Cook Right, Eat Right – Nutrition for Healthy Aging


[Music]>>Welcome to Johnson County Community College. I’m Michelle Riley. I’m an assistant professor of dietary
management here in the Hospitality and Culinary Academy, and we’re really excited to have you tonight to
talk about healthy aging. We have several great guests, and we will start
off with a presentation from our physician,
followed by our dietitian, and then our chef will demonstrate some recipes
that you’ll get to try.
Our first presenter is Dr. Shelley Bhattacharya. She is an associate professor in the division of
Geriatric Medicine at the University of Kansas Medical Center. I’m really excited to welcome her. I’m also going
to introduce Dr. Matt Taylor, who is a Post-Doc fellow in the Department of
Dietetics and nutrition, also at the University of Kansas Medical Center, who will be presenting after Dr. Bhattacharya.
So, welcome.
[applause]>>Thanks. It’s so great to be here in this wonderful venue. Thank you for the
introduction, I really appreciate it. I’m at the Landon Center on Aging at the KU
Med Center. Let’s get started. I have some basic objectives that we’ll be
covering today: the importance of nutrition in
older adults, some barriers to good nutrition as we get older,
what our clinical approach is to nutrition to help
guide you, to see what steps we can take in the clinical
world to help anyone that’s having nutritional problems, what those problems and consequences are
with deficiencies, and then ultimately, the team. It’s not just a physician, but a full team who can
help you when it comes to taking care of your
nutritional health. Here’s a quote that I like: “Nutrition is one of the
major determinants of successful aging, defined as the ability to maintain three behaviors: low risk of disease and disease-related
disability, high mental and physical function, and
active engagement in life”, The key of getting older is the quality of life, not
necessarily the quantity of life, so proper
nutrition helps to get you there. I think it’s a great quote that summarizes why
it’s so important. As you know, nutrition is vital to the quality of
life of older adults. Poor nutrition, which we call “hypoalbuminemia” – how many of you have heard of that term? A few of you have. That is a measure of protein in your body called
“albumin”. It’s a blood test that can be done by
your physician. When it’s low, that is called hypoalbuminemia,
which is a cardinal sign for higher morbidity and
mortality. “Mortality” means your risk of dying, while
“morbidity” is your complexity of disease, or
your disease burden. Albumin was used as a blood test to track
someone’s nutrition. Now, it’s no longer used as much in clinical work
in the dietetics world, but it’s one factor we can use, along with
cholesterol, as markers of nutrition. Poor nutrition leads to dehydration, increased
hospitalization, and of course, increased use of
health services and disability. Your nutritional status impacts your longevity.
There was a survey of over 50,000 centenarians, those that lived to be 100 years old in the US, and they were found to have higher HDL. HDL is
the “good” cholesterol in your panel. For example, exercise will raise your HDL
levels, the higher, the better. The minimum is 35 for your blood tests, and the
higher your HDL is, the better. Centenarians had higher HDL vitamin A and vitamin E levels, but lower RBC superoxide dismutase levels, These are enzymes that they studied – we don’t
do this clinically, but this was from the study –
[which showed there were] higher unsaturated to saturated fatty acid ratios
versus younger adults, aged 21 to 99, which
means higher proportions of unsaturated fats. For some examples: avocados are a great,
monounsaturated fat, as they will not raise your cholesterol levels. This will be discusses later as far as what
healthy fats there are, and which we all need in
our systems. Our membranes need fats, so don’t feel like a
nonfat diet is the best way to go, that’s not true.
We all need fats, [specifically] healthier ones. Then, higher DHA and EPA. Where do they
come from, any guesses? They come from fish oil. The key is knowing
how much of these ingredients, DHA and EPA,
are in each capsule. [The studied centenarians had] higher DHA and
EPA levels versus the younger cohort. Typically, about 32% of adults over age 65 have
about five servings of fruit and veggies per day, It would be great if you could have more servings of fruits and veggies, as many as you can. Some healthy fruits to focus on when you’re making those choices are citrus, melons and berries. As far as the vegetables: dark greens, deep
yellows, oranges and tomatoes. When you’re picking your garden for the spring
and summer, try to focus on those veggies and fruits to have, to help lower disease risk. Dehydration is the most common problem, when
it comes to fluid imbalance in older adults. As we age, a normal physiologic issue that
happens to our bodies is a decreased thirst
sensation. We don’t become as thirsty with the same
stressors as we did when we were younger, so
we’re less likely to take in [needed] fluid. [Because] we’re less likely to take in fluids when
our body is sensing dehydration, that means we’re more likely to become dehydrated. This is a normal, physiological [problem as we
age], so to help combat it is knowing about and
treating it. All of you have water bottles in front of you.
Drink them and then recycle the bottles. Drink [the equivalent of] at least eight glasses of
water] per day, the more, the better, but more
water [intake] means more bathroom trips. [By this], I mean decaffeinated fluids, as caffeine
is a diuretic, which may make you urinate more
and lose fluids, so think about that. I tell my patients not to [consume] any caffeine
after 12:00 noon, because of [having to] go to
the bathroom in the middle of the night. Caffeine may still be in our system at bedtime
when you take it in the afternoon. If you do drink coffee or tea, drink it in the
morning, and have decafs, water or flavored
packets, like Crystal Light, after noon. [To sum up], drink your water, as your sensation
of thirst is lowered as we age. Also, the ability to concentrate our urine
changes as we age. Their ability to reabsorb water to keep you
hydrated goes down, which means you’re
urinating more, which then means your blood volume is
increasingly dehydrated, so keep that in mind,
too. Keep drinking water, that is the key. If you can’t eat, whether it’s from an oral problem like poorly-fitting dentures, not -having- dentures, or other chewing problems, depression, not wanting to eat, being by
yourself, forgetting to eat or not able to swallow, which is
a common issue with progression of dementia,
or pharmaceutical interactions. Benadryl, found in Tylenol PM and Advil PM, can
contribute to dry mouth, which can really affect what and how much
you’re drinking, and increase your risk of falling. If I have anything to say about medications, it’s
to avoid Benadryl, and know how your medications are affecting
what you’re eating and drinking. If you’re losing your appetite or your thirst from
your medications, you should have them changed, then think of
what could be causing you to eat and drink less. Here are some barriers [to good nutrition]:
xerostomia means “dry mouth”. As I mentioned, one major side effect of
Benadryl is dry mouth. As we age, our gums recede, so dentures that
may have fitted well 10 years ago may not be fitting well now, because there isn’t as much support for them to
cling on to, so you [may need to have] them refitted. Altered [senses of] taste and smell could be
[caused by] medications or physiologic changes
happening in your body. Not being able to go to the store and buy the
food you need, so the food you have is from someone else
bringing it to you, or it might be from a facility. You may be in assisted living, independent living
or in a nursing home, so you’re reliant on them,
so mobility is a big factor in your food choices. Dysphasia is problems with swallowing, so if
you have problems swallowing, you’re not going
to eat much. We already mentioned medications. Then, medical conditions. We’re often strict when it comes to [conditions
like] diabetes, bringing down hemoglobin A1C and limiting your sugars, but those can have deleterious effects where
one doesn’t eat. They’re losing weight because we’re so strict on sugar [intake]. I tell all my students to take a look at their
patients. If they’re losing weight and their blood pressure
is high, we can treat their blood pressure, but
they need to be eating. You can’t just tell them [to eat] a low sodium
diet and send them out the door with no other guidance. If your blood pressure is high and your find that
you’re not eating anything because you’re
worried about that, tell your doctor. They can always treat your blood pressure, but you have to eat, as that’s much more important than your blood pressure, which we can treat. That balance is critical, and that’s where those
chronic medical conditions come in. Loss of appetite can be triggered by many
causes: cancer, medications, losing a loved
one, depression and social isolation. 80% of those over age 65 have at least one
chronic disease, and by that, I mean high blood
pressure, diabetes and arthritis, any disease that one has for a long time. Half of
[those over 65] have [at least] two [such
ailments]. Studies have found that having a healthy diet
can prevent and manage these conditions,
which is why this is even more important; and then, as we become older, we have
decreased hunger and early satiety, which means we’re “full” sooner and therefore,
aren’t taking in as many calories as we did
before. Also, chronic conditions can make that worse.
Another finding was that if you eat with others,
you’re likely to eat 23 percent more. If you’re seeing a loved one that’s losing weight
and they’re by themselves, try to have them go
out, even like congregate meals with Meals on
Wheels, as a way to gather people together, but you’re likely to eat significantly more when
you’re with other people. This shows how much less men and women eat as they age. Men in their 80s eat about a thousand
kilocalories less than when they’re in their 20s, and women eat about 600 to 800 kilocalories
less than when they were younger, so in general
we eat less as we age, for many reasons. We look at weight loss trends, because if you’re
not eating, you’re losing weight. Weight loss of 5 percent or more in one month
or 10 percent over six months is a red flag for
us, which is when we’re going to ask you about
what’s going on at home and how we can help
you, so keep track of your weight. When you [trigger] those red flags, that leads to
functional limitations and then more frequent hospitalizations. Questions we’ll ask are: “Have you lost more
than 10 pounds in the past six months without
trying to do so?” Unintentional weight loss is a key [indicator]. If you’re trying to lose weight, it’s fine, but no more than a pound per week. Is your BMI, your Body Mass Index, under 20,
which are your weight in kilograms over your
height in meters, squared? If it is under 20, we need to dig further, using a
tool called “DETERMINE”, which has questions to ask yourself to see if
you have a high risk for nutritional deficiencies. There are ten questions with yes or no answers,
and a score at the bottom. If you know someone that needs it, or if you
think you could benefit from it, feel free [to use
it]. Why do we care about poor nutrition? What are
some syndromes that can result from it? Anemia comes from having low hemoglobin.
You’re not taking in iron. That gives you cardiac problems. You give your
heart a lot of work when you have less
hemoglobin in your blood. As a result, you’re fatigued, with little energy
and can become depressed. Here’s a breakdown of how common this is,
among 65-year and 85-year olds. B12 deficiency is something I see pretty often
in older adults. I check it once a year on
everybody. You want to be at least at 500 or higher for B12,
if you’re 65 and older. 500 or higher has been found to help with
cognition, also gait and balance. There are lots of dietary sources of B12 that are
meat and non-meat based. I’m a vegetarian, myself. A big source is meat, so if you have a vegetarian
friend, look up how they can source [sufficient] vitamin B12. You can supplement over the counter for vitamin
B12, but it’s really important as we age. Calcium is so important, too. Who’s heard of
osteoporosis or osteopenia? Osteopenia is early bone density loss. All of this is [measured] by a bone density test. Low calcium and low vitamin D will lead to
osteopenia and osteoporosis, which can lead to
a fracture after a fall. A hip fracture has a 20% mortality within 12
months, so the whole idea is to prevent the hip
fracture from happening. By 2020, next year, half our population over age
50 will be affected by osteoporosis. That’s
huge. Vitamin D is a growing supplement, I’ll say, but
now it’s found to be more of a protein, which means it has lots of benefits throughout our bodies, not just for our bones. You want to have your vitamin D level checked annually, and you want it to be at least 30. Whatever your number is, your [medical] team
will decide whether you should have weekly or
daily vitamin D therapy. This is important, because vitamin D lowers your
risk of falling by helping with your balance. There’s that aforementioned 20% risk of
mortality within one year after a hip fracture, and then a higher risk of nursing home
admission when you have lower vitamin D levels. Sarcopenia happens with protein deficiencies,
as muscle wasting when we age, which will be
discussed soon. Also, dehydration can lead to hospitalization
and even death, if it’s severe enough. Colon health is improved when you have
[sufficient levels of] fiber [in your diet]. It reduces Irritable Bowel Syndrome symptoms
and colon cancer risk. A plant-based diet has found to be protective
against colon cancer. You probably know that red meats increase the
risk of colon cancer, so try to avoid red meats
and have more of a plant-based diet. Today, we’ll go through some plant-based and
meat-based options. You need unprocessed grains to [slow down
digestion] and lower exposure to toxins, which means you want to have both soluble and
insoluble fibers which can help push things
through your colon and get it out of you. Soluble fiber, which dissolves in water, are
oatmeal, fruits, psyllium (like Citrucel), and
barley. These bind to cholesterol to help expel it, so
these can lower your cholesterol levels. This is why oatmeal lowers cholesterol. However, this can make you more gassy and
distended. Insoluble fiber, like wheat, rye, bran and
vegetables, do not dissolve in water, and should
not give you gas. They’ll push right through you. The skin of fruits like apples, pears and
tangerines are all going right through to help
push [digested food] out. If you’re finding you’re not getting enough protein
and you’re losing weight, protein shakes are an option. Don’t do this as a meal replacement, do it as a
snack, because they fill you up and you’re not going to
eat real food if you’re full from the protein shake. Remember, they’re high calorie and high protein,
so if you’re trying to lose weight, this is not the
answer for you. Of course, come to these programs. Also,
[consult a dietitian], who can examine your
typical menus, and help you [improve them]. [As for your] environment, can you eat with with someone else, do you have access to the food that you want? Can you have food delivered to you or pick it up,
[already bagged] from the grocery store? [Many
grocery stores now have this option]. Talk to your nursing and dietetic staff talk to help
you improve your caloric intake. Meals on Wheels is an option that’s on a
donation basis. You can’t use it if you’re on a diabetic or
hypertension diet, but at least it gives you a meal that you can
have [part of today, then finish] tomorrow. It’s an option, food that’s on the table that you don’t have to cook. You can do it [as often as] whatever suits you. In summary, nutrition in older adults is vital. Try
to avoid undernutrition and unintentional weight
loss. Look for factors that could be worsening
appetite. Mood, dementia and thyroid problems can affect
how much you’re eating and how well you’re
metabolizing [food]. Also, medications and chronic diseases. Then, do you have any barriers to food, such as lack of money or transportation? Here are my references. Thank you, all.
[applause]>>Thank you, Dr. Bhattacharya, that was a
nice introduction. I’m a researcher at KU Medical Center, I’m
classically trained in nutrition and most of my
research is in nutrition and brain health, but I have recently made a bit of a shift. While I still [study] Alzheimer’s and brain health,
some of my research has now shifted into how
our body composition, muscle mass [and related issues] might affect
our brain health in some way. I’ll be talking about sarcopenia, which was
brought up in the previous presentation, and adding a point about brain health, since I
am a brain researcher. I can’t can’t help but talk about it. The World Health Organization has put forth a
definition for healthy aging, which states that we want to maintain our
health, well-being and functions throughout our
entire lifespans. We want to think about how we can do that from
both a physical and a mental perspective. This graph is a projection of how many millions
of people are going to be over the ages of 65 and
85, up to the year 2050. We expect there to be somewhere between 60
and 80 million people over the age of 65 by
2050, which for an Alzheimer’s researcher, is a rather
significant number which has grown drastically. [To promote] healthy aging, finding ways to
prevent chronic disease prior to its onset as we
grow older becomes really important, for not only our individual health, but healthcare’s
[impact] on the entire economy and overall well-
being of the country. I’m going to gonna briefly touch on physical
activity, because we focus a lot on that at our Alzheimer’s Disease Center at KU Medical
Center; and then also nutrition, since this is a healthy
cooking and eating presentation. I want to bring up sarcopenia, which was
previously mentioned. Had any of you been
familiar with that term? Sarcopenia is a condition, due to nutritional and
physical factors as we age, we become more
frail. People think of sarcopenia as being a condition of frailty. But as we continue to lose muscle mass and weight in frailty, that’s sarcopenia. Once you reach frailty, its a continual [downward
spiral] where you’ve lost muscle mass. This is
due to a handful of causes: There’s a phrase, “anorexia of aging”, which
basically means that this isn’t the eating
disorder [variety] of anorexia, this is about unintended weight loss, which can
be due to changes in appetite, thanks to a
[weakened] hunger mechanism. When this happens, there are other factors like
emotions that may also be affecting us as we
grow older. By the time the average person reaches 70,
they’ve taking in around 25% less energy than
what they consumed at 40. This then becomes a potential factor for other
diseases and having this frailty issue. It may be just due to the fact that you just eat
smaller meals and don’t really feel the need to
eat a whole meal, or you might not be snacking on nutritious
foods. There are a handful of possible [causes]
that can [contribute] it. I was supposed to have slide headers on this to
tell you what we were talking about, but I see
that they’re not on here. Anyhow, this slide is about protein. I’m sure
you’ve heard a lot about it, and it’s heavily
marketed. In the average American diet, most people aren’t
short on protein intake. We usually overestimate how much protein we
actually need, but in older age, there are actual
physiological reasons to eat more protein. One reason why we may have muscle mass
loss in older age is because we’re not quite as good as
processing the protein that we eat into muscle that would be stored on our bodies. The average human needs about 0.35 grams per
pound of body weight in protein, so if you weigh about 150 pounds, that’s
probably somewhere around 55 to 65 grams of
protein that would be considered adequate. If you’re more active, you probably need more
than that, but when we’re older, after about 65, our needs go up to somewhere around a half-
gram of protein per pound of body weight, or
about 75 grams for a 150 pound person, in order to make up for that inability to make as
much muscle as when you were younger. There have been been a lot of studies on this,
which showed that if an older adult continues to eat that lower amount of protein, what usually ends up happening is as they age, their protein intake decreases. If they’re eating somewhere around .35 grams of
protein per pound of body mass per day, they have somewhere around forty percent more
muscle mass loss than the people who eat a
half gram of protein per pound, per day. This shows how important it is to take in enough
protein, when we reach our sixties. The best sources [of protein] on my list would
be fish, such as salmon, which is filled with
many nutrients, or tuna. I have no qualms against any type of fish. I
think we don’t eat enough fish, so I suggest if you have a favorite that’s not up
there, continue to eat it. Poultry is a great source, such as chicken and
turkey, both white and dark. Nuts and legumes are great sources of protein
as well, but we need to remember that they’re not
complete sources of protein. They need a grain
to complement them. If you do eat lentils or peanuts, like peanut
butter, the [bread] in a peanut butter sandwich
helps make that a complete protein. Low fat dairy and eggs are also great sources of protein. This one is supposed to say, “The combination
of protein and exercise”. We are really focused
on exercise at our Alzheimer’s Disease Center, in its ability to help prevent Alzheimer’s and
dementia, and also helping to [moderate] some of the
negatives that appear, once someone has
dementia. A lot of research shows that if you take in plenty
of protein and exercise, they are more powerful
together than either on their own. It’s always important to stay moving if you can. This one is meant to say “antioxidants”, and I
was going to ask you what has antioxidants in
it, but clearly, they are it’s fruits and vegetables,
since you’ve already seen it. Antioxidants are effective to help fight off free radicals. Have you heard of that term? Free radicals roam through your body and cause
cellular damage, if you don’t have enough
antioxidants to offset them. Antioxidants bind with those free radicals and
remove them from your body. If you don’t have those in a sufficient quantity,
then [free radicals] can cause inflammation, and
may also drive down muscle mass. We think about proteins as as muscle-building,
but fruits and vegetables are also important for maintaining your muscle mass. I think some of the greatest sources are going to
be green, cruciferous vegetables, like broccoli,
kale or chard, anything that’s green, leafy and has some kind
of sprouts to it are great sources of antioxidants. Yellow and orange vegetables, like carrots, also
green, red, yellow and orange peppers, and
sweet potatoes, anything that has a bright, sort of red-orange or
yellow color. But the most powerful are berries, such as blueberries, blackberries, raspberries and strawberries. Anything that’s a berry is a great source of
antioxidants. Another nutrient that I think is really important
for maintaining your physical function and
muscle mass is vitamin D. Studies suggest that those with more Vitamin D
[in their diets] usually have a better muscle
mass, better body composition, and some more
functionality than those with less. It’s a little hard to obtain vitamin D from a natural
source, so most foods we eat with vitamin D in
them are fortified with, or added to them. Most people might assume that Vitamin D milk is naturally full of that vitamin, but we actually add it to milk. Good natural sources would be wild fish, and
then I think that [fortified] foods are good as well. I’m not [a fan of] supplements, but I think if there
are a couple that I could recommend, vitamin D
is one for sure, and then, omega-3 fatty acids. I think fish oil is a good supplement as well.
Omega-3s are needed for building muscle and
maintaining muscle mass. They have anti-inflammatory properties, so they
also help our immune system work better and
flush out damage caused by inflammation. I think fatty fish, like salmon, tuna and mackerel
are all great sources, as well as fish oil. Plant [sources include] walnuts, chia seeds and
flax seeds. If you happen to take vitamin D or consume
vitamin D in the diet and omega-3 together, they may have a greater [combined] impact on
maintaining muscle mass than taking [either on
their own]. As for their effects on the brain, we’re learning
that what’s good for the heart is also good for
the brain. Maintaining a healthy muscle mass and a
[healthy] activity level are helpful to make sure
our brains age well. If we have a healthy body, our brain tends to
follow along. [A few actions we can take are] to try to control
blood pressure, avoid diabetes, and reduce our risk of cardiovascular disease
through good nutrition. Have you heard of the Mediterranean diet? This
is a buzzworthy term right now, and we at KU Medical Center are conducting
research on that, too. There is some really good evidence that the
Mediterranean diet is healthy for the heart. We said that what’s healthy for the heart is
healthy for the brain, and there’s some really
good evidence which [supports that claim]. We’re conducting a clinical trial at KU Med to determine if that’s the case, but there’s some good observational data
showing that as people follow that diet, they
tend to have healthier brains and hearts. This [is a chart of] the Mediterranean Diet,
meant to mimic what people of the
Mediterranean [Basin] are eating. They tend to have some of the best health
outcomes on the planet, so we thought [that] we
could model our diet after what they’re doing. The foundation [of their diet] are whole grains.
They eat a lot of vegetables and fruits, and consume beans, legumes and nuts at a
pretty high rate. They consume a lot of olive oil, but not so much
cheese, yet in some Middle Eastern countries,
they put yogurt on everything. Then, fish, poultry, eggs, and very little sweets
or red meat. Another food group I want to mention is dairy. This is somewhat polarizing, and some are against it, but there’s a lot of really good research showing
that it can be beneficial in your diet. Our institution conducted a study which showed
that the more dairy people consumed, the higher their levels of glutathione in their
brains were. Glutathione is the brain’s
antioxidant pathway. It meant that the more milk you drank, the more defense [you had for] your brain tissue. In two different studies, we had exactly the
same results. In a current study, we’re asking people who drink
a low amount of milk to drink more for three
months, to observe their brains’ antioxidant levels. This is my plug on on some of the studies that
we have going on, if you’re interested in them. Our NICE study is where we’re studying nutrition
interventions in brain health, and the milk study I
just mentioned. Those are a couple of ways that, if you were interested, you could get involved. I think we’re going to make kebabs tonight, so it looks like we’ll have some protein from the chicken, and some good, colorful vegetables in there, just to round out what we talked about, here. So now, we get to the fun part. [applause]>>Perfect. Thank you, Dr. Taylor. Now, I would like to welcome Chef Mike Milster from our Hospitality Management Program. He has been a culinary educator for 25 years, so we’re happy to have him.>>Hi, everybody.
[applause] This is going to be pretty cool, ’cause I’ve got a little mini-meal coming out for you guys to sample. A couple of our students are up there. I was not exactly sure when they would be done, but they’re plating that up, now. They’ll be bringing it out and passing it to you, while I’m here, talking. It’s pretty cool. I am a chef by profession, and often, chefs seem to be kind of anti-nutrition. At one point in my life I was overweight, I smoked cigarettes and drank too much beer. I realized that wasn’t going to cut it, if I was going to live a long and rewarding life. Now, I’m 58 years old and am of normal weight. I’m five-nine and I weigh 157 pounds. I absolutely hate exercise, but I solved that problem by realizing that there were some things that I did like to do. I like to ride a bicycle, so I do that a lot, as I don’t think that’s “exercise”. Going to the gym and lifting weights is exercise, and I forced myself to do that a couple times per week too, even though I don’t like it, because I want to be ready for crashing my bicycle without breaking things. I do drink a lot of milk, by the way, so I’m hoping that helps a little, too. I read an interesting article not too long ago that I believe said – you mentioned people breaking their hip and low chances of recovery from it. A study showed that a lot of people who fell down and broke their hip actually broke their hip and -then- fell down. That’s how weak their bone structure was. If they started to trip, their hipbone actually breaks. I don’t know if you have heard about that, but it was a study that I read. While I don’t claim to be a doctor or a dietitian, I taught in the Department of Nutrition and Dietetics at St. Louis University for 12 years, so I was teaching dietitians and future physicians how to cook, and I’m going to try to share with you some of the ideas that I had about that, today. Also of relevance, here: I hope I wasn’t picked for this just because I’m an old chef. That wasn’t the deal, was it? Our young chefs got to to do other things. For a brief period, I was a consulting executive chef for one of the largest senior living community organizations in the US, which had these large senior living facilities in major cities all around the country. One thing that I found that I told them them about was their food didn’t have any taste, They [responded with], “We can’t let them have any salt”. Food without salt doesn’t taste good. I totally agree with you. I have mild high blood pressure, so my doctor said I had to quit eating salt. I said, “I’d rather die. Give me a pill to keep my blood pressure where it needs to be. I don’t want to eat bland, nasty food”. I finally said to these people, “I’ve traveled to some of [your facilities’] dining rooms, and I’m seeing old people sitting there dying, because they won’t eat. A 98 year-old lady was dying because she you won’t let her have a little sprinkle of salt. That’s not smart nutrition. Another piece of advice, when it comes to nutrition: don’t sit there and be paranoid about what you should not eat; think about what you should eat and eat some of it, sometimes.” The other cool thing about doing that is that we know from scientific studies that probably over 99% of our eating behaviors are learned, which means that if you are a person who doesn’t like liver or broccoli, it’s not because you were born that way or there was something about your mouth that makes you not like liver or broccoli. Somehow in your lifetime, you learned that broccoli and liver are “icky”, but those are actually two very healthy foods. You can learn differently, you can actually teach yourself to like something that you didn’t like. Sometimes, you tried something at some point and you didn’t like it, but when you try it again, maybe prepared a different way, you do. That’s happened to Brussels sprouts, just recently. People used to boil the ever-loving heck out of Brussels sprouts until they were just a stinky, nasty mush; but now, we’ve discovered that if you cut Brussels sprouts in half and deep-fry them in olive oil, man, that’s “the bomb”! Sprinkle a little Parmesan cheese on ’em, and they’ll make you want to jump up and slap your grandma, ’cause they’re so good, and they’re healthy! [Going back to the] Mediterranean diet, there’s olive oil, and Brussel Sprouts are a dark green, persistent, cruciferous vegetable. What we’re passing out now is a little example of what I think is a reflection of the kind of food that we would like to see people eating. You’ll notice that the little thing that you’ve got there – Michelle, did she get the vegetarian one? You got it, thank you. We made a special one for our vegetarian person. But, I do agree with the notion of a largely plant-based diet. This represents that. While it’s not vegetarian, as it does contain chicken, there are green, yellow and red vegetables, and a lot of protein from a couple of different sources: from the chicken itself and also the From that Food Pyramid, those are the ingredients, and then the wheat from the garlic naan is in there, too. You’ll also notice that there’s a lot of flavor to this food. It’s not bland, it’s interesting. Food should be interesting and exciting, and there should be a lot of layers of flavor. One layer of flavor that I brought – I didn’t use this in what you’re eating, but I love this stuff – is called “Cavender’s Greek Seasoning”. You can buy it in any grocery store. There’s nothing magical about it, and as far as I can tell, there’s nothing Greek nor particularly Mediterranean about it, but it’s a conglomeration of different ingredients. Whenever I taste food and I say it’s blah, – this is about home cooking, not as a professional chef – I can just sprinkle a little of this on it and make it flavorful. If anybody is trying to learn how to cook or become a better cook, but you feel like some of the foods that you make aren’t as good as you can get at other places, sprinkle a little of this on it, and it’ll make it taste good. I really like it. I had a bunch of fellow chefs to my farm a couple of years ago for a deer hunting trip, and I brought this stuff along, because we each took a turn cooking something. When I started sprinkling that on, they gave me a razzing about that: “You’re a chef and you’re using that?” A couple of week later, I got emails from all of them who admitted, “I put that sh– on everything!” It’s actually a really convenient product to have! You’ll notice you have a green sheet that has some directions on it. Notice that it doesn’t say you need to measure things out. Sometimes that’s important, but other times I think it’s important to just feel comfortable in the kitchen. I could go in the kitchen, and anybody can make a kebab out of just about anything. Buy some skewers, and you can use leftovers. I do that frequently. I have bits of junk laying in my vegetable drawer that I skewer. One thing that makes what you’re eating here a little more interesting is that I actually seasoned and flavored those four different components on your kebab: the chicken, peppers, green squash and yellow squash, were each seasoned differently. They all blend together with the flavors from that soybean and white bean hummus and the Aleppo pepper oil that I provided you with. I’m not going to show you how to do all this stuff, but I do want to show you that it’s very easy to make hummus. Hummus is a very healthy food and you can make it out of anything. Traditionally, hummus is made out of garbanzo beans, or chickpeas, with tahini, which is pureed sesame seeds, and usually salt and olive oil, but you can make it out of virtually any kind of bean. What I’m making mine out of – and I even brought my own small food processor so I could show you a demo of how to do this at home – I just bought some frozen edamame, or soybeans, and cooked them in a little water for about 10 minutes. This is not by a recipe, but I just put them on the stove and cooked them until they became soft. I have canned white beans – again, notice that I didn’t measure this? I’m not pre-measuring anything, I’m just throwing some in. The point that I’m making: his one thing that I gave you, and I hope everybody liked it, was Mediterranean-flavored. How easy would it be to take those ingredients, change them all up and make it Southwestern? We could have put a little spicy pepper or a palano pepper on these, or some chili powder and more cumin. You could just change the flavor profile of it very easily to suit your mood, maybe have it with some rice, or something like that. You can make a bean puree with almost anything. If we were making something Southwest American, we could have a black bean puree. You can do just about anything. This is not pre-measured, I just threw some in. I might as well use it all, but that’s some of the sesame paste. I’m just going to use some of my “magic” seasoning instead of salt, as already has salt in it. Basically, when I made the one that you at, I just put these in there, and turned it on. I often like to pour the olive oil in. All I’m doing with it is to eyeball it until it looks like it purees smoothly. This stuff is thick. This is not a very powerful food processor, but there you have it. It’s just that easy. I just made it essentially from the same thing that you’re all eating, and that’s quick. The Aleppo pepper oil I made the same way: I put the peppers and some garlic in there, then I By the way, I’m just as lazy as I can be. I didn’t bother washing the machine in between making these two different things. I figured that one would season the other a little. Here’s my last piece of advice I think is really smart: Sometimes, trying to figure out what’s healthy to eat can seem challenging, and sometimes you’re not really sure what to do, but part of the secret is if you can go to a grocery store and shop at its edges, rather than its middle, you’ll be eating fresh food rather than processed food, rather than processed food. Don’t get me wrong: I’m not against processed food, but in general, we know that you’re better off eating foods from the perimeter, and you’re better off if you can cook it for yourself than opening boxes and cans, that’s for sure. That’s what I’ve got!
[applause]
>>Thank you, Chef Milster.>>Absolutely!
>>It was great, and hopefully, everyone enjoyed the samples. We are really excited that you came out tonight. We hope everyone will join us in April, when the topic is going to be diabetes prevention. It should be really great. I believe it’s April 3rd, the first Wednesday in April, so we will put more information out about that one, as well. Thank you guys so much for coming, we really appreciate it.

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