Tuesday, January 26, 2010

No Whey to Build Muscle

As I was going into the gym this morning, I couldn’t help noticing how many large cans of a product called Muscle Milk were sitting on the counter. This product, along with many other similar supplements, comprise a $2.7 billion industry in this country. They are largely made from whey, which is a byproduct of cheese production. Remember your curds and whey?

How resourceful these companies are in turning what was essentially a minimally valued commodity into a must have for every Arnold aspiring teenage boy. With clever image marketing, they are selling a distorted story to a largely ignorant public in a largely unregulated industry.

I can speak from experience about the powerful influence these protein products have on teenagers. As one of the many ectomorphs aspiring to be a mesomorph young gym rat, I consumed many bottles of protein powders in my day. What I didn’t know in those days, and what the current crop of aspirants don’t know, is that the standard American diet is overloaded with protein. Our consumption levels are almost twice the amount that our bodies need to meet our physiological requirements and the excess protein has led to an alarming increase in the number of renal disorders.

When we add all the other bogus products that promise increased athletic efficiency, we are talking about a $25 billion industry that preys on our vanity and our desire for a magical potion.

PS : I was 160lbs as a teenager and am the same weight today

Sunday, January 24, 2010

Fat Head

There was an interesting story that appeared several months ago that I believe went largely unnoticed by the general public. It involved a gang in the Peruvian jungle that had been reported to be killing people for their fat. The local police were accusing the gang members of draining fat from the bodies and selling it on the black market for use in cosmetics. The suspects, who had confessed to killing five people, claimed that the fat was worth $80,000 a gallon.

The police stated that the gang members would cut off the victims’ heads, arms and legs, remove the organs, and then suspend the torsos from hooks above candles that warmed the flesh as the fat dripped into tubs below.

My wife Diana, had been in Peru on a photo shoot during the time the story had appeared in the NY Times. Although she had just traveled into the Amazon she was totally unaware of this gruesome incident.

Here’s my turning’’ lemons into lemonade’’ angle to this story.

With our economy in the pits and with over 60% of us obese or overweight, I’m proposing that our excess fat be declared a national resource. We could be the Saudi Arabia of fat in the global economy. To all the people who say that we don’t produce anything in this country anymore, I say, we have a virtual monopoly on this commodity. Most importantly, this resource is located in areas that have been impacted the most by this terrible recession, every small town in this country.

Tuesday, January 12, 2010

What Would Robert Bly Do ?

One of the more frequent complaints that I have heard from the numerous women who have begun the 21 day vegan kick-start program is that their husbands, and sometimes their children, still want to eat their customary meat. Even though most of the women work full time, they still feel obliged to prepare two sets of meals in their home.

Much of the stress these professional women feel is related to the longstanding societal role of the woman as the cook-caretaker in the family. This model often leads to a conflict between what they personally want to do and the tendency to subordinate their desires for the good of the family.

In my opinion, men need to disengage from their contemporary caveman relationship toward meat and embrace their partners attempt to develop a more compassionate attitude toward animals. As someone who has participated in a variety of mens groups for over 20 years, I have seen many men on the verge of a panic attack when they perceived their meat based diet being attacked.

There are so many more productive ways for men to assert their masculinity, than to participate in the ritual eating of a dead animal that led a horrific life on a factory farm. Try mentoring an inner-city youth or volunteer in a soup kitchen as an example…

Saturday, January 9, 2010

Rebel with a cause

August 11, 2009
How to Rein in Medical Costs, RIGHT NOW

I believe that there are still many ethical and professional American physicians and many intelligent American patients who are capable of, in an alliance of patients and physicians, doing "the right things". Their combined clout is being underestimated in the current healthcare reform debate.

Efforts to control American medical costs date from at least 1932. With few exceptions, they have failed. Health care reform, 2009 politics-style, is again in trouble over cost control. It would be such a shame if we once again fail to cover the uninsured because of hang-ups over costs.

Physician decisions drive the majority of expenditures in the US health care system. American health care costs will never be controlled until most physicians are no longer paid fees for specific services. The lure of economic incentives to provide unnecessary or unproven care, or even that known to be ineffective, drives many physicians to make the lucrative choice.

Hospitals and especially academic medical centers are also motivated to profit from many expensive procedures. Alternative payment forms used in integrated multispecialty delivery systems such as those at Geisinger, Mayo, and Kaiser Permanente are far more efficient and effective.
Fee-for-service incentives are a key reason why at least 30% of the $2.5 trillion expended annually for American health care is unnecessary. Eliminating that waste could save $750 billion annually with no harm to patient outcomes.

Currently several House and Senate bills include various proposals to lower costs. But they are tepid at best, in danger of being bought out by special interests at worst.
So, what can we in the USA do RIGHT NOW to begin to cut health care costs?
An alliance of informed patients and physicians can widely apply recently learned comparative effectiveness science to big ticket items, saving vast sums while improving quality of care.

Intensive medical therapy should be substituted for coronary artery bypass grafting (currently around 500,000 procedures annually) for many patients with established coronary artery disease, saving many billions of dollars annually.

The same for invasive angioplasty and stenting (currently around 1,000,000 procedures per year) saving tens of billions of dollars annually.

Most non-indicated PSA screening for prostate cancer should be stopped. Radical surgery as the usual treatment for most prostate cancers should cease since it causes more harm than good. Billions saved here.

Screening mammography in women under 50 who have no clinical indication should be stopped and for those over 50 sharply curtailed, since it now seems to lead to at least as much harm as good. More billions saved.

CAT scans and MRIs are impressive art forms and can be useful clinically. However, their use is unnecessary much of the time to guide correct therapeutic decisions. Such expensive diagnostic tests should not be paid for on a case by case basis but grouped along with other diagnostic tests, by some capitated or packaged method that is use-neutral. More billions saved.

We must stop paying huge sums to clinical oncologists and their institutions for administering chemotherapeutic false hope, along with real suffering from adverse effects, to patients with widespread metastatic cancer. More billions saved.

Death, which comes to us all, should be as dignified and free from pain and suffering as possible. We should stop paying physicians and institutions to prolong dying with false hope, bravado, and intensive therapy which only adds to their profit margin. Such behavior is almost unthinkable and yet is commonplace. More billions saved.

Why might many physicians, their patients and their institutions suddenly now change these established behaviors? Patriotism, recognition of new science, stewardship, and the economic survival of the America we love. No legislation is necessary to effect these huge savings. Physicians, patients, and their institutions need only take a good hard look in the mirror and then follow the medical science that most benefits patients and the public health at lowest cost. Academic medical centers should take the lead, rather than continuing to teach new doctors to "take the money and run".

Physicians can re-affirm their professionalism and patients their rights, with sound ethical behavior without undue concern for meeting revenue needs. The interests of the patients and the public must again supersede the self interest of the learned professional.

George D. Lundberg MD, is former Editor in Chief of Medscape, eMedicine, and the Journal of the American Medical Association. He's now President and Chair of the Board of The Lundberg Institute

Friday, January 8, 2010

The Bean Team

I’ve received quite a few interesting comments over my recent legume posting. A recent New York Times feature article by Mark Bittman on elevating simple legumes, stimulated my thinking again about this under- appreciated food.

One of the reasons I believe the lowly bean has not been accepted in this country is that unlike much of the world, we in the U.S. don’t have a national bean. Come to think of it, there are a great many things that either we do or don’t do that the rest of the world does. The Italians have the cannellini, borlotti and ceci, the French have the flageolet, the Latin countries have the black and pinto beans, the Asians have adzuki and soy and the Indians, along with many other Mediterranean and Middle Eastern countries have the chickpea and a wide variety of lentils. With the exception of black eye peas, navy and red kidney beans, there really isn’t much of a bean tradition in this country.

There have been some attempts to promote heirloom bean varieties by Rancho Gordo in Napa and Phipps ranch down south, but much of their limited production is oriented toward the likes of Thomas Keller, of French Laundry fame, and his brethren of celebrity chefs.

In my Pre – Vegan days as a youngster living in New York, the only beans that I was exposed to were Heinz vegetarian baked beans. They were the traditional accompaniment to my corned beef and pastrami sandwiches that I routinely consumed at the neighborhood deli. Occasionally when my mother wasn’t up to cooking dinner we would have ‘’franks and beans’’ which was the only other time that beans of any sort touched my lips.

It wasn’t until many years later, when I became vegetarian, that I become passionate about beans. I consume some variety of legume every morning for breakfast in the form of a bean or lentil spread that I consume with some whole grain bread. I prefer not to use tahini, which is an essential ingredient in traditional hummus, because in my opinion it tends to dominate the flavor profile of whatever legume you are using. The name hummus has also been contemporized to now include almost any type of bean accompanied by a variety of spices.

The marketing of the portobello mushroom is a good example of how we can create a sexy persona for our new national bean. Portobello is a created name for a more mature cremini or brown mushroom. What was essentially a throw away product became a must have item because of some clever marketing. We can do a similar campaign for whichever bean we choose to publicize.
I’m proposing a Bean Team be organized to name and promote our new national bean. Imagine the possibilities…

Saturday, January 2, 2010

An Owls View

I would like to pose the following question. Do you apply affirmative action principles when evaluating vegetarian restaurants? I often find myself feeling quite ambivalent over this issue. My compassionate side says that the food, good, bad or indifferent should be secondary to the fact that for every vegetarian meal consumed fewer animals are killed and that suffering is reduced immeasurably. On the other hand, my chef –food critic says that restaurants should be judged by the quality of its food, irrespective of whether the cuisine is Italian, Indian, Vegetarian or Mexican

Many of us, in our excitement to have an additional vegetarian restaurant to choose from, all too often gloss over the fact that the food that is served is often quite bad. My concern is that too many veggie wannabes will be turned off by the food, feeling that they could never ‘’eat this way”, and we will have lost potential converts to our cause.

My wife Diana and I recently went to Millennium in SF for Thanksgiving dinner. They were serving a holiday prix fix menu which consisted of an appetizer, soup, salad, entrée and dessert. It was extremely busy when we arrived and it was great to see so many people eager to experience a vegan Thanksgiving.

I had two major complaints with the meal, the soup and dessert. The pureed soup was cold, flavorless and had the consistency of baby food. It was so bad that neither Diana nor I ever considered sending it back, feeling it was beyond restoration. There were two desserts offered, so we each tried one. Diana’s selection, a pumpkin chocolate pie was very good. My choice, a mislabeled tart, severely missed the boat. The sorbet that accompanied the tart was also lacking in any redeemable qualities. The entrée, salad and appetizer were more than acceptable, but didn’t provide the WOW factor that we were looking forward to.

A friend of mine suggested that I shouldn’t judge a restaurant by its holiday offerings, since it was unusually busy and probably wasn’t truly representative of its finest work. I understand this viewpoint, however having a prix fix menu reduces the stress in the kitchen and in some way balances out the greater number of meals served.

I’ve been going to Millennium since the mid eighties, when it was known as Milly’s in San Rafael and will continue to dine there. My observation over the years is that the appetizers and sides tend to be very good but the entrees are generally the weakest part of the menu. We tend to order a number of small plates when dining and that strategy seems to work out pretty well.

We went to the new Encuentro Café in Oakland a few weeks ago. It’s a vegetarian wine bar that is partially owned by Eric Tucker, the chef at Millennium. They serve small plate items on rather small bistro style tables so that holding a wine glass while attempting to eat, can be a bit of a challenge. The majority of the limited menu is vegan with cheese playing a feature role in the vegetarian items. I wouldn’t describe it as a destination place, but if I were in the area and wanted a glass of wine and light snack, I would consider going there. The space is rather small and I felt a bit claustrophobic after a while. My impression is that it’s more of a womans place, but that’s just me...

Our final new dining experience was at Gather, in Berkeley, a new organic restaurant in the David Brower Center on Oxford street. Its mission statement is that everything they serve is organic, with at least half the menu being vegetarian – mostly vegan. I was particularly excited because they had a vegan pizza on the menu and when I had looked in earlier, to my delight they appeared to have a wood burning oven. Much to my chagrin, the pizza crust was especially lacking in texture and flavor. I discovered that because of a Berkeley ordinance prohibiting new wood burning ovens in restaurants, their oven although looking like a wood burning oven, was powered by gas. The high heat that wood or coal can produce creates the crispy charring crust that is so desirable. The problem with the pizza was more endemic than the oven. The dough just didn’t have any life to it, maybe it didn’t proof long enough, something was just not right. The red quinoa risotto and appetizer selections were pretty good, although the serving size of the risotto was fairly small, which is a pet peeve of mine when it comes to pasta and grain dishes. For an additional twenty to thirty cents a restaurant can serve an ample portion of a grain- based entree which would make the charge of 15 – 20 dollars for 2 -3 dollars of ingredients more palatable to the public. I would go back for the pizza if they can get their dough situation squared away. It just opened and I’m sure the kitchen will work through this problem.

Even with all the bumps in the road, I’m optimistic that as more vegetarian restaurants open, competition will force the quality of the food to improve in a very organic fashion.