Thursday, May 27, 2010

Too Much of a Good Thing?

The May 20, 2010 issue of the New England Journal of Medicine contains this interesting correspondence: Myxedema Coma Inducted by Ingestion of Raw Bok Choy. The letter was submitted by Michael Chu, MD and Terry F. Seltzer, MD, both of the New York University School of Medicine.

In summary, an 88-year old Chinese woman with diabetes was brought to the emergency room because she was lethargic and unable to walk for the past 3 days. The family reported she was eating 1 to 1.5 kilograms of raw bok choy daily for several months in the belief it would help control her diabetes. She had no thyroid disease.

In the emergency room, they found that her legs and eyelids were swollen and her tongue enlarged. And she was comatose. They did a bunch of labs on her and found that her thyroid tests were abnormal. She survived after intense medical therapy.

Drs. Chu and Seltzer discuss that cabbage contains substances called glucosinolates. The glucosinolates breakdown into compounds that have been implicated for their inhibitory effects on the thyroid. To complicate matters, when eaten raw, members of the cabbage family release another compound, myrosinase, that accelerates the breakdown of the glucosinolates. However, cooking the veg seems to deactivates the myrosinase.

What struck me as curious was the amount of raw bok choy this lady was eating daily---1 to 1.5 kilograms (2.2 to 3.3 pounds). Okay, okay, you say that no one would eat 2-3 pounds of raw bok choy daily. That would be an insane amount that no one could possibly keep up for more than a few days.

Or could they?

1 kilogram of raw bok choy per the USDA Nutrient Database has 20. 3 net carbs. (NOTE: bok choy is listed as Chinese cabbage pe tsai on the Database). So if an Atkineer aims to get at least one half---or more!-- of their daily net carbs from veggies alone and if they do as this unfortunate lady did, then perhaps the New England Journal of Medicine will receive another letter reporting myxedema coma and severe hypothyroidism in a person who went overboard on their veggie choice.

I think there were two things in play here: 1. The idea that “because it’s a vegetable, it can’t possibly be bad for you” and 2. The idea of “if alittle is good, then a lot must be better.” As this unfortunate case shows, vegetables should not be taken for granted and that moderation---even with vegetables--- is the key to health.

Tuesday, May 4, 2010

Low Carb Sushi Rolls---Purists Avert Thy Eyes!

Lots of low carbers try to make sushi rolls low carb. I have read lots of recipes using the cauliflower-rice recipe as the rice substitute. The drawback with the cauliflower rice recipe is that the cauli-rice does not stick together.

When I was thumbing through a Raw Foods Vegan cookbook, I saw recipes for Vietnamese-type spring rolls using shredded daikon radish or shredded carrot as the substitute for the rice noodles usually found in spring rolls. My little brain started doing backflips! What if I used shredded daikon radish as the rice substitute for sushi rolls?

Unfortunately my local international grocery store did not have a single diakon radish. But they had a special on jicama (89 cents a pound!---that’s cheap in my neck of the woods). Why wouldn't jicama work?

Traditional sushi rice is cooked short-grain rice seasoned with sugar, salt and vinegar (typically rice). Since the jicama has a natural sweetness, I tossed it with a bit of rice wine vinegar. To avoid watery jicama, I sprinkled the salt on just before I rolled the roll.

So the jicama rice would not fall into tiny pieces, I coarsely shredded it, rather than grated it. The shreds do not fall out of the sushi due to the size. I found using a box grater to be better than my Cuisinart food processor shredder blade, because I can make the shreds finer by using less pressure while shredding the jicama.

Using jicama will make the sushi crunchy, which is not the usual texture of sushi rolls. But I don’t find the crunchiness offensive at all. In fact, after having an authentic sushi roll a few nights ago, I find the texture the jicama gives the low carb roll to be more satisfying.

For the sushi "rice"
Peel and shred one jicama using the shred holes on a box grater. Put into a bowl. Add about ½ to 1 teaspoon rice wine vinegar, toss. Set aside.

For the sushi rolls:
Crab roll:
use the meat of either Alaskan king crab or snow crab claws (do not use the imitation crab because it is high in carbs!). Mix the meat with a bit of mayonnaise or softened cream cheese, using just enough for the crab to loosely hold together.
California roll: Dice avocado. And extract the meat from either the Alaskan king crab legs or snow crab legs.
Salmon roll: I use Scottish or cold smoked salmon because I’m too squeamish to eat raw fish!

Get rolling:
Put the nori sheet on a paper towel (fancy folks have the bamboo rolling mat, but a paper towel works just as well!) Put about ½ cup of the shredded jicama on the sheet. Spread it evenly so that it covers about 2/3 of the sheet. Sprinkle a pinch of salt over the jicama. If desired, smear some wasabi paste down the middle of the jicama. Layer your filling on top. And roll. Slice. Arrange prettily on a plate. Eat.

(One of these days, I will find stem ginger to make my own pickled ginger slices, until then I'm stuck using the pickled ginger made with artificial sweetener my international store sells.)