Last summer, after my patient Mrs. Price heard me say that her blood sugar was 204, a single tear ran down her cheek as she said,  “My eldest granddaughter is getting married next year.”  A blood sugar measurement over 200 is one way to confirm a diagnosis of diabetes.  Her parents had both died in their 60’s from complications of chronically elevated high blood sugars.  Here is what I told her.

“The most important difference between your situation and mine right now is that your body is no longer able to keep its blood sugars in the normal range by itself.  But that doesn’t mean you are going to suffer the terrible complications that your parents did.  Kidney failure, blindness, heart attacks and amputations are not inevitable complications of diabetes.  It’s not diabetes itself that’s the problem; it’s uncontrolled diabetes.”

“There’s good news here: First, we found out about this before it turned into a serious problem.  Secondly, as long as you learn to keep your blood sugars in the normal range, your risk of developing complications will be pretty close to mine, which is to say, low.  A diagnosis of diabetes doesn’t mean that you’re going to have trouble.  It just means that your body can’t control its sugars automatically anymore, and it’s going to need your help.  But as long as you give your body the help it needs, and you learn how to conserve your insulin, the payoff will be huge.  I have no doubt that we will be able to get your sugars in the normal range.  You’re just going to need to involve your brain in the process.”

“You’re not going to be able to keep your blood sugars in the normal range automatically anymore, because if you could, your blood sugars wouldn’t be over 200.  And I can’t keep your blood sugars in the normal range all by myself either.  But if we work together, we can and we will.  So let’s figure out what we need to do to get your sugars under good control.  And then let’s do it.”

When I take care of patients with diabetes, I have lots of goals.  I want to get their average blood sugars under 125.  I have goals for total cholesterol, triglycerides, HDL and LDL.  I want blood pressures below 135/85, and I want kidney function in the normal range.  I want strong peripheral pulses and I want my patients’ feet cared for expertly, at home and by the podiatrist.  I want my patients’ eyes checked at least once a year.  And so on.

“But you, Mrs. Price,” I continued, “have only one goal.  Your goal is to dance at your grandchildren’s weddings.  Not just attend them, but dance at them.  All of them.  Starting next summer.”  She smiled a little.

“Did you know that one hundred years ago, before we had medicine for diabetes, the only treatment for diabetes was a high fat diet?,” I asked.  She did not know that.

I taught Mrs. Price how to conserve her insulin using the “Four Recommendations.”  She stopped buying the cereal and orange juice she’d been eating at 11:30 a.m. for years.  I prescribed a medication “to make my insulin more efficient,” as she put it.  We made an agreement that she would begin to walk 5 minutes every day, and that she would begin to increase that number by 1 minute a month.  I reminded her that “Slow but steady wins the race,” because I certainly didn’t want her to sprain an ankle or get shin splints, two complications that would prevent her from getting much exercise at all for months.  She also made a rainy-day plan — to walk in the nearby mall in bad weather.  This is Cleveland, after all. 

We got Mrs. Price a glucometer, and I showed her that she could actually figure out which foods were causing blood sugar spikes by testing before she ate and then an hour afterward.  As time went by, she got better and better at predicting which foods were going to cause unacceptable spikes, and which foods kept her blood sugars in the normal range, more or less.  She stopped buying foods that spiked her blood sugar, except once in a while “special for the grandkids,” as she put it.  She started eating a protein-rich breakfast at 8 a.m., and noticed, to her surprise, that it resulted in significantly less after-dinner snacking.  As the year went by, we watched her 3-month blood sugar averages drop from 190 to 150 to 120.

Last weekend, I am pleased to report, Mrs. Price danced at her granddaughter’s wedding.

By Rhea Yablon Kennedy. Originally posted on PursueAction.org.

Last month in a post on PursueAction.org, I puzzled out the fierce public interest in healthy food that even a tragic oil spill and a coalmine disaster could not distract attention from. The grassroots groundswell for healthier food in the D.C. area included the passage of a sales tax on soft drinks. Similar bills recently emerged in many parts of the country. In this post, I take a closer look at “soda tax” campaigns and what they can teach us:

One such recent measure to apply a penny-per-ounce soda tax in New York State failed. New York Times reporter Anemona Hartocollis pinned it to a winning anti-tax campaign. She compared two ads focused on Governor David Paterson’s proposed cost jump, one aimed at promoting it, the other aimed at defeating it:

First, this radio ad from the Alliance for a Healthier New York, a name that only a health teacher could love. A pediatrician talks about diabetes, cancer and obesity, and says, “Helping New Yorkers lose weight is a matter of life and death.”

Next, this TV ad from New Yorkers Against Unfair Taxes, a name calculated to make the blood boil. A mother unpacks groceries in the kitchen as her son mixes a powdered lemonade, one of the drinks that would be taxed. “Tell Albany to trim their budget fat and leave our groceries alone,” the mother says.

…Now that [the measure] has been dropped from the state revenue bill, it has become a case study in the power of the anti-tax message.

This phenomenon is not unique to New York. Similar tax proposals tried to float to glory on public support in Vermont, Mississippi, Kansas, and Alaska, as well as Philadelphia, Washington, D.C., and many other cities—at least 20 in all this year, by The Wall Street Journal’s count. Yes, 33 states have already passed some kind of soda tax. But 2010 just wasn’t the year for new ones. The vast majority failed.

Looking at this news, I started to wonder. Couldn’t there be another reason, other than a simple, straight-to-the-heart message in a TV ad? Yes, and I think it was complex brew of convoluted, top-down measures.

Trying to fund one initiative with another–simultaneously deterring people from drinking unhealthy beverages while funding initiatives to promote healthy living–makes sense over all. But try to explain all the numbers, intricacies, and the calculated cost to the consumer, and you’ve taken a good 10 minutes. For anyone trying to engage a busy and distracted public, that’s nine minutes and 30 seconds too long.

Bans on smoking and trans fats, and even limits on sugary drinks have passed in other areas. They may not have been popular, but they were simple, not tied to a revenue bill, and they passed quickly without lengthy debate in a city council or state senate.

The soda sellers got that. They made it about parents and their grocery bills, all in a succinct ad.

Likewise, the anti-tax campaigners addressed consumers at eye level: a mom to other moms. Meanwhile, the health camp’s ad had a doctor tsk tsk at the masses.

A top-down approach to get people to change their personal choices clouds the waters. Even Michelle Obama, who could have her public eating a tablespoon of cement every morning if she just wagged her finger and said we’d better get to it, grasps this. When she talked about her Let’s Move nutrition and exercise initiative at the recent NAACP convention, she simply made the argument that eating better is a wise choice for the community. She even described a wake-up call from a pediatrician about her daughters’ weight. It’s a familiar tale she has used before, but the parent-to-parent connection shines even clearer when held next to that doctor-speak ad in New York. I doubt anyone left thinking of Michelle Obama as the nation’s new dietary dictator.

Another complication is that the soda tax debate played out on a slanted playing field. Sure—consumer groups, health organizations, and corporations all had an equal right to get in the game. But as the Times’ Hortocollis points out, when it comes to swaying public opinion, the competition all but closes to any ad campaign with a budget not subsidized by America’s most popular sugary beverages. So the public didn’t exactly get a balanced take on the issue. And when the public polls in opposition to a tax, the politicians must follow.

I don’t know—maybe the public needs a talking-to sometimes, and a top-down mandate here and there. One sure thing is that the food transformations suggested in the Let’s Move campaign—not to mention urban gardens, vegetable patches in school yards, and backyard chicken coops—have all seduced the public, and none of them did it with a bill or ad campaign. Or a ban. No intricate reasoning–just pure, simple food. No 30-second TV spots–just inspired people.

Photo by Alexander Kaiser.

Soda.  Pop.  Coke.  S.S.B. (sugar-sweetened beverage).  Whatever you wanna call it, it’s bad for you.  Or so argues Mark Bittman, the New York Times‘ “Minimalist” columnist and prominent foodie in this Sunday’s New York Times.  This phenomenal article poses the question of whether soda may be the next tobacco.  He interviews proponents calling for a special excise tax on soda to fund obesity prevention programs, as well as other measures to curb the intake of these empty calories in a can (or bottle).  The article comes after Michelle Obama’s appointment to lead a national campaign against childhood obesity, which some believe is linked to an excessive consumption of soda and candy.

Though I am no longer a child and do not suffer from obesity, I am embarrassed to admit that I am a near-daily consumer of soda – specifically, Dr. Pepper (ahhh…).  Therefore, this article was of personal interest to me.  Would an extra tax on soda, or the appearance of a cigarette-esque warning label on soda, deter me from feeding my addiction (and I do believe it is an addiction) to the stuff?

I am envious of friends that are naturally repulsed by soda, and who are likely healthier due to their avoidance of it.  It is a vice that I would gladly live without, though as with any addiction, it is not easy to quit.  Of course, my addiction is not helped by the ubiquity of soda advertisements in our society.  Indeed, the soda marketing people usually are successful at targeting those receptors in my brain that displace the long-term goal of being healthy and avoiding diabetes with the short-term goal of chemically-induced instant gratification.

Perhaps, though, I have found a happy medium that will wean me off of soda for good.  A friend and fellow soda “junkie” turned me onto a sodium- and calorie-free drink sold at Target and CostCo.  It is called “LaCroix Water,” and is essentially carbonated water with several fruit-flavor options.  Furthermore, they sell it in a 12-oz. can, which provides the same gratification as holding a cold 12-oz. can of Dr. Pepper…but leads to a healthier result.

Although human beings are conscious individuals with the ability to make informed decisions on what to consume, we also have areas of weakness (even Superman could be brought down by Kryptonite).  Unfortunately, Big Food – as Bittman calls the soda and snack food industry – knows this, and they depend on it for their revenue.  If the government can help empower individuals (especially children and their parents) to make healthier decisions and avoid these unhealthy chemical substances, then I will be grateful.

Indeed, if I hadn’t been introduced to Soda as a child, my affair with the dark sugary liquid would not have lasted as long as it has.

A Federal Court ruled yesterday that the Bush USDA’s approval of genetically engineered (GE) “RoundUp Ready” sugar beets was unlawful. The Court ordered the USDA to conduct a rigorous assessment of the environmental and economic impacts of the crop on farmers and the environment.

The federal district court for the Northern District of California ruled that the U. S. Department of Agriculture’s Animal and Plant Health Inspection Service (“APHIS”) violated the National Environmental Policy Act (“NEPA”) when it failed to prepare an Environmental Impact Statement (“EIS”) before deregulating sugar beets that have been genetically engineered (“GE”) to be resistant to glyphosate herbicide, marketed by Monsanto as Roundup.

This court decision is a wakeup call for the Obama USDA that they will not be allowed to ignore the biological pollution and economic impacts of GE crops … The Courts have made it clear that USDA’s job is to protect America’s farmers and consumers, not the interests of Monsanto.

Additionally, over 100 companies have joined the Non-GM Beet Sugar Registry opposing the introduction of GE sugar beets, and pledging to seek wherever possible to avoid using GM beet sugar in their products: www.seedsofdeception.com/includes/services/nongm_sugar_beet_registry_display.cfm. Check out the registry, and pass it on to food producers who want to stand in solidarity to reject this GE crop.

Sugar beet seed is grown primarily in Oregon’s Willamette Valley, which is also an important seed growing area for crops closely related to sugar beets, such as organic chard and table beets. GE sugar beets are wind pollinated and will inevitably cross-pollinate the related crops being grown in the same area. Such biological contamination would be devastating to organic farmers, who face debilitating losses when their crops are contaminated by a GE variety. Contamination also reduces the ability of conventional farmers to decide what to grow, and limits consumer choice of the foods they can eat. In his September 21, 2009 order requiring APHIS to prepare an EIS, Judge Jeffrey S. White emphasized that “the potential elimination of a farmer’s choice to grow non-genetically engineered crops, or a consumer’s choice to eat non-genetically engineered food, is an action that potentially eliminates or reduces the availability of a particular plant has a significant effect on the human environment.”

The Court found that the USDA failed to analyze the impacts of biological contamination on the related crops of red table beets and Swiss chard. Because organic seed is the foundation of organic farming and organic food integrity, and “organic” rules explicitly exclude GMOs, this GE crop threatened all organic chard and beets in the U.S. This victory is another step in protecting non-GE seeds along with the rights of organic farmers to be protected from negative economic impact from GE crops, and consumers rights’ to choose to eat food free of GE components.

“Roundup Ready” crops allow farmers to douse their fields with Monsanto’s Roundup herbicide without killing the crop. Constant application of the herbicide has resulted in weeds becoming resistant to it. There are now millions of acres across the U.S. of such “superweeds,” including marestail, ragweed, and waterhemp, and farmers are using greater applications of Roundup or other, even more toxic chemicals. According to an independent analysis of USDA data by former Board of Agriculture Chair of the National Academy of Sciences, Dr. Charles Benbrook, GE crops increased herbicide use in the U.S. by 138 million pounds – a huge increase of these herbicides attributed to GE crops.

There is also mounting evidence that Roundup itself is very harmful. A 2008 scientific study revealed that Roundup formulations and metabolic products cause the death of human embryonic, placental, and umbilical cells in vitro even at low concentrations. Other recent studies suggest Roundup is an endocrine disrupter, and that some amphibians and other organisms may be at risk from glyphosate.

Now that Judge White ruled in our favor, we now take Monsanto into the courtroom to move for a permanent injunction to halt the sale and planting of GE sugar beet seed, just like we did in the GE Alfalfa case…

For you lawyers out there, the case is Center for Food Safety v. Vilsack, No. C 08-00484 JSW (N.D. Cal. 2009). The decision follows on the heels of a June 2009 decision from the Ninth Circuit Court of Appeals affirming the illegality of the APHIS’ approval of Monsanto’s genetically engineered alfalfa, which Monsanto says they will now Petition the U.S. Supreme Court for review…

Stay tuned!

For press coverage, check out:
SF Chronicle:

www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/23/BACP19QTF7.DTL

NY Times:

www.nytimes.com/2009/09/23/business/23beet.html?_r=1&sq=sugar%20beets&st=cse&adxnnl=1&scp=1&adxnnlx=1253728815-Ut3l69B7bPr/u2PoX9llrg

What could be more dear to an ecologically minded keeper of kashrut in summer than a marshmallow? In San Francisco, a panel of tasters at the local daily voted the kosher brand as their top pick. Tell us in comments where to find kosher ‘mallows in your area! Has anyone tried to make one at home?

I’m in the minority as far as Jews go in that I’m blonde.  There are increasing number of blonde Jews but we’re still few and far between.  I was president of my Jewish sorority in college so my picture was smack in the middle of our composite photo.  Not only was I  front and center but I stuck out like a sore thumb as one of three or four blondes out of over 100 women on the  composite.  In any case, I’ve always embraced being blonde so when I was deciding what to bake recently blondies came to mind immediately.  I am a huge fan of chewy brownies but there’s something about blondies that make them even better than brownies, at least in my opinion.

I located a recipe on one of my favorite cooking blogs and after reading the recipe I realized what makes blondies so fantastic (beyond the hair color connection, of course): brown sugar!  Blondies are chewy and have a bit of a molasses flavor since they made using only brown sugar and no white sugar.

For those of you who are unfamiliar with blondies, they are sort of like a chocolate chip cookie in a bar form – but so much better.  There are a few reasons that blondies will be my quick and easy dessert of choice moving forward: they are versitile, easy to make without fancy kitchen electrics, and keep well in an airtight container for a few days.

As far as versitility goes, the recipe I used called for semi-sweet chocolate chips but I had a bag of Heath Toffee Bits that I wanted to use up so I did a bit of a swap.  Here are some of my other ideas for blondie add-ins: dried cherries or cranberries with white chocolate chips, semi-sweet or bittersweet chocolate chips with walnuts, semi-sweet or bittersweet chocolate chips andcrystalized ginger, and the list goes on…

Since these blondies keep well they would be great to serve at a dairy Shabbat lunch or just to make in advance for a small group of friends.  Please share your variations!

1/2 cup unsalted butter, melted

1 cup of tightly packed dark or light brown sugar

1 egg, lightly beaten

1 teaspoon of vanilla

1/2 teaspoon baking powder

1/8 teaspoon of baking soda

Pinch of salt

1 cup of all-purpose flour

1/3 cup Heath Toffee Bits (or whatever you’d like to add in)

Preheat the oven to 350°F.  Melt the butter in a microwave safe bowl (you can use a double boiler but this is quicker) Lightly butter an 8X8 pan. Whisk together the melted butter and sugar in a bowl.

Test the mixture to make sure it isn’t too warm for the egg.  Add the egg and vanilla extract and whisk.

Add the flour, baking soda, baking powder, and salt, mix it all together. Add the Heath Toffee Bits or other mix-ins.

Pour into the pan and spread evenly. Bake for 20-25 minutes or until a toothpick comes out clean.  If you don’t have a toothpick handy you can use a fork or knife.   Allow to cool. Cut into squares and serve.

Makes between 9 and 12 blondies.

So we only have a few days left of Pesach… and I happen to be quite happy about this!  It’s not that I don’t understand Pesach or why we don’t eat leavened things – I do.  I actually think the story of Pesach reminds us, as Jews, of some important lessons.  The reminder that I find to be most poignant is that we cannot consider ourselves free as long as others are oppressed.

Sorry for the digression – now back to food… I know some people find cooking during Pesach to be a fun challenge but I find it inconvenient.  As a vegetarian I rely (probably too much) on foods which are not considered “Kosher l’Pesach”, i.e. pasta, rice, bread, soy items, etc, so during Pesach I end up eating lots of matzoh pizza.  For anyone not familiar with matzoh pizza it is a basic combination of matzoh, tomato sauce and cheese which is then toasted (do not microwave because your matzoh pizza will be soggy).  I suppose one could come up with many variations to the aforementioned matzoh pizza recipe (please feel free to share your favorite) but no matter what it’s still matzoh pizza and is not even close to real pizza.

As you can infer from the previous paragraphs my brainstorming of what my boyfriend and I were going to eat during Pesach was a bit of a depressing process for me, however; there was one beacon of hope!  Early last week a friend emailed me for my matzoh crunch recipe.  I had made it last year and brought it to my office (filled with mostly Jews) and this friend like it so much that she went home that night and made it for her boyfriend.  He liked it so much that he requested it again this year!  I don’t know how but I until I received her email I had totally forgotten about the matzoh crunch.

This recipe is quick, easy, delicious and has brightened up my Pesach!  Some complain that it’s too sweet so I tried a variation this year by sprinkling the top with some citrus vanilla fleur de sel.  Being a fan of the salty/sweet combo I really enjoyed the variation.  I promise, you won’t regret making this treat for the last few days of Pesach!

Matzoh Crunch

5 plain matzohs

1 cup (2 sticks) local organic unsalted butter

1 cup packed brown sugar

about 8 oz (3/4 a standard bag) chocolate chips (I didn’t used Kosher l’Pesach chocolate because I don’t keep it that strictly but feel free to use it if you do keep strictly)

a few sprinkles of fleur de sel (optional)

other toppings such as nuts (optional)

Pre-heat oven to 375 degrees.  Line a large edged baking sheet with foil making sure to cover edges.  Line bottom of sheet with parchment paper.  This is important since the crunch can get very sticky.  Place matzohs on prepared sheet (you may have to break the fifth matzoh in half to make it fit).

Melt butter and brown sugar in a saucepan and let boil for a few minutes until thick.  Stir constantly.  Once thick remove from heat and immediately pour over matzohs spreading with knife to cover if necessary.

Place in oven and bake for about 10 mins.  Check matzoh after 5 mins to ensure it isn’t burning.

Remove from oven and sprinkle evenly with chocolate chips.  Let stand 5 mins so that chocolate chips melt.  Spread chocolate chips to cover matzohs.  Immediately sprinkle fleur de sel or other toppings if using.

Let cool fully and break into pieces.  Store in an airtight container.

Here in the Berkshires, we’ve reached perfect maple syrup tapping temperatures: days above freezing, and nights below freezing. I had the chance to participate in some tree tapping last week.

Today The Cleaner Plate Club featured an article on Vermont maple syrup and sugaring that gives a clear picture of the syrup-making process.

In the past many maple syrup producers tested the readiness of their product by putting a small amount of lard on top of the syrup; nowadays most maple syrup makers use vegetable oil. To make sure your syrup is kosher, look for a kosher certified symbol, or contact the farmer or manufacturer. Check out this site for more information on kosher maple syrup. If you get the chance, visit a sugar shack this season to enjoy in the delights of maple.

I promise I will have more recipes from my CSA in the next few days (here’s a hint: collard greens) but today I want to take a break from the veggies to share something really outstanding!  Last weekend my boyfriend and I had one of his old friends over for a bit of a feast, here is the menu: Maui ribs (for the boys – I’m a vegetarian), fork-mashed potatoes, kale, braised fennel… and of course dessert.

My boyfriend and I had been to a french restaurant the night prior and shared chocolate mousse for dessert.  It was good but a bit heavy and dense for my taste.  The next day I started thinking about what to make for dessert and lacked inspiration so I asked him what he wanted me to make.  He clearly didn’t get his filling of mousse the night before and asked me to make more!  I had never made mousse before so I set out to find a good recipe.  I looked through many cookbooks but ended up looking to the chef who is a master of all things comfort food – Tyler Florence, though I did adapt his recipe slightly.  Tyler’s recipes never steer you wrong.  In fact, if you’re ever looking for some outstanding mac and cheese his is fantastic.

Ok, back to the mousse… it turned out to be quite simple and absolutely delicious.  My boyfriend and his friend agreed that it was restaurant-quality!  The best part is that if you have extra and cover it tightly with plastic wrap it will last in the fridge for a few days.  Since you can make this ahead of time it would be perfect for a dairy Shabbat lunch for those of you who don’t cook on Shabbat.  As a side note, the reason you want to keep it covered is that it will take on flavors of other things in the fridge – same reason you always want butter covered.  Now for the recipe…

6oz (or half a regular sized bag) good quality semisweet chocolate chips (being in SF I prefer Guittard or Ghirardelli).

3 tbsp unsalted butter at room temperature

3 large eggs (grass fed and organic if possible), separated

1/2 tsp cream of tartar

1/4 cup plus 2 tbsp sugar

1/2 cup plus 1 cup heavy cream, cold

3/4 tsp vanilla extract

Put a medium/large mixing bowl in the freezer.

Put the chocolate and butter in a microwave safe bowl and microwave for 30 seconds, stir, repeat until totally smooth.  You can do this with a double boiler but I can’t imagine why you’d bother (more dishes to clean and more time). Let the chocolate and butter mixture cool.  Temper the egg yolks with a bit of the chocolate mixture so that their temperature gets higher (we don’t want scrambled egg yolks in chocolate).  Then grab a whisk and beat the egg yolks into the chocolate 1 at a time, beating until smooth after each addition.  Set aside.

In another bowl, beat the egg whites with an electric mixer until foamy.  Add the cream of tartar and beat until soft peaks form (a few minutes).  Gradually beat in 1/4 cup sugar and continue beating until stiff peaks form ( a few more minutes).

Remove the bowl from the freezer, beat the heavy cream in it with an electric mixer until it begins to thicken up. Add the remaining 2 tablespoons sugar and the vanilla and continue beating until the cream holds soft peaks.  Do not over beat or you’ll end up with butter.

Now that you’ve got everything prepared, put it all together. Gently fold the egg whites into the chocolate mixture to lighten it. Then, fold in the whipped cream. Make sure you don’t over work the mousse or it will be heavy (I think this is what happened to the mousse at the french restaurant I mentioned).  Divide the mousse between 4 individual glasses. Cover and chill for several hours.  Beat the remaining 1 cup heavy cream to make whipped cream for garnish.  The mousse is fairly sweet so I wouldn’t recommend making the whipped cream sweet too – but it’s up to you.  You could add a dash of cinnamon or vanilla extract though if you’d like.  Please let me know how yours turns out and enjoy!

According to OUKosher.org, “high fructose corn syrup made up… about 56% of the sweeteners that Americans consumed in 1997.” That was 12 years ago. Is a new pattern emerging, in favor of sugar?

This is an especially interesting question as we approach Passover. Generally, high fructose corn syrup is treated as a no-no chametz ingredient, come Passover. This discounts some popular foods during the eight days, including sodas and ketchup… unless it is known that the particular high fructose corn syrup used is a kosher-made variety.

Beyond the Passover debate, some circles have declared that drinks sweetened with real sugar, rather than the less expensive and plentiful sweetener of choice, corn syrup, are actually tastier. Some argue that the Mexican-made Coca Cola, said to be made with sugar rather than American-made Coca Cola, made with HFCS, is better. And now even Snapple is switching over, which, according to the New York Times, is at least part of the reason that some flavors of the drink are now lower in calories.  Stay tuned, sugar and high fructose corn syrup fans!