Healthy Food & Healthy Living by Dr. Ayala

Recipes for a healthy and happy Thanksgiving

Thanksgiving is a time to give thanks, celebrate fall, and enjoy the bounty of nature and the company of family and friends.

I love this holiday because it’s so important to take a break from focusing on all the problems in our world and in our lives, and spend time reflecting on the good in the world. There’s much to be grateful for, even in hard times.

As a vegetarian cook I follow the traditional Thanksgiving meal quite loosely. The palette of my presentation will definitely abide by the customary colors: the oranges, browns and reds of squashes, pumpkins, cranberries and chestnuts; the typical green of green beans or a fresh salad; and the lovely yellow of corn and corn meal. But otherwise, I let the quality seasonal produce I find show me the way, and I allow myself freedom in interpreting the Thanksgiving classics.

This week, I want to share a few of my healthy Thanksgiving recipes, most of which can be prepared well in advance and require minimal “finishing touches” right before the big meal.

Wishing you a happy and healthy holiday,

Dr Ayala

Roasted squash and chestnut soup with mulling spices

This is a terrific fall soup, perfect for the Thanksgiving holiday. It’s easy to make, and requires no pre-prepared soup stock. The aroma of the mulled spices is festive and somewhat surprising in a soup.

Ingredients:

• 2 butternut squash, peeled, halved lengthwise and cored
• 1 large onion
• 1 tablespoon canola oil
• 1 pound peeled roasted chestnuts (you can find peeled chestnuts sold in jars)
• 1-2 tablespoons honey
• Salt and freshly ground pepper to taste

For the mulling spices:

• 2 cinnamon sticks
• 1 teaspoon whole allspice
• 1/2 teaspoon whole cloves
• 5 cardamom pods, bruised
• Orange peel zest (the outer colorful skin of the orange peel)--about half an orange

Preparation:

Preheat the oven to 350 degrees F.

Place the squashes, cut-side down, on a baking pan and bake until tender, about 30-40 minutes. Cut into large chunks.

Gather the mulling spices into a muslin bag, tea ball or cheesecloth pouch. (The orange peel and cinnamon sticks can be allowed to roam free in the pot; they’ll be easy to fish out.)

In a large soup pot, over medium-high heat, sauté onions until translucent.

Add the chunks of roasted squash, honey, salt, pepper, and half the chestnuts.

Add water to cover by 1.5 inch and bring to a boil, then lower to a simmer.

Add the mulling spices, including the orange peel and cinnamon sticks.

Simmer over moderate heat for 20 minutes. Remove from heat. Remove the mulling spices, orange peel and cinnamon sticks.

Puree the soup with an immersion blender. (This is an inexpensive kitchen tool that saves a lot of cleanup. Immerse the blender into the pot in which the food has been cooked, and easily puree it with a switch of a button. If you don’t have an immersion blender you can use a blender or food processor.)

Crumble the remaining chestnuts into the pureed soup.

Taste and correct seasoning by adding ground cinnamon, more salt or some more freshly ground pepper.

To serve:

Garnish with freshly toasted pumpkin seeds (an excellent source of omega 3), and/or a cinnamon stick.

Serves 8-10.

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Roasted red and golden beets, with reduced balsamic vinegar

Beets are easy to find, especially between spring and fall. They make for a very simple, delicious, healthy dish that epitomizes fall color to me.
If you can find golden beets, they make for a delightful color contrast with the red beets. They also taste really great.

Ingredients:

• 3 medium red beets, rinsed, not peeled
• 3 medium golden beets, rinsed, not peeled
• 1/2 cup balsamic vinegar for reduced balsamic glaze
• Fresh herbs to garnish (chives, parsley or tarragon)
• Salt and freshly ground pepper to taste
• Optional - fresh goat cheese (chèvre)

Preparation:

Preheat the oven to 400 degrees F.

Wrap each beet in aluminum foil and place in pan in the oven.

Roast until tender and easily pierced with a fork, about 45 minutes to 1 hour.

Remove from the oven and let cool.

When beets are cool enough to handle, peel and slice them. (Red beets can be peeled and sliced in advance. Golden beets change color when exposed to air, so slice just before serving.)

To make reduced balsamic glaze: In a small pan over high heat, bring vinegar to a boil, then reduce heat to medium, and evaporate balsamic until quantity halves and turns to a light syrup.

Drizzle reduced balsamic over the beets.

Season with salt and freshly ground black pepper.

Garnish with fresh herbs, and add goat cheese if desired.

Serves 8-10 as a side dish.
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Wheat berry salad

Whole grains are important part for healthy nutrition. Wheat berries are the most wholesome and least processed wheat grain and include the entire wheat kernel—the bran, germ and endosperm. (For comparison, white flour is comprised only of ground endosperm.)
Look for wheat berries in the health food store or in the natural foods section of the supermarket. (Whole Foods usually sells them in bulk, which is great!) I like the hard red wheat berries, which are very high in protein, very nutritious, and have a sweet nutty flavor and a lovely chewy texture.

The trick with hard wheat berries is to plan ahead and soak them overnight. These grains are very hard indeed, and will require a very long cooking time if they’re not well-soaked.

This is a very simple recipe, and a dish everyone seems to love.
Ingredients:

• 1/2 cup wheat berries, soaked overnight
• 1 large ripe mango (can be replaced with oranges or persimmon), cut into cubes
• 3-4 celery stalks, with the fibery outer parts peeled and diced
• 10 dates, pitted and finely chopped (can be replaced by another dried fruit)
• A handful of dry cranberries
• A handful of nuts, such as roasted almonds, candied pecans or walnuts

Dressing:

• 1 tablespoon of a fine sweet and interesting marmalade. I use organic Adriatic fig spread (sold at Whole Foods)
• 2 tablespoons extra virgin olive oil
• 1 tablespoon balsamic vinegar
• 1 sprig of thyme, finely chopped

Preparation:

Cook the wheat berries by covering them with two inches of water, then bring them to a boil, lower the temperature to simmer, and cook until chewy—about 20-30 minutes. Drain and let cool.

Add all other salad ingredients besides the nuts.

Combine dressing ingredients.

Add the nuts and dressing right before serving.

Serves 6-8 as a side dish.
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Roasted French string beans with toasted sesame

Ingredients:

• 1 pound French string beans, both ends removed
• 2 tablespoons olive oil or toasted sesame oil
• 2 tablespoons sesame seeds
• Freshly ground black pepper and salt to taste
• A pinch or two of red pepper flakes (optional)

Preparation:

Preheat the oven to 400 degrees F with the oven pan in the oven.

Toss the string bean with the oil and spices.

Spread the beans in one layer on the pre-warmed oven pan.

Bake for 3-5 minutes, until beans become slightly brow and are sizzling, but are still very crunchy and vibrant.

Correct the seasoning by adding salt or pepper.

Serve hot, or at room temperature.

Serves 8-10 as a side dish.
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Pecan yeast “roses” cake

Pecan yeast “roses” cake is a perfect indulgence for the close of the Thanksgiving meal and a fresh take on pecan pie.
This isn’t a difficult recipe--yeast dough is actually easy to work with. The only real challenge is mastering the patience. You’ll have to factor in the rising time the dough needs to fully develop.
The “roses” part of this cake’s name comes from the delicate shapes formed on the individual cakes.

Ingredients:
For basic sweet yeast dough:

• 3 1/2 cups unbleached flour (I use King Arthur’s bread flour. All-purpose is fine too. Bread flour is a high-gluten flour called for in many bread and pizza crust recipes where you want the loftiness or chewiness that the extra gluten provides. All-purpose flour is made from a blend of high- and low-gluten wheats, and has a bit less protein than bread flour.)
• 1/2 cup sugar
• 1/2 cup milk
• 1/2 cup heavy cream
• 3 tablespoons melted unsalted butter
• 2 yolks
• 1 envelope rapid-rise yeast
• 1/2 teaspoon salt

For the pecan filling:

• 2 cups pecans, finely chopped (in the food processor or blender)
• 1 cup sugar
• 2 tablespoons butter
• 2/3 cup milk

Preparation:

To make the dough:

If you happen to own a bread machine, put all the ingredients in the mixing bowl and use the dough setting.

If kneading by hand: Put all the dough ingredients in a bowl, combine to make dough, and knead for about five minutes, until the dough is soft and elastic and not sticky at all. (Add a bit of extra flour or milk if you haven’t reached a really workable dough within five minutes, but that rarely happens with this recipe.)

Cover the bowl with a clean kitchen towel, and let sit for an hour and a half in a warm place, until the dough doubles its volume.

To make the filling:

Combine milk, sugar and butter in a small pot and bring to a boil, then lower to a simmer.
Add the nuts, and continue stirring on low heat for a minute or two.

Remove from heat and let chill completely. (The filling may seem too watery for handling when warm. Don’t worry. Its consistency will improve as it cools down.)

Putting it all together:

Roll the dough on a lightly floured surface to a rectangle, about 25 by 20 inches. Don’t be lazy! If you fail to roll it big enough the cake will have fewer leaves and too much dough between the nut layers. Rolling to a thin sheet is really important!

Spread the pecan filling on the dough and roll the dough.

Cut the roll crosswise into 2 inch pieces and place on a greased 10-inch spring pan, cut side up (will make 12-15 rolls).

Let rise again for about one hour.

Heat the oven to 350 degrees F.

Bake in the heated oven for 25 to 30 minutes, until golden brown.

Remove from oven and let chill on rack.

Serving suggestions:
The cake can be cut to slices (my preference) or separated into its rolls by hand.
This cake pairs very nicely with apple sauce, fresh berries or more simply, a steaming cup of herbal tea.

Serves 14-20
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Whole wheat banana bread with mint sauce

I’ve always wondered why banana bread is called banana bread and not banana cake.

Is it because it’s baked in a bread pan, and not in a round pan? Is the name designed to make us feel better about eating it—bread’s a necessity and cake’s an indulgence?

To be honest, this recipe, although a more nutritious version than your ordinary banana bread, still should be filed in the dessert section due to the sugar and fat content. (To me, bread is flour, yeast, salt and water, with maybe trace amounts of added fat and sugar.)

Having said that, I do love banana bread. Like most banana-loving families, I find over-ripe bananas in my fruit bowl quite often. Bananas are a tricky fruit: They’re at their best when just ripe, and if you happen to look away for a few hours and neglect to consume them in time, you’re in banana bread territory with over-ripe bananas—still delicious, but not lunchbox material.

I write and speak often about the poor eating habits most of us have, especially related to fruit and vegetable consumption. The Centers for Disease Control and Prevention reported this week that fewer than ten percent of U.S. high-school students eat the combined minimum five-a-day daily recommended servings of fruits and vegetables, with some states such as Arkansas and North Carolina faring significantly below those averages and some New England states, particularly Vermont, doing notably better.

Combining bananas and mint into a bread or cake isn’t the answer to our kids’ low intake of fruits and veggies—not at all. But it is another fine use for these plant-based foods we should have in plenty at home and in our kids’ lunchboxes, available for snacking and ready to eat. And, just to be clear, I recommend eating most fruit raw.

However, this bread/cake is a delightful exception-—moist, scented, full of fruit and really delicious! Try it.

INGREDIENTS

For the mint sauce:

1 cup packed fresh mint leaves
1/4 cup almonds
1/4 cup honey
1/2 tablespoon vanilla extract

For the banana bread:

3 or 4 very ripe mashed bananas
1½ cups of whole wheat flour
2 tablespoons melted butter
½ cup sugar
½ cup dark raisins
2 eggs
1 teaspoon ground coriander
1 teaspoon vanilla extract
1 teaspoon baking powder
Pinch of salt

PREPARATION

• Make the mint sauce: puree all ingredients to a thick paste using a food processor (or blender) fitted with the steel blade.

• Preheat the oven to 350°F.

• In a large bowl, combine all of the banana bread ingredients. You don’t need a mixer, but feel free to use one.

• Pour the banana bread mixture into the buttered 4x8 inch loaf pan.

• Swirl the mint sauce into the banana bread (Transfer the mint sauce into a small plastic bag with a corner snipped off. Drizzle it on in parallel lines and then run a knife through the lines from the other direction to swirl.)

• Bake for 30-40 minutes until a toothpick inserted into center of the loaf comes out clean and the bread is golden brown.

• Cool on a rack. Remove from pan and slice to serve.

Tip: The mint pesto will keep in a tight container for a week or so, and will pair up nicely with any chocolate dessert. Double the quantity and you’ll look like a pro when you serve chocolate ice cream or cake with a few dollops of this home-made mint sauce on the side.

For more of my whole wheat recipes go here and here.
Enjoy,
Dr. Ayala

Watermelons: A Healthy Taste of Summer

I am taking a summer break for a few weeks to spend time with my family and travel. Meantime, I'm reposting some of the more popular posts I’ve written over the past almost two years (wow, how time flies!) so that new readers have a chance to catch up. Enjoy this post! - Ayala

One of the best things to enjoy on a warm summer day is a cold watermelon. What could be better? Sweet, crisp, refreshing, red and nutritiously healthy.

My husband sees it as a personal failure when we open a watermelon and find a pinkish disappointment that tastes like a cucumber. He feels there must be a fool-proof way to pick the perfect fruit.

Alas, there’s no secret method, but I can offer a few tips for choosing a good watermelon:

Tapping: Tap the watermelon with the pads of your fingers. A winning watermelon will typically have a slight hollow sound, more like the sound you get when tapping your head rather than tapping your chest.

The yellow spot: At the bottom of the watermelon -- where it rested on the ground -- you want to find a yellow or cream-colored spot. If the spot is still white, the watermelon isn’t ripe.

Hardness: Press your fingers and thumbs into the watermelon’s skin. A good one should be hard all around with no soft spots.

Heaviness: A good watermelon feels heavy for its size.

I’ve been using these methods for years. Still, I have to admit I’m not convinced that digging through the watermelon bin using these tricks gets you a better success rate than randomly picking the first watermelon your hand touches with your eyes closed. I occasionally end up with disappointing watermelons no matter how hard I try. It just happens!

The good news though if you get a bad one: a not-so-sweet watermelon makes a wonderful and easy-to-prepare cold soup. (The cucumber in the recipe masks the cucumberness of the not-so-great watermelon.) It looks like a gazpacho, but is even more refreshing.

Watermelon and mint cold soup

Ingredients

6 cups seedless watermelon, diced
1/3 cup finely chopped fresh mint
1 cup cucumber, peeled and finely diced
1 small jalapeño pepper, seeds removed, minced
1 red onion, diced
1/2 cup young celery stalks, diced
2 tablespoons fresh lime juice or to taste
2 tablespoons balsamic or red wine vinegar
salt and fresh ground pepper to taste

Preparation

Puree the watermelon in a food processor, using the “pulse” setting; pulse several times until the watermelon is still chunky and not too smooth.

Transfer the puree to large bowl. Add the remaining ingredients. Refrigerate until cold (at least an hour).

Garnish with a few leaves of fresh mint and serve.

What’s so good about watermelons?

First and most important – it’s a fruit and it tastes good. And of course its color brightens up the table.

Watermelon is a low calorie nutritious treat: a one-cup serving of watermelon has only about 50 calories.

It’s an excellent source of vitamins C and A. It’s also a good source of vitamins B6 and B1, and minerals such as potassium and magnesium. Red watermelon (yes, there’s a yellow-orange type too!) is also a good source of lycopene (a carotenoid antioxidant). In fact, watermelons are a richer source of this beneficial antioxidant than tomatoes.

Watermelon is 92 percent water so it’s very good for hydration.

While we mostly eat the flesh of the watermelon, all parts are actually edible. The rinds can be stir-fried, stewed or pickled. Watermelon seeds are rich in fat and protein, and can be eaten as a snack (roasted), or made into an oilseed.

How big can they get?

Very, very big!

Hope, Arkansas, the birthplace of President Bill Clinton, is known for producing the world's largest watermelons.
The last world record was set at 268.8 pounds as far as I could find. I wonder what a watermelon this big tastes like.

Is watermelon a favorite fruit in your home?

Dr. Ayala

From garden to healthy table—zucchini, potato and fresh herbs gratin

As I’ve mentioned before, I’m an amateur organic gardener with many good intentions and a very modest yield.

I give my little vegetable patch lots of love, but the veggies are very slow to grow, and although some of my friends have been boasting home-grown produce for weeks, I harvested my first few cucumbers, tomatoes and zucchini just this week.

I love watching the plant in all its stages, and I’m especially fascinated to see how a fruit evolves from the flower. In the case of the zucchini, the beautiful golden flowers—both male and female—are edible and quite tasty, and can be eaten fresh, sprinkled into salads soups and pasta dishes, or cooked—stuffed zucchini flowers are a gorgeous delicacy.

By the way, only the female flower results in a zucchini: A bud appears at the base of the flower and grows into a zucchini. (And yes, a zucchini is botanically a fruit and not a vegetable.)

One of my favorite zucchini recipies is for an easy gratin. I usually make this with only zucchini, but since I had so few—and I didn’t want to mix my precious zucchini with the store-bought ones—I combined my zucchini with super new potatoes from my local farmer’s market. I was very pleased with this combination, since the lightness of the zucchini and herbs is balanced with the earthiness and heartiness of the potatoes.

As you’ll see, this dish relies on fresh herbs for its explosion of flavor. The fresh herbs also pack lots of nutrition—they’re a powerhouse of phytochemicals and antioxidants, and a great addition to your healthy diet.

Ingredients:

• 4-5 zucchini, peeled (if very fresh no need to peel) and cut to ¼-inch slices

• 8-10 small potatoes, peeled and very thinly sliced (can be done with a mandoline or food processor)

• ½ cup freshly grated parmesan cheese

For the sauce:

• 1 cup of mixed fresh herbs—tarragon, parsley, chives, oregano, thyme and basil are good options; be creative, but use more of the mild herbs, and less of the more potent oregano and thyme.

• 5 tablespoons extra virgin olive oil

• 1 clove garlic

• A pinch of hot pepper flakes

• Salt and pepper to taste

Preparation:

• Heat the oven to 350 degrees F.

• Prepare the sauce. If you have a food processor, pulse all ingredients to a course grind. Otherwise, chip all dry ingredients as finely as you can, and mix with the olive oil and spices.

• Mix all ingredients, taste the zucchini and correct the seasoning.

• Brush some olive oil on an oven-safe baking or gratin dish, and transfer the zucchini potato mix.

• Transfer to the oven, and bake for 60-80 minutes, until potatoes are well-softened. If the top darkens too much, and the potatoes aren’t yet soft, cover with tin foil and bake some more.

Serve immediately (will serve 8-10 diners as a side dish).

Enjoy,

Dr. Ayala

Go see Food, Inc. and improve your food and health

The New York Times called it “one of the scariest movies of the year.”

I wouldn’t know, since I generally avoid horror films, but while Robert Kenner’s Food, Inc. is indeed deeply disturbing and isn’t the light entertainment typically screened in the heat of summer, it’s an important movie to watch, and it does offer a hopeful note and an action plan. I bet you’ll be moved by this movie, and understand more than ever that there’s plenty we can do to affect our own diet and the food landscape in which we all live.

We buy our food in clean pastoral looking supermarkets. It’s beautifully packaged, and marketed as the bounty of our land and the product of smiling healthy looking farmers.

Once Kenner lifts the veil, the industrial food system looks very different and so much uglier.

Our industrial conventional foods are controlled by a handful of very large and powerful conglomerates shown to often put profit ahead of other consideration, including consumer health, the livelihood of the American farmer, and the safety of workers and the environment. Most of our supermarket foods are made from cash crops and subsidized grains, and the huge variety of processed foods (the average supermarket sells 47,000 items) is pretty much corn and soy rearranged to into something new, or what Michael Pollan—who’s featured in this film—dubs “food-like substances.”

The movie features very upsetting visuals of industrial animal farming. From the feedlots, where cows never see grass, to the chicken coops where chicken never see daylight, to the meat processing plants, the cruelty to the animals is horrific. The movie claims at one point that when companies treat animals with such cruelty and disrespect, they’ll soon lose compassion for their human workers, and it’s heartbreaking to see illegal workers, most of them with temporary jobs, endangering themselves while receiving so little back for their effort.

Even more upsetting is the fact that the industrial feedlot is the source of many food-borne health outbreaks. The tragic story of Barbara Kowalcyk, who lost her perfectly healthy two-year old Kevin after he contracted E. coli O157:H7 from a hamburger he ate on vacation, is a personal example of how this food system, which produces large quantities at a low price, has made food less safe and deteriorated our environment and therefore really costs us a fortune. This is the food system that, due to subsidies, created the absurd situation in which a hard-working low-income family (in which the dad already has diabetes) resorts to eating burgers and fries from a fast-food drive-in, because it’s so much cheaper than fresh produce (which isn’t subsidized). The unintended result of our food system is skyrocketing obesity and diabetes rates.

Mind you, this is not a movie that comes at you from the point of view of a vegetarian. Food, Inc. does not consider the raising and slaughter of animals as an ethical dilemma. It’s the life and death of the industrially raised animal that’s criticized and contrasted with the way organic farmer Joel Salatin raises his animals, which is seen as farm animals living quite a happy life. They work for the farmer but are also cared for in return (although they too are seen slaughtered for food).

The film ends with an empowering note: We do get a say in what we eat, and therefore we can affect what foods will be sold and how they’re made. We get to vote three times a day. If we demand better food, someone will make it!

Here are the 10 simple actions the movie makers share before they send us home:

• Stop drinking sodas and other sweetened beverages.

• Eat at home instead of eating out.

• Support the passage of laws requiring chain restaurants to post calorie information on menus and menu boards.

• Tell schools to stop selling sodas, junk food and sports drinks.

• Embrace Meatless Mondays—go without meat one day a week.

• Buy organic or sustainable food with little or no pesticides.

• Protect family farms; visit your local farmer's market.

• Make a point to know where your food comes from—READ LABELS.

• Tell Congress that food safety is important to you.

• Demand job protections for farm workers and food processors, ensuring fair wages and other protections.

I highly recommend seeing Food, Inc. Learning how industrial food is making us sicker, fatter and poorer isn’t pretty or funny, but it just might stir a few more people into action. I’d love to hear your thoughts.

Dr Ayala

Healthy summer frozen treats and the dreaded brain freeze

My dear kids bought me an ice cream maker for Mother's Day—they know my favorite gifts are connected to the kitchen and food. To their delight, I’ve been experimenting with frozen healthy treats for the past few weeks, and they get to sit on the sunny steps outside our kitchen where they taste, comment and compare.

These recipes call for an ice cream maker. Not every kitchen has or needs one—I give instructions for making these fruit treats without one—but if you have the space in your kitchen these small appliances aren’t expensive (under $50), and will probably earn their keep.

When making frozen desserts at home you’ll be using pure fresh ingredients, and none of the stabilizers, gums, colors and preservatives that are often found in the in prepared versions from the frozen food section of your supermarket.

Here are a few of our favorites:

Lemon, Verbena and Geranium Sorbet

Ingredients:

• 2 cups boiling water
• 1/2 cup sugar
• 5-8 leaves of rose geranium* (can be replaced by French tarragon or 1 teaspoon lavender flowers)
• 1 cup lemon juice
• 1 tablespoon minced fresh Lemon Verbena
• ½ teaspoon grated lemon peel (yellow part only)

*Another option is to replace rose geranium with 1 bottle of Ayala’s Herbal Water Lemon Verbena Geranium. If you do this, use just ½ cup of boiling water to melt the sugar.

To prepare:

Stir the sugar and rose geranium leaves in the boiling water until sugar is dissolved. Chill completely. Remove leaves just before making the sorbet.

Add the lemon juice, lemon Verbena and lemon peel.

Freeze in an ice cream maker according to manufacturer's directions 25-30 minutes.

If you do not have an ice cream maker

 Place mixture in freezer-proof container
 Freeze for one hour
 Remove from the freezer and beat the mixture using an electric mixer
 Repeat this entire process two more times (it’s worth it)

In case you’re wondering how I make the lemon zest spirals--it’s really easy, use a lemon zester in a circular motion around a washed lemon (see picture).

Very Berry Sherbet

Ingredients:

• 1 pound mixed berries. I like using a combination of sweet and tart berries: blueberries, strawberries, raspberries and blackberries. Frozen berries also work; let them thaw just a little before preparation
• 2-4 tablespoons sugar or agave (depending on berry sweetness)
• 1 cup milk (I use 2%)

To prepare:
Process all the ingredients coarsely in a food processor or blender.
Freeze in an ice cream maker according to manufacturer's directions, 20-25 minutes.

If you do not have an ice cream maker:

 Place mixture in freezer-proof container
 Freeze for one hour
 Remove from the freezer and beat the mixture using an electric mixer
 Repeat this entire process two more times

Watermelon Mint Slurpee

Ingredients:

• 1 pound sweet ripe watermelon
• 10 mint leaves, finely chopped
• Lime juice from half a lime
• a pinch of salt

To prepare:
Process all the ingredients in a food processor or blender.
Freeze in an ice cream maker according to manufacturer's directions for about 10-15 minutes. The consistency needs to be slurpable through a straw, so this one’s not supposed to completely freeze.

If you do not have an ice cream maker:

 Place mixture in freezer-proof container
 Freeze for one hour
 Remove from the freezer and beat the mixture using an electric mixer
 Repeat this entire process one more time

Serve in tall glass, with a wide straw.

Serving suggestions

These recipes serve 4-6 people

Sorbets may be served as a dessert or between courses to refresh the palate.

The texture of the sorbets varies by ingredients, preparation and temperature. These recipes are designed to be served immediately. If you do store the sorbet in the freezer, make sure you allow a short time to thaw before serving.

The dreaded brain freeze

Ice cream can teach us a very important healthy eating lesson—eat slowly. Although it’s always good advice to pace our meals, allow satiety to sink in and give ourselves time to really enjoy our food, ice cream, sorbets and other very cold foods often provide a very clear reminder to slow down: The dreaded ice-cream headache. This “brain freeze” not only causes us to momentarily stop our own eating, but if anyone else happens to cry out as they suffer this stinging pain, we all almost instinctively slow down in order to avoid it ourselves.

According to an editorial by neurologist Joseph Hulihan in the British Medical Journal, the ice cream headache is the most common cause of head pain, and affects a third of the population. It has no connection to other forms of headache. The pain begins a few seconds after gulping down cold foods or beverages--when really cold food touches the roof of the mouth--and peaks in 30-60 seconds. The good news is that it doesn’t last long.

Scientists aren’t sure about what causes this pain. One leading theory suggests that the cold food or drink may temporarily constrict blood vessels and cause pain in much the same way a migraine does. In any case, no need to worry. Hulihan concludes with:

“No treatment is usually required, and sufferers rarely seek medical attention. Since the posterior aspect of the palate is most likely to produce the referred pain of ice cream headache, avoiding contact of the cold food with this area can effectively eliminate the symptoms. Most people arrive at such preventive measures without the advice of doctors. Ice cream abstinence is not indicated.”

And you can always call on the classic trick to speed up recovery from brain freeze: press your tongue to the roof of your mouth until the pain subsides.

Your comments on summer treats or brain freezes are as always welcome.

Enjoy the warm weather in good health.

Dr. Ayala

Eating green for our planet – Vegans and vegetarian diets part 3

“Nothing will benefit human health and increase chances for survival of life on Earth as much as the evolution to a vegetarian diet.”

This quote is attributed to Albert Einstein, who—according to his writings—supported a vegetarian diet, but didn’t strictly adhere to it. In fact he admitted, "I have always eaten animal flesh with a somewhat guilty conscience."

After discussing the health impact of vegan and vegetarian lifestyle on personal health, I’ll be devoting this third chapter to the important subject of the environmental impact of meat production, and how eating meat (especially lots of it) affects the health of the planet.

A shocking report published in 2006 by the United Nations Food and Agriculture Organization, showed that the livestock sector generates more greenhouse gas emissions (as measured in CO2 equivalents)—18 percent of all greenhouse gas emissions—than transportation, and is also a major source of land and water degradation. Livestock production uses about a third of the world’s arable land, and as land becomes scarce, expansion of livestock production encroaches into forest land and is causing mass deforestation.

Given the livestock sector’s enormous environmental impact, the report calls for it to become a focus of environmental policy, and says such changes will have a huge potential payoff.

The American Journal of Clinical Nutrition’s May supplement on vegetarian, vegan and plant-based diets and their effects on health included two studies that examined how our eating choices affect the planet.

In the first of these studies, a review paper looking at the greenhouse gas contribution of different foods gives number values to our food choices.

Which greenhouse gases are the by-products of food production? There’s widespread conversation about carbon dioxide, and its contribution to climate change, and fossil fuels are used in agriculture for fertilizers, transportation and other energy requirements.

But two other gasses produced mainly by agriculture have an even larger green-house effect: methane and nitrous oxide. Methane is produced by ruminant livestock (such as cattle, sheep and goats) and stored manures, but also from rice grown under flooded conditions. Nitrous oxide is generated through feed-production processes and is an animal waste by-product.

Comparing emissions

A study of 22 food items sold in Sweden shows that the greenhouse gas emissions associated with foods differ greatly. For this study, carbon dioxide, methane and nitrous oxide were assessed for the farm-to-table production cycle, so storage, transportation, preparation and processing all factored into this calculation.

Here are the findings:

• The lowest emissions are produced by domestic vegetables, cereals and legumes (excluding rice).

• The highest emissions are produced by domestic beef, which produces about 70 times more greenhouse gasses per kilogram (about 2.2 pounds) of food than fresh domestic veggies fruit and grain.

• All animal products have higher greenhouse gas emissions than plant-based products, with the highest emissions produced by beef, cheese and pork, in that order.

• Fowl meat and eggs are relatively climate-friendly compared to beef; a kilogram of chicken produces about a sixth of the greenhouse gasses generated by a kilogram of beef.

• Tropical fruit, flown by plane, had emissions that were similar to animal foods.

• Fruit and grain shipped by boat had about double the amount of emissions compared to domestic fruits and grains, but their emissions were still 1/40 of domestic beef.

• Rice has greater emissions—about three times more—than other grains.

• Fish may cause high emissions due to high use of fossil fuels for fishing. Many fish are on the verge or under a severe threat of extinction, and the article sees the fish option as environmentally unsound for the most part.

To put these emissions in perspective, the researchers compare food emissions to those of the average European car: Consumption of one kilogram of domestic beef equals driving for about 100 miles in green-house gas measures.

Looking at the findings above, you may argue that comparing a kilogram of carrots to a kilogram of beef is misleading, as beef provides lots of protein, and therefore a bigger emission footprint might be justified. The paper therefore provides a table that shows how many grams of protein different foods make per kilogram greenhouse gas emissions.

The best-for-the-planet winner is domestic whole wheat, but even vegetables such as green beans and carrots, which contain very little protein, are more climate-efficient than beef in producing protein.

How green is your dinner?

The authors then analyzed the green-house gas effect of three meals, each containing a vegetable, a fruit, cereal, and a protein source, and all with similar nutritional value (i.e., the same amount of calories and protein).

• Meal A contained domestic carrots, domestic whole wheat, soybean from overseas by boat, and an orange from overseas by boat.

• Meal B contained green beans, potatoes, pork meat, and an orange from overseas by boat.

• Meal C contained frozen vegetables, rice from overseas by boat, domestic beef, and tropical fruit from overseas by plane.

The emissions of meal C are about 11 times those of meal A, while those of meal B are three times the emissions of meal A. (I daresay that besides the tropical fruit flown by plane, meal C is a pretty typical American meal). By this analysis, meal A is the “greenest.”

The authors conclude:

"The analysis shows that changes toward a more plant-based diet could help substantially in mitigating emissions of GHG (green house gasses)."

Comparing diets

The second American Journal of Clinical Nutrition study compared the environmental impact of vegetarian and non-vegetarian diets. The researchers looked at the data from the Seventh Day Adventist cohort, which includes 34,000 Adventists, 50 percent of whom are vegetarian, and found 11 food groups that vegetarian and non-vegetarians consume in significantly different amounts, such as animal foods (vegetarians consume less), and fruits, nuts and beans (vegetarians consume more). The researchers then looked at water consumption, energy use, pesticides and fertilizers applied to produce these foods using federal, state and industry data.

The non-vegetarian diet required 2.9 times more water, 2.5 more energy, 13 times more fertilizer and 1.4 times more pesticides than the vegetarian one.

These results are not surprising at all, considering the fact slaughter animals raised in factory farms are usually fed plant food (grains, such as corn and soy), which they convert very inefficiently to the animal meat that we eat. It’s of course much more efficient for us to eat the grain directly.

I’ve touched upon the animal rights and welfare argument very briefly in a previous post, and indeed, I think the morality and ethics of food and eating are an unscientific subject rooted in personal values on which many people may not easily find common ground.

However, the health argument for moderating meat intake, especially red meat intake, is quite compelling and supported by plenty of evidence. I’d buy into that.

Clearly the environmental impact of the expanding meat industry is huge, and evidence shows that if we just reduced our meat intake we’d see substantial environmental gains for our planet.

Unfortunately, the demand for meat is still growing as developing countries aspire toward a typical Western diet. The current global average daily consumption of meat is about 100 grams or 3.5 ounces per person, but there’s great disparity: The US intake is about half a pound a day, and Africa’s is about an ounce a day.

It’s clear that meat production even at current levels is unsustainable. If we want to combat global warming, land and water degradation and all of the other ills caused by industrial meat production, we need to reduce meat consumption. And the major reduction needs to occur where meat intake is high—half a pound a day is seriously way too much from a health point of view even if it were beneficial for the planet.

Current public policies are very friendly to the meat industry. For example, the grain animals are fed is subsidized, and meat and poultry producers aren’t forced to treat the mountains of waste an industrial farm generates. This ensures relatively inexpensive meat, which encourages us to eat more animal products.

No matter what your reason, I believe if you eat lots of meat, reducing meat intake is a significant personal action you can take to help reduce greenhouse gasses and improve your health.

What do you think?
Dr. Ayala

Vegans, vegetarians, diets and health-part 2

I’m devoting this weeks’ post to the current knowledge of the health effects of a vegetarian diet after discussing the vegan diet’s health effects in a post a fortnight ago.

The term vegetarian is quite broad, but for simplicity’s sake we’ll define vegetarians as those who avoid meat, fish/seafood and poultry, and do eat milk and eggs. It’s estimated (by a Harris Interactive poll) that 2.8 percent of the American population is vegetarian.

Much has changed in attitudes towards vegetarian lifestyles in the past decades. As a lifelong vegetarian, the first question I used to get was “Where do you get your protein?” The answer to this question is simple: Contrary to popular myth, plants--especially pulses (peas, beans and lentils), nuts, seeds and grains--have plenty of protein. Animal protein is considered a complete protein, meaning it has all essential amino acids in every bite. We now know that incomplete proteins can be stored in the body for many days to be combined with other incomplete proteins. Since different plant foods together contain all essential amino acids, it doesn’t matter if the proteins are complete or incomplete, and it’s also no longer recommended to bother with combining those different proteins in the same meal. Protein isn’t a problem.

The second question was usually “So what do you eat?” That led to an invitation to join us for a home-cooked meal that I’d prepare, or to a recommendation to try one of the many excellent vegetarian restaurants that prove the case that vegetarian food can be varied, extensive, deeply satisfying and extremely pleasurable.

A vegetarian diet is now much more accepted, vegetarian options have become much more popular, and vegetarian menus are less of a mystery. Many non-vegetarians are looking to eat more vegetarian foods, and it’s now proven that a healthy vegetarian diet is nutritionally adequate, doesn’t lead to any deficiencies of macro or micro nutrients and needs no supplementation. What’s also becoming quite clear is that vegetarian diets even confer some health protection.

As promised, I’m going back to The American Journal of Clinical Nutrition upcoming supplement on vegetarian, vegan and plant-based diets and their effects on health. A paper by Gary E. Fraser provides a balanced summery of the current science.

As you can imagine, studying large vegetarian cohorts is no easy task. There are a few such large cohorts. The California Adventists have been studied since 1958 and the study’s ongoing. The Seventh-day Adventist church is a Christian denomination that observes Saturday as the day of worship, but it’s also known for promoting a “healthy message,” including a vegetarian diet and avoidance of alcohol, caffeinated drinks, tobacco (they’ve been denouncing smoking for 150 years, well ahead of the medical community) and illegal drugs. Not all Adventists are vegetarian, so the effect of vegetarianism can be isolated within the Adventists. Other large study cohorts include the Health Food Shoppers’ Study and the Oxford Vegetarian Study both from the UK, and the German Heidelberg Vegetarian Study.

Fraser finds consistency in outcomes of vegetarian lifestyles across studies for the following considerations:

• Coronary heart disease is clearly lower for vegetarians. A combined analysis of these cohorts shows that non-vegetarians have 32% higher heart disease mortality than do vegetarians.

• Total LDL cholesterol is lower in vegetarians.

• Vegetarians are thinner than non-vegetarians.

• The risk of diabetes and hypertension is probably lower for vegetarians across studies.

Where Fraser finds inconsistent results is in the incidence of colon cancer. There’s general agreement from studies of non-vegetarians that red meat consumption increases the risk of colon cancer. The Adventists studies show that vegetarian Adventists indeed have a lower incidence of colon cancer, but the EPIC-Oxford study doesn’t show that vegetarians fare any better than the general British population. This of course demands explanation and further study.

Fraser concludes:

“Much remains to be understood. However, it seems clear that vegetarians experience less CHD (coronary artery disease) than do others. Their risk factor status would lead us to expect this result. The evidence that risk of diabetes is less in vegetarians is highly suggestive, although as yet it comes from cross-sectional work and mainly from California vegetarians. Again, what is known of causal factors in diabetes would lead us to expect this result. Body weight is lower in vegetarians and much lower in California Adventists. LDL cholesterol is lower in vegetarians, and this is probably true for blood pressure and risk of treated hypertension. The reasons for the blood pressure association are not well understood, and more research may refine our understanding of this.

Studies in both California and the United Kingdom are fairly consistent in finding at least moderate reductions in all-cause mortality in vegetarians, in comparison to other subjects living in the same communities. This would be expected on the basis of reduced cardiovascular mortality, unless some other presently unrecognized cause of death is increased in vegetarians. As suggested by the British work, it is also likely that there are other ways to similarly decrease mortality (the health-conscious nonvegetarians) aside from a dietary habit that is fully vegetarian.”

Vegans and vegetarians choose this lifestyle for many reasons, and the personal health advantage isn’t necessarily the main incentive to abstain from animal products. In fact, I don’t know if the health effects of these diets are a good enough reason for those who enjoy the taste of meat to give it up altogether, and I don’t think that there’s good evidence to suggest that eating quality meat in moderation is all that harmful.

On the other hand, there’s plenty of support for the recommendation to lower the (very high) consumption of red and processed meat in the average American diet.

A very recent study in the Archives of Internal Medicine followed half a million participants and found that red- and processed-meat intakes were associated with modest increases in total mortality, cancer mortality and cardiovascular disease mortality, and that the higher the red- and processed-meat intake, the higher the risk. The study of course cannot tell if it’s the meat that’s causing harm, or if those who eat lots of meat substitute it for beneficial foods, such as whole grains, fruits and vegetables.

There also is ample support for the advice to consume more fruits, veggies and whole grains. I’ve devoted several posts to that, and the evidence continues to accumulate: Just a few days ago, a very large prospective study, which followed more than 450,000 Europeans from ten countries for an average of almost nine years, showed that high consumption of fruit and vegetables is associated with a reduced risk of colon cancer.

My conclusion is that, from the health point of view, there’s plenty of evidence to suggest we should lower our consumption of animal products (especially red and processed meat) and increase our intake of plant-based foods, especially fruits and veggies.

No discussion of plant-based diets (as opposed to animal-based diets) is complete without getting into the impact our eating habits have on the environment, but that’s for another post.

Dr. Ayala

Vegans, vegetarians, diets and health

I’ve stated in my short bio here that I’ve been a lifetime vegetarian, and many assume that vegetarianism is part of my “healthy lifestyle” philosophy. Well, it is and it isn’t.

Let’s start with a few common definitions--these definitions of course fall short of describing the full range of dietary practices of those who restrict animal products from their plate, and there are many variations not covered by these rather simplistic definitions.

Vegetarians exclude meat and fish from their diet but do eat dairy and eggs. Vegans exclude all animal products, including meat, fish, dairy and eggs. The terms “vegetarian” and “vegan” are not interchangeable from the nutritional science point of view; the two diets are quite dissimilar.

Vegetarians and vegans choose to abstain from animal products for a variety of diverse reasons, ranging from health advantages and environmental priorities, to ethical and cultural considerations. Vegetarians and vegans tend to consume more fruits, vegetables and whole grains than their meat- and fish-eating friends (although that’s not always the case, and there are junk eaters among them too).

The American Journal of Clinical Nutrition is publishing a plethora of papers on vegetarian, vegan and plant-based diets and their effects on health as part of an upcoming supplement, so it’s a good time to take a look at the latest research.

A paper by Professor of Nutrition Winston J Craig, summarizes the current knowledge of vegan diets and offers some practical dietary recommendation for vegans:

• Statistics: Vegans comprise 1.4 percent of the American population (by a Harris Interactive poll), and their numbers are growing.

• Cardiovascular disease: Vegans are thinner, have lower total LDL cholesterol (the “bad” cholesterol), and modestly lower blood pressure. In general, both vegetarians and vegans have a lower risk of cardiovascular disease.

• Cancer: Although some studies suggest that a vegan diet is associated with lower risk of several cancers, this article sums it up in:

“To date, epidemiologic studies have not provided convincing evidence that a vegan diet provides significant protection against cancer”.

• Bone health: Vegans typically fall short of recommended suggested daily intake of calcium (calcium sources for vegans are green leafy vegetables, tofu, tahini, etc., none of which is as abundant as dairy products), and some studies show that bone-mineral density in long term vegans is lower. On the other hand, for those vegans who do consume adequate calcium and have enough vitamin D, bone fracture rates are the same as for omnivores.

• Iron: Contrary to common belief, the risk of iron-deficiency anemia is no larger for vegans than it is for omnivores, and vegans’ hemoglobin levels aren’t any lower.

• Vitamin B12: This vitamin is present only in animal products, and is therefore lacking in an un-supplemented vegan diet. Vegans do have a higher prevalence of B12 deficiency, and vitamin B12 needs to be added to their diet regularly in fortified foods or supplements.

Craig calls for further research to study the effects of a vegan diet on diabetes, cancer and other chronic diseases, and concludes that on the basis of our current knowledge, a vegan diet has no significant advantage over a vegetarian one regarding chronic diseases.

I for one don’t think the evidence is really there to convince a meat lover to change his habits for health reasons—although the evidence to support a diet rich in fruits and veggies and whole grains is convincing, there isn’t great proof that consuming quality meat in moderation is harmful, and eating quality fish is healthy.

Sure, there are studies that show a correlation between vegetarian and vegan lifestyles and lower incidence of several chronic diseases, but the evidence is far from conclusive, and there are many confounders in the study of a self-selected group, such as vegetarians and vegans.

I believe that most traditional diets, based on mostly plant food have proven themselves over time to be healthful. Indeed, people can thrive on many different diet regimens. The one diet that’s proving to be detrimental to health is our current Western diet of highly processed foods, fast foods and junk.

One hallmark of the American diet is very high consumption of animal products and especially meat (about half a pound of meat a day). What’s even worse is that most of those animal products come from animals raised in feedlots on a diet that’s unnatural to them (grains and even animal by-products, instead of grass, in the case of cows) and regimens of antibiotics and hormones.

So what’s my story?

My dad turned vegetarian when, as a kid, he saw a chicken slaughtered. When I was a teeny toddler my dad told me where meat comes from. He also told me that almost everyone eats meat, but he thinks animals do have a desire to live, show attachment to their young and do experience suffering.

I was convinced, and never tasted meat. I am concerned about animal welfare, and I think cruelty to animals—expressed in the extreme in feedlots and industrial slaughterhouses—has reached a point in which most people would be appalled if they actually saw where their meat comes from.

I admit it…for me it’s easy. I have no desire to eat meat and don’t even think of it as food, because I don't have a habit of eating it.

This is my anecdotal proof that what you feed your kids when they're young has a profound impact on their eating habits. I haven’t gone any further than my dad did with animal welfare. I do eat cheese and eggs. I’ll try to buy from producers that raise their animals in a humane and sustainable way, but I do realize that it's very difficult to give up foods you enjoy, were raised on and are part of your tradition. I don’t think I’d likely give up dairy completely, even if there were evidence that abstaining from it might benefit my health somewhat. After all, there’s risk everywhere; avoiding risk to the point of not enjoying yourself is risky too.

Every diet is characterized by what foods are eaten, not only by what’s excluded. At this point I think there’re plenty of reasons for everyone to eat more fruits and veggie—like the vegans do; it may turn out that the health benefits seen in vegans and vegetarians have more to do with what they eat, and not what they exclude.

There’s much more to talk about concerning vegetarian and vegan lifestyles, and I haven’t even touched on the environmental reasons against meat production, which are pretty compelling. But that’s another post.

In the meantime I welcome your perspectives.

Dr. Ayala