Make Food Your First Medicine

By John La Puma, MD

The longer I practice medicine, the more I see that health is a flavor issue.

Consider my patient Donna.

An active, overweight 58-year-old, she was eating a whole-grain cereal for breakfast, tiny portions of prunes and cottage cheese for lunch, and the occasional steak and French fries at the club for dinner, especially Fridays, Saturdays and Sundays.

Her doctor had told her she would have to start taking diabetes medicine if she didn't control her blood sugar. The dietitian had tried to be helpful: she had offered Donna pamphlets on diabetes and told her to watch her carbs and lose weight. But Donna was lost when she came to see me. Her blood sugars were almost normal before breakfast but 190 two hours later. "Why?" she asked. "I thought these dry cereal biscuits were good for me!"

Whole-grain cereal pucks are terrific as weapons, but without enough liquid in a cereal bowl they can be sort of slow-moving inside of you. And the sugar in cow's milk for some diabetics is too much for their pancreas to handle. Nearly all soy, almond and rice milks are sweetened, although you can find good ones that are unsweetened if you hunt.

A better breakfast choice has enough lean protein to last until lunch. Try a little almond butter, two eggs, or a part-skim cheese stick or two -- though not breaded and deep-fried cheese sticks.

What Donna needed for dinner was tasty fish and vegetables, not her occasional steak and French fries (solid fats and sugar-like starches, respectively).

Food can be and should be your first choice of medicine. With the right recipes and the best quality food, you can actually look forward to filling your prescriptions. Why not spend your hard-earned dollars at the grocery rather than at the hospital?

The best research shows that when measured against prescription pharmaceuticals, some foods and recipes work pretty well. In fact, learning how to cook can save your life.

People who eat fish have younger arteries, less impotence, less wrinkling of the skin, less memory loss, less cancer, more satisfying sex, less arthritis and fewer immune conditions.

People who drink wine sensibly have less heart disease, fewer heart attacks and fewer stomach ulcers. They also live longer and are less likely to have diabetes as they age.

People who eat soy and soy foods have lower blood pressure, less kidney disease, better-controlled diabetes, lower cholesterol levels, better-controlled menopausal symptoms and better bone density.

Sadly, the medical literature doesn't have therapeutic foods and recipes. So I created a recipe, below, that Donna found helpful in controlling her blood sugar after her meals.

The key is lowering the rate at which the sugar from the oranges is absorbed into the blood stream. The sesame oil does that in this recipe. A slower rise in blood sugar prevents spikes of insulin, the cratering of blood sugar, and the urge to tear the door off the refrigerator two hours later. That's true for diabetics and nondiabetics alike.

If you have type 2 diabetes, a slow, steady rise in blood sugar after you eat can also prevent a too-high A1C level, also known as glycohemoglobin, which your doctor may measure every three to six months. The A1C blood test shows approximately what your blood sugar has been averaging over that time.

But if you want more information now -- and who doesn't? -- checking blood sugar after a big meal can help you optimize what you eat. Because when food tastes as good as this, health is a flavor issue, in a very good way.

Grilled Citrus Trout Over Crunchy Mediterranean Slaw

The Blood Sugar Stabilizer

From "ChefMD's Big Book of Culinary Medicine: A Food Lover's Guide to Losing Weight, Preventing Disease and Getting Really Healthy"

Makes 4 servings

Grilled Citrus Trout Ingredients

  • - 2 large oranges, peeled
  • - 3 tablespoons reduced sodium soy sauce
  • - 1 tablespoon dark sesame oil
  • - 4 small fresh whole rainbow trout, dressed and deboned (6 to 8 ounces each)
  • - 3 cups packaged coleslaw mix

    Grilled Citrus Trout Preparation

    Prepare a charcoal or gas grill, or preheat broiler. Coarsely chop oranges, saving their juice. Measure 2 tablespoons juice (squeeze chopped oranges gently to extract juice if necessary) into a large bowl. Add soy sauce and sesame oil; mix well. Remove 2 tablespoons of the mixture for brushing over trout. Open trout like a book. Brush 1 tablespoon of the reserved mixture over skinless sides of trout.

    Grill trout covered, skin sides down, on an oiled grill or broil 5 inches from heat source in a broiler for 3 minutes. Brush remaining reserved 1 tablespoon soy sauce mixture over trout. Continue grilling or broiling 3 to 4 minutes or until trout is opaque in center.

    Add the chopped oranges and coleslaw mix to the soy sauce mixture in a large bowl. Toss well and transfer to four serving plates. Serve with the trout.

    Preparation time: 15 minutes

    Cooking time: 8 minutes

    264 calories per serving, 29 percent from fat; 8.6 grams total fat, 1.6grams saturated fat, 3.3 grams polyunsaturated fat, 3.1 grams monounsaturated fat, 3.6 grams fiber, 15 grams carbohydrate, 10.5grams sugar, 31.3 grams protein, 511 mg sodium, 153 mg calcium, 59.7 mg magnesium, 952.2 mg potassium.

    John La Puma, M.D., is a board-certified internist in Santa Barbara, Calif., and co-host of "Health Corner," airing on Lifetime TV every week.


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