Pears: Underrated Nutritional Superstars

This fall, instead of gravitating towards apples (I know — they’re so much easier to love: ripening more predictably in our fruit bowls, traveling better without bruising, simultaneously offering tart crunch and creamy flesh, and coming in a wide range of different flavors, shapes and colors), give pears a chance: this may be one of the healthiest food choices you can make.

Pears are a powerhouse of anti-cancer nutrition, especially if you eat their skins. Recent studies have shown that the skin of pears contains three to four times as many phenolic plant nutrients as the flesh. 

These phytonutrients include antioxidant, anti-inflammatory flavonoids and potentially anti-cancer phytonutrients like cinnamic acids. Pears are also an excellent source of dietary fiber – both soluble and insoluble – roughly half of which is concentrated in their skins.

One area in which pears have been found to be helpful is maintaining stable blood glucose levels. Certain chemicals in food can improve our cells’ insulin sensitivity – i.e. their receptiveness to insulin, a hormone our bodies produce to regulate blood glucose levels. High blood glucose and insulin levels increase our cancer risk, so it’s important to keep these moderate, and by sensitizing our cells to the effects of insulin, we can lower both the insulin and the glucose circulating in our bloodstream.

Of special interest in this area have been three groups of flavonoids (flavonols, flavan-3-ols, and anthocyanins); all pears contain flavonoids falling within the first two groups, and red-skinned pears contain anthocyanins as well. Most phytonutrients such as these provide antioxidant as well as anti-inflammatory benefits. As a result, intake of pears has now been associated with decreased risk of several common chronic diseases that begin with chronic inflammation and excessive oxidative stress, including heart disease and type 2 diabetes.

Pears also appear to reduce cancer risks. For one, fiber from pears can bind together not only with bile acids as a whole, but also with a group of bile acids called “secondary bile acids”. Excessive amounts of secondary bile acids in the intestine can increase our risk of colorectal cancer. By binding together with secondary bile acids, pear fibers can help decrease their concentration in the intestine and lower our risk of cancer development.

In the case of stomach cancer, pear consumption has also been shown to reduce risk. Here the key focus has not been on pear fiber, but on pear phytonutrients, especially cinnamic acids (including coumaric acid, ferulic acid, and 5-caffeoylquinic acid). In a recent study from Mexico City, it took approximately two total fruit servings per day and four daily vegetable servings to accomplish a decrease in gastric cancer risk. Pears and mangos were among the key foods determined to provide cinnamic acids in the study.

Esophageal cancer (specifically, esophageal squamous cell carcinoma, or ESCC) is a third cancer type for which pear intake helps lower risk. In a very large-scale study conducted by the National Institutes of Health and the American Association of Retired Persons (involving 490,802 participants), pears were found to be a key food associated with reduced risk of ESCC. Interestingly, numerous foods belonging the rose (Rosaceae) family were also found to lower risk of ESCC, including apples, plums, and strawberries (1).

So let’s hear if for pears! And why not celebrate them in style with this delicious pan-cake that makes a nourishing breakfast, after-school snack or dessert. It’s quick and simple to prepare, especially if you use a well-seasoned cast-iron pan.

Pear and Almond Pancake (serves 4-5) – loosely inspired by a recipe in the Oct/Nov 2012 edition of Fine Cooking.

2 ripe-yet-firm pears (organic)
finely grated zest and juice of 1 large lemon (organic)
3 large eggs
½ cup almond milk
1 tbsp raw, runny honey
1 tsp natural vanilla extract
pinch of salt
½ tsp ground cardamom or ginger
½ cup ground almonds
2 tbsp unsalted fresh butter or ghee (clarified butter)
1 tbsp almond slivers
1 tsp confectioner’s sugar

Pre-heat oven to 400°F/200°C.

Wash the pears and cut them into eighths, removing the cores. Place them in a bowl and drizzle with the lemon juice, toss to cover with the juice and set aside.

In a medium mixing bowl, beat eggs with an electric whisk on high speed until they are light and foamy – about 3 minutes. Add almond milk, honey, vanilla, salt, cardamom and lemon zest and mix on low speed to combine. Add ground almonds and mix again to combine.

Heat a 12-inch cast-iron skillet over medium heat until hot – about 2 minutes. Add the butter or ghee (whichever using) and when it is hot, add the pear slices. Cook for 1-2 minutes on each side until golden, arrange pear slices in a single layer in the pan, pour batter evenly over the pears and sprinkle with almond slivers. Slide the skillet into the pre-heated oven and bake until the cake is set in the middle and puffy around the sides, and the bottom is lightly browned – about 20 minutes.

Remove and dust lightly with confectioner’s sugar (if desired). Serve with a teaspoon of plain Greek yogurt or sour cream; can be served immediately or eaten at room temperature.

References
(1)      My thanks to World’s Healthiest Foods for their detailed analysis of pears’ health benefits. More information can be found here:  http://www.whfoods.com/genpage.php?tname=foodspice&dbid=28.

Is It Still Safe To Eat Rice?

In light of recent shocking revelations by Consumer Reports Magazine, you may be wondering whether you should still be eating rice.

The independent testing organization discovered that many widely-eaten rice products – including white rice, brown rice, organic rice baby cereal, and rice breakfast cereals – contain arsenic, a powerful carcinogen. The products tested included well-known labels as well as store brands, organic products and conventional ones; some were aimed at the booming gluten-free market.

“In virtually every product tested, we found measurable amounts of total arsenic in its two forms,” the report stated. “We found significant levels of inorganic arsenic, which is a carcinogen, in almost every product category, along with organic arsenic, which is less toxic but still of concern.”

Some doctors immediately advised limiting rice consumption, especially in children, who are far more susceptible to the dangerous impacts of arsenic exposure. Consumer Reports suggested capping weekly servings to less than a cup of cooked rice for children and about 1½ cups of cooked rice for adults.

The FDA did not go as far as advising limiting rice consumption, or even arsenic residues in rice. But it did say that the findings have prompted it to test about 1,000 more samples by the end of the year in order to come up with “science based” recommendations.

So what’s a rice-eater to do in the meantime? This article in the Chicago Tribune offers some helpful suggestions:

• Rinse your rice thoroughly. The FDA cites several studies indicating that “thoroughly rinsing rice until the water is clear (four to six changes of water) reduced the total arsenic content by up to approximately 25-30 percent.” 
• Check your municipal water report. “Make sure your local water supply does not have high levels of arsenic,” says John Duxbury of Cornell University, who studies arsenic and rice. “If you do have high levels, washing can make it worse. But if you are under 10 parts per billion, it should help.” 
• Cook and drain your rice like pasta. “We say to use about 6 parts water to 1 part rice,” says Michael Hansen, a senior staff scientist at Consumer Reports. “And then drain off the water after it’s done.” The FDA says that studies show rinsing and cooking in excess water can reduce total arsenic levels by 50 to 60 percent. “However, it should be noted that for enriched rice, rinsing will also likely reduce the amount of added nutrients,” the agency said. 
• Choose aromatic rices. For those who are already fans of Indian basmati or Thai jasmine rices, the news is not so bad. According to the hundreds of recently released test results, aromatic rice varieties show the lowest levels of inorganic arsenic. Imported basmati and jasmine rices showed about half to one-eighth the level of arsenic as regular rices grown in the Southern U.S.

Avoid brown rice
For people who eat a lot of brown rice – for instance, those who follow macrobiotic diets that consist to 50-60% of brown rice – the findings are particularly bad news, for brown rice contains significantly more arsenic than white.

And arsenic isn’t the only problem in brown rice. It is also less nutritious than many of us – myself included – have long believed. For although it does contain more nutrients than white rice, it also contains higher levels of phytic acid, a compound that blocks the absorption of the nutrients in the rice (1). Phytic acid, which is present in most whole grains and seeds, binds with minerals such as zinc, iron, calcium and magnesium, making them unavailable for absorption and assimilation.  This is why phytic acid is often referred to as an “anti-nutrient.”

To top it all off, brown rice has been found to reduce the digestibility of protein, and fat and to impair the absorption rates of sodium, potassium and phosphorus (2).

If you think all the rinsing and draining described above are too much like hard work, let me suggest a radical alternative to rice of all kinds: Cauli-Rice. (Or as it’s called in my book, Zest for Life, “Cauliflower Couscous.”)  How can I sing its praises?

1. This dish does not contain any rice, and therefore is not likely to be laced with arsenic.
2. It is made from cauliflower, a vegetable from the brassica family known for its powerful detoxifying and anti-cancer benefits. (In the recipe below, turmeric, onions and garlic add further cancer-fighting compounds.)
3. Cauliflower can be bought from a local grower rather than needing to be shipped from a fragrant rice paddy half-way across the world, which is good news for locavores.
4. This dish has a satisfying crunchy texture not unlike that of rice and works well as a side dish to any meal at which one would normally eat rice.

The most compelling argument, however, has to be cauliflower’s superior nutritional value and vastly lower caloric and carbohydrate load, as shown in the table below (selected data obtained from Nutritiondata.com; see here for full profiles: cauliflower and rice).

	Cauliflower, cooked (100g)	White long-grain rice, boiled (100g)
Calories	23	130
Total carbohydrate	4.4 g	28.2 g
Omega 3 fatty acids	167 mg	50 mg
Omega 6 fatty acids	13 mg	62 mg
Vitamin C	44.3 mg	0 mg
Vitamin K	13.8 mcg	0 mg
Calcium	16 mg	10 mg
Magnesium	9 mg	12 mg
Potassium	142 mg	35 mg
Dietary fiber	2.3 g	0.4 g
Estimated glycemic load	2 (low)	15 (moderate-to-high)
Inflammation rating	18 (mildly anti-inflammatory)	-97 (mildly pro-inflammatory)

Note cauliflower’s anti-inflammatory rating (compared with rice’s pro-inflammatory one); its vastly lower glycemic impact, its higher fiber content and its more attractive omega-6-to-3 ratios (although absolute quantities are small, cauliflower contains 12 times more omega-3’s than omega-6’s, whereas rice has 1.24 times more omega-6’s than omega-3’s). Because cauliflower contains six times fewer carbohydrates than rice, eating it is also likely to trigger a much smaller secretion of insulin, a hormone that promotes the growth and spread of cancer cells.

I know which I’d rather eat! Without further ado, therefore, I give you:

Cauliflower Rice (serves 4 as a side-dish) (from Zest for Life)

2 tbsp olive oil
1 onion, chopped
2 cloves garlic, chopped
1 tsp turmeric
1 cauliflower, cut into florets
squeeze of lemon juice
1 tbsp chopped parsley
salt & black pepper
black sesame seeds and/or chopped parsley or cilantro

In a large pot gently warm olive oil on medium heat and cook chopped onion and garlic until translucent. Add turmeric and cook for another minute, stirring constantly.

In a food processor, chop raw cauliflower until it resembles the size of rice grains. Add cauliflower and 2fl oz/¼ cup/60ml of water to the onions and garlic, cover and cook, stirring regularly until the cauliflower is al dente – about 10 minutes. Season to taste with salt, pepper and a squeeze of lemon juice and serve immediately, sprinkled, if you like, with black sesame seeds and finely chopped herbs.

References
(1) Callegaro Mda D, Tirapegui J. Comparison of the nutritional value between brown rice and white rice. Arq Gastroenterol. 1996 Oct-Dec;33(4):225-31. http://www.ncbi.nlm.nih.gov/pubmed/9302338
(2) Miyoshi H, Okuda T, Okuda K, Koishi H. Effects of brown rice on apparent digestibility and balance of nutrients in young men on low protein diets. J Nutr Sci Vitaminol (Tokyo). 1987 Jun;33(3):207-18. http://www.ncbi.nlm.nih.gov/pubmed/2822877

Watercress and Red Cabbage Salad

Today’s recipe is from Elyn Jacobs, who has not only overcome breast cancer, but was inspired by her own healing journey to help others in theirs. Following her treatment, she gave up her high-flying Wall Street job and became a cancer coach and radio host. 

Here is Elyn’s story (told by herself), followed by her delicious recipe for watercress and red cabbage salad:
“You have cancer” – the words you never want to hear. 

Yet, I heard them just days after I had decided to take a break from the long hours of a Wall Street bond trader; I had put in 23 years; I was 45. My husband had convinced me to leave the relentless stress and enjoy the boys.  Our youngest was just about to turn one, his brother was two.  I then spent a glorious weekend with my girlfriends as we celebrated our time together and my break from the “real world”.

Well, my world was rocked when I returned home, went for my routine mammogram and learned how very real my world was: stage one invasive breast cancer; micro-calcifications were widely distributed throughout my left breast, resembling constellations in the galaxy.  I decided that a bilateral mastectomy with reconstruction was the best option for me, for my cancer.

My margins were declared clean and no nodal involvement was found; my prognosis was good.  No follow up treatment was necessary. Still, I felt that if cancer liked my body once, it might like it again. My mother lost her battle just after my surgery; my sister was diagnosed a few months later.  I was highly motivated to learn all I could about this disease.

I began extensive research and found there was much I could do to help prevent recurrence.  I consulted an integrative oncologist and he has since been instrumental in my journey for wellness.  We tweaked my diet, added many supplements and worked on reducing my stress.  He suggested meditation, and while I am not very good with this, I have a modified version that works for me.

I did not know this then, but I would not return to Wall Street.  My encounter with breast cancer propelled me on a life-changing course.  What I discovered was that I had an amazing team; my husband, family, friends and yes, my incredible team of doctors made my journey relatively easy.  I realized this was not the case for many, especially as more and more people started coming to me for advice.

So I decided to become a coach to others, to empower them to find the best treatment and team for their cancer.  I travel with my clients to their appointments, to make sure their questions are answered and to take notes and provide clarity.  I help my clients become active participants in their care and their health.  

Together we work on lifestyle changes supportive of wellness; small steps, big payoffs.  My goal is to help them beat cancer, thrive and live well.” 

You can visit Elyn at www.elynjacobs.wordpress.com. Or join her on her radio show, Survive and Live Well, Tuesdays at 1pm, EST, on www.W4CS.com or listen via ITunes.


Watercress and Red Cabbage Salad

Wash one bunch of watercress and chop (if using hydroponic, use two bunches if small)
Remove outer layers of red cabbage and shred, slice thin or chop (use about ¼ of a medium head for one bunch of watercress).
Organic extra virgin olive oil, to taste, but approximately 2-3 Tablespoons
Aged Balsamic vinegar, to taste, but approximately 1-2 Tablespoons
Optional—add a handful of raw pine nuts or ¼ cup chopped parsley
Toss salad with a pinch of salt, fresh pepper (if desired) and drizzle with balsamic vinegar and olive oil. Note:  use the best quality oil and vinegar you can find; most grocery store brands lack flavor and depth and are often derived from chemical processes.
Serve at once

Nutritition notes:

Watercress offers a hefty dose of beta-carotene, copious amounts of calcium, carotenes like lutein, and trace amounts of omega-3’s.  Watercress also contains a high amount of PEITC (phenylethylisotiocyante) which appears to block cancer-causing chemicals, perhaps even protecting the lungs of smokers from the carcinogens associated with tobacco (however, please don’t smoke…I tell you this to understand the power of watercress).

Red cabbage boosts immunity and is a member of the cruciferous family, whose indoles help with estrogen metabolism.  It also contains anthocyanins, a class of flavonids that provides as many as 36 different varieties of anticancer chemicals. Cabbage also contains a significant amount of glutamine, an amino acid that has anti-inflammatory properties. Red Cabbage boosts the immune system’s ability to produce more antibodies. Red cabbage contains large quantities of sulfur and other minerals that work as cleansing agents for the digestive system.  Raw red cabbage cleans the bowels, thus helping to prevent indigestion and constipation.

Parsley has potent anti-inflammatory and anticancer abilities. The phytochemicals in parsley can slow the speed of cell division, leaving time for the cell to correct DNA mistakes or to activate apoptosis, and recent research shows that one particular compound found in parsley and celery, apigenin, can stop certain breast cancer tumor cells from multiplying and growing, so it’s a good idea to have some everyday.

Red-Pepper Hummus

The Integrative Oncology Essentials team – Brian Lawenda and myself – attended the Society for Integrative Oncology’s Ninth International Conference in Albuquerque, New Mexico, these past three days. It was a fantastic event featuring presentations by leading experts in the field of integrative oncology from a wide range of disciplines. 

In addition to “traditional” oncologists with an interest in integrative medicine there were Chinese medicine practitioners, naturopaths, ayurvedic doctors, body-mind practitioners, healing-touch therapists, health educators, psychotherapists, herbalists, academic researchers and even a nutritionist who teaches anti-cancer cooking classes.

Yes, yours truly hosted a workshop called “Let’s Get Cooking” at which I gave a talk about the Mediterranean diet’s anti-cancer benefits that was followed by a small demonstration of two healthy whole-food recipes: the red-pepper hummus pictured above and the avocado-chocolate pudding I posted a few days ago. 

In a relaxed and convivial atmosphere — as befits a Mediterranean food event — and ignoring the fact that we were trying to “cook” in a Marriott ballroom, we donned our aprons and milled around a hastily assembled island of side-tables as everybody chipped in: one person peeling a mound of garlic cloves, the next juicing the lemons, a third spooning tahini into the blender whilst yet another added the grilled peppers and mixed everything into a fine puree. 
 
Yet more “sous-chefs” doled the hummus into bowls, drizzled it with extra-virgin olive oil and pine kernels, and finally everyone dug in, scooping up hummus with the help of carrot and celery sticks and gluten-free falafel chips. More fun teamwork was had as we prepared — and then wolfed down — the avocado-chocolate pudding.

All of which just goes to show: in extremis, you don’t even need a kitchen to prepare a Mediterranean meal! And: too many cooks don’t necessarily spoil the broth. (My heartfelt thanks Catherine Wood, who shlepped in countless kitchen utensils from her home for this workshop. I couldn’t have done it without you!) 

For those of you who missed the workshop, here’s the hummus recipe.

Hummus – a tasty Eastern-Mediterranean chickpea and sesame puree – is a powerhouse of nutrition, supplying protein, fiber, phytoestrogens, garlic and healthy oils. By adding red peppers, you’re also throwing in powerful antioxidants such as lycopene, a member of the carotenoid family thought to protect against prostate cancer, among others.

Hummus makes a delicious dip for raw vegetables, a succulent sandwich filling (topped, for example, with broccoli sprouts or grilled bell peppers) or a speedy hors d’oeuvre served in an avocado half. It’s best to use chick peas that you have prepared from scratch (ideally, sprouted first to boost nutrient content and make them easier to digest). Alternatively, you can use pre-cooked chickpeas from a glass jar. Try to avoid canned chickpeas; as I have written about previously, some of the chemicals used to make the plastic linings of food cans (such as bisphenol-A) are thought to disrupt our bodies’ natural hormones because of their estrogen-like chemical structure.  

Red-pepper hummus (makes about 1.1lb/500g)

15oz/400g cooked chickpeas, drained
2 tbsp olive oil
juice of 1 lemon
pinch of lemon zest (untreated)
1 clove garlic, crushed
2-3 slices roast red peppers from a jar (packed in olive oil or water) – about 3.5 oz/100g
5 fl oz/⅔ cup/150 ml water or garbanzo cooking liquid
3oz/1/3 cup/80g tahini (unsalted sesame paste)
olive oil and red pepper flakes, paprika powder or ground cumin as garnish
salt & freshly ground black pepper

Drain the softened chickpeas but reserve cooking liquid. Place chickpeas in a food processor with olive oil, lemon juice and zest, garlic, red pepper slices and water (if you’ve soaked and cooked the chickpeas from scratch, use the cooking liquid). Start blending and gradually add tahini. The consistency should be like thick cream; if it seems too dry, add more cooking liquid or water. 

Season to taste with salt and pepper. Transfer to a serving bowl, drizzle with olive oil and sprinkle with red pepper flakes or paprika powder or ground cumin.

Magical Chicken Soup

To my mind, everything about chicken soup is magical: the sweet, brothy scent that wafts through the house as the ingredients’ aromas meld in my stock pot; its deeply comforting flavors as I slowly slurp it down; and the sustained sense of nourishment and belly-warmth I feel long after I have finished my meal. No wonder mothers throughout the ages have administered chicken soup to nourish their loved ones’ bodies and souls.  

Every culinary culture has its chicken soup:  in China it is perfumed with ginger, scallions, black pepper, soy sauce, rice wine and sesame oil; in France they add bay leaf, fresh thyme, garlic and dry white wine; the Greeks flavor their famous avgolemono soup with lemon and thicken it with egg; the colonial Brits added Indian spices and split yellow peas  to their traditional English chicken soup, thus creating Mulligatawny – a very useful recipe for any anti-cancer repertory. And let’s not forget that all-time classic, Jewish chicken soup with matzoh balls or egg noodles, widely described as “Jewish penicillin”. 

In fact, chicken soup is such an integral part of healing traditions across the world that two Israeli researchers wrote a somewhat tongue-in-cheek article in the Journal of the Canadian Medical Association declaring it an “essential drug” (1).

Home-made chicken soup is indeed a concentrated source of nutrients, which is especially important for cancer patients undergoing chemotherapy or radiation therapy in need of nutrient-rich but easy-to-digest food and hydration. Vegetables, mushrooms and herbs provide a wide range of vitamins and plant chemicals that can help our body get rid of toxins and fight infections. The easily digested protein of chicken meat helps prevent weight loss and supports immune strength. Indeed, chicken soup has even been shown to have an anti-inflammatory effect, which may be why it is often used to combat colds and flus (2).

The recipe that follows contains ingredients – onions, leeks, bok choi, garlic, celery and green tea – whose chemical components are thought to enhance the effectiveness of various cancer treatments by increasing cancer cells’ sensitivity to radiation or chemotherapy, protecting the healthy tissues from the effects of the treatment, as well as supporting the liver in breaking down toxins.

This recipe doesn’t involve much work; just some light vegetable scrubbing, peeling, chopping and patience as the chicken, vegetables and herbs yield their comforting aromas to the broth. You can make this as chunky or liquid as you want: if you feel weak and digestively challenged, you may prefer to sip just the broth. If you want something more sustaining, add some finely shredded chicken meat, mushrooms and bok choy, or perhaps a little pre-cooked basmati rice to make the soup even more satisfying.
A small word of warning: according to the Environmental Working Group, celery is often tainted with pesticide residues – in fact, it ranks second on the organization’s “Dirty Dozen” list (2); I recommend you buy organic celery only.
The same goes for the chicken you use to make this soup: treat yourself to an organically reared one (ideally, a chicken that’s led an active outdoor life and is a little older than average: the older, the tastier!)  Most supermarket chickens are reared at lightning speed in confined spaces and fattened with corn and antibiotics. They may look nice and plump under their shiny shrink wrap, but they have little flavor and contain unhealthy fats since corn is rich in inflammatory omega-6 fatty acids that make their way into the meat of the chicken.

Magical Chicken Soup (Serves 4-5)
 
1 small organic chicken (2-3lb/1-1½ kg), any giblets removed
2 leeks, darkest third cut off, rinsed under running water (peeling the outer leaves apart) to re-move any grit; then coarsely chopped
3 carrots, peeled and sliced
1 yellow onion, coarsely chopped
2 ribs organic celery (non-organic celery may contain pesticide residues), coarsely chopped
1 large chunk of fresh ginger root (1-1½ inch/3-4 cm), coarsely sliced
3 cloves garlic, chopped
½ tsp thyme
1 bay leaf
10fl oz/1 ¼ cups/300ml strong green tea
3.5oz/⅔ cup/100g green peas (fresh or frozen)
1 cup thinly sliced shiitake mushrooms
1 head bok choi, green portions finely shredded
½ cup peas (fresh or frozen)
3-4 tbsp cooked rice (optional)
1-2 tbsp lemon juice,
a drizzle of Thai fish sauce (optional)
3 tbsp finely chopped fresh cilantro (coriander) or parsley
salt & freshly ground black pepper  
 
Wash the chicken inside and out and place in a large cooking pot with a lid. Sprinkle the chopped leeks, carrots, onion, celery and ginger around the chicken along with bay leaf, thyme and a table-spoon of lemon juice. Fill the pot with just enough cold water to barely cover the chicken. Bring to the boil, skim off any foam that may rise to the surface, cover and simmer on lowest setting for 1½ hours.
 
When the chicken is cooked through, lift it out of the broth and set aside to cool on a plate. Pour the broth through a fine-meshed strainer or cheese cloth into another large pot and discard the vegetables. If you want to drink just the broth, season it now with salt, pepper, fish sauce (if desired), lemon juice and add a small sprinkling of chopped cilantro or parsley. (You can shred the chicken meat and freeze it for later use in a salad or soup.)

If you want a more sustaining soup, bring the both back to a simmer and add sliced shiitake mush-rooms; cook around 5 minutes until they begin to soften.  While the mushrooms are cooking, remove the chicken skin, shred one or both chicken breasts (depending on how much meat you want) and refrigerate or freeze the rest of the meat for another meal.

Add shredded meat, finely sliced bok choi, peas, cooked rice (if using) and green tea to the broth and cook 1-2 minutes until the bok choi  is soft but still retains its bright green color.

Season to taste with pepper, salt, fish sauce (if desired) and lemon juice. Sprinkle with cilantro (coriander) or parsley and serve immediately.

References
(1)     Is Chicken Soup an Essential Drug? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1230870/pdf/cmaj_161_12_1532.pdf
(2)     Rennard BO, Ertl RF, Gossman GL, Robbins RA, Rennard SI. Chicken soup inhibits neutrophil chemotaxis in vitro. http://www.ncbi.nlm.nih.gov/pubmed/11035691
(3)    EWG’s Dirty Dozen list http://www.ewg.org/foodnews/summary/

Verity's Cottage Pie

Meet Verity, breast cancer thriver extraordinaire.
 
Through a combination of conventional and complementary treatments, exercise, spiritual practice, dietary change and gritty determination, she is in remission from stage IV – also known as metastatic – breast cancer.

Today’s recipe is hers, but first, I’d like to share her story with you.

Two years ago – she had just celebrated her 37th birthday and her daughter was about to turn one –Verity found a lump in her breast. In just a few weeks that lump turned out not only to be breast cancer, but breast cancer that had spread to her bones and was destroying her vertebrae. Having just spent the past year settling into her new career as a mother, Verity’s life was turned upside down again by the cancer diagnosis.

Metastatic breast cancer (MBC) is a disease where cancer has traveled through the bloodstream and spread to other parts of the body, such as the bones, liver, or brain. According to Breastcancer.org, “many women can live for years with metastatic cancer that’s under control. For these women, living with a diagnosis of metastatic breast cancer is like living with a chronic disease. It can go into remission, be active sometimes and not others, or move quickly. It frequently involves trying one treatment after another, ideally with breaks in between treatments when you feel good. The goal of treatment is to help you feel as well as possible and live a longer life.”

Even so, a stage IV diagnosis is grim: the median survival rate of women with metastatic breast cancer is two to three years. Frustratingly for MBC patients, there is relatively little funding for research into stage IV breast cancer. According to MetaVivor, a non-profit organization pushing for more MBC research funding, only 2-5% of U.S. breast-cancer research funds are being used to research treatments for MBC, even though nearly one-third of breast cancer patients have MBC.

“The Pink Ribbon Movement continues to focus on prevention, early detection and the stories of non-recurred survivors,” Metavivor says on its website. However, “it scarcely mentions the existence or extent of the metastatic breast cancer community. The ignored reality? Of those diagnosed with breast cancer, 30% will metastasize and almost all of those will die. The reality is just about as far from rosy pink as it gets. Read the stats the pink movement never mentions.”

In the absence of effective long-term treatments, many MBC patients do what they can to boost their cancer defenses. Verity is one of them.

Soon after being diagnosed, she read Dr. David Servan-Schreiber’s book, “Anticancer, A New Way Of Life” and began looking into integrative cancer treatments. In addition to conventional treatments – surgery, chemotherapy and radiation – she used a wide range of complementary interventions to support her treatment.

“I regained a sense of control of my life through food, juicing, exercise, and a combination of orthodox and complementary medicine,” Verity explains. “The list goes on and I am forever refining it.” The most frequently-read post on her blog, Verity’s Lifestyle.com, is entitled “My Anti-Cancer Toolbox” and lists all the resources she has used to help her back to health.

The integrative approach Verity has used may be paying off. “As of this breast Cancer Awareness Month [2012] I am officially in remission from Stage IV cancer and intend to be the healthiest in mind, body and spirit going forward.”

What a journey it’s been. Two years ago, Verity recalls, “I didn’t know if I was going to be able to go on lovely long dog walks in the country or on the beach anymore. In fact I had even talked with my husband about moving to a house more suitable should I need a wheelchair.”

“My back was so messed up from my collapsed vertebrae that I had to employ the aid of two walking poles and although I got very speedy on them I was also reliant on them. I visited my favorite beaches with a few of my best friends last winter and quietly lamented to myself that I may never be able to do a beautiful four-mile beach walk again.”

Fast forward to this spring and summer, after a lot of exercise and holistic treatments.“I walked those four miles and more. Then I went on a juice retreat … where I took up rebounding and yoga and walked six hilly miles on several occasions,” Verity recounts. “At that retreat I also decided that next year I will be walking the Moonwalk in London to raise money for a variety of breast cancer charities including one that supported me while I was ill, Penny Brohn Cancer Care.”

This summer, Verity even braved the Norfolk surf with her body-board (see picture, above). “Who’d have thought it two years ago – I wouldn’t!” she marvels, adding wistfully: “I know I’m very lucky to be in this position and I never take it for granted.”

On her blog Verity posts delicious, healthy recipes she has developed over the past two years. There is also an inspirational post by her husband David: “On Being Supportive,” written to encourage partners of cancer patients.

One of Verity’s greatest allies has been her iron determination in the face of MBC. “I decided very early on to use one of my strongest qualities to regain health. I’m bossy, so I’ve used that with my cancer,” she laughs. Still, even self-avowed bossy-boots have wobbly moments. “Don’t think that I have a brave face all the time!” What has helped in those moments has been her “great network of friends and family who support me.”

Verity has kindly contributed one of her recipes, a super-healthy vegetarian Cottage Pie (replacing beef with lentils and peas) using a wide variety of anti-cancer herbs and vegetables. Perfect cancer-warrior soul food.



Verity’s Cottage Pie

Filling
This recipe makes enough for 8-10 servings of pie filling; I make up half then freeze the rest, adding the topping when I want to cook it.

1 cup Puy lentils (small, dark green French lentils)
1 cup of brown lentils
1 large onion, chopped
3 garlic cloves, smashed and left for 10 minutes before finely chopping
2 tbsp of olive oil/coconut oil
3 large Portobello mushrooms chopped into approx 1-inch/2cm cubes
6 medium carrots, chopped into quarter rounds
2 cups frozen peas
1 level tsp ground cinnamon
2 tsp dried mixed herbs
2 tbsp tomato purée 2 ½ pints/1.4l vegetable stock
freshly ground black pepper

Topping (for 4-5 portions)
1 leek, finely chopped
2 medium sized sweet potatoes, peeled and chopped
2 tbsp olive oil

Pre-soak the lentils in water for approximately 4 hours (even better to sprout them for 2 days). Drain the water.

In a large saucepan gently cook the onions in the oil until translucent, then add the garlic and stir for a couple of minutes. Add cinnamon, mushrooms, carrots and lentils and cook over a gentle heat for a few minutes. Next stir in the tomato purée and vegetable stock, cover and simmer for approximately 30 minutes. You don’t want the mixture to get dry – it needs“gravy” so it’s worth checking to see whether you need to add a little extra water.

While this is simmering, cook the leeks gently in a saucepan with a little oil and steam the sweet potato. When both are cooked, mix together with a fork to create a chunky mash.

When the lentil vegetable mixture is cooked add in the mixed herbs, peas and plenty of freshly ground black pepper – stir well. Spoon half the lentil-vegetable mixture into an ovenproof dish (about 11 x 8 inches / 27cm x 20cm) and scoop the topping over to cover. You can add some grated organic goats’ cheese if you like.

Pop into an oven pre-heated to 340°F (170°C) and bake for 25 – 30 minutes until the top is just going brown. Serve with some lightly steamed broccoli or cabbage.

Healthy Chocolate-hazelnut Paste

A reader expressed surprise that I had included what she thought was commercial chocolate-hazelnut paste in my avocado-chocolate pudding; please let me take this opportunity to clear up the misunderstanding with today’s recipe for a healthy alternative to Nutella.
 
First, a confession: as a child, I was a Nutella addict. Persuaded by advertisements like this one  that the sugary chocolate paste was an excellent source of energy for growing children, my mother bought a steady supply of the sweet confection and we ate it greedily, usually by the spoonful when no one was looking, but also at breakfast, spread on white toast.

(By the way, notice how the mom in the commercial talks about “multigrain toast,” “whole wheat waffles” and “simple, quality ingredients like hazelnuts”? I call that “health claim by association”: when you’re selling a less-than-healthy product, pair it with healthy ones and hope their health halo will extend to your sugary confection. Does Nutella make you “ready to tackle the day”? Yes, for about an hour before the likely blood-sugar crash… No to mention the long-term effects of eating nutrient-depleted sugar pastes on white bread, washed down with OJ year-in, year out… But I digress.)

It was only decades later, when I began to understand the connection between health and food, that I realized why spooning down Nutella was not a good idea. A look at the ingredients as posted on their U.S. website (1) sends shudders down my spine: they are listed (in this order) as “sugar, palm oil, hazelnuts, cocoa, skim milk, reduced minerals whey (milk), lecithin as emulsifier (soy), vanillin: an artificial flavor.”
Hazelnuts in third place — that doesn’t sound so bad, you say? No, it doesn’t – until you realize that third place comes a loooong way after sugar (which accounts for 54.4% of the paste) and palm oil (30.3%), leaving only a measly 15% for hazelnuts, milk and cocoa (2). Oh, and artificial flavoring.

Nutella packs in 200 calories per two-tablespoon serving. I’m no calorie-phobe, but when fast-developing children regularly eat 200 calories that are entirely devoid of nutritional value, that’s a disaster. This is not to say that we can’t occasionally indulge in a teaspoon of Nutella at a hotel or when visiting a Nutella-eater’s house, but let’s try not to bring it into our homes, because once it’s there, it’s hard to stop at two tablespoons…

Especially when we can make our own vastly more nutritious (and, I would argue, more delicious) Nutella replacement!

The following recipe, taken from my book Zest for Life, is inspired by Nutella (even I can’t deny that hazelnuts and chocolate are a match made in heaven), but is free from palm oil, sugar, artificial flavorings and dairy. 

Instead, it’s heavy on hazelnuts, whose skins have an antioxidant capacity 7-8 times that of dark chocolate, 10 times that of espresso coffee, and 25 times that of blackberries (3). Hazelnuts also provide healthy monounsaturated fats and protein, so this home-made paste is likely to keep you sated longer than commercial equivalents and thus curb snack-attacks.

The paste’s sweetness comes from honey (whose praises I sang in the previous post) and prunes which, in addition to having a moderate glycemic impact, contain natural compounds that have been shown to selectively kill human breast cancer cells while leaving healthy cells intact (which I have written about here). These compounds – chlorogenic and neo-chlorogenic acid – have also been shown in rodent studies to inhibit the spread of cancer cells (metastasis).

Homemade Hazelnut-Chocolate Spread (makes about 10oz/1¼ cup/300g)

5¼ oz/⅔ cup/150g hazelnut butter
3.5oz/scant ½ cup/100g prune puree (health-food shop, or make it yourself: combine 1/2 cup pitted prunes with 3-4 tbsp hot water in a food processor and blend until smooth.)
2-3 tbsp honey (to taste)
1 heaped tbsp pure, unsweetened cocoa
2-3 tbsp lukewarm water
1 tsp natural vanilla extract

In a mixing bowl, combine all the ingredients except hazelnut butter and mix. With a metal spoon, carefully fold hazelnut paste into this mixture, taking care not to stir too vigorously or the oil may separate out. Add a little lukewarm water if you want a softer paste.

Transfer to an empty, clean jam jar; keeps for about two weeks in the refrigerator.

Slather on wholegrain toast, waffles and pancakes, dab on banana slices or stir into yogurt. (This paste is rich in calories, so enjoy sparingly – for even nutrient-dense calories are calories!)

References
(1)      U.S. Nutella website: http://www.nutellausa.com/ingredients.htm
(2)      Australian Nutella website: http://www.nutella.com.au/faq/
(3)      Del Rio D., Calani L., Dall’Asta M., Brighenti F.: Polyphenolic composition of hazelnut skin.  J Agric Food Chem. 2011 Sep 28;59(18):9935-41:

Avocado Chocolate "Nutella" Pudding

If you think you’ve misread the title of this dish – “Avocados and chocolate? Surely not!” – please bear with us; it’s not what it seems. 
 
Granted, it does sound like a bold combination; but when you think about it, avocadoes are fruits, and they don’t have to be eaten as guacamole. Moreover, both avocados and chocolate contain powerful anti-cancer nutrients, so that’s as good a reason as any for us to enjoy this dish regularly.

This confection is also ridiculously delicious, and that’s not something you can say of a lot of gluten-free, egg-free, dairy-free desserts. In fact, it’s so non-avocado-ey that my hyper-sensitive and uber-critical testers (my three kids) didn’t flinch when they tasted this, safe in the conviction that they were eating a traditional egg-cream-chocolate mousse. The avocado revelation blew them away.


Before we start cooking, a quick nutritional review.


Avocados are a veritable font of health. For one, they boast a long list of carotenoids (powerful antioxidants erroneously associated only with red, yellow and orange produce) such as beta-carotene, alpha-carotene and lutein, and the more obscure neochrome, neoxanthin, chrysanthemaxanthin, beta-cryptoxanthin, zeaxanthin, and violaxanthin.

Moreover, avocados contain several extremely healthy fats. (Yes, the terms “fat” and “health” can be compatible!)

First are the phytosterols (such as beta-sitosterol, campesterol, and stigmasterol), compounds that help to keep inflammation under control. Second are avocados’ polyhydroxylated fatty alcohols (PFAs), which provide further anti-inflammatory benefits. Third is the oleic acid in avocado (it’s also the predominant fatty acid in olive oil); oleic acid helps our digestive tract form transport molecules that facilitate the absorption of fat-soluble nutrients like carotenoids.

Add to the list of anti-cancer factors in avocados the flavonoids epicatechin and epigallocatechin 3-0-gallate, vitamins C and E, and the minerals manganese, selenium, and zinc and omega-3 fatty acids, and you’ve got yourself a super food!  

Alas, there isn’t (yet) much research available on the anti-cancer properties of avocados, but one interesting study showed that avocado extract can selectively kill oral cancer cells by prompting them to self-destruct (a process called apoptosis); at the same time, it supports the health of non-cancerous cells by increasing their supply antioxidant and anti-inflammatory nutrients.

But what about cocoa? Due to its high concentration of catechins and procyanidins (plant chemicals with antioxidant properties), cocoa may also have beneficial health effects against oxidative stress and chronic inflammation. Procyanidins are prevalent in red wine, but cocoa is an excellent alternative for teetotalers: for two to three squares of good-quality chocolate containing 70-85% cocoa solids are equivalent to a 125 milliliter glass of procyanidin-rich red wine. Research into the link between cocoa and cancer is still in its infancy, but scientists have observed that cocoa procyanidins slow the development of breast cancer in laboratory cell cultures, prostate cancer in rats and may lower inflammation in humans.

Most supermarkets sell chocolate with 70% cocoa content or more; if yours doesn’t, you can find it at a health-food store or online. Raw cacao (which hasn’t been roasted or processed with an alkalizing agent – a process called “dutching”) is the best to use here as it contains a much greater concentration of antioxidant flavonols than processed cocoa. (One study found that 60% of natural cocoa’s original antioxidants were destroyed by even light dutching, and 90% were destroyed by heavy dutching.) Because some cocoa-producing countries allow the use on cocoa plants of pesticides banned in the US and Europe, we suggest you buy cocoa products with an organic certification.

Before we finally start cooking, I should confess that I haven’t created this recipe myself; it’s been rumbling around the internet, making the rounds in the vegan and paleo diet communities (achieving a rare meeting of minds over this one dish). I wish I knew who started it because I should like to hug them and thank them for this fabulous addition to my healthy-eating repertoire. I have adapted it slightly by adding hazelnut butter to make it taste like my erstwhile favorite confection, Nutella.

Finally, I’d also like to thank the amazing team at “World’s Healthiest Foods” for supplying such detailed information about the benefits of avocados.

And now for the recipe.


Avocado-Chocolate “Nutella” Pudding (Serves 2-3)
1 ripe avocado
1 teaspoon vanilla extract
1/4 cup cocoa powder
1/4 cup Grade B maple syrup
1 tbsp hazelnut butter           
6 tablespoons coconut or hazelnut milk
Optional toppings: grated coconut, almond slivers, ground cocoa nibs, coarsely grated chocolate

Place all the ingredients in a small electric blender. Blend until perfectly smooth and creamy.
Spoon into cups/bowls/ramekins and top if desired.
Serve.
Swoon…

Broccoli and Carrot Fritters

When you type “broccoli” and “cancer” into the PubMed search field, you get 679 results, testament to broccoli’s cancer-busting antioxidant, anti-inflammatory and detoxifying properties.

Research links it to a decreased risk of prostate cancer, colon cancer, breast cancer, bladder cancer, and ovarian cancer, and studies into other types of cancer are ongoing. My family eats it at least twice a week – often more – and I would encourage you to do the same.

Sulforaphane, the molecule that gives brassicas their sharp taste, helps eliminate toxic compounds linked to the development of cancer and may trigger the self destruction (apoptosis) of some types of cancer cells. Among brassicas, broccoli is the best source of sulforaphane. Sprouted broccoli seeds, sold in health-food shops but also easy to grow at home, are an even more concentrated source of this compound: they contain between 10 and 100 times more sulforaphane than broccoli.

Broccoli also contains a compound called indole-3-carbinol which has been found in laboratory studies to inhibit the development of cancers of the breast, stomach, colon, lung and liver, and may reverse pre-cancerous changes in the cervix. It may also affect estrogen activity and thus prevent estrogen-sensitive breast cancer. In addition, broccoli contains a flavonoid called kaempferol which has powerful anti-inflammatory properties.

If you want to eat more broccoli but are bored by plain, steamed (alas, often overcooked) florets, why not try these nifty little fritters? They’re actually a meal-in-one as they contain protein (from the eggs), blood-sugar stabilizing starches (vegetables and coconut flour, lots of sating fiber (ditto) and coconut oil’s healthy fats. Eat them on their own, or top them with guacamole and broccoli sprouts or a slice of raw salmon, sashimi-style. (Make sure any raw fish you eat is super-super-fresh; if your immune system is weakened or you are pregnant, replace raw fish with wasabi-salmon mousse – recipe coming soon!).

It’s easy to double this recipe and freeze the fritters (separated by sheets of baking parchment for easy defrosting) for quick re-heating at a later date.  These make great lunch-box fillers too! And if you suffer from sensitivities, they’re gluten-free and dairy-free.


Broccoli and Carrot Fritters – Recipe (makes 10-12 fritters)

1 head (approx. 8 oz) baby broccoli, or “adult” broccoli, stems removed
4 eggs
1 grated carrot (grate on the coarse side of a box grater)
1 tbsp grated ginger root
2 cloves garlic, crushed
2 tbsp coconut flour (available in health-food shops)
1 tbsp black sesame seeds
2 tbsp finely chopped cilantro
juice of ½ lime
salt, freshly ground black pepper
2-3 tbsp coconut oil

In a medium pot fitted with a stainless steel steaming basket, bring an inch of water to boil; meanwhile, chop the broccoli with a long kitchen knife until you get coarse chunks resembling fine rubble. Steam the broccoli for 5 minutes, or until al dente. Drain in a colander and set aside.

While the broccoli is cooking, in a medium bowl beat the eggs with the grated carrot, grated ginger, crushed garlic, coconut flour, sesame seeds, cilantro and lime juice. Add the drained broccoli crumbs to this mixture and stir to mix well. Season with salt and pepper.

Gently melt the coconut oil in a large, cast-iron frying pan. Once it’s hot, spoon the broccoli batter into the pan – about two dessert spoons’ worth of batter per fritter. Cook for 2-3 minutes until golden, then flip with a spatula and cook the other side until golden.

Remove and drain off any excess fat onto kitchen paper; keep warm until all fritters are cooked, then serve immediately.

Eggplant "Pizzas"

Grilled eggplant slices act as the “pizza crust” onto which you can pile any number of vegetables, nuts, fish, seeds, olives, capers, cheeses, etc. The version below contains seven vegetables (including those used to make the sauce)!  As an added benefit, they’re very easy to make, and quick, too, if you have Basic tomato sauce (see below) in your refrigerator or freezer.

Because of their high water content, many people think that eggplants don’t offer much in the way of nutrients. However, nothing could be further from the truth! In addition to providing a wide range of vitamins and minerals, eggplants also contains important plant nutrients thought to have anti-cancer benefits, such as caffeic and chlorogenic acid, and flavonoids such as nasunin.

Another way in which eggplants provide cancer protection is by removing excess iron from our bodies, for nasunin is not only a potent antioxidant, but also an iron chelator (a compound that binds to iron, making it unavailable for use by the body). Although iron is an essential nutrient, too much of it boosts the production of free radicals and is associated with an increased risk of heart disease and cancer.  By binding iron, nasunin lowers the risk of cellular damage that can promote cancer.

Most of eggplants’ healthy compounds are concentrated in the skin, so either buy organic eggplants or, if you buy conventionally grown eggplants, make sure you wash them thoroughly. One note of caution: eggplants belong to the nightshade family of plants. For most people this is not a problem, but people with nightshade allergies should avoid these (along with tomatoes, peppers, cayenne and chili peppers and potatoes).

Serves 4 as a side dish or hors d’oeuvre.

2 large, firm eggplants

2fl oz/¼ cup/60ml olive oil

7fl oz/scant 1 cup/200ml Basic tomato sauce (see below)

6oz/170g roast peppers in olive oil

15 sliced chestnut or button mushrooms

3oz/85g feta or mozzarella cheese

10 black olives, chopped or sliced

4 tbsp pine nuts

Preheat grill to medium.

With a long knife, cut off a thin slice on either side of the eggplants, and then slice the rest of the eggplants into 4-5 slices approximately as thick as your index finger.

Cover a baking tray with parchment and lay eggplant slices on it; lightly brush both sides with olive oil and slide under the grill. Grill 5-6 minutes on each side until golden.

Remove and spread tomato sauce onto each eggplant slice. Top with grilled peppers, mushrooms, cheese, olives and pine nuts or anything else you would top a pizza with. Grill for another 8-10 minutes until the toppings begin to turn golden and the cheese has melted.

Lift onto plates with a spatula. To really boost your vegetable quota, serve with a mixed salad or steamed vegetables of your choice.

Variation

These taste delicious on slices of sourdough bread that have been lightly toasted, rubbed with fresh garlic and drizzled with olive oil, Spanish tapa-style.

Basic Tomato Sauce

This can be made in 15 minutes, but the longer you let it simmer, the better it will taste. Unseasoned, unsalted tomatoes in jars are fine if you can’t get fresh ones.

2 tbsp olive oil

2 onions, chopped

2 cloves garlic, chopped

1¾lb/800g fresh tomatoes, coarsely chopped

½ tsp each of thyme and oregano

1 bay leaf

3 tbsp tomato paste

salt & freshly ground black pepper

acacia honey (optional) 

In a heavy-bottomed pot, gently warm olive oil and cook onion and garlic until translucent. Add tomatoes, herbs and tomato paste, bring to the boil, cover and simmer on low heat for at least 15 minutes. If it seems too thick, add some water or a splash of white or red wine.

Remove bay leaf. Transfer sauce to blender and liquidize until smooth and creamy. Season with salt and pepper; add a little acacia honey if it is too acidic.