Friday, June 24, 2011

Eating Animals

I recently read Eating Animals by Jonathan Safran Foer, as it interested me both from the food production perspective and also because my diet relies heavily on animal products.

Briefly, Eating Animals is a combination of personal narrative and investigation into the U.S. meat production system.  Foer wrote the book in response to his then soon-to-be-born child because he suddenly had the responsibility of deciding someone else's diet.  He writes in the context of our culture of meat eating, and focuses on our consumption of the main food animals - beef, pork, chicken, and salmon and tuna.  His exposé of our animal production system is not new, yet not well known.  Specifically, Foer documents the abhorrent treatment of the animals, and the environmental and public health consequences, caused by waste problems and systematic antibiotic use, respectively, that are driven by the demand for cheap meat by the consumers and profits for the producers.  While he does highlight the improved efforts of the "local" or "real" food movements, he concludes that while there may be a better way to produce meat, vegetarianism is the only morally sound means to rid ourselves of the consequences of meat production.

He provides a strong argument against factory farmed animals, which I strongly agree with, and does an important job of moving beyond beef production to describe the similarly loathsome production of pork, poultry, and fish.  Regardless of personal diet, the vast majority of people would agree that animals deserve much better treatment and a better life before slaughter than we currently provide.  But even from a merely human-centrist perspective, our current system that promotes grain monoculture and waste run-off, and the chronic administration of antibiotics, is beginning to and will ever increasingly damage the lives and health of human populations.  Clearly, our current system has to change.

More personally, this book gave me a much better understanding of vegetarianism.  I had at one time, like many others, seen vegetarianism as more of a cultural rebellion or purported health cause than a moral cause.  It's hard not to when the loudest voices are the most offensive (PETA - I could have chosen much worse) or blatantly self-centered (Skinny Bitch).  I have much respect for Foer's writing, and his ultimate conclusion to not eat meat or feed it to his family.  And as an individual, it could very well be the most efficacious way to improve the treatment of animals.  However, I disagree with his fundamental argument to absolutely avoid meat, as the complexity of diet, health, and our relationship with animals warrants a more complex behavior.

After reading the book, I am still unclear about his stance on eating any animal products - dairy and eggs - since he doesn't explicitly address this; but the same ethical reasons against factory farming also apply to dairy and egg production.  While meat production has additional ethical considerations such as higher slaughter rates and the fact that these animals have essentially been bred for meat and not for life (the size of conventionally produced chicken breasts are not ecologically favorable), it's hardly a home-run to choose industrial-based vegetarianism over being an industrial-based omnivore. However, if he is advocating a strictly vegan diet, then he should have further expanded his argument.

I agree with Foer that health and food production are often improperly conflated and often hinder any argument for one or the other.  For one, there is no a priori reason to believe that the optimal human diet, or even a sufficiently healthy one, is also the most sustainable; although health does apply restrictions to the argument of food production - man can't live on bread and water alone.  While there is no question that humans can do well on primarily vegetarian diets, vegan diets are undeniably trickier.  Strict veganism is not widely practiced, and almost assuredly requires supplementation of primarily animal derived nutrients - Vitamin B12, the omega-3 fats EPA and DHA - or the ones more easily attained in animal products - iron, choline, and iodine.  To reiterate, there are many peoples who live very well on vegetarian and nearly vegan diets, such as the Seventh-day Adventists, so it can be sufficiently healthy, but it is not necessarily so.  
The American Dietetic Association's position is that "well-planned vegetarian (including vegan) diets are appropriate for individuals during all stages of the life cycle", including infants and toddlers.  The operative word is well-planned.  Lacto-ovo vegetarians probably don't require much additional effort to attain sufficient nutrition over omnivorous diets, but vegan diets likely need much more.  Synthetic or naturally extracted sources of isolated nutrients add a considerable amount of nutrition to a strictly vegan diet.  But I am skeptical of how sure we are of this based on some basic observations: humans evolved eating animals and it likely permitted the development of our large brains, we have more than simple taste preferances for animal products, and while many cultures eat low amounts of animal products and even less meat, they probably don't avoid animal products at all cost, but instead eat them opportunistically. Furthermore, strict vegan cultures have established cultural traditions that optimize their diets, whereas American vegans can only operate in the available food system where there is no precent for a strong vegan culture.  We are obviously capable of more than our primitive desires, but I don't think we should ignore them for the sake of an absolutist argument.

And this is my major criticism of his argument: Foer attempts to produce a black and white argument where we should not eat any animals.  He seems to conclude that even the selective omnivore's diet, expressed in In Defense of Food, is not morally sound enough.  As an example, he describes our paradoxical relationships with pet animals (dogs and cats) and meat animals (pigs).  As a western culture, we are appalled by the notion of eating dogs but pay little attention to the misery of factory produced pork, which are much smarter and likely as empathetic as dogs.  As it goes, these relationships and selective omnivory are relativistic, and therefore fundamentally flawed.  But I think it's foolish to try and reduce the complexity of any aspect of the human experience down to simple and static, or black and white.  I would rather strive for a dynamic stability of sorts.  As an example of what I mean, high level fighting sports are a complex human phenomenon.  Rivals literally live and train for competition as tough going to battle, yet this mentality and violence is largely contained "within the ring" and does not spill over into a vendetta.  This is a dynamic stability between aggression and respect, and would fail if it was one or the other.  Why can't our relationship with animals be similarly dynamic?  We evolved eating animals and do well eating them, but we also evolved empathy with other humans, which easily extends to animals.  We don't need to forgo one evolutionary trait for the other. They can converge on an optimal solution where we still eat animals, but establish a unique relationship and respect for them, especially in light of their literal sacrifice.

I still hold that the selective omnivore approach is the most comprehensive solution to a complex problem.  It's not simple or black and white, but it is reasonable and addresses many issues.  An individual's choice to avoid meat could very well be more powerful.  I respect Foer's cause, and his writing offers a powerful perspective and additional inspiration for improving our current food system, particularly meat production.  Given my current financial situation and the situation of our food system, I will still eat factory farmed animals.  But that doesn't mean I won't try to improve.  At the end of the day, this change has to start somewhere.  Here's to meatless lunches.

Pinquito beans, rice and sautéed kale.  Butter from pastured cows.

Tuesday, June 21, 2011

Salmon Cakes

I couldn't recall the last time that I had eaten salmon cakes, so I was excited to make them. But wow!  They were even better than I had anticipated.  Serve with an arugula salad dressed with a lemon-vinegerette, and you have a perfect low carb Summer dinner.  Now if only June-gloom would pass so it would be warm enough to sit outside...

Pan-fried Salmon Cakes

Prepare seasoning and fillers while the salmon comes to temperature.  Finely chop 2 tbsp each of fresh parsley, shallot, and scallion.  Mix in a bowl with 3-4 tbsp of bread crumbs (I will try gluten-free next time), juice from one half of a lemon, 1/2 tbsp of dijon mustard, and 2 tbsp mayo.  Season with salt and pepper.

Slice 1lb of skinless salmon fillet into manageable pieces.  Coarsely grind in a food processor using short bursts.  It's probably best to do it in batches to ensure better uniformity in the grind - remember, we want ground salmon, not salmon paste.

Mix ground salmon with fillers until combined.  I was able to make six uniform patties with this batch.  Once formed, gently coat them with bread crumbs by setting them in a bed of bread crumbs on a separate plate.  

Heat several tablespoons of cooking fat on medium-high.  I used left-over bacon fat, but I suppose vegetable oil would suffice.  Drop a couple of bread crumbs into the hot fat, and if it bubbles, then it's ready to fry.  Cook until golden-brown, two-three minutes per each side.  

Drain over paper towels and serve with homemade tartar sauce (thanks mom).  

And when they're in season, don't forget the berries and cream.

Sunday, June 19, 2011



The USDA has recently released its newest dietary food guide: MyPlate.  The side-ways and striped MyPyramid that replaced the upright and grains-at-the-bottom pyramid has now, in-turn, been replaced by another info-graphic.  You can read an LA Times article here.  MyPyramid was a modest update to the original pyramid as it was an internet-only food guide, and even advocated some so-called "healthy" fats such as avocado and salad oils.  But the icon didn't actually contain any information regarding food, and instead relied on the interactive website.  This created an obvious deficit - that we need to see what we should eat - so the USDA is trying yet another design.

I have to commend them for using a single meal representation since few of us think of an entire day's worth of food in one thought.  It gives us some idea of what a meal should look like.  You might laugh at the notion that we have forgotten what a meal looks like, but clearly, as a society we have lost something.  Although I personally prepare my meals in a similar component-derived way (protein, some veggies, plenty of fat, maybe some fruit), this icon doesn't lend it self well to traditional meals such as curries, pots of beans with rice and veggies, or a dinner salad and soup.  And many cultures have thrived without breaking up their meals into various proportions.  But this is only a symptom of the actual problem - the untenable notion that we can summarize our entire diet into a single image.

Nutrition is in a unique position because it is both a science and a public health issue - unlike, say, particle physics.  A major goal of the science of nutrition is to reduce diet down to some fundamental level that allows us to explain our observations of diet, health, and disease.  And as a public health issue, the authorities want to communicate the healthiest diet in the shortest message.  This is a double-wammy of reductionism, which is one of the concerns of the current "food movement."

I recently listened to a lecture by Michael Pollan where he outlined the principles of his book In Defense of Food.  One of his main arguments against our current food culture is that of nutritionism.  Nutritionism, as opposed to nutrition, is the psuedo-science ideology that focuses on building a healthy diet from our current understanding of individual nutrients - antioxidants, omega-3's, fiber - that have been completely isolated from the foods, meals, and diets that they are components of.  In essence, it is an overly simplified and hubristic view of the complexities of nutrition.  And so we have guideliness that consist of discrete dietary components - dairy, protein, fruit - that should all be consumed in correct proportions and all at the same time.  No other culture has viewed diet in such a way, so why should we?  Pollan offers a more fluid algorithim-like recommendation for food: "Eat food.  Not too much.  Mostly plants."  And let culture fill in the rest.  I agree that Pollan's is probably best, albeit vague, but both guidelines make a flawed assumption.

The second major problem with dietary guidelines is that they attempt to be applicable to everyone - even the obese and diabetic.  As of 2010, one third of the U.S. is considered obese while another third is considered overweight (Flegal JAMA 2010); and roughly 11% of adults over the age of 20 have diabetes (CDC Fact Sheet).  Given that our population is no longer "normal" and that the preponderance of these cases, both obesity and diabetes, are directly related to diet, we cannot assume that one set of guidelines is remotely appropriate for everyone.  Although to be fair, those who are effortlessly lean may avoid obesity by following these guidelines as long as they follow the recommendations to "drink water instead of sugary drinks" and notice there is no section for dessert.  After all, not everyone needs to restrict carbohydrates.  But we need to change how we view obesity before addressing dietary guidelines, whether to everyone or to individuals.

The conventional wisdom suggests that obesity is simply the far end of a weight spectrum, and therefore obese people just need to eat like lean people do.  Or as the USDA recommends "enjoy your food, but eat less."  We don't tell smokers to simply smoke less, or alcoholics to simply drink less, or people with depression to simply "cheer up."  In these conditions, we acknowledge that there is a disorder or pathology, and that we need to change behavior in order to return to normality - by tapering off of cigarettes, absteining from alcohol, or going to therapy and taking medication.  Obesity is unique in that we ignore the disorder - as Taubes puts it, "a disorder of excess fat accumilation" - and plead for normality.  We need to acknowledge that a large number of people fatten differently than others, and therefore need a different diet if they want to control their weight.

Again, the USDA has made a modest improvement.  But it won't stop publishing dietary guidelines in info-graphic format any time soon, nor will it offer something that is removed from the economic responsibilities of the USDA (good article here).  So as someone who can't simply follow the USDA's guidelines without gaining weight, I'll combat obesity with what works for me.  Cheers to MoosePlate.
Bison steak with herb-butter.  Caprese salad of heirloom tomatoes and basil purée.

Sunday, June 12, 2011

Dinner a la The Sweet Beet blog

The Sweet Beet posted a recent recipe for "egg-muffins" that I was dying to try out.  So, the girlfriend and I made a Sunday supper out of them.  Like the previous post, it lends itself to farmers market ingredients.

We made a jam-packed spinach salad with apples, avocado, feta, and bacon.  It was dressed with a walnut-gorganzola-rasberry vinaigrette from Trader Joe's.  The muffins ended up as a side to the salad.  The girlfriend also picked up a couple of adirondack chairs for her balcony, so we took this occasion to open a Reisling from our Temecula trip in order to celebrate the weather and the supper.

Happy low-carb.  Happy farmers market.  Happy Sunday.

Saturday, June 11, 2011

Easy Farmers Market Dinner

There are few things more satisfying that making an entire meal from the day's trip to the farmers market.  Unless, of course, you farmed the food yourself.  But that's another post.

Hopefully this will inspire some ideas or future meals.  Nothing extraordinary; it just helps to see what is easily forgotten.

Start with the appetizer.

Prepare an artichoke by clipping off the spikey ends of the outer leaves and chopping off the top of the 'choke, about an inch from the apex.

Steam for roughly 30 minutes, or until leaves are tender.  This was a gigantic artichoke.
Serve with melted butter and some cheddar from the market.  Unforuntately, gluten-free crackers are not to be found at the market.

And don't forget the wine.  Never forget the wine.

Roasted Herbed Chicken
We picked up a whole bird from the "egg guy."  They don't have broiler chickens, but instead sell old laying hens.  Simply delicious.

Remove the innards from the cavity, rinse with water, and dry very well.  I like to loosen the skin around the breast and thighs so that I can spread the softened butter and herb mixtures underneath the skin - any herbs will do.  Liberally season with salt and pepper over the skin.  And yes, I used twisted aluminum foil to tie the legs together.  Roast at 450°F for about 55 minutes (I believe this was a 3.5 lb. bird). 

Roasted Heirloom Carrots
We came across some heirloom carrots, and had to try them out.  They were stout  and came in bunches consisting of yellow ones, pink ones, and white ones.  

Since they were smaller than conventional carrots, we just sliced them into halves.  I like to toss them in melted butter, thyme, salt and pepper, then speard them over a baking sheet.  We covered the entire sheet with aluminum foil and roasted them with the chicken (450°F) for 25-30 minutes.  They browned sooner than I expected, but I caught them just in time.

Fresh cherries for dessert.  

Bon Appétit!

Tuesday, June 7, 2011

Not-So-Placebo Controlled Trials

Source: Paul at FreeDigitalPhotos
Imagine that you are a new parent.  Your wife has had diabetes since childhood, and after being tested, you find out that you have a diabetes-associated HLA genotype.  Together, this means that your newborn has a genetic risk for diabetes (I'm referring to type 1 or insulin-dependent diabetes for this post), and if the right environmental exposure is present, she could develop the disease.  Being as proactive as you can, you search for available clinical trials that are testing interventions to prevent diabetes.  You acknowledge that it is important to advance scientific understanding of medicine and disease, but let's be honest, you are primarily concerned with your child.  Given that you are not the only participant with this mind-set, how are these experiments influenced by the evolving and sentient nature of human subjects?  After all, lab rats don't know what hypothesis is being tested, but you just might.

Randomized placebo controlled trials (controlled trials, for short) are arguably the best experimental design to understand human biology and behavior.  Unlike observational epidemiology, such as cohort studies that can only observe causal associations, controlled trials are able to determine the causality between an exposure - think treatment - and an outcome.  This is because controlled trials best approximate the "counter-factual," which is the impossible ideal where by the same subject is studied at the same time with and without an exposure.  This is accomplished by randomizing sufficiently large numbers of people into a control and an experimental group(s) so that any confounding characteristics are equally distributed between the groups to remove their influence on the exposure-outcome relationship, thereby studying the "same people" at the same time.  However, this assumes that both groups maintain randomization.

If a trial is sufficiently long enough, let's say between six months and a year or more, then some number of subjects will drop-out of the trial.  As mentioned above, subjects are randomized into two or more groups, and then demonstrated to be identical at baseline, at least for any known pertinent characteristics.  For example, groups will be shown to have the same distribution of body mass indexes, age, and exercise level.  However, as the trial progresses, some subjects will leave the trial, which could result in 20% to 40% attrition.  Every publication of a trial documents the similar baseline characteristics, the number of subjects in each group, and the attrition (See figure).  Researchers must keep track of who leaves the trial and why.

A particular concern is that subjects will learn what group they are in, and if they are unsatisfied with their assignment, may leave the trial and create a selection bias since the groups are no longer identical.  This is one of the reasons to blind the subjects, that is, give them a placebo treatment.  But this is usually easier said than done, especially in dietary trials, which is a concern for this blog.  One problem is that there is no sugar pill equivalent for a diet since we are all very aware of what are eating and have some idea, whether right or wrong, of the nutritional implications of our food. The A-to-Z trial* compared the effectiveness of several popular diets, including the Atkin's Diet and the Ornish Diet, on weight-loss and metabolic parameters.  The Ornish Diet is essentially a whole-foods nearly-vegan diet, while the Atkin's Diet is, well, the Atkin's Diet.  Unless you've been living under a rock, you would already have a preconceived notion of the Atkin's Diet and might even leave the experiment after watching an episode of Dr. Oz half-way through the trial.  Fortunately, the investigators documented how many people left the trial and why, and there was no apparent bias.  Although the degree of adherence was another matter.

The placebo is also necessary to ensure that the groups are exposed to the treatment in the desired manner - this is to avoid what is known as bias by differential misclassification.  This was particularly evident in a primary prevention trial for children at high risk for diabetes.  Previous non-trial research has shown a link between the age of dietary gluten introduction and the onset of diabetes, so that researchers hypothesized that delaying the introduction of gluten from 6 months of age to 12 months of age would prevent pancreatic islet auto-immunity and subsequent diabetes.  While this was a preliminary study designed to test the feasability and safety of such an intervention, it was still disappointing that the results were null.  But for our purposes, it demonstrated the placebo problem.  Subjects, by and large, did not leave the trial, but many opted to ignore their assignment.  At least 15% of subjects switched from the control group to the experimental group because they perceived a greater chance of success by delaying gluten exposure.  The researchers did analyze the initial assignments, and also the "new" experimental and control groups to avoid the differential misclassification bias.  However, this later analysis means that the groups were no longer randomized and that the experimental group now had a greater proportion of participants that are willing to switch groups - and any other characteristics (highly motivated, well-informed, aggressive?) that these types of people have.  Thus, the actions of the subjects can make our initial assumptions, that both groups are random and appropriately exposed, invalid, or at least, less valid.

Experimental trials are the most sound means for determining the causal association between an exposure and an outcome, but they still have inherent flaws that we must anticipate.  And his extends beyond mere methodological considerations and offers practical implications.  First, it may help to interpret clinical trials based on how well you match the study population - are you the same sex, age, BMI classification, and would you yourself participate in such a trial (this may help gauge your behavioral similarities with the study).  Second, the results of an experimental trial should not be regarded as dogma.  One clinical trial with little grounding in basic science (e.g. homeopathic medicine) likely needs much more investigation;  whereas several clinical trials that refute modest epidemiological evidence (e.g. dietary saturated fat and heart disease risk factors) probably clarify the true association.  We cannot study ourselves as though we are lab rats, so let's not interpret our studies as though we are.

*In case you didn't look at the link, the Atkin's Diet surpassed all of the other diets, including the Ornish Diet, in terms of weight loss and improvements in cholesterol/metabolic markers after one year in pre-menopausal women.  Perhaps this changes your preconceptions a bit?