As I mentioned last time, I have a dog who has cancer and we are dealing with that as best we can, part of which is giving him a chemotherapy drug. He’s 14 years old and we decided we would not do any invasive procedures at all (ie, surgery) and if he doesn’t tolerate the chemo well we will discontinue it, but this week I had an experience that was harrowing because of its implications, both for our pets and for us as humans who must visit doctors.
This is Karloff:
Karloff had visited the oncologist our vet recommended, and she prescribed a drug called Palladia for his cancer. This drug is so toxic they tell you to wear rubber gloves when you give to to the dog and to keep the dog from licking you while he is taking it, so we know it is pretty strong stuff.
We gave Karloff his first prescribed 80mg dose of Palladia Wednesday with dinner. Thursday morning, out of curiosity, I was reading about the drug online and I saw that Pfizer recommends a far lower dosage for a dog Karloff’s size so I called the oncologist to make sure the amount is what Dr. XXXX wants us to give Karloff. Dr. XXXX wasn’t in but Dr. ZZZZ told me it was not correct and I should bring Karloff in right away, which I did. She ran a blood test, which apparently came back okay, and she apologized for the error, which she realized was a very serious one; if I hadn’t caught it, we would have given Karloff 80mg each time instead of the 35mg he is supposed to get. (She said she thought the dosage had been miscalculated as mg/pound instead of mg/kg like it is supposed to be.) She also prescribed an antacid for any stomach issues for the next week, and she tried to contact the manufacturer to see what they had to say about overdosing with this drug, only to be told that they were “all in a meeting”, something which boggles my mind, given the size of Pfizer.
Dr. ZZZZ was great about all of this, and I thanked her for seeing Karloff right away and I told her that I did not blame her for someone else’s error, but I asked her to express my extreme displeasure about this to “whomever was responsible”, and I also asked her if she could see if they could institute some sort of protocol to prevent this from happening again to another client. Karloff seems to be tolerating the 220% overdose of the chemo okay, but many dogs might not have handled it as well, however the really serious issue here is this: what if the client hadn’t decided to read up on the drug and hadn’t checked the vet’s math? How many people do that, anyway? Then the dog would have been getting the overdose for the entire course of chemo – at least until the next visit when the mistake might have been caught, but maybe it wouldn’t, either.
Where this assumes more importance than just somebody on a blog talking about his dog who has cancer is that in humans mistakes like this are one of the leading causes of death in the United States. (Third highest, to be exact.) When I first read this I was astonished and I had a hard time believing it but now that I have had a firsthand experience with it I can see how even the most qualified people can make errors and the implication is disturbing. Take a look at this study to see what I mean. And here is another article on the same topic. There are people who claim this is all fearmongering paranoia but after my own experience this week I can’t take them seriously.
I would encourage anybody who is taking medications to review them and make sure the dosages are correct!
*Iatrogenic death means death caused by the doctor.
Here’s one of Mrs. Tyrannocaster’s easy summer recipes, another great side dish like her roasted peppers.
Since I’ve pretty much given everything away in the picture above, let’s get right to it.
Mrs. Tyrannocaster’s Onions & Balsamic Basil
Ingredients
3 large red onions, sliced
1 cup packed fresh basil
1 tablespoon balsamic vinegar
3-4 tablespoons avocado oil
Salt & pepper
What To Do
Toss the onions with 2-3 tablespoons of oil. Roast for 20 minutes at 400F. (You might want to use a lower temperature if you are not using avocado oil, which has a high smoke/oxidation point.) Stir, add more oil if needed; cook another 10-15 minutes. Add balsamic vinegar and cook until soft and sticky, 5 minutes. Stir in basil, which will wilt; add salt & pepper to taste and serve immediately.
Here are the onions after they have cooked for a while, with their added balsamic vinegar:
Here is the added basil:
The finished dish, ready to serve:
With a meal:
Top left, vampire-resistant aïoli. Clockwise from the meat: Pastured lamb steak with vermouth and thyme glaze; the onions; shredded red cabbage and carrots sauteed in lard with sesame oil and wheat-free soy sauce; baby asparagus roasted in avocado oil. – Mrs. Tyrannocaster
In the 1980s I used to see adds for a new “superfood” – amaranth, which was advertised as the “mystic grain of the Aztecs”. This became a standing joke in our household, one which still pops up from time to time. There’s just something funny about the marketers’ attempt to sell this starchy food as a breakfast cereal by tying it to mysticism and feathered serpents that naturally invites mockery.
Amaranth is a grain (mystic or not), and I won’t eat it now. There’s nothing in any grain that I can’t get from vegetables and meat, and there is a lot in grain that I don’t want to get; gluten, gliadin, zein, avenin, lectins, and so forth. These proteins have one thing in common: they cause inflammation. And they do it to everybody to some extent, although some people are affected more than others, and some proteins are worse for some people than others.
There is a common meme among the paleo eaters of the world that a percentage compliance of 80/20 good/bad will get you the most benefit for your effort. Whether this is true or not, when it comes to trying to improve your health it makes sense to pick off the weakest pack members (hunter analogy) or harvest the most low-hanging fruit (gatherer analogy) first. In terms of general health, that is, discounting specific problems like your acromial impingement or tennis elbow, I think the most effective targeting strategy is to reduce inflammation in your body. This is a great idea because at the same time you address the causes of so many potential problems – joint pain, fatigue, multiple skin conditions (including dandruff), and mental problems like fog (possibly even dementia) can often be tied directly to inflammation, and excess weight has a relationship with inflammation as well.
Personally, because of the problems I experienced with wheat and all of the nasty ingredients in it, I don’t even try to go for the 80/20 protocol where it is concerned; I have to stick to 100/0 because if I don’t, I get in trouble. Right away. That acts as a reminder for me and an incentive to try to take the same approach to the other inflammation triggers that I know about. There are three broad classes of these, and they are the ones in the graphic above: sugar, grains, and vegetable oils. The order doesn’t matter; they all important.
Reducing (eliminating would be better) our intake of these is probably the most useful health strategy we can employ in terms of what we get back for the effort.
Eat Sugar For Energy?
Sugar is everywhere; it’s literally omnipresent. And if you’ve read any of my earlier posts about Sugar Information, Incorporated, you know that this is no accident. Sugar is made from federally subsidized crops, so we are all paying to keep it cheap, just as we pay to keep wheat, corn, and soy cheap, as well as many other crops. But let’s stick with sugar right now. We are all aware of the sugar in soft drinks (or I hope we are), but many of us don’t realize that those helpful food labels carefully manipulate the ingredient lists in such a way that the sugar in other products is often hidden by virtue of its multiple appearances under different names. The sugar lobby is fighting tooth and nail to avoid having a category of added sugars listed on these labels because that would tip their hand, but let’s gloss over that for the moment.
Here is a list of extra sugars that you can find on food labels. Because ingredients are listed in the order of their volume, if you see any of those in the top percentage of the list you know you have got a fair amount of less-than-visible sugar. Of course, the advisability of eating anything with a long list of ingredients is questionable, but perhaps there is some food product out that that meets the test.
Dr. Robert Lustig really has a bee in his bonnet about sugar, but he has a point; the stuff is nasty. He has several YouTube videos if you don’t like reading printed matter, but his books are worthwhile. He focuses his attention on sugar to the exclusion of other possible contributors to the obesity epidemic (and while I believe there are several, sugar is a big one), but aside from that I think he’s spot-on. If you view his work as a critique of sugar itself and not an overall analysis of why we get fat then his books and videos are absolutely invaluable. Short version: eating sugar in the quantities that we do leads to inflammation. And we do eat sugar in quantity: 156 pounds per person per year. But “only” 29 pounds of of that is in the form of table sugar; the rest comes in the form of sugar in the processed food we eat and drink.
So perhaps the topic of “paleo desserts”, which you will see everywhere on the net, is something of an oxymoron in health terms. But people like sweets and once you’re addicted to something it’s hard to give it up. Boy, is it hard. My great-grandparents ate a small fraction of the sugar that the average American today eats, and in their time the biggest cause of death was infectious diseases. Western medicine has done a good job on those and today, our biggest health problem is chronic diseases, most of which are directly related to what we eat. And we are not eating what my great-grandparents ate. That results in conditions like obesity, diabetes, arthritis, and others, most (if not all) of which can be tied directly to our diet.
Short version: if you’re going to start with anything, start with sugar. But don’t stop there, because grains are just as bad in their own but more subtle way.
“Healthy” Whole Grains
Again, these tend to be subsidized crops which we pay to keep cheap so manufacturers can add them easily to our food. If you visit your local supermarket and don’t prowl the outside of the store but instead walk through the maze of aisles and freezer compartments, take a look around you and make a note of how much grain there is in everything; it’s astonishing. Almost everything that comes in a box has wheat in it to some degree, unless it has corn.
This is not an accident; wheat has so many great properties from a seller’s point of view that they can’t resist using it: it makes you want to eat more because of the effect it has on your brain, which mimics hard drugs albeit in a much less potent way; it is so cheap for them to add that its inclusion costs virtually nothing in the context of the product itself, and in fact the advertising and packaging for the product probably cost more than the ingredients by quite a bit; the texture that gluten imparts makes for great mouth feel in breads, crackers, and others; it thickens liquids very nicely, and it acts as a cheap extender to replace more costly ingredients.
What’s not to like from the perspective of the American Tobacco Company, now owner of Kraft Foods but also the company behind that incredibly offensive ad campaign for Tareyton cigarettes that I have have already profiled. The thought that the tobacco industry moved into industrial food after it got burned so badly by the states’ lawsuits (which inflicted some real damage to them for the first time) should make you pause to think: how did this industry behave when it was in control of tobacco, a product that we knew at the time was dangerous? Is there any reason why they should change their behavior when the financial motives that applied to tobacco then are exactly the same now?
Anyone who needs proof of the harmful effects of wheat (and the mechanisms whereby they are produced) can go to Dr. Davis’ Wheatbelly site and certainly find it. But wheat is not the only suitor in this engagement from hell; for various reasons, it’s best to avoid the other grains, too. I referred to zein and avenin earlier – they are the gluten equivalents found in corn and oats, respectively, and the more you dig into this subject, the deeper it gets. In the end, I decided that I would just skip the whole issue and get my carbohydrates from vegetables because as I also mentioned earlier, there isn’t anything in grain that you can’t get from vegetables and meat; in fact, the nutrient density of vegetables and meat is far, far higher than that of grains, but without the antinutrients in grains (such as phytates, which actually prevent your body from utilizing minerals – how useful is that?) and without the concomitant weight gain, which none of us needs these days.
These grains were a lifesaver thousands of years ago when people needed a way to feed populations that were getting bigger and bigger and more and more sessile – in other words, cities. But we paid a huge price in health for the advantages we got so the bargain was not quite the deal we thought at the time. Advantageous in the short term, in hindsight it has become something of a lemon of a buy in the long term because we got smaller, our facial structures changed (causing problems with our teeth) and our problems with degenerative diseases ramped up. It’s interesting to read about Ötzi, the so-called “Ice Man” found in the Swiss mountains in 1991, and learn that he ate grains and had lousy teeth 5,000 years ago. And yet many, many fossils of primitive people do not suffer from this; in fact, Dr. Weston Price has documented 15 or 16 so-called “primitive” societies that had survived into the Twentieth Century and yet had excellent dentition and health. His book Nutrition and Physical Degeneration is a must-read for anyone interested in the subject. The final word on grains’ impact on the health of early peoples comes from the ancient Egyptians, most of whom were not affluent enough to eat large quantities of meat. There, you find folk subsisting mostly on grains (and beer, which is made from grain) and leaving behind a trail of mummies with bad teeth, periodontal disease, arthritis, diminished physical size, and many other characteristics that accompany a lousy diet. It’s in the archaeological record, people.
As a side note I should add that soy, which I haven’t really spoken about here because it is not technically a grain (it’s a legume) is another problem food which is, you got it, subsidized. Until comparatively recently soy beans were only used to replenish the soil during an off year when the farmer wasn’t growing a productive crop. Their weird estrogen mimicry in the body makes them a food I’d rather do without.
Oil From Plants
Well, some of them, anyway. A couple of them turn out to be pretty good for you but except for olive oil they aren’t the ones you usually hear about.
The third corner of this subsidized Devil’s Triangle is vegetable oils. Corn is so heavily subsidized that the state of Ohio practically exists to serve it; what a great deal corn has gotten for itself! (So says Michael Pollan, anyway.) But corn is only the second biggest crop in Ohio; our friend from a couple of paragraphs ago, soy, is the biggest. Iowa is the state where corn is number one; this otherwise uninteresting fact gains new meaning when you remember that Iowa has an unfortunate influence politically by virtue of our peculiar system of primaries; in America, the farm lobby can keep someone from becoming president because Iowa’s primary is the first one in the country and nobody runs there that the lobby (which gives to both parties) won’t accept. [Note: Iowa grew 13.1 million acres of corn in 2012, but only a tiny fraction was sweet corn. The same source shows that in 2007 Iowa only grew 3,500 acres of sweet corn. Sweet corn is usually not GMO, while feed and ethanol corn almost always is. Think about that.] Corn oil, soybean oil, canola oil (which is actually rapeseed oil, only how good is that for PR?), safflower oil (which until the 1960s was used mostly by the paint industry!), and of course, their unholy stepchild margarine, are all made from subsidized crops and they all oxidize easily, turning to toxic substances when heated or exposed to the air for too long. (Even exposure to light will oxidize them but they still get sold in clear bottles that do nothing to prevent it. What matters most here?) This causes inflammation when living creatures ingest them (zombies may fare better but that’s a different story and there haven’t been a lot of studies yet on the effects of trans fat consumption among the undead anyway) and then we are back to the litany of so-called “civilized diseases”.
These oils are high in Omega-6 fatty acids, with soy being the biggest source. Omega-3 fatty acids, which come from fish and pastured animals, used to be found in human diets in much greater proportions that they are now; from a near 1:1 ratio long ago they are now in the range of 20:1 [O6:O3] or even higher, depending on your source. More inflammation. The mechanical process which is used to produce vegetable oils uses high pressure, which produces heat, which guarantees some oxidization. Canola oil has a better ratio than the others here, but it has its own problems. Take a look at this video, which is sponsored by the industry:
Don’t you feel better now? Love that “don’t eat saturated fat” message. Believe it if you want to. This is a great example of the way industry slants its message. “The producers of canola oil have your best interests at heart” – would you believe that if you knew who was saying it? “We don’t need to eat fast foods that are not made with canola.” Some of us might argue that we shouldn’t be eating fast foods at all, but let it go. Bottom line here (reinforced by the text at the bottom of the video): eat less fat. Nobody should go overboard on anything, but it’s not that simple.
At first I found it hard to tell friend from foe when it comes to oils because there are so many of them and like the rest of us I grew up hearing that fats are bad for you anyway. Rather than running it all down here is a link to a reasonable summary. The short version is that you can (and should) eat (not necessarily in order) these oils/fats, many of which have been demonized by groups that should know better.
and some others, but also other sources of fat such as pastured eggs, and wild fish. More info here.
If you have not already read it, I recommend getting a copy of Nina Teicholz’ book The Big Fat Surprise from your library and spending some time with it. When even Time magazine is running pictures of butter on its cover and saying “Eat Butter” you know the times they are a-changin’. (Registration required for the full article, alas, but if you search around the net you can find the entire text. However, the video does not require registration and it’s not bad, especially from a mainstream publication.)
The war on fat has had a lot of casualties over the years, including my own father-in-law, who did his very best to eat no fat, eat lots of “heart-healthy whole grains”, exercised like crazy, and yet died of pancreatic cancer, a cancer which is made much more likely on a low fat, high carb diet because of the way it stresses the pancreas. As far as I am concerned, he was a victim of iatrogenic disease, or “doctor-caused disease”. But just look around you; look at all the obese people in America and remember that most of them are not lazy slobs who simply don’t want to eat right; most of them are trying like crazy to lose weight…by eating the way their doctors tell them to. Only since their doctors don’t know anything about nutrition their success rate is abysmal.
¿uǝddɐɥ sıɥʇ pıp ʍoɥ ¡uʍop ǝpısdn sı pןɹoʍ ǝɥʇ
I think that the causes (note the plural) are so complex that there is no solution, there are only incremental actions that we can try to take and most of them will have little or no immediate impact. First of all, we can try to eat the way we think is best and stick to our philosophy, voting with our money. At the same time, there will, of course, be vegans and low-fat dieters doing the same thing, and a majority of people ignoring the entire issue, so the impact of a few paleo eaters isn’t going to make that much difference. But we can make a huge difference on our own lives, just as I have already done with mine.
More importantly, and this is where my speech here becomes “inflammatory”, I believe we have to change the political and financial environment that makes these three inflammatory commercial powerhouses so strong: we have to change the subsidy program that literally feeds them, and to do that we probably have to change the way our primaries are scheduled to remove the death grip Iowa has on our national elections. I don’t see anything less having an effect, but I am also realistic enough to know that the chances of this are…well, they suck. But this will be a bottom-up movement, not one from the top down, so I guess it’s a little less disheartening to know that I’m on the bottom. And you probably are too, if you’ve managed to read this far.
What would those Aztecs think of us, I wonder: millions of people too fat to run, millions of people too sick to climb trees, millions of children with diabetes that could have been prevented by eating different food, and millions of unnecessary deaths. And we see them as bloodthirsty murderers who idolized pagan gods.
This devastating image is the leadoff picture in a new article in Businessweek about Coca Cola’s declining sales. Admittedly, Businessweek is part of Bloomberg’s empire and thus has no love for sugar-infested sodas so perhaps it is not the most neutral reporter on the case…but this picture is far more damaging to Coca Cola than the article because it really does do more than a thousand words could. Nice job, Mr. Parkins: two claws up.
There was a fascinating tidbit that slipped out in the article: “Next year the company hopes for a national rollout of Fairlife, milk in which the molecules have been disassembled and then reformed to create different variations (high-protein, lactose-free milk) that taste like the regular thing.”
I suppose we’ll all line up, clamoring to drink our refreshing disassembled molecules…or maybe not. I think that instead of calling this milk we should call it bilk.
The first time I ate some raw garlic I didn’t know any better; I grabbed a big clove, peeled it, stuck it in my mouth and chomped down on it. Then I started chewing. Here is an actual photo of me thirty seconds later:
Well, I learned a lesson, didn’t I? This stuff is really, really potent in its raw form. That’s what makes it such a good (and interesting) addition to your medicine chest because it works on bacteria that you don’t want in your system, even including viruses, and that’s something that antibiotics can’t do. For me, that last bit of information was a real eye opener.
The first time I heard about using raw garlic from what I would consider to be a credible source was when my naturopath told me she had stopped a sinus infection with it. This got my attention, because I have a history of these, or I should say I had a history of sinus infections when I was still eating wheat; I haven’t had one in the three years since I stopped. So I did some reading and found that people claim it cures just about anything. Immediately, my skepticism kicked in because you find the same thing about everything from vitamin E to Kombucha. I like Kombucha and I make my own, and I even see some health benefits to it, but come on – some of the claims are preposterous and it’s hard not to feel the same way about garlic. But garlic has a lot going on for it.
First, there’s that interesting notion that it can kill viruses, something that antibiotics cannot do. And fascinatingly, it even acts on resistant strains of bacteria that have developed in response to the use of antibiotics and the bacteria are not able to develop resistance to the garlic because it does not operate the same way biochemically that the antibiotics do (apparently it even kills MRSA, the resistant staph bacterium you may have heard about); this is cool, indeed, even if they are only speaking of direct application to the bacteria, which is unclear to me in the reference.
Hence my experience above. I had felt like I was starting to get a sore throat, so I gave the garlic a try. It really did feel like the cure was worse than the disease, what with all the steam coming out of my ears, the flashing purple light I saw, the bells ringing in my ears, just kidding – but it was too strong for me to do on a regular basis. But then I noticed that the sore throat never progressed. Right, it’s just anecdotal evidence but I found it intriguing. (If I say “I broke my leg” it’s just anecdotal evidence, too, but the leg is still broken. You have to start somewhere.)
There is an immense amount of material available on garlic so I won’t load this post down with more links when you can probably Google sites tailored to your specific interest – I am more interested in trying to figure out how to eat the stuff raw. It doesn’t do you any good medicinally if you cook it, but in its raw form it’s pretty corrosive when you try to just eat it. So further experiments were necessary.
While a lot of people like to eat it in salsa I find that the easiest way for me to take it is mixed with fat, and in my case that would be mayonnaise. We make our own mayonnaise because all of the commercial products we have access to are made with soy, a “food” that I want nothing to do with. While I wrote of my frustration with trying to make mayo using MCT oil we don’t seem to have such problems with olive oil and if you use very light olive oil the result tastes a lot better than the bitter mayonnaise you get with extra virgin oil. And since I love aïoli using garlic with mayo is a no-brainer indeed. For me, the best way to eat raw garlic is to mash a good sized clove in the press, let it sit for 15 minutes (this step increases the production of allicin, one of the Good Guys in the story and without a doubt the inspiration for Elvis Costello’s song) and then mix it with a tablespoon or so of mayonnaise and some salt. Then I eat it with a meal. For me, raw garlic on an empty stomach is not a good thing, so I always eat it with some food.
A blob of mayo with garlic in its natural habitat:
Note: the wide angle lens makes that blob look bigger than it really is. I like mayo, but come on!
Clockwise from the mayo: Tri-colored carrots and chopped red onion simmered in butter with mixed herbs; pastured beef shanks braised with port and root vegetables; romano beans sauteed in butter, salt and pepper. -Mrs. Tyrannocaster
It was so hot last evening that I had a rather small meal, which explains the mingy quantities of food for a dinner. 🙂 I could have also just mixed the crushed garlic with some of the bone marrow you can see next to the shank in back and added a bit of salt but I didn’t think of it in time. That’s delicious, though, and I’ll do that tonight since dinner’s going to be the same entrée.
Important note (besides the mention of fermenting garlic, which is in the comments): use only garlic that you know has not been irradiated. All garlic that comes to us from outside the USA has been nuked. That’s one tangible benefit to buying organic; radiation not allowed.
Stay young and monstrous.
Also…Välkommen till alla mina nya besökare från Sverige! Mina farföräldrar kom från Sverige i slutet av 1800-talet, men tyvärr talar jag inte svenska. Jag hoppas att du tycker om min webbplats. (Thanks to Risto of Rikstone Amps for translating that for me.)
When people decide to stop eating wheat and/or other grains or just decide for whatever reason to “go paleo” their first reaction is often one of confusion about the specifics; what do I eat? I thought it might be nice to talk about how we address that question, especially since it seems like many people don’t cook from scratch. To this end, I’m going to get Mrs. Tyrannocaster describe a couple of our meals and I’ll also offer up one of my favorite recipes.
I have side dishes on the brain (as opposed to dishes made with brains). They are incredibly useful when you make enough to get a few meals’ worth out of them, and the variety is endless, just as it is with entrées. One of my personal favorites is bell peppers (although I don’t really like the green ones that much) and I thought I’d give them a mention here.
Assuming you don’t have a problem with peppers of this sort, which are members of the nightshade family and thus a potential issue for some people, peppers are a very good way to get some color onto your table and some micronutrients into your body. I hate all those posts that enthuse about antioxidant-packed powerhouses and all the other buzz words the web loves so much, so I won’t dump a lot of background information on you. I’m just going to assume you’re interested in learning another way to fix these things.
My favorite dish of peppers is also quite easy to prepare so Mrs. Tyrannocaster makes it reasonably often, and I’m going to get her to comment on this whole thing later on. If you haven’t tried roasting these, you have to do it at least once; they are delicious – sweet, juicy and crunchy at the same time, and they are also gorgeous on the plate.
Mrs. Tyrannocaster’s Roasted Peppers (That would bePoivrons à la Tyrannocasteuse, LOL)
Ingredients
3 bell peppers, sliced (Trader Joe’s sells bags of red/yellow/orange organic peppers, which is what we used here)
1 pepper-sized onion, sliced
3 tablespoons avocado oil (This is an expensive oil, but you can find it a Costco at a pretty good price. It has an extremely high smoke point, so it is good for roasting and frying.) If you don’t have avocado oil, coconut oil works well too and adds a sweeter taste, or use what sounds best to you.
Instructions
Slice the vegetables and place each slice into the roasting pan individually, balancing them delicately dump them in:
Add the oil and toss them around so they are reasonably evenly coated. Roast at 400F for about 40 minutes, turning occasionally. Could something be more simple? Here’s how they will look then:
That’s it! Serve them along with whatever you have, but the great thing about this is that if you make enough to last for a few meals you are set for a bit; cooking from scratch takes more effort than using prepared food-like substances, but it’s worth it…if you make enough so that you don’t have to do it constantly. This quantity will give us enough for 4-6 individual servings, depending on how hungry you are. We always try to have three vegetable dishes on the plate in addition to the main entrée; this is really something of a necessity when you don’t eat starchy carbs like potatoes, rice or (of course) bread.
Now, here are the peppers being used for the first time at dinner, and I am going to let Mrs. Tyrannocaster (in italics) talk about the meal itself:
Clockwise, from the meat: Thrifty steak strips! Round steak and sliced onions sauteed in bacon drippings, then simmered in the remaining gravy from the pot roast we’d just finished up; the peppers; sliced kohlrabi sauteed in home-rendered lard with cherry tomatoes and oregano; fresh spinach wilted into butter-sauteed slivers of carrots and diced celery.
And here they are making their second appearance at lunch the next day:
Clockwise, from the meat: Pork belly with an Italian lemon, aniseed and salt rub, slow-roasted in white wine (leftover); spicy pear chutney made with pears from our tree; shredded cabbage sauteed in butter with lots of black pepper and some salt; same spinach as above; and the peppers.
You can see how the vegetable dishes get rotated, so it’s nice to try to have enough of them around to make that possible. This is one reason why we like roasted vegetables; they are so easy to fix and eat immediately but you can have them again later and they reheat nicely – a gift that keeps on giving. Is steaming some broccoli easier? Maybe, but while I love steamed broccoli with good butter on it I need some variety, and roasting seems to provide that.
I like having better descriptions of these dishes than I am able to provide from memory, so I’m going to see if I can’t get Mrs. T to do this more often. And I have another side dish recipe in the wings, just waiting to take a bow. Oh, and an important point: while cooking your food from scratch like this takes time, Mrs. T has a full time job, so it can be done. I think the “secret” lies in making enough so that there are always leftovers.
Thirty years ago, when I went through medical school, we covered nutrition in one single afternoon: “get rid of the darn thing and move on to more important stuff”. I would have hoped things would have gotten better with passing years. They have not. Nutrition (even “useless” main stream nutrition) is paid lip service in medical school. And it is not only medical education: there is a strong feeling among my colleagues that nutrition is a waste of time. I am just finishing a course in tropical medicine and the grain-based diet of many third world countries affects very negatively many diseases because of the massive lack of nutrients of these diets. We were given an excellent lecture about that very subject. It was very badly received and most of the 110 people in the class (I was, as far as I can see, the only exception) bitterly complained about this “useless” course.
This crystallized for me some of the issues that lie behind our current miasmatic state of health. It also made me wonder, first, why should this be the case and second, does it even matter since there is no agreement on what “good nutrition” is? And finally, a third question came to mind: how does this affect the patient who needs help?
The first thing I did was search online and lo and behold a simple query produced a lot of viable hits immediately. It seems that a lot of people are asking my first question.
Right away I found considerable copy which seems to indicate that yes, in fact there is very little time spent on nutrition in medical school. This story says:
Only a quarter of schools have a course dedicated to the subject, and more than half of graduates rate their nutrition knowledge as inadequate.
Nutrition education in U.S. medical schools is lacking, leaving new physicians unprepared to counsel patients about obesity and related health issues, according to a study in the September issue of Academic Medicine.
A steady decline in nutrition instruction is alarming, given rising obesity rates and proven links between dietary habits and chronic disease risk, said Kelly Adams, MPH, one of the study’s authors and an assistant project director of the University of North Carolina at Chapel Hill’s Nutrition in Medicine program.
The Chicago Tribune ran an article which makes a similar point:
On average, doctors receive 19 hours of total nutrition education in medical school; in 2004 the average was 22.3 hours
One survey published in 2003, for example, found that 96 percent of internists and 84 percent of the cardiologists who responded did not know that a low-fat diet, in general, would increase triglycerides in the blood.
“But that’s just a newspaper story,” I thought. What do the people in the profession think? Here is a lengthy thread (15 pages or so) on the subject by educated people in the health care business. What leaps out at me is that there is no consensus at all. There is one person who thinks the subject is woefully lacking in med school, but there is another doctor who feels that doctors’ education is not the issue – obese people are that way because “they just eat too much food that makes them fat”, even going on to say that over-eaters should be taxed because he is having to pay for their healthcare; this is classic blame-the-patient philosophy that certainly doesn’t help and we know now that it doesn’t work at all. A doctor should know better, surely.
I have also read that the American Medical Association has opposed efforts to get more nutrition education into med school, but I cannot find corroboration of that while searching now, and unfortunately, I didn’t bookmark the source at the time; it may have been in print media, anyway. However, I did find evidence of the California Medical Association doing something similar, although it was continuing education, not med school. “Last year, a bill was introduced in California to mandate that physicians get continuing medical education in nutrition (see Nutrition Education Mandate Introduced for Doctors). Unbelievably, physician trade groups such as the California Medical Association came out in opposition to the bill, which would only require doctors to get a measly 7 hours of nutrition training anytime before 2017”
But wait – what if all of this isn’t true? What if doctors are actually taught about nutrition in med school and the rest of us are just behaving like uninformed conspiracy theorists? I found one physician who says that the idea that med students are not given sufficient nutritional education is a myth, that doctors do in fact study a lot of nutrition and are much better informed about it than the rest of us want to believe. (So much for Dr. François in the earlier paragraph!) Of course this doctor is also making a living (probably a rather well paid living at that) doing lap band surgery on obese people, so he may have a somewhat…differently motivated perspective on things. In that article he comes right out and says “Food can kill you, but it can’t cure you,” and he goes on to say “you cannot cure heart disease with diet, nor can you cure cancer with diet, nor can you cure appendicitis with diet, nor can you cleanse the liver, or cleanse the colon.” He cites Steve Jobs as an example of someone who tried to cure cancer via diet and failed, without mentioning that the Ornish diet Jobs went on is probably the worst possible thing someone with pancreatic cancer could try – in other words, there is more than one diet-based approach available for this problem, just as there is to allopaths who try to treat a condition. I don’t think this doctor would be very good at skinning cats, which can be famously skinned in many different ways. I can think of another doctor who tells a very different story; Dr. Terry Wahls seems to have overcome (not “cured”, necessarily) her MS by changing her diet and her now-famous YouTube videos are must-see material if you haven’t already seen them. So here we have two doctors with opposing viewpoints. I know that from my own experience with metabolic syndrome it IS possible to directly affect your medical condition just by changing your diet, but Dr. Wahls has gone way beyond just lowering your blood sugar and triglyceride levels – it’s pretty clear which dog I think is the winner in this fight.
For another opinion I asked a naturopath I know what she thought the reason for the apparent lack of nutritional education in med school was and her response was direct: Simple. Most medical doctors don’t appear to think that food and nutrition have much to do with health. There are some notable exceptions to be sure.
And what about those notable exceptions; if you do find a physician who thinks this is an important subject, how do you evaluate their approach? They are the professional people – we are the autodidacts without formal training; we get things wrong and we don’t agree. But the same thing seems to be true for the professionals. You can find doctors who will tell you to eat vegetarian diets (no thanks, but that’s me – I don’t want to be Steve Jobs), Mediterranean diets, even paleo diets, or (worst of all, but so far the most typical approach) low-fat diets with lots of “healthy whole grains” and lean meat. I say “worst of all” because it seems to me that the ones that espouse this particular dogma are simply reciting rote memorized information and at best they simply have not looked outside of their own spheres of interest for far too long. And because my own particular bias leads me to think that this approach doesn’t work; well, it certainly didn’t work for me.
Thus I discover that my second and third questions are really the same thing. In order to help yourself you have to have some control over the process and you have to try to find a physician you can trust. What a long-winded way to get around to saying what’s obvious to everybody but me, LOL.
There is also the issue of paying for these services. Most of us are not wealthy enough to just go to a doctor and pay her, so we rely on insurance (if we are fortunate enough to have it in America) or we do without. But if you have insurance, unless it is a pretty top-line policy you may not be able to see anyone who is not going to offer up the standard line, which is “Take this medication, don’t eat too many fats, and get some exercise. Next patient!”. So the list of problems continues for a lot of us.
I didn’t expect to truly answer the questions I posed in the beginning of this thing, but I also thought things might be less complicated than they seem to have turned out. I am left with these queries, which are quite different from each other:
1. If med school students receive too little nutritional education, why is that? If it is deemed not important enough to have a place in the curriculum, why is that (and who influences the deeming)?
2. If you have to find a doctor you can work with, how can you best do this? Obviously, a large and separate topic.
3. How in the world can many people in this country hope to do that and pay for it too?
The first two can be approached on an individual level – they are opinions or decisions for you and me to make on our own. The third is a societal question that is beyond the scope of individual action, unfortunately.
And note that I didn’t even bring up the question of hospital food…until now.
I am working on something a lot less snarky but it’s not ready for publication, so since I rendered some lard yesterday morning I thought I’d take a few minutes to run down the procedure in case any of the unsuspecting victims who stumble on this blog might not know how to make it. It’s quite easy, and since we know now that lard is actually good for you, there’s not much reason not to use it. It also tastes wonderful.
Of course, I’m not talking about the hydrogenated glarp you buy in the store, usually in the “ethnic” section.
Real lard is just pork fat which has been melted and the remaining solids removed. Most people make it from pork fatback, which you can think of as uncured bacon with no meaty part in it – it’s just fat. I used a pound of fatback, which cost me $3.50 from a butcher that supplies very good, hazelnut-finished animals. (If you happen to be in Portland, I really recommend these guys. And they don’t know me from Adam so there’s no quid pro quo going on here.) The pound of fatback will make enough lard to just about fill a 16 ounce tub.
1. Cut the lard into small pieces, put it in a kettle and add enough water to come up about even with the top of the lard. The water is there to keep the lard from burning at the beginning of the process. At first, you can use a pretty high heat, but this first step is just to boil off the water and get the lard started. Once most of the water is gone you must turn the heat down. Here’s my lard after it’s started to boil, with some water still in the pot:
2. Turn the heat down and let the lard bubble, stirring occasionally. As the lard liquifies, the solid bits will get smaller and more and more liquid will surround them. The bubbles will get smaller and smaller, and eventually the small pieces of solid matter will start to turn brown – at this point I pour off the liquid into a metal bowl:
3. While the liquid cools I finish rendering the cracklings, which is what those solid bits are called. I do this away from the liquid so that if I mess up and overdo it I won’t give the rendered lard a browned taste. You can still use it if you do, but you probably wouldn’t want it in anything that isn’t a savory dish. I don’t eat grains so pastry is not on my menu, but if you want to you can make the best tasting, most flaky pastry you ever had with this stuff. This is what our great-grandparents’ pies were made with.
Lard cooling; it will be entirely ivory when done.
4. That’s it. Put the rendered lard in the refrigerator, where the lard will turn white (unless you really overcooked the cracklings first, LOL), salt the cracklings and taste ‘em; they hit the “french fry spot” better than anything else I’ve found since I stopped eating starchy carbs. Or put them directly on something and have a snack:
My usual patented, mismatched lighting for eating
You can, of course, render other types of fat too. Here’s how you can make tallow if you have some beef heart handy. I realize that’s not too likely, but some might find it interesting, although the basic technique is the same as that used here for lard. In the absence of beef hearts (which usually have quite a bit of fat on the outside) you can do the same thing with suet, which you could get from a decent butcher.
New York – The McDonald’s and Monsanto corporations announced today that they have reached agreement on terms leading to a merger of the two industry leaders. The new entity, to be called “McSanto’s”, will be a “complete top-to-bottom market-streaming food payload delivery system of unparalleled depth covering a full spectrum age demographic”, according to analyst Jeffrey Spottiswode of Scientists Helping Industrial Litigation Licensing. “We have been examining the proposed merger for some time and I am satisfied that the real beneficiary of the deal will be the consumer, who will have better access to food choices than she has ever had at any time in history.”
Both companies’ stock prices rose slightly on the announcement.
The news couldn’t have come at a better time; there have been problems in the past. On May 3, 2007 Monsanto was dealt a judicial setback when a court in San Francisco ruled that the USDA’s 2005 approval of its genetically engineered “Roundup Ready” alfalfa was illegal, the first time the company has been handed such a reversal. McDonald’s has recently been in the news because of adverse public reactions to one of its new kids’ meal items; the genetically engineered Smorgasbird (the ads’ tagline is “Every part is edible”) has proved a difficult sell, in part due to the footage of projectile diarrhea featured in the sixteen now famous YouTube videos.
McSanto’s has bold plans for future movement: the introduction of Roundup Ready Fries, which will blend a friendly western image with the ability to resist the world’s most common herbicide; Harpy Meals, the reformulated (“safer than ever”) version of the Smorgasbird-derived food product system; Malted Meatballs, the first actual meat product synthesized from petroleum; rBeST sHakes, the new line of bovine growth hormone dairy drinks, and most intriguing of all, the retirement of an old friend, Ronald McDonald.
The beloved ad mascot will be making way for a pair of fun loving logotypes; McSanto Claus will take over much of Ronald’s current duties vis-à-vis food marketing and children’s PR functions, while the Happy Pharmer is being introduced “as a way to help them to trust the brand at a younger age while still communicating solid information to adults”, according to company spokesperson Shirleen Inkerton. “With McSanto Claus the kids will know it’s Christmas all year round”, while the Happy Pharmer will be giving PowerPoint presentations on free DVDs which accompany the meals. “We got the idea from Al Gore, and just look what it did for him!” said Shirleen.
Each personality will also be sold as Nag-ems, edible plastic action figures carefully researched for their so-called “nag factor”, or the ability to get kids to pester on demand. Nag-ems are the fastest growing item in the current McSanto hierarchy of action figures.
The move comes at a time when the industry faces more competition than ever before, especially as the organic movement takes off. Targeted niche marketers such as Burger Queen (organic choices for gays and lesbians) and Rat-In-The-Box (from Disney’s GenX-to-slacker marketing arm) have made inroads on fast food profits, while truly specialized venues such as Hank’s Booze & Shoots chain (tavern and firing range separated by the bar) have also siphoned off revenue.
McSanto’s also revealed today that it has acquired the infant formula brand Babes In Soyland as well as the chain of Leafy Rest assisted living communities and its subsidiary, Cenotaph, Incorporated – the second-largest mortuary concern in the state of California.
“Now they’ve got you,” laughs Spottiswode, the analyst. “Cradle to grave.”
We received this letter from our HMO the other day and I was interested (but not surprised) to see that they are still stuck in the Great Cholesterol Fear campaign. There is so much information available now about all the problems with this simplistic approach that nothing that I can say is going to convince anybody in any new fashion that Kaiser is completely wrong here. But I like a good rant as much as the next pirate (even if I don’t rant quite as well as Pirate Ben’s grandmother) so I’ve posted this as a companion piece to the tribute to Kaiser Permanente which I ran when I started this blog.
The problem with Kaiser is that it is completely governed by committee thought, and that does not make for good medicine. The use of medical guidelines to determine health care treatments is, in my opinion, one of the worst things that has happened to us – what are you supposed to do when you know the guidelines are wrong? This puts you in a terrible position, because you can no longer trust your doctor. That the staff at Kaiser is overworked and overbooked only adds to the difficulty; you get about 15 minutes with somebody…if you are lucky. And of that 15 minutes, how much of it is actual face-to-face conversation? And since the doctor is so pressed for time now, she has to spend the entire visit typing on her keyboard, which means she can’t even look at you beyond the initial greeting. Tell me that the visual aspect of a doctor visit is not important.
I think western medicine is great if you have a trauma issue or an infection. But the number one problem in our society now (speaking in medical terms) is not infectious diseases like it was 100 years ago, it’s chronic conditions. And most of those are caused by lifestyle choices we make or which, unbeknownst to us, are made for us. Diabetes, obesity, arthritis, I don’t know where to begin – an entire list would be enormous. As Sarah Ballantyne points out, you can start with these as having inflammatory causes which are strongly related to what you eat:
Ballantyne lists several pages of such conditions in her book The Paleo Approach: Reverse Autoimmune Disease, Heal Your Body. Friends, this is the book to have handy if you need biochemistry to back up your arguments! (Mini review: great book for dealing with autoimmune conditions or just understanding how your body reacts to various inputs, very tech heavy through the first section, somewhat spoiled by almost complete reliance on boring stock photographs; except for the occasional headshot of a quoted person all the photos are generic images from stock agencies and they could go in any medically related book at all. Too bad, because otherwise it is a good book.)
My point here is that while western medicine is great if you break a leg and need it set, or if you need surgery for an acromial impingement (like I did), it is mostly ineffective when it comes to managing conditions which are food or lifestyle related. The discouraging thing is that most doctors don’t seem to think this is a problem, so maybe all it means is that I don’t know what I’m talking about and I should shut up and listen to them. After all, they are the experts with degrees, aren’t they?
Problem is, these same people are the ones who told me for thirty years that I either had imaginary problems, or that I was depressed, or that I had problems of idiopathic origin (which just means that they don’t know what the problem is but it sounds a lot more official, doesn’t it?), or that I should try an anti-dandruff shampoo (I’m not kidding). And *I* am the person who found out on my own what the real problem was; it was the damn wheat I had been eating all my life. So why in the world should I take these people seriously when they tell me now that elevated cholesterol can increase my risk of heart attack when this time I know it simply is not true? I’m not the totally uninformed patient I was a few years ago, guys. I’ve read enough comments by doctors on their own blogs about how patients are getting more involved in their care and I can see how, from the doctors’ point of view, this could be a problem when everybody is questioning their treatment, but in this case I think the doctors have nobody but themselves (as a profession) to blame. If they hadn’t been so enamored of fright-based messages like ELEVATED CHOLESTEROL CAN INCREASE YOUR RISK OF HEART ATTACK then perhaps we might have a bit more trust in their diagnoses and treatment.
WTF 