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"Pass the Flavor, Please" 

Chances are, you know someone who follows a special diet: your parents, grandparents, maybe even you. Sometimes called "therapeutic diets," these can range from reduced salt for high blood pressure to a very complex renal diet for kidney disease, which sometimes requires months of learning what to eat. For many people, hearing their doctor say, "You're going to have to change your diet" evokes a fear of being sentenced to a life of tasteless meals. And there may be good reason. I've met fellow dietitians who just don't cook (I was guilty of that too early in my career). The irony of medical doctors receiving meager nutrition training is also reflected in dietitians generally not receiving enough culinary training. Nutrition school curricula may include food preparation courses that teach basic cooking techniques with proteins, vegetables, etc., but not how to prepare modified diets and use flavor enhancements. On the flipside, culinary schools usually skip the section on healthful cooking. There are some clinical and outpatient dietitians educating patients how to eat who do not realize that the diets they are preaching are not palatable or realistic. Thankfully, due in part to high profile foodie dietitians like Ellie Krieger, celebrity chefs who embrace healthful cooking, and an increasing number of television food/cooking shows, more dietitians are becoming true food experts.  

I recently received a sample shipment of beautifully wrapped products created by dietitians in Alabama who counsel a wide range of patients. Their company The Delicious Dietitian sells food enhancements like high quality flavored vinegars and spice blends that are free of salt, sugar, potassium, MSG and gluten. Spices contain powerful plant chemicals that fight disease, and many have anti-inflammatory properties. Countries with low rates of cancer and heart disease generally have a higher intake of spices, which may reflect their greater use of fresh whole foods needing added flavoring, rather than processed packaged foods that are filled with salt and artificial flavors. I whipped up The Delicious Dietitian's recipes for a signature marinade and a salad dressing using their Red Muscadine Wine Vinegar and Zalea Zest All-Purpose Spice Blend. I added the marinade to skinless chicken thighs, which really sparked my taste buds with its pleasant tartness, and the olive oil-based salad dressing went perfectly with colorful greens and vegetables. When your mouth is processing all those complex flavors, it doesn't have time to miss the saltiness that may be lacking.

Example of a renal meal with low potassium vegetables, herbed whole wheat couscous, and baked chicken flavored with sodium-free seasonings.

Tips for cooking therapeutic meals:

  • Start with the best quality unprocessed ingredients available, which already taste great with few enhancements. 
  • If you have to reduce the sugar or salt in your diet, explore the "sour" taste bud with tart flavors found in vinegars and citrus foods. You can still use some sweet or salty additives but the overall amount needed may be less.
  • Buy a spick rack and fresh herbs; learn how each tastes and which foods they complement. Try low/no sodium salsas and spice blends such as Mrs. Dash or those mentioned above. See Cooking with Herbs and Spices.
  • Learn about food substitutions that are not as noticeable tastewise but make a big difference healthwise: Replacing whole wheat flour in baking for white flour, choosing low fat Greek yogurt that tastes richer and is higher in protein than highly sugared standard yogurts, using olive and canola oils in cooking to retain richness but without the saturated fat and high salt found in butter.
  • Take time to make your plate visually appealing with colorful dinnerware and vibrant fruits or vegetables, which may increase your eating enjoyment.

Udon Noodles with Almond Sauce and Tofu

I just adore udon noodle soup. What's more satisfying than slurping those thick, chewy noodles? I wondered if udon would taste good as a non-soup dish and noticed many recipes preparing it with peanut sauce. I decided to try an easy healthful recipe from Caring4Cancer with a few modifications, including substituting almond butter for the peanut butter. Almond butter is found at Whole Foods, Trader Joe’s or in the health food section of regular supermarkets. It ranges from expensive ($6 for a 10 oz. jar) to waaay more expensive ($24 for a 16 oz. jar made with raw organic almonds). Still, it's a nice change from peanut butter and has a smidgen more nutrients (slightly higher in iron, vitamin E and fiber). The brands I saw were also lower in sodium (up to 50% less) than popular peanut butter brands but the protein, calories, fat and sugar content were about the same. You can use either creamy or crunchy versions in this noodle recipe. I found my udon noodles online at Asian Food Grocer. Some varieties are very high in sodium so I chose an organic, no salt added version. I also added tofu, low fat milk and chopped almonds for additional protein. It’s a complete meal and tastes great warm from the stovetop or at room temperature if you’re packing it for lunch.  

Udon Noodles with Almond Sauce and Tofu


For Dressing

1/2 cup low fat milk

1/2 cup almond butter

1 T grated fresh ginger root

2 cloves garlic, finely chopped

1-3 T lower-sodium soy sauce (depending on your taste preference)

1/4 t red pepper (cayenne)

For Stir-Fry

1 medium head broccoli, cut into small pieces

1 cup shredded carrots

1 cup chopped extra firm tofu

3 scallions, chopped

1 package udon noodles (about 7-8 oz.)

2 T sesame oil

2 T chopped almonds, for garnish


  1. In a small bowl, add dressing ingredients and mix well. Set aside.
  2. Chop vegetables and tofu.
  3. Bring large pot of water to a boil. Add udon noodles to boiling water and cook according to package directions.
  4. While the noodles cook, heat sesame oil over medium-high heat in a large nonstick skillet for 1-2 minutes. Add broccoli, carrots, scallions and tofu to oil. Stir-fry until lightly cooked but still crisp, about 5 minutes. Turn heat down to lowest setting.
  5. Drain udon noodles and add to skillet.
  6. Pour dressing over noodle mixture. Toss to combine. Plate noodles and garnish with chopped almonds.

Strength Training: No Equipment Necessary

I received a book to review and really liked the cover. Well, sure, the author is amazingly attractive but I also appreciated the title: You Are Your Own Gym. I'm all for gyms because I believe some people need the accountability and support that gyms offer to succeed in exercising consistently. But there are times when you can't make it to the gym, and this book offers great ideas for a home-based program. The creator, Mark Lauren, has coached almost a thousand military trainees in U.S. Special Operations forces (e.g., Navy SEALS, Army Green Berets) in the past decade. Through his training experiences, he's developed an exercise regimen that you can do in the privacy of your home without equipment. Some of his thoughts about fitness are provocative, going so far as to suggest that the current exercise recommendations from the Centers for Disease Control and Prevention are flawed. Mark shared his insights with me in a recent interview.

Q: What's missing from a traditional strength training class that your program offers?

A: My bodyweight exercises engage many muscles at once. Often, exercises requiring equipment have the user sitting or lying down while isolating only one or two muscle groups. This is less effective since people rarely exert themselves while lying or sitting down. Many strength training, yoga and Pilates classes fail to address all the qualities of fitness: cardiovascular endurance, muscular endurance, strength, power, flexibility, balance, speed and coordination. With my program these qualities are developed systematically through the use of bodyweight movements engaging several muscles in short intense interval-type workouts. The user is gradually and safely progressed to these intense workouts by beginning with longer less intense workouts.

Q: Do you disagree with the CDCs exercise recommendations for adults that include regular aerobic activity?

A: The problem with their advice is that splitting up cardiovascular training and strength training is outdated and inefficient. Through the use of short intense interval-type workouts, you get much better results in far less time, especially if you're using bodyweight exercises, and you can train anywhere. High intensity interval training (HIIT) produces incredible changes faster. Cardio can actually make you lose strength and muscle, since not all muscles are engaged, and very little muscle is needed to perform an easy movement over and over.

Q: What do you suggest for frequency and type of exercise for someone who wants to lose weight?

A: My program is effective with 16-40 minute workouts performed 4-5 times a week (or 2-3 hours total). With short intense interval-type workouts using many muscles at once, you build muscle and boost your metabolism. One study found that HIIT was 9 times as effective at burning fat as cardio. HIIT produced greater changes in body composition in less time (20 minutes of HIIT vs. 1 hour of cardio). Muscle is always active so you not only burn calories while resting, you also burn far more calories while training. It's like working with a 6-cylinder motor instead of a 4-cylinder motor. The bigger motor requires much more fuel when working, and that fuel is calories.

Q: Have you trained frail elderly and those with more limited physical function, or mainly athletes and military personnel?

A: Most of the feedback I’ve received from this book is from people 40-60+ years old but I've gotten great feedback from many elderly people. Some require advice regarding ways to train around particular injuries, usually bad knees, which I address in my website’s forum section. This program is especially beneficial for the elderly because it develops functional skills that translate to activities of day-to-day living. Through improved balance, flexibility, muscular strength, joint strength, bone density and coordination, people are able to get through life with greater mobility and safety.

Here are my two cents on this book:  

PROS: Mark is a thorough writer with clear explanations and accompanying photos. His nutrition section gets a thumbs-up with very sound advice. The exercise variations are great; for example he demonstrates 10 different kinds of push-ups! Most exercises offer basic to advanced levels. If you're a seasoned exerciser, you'll get many new ideas. It's perfect for days when you don't feel like the gym or if you're traveling.

CONS: He uses props such as phone books, food cans, backpacks and gallon jugs for weighted resistance. I question some of them simply because they're not made for weight training: your hands may not grip them properly, causing potential injury if say, a heavy can falls on your foot! Other props are downright scary: using a broomstick propped on stereo speakers for pull-ups (a cheap broom handle might not support a very heavy person), and use of plastic deck chairs, which are generally flimsy.

BEST AUDIENCE: Those who are moderate to advanced exercisers who've taken a strength training class and understand basic proper form. A benefit of a class or personal trainer is that the instructor can correct improper movements that could cause injury. If you're a novice, I'd suggest using this book along with a strength program at a gym or with a fitness trainer. Want your own free copy? Click on "Contact Me" and send your name and email address by September 21 to be entered in a random drawing. I'll contact you if you're the winner and send you Mark's book You Are Your Own Gym ASAP!

Also check out the p90x workout for an effective exercise program performed with high quality equipment in the convenience of your own home.

Below is one of Mark's exercises demonstrated by Mia, one of my Zumba students and an undergraduate at MIT studying chemistry. The movement simultaneously works the triceps, shoulders, glutes and hamstrings.

Sit upright with your back straight. Place your arms by your sides, fingertips pointed at your feet.           With straight arms, push upward and raise your hips so the soles of your feet are flat and your knees are bent 90 degrees. Hold for 3 seconds and slowly release to starting position.