adult palate formula tastes disgusting, and yet look how many babies take it willingly. And how many babies do you know love to increase their roughage with eating paper and dirt? So we know babies are willing to try many things. The trick is to get them to keep eating those things. Babies taste buds develop with time, and developmentally babies put things in their mouths between ages 6-12 months. This is the perfect time to introduce foods that have the complex flavors you find in vegetables. If your baby rejects it the first time you offer it, don't despair. Just because a baby rejects something does not mean they truly dislike it. You have to try it about 20 times before you should accept that this is a food they do not like. Taste and preference develop with time.


Roasted vegetables are foods that lend themselves to something you can cook for the whole family and experiment with different tastes. You also take advantage of the roasting process which caramelizes the vegetables. As the name "caramel" implies, there will be a natural sweetness that occurs as result of this process. You can make a lot at one time so that you have enough for more than one meal and you can puree the extra to make baby food.

ROASTED VEGETABLES (Pick your family's favorites and throw in some new ones each time you do it.

Preheat to 425 degrees.
Start with the root vegetables. Put oil (I prefer olive oil for taste and nutrition) and garlic cloves in the bottom of the pan
Put unpeeled beets in foil by themselves (they are messy)
Add vegetables to pan in oven as you finish peeling and cutting them
Peel the beets and slice.
Sprinkle with salt and pepper to taste.

You can serve them separately or throw them all in one bowl (which is what I do.)

Carrots (if you buy the baby ones, you don't have to peel them)
Buy and scrub baby potatoes or peel and cut waxy potatoes (not russets)
Turnips
Parsnips
Sunchokes
Small onions (like pearl onions)
Brussel Sprouts
Cauliflower

Add "summer vegetables" (these days you can often find them year round)
Asparagus
Eggplants
Summer squash
String beans

Cook the root vegetables 30-45 mins until brown and soft when stuck with a knife and the summer vegetables 10-25 mins until slightly brown (if you do not have root vegetables you can increase the heat to 450 degrees.)


The next day you can either reheat in the microwave, or serve as a cold salad with your favorite dressing.