Vegetables, Not Prozac

Oftentimes in my medical practice, I counsel people on the most basic medicine available to them - their food, and as I tell them, it is this medicine that they happen to put into their bodies several times a day. It’s completely possible that disease can be addressed purely through diet for certain conditions such as metabolic syndrome, diabetes, and cardiovascular disease, but, it can also impact other diseases for which one may not think would be amenable to dietary treatment such as cancer or multiple sclerosis for example. One of the biggest challenges I face is to be able to change a patients food routine, as many of the millions of Americans who have ever tried dieting know. It can be quite a monumental task. I find that the psychological aspect is usually the greatest barrier to adapting a more healthful diet, not the lack of knowledge. While it’s true that there are varying opinions out there on what constitutes healthy food, I think we can all agree that the addition of a wide range of vegetables and fruits is highly beneficial across the board. A large majority of people that I see know this but implentation and consistency is surely a different story. This is especially true when you start off with what I call a SAD diet (standard ameridan diet), which is essentially brown, white and tan foods; asking someone to incorporate colorful vegetables and fruits can seem alien and can actually be unpalatable.  People tend to turn to their comfort foods especially in times of an illness (emotionally or physically).  The term “comfort food” means simple, informal home cooked foods that have an emotional significance to an individual. There is a sense of being nourished and happily satiated with the particular food and the emotional connection may be tied to postitive childhood associations e.g. getting ice-cream as a reward or a way to lift the spirits, easily digested rice, bread or pasta when one is ill. Though they can vary quite significantly from person to person, they generally tend to be some variation of fat, carbohydates and sugar. There are some interesting biochemical theories to explain the phenomena, one being that carbohydrates increase the synthesis of serotonin, a neurotransmitter, known to be involved in improving mood. So a bowl of mashed potatoes may lead to the release of serotonin thus leading one to feel an emotional satiety/happiness. Much of this theory is dicussed in the book “Potatoes, Not Prozac” by Kathleen DesMaisons.

Why the jury is still out (and will be out for many years to come), the question I have is this: putting aside the possibility that there may be complex biological mechanisms for the preference for fat, carbs and sugar, can we enforce a psychological and emotional positivity around healthy foods like vegetables? Can a child grow up with sugar snap peas as their comfort food if given the right postitive associations early in life? It seems very plausible. My sister-in-law S told me that when she grew up surrounded by farms, she learned to eat and love vegetables by picking and enjoying them right on the spot. She and her two sisters eventually became vegetarian. This is anecdotal for sure, but I believe that this is one important piece of the puzzle and I think the awareness and exposure you give a child is one of the major ways you can overcome a lifetime preference for unhealthy food. We recently had kids aged 4-7 at our homestead. We picked some english peas to try. The kids had no idea that peas, which they had eaten a lot of in their short lives, came from a plant, and had to be shelled from a pod. And when they tasted it, no sugary candy could compare. For the next few hours we had constant requests to revisit the pea trellises for more peas! These kids will hopefully have fond memories and associations with this simple interaction by equating peas with pleasure among other things. These are but simple steps to create an awareness that can possibly have huge implications on their health and the health of our planet.

Many farms have educational programs for children. Nearby us are Stone Barns Center for Food and Agriculture (Pocantico Hills, NY), Rainbeau Ridge (Bedford, NY), and Sprout Creek Farm (Poukeepsie, NY). I encourage all of you to expose the children in your lives to there programs. We brought our nephew MM to see a 45 minute production called “Clucky the Brave Little Hen” last week at Stone Barns. It’s a story about a factory-raised hen who yearns to be free in the pastures. Clucky makes friends with a little cell-phone toting, high fructose corn syrup juice-drinking girl who hates being outside for fear of bugs and dirt and who finds the pleasure of video/TV/phone/internet far more entertaining. They head out to find a farm that has happy well-cared for animals. While there, instead of pure grain-feed laced with antibiotics, Cluckly happily acquires the taste for bugs and grass. Similarly, the little girl then finds the strange long orange vegetable called a carrot, as sweet and better than her artifically colored and flavored jelly beans. Interspersed with song and high-energy comedy, the show covered all the important concepts like composting, the cycle of life, humane treatment of farm animals, and sustainable farming. I found it so entertaining, I would even recommend it to any adult on its own merits. And, David Rockefeller, at age 92, patron of Stone Barns, was even at the back row enjoying the show.

There is one performance date left on July 12 and special ticket packages include a livestock tour or a pick-your own eggs event after the show.

Farmer Pam, MD

Weekly Musings: Beet Greens

Last winter, when we were trying to plan non-material holiday gifts for the family, I asked my sister-in-law if she'd enjoy a CSA (community supported agriculture) subscription enabling her family to access local produce on a weekly basis from the spring through the fall.  Her hesitation was that she didn't want to be stuck with vegetables she didn't know what to do with or that would require too many precious hours trying to figure out what to do with.  This is the issue that a lot of people have with CSA's - no voice in the choice of what they get.  Probably conjures up, to some, what socialism must feel like: you get what you get and that's it.  But with a little effort, and a change in thinking about food, it's probably a really beneficial thing in the end when you consider how little we rotate the typs of food we eat.  And in my experience, repetitious eating of one type of food has led the susceptible some to develop food intolerances or food allergies.

One interesting reflection is this: my homestead/farm is a giant CSA box and during this first full year of production, I'm feeling the challange of eating seasonally and locally on a large scale.  How many ways can I have english peas, sugar snap peas, and puntarelle (Italian dandelion)?  Just yesterday, I harvested 9 lbs of baby beets of which 6 lbs of those were beet greens.  Only recently have I seen beet greens packaged in salad bags at Whole Foods.  Typically, they were discarded or given away for free from the grocer years ago, but I've witnessed their revival as a "new" addition to the green leafy vegetable repetoire.  Beets can be easily stored in the refrigerator crisper if you remove the greens and leave about an inch of stem in place but the greens need to be eaten in a much shorter period of time.  I counsel people very frequently on food as either part of prevention or for therapeutic reasons and I find myself, like some of my patients who almost exclusively enjoy a brown, white and tan diet, a little afraid of the large mound of beet greens that lay in front of me.  There's the obvious sauteeing of the greens with garlic and oil.  Simple, nice, but over the next week, my taste buds need more to interest me.

photo from The New York Times 

 Here are some interesting recipes I have lined up for the next week, all found on the web:

1. Sauteed Beet Greens (non vegetarian)

2. Sauteed Beet Greens (vegetarian)

3. Roasted Beet Salad with Beet Greens and Oranges (from Epicurious)

4. Beet Green Pasta (from Alice Waters Chez Panisse Vegetables)

If a structured recipe is not your thing, Chowhound has wealth of ideas from many people answering a blog query on ideas for beet greens.

Eat mindfully!

Farmer Pam, MD

Update on Tuesday, August 17, 2010 at 8:45PM by Pam

I have to share the latest beet green recipe I've discovered.  It has an Indian influence and can easily be interchanged with swiss chard.  Yum!

RECIPE: Spice Sautéed Beet Greens with Almonds and Chickpeas

Bitter Melon, Bitter Medicine

Some of the choices we made in the selection of vegetables and fruits to grow not only reflected what we wanted to eat on a regular basis but also how accessible is the food itself. When I decide to plan a meal and  I open an ethnic cookbook, I’m often limited by the availability of the ingredients. I’m not about to travel an hour plus to find Chinese Bitter Melon, for example, so I decided to grow it along with other esoteric produce. So what can one do with Chinese Bitter Melon?

Medicinal Uses of Bitter Melon (Momordica charantia)

First of all, this warty looking oblong melon or gourd, like it’s name implies, is quite bitter especially when eaten raw (not recommended). It is high in Vitamin C and folic acid and used in a range of different cultures known as “fu gwa” in China, “karela” in India and “nigauri” in Japan. It’s typically prepared in soups and stir-fries. Like many other bitter vegetables, bitter melon is helpful for digestion. Europeans have traditionally used “Swedish Bitters,” a mixture of bitter herbs including angelica root, aloe, myrrh, rhubarb root, camphor and saffron, for a variety of digestive ills. Its mechanism of action is thought to be through the release of digestive “juices” including saliva, bile, gastric acid and pancreatic enzymes. Angostura Bitters, made primarily from Gentian root, is used in various alcoholic beverages in addition to aiding in digestion as well.

Of all the flavors discernable by the human tongue: salt, sugar, sour, bitter and the more recently recognized 5th taste “umami,” the western palette favors bitter flavors the least. Some examples are endive, mustard greens, broccoli rabe, and brussels sprouts. The interesting association that bitterness=medicine=good for you may hold true here, at least in the case of the family of cruciferous vegetables (broccoli, cabbage, kale, brussels sprouts, mustard greens and broccoli rabe). They tend to become more bitter as they mature or when cooked and recent research is continuing to amass significant evidence showing the phytochemicals present in this family of vegetables is a crucial element in cancer prevention and may even be helpful to those with existing cancers.

There are other benefits of bitter foods aside from digestion and cancer prevention (though at this point I’m hoping you’ll be more inclined to add these into your food repertoire after hearing the health benefits), which brings me back to Chinese bitter melon. Increasing data points to this cucurbit’s ability to help with sugar metabolism. You might see it as one of the principle agents in supplements and neutraceuticals targeted to diabetes, metabolic syndrome, or glucose intolerance. Studies are small and not very vigorous so far but what evidence is currently available seems to suggest a glucose lowering benefit from consuming these fruits or their extracts. A 7 week study demonstrated significant lowering of the HbA1c (an average indicator of a person’s sugar level). You will also undoubtedly see Bitter Melon in weight loss supplements but there is no current evidence to suggest that, only a theoretical one. In addition, it seems that bitter melon can also have a cholesterol-lowering effect due to the flavonoid content and will bound to be, if not already, the next herbal addition to cholesterol lowering supplements.

From a non western medicinal viewpoint, I also want to add that bitter melon is used in traditional Chinese medicine for dispelling excess “heat.” In Ayurvedic medicine, Bitter Melon or “karela” as it’s known, can affect the Doshas (the three basic physiological principles that maintain balance in the body) specifically calming Pitta and Kapha doshas.

It is not advisable to consume this during pregnancy as recommended from traditional cultures.

How to Grow

My seed was saved from an aunt but seeds can be found online relatively easily. I’d recommend Kitazawa Seed Co. I started my seed indoors under a heat mat 2 weeks before the final frost date but these can be easily seeded directly provided the soil temperature is warm enough. I’d recommend starting indoors for those with a shorter growing season. They enjoy heat and sun. Remember, they are a sub-tropical fruit. They also need a trellis or similar type of support system as this is a vining plant. Harvest younger fruits for best taste.

Recipe

Pork Filled Chinese Bitter Melon with Black Beans

Ingredients:
1 tsp chopped garlic
salt
1 tsp sesame oil
1/2-1 Tbs corn starch
1/2 tsp sugar
1/2 cup water
Bitter Melon 1/2 lb
Ground Pork 6 ounces
1 tsp fermented black beans*
1 tsp crushed red pepper
2 scallions chopped and 2 Tbs chopped cilantro (optional)
Vegetable Oil for frying (suggestions: grapeseed, rice bran, canola oil)

Cut off ends of the bitter melon and cut 3/4”-1” thick slices and discard the seeds. Place melon in boiling salted water for 3 minutes then drain and rinse with cold water. When cooled, dry the melon.
Combine 1/2 tsp salt, 1/2 tsp sugar and 1/4 cup of water. Mix to dissolve and put aside.
Mix ground pork with the garlic, 1/2 tsp salt, sesame oil and 1 Tbs corn starch and the scallions and cilantro.
Coat the inside of the melon with a little corn starch and fill with the pork mixture.
Heat a frying pan and add approximately 2 Tbs oil. Cook both sides of the pork-filled melon around 3 minutes each then remove to a plate.
To the existing hot oil, add the red pepper flakes and black beans and cook for 1 minute. Add the pork-filled melon slices and add the the salt/sugar mixture in. Cook for 3-4 minutes longer. Serve with rice. Serves 2.

* available at Asian markets

Farmer Pam, MD

Origins

I grew up in Queens, New York in the 1970’s. The quintessential NYC suburburban-like borough attracted large amounts of middle class immigrant populations changing the standard white landscape into a myriad of colors.  My friends were either Greek, Italian, Korean, Chinese, or Indian.  Today, much of Queens has become neighborhoods of small ethnic enclaves where one can find a vast culinary palette and as authentic as the real travel to those countries.  But back then, the ease of finding certain ingredients for cooking your particular ethnic food would be more than a short walk to Key Foods, our neighborhood market.  Bok choy, a common vegetable now even at large chain grocery stores, were far from readily available, so growing your own unusual foods became a routine event every spring at my home and on the smallest patch of land.  As I try and think of utilizing the comparatively larger space I now have to grow food, my Chinese grandmother had already figured out how to trellis all sort of heavy Chinese melons, grow the requisite tomato -- for Tomato Beef of course, not marinara, and yard long asparagus beans for wok-charred beans. All in a 2 1/2’x5’ plot and enough to supplement feeding a family of five.  And she never spent a penny on buying a trellis.  It was constructed from saved bakery string, bamboo sticks reused from year to year and branches and twigs which she’d collect.  We lived in a development at the time, a step up from Jackson Heights, where one could have a small patch of grass and look out onto virtually treeless lawnscapes and poorly placed rock formations desperately trying to look like they were there forever.  There were no forests or lush landscapes where one can pick up twigs or branches so grandma was always on the lookout for these things wherever she walked.  And she always saved seed so I suppose I was always eating heirloom varieties as a child.

My grandmother raised her family in a small village near Canton, China and had a few acres of rice fields.  I recently spoke to my father about his recollection of how food was grown in his village.  He said, in a cautious voice, “Well, it was very disgusting.”  “What do you mean?” I asked knowing full well this would entail something unsanitary and shocking.  “People used poop, like cow, pig and...” “Human manure?!”  I interjected.  Apparently, pigs and cows had a presence on the farm but it was not enough to fertilize all of the rice fields and human waste products made up for the rest.  “We all went to the toilet at the edge of the town.”  This immediately conjured up the outhouse scene from Slumdog Millionaire and my stomach started to churn.  But our modern-day revulsion aside, the use of human manure for fertilizer has been a centuries old tradition in many countries and this practice of using both human manure and urine continues in poor developing world cities.   But as far fetched as this may sound, right here in the US, Milwaukee has been using “night soil,” the euphemism for treated human feces, as dried and bagged fertilizer for more than 60 years and Duluth, Minnesota had also caught on to the free crop boosting from sludge aka human poop, in 2003. (Incidentally Duluth is 60 miles south of where my grandma emigrated to from China and where my Dad went to college).  Aside from the usual worries of bacterial, protozoal and viral pathogens, I’d worry about all the potential medication residue from our pharmaceutical excesses.

So naturally, I wondered whether or not any of these practices made it back to Queens, New York.  “So Dad, Grandma didn’t use any chemicals right?” After all grandma started sounding like an eco-conscious, seed-saving organic farmer before it was all popular.  “Urine” was my Dad’s reply.  “Huh?” I said.  “Bernie’s baby urine” he uttered, hoping not disgust me by making the unpalatable more palatable by making it come from a baby.  I fully knew that Bernie, my brother, was no baby when I was started to become aware of grandma gardening.  And as it turned out, the two males in the family, my brother and my dad were the ones that could easily contribute from time to time.  Now, as I realize I am starting to sound like I come from one seriously backwards (or at least backwoods) family, I want to point out that urine is a great source of nitrogen, potassium, phosphorus and some other trace minerals.  Researchers in Finland reported the use of human urine as fertilizer in a 2007 study showing that cabbage showed better growth and biomass when grown with urine compared to conventional fertilizers and without any nutritional compromise.  And keep in mind that urine is sterile, in fact, it was used during war to help wash off wounds when there was no available water source.  It has become a topic of eco-conscious gardeners who truly want to reduce, reuse and recycle!  And, as long as my dog takes a short piss on the lawn, it'll make the grass grow beautifully in that one spot; too much of it, like any other fertilizer, will kill the grass.  I asked my dogs if they’d consider drinking more water to dilute their urine and perhaps making a conscious effort to spread the love over the entire lawn, but to no avail.

After consideration of my family farming methods, as an organic homesteader, I am taking a different direction and turning to compost (sans animal or human waste, mind you) as the main method of supplying soil fertility.  And like grandma, I will seed save and use my creative imagination to put together what I already have lying around (not in the toilet!) to continue to keep up the farm.

Farmer Pam, MD