March’s Healthy Habit: Get Cooking

One of my New Year’s resolutions was to come up with monthly “resolutions” for myself and for anyone who follows this blog.  Cooking Light magazine (which is one of my favorite sources of recipes and ideas for healthy living) had the same idea, so I am shamelessly borrowing their healthy habits!

Cooking Light’s 12 Healthy Habits

Last week I had a fairly common conversation with one of my residents.  She told me that with her schedule it’s almost impossible for either parent to cook for the family.  Secondly, she said when she does shop for food, she buys everything she thinks she might need… and half of it goes bad in the refrigerator.   They have resorted to picking up take-out as their solution to the problem.  There are at least two major problems with this strategy (and a lot of other minor problems): 1)  It costs a LOT more and 2) It is clearly not going to be as healthy.

I know this is a common scenario, hence why this month’s resolution is to cook at least 3 meals a week at home.  It’s doable!  Here’s how to get started:

Change your mindset about cooking.

Cooking is not hard and it doesn’t take as long as you think.  There are some basic skills you have to know, but you can start small and add new skills one at a time.  Make up your mind that you are going to acquire this important skill and practice!  Start with one simple act – sautéing an onion.  Here’s how to cut up an onion and how to sauté.  If you get this one simple skill down, you’ve learned the beginning of many, many recipes!

Make a plan

Decide ahead of time what you are going to cook and write it down. You can map out the whole week if you are a “gunner” – but,  at a minimum a) find 3 recipes for the week b) make a shopping list for the ingredients in those three recipes and c) go shopping.  If you plan ahead, you’ll have everything you need – but not a lot more (so no more growing interesting molds in the back of the refrigerator).  You’ll also be able to really eat well when you are on call (which is the hardest day to plan for).

Remember the pizza rule.

No one who is really busy has time to do fussy cooking.  You should look for recipes that take less than 30 minutes (the time it takes to order a pizza).  I’ve posted a lot of recipes that meet this requirement (use the tag marked “recipes” to the left of this web page).  Another strategy is to pick a cookbook, one issue of a magazine, or a website (some of my favorites are listed below) to choose the week’s recipes.  Another option is to subscribe to a site that will send you weekly menus (and will also automatically make your shopping list) – like Six O’Clock Scramble ($54.50/year) , Send Me Recipes ($65/year), Dinner Planner, ($60/year), or Make Dinner Easy (free).

Cook ahead for the week

It’s boring to eat the same thing over and over… but it beats buying fast food on the way home.  If you cook a big casserole or stew on the weekend, you’ll have it for meals on call, late at night or lunches.  If you really want to cook just once for the entire week, you can double the recipe or make two different dishes at the same time, and freeze portions for later in the week.

Supplement your main dish with lots of fruits and vegetables

If you don’t have a steamer basket, this is a cheap piece of kitchen equipment that is really worth having.  Almost any vegetable can be sautéed or steamed and it’s really easy to do.  Buy vegetables fresh, wash them, dry them and then store (clean) in the refrigerator (one less thing to do when you are tired). Refrigerator to plate will be less than 10 minutes for most veggies. (Here’s a table of cooking times for vegetables.)  Leftover steamed vegetables make a great “salad” by themselves (just add some olive oil, vinegar, salt and pepper) or as an addition to other salads.  You can also toss them into scrambled eggs or an omelet.  Having steamed potatoes in the refrigerator is particularly helpful – they are great in salads, with eggs, or just as a snack.  Frozen vegetables are more expensive, but are perfectly fine, too.

Make a list of  “emergency” meals (<5 minutes) for nights you are completely exhausted and really, really don’t want to cook. (And keep these items in your pantry and/or refrigerator.)

Here are some ideas to get you started:

1.    Scrambled eggs or egg whites (with leftover veggies and/or cheese if you have them) with toast.

2.    Angel hair pasta (takes 3-5 minutes) with bottled spaghetti sauce with a green salad

3.    Veggie (or regular) hamburgers (from the freezer) with a green salad

4.    Couscous with canned beans, canned tomatoes and any leftover (or frozen) vegetables you have

5.    Sandwiches

6.    Pancakes

Websites for “pizza rule” recipes

eatingwell.com

cookinglight.com

myrecipes.com

foodnetwork.com

My favorite magazines to cook from

Cooking Light

Bon Appetit

Clean Eating

Vegetarian Times

Cookbooks worth buying

How To Cook Everything

Joy of Cooking

The Silver Palate Cookbook

The Art of Simple Food

The Moosewood Cookbook

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Farmer’s Markets

I just got back from my weekly (when I’m not on call) trip to the farmer’s market.    I’m going to try to convince you why buying food at a farmer’s market should be a regular habit for any medical student or resident (although I think it applies to everyone else, too).

What the heck is a farmer’s market?

In general, farmer’s markets are open air markets where local farmers bring their food to sell. They usually take place once a week (often on Saturdays).

Just to give you an example – this is the market I go to most often in Houston:

http://www.urbanharvest.org/programs/market/index.html

How do I find out where they are?

The best way is to search the internet for your city.  Local harvest is a web site that covers most farmer’s markets, but there may be smaller (and possibly more convenient) markets in your city that aren’t listed here:   http://www.localharvest.org/farmers-markets/

If it doesn’t look like there is a farmer’s market near you, another option is to buy a share in a CSA (Community Supported Agriculture).  If you buy into a CSA you will pick up a fairly large quantity (usually a good sized box) of whatever is being grown at the time – usually once a week.   If you can find a group of friends to split this with, its a great option.  http://www.localharvest.org/csa/

What should I do to look cool if I’ve never been to a farmer’s market before?

Bring your own bags. This isn’t an absolute requirement, but it’s much cooler than relying on the vendors.  They often have small paper or plastic bags, but it will be easier if you bring your own.  In the big picture, you should do this no matter where you shop (good environmental karma!).  Fortunately, the “give away” bags at medical meetings are perfect for this!   A lot of grocery stores sell reusable shopping bags or you can find them on the internet.  I’m not endorsing this particular site, but here’s an example: http://cheaptotes.com/canvas_tote_bag_8.html

Bring cash. I’ve seen some people writing checks, but don’t count on it.  I’ve never seen a way to pay with a credit card at any farmer’s market.

Does it cost more?

Yes (but not a lot more).  But don’t let that stop you!  Value isn’t always measured by money – even if you are poor student or resident.  It’s not going to be a lot more and it’s completely worth it. (see below)

If it costs more and it takes more time, why should I bother?

The food absolutely and unequivocally tastes better.  The first time I bought potatoes at a farmer’s market was a revelation for me.  I knew that tomatoes and peaches would be better, but I had no idea that a potato would be in the same category.  The produce you buy at a farmer’s market was in the ground (usually) less than 24 hours ago.  It is incredible how much better it tastes!

The food is probably better for you.  Most farmer’s markets sell organic or near organic food.  There’s good data that organic plants are higher in many nutrients and it’s intuitively obvious that avoiding pesticide residues on your food should be beneficial. http://www.healthy-eating-made-easy.com/advantages-of-organic-foods.html

You’ll eat with the seasons. There are no data that this is better for you, but it really makes sense.  If nothing else, it will taste better and you’ll be helping the environment by not eating things that travelled thousands of miles to get to you.

You’ll get to know the people growing your food. This sounds trivial, but it’s really cool.  You can ask them about how they grow the food, and you’ll hear stories about what’s happening on their farms.  One of my favorite vendors has great pictures and stories about her farm which she also shares on Facebook and her website: http://blueherontexas.com/.  There is also something intangible (but cool) in knowing that someone (not just a big corporation) cares enough to grow your food.

The farmer’s market is a once a week “sanity break”. You are outside, surrounded by beautiful food and happy people.  At the market I usually go to, there is always some live music, too.  It’s a great experience and, combined with the fact that you are doing something healthy for yourself, it’s a once a week mood changer!

Cooking for Yourself in Medical School and Residency

Most medical students and residents eat poorly.  It’s not really a surprise – the days are packed with work from sun-up to sun-down.  There are no planned meals because there can’t be.  Food is a quick bite when it is available.  It’s feast or famine.  On the far end of the scale, the stereotypical diet of a resident is no breakfast (but usually coffee), a doughnut and coffee grabbed on the run once you get to work, some mid-day meal of fast food, and pizza on call.  Food, particularly fast food, becomes solace.  In the stressful world of residency, this kind of “comfort food” becomes a “reward” for the hard work and tribulations. It’s not rocket science.  This kind of diet doesn’t give you the energy you need to function at your peak.  It is also a diet that is very likely to lead to weight gain.  In your 20s, your body can cope with this suboptimal fuel, but it’s not ideal.  However, what “works” in your 20s won’t work as you get older and could even be responsible for a heart attack, diabetes, or other medical problems in your 40s and 50s.  On a more philosophical level, you would never advise this kind of diet to one of your patients.  None of us want to be hypocrites.

The answer is to cook for yourself.  Not everyone likes to cook, and not every one knows how.   I’m going to make a case that you should learn.  Trust me – if you can learn to take out an appendix, or diagnose a pneumonia, you can learn to cook.   I’m going to assume that you are single for the sake of this description.  But, if you have a significant other, it’s even more important to cook at home.  He or she can participate in helping with the meal preparation, and, by doing this together and for each other, there is added benefit for your relationship.  Having dinner at home with a significant other will become an “anchor” to your day that will become very important to you.  As hard as it is to work around a busy schedule, if you can eat together, and have a real conversation, you will both benefit greatly.

Cooking is a wonderful therapy for the stress of medical school and residency.  If you’ve never learned how to cook, this is a hard time to learn complicated techniques, but it’s not hard to learn simple techniques.  There are several advantages of cooking for yourself that outweigh (on most days) the hassle of spending the time.  The act of cooking for yourself can be a time of “decompressing” from work.  Arranging vegetables, cutting them, smelling the odor of the food appeals to all your senses and is a moment in the day that you can intentionally slow down.  It’s very important that the recipes you choose are simple and quickly prepared.  No one wants to come home to a 2 hour task in the kitchen after a hard day.  Cooking for yourself has other benefits as well.  First, it is tangible evidence that you are taking care of yourself.  This is not a trivial point.  There are days during your training when it seems no one is taking care of you.  Having concrete evidence that you are caring for yourself is an antidote to that feeling.  Secondly, you will eat better.  By cooking from fresh ingredients, you will decrease the amount of pre-packaged and fast food.  Even without medical school, you know that this will result in better nutrition.  Thirdly, you will eat cheaper.  Other than the “free” pizza (ethically debatable, but financially clear), processed food is usually more expensive.  And lastly, you can share.  It isn’t any more work to make 4 or 6 portions of a dish than it is to make 2, and it usually isn’t that much more expensive, either.  If you can convince one of your colleagues that this is a good idea, you can cook for each other on alternate days.   Likewise, you can cook larger amounts and, using freezer ready containers, freeze portions for yourself for the future.  Doesn’t homemade pasta with a side of fresh vegetables really sound better than the greasy middle of the night food that is available in most hospitals?   It’s true that you can’t cook just anything with the kind of schedule you will have in medical school and your residency.  But, there are few key rules that will make it possible for you to do this, enjoy it, and eat well.

Rule 1:  Don’t cook anything that takes more than 30 minutes to prepare.

Let’s be realistic – you are not going to walk into your home at 8 o’clock at night, hungry, and spend an hour preparing something.  But – there are very nutritious dinners that take less than 10 minutes, so getting home late is no excuse.

Rule 2:  Plan ahead.

The first step in preparing dinner for most busy people is to open the refrigerator door and ask “What can I eat tonight?:  If you are anything like I was in residency, the refrigerator had some cheese, some vegetables (often way past their prime), and maybe some leftovers.  Not very appetizing.  There is an easy way to prevent this from happening.  On whatever day you have off and have time to shop, spend 30 minutes making a menu.  Start by making a table for the week with what is happening.

Breakfast Lunch Snack Dinner Comments
Sun
Mon On call – take Tues meals, too
Tues
Wed Out Out with friends after rounds
Thur
Fri On call
Sat

Once you have an outline of your week, fill in the blanks with the meals.  Now, most of us can handle “hamburgers” or “Raisin Bran” as a menu item… but it’s more fun, and healthier to branch out a bit.  So, if you are not used to looking for new things to cook, how do you find recipes?  Cookbooks can be fun, particularly if you are looking for a particular ethnic food or a style (e.g. low-fat) of cooking.  If you like cookbooks, and bookstores, find the used book store nearest you and go to town!  There are also web sites for recipes.  Many of them also have “cooking lessons” on line.  Most cooking shows have a web based recipe site as well.   So, say you start by searching the web and find this recipe. (for this particular recipe, I’m assuming you have no concerns about calories)  It looks easy, and like it would taste good.   So you print it out.

NEW ORLEANS PASTA

ESSENCE OF EMERIL (FOODTV)   SHOW #EE123 – http://www.recipesource.com/main-dishes/pasta/11/rec1100.html

1 tablespoon olive oil

16 ounces chicken breast half, cut into strips (about 1/2 cup)

1/4 cup chopped chorizo sausage

2 tablespoons chopped green onions, plus extra for garnish

1/2 tablespoon chopped garlic

Tabasco and Worcestershire sauce

3/4 cup heavy cream

1/4 cup grated Parmesan cheese

1/4 pound shrimp, peeled and deveined

1/2 pound penne pasta, cooked al dente and tossed in oil to coat

Creole spice, salt and pepper

In a large saute pan heat oil, add chicken and sausage and cook 5 minutes, stirring often. Add green onions, garlic, 2 dashes each Tabasco and Worcestershire sauce or to taste, and cook for 1 minute. Add cream, cheese, shrimp and pasta. Cook, tossing, to heat through. Adjust seasoning to taste with Creole spice, salt and pepper. Serve garnished with green onions.

Yield: 2 servings

Now what?  First, cut and paste the ingredient list to a shopping list.  If you are compulsive, you can organize it into meat, dairy, produce, etc (it makes shopping easier, but it’s not essential).  You’ll need to add a vegetable or salad to balance this out nutritionally. (I picked broccoli as an example) If you can afford the calories, add a desert. (Ice cream in this case)  Then decide what night in your schedule this will work best.  This recipe will take about 12 minutes total so it would be great for a night you are getting home late.  You can either share the other portion with your significant other or you can take it with you the next day as lunch.  You can double the recipe and have it more than one night.   For example:

Breakfast Lunch Snack Dinner Comments
Sun
Mon On call – take Tues meals, too
Tues
Wed Out Out with friends after roundsThaw shrimp for tomorrow
Thur NEW ORLEANS PASTA (CHICKEN, CHORIZO)Steamed broccoliIce Cream Freeze one portion for later
Fri NEW ORLEANS PASTA (CHICKEN, CHORIZO)Steamed broccoli On call
Sat NEW NEW ORLEANS PASTA (CHICKEN, CHORIZO)Steamed broccoli

Shopping list:

2 lbs chicken breast (16 oz x 2)

1/2 cup chopped chorizo sausage

1/2 pound shrimp, peeled and deveined

heavy cream   (need 1 1/5  cup)

Parmesan cheese  (need 1/2 cup grated)

Olive oil

Creole spice

green onions

garlic

broccoli (4 portions to steam)

One pound penne pasta

Ice cream

Rule 3:  Cook (or prep) today today to eat tomorrow

As soon as you get home from the grocery store:

  • Freeze any meat that is for later in the week (and make a note to yourself to put in into the refrigerator to thaw a day or two before you are going to use it.)
  • Wash the vegetables, dry them and put them away
  • Wash lettuce for salads and dry completely (a spin dryer is the best).  Store in a zip lock plastic bag with a paper towel in the bag (which absorbs any residual water).  Make sure you squeeze out all the air you can before closing the bag.

Take advantage of days off to cook things that may take a little more time or effort.  While  you are watch the football game on Sunday, you can cook chili in a crock pot for Wednesday.  If you know that your vegetable stir fry on Tuesday is going to be after a long day, go ahead and chop all the vegetables and meat a day or two before when you have the time and have them stored in the refrigerator.   When Tuesday rolls around (and you are exhausted from work), you’ll have all the ingredients chopped and ready to throw in the pan.

Learning to cook after a trip to the farmer's market!

Learning to cook after a trip to the farmer’s market!