One year blog birthday!

Since its inception, this blog has received over 7,700 hits (thanks mom and dad!); been picked up as a regular column for in-Training, a peer-reviewed medical student journal (thanks Ajay and Aleena!); and gained acceptance to an AMSA Medical Humanities conference. It has also introduced me to peers passionate about food and others who work in nutrition. Over a year when I've spent many hours alone studying material that departed from my previous schooling, this blog has connected me to others and to my past self, who was interested in writing, public health, and cooking. Thanks to all my readers!

I've also had friends tell me that they "don't cook" or that they try to cook but that the results don't taste good. A friend started a mock "medschoolfailblog" in which he would send me photos of dinner disasters. My two cents is that learning to cook is a matter of practice and becoming familiar in the kitchen. I grew up sitting on the countertop or helping to chop vegetables while my dad cooked; this gave me and my brother an incredible level of comfort in the kitchen. On the other hand, my first cooking experiments in high school were failures: inedible Italian egg drop soup (canned broth does not equal chicken soup), tomato sauce that would not taste as good as my dad's (I learned to give in and use butter). Over several years of practice and simplification (fewer ingredients, fewer random spices), my cooking has gotten better. There's still the occasional bitter or bland or painfully weird tasting dish: I recently got overambitious with a cold rainbow carrot-cumin-quinoa-chickpea salad that I refused to accept as inedible and which I attempted to save by pureeing into a sweet tasting hummus before tossing it into the trash.

So tonight's post has no recipe but I encourage you to cook something, and if it tastes good, to let me know!

Carefully documented, beautiful looking, 

totally inedible rainbow carrot-cumin-quinoa-chickpea salad

Envy-of-the-co-op salad

There are musicians who can play any song by ear. I don't have an ear for music, but I do have a palate for spices and an average ability to read ingredient lists. I also don't really like to pay for prepared food unless it's really good, but occasionally I treat myself and I try to use these opportunities as inspiration for new recipes. A few weeks ago I tried a great tofu-and-quinoa salad (sans spinach) from Albany's Honest Weight Food Co-op; that salad provided the inspiration for tomorrow's lunch (and tonight's late night snack).

Spinach, quinoa, and tofu salad:

• ~1/3 block firm tofu
• 1/2 cup uncooked quinoa, prepared in a rice cooker
• raw spinach
• 1 carrot
• scallions (few)
• cilantro (handful)
• suggested seasoning for tofu, to taste, using just a drop or a pinch each: canola oil, sesame oil, soy sauce or black vinegar, five spice powder, spoonful of sesame paste or peanut butter (alternate tofu seasoning with fresh spices suggested here)
• dressing: dash of sesame oil and soy sauce

You can either press and marinate the tofu as I do here or, more simply, cube the tofu and toss it in your sauces and spices directly in a pan before baking at 400 degrees. Bake about 10-15 minutes, or longer for crispier cubes. Meanwhile, wash and chop your spinach, peel and grate the carrot, and chop the scallions and cilantro. Once the tofu is done to your liking, toss all ingredients together and dress sparingly with sesame oil and soy sauce, being wary of overdressing the salad. Makes two "side" salads or one large salad.

Biochemistry of stress eating: Part I

I have always thought of stress eating as a pyschological phenomenon: snacking as avoidance, food as comfort. This may be true, but it doesn't fully explain how truly hungry I felt just after the renal exam last week, even after the need to procrastinate through eating had gone away.

According to a 2007 review article in Nutrition entitled "Relationship between stress, eating behavior, and obesity," I am not alone:

The effect of a major stressful event (school examination) on food consumption was investigated in 225 male and female high school students. Total energy intake was significantly greater on the examination day when compared with the stress free day (2225 versus 2074 kcal).

In a large cross-sectional study with 12,110 individuals, greater perceived stress was associated with a higher-fat diet. Individuals in situations of greater perceived workload and perceived stress reported increases in total energy and fat intake compare with periods of low workload and low perceived stress.

But why? Is stress eating purely psychological, or can we find a biochemical explanation?

One of our renal workshop cases got me thinking: cortisol, a stress hormone, causes transient insulin resistance. For instance, diabetic patients on insulin need to increase their dose under periods of stress (illness, surgery, psychosocial) to avoid hyperglycemia. Could the stress of exam anxiety be enough to affect glucose metabolism through cortisol release? Would that impact appetite? What other effects could cortisol have on appetite?

Cortisol mobilizes energy stores -- glucose from the liver, protein and fat breakdown. Perhaps we eat to increase or replace these nutrients. So does cortisol affect appetite directly? Unfortunately, I haven't been able to find conclusive data, either online or in old lectures. According to a 2014 study accepted for publication in Psychiatry and Clinical Neurosciences ("Plasma levels of leptin in reproductive women with mild depressive and anxious states"), stress in humans has been associated with decreased, increased, and normal levels of leptin -- a hormone that inhibits appetite.

How does this...

Source: 2007 Nutrition review

Lead to this?

Part II -- Nutritionists in my audience, how can we improve satiety under stressful situations? Foods to eat or avoid? Please write in and let me know!