Monday, November 25, 2019

Nixtamalized Tortillas

Many traditional cuisines have great ideas. Anyone who has been following my blogs and coming to our cooking classes has seen how I get inspiration from the Bangladeshi community in our area, both in terms of the kinds of vegetables we use and the selection of spices. But, we also have a great Mexican restaurant in the neighborhood in Taqueria Tlaxcalli on Starling Avenue, and the wife of the owner, Jesse Caballero has been interested in plant-based food for a while and from time to time they have made some food for the plant-based health fair at St. Helena's. On the menu there is not a lot of choice yet, but the cactus salad remains a favorite of mine, as long as they leave out the queso and the oil. If you are making it yourself, you can use firm tofu instead of queso.

Recently, we got talking about Nixtamalized Tortillas after there was a big article in the NY Times about Tortilleria Nixtamal in Queens, which used to be a restaurant, but these days is only a Tortilla bakery, where you can go and buy fresh tortillas, and they deliver to stores and restaurants. A one pound package is $2.00.

I went there recently with a friend who lives in that area. The process of nixtamalization starts with cooking the cornflour in a briney solution and it makes the cornflour much more easily digestible and nutritious. It is an old, traditional Aztec way of preparing the corn and it creates a delicious and healthy tortilla. Worth a try. There is a lot of information on-line about the process:
Have a ball, and please let me know if you find Nixtamal Tortillas in our neighborhood.

Saturday, November 23, 2019

Pre-Thanksgiving Dinner

Here were our festive dishes... with some Thanksgiving-styled ideas.

Pumpkin- ginger soup

Ingredients


  • 1 average sized organic Hokkaido Pumpkin, or Kabocha Squash cut into chunks (deseed but don't peel)
  • 3-5 onions chopped
  • 3-10 cloves of garlic, chopped
  • 1-2 inch piece of ginger sliced, or ginger powder
  • 2-3 pieces of turmeric sliced, or turmeric powder
  • pint of vegetable stock
  • 1-2 jalapenos, seeded
  • 2-3 small green chilies, sliced
  • 1 tbsp panch puran
  • 2 table spoons of whole wheat flour

Preparation

  1. caramelize the onions adding garlic, chili and jalapeno, and panchpuran and gradually add the whole wheat flour and liquify with some veggie stock
  2. gradually add all of the soup stock, and let it come to the boil
  3. add the pumpkin and let it boil about 20 mins.
  4. Allow the soup to cool down a little then pour into a blender and blend at high speed till smooth and creamy, or use an immersion blender to achieve the same result. 
Evidently, you can make this as spicy as you like, by varying the amounts of turmeric, ginger, chilis and peppers. You can use a small amount of Bragg's Liquid Aminos or Yondo to finish to taste, but if you are using the Panch Puran, you should not need much at all. The whole point is that by choosing aromatic spices, you can pretty much eliminate the need for added salt. With turmeric and ginger if you can use fresh, that makes all the difference in the world. If you want to give it some extra zing, you could slice some scallions on top for garnish.

Baked Cauliflower with Fennel 

Ingredients

  • 1 head cauliflower, cut into florets (about 3 cups)
  • 1 bulb fennel, halved and sliced thin (about 2 cups)
  • 1 pomegranate, seeded (about ¾ cup)
  • ½ cup pecans
  • 1 tsp lemon juice
  • ½ tsp turmeric powder
  • ½ tsp mustard powder
  • ½ tsp cinnamon
  • ¼ tsp pink Himalayan salt, or to taste

Preparation

  1. Preheat the oven to 400 degrees F and line a baking sheet with parchment paper. 
  2. Place cauliflower florets in a large container with a lid. Drizzle with lemon juice, turmeric, mustard powder, cinnamon, and salt. Cover the container with the lid and shake it up until the cauliflower is completely coated. 
  3. Spread the cauliflower evenly on the baking sheet.
  4. Place the fennel slices on baking sheet with the cauliflower.
  5. Bake for 15 minutes.
  6. Remove from the oven and add the pecans. Bake for another 5 minutes.
  7. Remove from the oven and sprinkle with pomegranate seeds.

Mashed Potatoes recipe from Whole Foods Market

Ingredients

  • 2 pounds potato, such as Russet or Yukon Gold cut into 3/4-inch cubes
  • 1 medium white onion diced
  • 1/3 cup low-sodium vegetable broth
  • 4 cloves garlic finely chopped
  • 1 cup unsweetened oatmilk, soymilk, almondmilk or ricemilk
  • 3 tablespoons nutritional yeast
  • 1 teaspoon granulated onion
  • 1/2 teaspoon ground black pepper

Preparation

  1. Place potatoes in a saucepot and cover with cold water. Bring to a boil.
  2. Reduce heat and simmer until potatoes are very tender, about 20 minutes. 
  3. Drain potatoes and return to pot. Stir over low heat until potatoes are falling apart and slightly dry, about 5 minutes. 
  4. Remove from heat and mash potatoes or purée with a ricer until smooth.
  5. Meanwhile, heat a large skillet over medium heat. Add onion and cook, stirring frequently until lightly browned and beginning to stick to the pan, about 5 minutes. 
  6. Stir in broth and garlic and continue to cook, stirring frequently, until onions are tender and golden, 6 to 8 minutes.
  7. Add onion mixture, oatmilk, nutritional yeast, granulated onion and pepper to pot with potatoes and stir until combined. Serve immediately.

Mushroom Sauce

Ingredients

  • 1/2 onion diced
  • 4 cloves garlic minced
  • 2 Tbs white wine (or sub veg broth)
  • 8 oz mushrooms sliced
  • 2 Tbls Soy Sauce low sodium variety, Braggs Liquid Aminos, or Yondu
  • 1/4 cup whole wheat flour
  • 1 Tbs nutritional yeast
  • 1/2 tsp thyme
  • 1/2 tsp rubbed sage
  • 1/2 tsp rosemary
  • 2 1/4 cups vegetable broth low sodium variety
  • 1/2 tsp kitchen bouquet browning sauce
  • Drop or two of liquid smoke (optional)

Preparation

  1. Saute onion and garlic in wine until softened
  2. Add mushrooms and soy sauce and cook until reduced
  3. In a separate pan, lightly toast flour, nutritional yeast, and herbs
  4. Add flour mixture to mushrooms and stir well
  5. Slowly add vegetable broth and stir well to combine
  6. Add browning sauce and liquid smoke and heat to desired consistency

Red Leaf & Spinach Salad

  • 1 Head Red Leaf Lettuce
  • 1 bunch fresh young spinach
  • 1 red onion
  • 1 red pepper
  • 1 yellow pepper
  • 1 box cherry tomatoes
  • optional: some scoops of chia seeds, or milled flaxseed.

1/2/3 dressing with lemon and lime juice


Economics

Plant-based is pretty affordable... we had 7 people or about $105 to work with, and we spent $75, meaning we contributed $30 to St. Helena's. Or, we spent about $10.50 per person, and some people took food home, plus we left an ample portion for Fr. David.

Wednesday, November 6, 2019

The Third Annual Montefiore-Einstein Preventive Cardiology Conference.

You can easily get your own report on the conference by searching #MEPCC19 on Twitter.





  There was once again a stellar group of presenters there, starting with Dr. Ostfeld himself, who opened the conference, followed by

  • Dr. Caldwell Esselstyn, Jr. on his favorite topic: why Heart disease is a paper tiger that need not exist, and if it does can be reversed with diet. I never get tired of hearing him and I had a chance to speak with him briefly.
  • Dr. Philip Gordts, on a fascinating (relatively) new evolutionary theory on why red meat is such a trigger for heart disease in humans. Understanding the "why" is always helpful. See also this newspaper article Red meat triggers toxic immune reaction which causes cancer, scientists find. Bottom line: we always knew from the research of Dr. Colin Campbell that animal proteins tend to stimulate tumor growth and now this mechanism that Dr. Gordts discussed may be the evolutionary reason why our bodies reject meat - it contains a sugar which occurs in many mammals, but not humans, called Neu5Gc and the body rejects it and treats it as a foreign invader.
  • Dr. Walter Willett, on achieving an optimal diet.
  • Dr. Wilson Tang, on Diet, Intestinal Biota and Cardio-renal Disease Risk. This area is ever so important. The first shocker always is that it takes only three days on a #WFPB diet for your gut to stop making TMAO, which is a leading cause of CVD.
  • Dr. Andrew Freeman on why 2019 is the year of the Plant-based diets.
  • Dr. Michelle McMacken, who runs the Lifestyle Medicine program at Bellevue gave the Daniel and Michael Ostfeld Memorial Lecture
  • Dr. Ostfeld himself presenting on the practical issues in implementing the diet in your clinical practice (Answer: leverage outsourced support mechanisms as much as possible).
  • Then a series of presentations by interns who are active in the Lifestyle Medicine field, which was brilliant. Speakers were Drs. Danielle Belardo, on a Cardiac case, Sasha deJesus, again on Cardiac issues, Clark Yarber, on an outlier case of Cardiac Syndrome X, and Timothy A. Zaki on Type 2 Diabetes.
All followed by a panel discussion of questions from the public.



There's too much information that comes out of an event like this, but here are a few highlights that stood out for me:

  • Esselstyn: Focusing on the green leafies for the nitrates that convert to nitric oxide in the body, which keeps your arteries limber, combined with the high ORAC value of various fruits, particularly berries, for that is what repairs cell damage. Those are just two simple concepts that makes the whole logic of the whole foods, plant-based diet understandable.
    Complete reversals, even without statins, are typically possible in three to four weeks, but certainly within 3 months. Angina usually is much reduced within 1-2 weeks. His conclusion was that he "... felt more excited about medicine today, 20 years after retiring as a surgeon," because of the increasing uptake of these new ideas in the medical field. A comment from Dr. Joel Kahn emphasized again that stents or bypass surgery only correct for the effects of heart disease, but do not heal the disease itself - only diet will.
  • Dr. Walter Willett commented on the general fact that 5-10 years life extension is a reasonable expectation from changing to a whole foods, plant-based diet. He focused on the big picture of planetary health and the EAT/Lancet study. He cautioned against becoming overly simplistic about lowering medical costs, as people will live longer. So they might spend less on medical services per year, but live more years. Time will tell.
  • Dr. Wilson Tang took us through the whole TMAO issue and how choline is converted to TMA by the enzymes in the intestinal tract and subsequently oxidized in the liver to result in TMAO. It is a big cause of inflammation and implicated in heart disease (CVD/CAD), type 2 diabetes (T2D), and chronic kidney disease (CKD). Evidently, the point is that a plant-based diet will stop this immediately.
  • Dr. Walter Willett's take away points were that even the Economist labeled 2019 the year of the vegan and the fact that Medicare and most major insurers now cover either the Dean Ornish program or the Pritikin protocol for reversing heart disease. Equally obvious, it is still cheaper to change to a #WFPB diet now, rather than wait until you have heart disease.
  • Dr. Michelle McMacken injected a dose of reality with a beautiful case history of a 42-year-old with undiagnosed T2D and an A1C at 12.7%, who was no longer a diabetic after 4 months (A1C below 6) after throwing out his metformin at 2 months in. She also cautioned that "unhealthy vegan" is as bad or worse as the SAD.
Here is a summary on YouTube by Dr. Joel Kahn.

The whole thing was brilliant as always and an enormous asset of our community in the Bronx. Meanwhile, once again no one from the Bronx officialdom was present, but Eric Adams' office was represented, even if he could not make it. Otherwise, people came from all over. At lunch, I talked with a lovely doctor from Montgomery, Al.

Monday, October 28, 2019

Plant-Based on a budget - update

To me, this is as important as anything. The truth is there are too many recipes that are overly fancy, and before you know it, you end up thinking you really need all that to live plant-based, but you don't. You can start very simple.

I will discuss some sites here and leave you with some suggestions based on conditions in our own neighborhood.

Here is one great site:
https://www.thepennyhoarder.com/food/groceries/eating-vegan-on-a-budget/

but the best one is perhaps Plant-based on a budget, just like the title of this article.

But, there are plenty of ideas. It starts with buying in bulk wherever suitable.

I always like to point out that on our street in the Bangladeshi stores, there is an absolute feast of staples available...

  • 10 lbs brown basmati rice $12-15
  • 10 lbs onions $1.99 - $5.99, depending on the grade of onions and with seasonal variations
  • 4 lbs red lentils $3 or 2x4 lbs for $5.
 And here is a wonderful suggestion from Costco:


Once you have those kinds of things in stock, and some condiments, the sky is the limit and for your other veggies you buy whats on sale/in season, and of course various fruits in between.

You start your days with steel cut oats, 30 Oz is still $3.29 at Shoprite, and I make it with a constantly varying set of fruits, usually starting with a Granny Smith Apple, and some Blueberries, some raisins and goji berry, and whatever else comes along - I usually add a banana as well.
I usually decorate it with balsamic vinegar (4% acidity) and hemp seeds.

You can also work wonders with frozen vegetables of various kinds. Or, when I find some great vegetable on sale, I might cook ahead.

St. Helena's Communal Meal Prep 10/26/19

This time the theme was leafy greens.

Eating leafy greens, either raw or cooked 4-6 times a day is the standard recommendation of Dr. Caldwell Esselstyn for it will keep your arteries flexible. Chewing the leafy greens will convert nitrate and with the enzymes from your saliva ultimately it will produce the nitric oxide that helps your bloodvessel stay limber.

Some of the best foods for this are:
  1. Beets
  2. Garlic
  3. Leafy greens
  4. Pomegranate
  5. Nuts and seeds (but.. we want to go light on those because of the high oil content).

Two Salads

Green Salad

  • 1 Green lettuce
  • 3 Vine tomatoes
  • a can of black-eyed peas (or whatever beans or peas you can find)
  • some quinoa
  • yellow, red, green peppers
  • a can of sliced beets
  • a carrot sliced thin (we skipped this because we already had the veggie spaghetti salad with carrot)
  • capers
  • olives
  • a red onion, cut up.
  • a pomegranate
  • 1/2/3 dressing: 1 measure maple syrup, 2 measures Dijon Mustard, 3 measures Balsamic Vinegar, and lemon and lime juice to taste
  • add milled flax seed and/or chia seeds for Omega-3's
Endless variations on the above are possible, and depending on the addition of quinoa and beans, you can make this a meal salad.

 






 Veggie Spaghetti Salad

We made this with a mandolin, but you could use a spiralizer of some sort. Taste is the same, but the long spaghetti strands present better - maybe.

For a dressing we used some 1/2/3 dressing with thyme and some Veggie Mayo (see below).

  • Shredded Zucchini
  • Shredded Daikon
  • Shredded Green Papaya
  • Shredded Carrot

Veggie Mayo

  • 1 package of Silken Tofu
  • 1 tbsp maple syrup (or date sugar)
  • 1 tpsp red wine vinegar or fresh lemon juice
  • 1 tbsp of Dijon Mustard
 Drain the tofu on a paper towel, and mix the ingredients with an immersion blender.





Leafy Greens Galore

It was Khokon, the owner of Neerob Restaurant, who taught me to make a medley of green leafy vegetables.

The message is that you can make either pure spinach, or Malabar spinach (poi leaf for the Bangladeshis), or Swiss chard, or any other green leafy vegetables by itself, or you can make a medley.

You can create a simple and delicious flavor with caramelized onions and garlic, some turmeric (preferably fresh) and perhaps Panch Puran or other spices.

 The way to build it up is to caramelize the onions first:

  • cut up the onions finely
  • optionally: cut up some chilis
  • roast dry for 5 minutes - just until the onions start turning brown and sticking to the bottom of the pan.
  • mince some garlic
  • mince turmeric
  • 1/2 cup of veggie broth 
  • now stir-fry for five minutes, keeping it liquid with the broth.
  • meanwhile cut up the stems of your leafy greens if they have heavy stems.
  • now stir-fry another 5-7 minutes with the stems.
  • cut up the leaves into 1-1/2" strips and add
  • cook on medium until the leaves are al dente
The above is just perfect for making green leafies as a side dish. Alternatively, you can make dal, as follows:
  • after stir-frying with the stems, you add more water and red lentils (hulled red lentils) in about 2:1 proportions water to lentils, let it cook about 10 mins then add the green leaves and let it cook for five minutes.
In other words, you start the same way for making green leafies as a side dish or the dal with green vegetables.

Butternut Squash

The last thing we made was butternut squash. We cut one in half lengthwise and put two garlic cloves in the hollow, and filled it up about half-way with veggie stock.
30-40 minutes in the oven at 400F, until soft.

Desert was grapes, which were also delicious.

It seemed everyone enjoyed the meal.

From the money dept

We had eight people, or $120 in funds, and we spent $87.31. In short, we are donating $32.69 to St. Helena's. There was plenty of food, even considering that two people did not show up. 

Sunday, October 13, 2019

The Low Down on Verrgie Broth in the Hood

OK, it's time to take stock of (veggie) stock in the hood. I am not sure what the difference is between veggie stock and veggie broth. Wikipedia quotes James Beard as saying:
...that stock, broth, and bouillon "are all the same thing"
and it goes on to say that the distinction, if any, tends to be fluid. Swanson does seem to know the difference, but they don't explain it either: Organic Vegetable Broth, v.s. 100% natural vegetable cooking stock, and Vegetable Broth. I use them interchangeably.

One of the insidious features of any packaged foods is that you really need to read the label, for too often too much salt, sugar, or oil sneaks in, not to mention some other nefarious chemicals you may not like. However, if you do get into the habit, you will be rewarded and soon you will find your way to better solutions.

Remember always to check for what they say about serving size, for those can often be wildly unrealistic. A bag of potato chips may contain many "servings" but I don't know anybody who would not eat the whole bag. With veggie broth it seems to be easier - a serving is an 8 Oz cup. That much is straigtforward. The % of RDA means nothing for the RDA is completely different in plant-based nutrition. You want 10% of calories from fat (no added fat), 10% from protein, and 80% from Complex Carbohydrates. For sodium, the recommended level in the plant-based community tends to be 1,500 mg daily, whereas generally, anything below 2,000 mg daily is regarded as low sodium.

This time I want to research Vegetable Broth/Stock in our area. I am listing ingredients and prices and a recommendation. I will keep adding to the list. Besides Chiang-Li and Key Food, I will also visit ShopRite on the Bruckner.
I make note of the color because for some situations the dark color might be too much, e.g. if you want to create a light-colored sauce.

As to the salt content, clearly, there are several reasonable ones and a couple of very good ones. If the goal is not to exceed 1,500 mg a day, you can see how it adds up. Again, in general, anything below 2,000 mg/day is looked at as low salt.

Broth Alternatives

In our cooking classes, we have discussed both Bragg's Liquid Aminos and Yondu as easy alternatives to veggie broth.




For example, when caramelizing onions, you really only need a little bit of water to keep them good and liquid and prevent them from sticking to the pan or getting burned.
I typically use about 1/2 cup of water with a teaspoon of Yondu or Braggs if I do not have veggie broth handy.

Both are alternatives that are reasonably low in sodium.

At the other extreme, I periodically am brave enough to make my own veggie broth from roast veggies. Sometimes, when I do this, I also freeze a couple of trays of ice-cubes of veggie broth. 2-3 icecubes of broth may be all you need to liquify stir-fried onions.

Chiang-Li Supermarket

  •  College Inn, 32 Oz 100% Natural Garden Vegetable Broth - $3.39
    • 20 Calories
    • 0 g of Fat (0% of RDA)
    • 0 mg Cholesterol
    • 700 mg Sodium (30% of RDA)
    • 4 g Total Carbohydrates (1% RDA)
      • 3g added sugars
    • 0g protein
    • NB.: High in Sodium! This is a light colored broth.
  • College Inn, 32 Oz, 100% Natural Garden Vegetable Broth (40% less sodium) - $3.39
    • 0g Fat
    • 0 mg Cholesterol
    • 420 mg Sodium (sic!)
    • 4 g Carbohydrates
      • 3g added sugar
    • 0g protein
    • NB: This is a light colored broth.
    • Recommended!
  •  Swanson, 32 Oz, Organic Vegetable Broth - $3.79
    • 10 Calories
    • 0g Fat
    • 0 mg Cholesterol
    • 530 mg Sodium
    • 2 g Total Carbohydrates
      • 1 g added sugars
    • 0 g Protein
    • Recommended!
  •  Kitchen Basics, 32 Oz, Unsalted Vegetable Stock.
    • 0 g Fat
    • 0 mg Cholesterol
    • 210 mg Sodium
    • 100 mg Potassium
    • 6g Total Carbohydrates
      • sugars 4g
    • 0 g Protein
    • Recommended! 
    • N.B. Color dark. 

 Key Foods, Metropolitan

  •  Swanson, 32 Oz. Vegetable Broth,  on sale 2 for $6.
    • 10 Calories
    • 0 g Fat
    • 0 mg Cholesterol
    • 800 mg Sodium
    • 2 g Carbohydrates
      • 2 g sugars
    • 0 g Protein
    • NB: High Sodium - avoid, color light.
  • Swanson, 32 Oz. Vegetable Cooking Stock, on sale 2 for $6
    • 15 Caloreies
    • 0.5 g fat
    • 0 g Cholesterol
    • 550 mg Sodium
    • 2 g Total Carbohydrates
      •  2 g Sugars
    • 0 g Protein
    • N.B. Light color
    • Recommended!
  • Pacific Foods, 32 Oz. Organic Vegetable Broth - $3.99 (on sale)
    • 15 Calories
    • 0 g Fat
    • 0 g Cholesterol
    • 500 mg Sodium
    • 3 g Carbohydrates
      • 1 g Sugars
      • 1 g Dietary Fiber
    • 1 g Protein
    • N. B. Light color
    • Recommended! 
Options galore. I will keep adding to this as I take inventory at Shoprite.

ShopRite Bruckner Commons

Ok, I finally made my veggie broth run to ShopRite. Here's the harvest (I am reporting list prices, though some were on sale):
  •  Wholesome Pantry, 32 Oz Vegetable Cooking Stock, $2.21
    • 10 Calories
    • 0 g Fat
    • 0 g Cholesterol
    • 570 mg Sodium
    • 3g carbohydrates
      • includes 2g added sugars
    • 0 g Protein
    • N.B. Light color
  •  Swanson, 32 Oz Vegetable Broth, $2.79
    •  Otherwise as above
  • Swanson, 32 Oz Organic Vegetable Broth, $3.49
    • Otherwise as above
  •  College Inn, 32 Oz, 100% Natural Garden Vegetable Broth, $2.99
    • Otherwise as above
  • Progresso, 32 Oz, Vegetable Broth, $2.19
    • 5 Cal
    • 0 g Fat
    • 0 g Cholesterol
    • 400 mg Sodium
    • 0g carbohydrates
    • 0 g Protein
    • N.B. relatively low sodium
  • Emeril's 32 Oz Organic Vegetable Stock, $2.19
    • 10 Calories
    • 0 g fat
    • 0 mg Cholesterol
    • 570 mg Sodium
    • 2 g Carbohydrates
      • 2g sugars
    • 0 g Protein
    • N.B. dark color. Sodium in mid range.
  • Rachael Rae, 32 Oz All Natural Veggie Stock $2.60
    • 10 Calories
    • 0 g Fat
    • 0 mg Cholesterol
    • 480 mg Sodium
    • 2 g Carbohydrates
      • less than 1g sugar
    •  0 g Protein
    • N.B. Sodium about average. Darker color.
    • Recommended
In all almost all the broths were on-sale, so I did considerably better than the list prices indicate.

Monday, September 23, 2019

Serious Oatmeal

As I have been discussing serious oatmeal with some people, I will share my process here...

First, this was today's version:

Serious Oatmeal

Two day prep

I usually prepare Oatmeal for two days at a time. I take one measuring cup of steelcut oats (I get them from ShopRïte, at $3.29 for 30 Oz of organic oats), and prepare it overnight in my trusted Zojirushi NP-GBC05 rice cooker. It is ready for me at 6:30 AM with the timer.

Then I add:
  • a shredded Granny Smith apple, 
  • 1/2 pint blueberries
  • 1 tbsp goji berries
  • 2 tbsp raisins
  • 1 tbsp cocoa nibs
  • 1 tsp cinnamon
     
and I let that sit on "keep warm" for min 5 mins.

The daily plate of Oatmeal

Then I save half for next day and I serve the other half, fixed up as follows (in this case):
  • a ring of berries (stawberries, raspberries, etc.) and other fruit (today it was Raspberries and Starfruit)
  • a sliced banana sometimes even more fruit (I love me some jackfruit).
  • a tbsp of hemp seed (part of my Omega-3 for the day)
  • A drizzle of Balsamic vinegar.
And here is another version:
Serious Oatmeal also, but with Strawberries


A note, you do not want to O/D on Omega-3. Too much is no good, what matters is the proportion between Omega-3 and Omega-6. Personally, I use 2-3 tbsp a day of hemp seeds, milled flax seed, or chia seeds. That seems to be about right for me. Individual mileage may vary, so consult with your plant-based doctor at the time of your physical ;-)