Paging Dr La Puma

May13

Final Week: First Med Student Clinical Elective in Culinary Medicine

Posted in: Common Conditions, Food FAQ's, Wellness and Health

Last week I finished teaching and supervising the first medical student clinical elective in culinary medicine…and credit was given! Awesome!

Each day had assigned reading (peer-reviewed papers, book chapters from my ChefMD’s Big Book of Culinary Medicine) and viewing (culinary medicine FAQ from viewers and readers, Tulane University basic nutritional science review from their new Center for Culinary Medicine, and more).

As a parting present, I gave a become-an-olive-oil-expert taster, to the right: tiny quantities of differently infused oils (garlic, basil, fig) in tiny quantities: it’s also available online. Identifying flavors is something we’ll do more of next time, especially with herbs and spices. We did identify fava bean maturity, and note the way nutritional content, flavor and texture change as the bean matures (mature fava beans can be planted too).

The week was divided into one basic topic area per day:

1. Hospital and Clinic (seeing patients, meeting other med students);

2. Home, Garden and Kitchen (harvesting, cooking techniques and dish creation, presentation, clean up, with food safety and recipe reading and development);

3. Organizations and Community (participation in Foodbank teaching, food advocacy initatives, and food literacy classes);

4. Research and Writing (curriculum critique, study of questions which arose during the week, work on assigned projects);

5. Menu Analysis and Eating Out (read-between-the-lines assessment, how to order and taste, deconstructing flavors and texture, portion size, control and rate of eating);

6. Shopping (farmer’s market tour, farmer interviews, buying, seasonality, comparison with grocery store fare and products) and Conclusion (final turn in of projects and papers).

7. Rest.

We also integrated personal exercise into this, and that’s something we’ll do more of next time too: so important for students to know what they are asking patients to do. Although Santa Barbara is a paradise for walking, running, climbing and more, many of my own patients prefer to get their exercise inside, so they can count their numbers, which I fully support. Many of you know that I love the Smooth Fitness CE-3.6 Elliptical Trainer; the Sole E35 I previously recommended is sold out.

I don’t have the final numbers yet, but the elective appears to have provided about 60 contact hours in two weeks with 17 faculty members from 6 different disciplines: Internal Medicine, Professional Cooking, Nutrition, Public Health, Community Leadership, Organizational Development. You can read about Week 1 here.

The photo to the right is one idea of how culinary medicine relates to 3 of its contributing disciplines.

Although I believe that it is logically a part of medicine and medical practice, it may be that the people to undertake its refinement and day to day application are actually chefs and cooking instructors, more than physicians or nutritionists or dietitians.

Chefs meet people where they eat, and as more and more of our budget goes towards eating out, it is clear that cooks and chefs outside the home will continue to have an outsized effect on how people eat and choose food.

This, of course, is despite my own, Michael Pollan’s new excellent Cooked book, and Mark Hyman’s exhortations that the key to health is learning to cook. I think it is still the key: but it takes time and skills that the culinary medicine elective teaches.

But who should be its students, leaders and champions? And what should it do? Stay tuned.

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Oct24

Interview: People’s Pharmacy on NPR and My Research Sources (Accessible!)

Posted in: Food FAQ's, Obesity and Weight Loss, Wellness and Health
I had the privilege of again speaking with Joe and Terry Graedon of People’s Pharmacy for their legendary podcast and national NPR show. It will be broadcast on December 8, but stay online. We covered a lot:

*how and why I think culinary medicine offers real value to people

*what (and how) women can say to men about their health

*healthy eating for healthy holidays (and weight loss thereafter)

*lowering cholesterol with your diet, and

*the top 4 Food and Nutrition Stories of 2012: what you need to remember

I did a lot of research and preparation for it, and I’ll be unpacking it for weeks. Here are a few quickies.

What women can say to men about their health and diet especially is sometimes touchy. Men want to get healthy, be strong and lean, and take care of themselves.

They just do it differently than do women. Actually, some men just do more steps (with the Precor Treadmill– my favorite). Or the Livestrong Elliptical (ditto). And keep track using the Timex Global Trainer Speed and Distance GPS Watch. Which is also awesome.

Women can help men who are reluctant to see the doctor or lose weight: they just need the right language. I’ll cover more of this on http://manlyeating.com, and in my new book, with a revolutionary new approach to men’s health, next year.

Some cholesterol, statin and supplement answers are in my published ChefMD book (about culinary medicine) and my 5-DVD set . My sources are ones you can use too:

1. Latest in Clinical Nutrition, 2012: Volumes 1-10 (12 DVD Set)

2. Food and Nutrients in Disease Management

3. Advancing Medicine with Food and Nutrients, Second Edition (nb: will be released 12.12)

And on the web
1. www.naturaldatabase.com (regularly updated by pharmacologists and other scientists).
2. www.pubmed.gov (all peer-reviewed stories, with good filters)
3. www.lpi.oregonstate.edu (tremendous science, especially about cancer and immunity, part of my Dr Oz Show appearance).
P.S. Thrillingly, the Dr Oz Show put the ChefMD book in the running for the New York Times best-seller list—again! We’ll see shortly: until then, the Honeyed Chinese Chicken recipe he and I prepared is free, if you’d like to receive my Paging Dr. La Puma newsletter, “Healthy Bites“.

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Aug11

Basic Food as Medicine

Posted in: Food FAQ's, High Cholesterol, Media, Wellness and Health

I had the privilege of speaking with Joe and Terry Graedon, founders of The People’s Pharmacy, on their syndicated NPR show (free podcast here) broadcast today)!, about how we’re trying to make your health and health care awesome with the right food.

Their questions made me think about why it’s so important to help people wherever they are starting.

For example, I love farmer’s markets. I give market tours, I know many farmers personally, I created a PBS DVD library on how to eat healthy (available for a donation to PBS, which I support) and I love to cook locally grown foods.

But most people buy food shipped into supermarkets, and are worried and time-pressed about cooking.

So it’s become more important to me to show how to buy and cook any broccoli, even bad broccoli (as Mark Bittman writes) than to search out the most pristine, tight head. Or to explore the wonders of the youngest broccosprouts (highest in sulforphane, and patented by Johns Hopkins).

Getting people to cook more–and people are catching up and catching on–is the key to helping them lose weight. Especially men.

Thousands of people (according to my Dear ChefMD e-mail!) want to change their cholesterol, blood pressure, back pain, constipation, irritable bowel, heart disease and diabetes. And those who have have great stories.

So if you were going to stock a kitchen medicine chest, like the one I describe in the ChefMD book, and you wanted just 10 foods instead of the 50 I name, what would they be and why? Here are mine:

Broccoli: detoxify carcinogens, reduce estrogen levels

Chilies: faster metabolism, better control of diabetes

Dark Chocolate: lower blood pressure, improve insulin sensitivity

Cinnamon: lower LDL cholesterol, improve insulin sensitivity

Fish: fewer heart attacks, fewer strokes

Garlic: less stomach, colon and rectal cancer; lower blood pressure

Nuts: lower cholesterol, improve satiety

Walnuts: protect brain cells, protect interior arterial linings against junk food

Wine (sensibly): raise HDL (healthy) cholesterol, reduce risk of heart attack, peptic ulcer disease

Yogurt: lower risk of antibiotic related diarrhea; reduce irritable bowel syndrome symptoms

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Feb20

IACP Cookbook Awards: Health. Somewhat.

Posted in: Diabetes, Food FAQ's, Wellness and Health

The International Association of Culinary Professionals (IACP) 2012 Cookbook Award Finalists have just been announced. The IACP has never been terribly interested in Health, seeing cooking as a master craft, and health as something to put up with.

I feel lucky to have been invited to speak in Portland at the national annual IACP meeting two years ago, on culinary medicine. The audience loved it. Or maybe it was just David Briggs’ gourmet chocolates for free (just mentioned in the Wall Street Journal as a taste of Portlandia).

But with these books, and with the upcoming annual conference, there’s just the faintest lessening of daylight between cooking on the one hand, and health on the other, in the peri-Chew culinary world.

(though tellingly, when I googled “iacp new york conference 2012 health track”, the top two hits belonged to the International Association of the Chiefs of Police).

These books, though, make health taste really, really good: check them out.

Ancient Grains for Modern Meals
Author: Maria Speck (finally, what to do with whole grains!)

Food Intolerance Management Plan
(already a hit in Australia, and just being released in the U.S: resembles the Specific Carb Diet approach)
Authors: Dr. Sue Shepherd, Dr. Peter Gibson

The Sweet Life: Diabetes Without Boundaries
Author: Sam Talbot (a rockstar chef, and Dr Oz guest)

For those who believe that butter and salt are actually techniques, and not merely ingredients, as does IACP keynoter, former CIA instructor, writer and entrepreneur Mark Ruhlman in Ruhlman’s 20, here are the IACP Cookbooks of the Year for 2009, 2010 and 2011. Enjoy!

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Sep21

5 Quick, Simple Ways to Use the Odd Bits of Veggies

Posted in: Aging and Costs of Aging, Food FAQ's, Obesity and Weight Loss, Recipes, Wellness and Health

Everyone knows that odd bits of an animal are simply offal.

But the odd bits of fruits, vegetables and legumes are rich. Rich in most of the vitamins, minerals and phytochemicals packed into produce.

Good cooks will want to know what’s in those odd bits, and use them, instead of tossing them down the disposal, into the compost or on the landfill. Plus, you paid for the whole plant…why not use it?

Here are 5 quick, simple ways to use chard stems, citrus peels and squash innards.

1. Sauté finely chopped chard stems and greens with garlic and onion in olive oil, until soft; add balsamic vinegar, salt and pepper and Tabasco to serve as a side dish

2. Sauté finely chopped chard stems with onion and garlic for any saute or soup base, or with sweet potatoes, milk and gruyere in a gratin

3. Puree whole organic lemons, quartered and unpeeled, with seeded watermelon and a touch of agave nector for an agua fresca

4. Add whole organic lemon and orange peels, before or after zesting, to a sangria, with peaches, benedictine, grenache and cointreau

5. Scoop out pumpkin, hubbard, kabocha and acorn squash seeds, either after roasting the split halves, or before. Rinse the seeds of most of their strings, sprinkle with salt or curry powder, roast in a single layer at 400 degrees for 10-12 minutes on a sheet pan, for a snack

Chard stems are tender when sliced thin and cooked well, and stuffed with insoluble fiber. They help things run smoothly.

Citrus peels contains higher concentrations of flavonoids than the actual pulp. Just beneath the skin is the white pith, rich in pectin and other insoluble fibers, which improve satiety.

Squash seeds contain the potential of the whole plant. Crispy, spicy and crunchy, they supply something that’s often missing in good-for-you food: texture and flavor. The seeds are protein, calcium and zinc rich.

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