Healthy Programs: January 2012

Tomato and Avocado Salsa: A Basic Salsa Recipe of Deliciousness

This post first appeared in January 2010. (Um, you can probably tell by the first line.)

It’s the second full week of 2010. By now, you may be ten or eleven days into a resolution diet. You’re probably feeling really good about your progress. Chances are you lost a little weight. There’s a possibility you noticed a physical change already. You might even be thinking (and justifiably so): “I am the greatest person alive! Besides Eddie Vedder, I mean.”

Sadly, this may also have crossed your mind: “If eat one more salad, I’m going to set my face on fire.”

Sweet baby Jane, I hear you. When I began to change my eating habits, salads made up a big chunk of my diet. Office lunches were never-ending parades of the Caesar varietals (with light dressing, natch), and I got real tired, real fast of baby spinach. Then, I learned to cook and life got exponentially better. (Exponentially! That’s a lot.)

Anyway, once I started puttering around the kitchen, I realized the following:

lean meat + sauces, spreads, dips, salsas or dressings = excellence

With a creative topping, you can turn five ounces of pedestrian grilled chicken into a succulent celebration, a flavoral fooferaw, or even a scrumptious shindig. (Or any other gratuitously alliterative party.) Think of the meat as your canvas, and the accompaniment as your pretty rainbow paint of rainbows.

Take Gail Simmons’ Tomato and Avocado Salsa from Food & Wine, for example. You can use it as a dip for chips or veggies, sure. (The Super Bowl’s coming up, after all.) But on plain poultry, it becomes something else entirely: a tasty, filling, healthy dinner. Like almost all salsas, the recipe is staggeringly easy to make and constitutes a solid serving of vegetables. For $1 and 100 extra calories, that ain’t too shabby.

This week, when you’re choking down another round of Romaine, stop. Grab an avocado and a few grape tomatoes, grill a slice of chicken, and treat yourself to Tomato and Avocado Salsa. It’ll make the next few months a lot easier to stomach.

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If you like this recipe, you might also dig:

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Tomato and Avocado Salsa
Serves 4.
Adapted from Food & Wine.

1 1/2 cups grape tomatoes, halved or quartered
1 Hass avocado, diced small
1/4 cup onion, chopped small
1/2 small jalapeno, seeded and minced
1/8 cup cilantro, chopped
1/8 cup fresh lime juice
Kosher salt and freshly ground pepper

1) In a medium bowl, gently combine all the ingredients. Salt and pepper to taste. Stir again to combine. Serve on meat, chicken, fish, chips, cheese, or … anything, really.

NOTE: If you’d like a less chunky salsa, chop the tomatoes and avocado even smaller.

Approximate Calories, Fat, Fiber, and Price Per Serving
4 servings: 100 calories, 7.4 g fat, 3.7 g fiber, $1.04

Calculations
1 1/2 cups grape tomatoes, halved or quartered: 45 calories, 0 g fat, 0.1 g fiber, $2.50
1 Hass avocado, diced small: 322 calories, 29.5 g fat, 13.5 g fiber, $0.99
1/4 cup onion, chopped small: 13 calories, 0 g fat, 0.6 g fiber, $0.08
1/2 small jalapeno, seeded and minced: 9 calories, 0 g fat, 0.3 g fiber, $0.05
1/8 cup cilantro, chopped: negligible calories and fat, 0.1 g fiber, $0.25
1/8 cup fresh lime juice: 10 calories, 0 g fat, 0.2 g fiber, $0.25
Kosher salt and freshly ground pepper: negligible calories, fat, and fiber, $0.03
TOTAL: 399 calories, 29.5 g fat, 14.8 g fiber, $4.15
PER SERVING (TOTAL/4): 100 calories, 7.4 g fat, 3.7 g fiber, $1.04

What Causes Insulin Resistance? Part III

As discussed in previous posts, cellular energy excess and inflammation are two important and interlinked causes of insulin resistance. Continuing our exploration of insulin resistance, let's turn our attention to the brain.

The brain influences every tissue in the body, in many instances managing tissue processes to react to changing environmental or internal conditions. It is intimately involved in insulin signaling in various tissues, for example by:

regulating insulin secretion by the pancreas (1)
regulating glucose absorption by tissues in response to insulin (2)
regulating the suppression of glucose production by the liver in response to insulin (3)
regulating the trafficking of fatty acids in and out of fat cells in response to insulin (4, 5)

Because of its important role in insulin signaling, the brain is a candidate mechanism of insulin resistance.

Read more »

What Causes Insulin Resistance? Part II

In the last post, I described how cellular energy excess causes insulin resistance, and how this is triggered by whole-body energy imbalance. In this post, I'll describe another major cause of insulin resistance: inflammation.

Inflammation

In 1876, a German physician named W Ebstein reported that high doses of sodium salicylate could totally eliminate the signs and symptoms of diabetes in certain patients (Berliner Klinische Wochenschrift. 13:337. 1876). Following up on this work in 1901, the British physician RT Williamson reported that treating diabetic patients with sodium salicylate caused a striking decrease in the amount of glucose contained in the patients' urine, also indicating an apparent improvement in diabetes (2). This effect was essentially forgotten until 1957, when it was rediscovered.

Read more »

What Causes Insulin Resistance? Part I

Insulin is an ancient hormone that influences many processes in the body. Its main role is to manage circulating concentrations of nutrients (principally glucose and fatty acids, the body's two main fuels), keeping them within a fairly narrow range*. It does this by encouraging the transport of nutrients into cells from the circulation, and discouraging the export of nutrients out of storage sites, in response to an increase in circulating nutrients (glucose or fatty acids). It therefore operates a negative feedback loop that constrains circulating nutrient concentrations. It also has many other functions that are tissue-specific.

Insulin resistance is a state in which cells lose sensitivity to the effects of insulin, eventually leading to a diminished ability to control circulating nutrients (glucose and fatty acids). It is a major contributor to diabetes risk, and probably a contributor to the risk of cardiovascular disease, certain cancers and a number of other disorders.

Why is it important to manage the concentration of circulating nutrients to keep them within a narrow range? The answer to that question is the crux of this post.

Read more »

New York Times Magazine Article on Obesity

For those of you who haven't seen it, Tara Parker-Pope write a nice article on obesity in the latest issue of NY Times Magazine (1). She discusses research showing that the body "resists" fat loss attempts, making it difficult to lose fat and maintain fat loss once obesity is established.
Read more »

Egg McMuffins for Homeskillets

This was first published in 2009. In retrospect ... a tuna can? Yep. A tuna can.

Like 10% of all Americans, I used to work at McDonalds. Like 33% of all McDonalds workers, it was the morning shift.

Everyday in the summer of 1997, I hauled my cookies in at 5am to start the percolator, fire up the grill, and lug 50 pounds of Happy Meal toys out of the sub-basement. My early morning co-workers were a sweet 72-year-old, a slightly retarded janitor, and a middle-aged woman that had no business dealing with the public. On good days, I got to take orders from the drive-through, and didn’t have to face anyone for a few hours. On bad days, entire buses of senior citizens would argue with me over the price of a 60-cent cup of coffee.

During that time, I learned the menu backwards and forwards, including basic nutritional information for most of the meals. While the Deluxe breakfast would melt your aorta, I was always pleasantly surprised at the Egg McMuffin. An egg, a muffin, a slice of Canadian bacon, and a dollop of cheese would come in around 300 calories, which still stands as one of the leanest fast food breakfasts around. Plus, they were (and are) delicious. I know. I ate one every morning for three months.

After last week’s Strata, I had a bunch of leftover Canadian bacon, and decided to give homemade Egg McMuffins a shot. Happily, it wasn’t rocket science, and ten minutes of cooking time scored me two eminently edible imitations of the real thing. Even better, no one yelled at me afterward.

So! For your McMuffining pleasure, here are step-by-step instructions for homemade Mickey D’s. Of course, there are a few things to know first:

1) If you don’t have an egg ring handy (and who does?), try a THOROUGHLY WASHED tuna can with the lids pried off. (NOTE: Don’t use a Bumblebee can. The bottom lid sticks outward, making it nearly impossible to remove. See the pics below? It took ten minutes of straight-up wrestling to create that hole. In the end, it was big enough to pour the egg through, but I almost lost a thumb in the process.)

2) For a more McDonalds-like experience, go with American Cheese. Then, have a 62-year-old retiree berate you because his coffee was too hot.

3) The muffins aren’t browned in a toaster for two reasons: A) they’re harder to hold, and B) I like ‘em better this way.

4) At $0.93 a serving, these should be cheaper than your local Mickey D’s. If not, look at it this way: you don’t have to deal with the tall girl behind the counter. You know – the one with the 1000-yard stare, whose only thought is, “Man, I can’t wait to get back to school. This nametag is making my boobs itch.”

Happy cooking!

Egg McMuffins
Makes 2 McMuffins

Cooking spray
2 English muffins, split in half
2 slices Canadian bacon
2 large eggs
1 ounce reduced-fat sharp cheddar cheese, grated (I prefer Cracker Barrel)
Salt and pepper to taste

1) Coat a medium non-stick pan with cooking spray and heat on medium-high. Once pan is warm, place English muffins facedown on pan. Squish lightly with a spatula, so they get evenly browned.

2) While muffins are toasting, break one egg into a cup. Break its yolk with a fork, but DON’T beat the egg.

3) When muffins have been lightly toasted (about 3 minutes), place them on a plate and IMMEDIATELY sprinkle grated cheese on one side. This will get the melting process started.

4) Re-coat the pan with cooking spray. (Note: if you have a gas oven, do this away from the stovetop to avoid a fire.) Place the Canadian bacon in the pan. Place an egg ring OR thoroughly washed tuna can (with both lids removed) on the pan. Pour the egg into the ring. If some should leak out the bottom, no worries. You can flip it later.

5) After 2 or 3 minutes, the egg should be pretty set, so cut it out of the ring and flip it over. Then, add egg #2 to the ring. Flip the bacon while you're at it, too.

6) After another minute or so, egg #1 should be finished. Place it on top of one of the cheese-covered muffin halves, and add salt and pepper to taste. Then, add a slice of Canadian bacon and top with the other muffin half. Press down lightly with a spatula so the egg will finish melting the cheese.

7) Repeat steps 5 and 6 with the remaining ingredients.

8) Take a blog picture in front of a sufficient light source.

9) Serve and eat with glee.

Approximate Calories, Fat, and Price Per Serving
283 calories, 12.4 g fat, $0.93

Calculations
Cooking spray: 0 calories, 0 g fat, $0.04
2 English muffins, split in half: 240 calories, 2 g fat, $0.38
2 slices Canadian bacon: 89 calories, 4 g fat, $0.79
2 large eggs: 147 calories, 9.9 g fat, $0.38
1 ounce reduced-fat sharp cheddar cheese, grated: 90 calories, 9 g fat, $0.25
Salt and pepper to taste: 0 calories, 0 g fat, $0.02
TOTAL: 566 calories, 24.9 g fat, $1.86
PER SERVING (TOTAL/2): 283 calories, 12.4 g fat, $0.93

Medical tourism: Trends for 2012 and beyond

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: "Medical tourism: Trends for 2012 and beyond"

Medical tourism: Trends for 2012 and beyond
Christmas is over, the New Year is upon us, so it’s time to dust off the crystal ball and put forward our take on what’s in store for medical tourism in 2012 and beyond. We’ve looked at the future of medical tourism from three perspectives – the market, the patient and the industry

The market

The global economic downturn and medical tourism
Forecasts for the global economy are not encouraging....recession in Europe, anaemic growth in the US and slow growth in the emerging market economies is anticipated for 2012 (Morgan Stanley: 2012 Outlook). If you are in the medical tourism sector, you need to understand some of the fundamental trends that affect businesses and markets in a recession.

In the mature, developed economies (e.g. USA, Europe) continued unemployment and pressure on disposable income will influence demand in 2012. Consumers will minimise or reduce spending on healthcare where they can. This does not mean that hard pressed consumers will be flocking abroad for their operations to save money. Many will delay treatment, or in the case of “optional surgery” such as cosmetic surgery, they may not be able to afford it at all. Domestic prices for surgery will be driven down as hospitals apply marginal costing and prices to fill empty beds. In areas of treatment, where the need for treatment is “income-inelastic”, demand for medical tourism services will remain strong. Patients will continue to dig deep for services such as infertility treatment, stem cell treatment, and for surgery which is essential, life-saving or life changing.
In emerging markets (such as Russia, China), the growth in incomes (and freedom to spend) is outstripping the development of domestic healthcare services and this may drive demand for medical tourism and present new opportunities.

The big question is whether corporate or insurer paid medical travel will get off the ground in 2012. Will employers and insurers see medical travel as a realistic and credible option to reduce healthcare costs. And will their client and subscriber base actually “buy in” to the medical travel option if it is offered to them?

Medical tourism..... global healthcare or regional medicine?
In 2012, there’s a risk that we get distracted by the trumpeting of “global healthcare”. It’s a nice turn of phrase, but in the real world, medical tourism is about regional medicine and cross-border healthcare; this is not going to change in 2012. In fact, the boundaries of medical travel may be drawn in, as travel costs increase. As travel costs climb, the concept of long distance medical tourism becomes less attractive. The imposition of hefty departure taxes in countries such as the UK, Germany and elsewhere will reduce the cost advantages of some destinations.

If you are in the medical tourism business, ALWAYS remember that, for most patients, going abroad for treatment is a decision of last resort. AND that the further a patient has to go... further from their own country....further from their own culture... the greater is the actual and perceived risk. The patient needing major surgery who takes a five hour flight to a country with a different language and a different culture is a comparative rarity.

So is it medical tourism boom.... or bust?
The honest answer to this one.... is probably neither. In recent years, we’ve listened to the hype........

.........to find out more about "Medical tourism: Trends for 2012 and beyond", read the full medical tourism article at IMTJ.

High-Fat Diets, Obesity and Brain Damage

Many of you have probably heard the news this week:

High-fat diet may damage the brain
Eating a high-fat diet may rapidly injure brain cells
High fat diet injures the brain
Brain injury from high-fat foods

Your brain cells are exploding with every bite of butter! Just kidding. The study in question is titled "Obesity is Associated with Hypothalamic Injury in Rodents and Humans", by Dr. Josh Thaler and colleagues, with my mentor Dr. Mike Schwartz as senior author (1). We collaborated with the labs of Drs. Tamas Horvath and Matthias Tschop. I'm fourth author on the paper, so let me explain what we found and why it's important.

The Questions

Among the many questions that interest obesity researchers, two stand out:

What causes obesity?
Once obesity is established, why is it so difficult to treat?

Our study expands on the efforts of many other labs to answer the first question, and takes a stab at the second one as well. Dr. Licio Velloso and collaborators were the first to show in 2005 that inflammation in a part of the brain called the hypothalamus contributes to the development of obesity in rodents (2), and this has been independently confirmed several times since then. The hypothalamus is an important brain region for the regulation of body fatness, and inflammation keeps it from doing its job correctly.

The Findings

Read more »

Welcome to CHG: A Quick Overview

With the dawn of 2012, comes the dawn of many a resolution. If you’re visiting the blog for the first time, welcome! We’re so happy to have you. Bathroom’s on the left. If you’re a longtime reader, we love you! We’re not kidding. It's a little scary.

To get an idea of what CHG is all about, our FAQ and mission statement are good places to begin. To go a little deeper, these six posts give a pretty solid overview of what we do here:

Our master article directory of over 150 similar pieces can be found here. We also post one or two frugal, healthy, and delicious recipes per week, which are compiled here. There are over 400 right now, and we’re always adding to the list. Here are ten fairly simple favorites to get you started:

Hope you’re enjoying the blog so far. We’d love to hear from you if you have suggestions, and best of luck with your resolutions!

Junk Free January

Last year, Matt Lentzner organized a project called Gluten Free January, in which 546 people from around the world gave up gluten for one month. The results were striking: a surprisingly large proportion of participants lost weight, experienced improved energy, better digestion and other benefits (1, 2). This January, Lentzner organized a similar project called Junk Free January. Participants can choose between four different diet styles:

Gluten free
Seed oil free (soybean, sunflower, corn oil, etc.)
Sugar free
Gluten, seed oil and sugar free

Wheat, seed oils and added sugar are three factors that, in my opinion, are probably linked to the modern "diseases of affluence" such as obesity, diabetes and coronary heart disease. This is particularly true if the wheat is eaten in the form of white flour products, and the seed oils are industrially refined and used in high-heat cooking applications.

If you've been waiting for an excuse to improve your diet, why not join Junk Free January?