Chicken, Vermouth, and Wild Rice Stew

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Ingredients

1 vidalia onion

3 shallotsIMG_5242

2 tbsp olive oil

salt to taste

1 packet mushrooms (I like a variety: chanterelle, shitake, bellas, etc)

1 cup chopped carrots

3-4 cups chicken stock

1 cup Vermouth

4 chicken thighs

1 chicken breast

1 package wild rice

fresh oregano

Directions:

Chop onions and shallots. Throw into large pot with olive oil and  a pinch of salt.  Cook on medium height until onions are translucent.

Add mushrooms.  Cook on medium heat for a couple of minutes or until mushrooms are cooked through.  Add chopped carrots, chicken stock, vermouth, wild rice, and chicken.

Cover and simmer over low heat for approximately two hours, or until chicken begins to fall off bone and wild rice is cooked through.  Add salt and oregano to taste.

Suggestion: Serve with hot sauce.

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Caponata Siciliana and Why You Should Join the Eggplant Fan Club

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3 Reasons to Eat More Eggplant

  1. Eggplant is rich in essential nutrients.  It is a source of fiber, potassium, vitamin A, vitamin C, vitamin B-6, iron, and magnesium.
  2. Eggplant contains flavonoids known as anthocyanins which have been proven to play a major role in lowering risk of cardiovascular disease.
  3. Eggplant is ranked among the top 10 vegetables in terms of oxygen radical absorbance capacity!  This makes it a powerful free radical scavenger, protecting you from all the terrors caused by free radicals.

If I haven’t convinced you to join the eggplant fan club, then try my recipe below, or pop on over for dinner sometime.  Caponata, a Sicilian vegetable appetizer happens to be the first dish I learned to make in cooking school in Sicily.  A simple party-pleaser, it’s something I often turn to when I’m lazy and craving something healthy and tasty.

 

Caponata Siciliana

Ingredients

  • 1 large egg shaped purple eggplant (make sure it’s not squishy)
  • 5 tbsp olive oil
  • 1/3 cup red wine
  • 3 ripe sweet beautiful (or ugly) tomatoes
  • 4 cloves garlic
  • red pepper to taste
  • pinch salt
  • 1 bunch fresh basil
  • 1/4 cup sliced almonds
  • parmesan cheese (for garnish)
  • IMG_5096

 

IMG_5093Directions

Preheat oven to 400 degrees F

Chop eggplant into thumb sized cubes and place in large glass pan.  Top with olive oil and red wine and cover with sheet of aluminum foil.  Place pan in heated oven.

While eggplant begins to cook, peel garlic and mince.  Place garlic in oiled pan on stove over low heat and cook making sure garlic cloves don’t brown.  As they begin to get golden, chop and add tomatoes. sprinkle salt and red pepper flakes.  Cook over medium to low heat until tomatoes fall apart and form a fragrant garlicky tomato paste.  Remove garlic cloves if desired.

Remove eggplant from oven and spread sauce over eggplant.  Sprinkle with sliced almonds.  Add more olive oil and wine if eggplant is too dry.  Cover again and return to oven.  Bake covered for an hour or until eggplant in brown and mushy

Top with fresh basil and parmesan cheese.

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Is Alcohol Both a Stimulant and a Depressant?

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The other day I was drinking with a bunch of nerds, as I prefer to do, and one such nerd tried to convince me that hard alcohol differs from wine and beer  not only in alcohol content but also that it acts as a stimulant rather than a depressant.  This seemed a rather strange statement as I have definitely felt “stimulant” effects from both beer and wine on occasion.  I’ve always wondered why we learned that alcohol is a depressant back in health class, when tequila clearly isn’t.  How can alcohol act as both a stimulant and a depressant? Why am I suddenly getting sleepy when I was so energetic before?

The answer begins to unravel (along with your inhibitions) when that shot is poured down your esophagus.  Almost immediately your body makes metabolizing the alcohol in your system a priority.  Most people believe that alcohol is metabolized as sugar, because that’s what it’s made from; however, unlike protein, fat, and carbohydrates/sugar, alcohol can’t be stored in our body.  It is therefore metabolized first.

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In your stomach, about 20% of the alcohol can be absorbed directly into your blood stream.  From there it travels into your brain.  The rest of the alcohol travels to the small intestines, where it is absorbed along with other nutrients.  The liver is the primary site for alcohol oxidation, which is why excessive drinking can lead to liver problems.

Alcohol’s classification as a depressant is outdated.  Stimulants often influence dopamine and norepinephrine.  Depressants often stimulate GABA, an inhibitory neurotransmitter, which works to reduce neuronal excitability throughout the central nervous system.  Research has found that alcohol actually works on both.

Alcohol can act as either a stimulant or a depressant depending on whether your BAC is rising or falling.  Drinking both increases norepinephrine as well as acts at GABA receptors.  This could explain alcohol’s effects as both a stimulant and a depressant.  A less common type of GABA receptor contains a delta subunit, which responds only to low levels of alcohol, such as a beer or a glass of wine.  This could explain both the depressant effects of drinking wine/beer slowly as well as the depressant effects you feel as your BAC decreases.

So in conclusion there was some truth to what my friend argued.  Your body does react differently to different types of alcohol, but it has more to do with the amount of alcohol in your blood stream than anything else.

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Semi-Sweet Potato Latkes

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Happy  fifth day of Hanukkah!

I would have liked to have had this recipe ready on the first day of Hanukkah, but sadly a stream of holiday parties and work got in the way.  As I am now home in sunny San Diego for the holidays, I can finally relax and write.

One of the aforementioned holiday parties, was an impromptu Hanukkah party I threw at my house last Tuesday.  Unsure how many folks would make it out to Berkeley on a Tuesday night, I grabbed seven potatoes and got to work.  A menorah and wine was kindly provided by my lovely and very helpful friends, and two hours later our bellies were stuffed with golden latkes and wine.

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Semi-Sweet Potato Latkes

Ingredients:

2 sweet potatoesIMG_5081

5 yukon gold potatoes

5 eggs

1/2 cup oat flour

1 tsp salt

1 tsp cracked black pepper

lots of olive oil

Directions:

Peel and grate potatoes.  In a large bowl mix grated potatoes, eggs, flour, salt, and pepper.  Make sure batter is sticky enough to stick together when molded into a patty, but not too eggy.  Add flour until you get the right consistency.

Heat 1/4-1/2 inch olive oil in a large skillet over medium heat.  Using your hands mold batter into patties about the size of your palm.  Cook patties in oiled pan flipping when one side is golden brown (about five minutes).  Latkes are done when both sides are brown and inside is cooked through.

Serve with sour cream and apple sauce.

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Building a Healthy Relationship with Food and Your Body

Building a Healthy Relationship with Food and Your Body

You’ve just finished a huge Thanksgiving meal.

Some of you are stuffed to nauseous status, others are stuffed to guilty status.

Now I’m going to speak to the guilty ones right now:  Stop feeling guilty.  Accept it for what it is. If you’re feeling extremely full, go on a family walk, or just pass out in front of the football game.

 

I both work in weight loss and have struggled with my own weight, so I understand building a healthy relationship with food is a challenge.  Weight and body image are sensitive subjects, and I’d be preaching to the choir if I wrote an article about the effect our society plays, so instead I’ll stick to the positive, how to develop a good relationship with food and your body.

This is a raging battle for most, and for a type 1 diabetic, it’s a hundred times worse.  As a diabetic, taking care of yourself means examining every morsel you let down your esophagus and calculating how your metabolism will react and the amount of insulin required.  We constantly play the balancing act trying to maintain sugar levels in the normal range and hopefully avoiding lows and highs.  Food is a crucial factor in diabetes care, meaning it can take over your life, as it did mine.  Even with the medical technology we now have, pumps and continuous glucose monitoring, constant awareness and carbohydrate counting are still crucial for control.  I have friends who when concerned or stressed will forget to eat (the health of this is questionable).  As a diabetic it is impossible to simply forget to eat or forget about food, because your diabetes will remind you.  Maybe you’ll get low in the middle of a meeting or run out of glucose mid run because you didn’t eat lunch.  Whatever it is, at some point food will rule your thoughts.

For diabetics and non-diabetics alike, a positive relationship with food and your body is still important, and something most of us need to work on

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 8 Steps to Creating a Healthy Relationship with Food

1.  Stop Stressing about every calorie you eat and start really enjoying ever bite.

You probably already have enough stress in your lives and don’t need to add to that by capping your calories at 1200.  Instead enjoy every bite and try to eat as cleanly and colorfully (I’m not referring to skittles) as possible.  The more micronutrients you have in your diet, the better you’ll feel.

 

2. Be proud of your physical accomplishments

Yes, most of us have those days when our body refuses to do what we think it ought to.  Whether you’re struggling to get into side crow, Run those miles, or do a final rep with a heavy weight, remember to be proud that you are at least making the effort.  Keep putting in that effort, and hopefully you’ll be going from crow to headstand or finishing your first half marathon (something I have yet to do).

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3. stop feeling guilty after eating

We all do it, and with holiday parties approaching, the guilt may creep in.  Instead of setting yourself up for a guilt trip and then taking it out on your body the next day, allow yourself to slip up and enjoy that slip up.  If you feel terrible treat yourself to a relaxing walk or swim.

5. Be naked more often

Or at least wear less clothing around your house.  This may make you seem like an exhibitionist, but it will help you become more comfortable with your body, ideally leading to more self-love.

6. Masturbate

I’m not kidding. You may ask me how this could possibly help with your body image, but it does. Even if you’re in a relationship, taking time for yourself is important, and what could be more personal?  An added plus is the dopamine/oxytocin high.

7.  Spend more time outside

Yes, it’s winter even in San Francisco, but taking your workouts outside still has all the same benefits as it did in the summer.

8. Remain Positive

In the studies I work on, the participants that remain positive even when they aren’t losing the most weight, are the most successful.  I have to believe that this is because they don’t get discouraged or sweat the small stuff, but instead see the big picture: the goal is to be as healthy as you can be both mentally and physically.

 

 

Egg in a Pancake Hole/Basket

 

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Do you ever have trouble deciding what to eat?

I constantly have this problem.  I’ll stare at a menu, or in my cupboard, or in my fridge and imagine three or four possible and equally enticing meals.  Never ever take me out for a meal, because I will most-likely over order and probably munch on your dish just so I can taste everything.

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Brunch is particularly dangerous.  It’s rare that I want just one thing.  In fact, I have been known to make 4 course brunches including pancakes, eggs, fruit, and even a side salad.  I console my inner nutritionist by explaining that I clearly need a hearty meal of protein, carbs, and vitamins to help heal my body from the damage alcohol and little sleep causes.

If you’ve already heard me say this skip ahead.  Eggs are the absolute best food for hangovers.  They contain large amounts of cysteine and taurine two amino acids that in some studies have been shown to reverse liver damage caused by drinking.  Cysteine also works to counteract acetaldehyde, one of the chemicals formed in metabolizing alcohol that causes what we think of as a hangover.  Reverse liver damage and live your Saturday hangover free?  Better start cooking those eggs!

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It was one such achy morning when I was craving both pancakes and eggs that I decided to combine them.  I created a savory pancake basket in which I laid the eggs, and voila brunch was served and hangover was gone.

Ingredients:IMG_4933

4 eggs (2 per pancake)

1/4 cup plain greek yogurt

1 cup oat flour

1 teaspoon garlic salt

1 pinch basil ( I prefer chopped fresh basil, but dried works as well)

1/4 cup coconut almond milk

1 tbsp melted coconut oil

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Directions for two:

Preheat oven to 400 F

In a large bowl mix flour, 2 eggs, garlic salt, basil, yogurt, coconut oil, and coconut-almond milk together until a smooth batter forms.

Coat cast iron skillet with olive oil.

Heat on medium and form two pancakes from batter.

once pancakes begin to harden on bottom side take knife and cut a yolk-shaped hole in the middle of each pancake

Crack egg and coat top of pancake with white, placing yolk in hole.  (see images for clarification)

Remove skillet from stove and place in preheated oven.

Bake for 5-10 minutes or until the eggs have set (the whites are opaque and the yolks are golden)

Serve with fresh avocados and hot sauce!

 

 

 

Blame it on Progesterone

 

The effects of hyperglycemia: flushed cheeks, fatigue, irritability

The effects of hyperglycemia: flushed cheeks, fatigue, irritability

My roommate joked the other day that I blame absolutely everything on my period.  Insomnia, bitchiness, incessant crying, extreme cramps, acne, oily hair, and overheating a week before that time of the month are all things I link to the building and shedding of uterine walls and the hormonal activity that accompanies it.

 

Yes, woman have been complaining of PMS since the dawn of human-kind; however, as only 3% of the world has type 1 diabetes and judging that close to half of those are women, we’ll estimate that about 1.5% of the worlds population deals with controlling their blood sugar during the luteal phase of their menstrual cycle.

 

photo 2To all my male endocrinoligists: Want to know why my A1C is high?  To my boss:  Want to know why I can’t function one week of the month?

Blame it on the Progesterone.

 

For a type 1 diabetic the luteal phase or the weeks leading up to menstruation are the absolute worst.  They are chalk full of hyperglycemia, hypoglycemia, and even diabetic ketoacidosis.  Just as everyone experiences different symptoms of PMS, I would assume the hormonal effect on insulin sensitivity varies from diabetic to diabetic; however, a link has been made between the luteal phase and increased insulin resistance.

In my experience, in the week leading up to my period, my blood sugar becomes uncontrollable, my Dexcom CGM a roller coaster of extreme highs and lows, resulting in extreme fatigue and frustration.

 

Probable Causes

photo 5The little research published on this phenomenon suggests that a decrease in insulin sensitivity during the luteal phase may be a result of increased progesterone levels.

Progesterone is secreted by the corpus luteum and is present in significant amounts only during the luteal phase of the menstrual cycle.  Progesterone levels increase gradually after ovulation peaking at the same time that estrogen peaks around days 21-23 of the 28-day menstrual cycle.  Negative feedback to the anterior pituitary gland and hypothalamus cause gonadotropin levels to fall resulting in decreasing estrogen and progesterone levels.  Menstrual bleeding occurs as a consequence of hormonal withdrawal.

Studies on rats have shown that progesterone impairs glucose uptake in skeletal muscle and adipose tissue.(1)  Progesterone was also shown to augment pancreatic insulin release in animals, theoretically in response to an increase in insulin resistance.  Human trials testing glucose disposal at different phases of the menstrual cycle showed only a 24% decrease in insulin resistance in the luteal phase compared to the follicular phase,(2) not the evidence I would expect from my own personal experience.

Another possible cause of decreasing insulin sensitivity could be low-grade inflammation during this phase.  High sensitivity C-reactive protein change with menstrual cycle phase, which is correlated with physical and mood symptoms associated with menstruation.  This could in turn affect insulin resistance.

Although, it is not completely clear if a rise in progesterone during the luteal phase is entirely responsible for decrease in insulin resistance, it is clear that progesterone plays a part in this phenomenon.

 

Suggested Treatment

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It’s advisable to set alerts and check your CGM or finger prick at least once an hour.  I would also advise greatly decreasing your intake of carbohydrates and increasing your basal rate (if pumping) or lantus dosage.  Upon the start of menstruation it is advisable to lower these to avoid hypoglycemia.

As hormone levels fluctuate uncontrollably there is no estimating the exact times when insulin resistance will rise and fall, resulting in what I like to call the roller coaster effect.  If I had a perfect method of treatment, I wouldn’t experience DKA (Diabetic Ketoacidosis) almost every month.  Right now all I can do is wait for the widely anticipated bionic pancreas estimated to be approved and on the market in 2017.

 

(1) Rushakoff RJ, Kalkhoff RK. Effects of pregnancy and sex steroid administration on skeletal muscle metabolism in the rat. Diabetes. 1981;30:545–550.

(2)Trout KK, Rickels MR, Schutta MH, et al. Menstrual cycle effects on insulin sensitivity in women with type 1 diabetes: A pilot study. Diabetes Technol Ther. 2007;9:176–182.