Recipe: Green Cabbage Salad

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I have posted one or more cabbage recipes on this blog. Use the search box if interested.

When I was a wee lad, my mother never served cabbage. Don’t know why.

Adam Piggott is a good writer. He claims he has the best cabbage recipe ever. Here ’tis:

Ingredients:

  • 1 fresh green cabbage
  • Salt
  • Cumin
  • Apple [cider] vinegar
  • Extra virgin olive oil.

Remove the rough outside leaves of the cabbage and then cut it into quarters. Using a mandoline slicer or a grater, carefully shave the cabbage as thinly as possible. 

Now add the other ingredients in the order in which I listed them. Then mix well together and leave to sit for a few hours. Yes, a few hours and the longer the better. A minimum of one hour but if you can leave it all afternoon then you will thank me. This is why I was worried about them running out at the lunch. The cabbage will release some fluids over this time. Check for seasoning and olive oil before serving as you may have to add a little more.

His original post didn’t include specific amounts of most ingredients. Adam elaborated in the comments section:

Yes, the amounts are the issue here and it is what makes this a unique dish. Salt is the key. I use a large salt grinder which you can see in the last photo. I had half a cabbage for lunch and I would say that I used a good half tablespoon of salt. I added a little more at the end. Remember though with salt – you can always add more but you can’t take any away.

I used a quarter teaspoon of cumin. You’re just after a hint of the taste there. A small splash of the vinegar. Too much vinegar becomes overpowering; you can always add more later if you think you need it. Olive oil you can give it a good splash. Looking at the bowl of cabbage you should not see any liquid oozing out of the bottom. If you do then you have used too much oil or vinegar.

You can definitely refrigerate it but you don’t have to. If you do then you should cover it with cling film.

Read Adam’s entire post. It’s not long. You won’t regret it.

Steve Parker, M.D.

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Chronic Use of Proton Pump Inhibitors Is Dangerous

I have nothing against Prilosec in particular. It can be very helpful. It’s one of several PPIs on the market.

Proton Pump Inhibitor drugs (PPIs) greatly reduce the production of acid in the stomach. They revolutionized and improved the treatment of ulcers in the stomach and duodenum. When I started medical practice in 1981, I saw many patients who had required stomach surgery to treat their ulcers. Remember the good ol’ Billroth procedures? Of course you don’t. The first PPI approved for use in the US. was cimetidine (Tagamet) in 1979.

But wait, you say. “Isn’t there a reason we have stomach acid in the first place?” Good question! Because if we reduce stomach acid, it may cause problems. Regardless of what acid contributes to food digestion, it also kills germs in food and water. Germs that may kill us if ignored. Most of us in the developed world would be horrified to drink untreated water out of a lake, stream, river, or spring. But what do you think Homo sapiens did for most our 200,000 years of our existence?

From Joe Alcock, M.D.:

Omeprazole was made over the counter in 2003 but I don’t think these drugs should ever have been made available without prescription. PPIs are powerful drugs that treat heartburn by reducing gastric acid production. This is accomplished by PPI binding to the hydrogen/potassium ATPase enzyme on gastric parietal cells lining the stomach. PPIs do more than block acid. They are associated with an increased risk of congestive heart failure, kidney disease, long bone fractures, and dementia, vitamin B12 deficiency, reviewed here. Regular use of proton pump inhibitors is associated with increased incidence of type two diabetes, about 24% higher compared to non-users of the drug. Proton pump inhibitors are also linked an with increased risk of small intestinal bacterial overgrowth (which is a clue as to why these drugs can be harmful). They also increase the risk of infection by Clostridiales difficile by about 2x.

Most of these individual observational studies are unable to establish causation, but the preponderance of evidence points to PPIs causing harm.

Dr Alcock also found evidence that PPI users who catch COVID-19 have 1.6x increased risk for severe disease and death.

If you’re prescribed a PPI for chronic use, check with your physician to see if you still need it. Occasional use for heartburn shouldn’t be a problem. For chronic heartburn, consider a low-carb diet and stop nocturnal alcohol consumption.

Steve Parker, M.D.

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Mediterranean Diet Likely Just As Healthful For Children As For Adults

Not sure where this is. Leave a comment if you recognize it.

Nearly all studies demonstrating the healthful effects of the Mediterranean diet were done in adults. Here’s one suggesting benefit in children.

Our findings suggest a positive correlation of Mediterranean diet  adherence with health-related quality of life in children and adolescents. However, future research is needed to strengthen the evidence of this relationship.

Source: Adherence to Mediterranean diet associated with health-related quality of life in children and adolescents: a systematic review | BMC Nutrition | Full Text

     Steve Parker, M.D.

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Recipe: Low-Carb Salads

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20 recipes from Diet Doctor:

Many people think of salads as boring diet food that will leave you hungry and unsatisfied. But we disagree. Our keto salad recipes are rich in protein — and they’re filled with nutrition, flavors, and healthy fats to keep you fueled all day long.

Steve Parker, M.D.

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Recipe: Breakfast Mushrooms

Click for the recipe.

That looks and sounds scrumptious to me! (That’s a word, right?)

My wife and daughter would never try this. There’s just something about mushrooms, they say. Can’t even stand the smell.

Posting this here for future reference. Just a matter of time…

Steve Parker, M.D.

h/t Jan at The Low Carb Diabetic blog.

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Do You Still Trust Your Physician?

From WebMD: “Comorbidity is a medical term that you may have heard your doctor use. It describes the existence of more than one disease or condition within your body at the same time. Comorbidities are usually long-term, or chronic. They may or may not interact with each other.”

“JC Dodge” posted a thought-provoking article at American Partisan. For example:

Although we are all dealing with COmorVIDities, anyone who has COmorVIDities from the vaccine can place them purely at the feet of the medical community. You might say, “But JC, the government and companies required it of Employees.”. Although this appears true on it’s face, if the medical community had stood up and acted on the, “First do no harm.” oath they took as medical providers, the government and businesses wouldn’t have had anywhere to go but “STOP”.

One of the COmorVIDities I now have, is a fear that anything I am told by any medical provider, whether for my kids or myself, is BS and aimed at padding their pocket. The majority of them have proven they will take kickbacks from the GOV or Big Pharma, over providing quality medical care.

I actually questioned my Child’s Pediatrician, when she was getting a normal childhood vaccine, because it didn’t sound like the ones my other three kids had received over the last 24 years. Why? Because I no longer trust them to do the right thing for their Patients.

Although I know some good Doctors and Nurses, I believe most of them were forced out of what is considered, “The Medical Community”, because they weren’t foolish enough to get the vaccine, or wanted to be able to prescribe “Non-Approved by Big Pharma” treatments. Most of those left are getting their “30 Pieces of Silver” from Big Pharma and the GOV, and couldn’t be happier.

I am a hospitalist. Most of the physicians I know are frontline in-the-trenches doctors taking care of patients and in no position of authority over hospital administrators, business administrators, and public health authorities.

I remember only two things from the first day of medical school, spoken by an Asian professor:

  • “If you’re sitting here today, you probably have an IQ of at least 120.” (So don’t worry, you can handle the workload.)
  • Mention of Sir William Osler’s Aequanimitas essay.
  • “Every day not sunny day.”

Most of medical school, which typically lasts four years, involves memorization of massive amounts of information, which you regurgitate and on a test and have mostly forgotten a month later. It is not fun, to say the least. Medical students have actually done more analytic thinking while acquiring their undergraduate degrees and in high school. After med school, physicians spend at least three to five years in a residency that also requires incredible memorization, but you tend to retain more since it is clinically relevant. Much of the actual thinking of a practicing physician revolves around establishing a diagnosis and formulating a rational treatment plan. Even then, much of the diagnosis is made by high-tech imaging and blood tests, so the doctor has to do less thinking than our predecessors of 40 years ago. Similarly, we have “clinical practice guidelines” that are composed by “authoritative” committees, telling us how to treat specific conditions. If we follow those guidelines, we may be more likely to retain our jobs, earn a salary bonus, and prevail in malpractice lawsuits. Physicians who think and question the guidelines are too often seen as trouble-makers. Unlike 40 years ago, a majority of physicians are not independent, but are employed by large organizations that tend to control them via a paycheck.

My point is: Many practicing physicians don’t have to do much thinking, so they don’t. Sad, but true.

So JC Dodqe is right to question his child’s pediatrician.

Steve Parker, M.D.

PS: One of the reasons for specialization is that there is so much to learn in any given field, there’s just no time or mental capacity to keep up with less pertinent aspects of medicine. An orthopedic surgeon doesn’t need to know much at all about heart failure, diabetes, and anemia. That’s my job.

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Books for Folks With Type 1 Diabetes

Roasted Radishes and Brussels Sprouts. For recipe, use search box.

Diabetes Daily has an article by Julia Flaherty that reviews books regarding type 1 diabetes. Just thought you might be interested. It didn’t review Cheating Destiny: Living with Diabetes, which I am mentioned in.

Steve Parker, M.D.

PS: Here’s another book for people with type 1 or 2 diabetes:

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ADA Promoting Low-Carb Eating

Conquer Diabetes and Prediabetes, Steve Parker MD
A very low-carb meal

Interestingly, the American Diabetes Association (ADA) is selling to healthcare providers Low Carbohydrate and Very Low Carbohydrate Eating Patterns in Adults with Diabetes: A Guide for Health Care Providers

About:

The American Diabetes Association has identified low-carbohydrate (LC) and very low-carbohydrate (VLC) eating patterns as options that can improve outcomes in adults with type 2 diabetes.  This 28-page guide was designed to assist registered dietitians, certified diabetes care & education specialists, and other health care practitioners in assessing the appropriateness of a LC or VLC intervention for their patients.  Additionally, it provides strategies and sample meal plans for implementing a LC or VLC eating pattern as an evidence-based intervention in adult with type 2 diabetes.

In my world, “very low-carbohydrate” means ketogenic.

Steve Parker, M.D.

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Recipe: Low-Carb Zuppa Toscana

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DJ Foodie has come up with a low-carb version of zuppa toscana, my wife’s favorite soup at Olive Garden restaurants. I prefer the pasta e fagioli. We haven’t tried it yet but post a link here for future reference. 9.4 net carbs per 330 calorie serving.

Steve Parker, M.D.

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Dr Hall Reviews Weight-Loss Pill Plenity

Dr Harriet Hall wrote a brief review of the new weight-loss drug Plenity at Science-Based Medicine. Her conclusion:

So far, effectiveness has been shown in only one placebo-controlled trial. Diet and exercise must be continued. It doesn’t work well for everyone: 6 out of 10 users lost at least 5% of their body weight; the other 4 didn’t. It appears to have fewer side effects than other weight loss products. Not a way to achieve ideal weight, but probably worth trying for patients who understand that it is only an aid and not a final solution. I hope they will be encouraged enough by a 22-pound weight loss to continue losing weight with or without Plenity.

Overweight and obese folks with diabetes also tend to lose weight with the new once-weekly injection therapy called tirzepatide, brand name Moujaro. (Where do they get these names?!) And remember that bariatric surgery is often very effective at weight loss and controlling diabetes…if you survive the operation.

Steve Parker, M.D.

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