Vegetable Lasagna - our January 2018 Suppers/#WFPB meal at St. Helena's

This time around it was all chaos, as one of the organizers was not feeling well, but we made it work regardless.

The plan was vegetable lasagna, based on a recipe from the book The Vegan Cheat Sheet by Amy Cramer and Lisa McComsey, with a side dish of spinach, and a mixed green salad with Dr. Barnard's Roasted Red Pepper Vinaigrette. (Note: the book underestimates the amount of filling you need, in my view, so below I upped the amount of cauliflower relative to the book. We found out the hard way that we ran out of the white filling too soon.)

This is a very lovely #WFPB (Whole Foods, Plant-Based) dinner. And the #not62 health campaign in the Bronx would not be the same without it! The people of the Bronx are learning.

The Menu - Recipes

Note: these quantities were for 9 people. You can adjust them accordingly. Out of our $15 grocery money we only spend about $9, so in all there was an $6.00 refund.

To begin with, here is the salad dressing:

Dr. Barnard's Roasted Red Pepper Vinaigrette

Makes enough dressing for 1 large salad

1 large roasted red pepper

1 clove garlic

2 tbsp balsamic vinegar

1/8 tsp salt

1/4 tsp pep per

1/2 tsp fresh thyme leaves

Place all ingredients in a blender or food processor. Serve and enjoy.

For the salad we used:

1 head of red leaf lettuce

1 head of green leaf lettuce

1 head of romaine lettuce 

1 green pepper

1 red pepper

1 yellow pepper

1 red onion

6 cloves of garlic

6 sundried tomatoes

4 fresh tomatoes

2 tablespoons of Chia seeds

2 tablespoons of milled flax seeds

(Confession, we ran out of time, and we ended up making a 3/2/1 dressing with red pepper - 3 measures balsamic, 2 measures dijon mustard, and 1 measure maple syrup), so we'll do this recipe again some other time. In fact I will make it today.)

Tomato Sauce (Red)

Note: finding oil-free pasta sauce is not always easy, though there are some on the market. You can find one at Trader Joes, see this listing of OIl-free vegan products at Trader Joes, provided by Forks over Knives. Anyway, we could not find an oil-free sauce in the neighborhood, so I made it from scratch. As it was I started a bit late, but the idea was to have the pasta sauce ready when the class started at 3 PM, so that the class could make the salad, the spinach, and build the lasagna, so we just had to shove it in the oven. So we ran a bit late this time, but the meal was enjoyable.

Ingredients:

4 28Oz cans of Organic Diced Tomatoes

4 onions, cut fine

8 cloves of garlic 

10-20 leaves of fresh basil chopped fine

7 leaves of laurel

2 peppers

2 8 Oz packs of mushrooms (one white and one crimini)

1 lb of carrots shredded

Braggs Liquid Aminos to taste 

Preparation:

• Cut up the onions fine, and start dry-roasting them in the pan
• add the peppers, cut up, and stir it up
• add the garlic (first flatten it and cut it fine) and stir it up
• add the carrots (match stick cut) and stir it up
• add the mushrooms, sliced (note the mushrooms yield a lot of moisture) and stir it up
• when these ingredients start to get soft and feel cooked, add the tomatoes and stir it up
• let simmer, and finish with Liquid Aminos to taste
• make it smooth with an immersion blender

Spinach side dish

4 bundles of spinach cut in 1.5" lengths

2 onions cut up fine

7 cloves of garlic flattened and cut fine

8 chilis sliced fine

3 jalapenos, remove the seeds

(Note: the chilis were fine for most, but a bit much for a few people, but evidently, you can vary that to taste. The jalapenos are much milder.)

Again, start with dry-roasting the onlons, chilis, jalapenos and garlic, and when it is soft, add the spinach, and let it cook slowly for another 7-10 minutes.

Lasagna filling (White)

2 14 Oz packs of Silken Tofu
5-6 cups of steamed cauliflower
(Note: the original recipe suggests 2 cups of cauliflower per pack of tofu, but in practice, I find 3 cups of cauliflower per pack of tofu is a better ratio. Be sure to cook the cauliflower really soft.)

When the cauliflower is soft, add the tofu, and make a smooth sauce with a stick blender.

3 yellow squash sliced
3 zucchini sliced

Building the Lasagna

2 12 Oz packs of Whole Wheat Lasagna, or 3 packs if they are 9 Oz
some nutritional yeast

(Note: this was the fun part, doing it assembly style... We used 2 12 Oz boxes of Ronzoni Healthy Harvest Whole Wheat Lasagna - note: it is available next door, at Chang-Li Supermarket. More and more supermarkets are starting to carry it.)
Preheat the oven to 425 F

• start with a layer of pasta sauce
• layer whole wheat lasagna strips in the sauce (typically 3 strips make one layer)
• layer on the white filling
• make a layer of sliced squash/zucchini
• repeat until the pan is full, finish with a layer of red sauce on top.

 In the oven for ca 45 mins.

Serving suggestions:
The salad is obviously colorful.
The main dish is red/white, with a side of green.
For topping, you can sprinkle on some nutritional yeast

Conclusions

The above is a very complete and satisfying meal. And, it was fun to build with the group, even though this time we went far over schedule, mainly because I started too late to make the pasta sauce and the Cauliflower/tofu filling in advance.
As a reminder, why do we avoid ADDED oils? In other words, why did I make fresh tomato sauce because I could not find an oil-free sauce nearby? Because added oils paralyze our bloodvessels for 3-6 hours after every meal. The blood vessels can no longer expand with extra energy expenditure. It is tremendously important for heart and vascular health to understand that you do not want any added oil in your diet. Here you can hear it from the horse's mouth: Dr. Caldwell Esselstyn says no oil. I repeat, Dr. Caldwell B. Esselstyn, Jr. says: "No oil!" If you're still not clear, here is Dr. John McDougall saying the same thing.

Another feature: this meal really embodied 2 of our 4-6 daily portions of green leafy vegetables - a salad and a side dish of spinach. Green leafies provide massive doses of anti-oxidants, and by chewing them we are converting nitrates to nitrites and enabling our digestive system to manufacture nitric oxide, which is what keeps your endothelium healthy.



The point of the exercise however, remains, that in the spirit of the Suppers program, this is all about home cooking, and about creating a mutual support mechanism on a local level. Audelle has been doing Suppers meetings at her home in Throgs Neck for a long time, but doing this at the St. Helena's school cafeteria enables a slightly larger group.
Meanwhile, the idea of sharing the grocery bill, also teaches us that a very healthy and abundant Whole Foods Plant-Based meal can be made on a budget. In this case, we came out to $9 per person. The highest we ever did was $11.50 per person, but it seems that we can typically do these productions for under $10 pp in groceries. You can do it for less, or you can spend more. In the long term you are reducing your medical expenses and nearly completely eliminates the need for any supplements. In this case we added chia seeds and milled flax seed to the salad for Omega-3s and as long as you keep that in mind, the only supplement you should ever need is a vitamin B12 every other day.
If you think about it, the degenerative diseases which consume 86% of our healthcare expenditure, are diseases of affluence and can largely (ca 75%) be prevented or largely reversed with the Whole Foods, Plant-Based diet. It produces such nutritional abundance that the mere thought of supplements is silly. On top of that, there is more and more evidence that isolated supplements are not absorbed as well by the body, or even absorbed at all, as nutrients which are consumed as part of a whole foods diet. In some cases, supplements can even be toxic.

The #WFPB Nutrition Paradigm Shift Is Under Way in the Bronx

On Friday October 27th, I attended the first annual Montefiore Preventive Cardiology Conference, which was an amazing experience.

Many of the heavyweights in the field were there, and it was a truly amazing experience. While the material was meaty, since the conference offers educational credits for medical professionals, it was accessible to the general public as well, and people had come from all over the country. There was even a delegation from the Brooklyn Borough President's office, as well as from the Mayor's office, in this week when it had just been announced that Brooklyn was launching Meatless Mondays in 15 public schools.

The speakers included the following:

• Opening remarks by Dr. Robert Ostfeld, cardiologist at Montefiore, who was the conference organizer.
• He was followed by Dr. Paul M. Ridker, Director of the Center for Cardiovascular Disease Prevention at the Brigham and Women's Hospital, who spoke on the issue of inflammation in cardiovascular disease. The bottom line is that cholesterol levels and inflammation are equally important in cardiovascular disease (CVD).
• Next came Dr. Neal Barnard (he of PCRM fame), who spoke on the role of nutrition in the prevention and treatment of diabetes. The bottom line is that the ADA approach (low carb), does not work nearly as well as a Whole Foods Plant-Based diet without added sugar, oil or salt, and that this is now fully scientifically proven. It is notable that fruit is healthy for diabetics because the sugar in the context of fruit is not a problem, it's the refined sugar we add to food that is the problem. Carbs are also essential, and sugar in and of itself does not cause diabetes, fat does. So, the avoidance of added oils and fats is critical. Most importantly, once a patient starts on the diet, the changes can happen so fast that medical supervision is critical since otherwise people can become hypoglycemic if their medications are not adjusted in a timely fashion. Not in all cases, but for probably two thirds of diabetics it seems realistically possible to get off of medicine and insulin altogether within weeks or months.
  Dr. Barnard's graphical illustrations of the diabetes mechanism were extremely helpful.
  Barnard also brought up a fascinating report on Geico, where he was involved in lowering health care costs with a Whole Foods Plant Based diet, for a company that is self-insured for health. This type of development could point the way towards a better solution for our healthcare crisis. Whole Foods operates along similar lines.
• Next was Dr. Kim Williams of Rush University Medical Center in Chicago and former president of the American College of Cardiology, who spoke on "Describing My Evolution Toward Advocating for a Lifestyle Oriented Approach for the Prevention and Treatment of Cardiovascular Disease. A very engaging speech - you can get a little taste here.
• Next up was Dr. Caldwell Esselstyn, Jr. and it is always a delight to hear him state his core position, that heart disease is a toothless paper tiger that does not even exist, not to mention how amazing it is that this has become a multi-billion dollar medical specialty in the Western world, without anybody wondering why large parts of the world do not even have this problem. In short, coronary heart disease is entirely preventable and in most cases (except when it is totally critical) reversible with diet and exercise.
• Finally, Dr. Robert Ostfeld spoke specifically on the challenges of the Bronx, the borough that steadily always comes in at #62 of 62 counties in NY in the Robert Woods Johnson survey of health outcomes for the state. With his customary sense of humor he described the challenges of working in a poor community and focusing on teaching people to make the transition to a WFPB diet on a budget.
• Next, there was a panel discussion, which also included Dr. Michelle McMacken, Assistant Professor of Medicine at NYU School of Medicine and Director of the Adult Weight Management Program at Bellevue Hospital.

One of the more hilarious moments of the day (and there were many) was in the presentation by Dr. Kim Williams about a study where the relationship of dietary intake to premature death from heart disease was analyzed. At first it seemed the study indicated that red meat was worse than eggs, until it became clear that consumption of eggs causes cancer, and the patients in the study died from cancer before they died from heart disease. Conclusion: eggs are the incredible, edible carcinogen.

Another salient point that came out during the day was the difference between a "vegan" diet, defined in the negative (no animal products), but not observing the whole foods paradigm, which often produces worse health outcomes than a meat-based diet. This confirms again that "vegan" is not a useful category from a nutritional standpoint, for a whole foods plant-based diet, without added Sugar, Oil and Salt is really the issue. Potato chips, Coca Cola and chocolate may make a "vegan" diet, they do not add up to a healthy lifestyle.

Overall, it is increasingly clear that the Whole Foods, Plant-Based nutritional model is slowly becoming main stream and in fact that the adoption is picking up speed as evidenced by the developments in Brooklyn, which now are getting the support from the mayor's office, as well as the adoption in hospitals, such as the Montefiore health system, which includes five hospitals. Both AMA and the American College of Cardiology now recommend that hospitals offer plant-based menu options at every meal.

Throughout the day the food was excellent and a worthwhile demonstration of the variations that are possible within the #WFPB paradigm. The sky is the limit. Literally - as was also emphasized by various speakers - #WFPB is more bulky but you lose weight automatically and end up returning to a homeostatic, healthy weight. Overeating is never a problem because the diet is rich in fiber and nutritionally abundant as long as people eat enough different foods. There is no such thing as a protein deficiency if people eat a reasonably varied plant-based diet, and likewise the notion of supplements is completely moot, with the sole exception of B12. It was not discussed in detail, but there was mention of the fact that supplements from bottles can indeed easily be counter productive - everything is more easily absorbed from food, and the plant based diet will provide abundant nutrients.

Another simple way of looking at the problem is this: your body produces all the cholesterol it really needs, you need no dietary cholesterol ever. Plant-based nutrition has zero cholesterol and all animal-based nutrition has cholesterol, hence you should not eat it. 

As to added sugar, oil and salt: 

• sugar is harmless in fruit, but adding refined sugar in any form is bad news
• added oil is always bad, it damages the endothelium immediately, preventing your bloodvessels from dilating normally with exercise. You'll get about 10% of your calories from naturally occurring oil if you include small amounts of nuts, avocado or coconut in your diet, but, generally speaking, all plants contain small amounts of oil naturally, so it is easy to go over.
• as to salt, 2,000 micro grams per day is all you need which is easy to meet if you eat all plants, and sometimes you can even add a sprinkle, but generally you want to use herbs and spices for seasoning, not salt. All vegetables and grains contain sodium naturally.

Meanwhile, it is clear that different doctors have slightly different attitudes in practice, but they all focus on helping patients with at least a half-day of intensive nutrition counseling that includes the significant other, in order to help people get on track about their diet and stay on track. In Dr. Ostfeld's program at the Montefiore Cardiac Wellness program, this is typically a half-day program on a Saturday, that includes food so people leave inspired about the many options that exist within the plant-based paradigm.

Ostfeld tends to be rather mild and focuses on not letting the perfect get in the way of the merely good: progress is progress. The other side of that coin is that, as reported above, a sloppy and only nominally "vegan" diet is really counter productive, and in practice is often the reason why would-be vegans fail. Esselstyn typically does not allow his patients any wiggle room for that reason, for he knows that once you are on the right track, you will feel so much better, you will not want to get off it. One thing sums up the difference perhaps. Esselstyn recommends 6 fist-sized green leafies per day, typically cooked kale with balsamic vinegar, which taken together is great for nitrous oxide production. Ostfeld, more modestly, ask for four. Personally I find that cooked kale, drizzled with balsamic vinegar is an absolute delight, and I miss it when I don't have it.

Post Script:
In other news, the movie Code Blue is being announced, which is going to be a next chapter in the adoption of the Plant-based nutritional program in clinical practice. It reminds us of the fact that 86% of our healthcare spending is on treating the degenerative chronic diseases, which by and large are the result of bad diet and conversely are preventable and most often reversible with a Whole Foods Plant-Based diet. If we can eliminate 75% of the 86%, we will have largely solved the healthcare crisis. In this conference only heart disease and diabetes were being discussed at length, though the more general application was mentioned. The movie Code Blue is going to add MS to the discussion. The implications are truly staggering.

The #WFPB Nutritional Paradigm

#WFPB, the Whole Foods, Plant-Based diet as developed on the basis of The China Study, and the clinical work of cardiologist Caldwell Esselstyn, Jr is a completely new paradigm of nutrition and health. The best known introduction these days is the documentary Forks over Knives.

Veganism is usually defined in the negative, as in: no animal protein, and some vegans do not even eat honey, because it is animal based. Motivations for veganism are sometimes environmental, or based on concerns over animal welfare, and sometimes vaguely based on health concerns. Yet, if you look around in restaurants and on food labels, "vegan" is a meaningless term, because it lacks any positive assertive nutritional concept behind it.
Perhaps the most famous proponent of veganism is Israeli activist Gary Yourovsky:

Gary Yourofsky at City College of NY

The #WFPB Paradigm

#WFPB (the Whole Foods Plant-Based diet) on the other hand is a completely new paradigm for nutrition and health. The fundamental tenets could be defined as follows:

• Focus on the quality, not the quantity of protein intake.
• Healthy protein sources are plant-based, unhealthy protein sources are animal based, be it meat, fish, fowl or dairy.
• By substituting plant-based proteins for animal proteins, you also lower your overall calories from protein to a healthy 5-15% and increase your fiber intake, which is often unhealthy under an omnivore diet.
• Use whole foods, and do not use added oils or sugar.
• "Dieting" does not exist in #WFPB, because whole foods, plant-based nutrition speeds up the metabolism and people automatically achieve a homeostatic, healthy weight.
• Nutritional supplements are meaningless for #WFPB is Nutritionally complete: the only possible exceptions are some moderate supplementation of B12 and maybe vitamin D.

The fundamental research for the #WFPB lifestyle is The China Study, which was just published in a new, updated 2017 edition, by T. Colin Campbell, Ph.D. and his son Tom Campbell, MD. The clinical work that matches up to the China Study came primarily from Caldwell Esselstyn, Jr., M.D., a cardiologist from the Cleveland Clinic in Ohio, which was first published in his book, Prevent and Reverse Heart Disease. many other doctors work in the same vein. Here in the Bronx, we have Robert Ostfeld, M.D. a cardiologist at Montefiore Hospital, who runs the Montefiore Cardiac Wellness program.

T. Colin Campbell, Ph.D. on #WFPB

Nutritionally complete: the Omega-3, B12,D-vitamin

The key concept is that for all practical purposes #WFPB is nutritionally complete, if you eat a reasonably balanced range of plant-based foods.

Omega-3

A lot is often made of the difficulty to get a favorable Omega-3 to Omega-6 balance in vegan nutriton, this is a fallacy. Here are some of the sources of Omega-3 for vegans:
flaxseed, chia seed, hemp seed, mustard seed, seaweed, beans, winter squash to broccoli, cauliflower, and brussels sprouts, leafy greens, cabbage, berries, wild rice, various herbs and spices, mangoes, honeydew melon.

B12 vitamin

The only vitamin vegans generally need to supplement is B12. and that's all.

D vitamin

Supplementation of D vitamin is another issue, but that is more generic to the whole population, not just vegans. Here is a great article on vegan sources of vitamin D (note that vitamin D3 is the easiest to absorb form), and if you do not get enough sun, you may need a little vitamin D supplementation.

Beware of vegan marketing hype

Nutritional advice for vegans is usually useless if you follow #WFPB, for if your intake is reasonably varied. There are great vegan sources of iron, from raisins, to prunes, olives, avocado and dried apricots, to asparagus, endives, peas, acorn squash, dandelion greens, Kale, turnip greens, to lentils, chick peas, quinoa, wheat germ, brown rice, and sprouted beans or seeds, and lastly morel mushrooms, brewer's yeast, spirulina, and blackstrap molasses.

But by and large the whole notion that supplements are useful are part of the SAD legacy. In the context of the SAD paradigm, supplements may seem helpful, but this type of research is really silly and misleading, because it focuses on how single nutrients (or medications) improve health outcomes, without questioning the overall train wreck that is the Standard American Diet. Under #WFPB the notion of dietary supplements is silly. The body can generally not absorb them very well, so other than expensive urine, the benefits are limited. It is absurd to ask for small improvements amidst a perfectly preventable disaster. 

The health care angle

As a nation, we are spending 75% of our healthcare dollars on treating degenerative illnesses that can generally be reversed with better nutrition, specifically #WFPB. We spend more on healthcare than any other nation, but without results, for our health statistics remain bad. Here is a brilliant presentation by T. Colin Campbell that sums it all up.

These days the Physicians Committee for Responsible Medicine (PCRM) practically has become the standard bearer for the role of nutrition in medicine. And things are picking up speed at a remarkable rate. Here is some of the latest:

• They just finished up hosting the Fifth-Annual International Conference on Nutrition in Medicine, and one of the fruits of it was an impressive YouTube video about 700 doctors advocating for Prevention over Pills - a ringing endorsement of the #WFPB lifestyle.
• They reported on a recent article by Russel Simmons on refocusing the SNAP program on healthy foods, because the poor have such bad health outcomes already. It is truly criminal to use a government program to provide people more junk food that makes them ill.
• Dr. Neal Barnard's latest book, The Cheese Trap, makes the brilliant case of the correlation of our obesity crisis with the growing cheese consumption, and why cheese is literally addictive (there is a weak opioid in milk that becomes concentrated in cheese). The book also sheds light on government complicity with the dairy industry.
• PCRM came out petitioning the USDA to modify the MyPlate nutritional recommendation and to ditch dairy, and swap animal protein for legumes.
• The American College of Cardiology urges hospitals to add plant-based meals and eliminate processed meats.
• The AMA passed a resolution: Hospitals should provide plant-based meals and remove cancer-causing processed meats.
• The AMA calls for healthier foods in the SNAP program.

This list is evidence of the impressive progress PCRM is making, and they are only just getting started. They truly stand on the shoulders of giants, for it is the work of T. Colin Campbell and his associates in The China Study which is the foundation of all the further research in this area. There is also an excellent documentary on the health issue, What the Health.

Eat your heart out, dieters

The upshot is that the #WFPB lifestyle is actually easier and cheaper than the alternative - meat is surprisingly expensive. Going to a #WFPB will cost you some money in the change over. You may want some different kitchen appliances, and your pantry needs restocking, but you can do that gradually over time, though some folks need to do it all at once, lest they fool themselves and hang on to old, bad habits, such as added oils or sugar.
But since plant-based nutrition speeds up your metabolism, there is no dieting under this concept. Eat to your heart's content, as long as it is reasonably varied, and your body will automatically return to a homeostatic, optimal weight, without even having to think about it.
In short, indulge, you are eating your way to health, as long as you stay within the #WFPB paradigm.