The Sentences and the Fury

ALERT! ALERT! This is a serious post that will discuss important social issues and reference scientific research. You’ve been warned.

Maybe I’m overreacting. But darn if this didn’t set me off when I read this last week:

A nation in which the poor are defined by an income level that in most countries would make them prosperous is a nation that has all but forgotten the true meaning of poverty. A nation in which obesity is largely a problem of the poor (and anorexia of the upper-middle class) does not understand the word "hunger."

The offending two sentences came early on in an op-ed by Bret Stephens, a member of the Wall Street Journal editorial board, in the Journal’s online “Opinion Journal.” In the context of the larger commentary -- a backhanded slap at anybody who dare complain about “divisions” in America or about the progress, or lack thereof, in Iraq -- these two sentences were nothing more than punditry detritus.

But those two sentences say a heck of a lot to me about how a good portion of people in this country view the socioeconomics of food and, more specifically, nutrition.

It’s true, of course, that the obesity epidemic is concentrated in less-affluent populations (how’s that for medico-journalese!). And there’s a very good reason for that: cheap, calorie-laden food is what many low-income people can afford.

Just last month, researchers from the University of Washington reported something that might surprise Mr. Stephens, but not anybody who’s been paying attention:

They found that the foods which are less energy-dense -- generally fresh fruits and vegetables -- are much more expensive per calorie than energy-dense foods -- such as those high in refined grains, added sugars, and added fats.

[snip]

Lower-calorie foods jumped in price by about 19.5 percent in that two-year period, while the prices of very calorie-rich foods stayed stable or even dropped slightly, the researchers found.

And this isn’t some short-term phenomenon:

Since 1985, the actual price of fruits and vegetables has increased 40 percent, while the price of sugar and fats has declined by 14 percent.

The bottom line is that more fattening foods are far cheaper than healthful foods. This is due in very large part, of course, to the federal subsidies paid to support the growth of corn, soy, and several other “commodity crops” that are the backbone of those calorie-laden foods (e.g., the gazillion tons of corn used to feed all those cows needed to produce those flimsy little meat patties at McDonalds).

In the same McClatchy article, a beautiful chart shows that of the $70.2 billion in subsidies – that’s right, BILLION – given to agriculture interests between 1995 and 2004, only $1.55 billion went to support fruits and veggies.

So is it any wonder that, when a mom of two making, say, $16,000 a year, sees what it will cost her to buy four or five oranges, and then realizes she can get a case of generic orange soda for the same price, she chooses the case of soda?

This whole diatribe thus far brings me round to another recent study, published just this month and covered by the New York Times’ Tara Parker-Pope, which demonstrated that giving poor people vouchers to purchase fruits and veggies actually… wait for it… increased the amount of fruits and veggies they ate.

Who would have thunk it? Certainly not Mr. Stephens, who I have little doubt would decry such a program proposal as a government “handout” -- unlike those billions of dollars in federal subsidies for growing the corn so desperately needed to produce Cherry Pepsi.

In the study, women were given $10 vouchers weekly for use at a farm market or supermarket.

After six months, women who shopped at the farmers’ markets were eating about three additional servings of fruits and vegetables a day, compared to the control group. Supermarket shoppers consumed 1.5 extra servings.

The study results, Ms. Pope reported, coincide with a decision by the USDA -- after apparently a bit of pressure from public health groups -- to start giving participants in the federal W.I.C. program (Women, Infants, and Children) subsidies for purchasing fruits and vegetables.

“Wonderful!” you might think. “Fantastic, even!”

Think again:

The W.I.C. program will provide monthly vouchers worth $8 to each recipient and $6 to each child. Breastfeeding women will receive just $10 a month toward fruits and vegetables.

So here you have a study that demonstrates quite clearly that the eating habits of poor women with children can be significantly improved through nominal weekly vouchers for fruits and veggies. In contrast, you see an action by the USDA intended merely to provide a talking point, something along the lines of, “We are helping poor women and their children eat healthier with vouchers for fruits and vegetables…”

The well-documented socioeconomic disparities in deaths from diseases like cancer and heart disease are not due to happenstance. There are directly attributed to environmental and economic factors, such as whether somebody can afford to buy a bunch of grapes or a bag of carrots at the grocery store. And, meanwhile, you have the government subsidizing the production of the most fattening and cheap foods on the planet, while doing almost nothing to help those in most need of getting an apple a day.

And what are the costs of this?

A new study shows that the nation's unchecked diabetes epidemic exacts a heavy financial toll as well: $174 billion a year. That's about as much as the conflicts in Iraq, Afghanistan and the global war on terrorism combined.

[snip]

The incidence of diabetes has ballooned — there are 1 million new cases a year — as more Americans become overweight or obese, according to the study, released Wednesday by the American Diabetes Association. The cost of diabetes — both in direct medical care and lost productivity — has swelled 32% since 2002, the report shows. (emphasis added)

So, contrary to Mr. Stephens’ assertion, I would argue that, as a country, we definitely understand what “hunger” means. There are many kids and adults who go to bed -- or heck, spend a good portion of their day – hungry, and there are many others who have enough money to eat, but only the cheapest foods, the stuff that leads to things like obesity and diabetes.

I don’t know how much any one individual can do about any of this. But aside from the superior taste and quality of everything I get from local providers, buying as much as I can from local farms is one way I see to help further develop a local food infrastructure that can, in its own way, be part of the solution to these problems.

I know that our CSA, Harvest Valley Farms, participates in WIC, and hopefully as people start to demand more sustainably raised produce and meat, more of it will become available, the price will begin to inch down, and something good can begin to take hold well beyond what’s in my CSA basket each Tuesday from May to November.

Delicious and Befuddled

Several moons ago, there was a popular Pan-Asian restaurant in Bethesda, Md., called Oodles Noodles. As its name implied, noodles were the house specialty, and they were done well. [Sadly, the restaurant is no longer there, replaced some time ago by a New Orleans-themed restaurant that itself may have already closed – ah, the dangerous lives of restaurants.]

At one point, my wife and I probably ate there once a week, rotating our meal choices around a few favorites, among which included peanut noodles, which featured two different types of long noodles in a warm peanut sauce; mee goreng, a somewhat fiery, curry-infused dish with noodles reminiscent of traditional spaghetti in thickness, but not length or texture; and, one of my all-time favorite soups, Siam noodle soup.

The first slurp of Siam noodle soup was always an adventure, because no matter how I approached it, the broth’s spiciness would reach up through my nose and steal a breath. This soup truly was a circus in your mouth, full of tang and fire (and shrimp and squid and, of course, noodles!), begging you to not abandon a single slurp to the depths of the huge bowl in which it was served, and always leaving a dripping ring of perspiration underneath each of my eyes.

With a hankering for a spicy Asian soup, I recently went searching through a few of our cookbooks and found one in Barbara Kafka’s Soup: A Way of Life that sounded like just the ticket. The recipe, borrowed from Jean-Georges Vongerichten, called for ginger, lemongrass, curry paste, onion, garlic, lime juice, fish sauce, and an ingredient that has taken a hold on whatever part of my brain controls appetite and flavor desire, coconut milk.

It also called for kaffir lime leaves and probably my least favorite meat, boneless chicken breast. I didn’t have easy access to the former and Ms. Kafka, in the commentary accompanying the recipe, suggested the lime leaves weren’t an absolute necessity, a claim of which I was dubious, but in no position to challenge unless I wanted to spend my lunch hour trekking down to the Strip District to pick some up at one of the several Asian markets there, which was just not in the offing. I had some Bell & Evans chicken breasts in the freezer, and, honestly, I didn’t think much of their inclusion at the time I was making the soup.

I brought up Siam noodle soup earlier because this recipe, despite its inclusion of coconut milk, immediately made me think of it, meaning that it had to be made, kaffir lime leaves or not.

The end result, topped with chopped cilantro and green onion, was quite good and quenched my hankering. That said, one thing about it truly bothered me: the chicken. Its only purpose, from what I could tell, was to add some protein in the case that it would be served as the main meal. The chicken had no flavor and, consequently, was a taste distraction—a roadblock through which the other robust flavors had to bust through.

A Thai cookbook we have contained a similar soup recipe: No curry paste, a lot more lime leaves, and, to my disbelief, boneless chicken breast. Here it was again, this flavorless intrusion into a soup that, in all other respects, is a celebration of robust flavor.

Then I thought back to the book Heat, by Bill Buford, which I recently finished reading and highly recommend. In the book, Buford, who, through means that aren’t fully evident to me (or, at the least, aren’t explained enough to truly make sense of it) quits his life as a magazine editor to serve as Mario Batali’s “kitchen slave” at MM’s famous New York restaurant, Babbo.

At one point, Buford discusses the publication of the Babbo Cookbook and dishes some inside dirt on how restaurant offerings are transmogrified into a hopefully easy to follow recipe for the home cook. In short, what’s in the cookbook does not recapitulate what happens at the restaurant. It can’t be done.

And I have to wonder if the same general concept applies to these recipes. I doubt there's much boneless chicken breast used in traditional Thai cooking. In my experience, it’s more likely to be the dark stuff. But average Joe and Jane Cookbook Buyer, for reasons I can’t fathom, prefer the tasteless boneless chicken breast (usually breaded and fried on a Kaiser roll), so cookbook authors toss them a bone here and there, just to keep them happy.

In any case, I plan on making this soup again fairly soon. Next time, I’ll have the lime leaves, but the chicken will be replaced by shrimp. And, in honor of a long-lost friend, I suspect some noodles will find their way in, too.

Two Days in Manhattan

Last week, my wife and I had the rare opportunity – rare for us, that is – to spend not quite two days in New York City.

The trip, ostensibly to see the (still) undefeated Pitt men’s basketball team take on (the no longer!) undefeated Duke men’s basketball team (you da’ man, Levance) at Madison Square Garden, almost didn’t happen because of various familial illnesses. In the end, however, it did happen, although not quite as I had planned – said plan almost strictly revolving around food.

Most of the details of the trip are, as Dr. Evil once opined, inconsequential. One worth noting is that my intention to eat a Neapolitan-style coal- or wood-fired pizza never materialized, primarily because of my own stupidity and indecisiveness.

The other is that, of the two exemplary meals we did have, the stars were the appetizers. Here some details are necessary.

Market Table

The first meal was at a restaurant called Market Table in Greenwich Village, a well-regarded eatery that has ties to an even more highly regarded restaurant called The Little Owl where I tried, but failed, to get a reservation.

We arrived, amazingly, at 10:00 p.m., the exact time of our reservation, despite the basketball game running long because of overly intrusive referees and one (incredible) overtime period.

We had hardly eaten all day and, truth be told, neither my wife nor I were in ideal gastrointestinal condition for a meal at a fairly high-end restaurant. But we were in the Big Apple, and had no intention of letting a little GI distress interfere with well-researched plans to enjoy culinary delights.

My wife ordered the bacon-wrapped scallops, hardly a unique appetizer, but one that came highly recommended (via Chowhound's Manhattan board) nonetheless. I went with the gnocchi with short ribs. This read like a heavy appetizer and probably not the ideal choice given the situation. In the end, however, it was the best decision I have made in some time.

There is no picture to be had because our digital camera was resting idly in our valet-parked car at the hotel, which means it was, for all intensive purposes, out of reach until our departure on Saturday morning. And it was too dark for my camera phone to provide anything more than what resembled a pasta apparition.

In any case, a picture would not do this little plate of wonder any justice: light, perfectly chewy petite gnocchi, with little shreds of succulent short ribs and tender escarole chunks in a savory “parmesan broth” that I would have poured down my throat if I were sitting at my own dining room table.

My wife agreed that, although her scallops were excellent, the gnocchi were beyond exceptional. Which led me to actually vocalize the question:

Will this be a case in which the entrée will, for no fault of its own, be a letdown?

I had just eaten what was, in my estimation, one of the most wonderful things I have tasted in a long time. By that measure, how could it not?

As it turns out, the entrée, a mammoth braised lamb shank (accompanied by a gruyere gratin and some braised escarole), was quite good. Excellent, in fact. But it did not exceed the gnocchi.

In the lamb shank’s defense, I was already feeling full by the time it arrived. Remnants of a nasty, cruel flu-like illness were still lurking in my chest cavity, and, as a result, I had eaten so little over the past two weeks that I had lost two pounds without a lick of exercise. Also, we had already downed two-thirds of a bottle of red by the time the lamb arrived.

The lamb shank was incredibly flavorful and tender, pieces effortlessly dropping from the bone with only a slight prodding from my fork. The flavor, in fact, was too intense. The dish was so rich that I had to take each lamb bit with a little gratin and escarole to tame it. Even with this workaround, I ate not even a quarter of the lamb shank, apologizing to our waitress for letting so much food go to waste and cursing the fact that our hotel room had no refrigerator.

August

The next night we had 8:45 reservations at another well-regarded restaurant, August, run by an alumni of Mario Batali’s uber-famous Babbo (yet another place where 3 weeks was insufficient lead time to obtain a reservation!), Tony Liu.

The star of August is the wood-burning oven, which is where a majority of the dishes on the sparse, but intriguing, European menu are cooked. This includes, not surprisingly, the tarte flambé.

The flambé begins with a light, crisp, flavorful (dare I say perfect!) crust accented by just a little char. It was the perfect delivery vehicle for seriously luscious caramelized onions and bacon and red cabbage, all sitting on a bed of crème fraiche. Again, here we were, faced with a welcome dilemma, that the entrée could potentially be a disappointment following such a wonderful starter.

Our entrees were both well prepared. My wife had the whole oven-roasted orata and I had a really interesting (“interesting” in the best sense of the word, not the backhanded insult kind of way) baked farro pizzichi pasta, which had bits of speck, red cabbage, and a healthy dose of sage. These were new flavor combinations for me and were truly enjoyable. But my dish, at least, was not as good as the flambé. The orata was quite remarkable, but if I were forced to choose, I’d probably have another flambé.

I’m still kicking myself about the pizza. And I’m still dreaming about that gnocchi.

* Statue of Liberty image from Ellis Island Foundation Statue of Liberty picture page.

Looming Breakdowns?

Michael Pollan had an excellent piece in Sunday’s New York Times Magazine, discussing just what the term “sustainable” really means in the context of agriculture and food production.

To call a practice or system unsustainable is not just to lodge an objection based on aesthetics, say, or fairness or some ideal of environmental rectitude. What it means is that the practice or process can’t go on indefinitely because it is destroying the very conditions on which it depends. It means that, as the Marxists used to say, there are internal contradictions that sooner or later will lead to a breakdown.

He cites two examples of looming breakdowns to illustrate a larger point about the unsustainable practices in agriculture today, including one about the extreme reliance on antibiotics on huge factory farms, where pigs and chickens and cattle are raised in such tight, and terribly filthy, quarters that infections, once unleashed, can race through inmate population like horses at the beginning of a Triple Crown race.

Public-health experts have been warning us for years that this situation is a public-health disaster waiting to happen. Sooner or later, the profligate use of these antibiotics — in many cases the very same ones we depend on when we’re sick — would lead to the evolution of bacteria that could shake them off like a spring shower. It appears that “sooner or later” may be now. Recent studies in Europe and Canada found that confinement pig operations have become reservoirs of MRSA. A European study found that 60 percent of pig farms that routinely used antibiotics had MRSA-positive pigs (compared with 5 percent of farms that did not feed pigs antibiotics). This month, the Centers for Disease Control and Prevention published a study showing that a strain of “MRSA from an animal reservoir has recently entered the human population and is now responsible for [more than] 20 percent of all MRSA in the Netherlands.”

And, by the way, it’s not just the animals infected with these resistant bacteria. According to a new Johns Hopkins study, it’s the people who work with them.

Poultry workers in the United States are 32 times more likely to carry E. coli bacteria resistant to the commonly used antibiotic, gentamicin, than others outside the poultry industry, according to a recent study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health.

[snip]

Currently 16 different antimicrobial drugs are approved for use in U.S. poultry production, with gentamicin reported to be the most widely used.

This is a huge part of why we try our best to buy our chicken, pork, and beef from local farms. The chicken and pork, in particular, not only tastes much better, but I know that I’m supporting farms that are doing things the “right” way – not damaging the environment, treating their animals well, and not promoting potential public health nightmares like rampant antibiotic resistance.

We’re fortunate to have access to these local farms and their products and, when necessary, to purchase meat sourced from somewhat more sustainably raised animals at places like Whole Foods. I know that’s not the case for a lot of people and I would never say that those with limited means should make sacrifices to purchase more sustainably produced products.

However, when scientists like Dr. Terry Etherton at Penn State – part of Pennsylvania Department of Agriculture Secretary Dennis Wolff’s infamous Food Labeling Advisory Committee -- claims that people like me, who are concerned about the use of antibiotics and synthetic growth hormones in the source animals for our food supply, are just snake oil salesmen who are “anti-ag, anti-biotech, and anti-science … who use campaigns of misinformation and junk science to scare consumers,” I’d like to take information like this Hopkins study and smack him over the head with it.

There are unintended effects, Dr. Etherton, of the way the majority of animals for food productions are now raised in this country. And while you may see unlimited use of antibiotics and growth hormones as an important part of the solution, there are mounting data that say using them in such an irresponsible manner on massive factory farms may be creating more problems than they are solving.

At the moment, their use may make a T-bone or a pork tenderloin more affordable for Joe and Jane American, but in the not-so-distant future, it may mean increasing rates of infections with antibiotic-resistant strains of bacteria or maybe increased rates of cancer. So if we’re going to debate the facts – which is what Dr. Terry Etherton says is the purpose of his blog -- let’s talk about all of them, not just a carefully defined subset.

As one funny and wise blogger once wrote: Just. Friggin’. Sayin’.

* Image from University of California

The Terrace Is Closed

I was in the swamplands of Washington, D.C., last week for work, and met a friend for dinner at Tako Grill, a great sushi place in Bethesda (Md.) and, conveniently enough, just a few blocks from my hotel. Before dinner, I walked by a favorite restaurant from our past life, Café Europa. Curtains cloaked the windows. It was closed. For good.

As one-time regulars at Café Europa (in our pre-children days), we got to know the owner, Jack. In the spring and summer, my wife and I often would walk to the restaurant from our one-bedroom condo -- or after catching a movie at our usual theater in Dupont Circle -- for a late meal on the terrace (or, in the guise of Jack’s accent, “tear-AUS,”). Once there, we would slowly consume a bottle of wine, with a simply prepared piece of fish, ravioli with rock shrimp in a saffron-laced cream sauce, or, one particular meal that has always stood out, flank steak with a creamy mustard sauce. Often Jack would bring us a limoncello to have with our desert -- on the house -- and sit down for a brief chat.

A native of France (Toulouse, I believe), Jack could never be confused for a businessman. He initially was a co-owner, but his partner, who I’m fairly certain led the shop when it came to the financial and other managerial aspects of the restaurant, left after a few years to take over an Italian-American restaurant in the Virginia suburbs of D.C. where he had once been a manager. It was a successful restaurant, I remember Jack telling me, gently suggesting that his partner had, in effect, opted to take a step down in cuisine—lots of pasta and red sauce, little else—for the security of a tried and true business.

Even before this parting of the ways, though, Café Europa had an unsettling existence. Weekend business was typically brisk, although not overflowing like many nearby restaurants, but getting eaters into its cozy confines during the week was clearly a challenge, as was attracting younger diners, who tend to eat and, cha-ching, drink more.

The turning point, when things went from troublesome to terrifying, arrived in the form of a retail rejuvenation of a three-block neighborhood of Bethesda just a mile or so away from Café Europa. In went a new stadium-style movie theater and a host of new restaurants with plenty of bar space, including several family-friendly places with good food.

This portion of Bethesda also was an easier walk from the Metro, had a huge Barnes & Noble always buzzing with lots of customers, and, at the time, in the dawning days of the new decade, more condos and townhouses in close proximity, housing well-off singles and young families with lots of expendable income.

Suddenly, the foot traffic in “Bethesda triangle,” as the portion of Bethesda where Café Europa resides is called, began to drop off. More and more restaurants — and there were many from which to choose — had a disturbing number of empty tables on weeknights and perhaps only a full house for the first seating on weekends. In the matter of a year or two, spring and summer nights in “the triangle” went from bustling to barely breathing (it’s since been revived, with the arrival of many new luxury condos and the addition of even more, including some very well-reviewed, restaurants).

Jack tried various remedies: updating the menu (although probably not enough – it was, truth be told, never a very exciting menu); getting rid of the brick-oven pizzas; bringing back the brick-oven pizzas; reinvigorating the interior with new tables and seductive lighting (Jack had made some of the original tables himself) and the exterior with stark red awnings that proclaimed “crepes” “steak” “pasta;” sinking a huge chunk of change into adding a swanky lounge, with live jazz on the weekends.

But nothing seemed to work. From its earliest days, there were problems with the service, something that plagued Café Europa ‘til its end. I believe there were issues with some temperamental chefs, including a soup chef who was too drunk to make it in one busy Saturday night when we were there. I know that friends and colleagues who had eaten there complained about the food being uneven, although I can honestly say that most of our meals there during the years were quite good.

The stress of trying to keep the restaurant afloat clearly got to Jack. The last few times I saw him, he was slightly drunk and overwrought by stress, running his hands through his hair as he recounted the latest attempts to revive the business. “I don’t know, you know,” he would say, mashing a hand through his thinning black hair as if he couldn’t push hard enough.

The very last time I spoke with him he was clearly inebriated. "Let me tell you something, I think I just made a huge mistake," he said, as I sipped a Bombay and tonic at the lounge bar, not quite sure what was about to follow. He had sold his condo in Bethesda and, using money he took out of the restaurant, had bought a house in Chevy Chase, where the lowest range of any house is at least $1 million. He wasn't even sure why he had done it.

The red awnings were still there when I walked by last week. A small orange sign in the window indicated that the new inhabitant of the corner of St. Elmo and Norfolk would be a sushi restaurant, which was in the process of getting its liquor license.

Despite all of its troubles, Café Europa made a respectable run of it. It lasted for approximately 8 years by my count, which in the kill or be-roasted world of Bethesda restaurants, is no easy task. The owners of this new sushi joint should hope to be as fortunate.

Cheers, Jack. Thanks for the meals and memories.