This new found fruit has seen a rise in consumption in Singapore. It is mostly ingested in a pill form and is said to have many different benefits, including weight loss.
What is it?
Garcinia cambogia is a tropical fruit native to South and South-east Asia that is very commonly used in Asian recipes. It is green, rather small (the size of an apple), and is pumpkin shaped. It is well known for its sour taste. In the late 1960s, an acid (hydroxycitric acid) has been discovered in the fruit’s rind, which has been found to provide many benefits, such as appetite reduction, improved cholesterol and triglyceride levels, increased weight loss, and mood enhancement.
How does hydroxycitric acid work?
Hydroxycitric acid (HCA) was discovered over four decades ago, and since then studies have shown that it provides many benefits for humans. HCA seems to inhibit citrate lyase, an enzyme that is used by the body to produce fat out of carbohydrates. HCA blocks a portion of this enzyme, making it more difficult for the body to turn starches and sugars into fat. This means that rather than be accumulated as fat, carbohydrates are diverted into energy production.
What are the benefits of garcinia cambogia?
As discussed above, one of the benefits of garcinia cambogia is less energy being stored as fat, which means that it should (and does) aid weight loss. One recent study by Dr. Harry Preuss of Georgetown University Medical Center showed that participants HCAHCA lost significantly more weight than those using placebo. In another study, also by Dr. Preuss, those not supplementing HCA lost an average of 3.5 pounds, whereas those that did supplement HCA, lost an average of 10.5 pounds.
The first half of this past week flew by, a blur of class and reading and clients and work. The second half screeched to a halt with the arrival of a fall cold and a middle ear infection, which forced me to slow down and spend most of yesterday curled up on my sofa. I was supposed to travel to DC today for my cousin’s baby shower, but, with my first set of midterms coming up this week and more travel on the horizon later this month (not to mention the undesirable prospect of getting other family members sick!), I chose to stay home and rest up.
I’m not a good patient, and I don’t like slowing down, but seasonal sniffles are an important invitation to give our bodies care and attention. Since it’s gloomy and drizzly and cold in New York this weekend anyway, I’m hunkering down with lots of soup and lots of flash cards. And I’ve gotten some pleasant distraction from the following recipes and reads.
It’s back-to-school season, and whether you’re feeding yourself or your kids, it never hurts to have another homemade snack bar recipe handy. I love this recipe for coconut-almond granola bars from my friend Alexandra–it’s easy to make and the bars look scrumptious.
My Darling Lemon Thyme’s beautiful baby beetroot, quinoa, and kumquat salad is full of color, and it would be a lovely appetizer or side dish for fall or winter entertaining. There’s feta as written, but cashew cheese or tofu ricotta would both work well as a replacement (or you could skip them both and add chopped avocado, toasted nuts, etc.).
And finally, dessert. Abby of The Frosted Vegan has created the most authentic-looking, beautiful vegan lemon bars I ever did see, with a rich shortbread crust. I would imagine these make for wonderful edible gifts around the holidays, so I’m bookmarking the recipe!
2. It’s worth reading the fabulous and articulate Miyoko Schinner‘s letter exchange with Ryan Bethencourt, relayed in Medium as part of the magazines “Future of Food” series. I’m linking to Miyoko’s third letter, but you can read it and track back to the other two exchanges, which surround such issues as sustainability, hunger, technology and food innovation, and the necessity of helping consumers to reconnect with the process of cooking. I think Miyoko articulates the vegan perspective calmly and persuasively, but with a lot of compassion and a broad perspective.
3. A fascinating article, via Aeon, on the phenomenon of hearing voices and whether or not it can ever be regarded as a therapeutic tool. We tend to look at hearing voices as a symptom of mental illness that begs correction, but the author sheds light on a growing “hearing voices movement,” in which those who do hear voices claim that listening to and analyzing what’s heard can help to resolve or shed light on trauma and personal history. I have no doubt that this is totally situational–for some, hearing voices may be an intolerable burden, while for others, it may not be. But I was interested in the perspective that these voices might not always be a source of dissonance.
When my grandmother was slipping into the end of her life and experiencing dementia, she often seemed to recognize individuals who weren’t there, or to hear the voices of loved ones who were gone. It was distressing to watch, but what I realized over time was that many of these perceived characters from her past were offering her comfort and solace as she journeyed to another place. I know that this is different from apprehension of voices in the midst of youth or middle age, but the article reminded me of it.
Anyway, worth reading!
4. Abby Norman has written a terrific article on the phenomenon of pain and how it intersects problematically with medical practice. Why is pain so hard to communicate for both patients and physicians? Why are doctors so often made uncomfortable by the condition of chronic pain? Are there ways for doctors to become more sensitively attuned to their patients’ experience of pain? All important questions, and Norman describes some promising strides forward (such as the keeping of pain diaries) in this area.
Like many food bloggers, I spend most of August diligently waiting for the moment when it will be seasonally appropriate to start putting pumpkin in anything and everything. Today, the first day of October, feels more than timely. Let orange-hued baking and beta-carotene in everything commence!
This pumpkin skillet cornbread is a total winner. It’s the perfect in-between of sweet and savory, ridiculously easy to make, and the perfect side dish for a night when you’re not quite in the mood for rice or quinoa (or any of your other regular whole grains). While you won’t exactly taste pumpkin in the bread, you will see a lovely, golden hue when the skillet comes out of the oven, and you may catch the very slight hint of cinnamon that I added to the recipe. It’s enough to make it taste like fall, but not enough for the cornbread to taste like a traditional pumpkin or apple loaf.
Using pumpkin also means that the recipe stays nice and moist without the addition of too much oil. I think the texture is perfect–the right amount of crumbly, the right amount of moisture. I use finely ground cornmeal or corn flour for cornbreads, which gives them a light texture, but if you want something more rustic and dense, medium grind cornmeal should work nicely, too.
1 1/2 cups gluten free, all purpose flour (I use Bob’s Red Mill)
2 teaspoons baking powder
1/2 teaspoon baking soda
1/4 teaspoon cinnamon
1 teaspoon salt
1 teaspoon apple cider vinegar
2 cups almond milk (or another non-dairy milk of choice)
1/3 cup maple syrup
1/4 cup grapeseed or melted coconut oil
1 cup unsweetened pumpkin puree
Preheat your oven to 350F. Lightly oil a 12-inch, cast iron skillet and dust it with cornmeal. If you don’t have a cast iron skillet, you can use a 10″ square baking pan instead.
Whisk the dry ingredients together in a large mixing bowl.
Pour the almond milk into a medium sized mixing bowl and add the vinegar. Whisk vigorously, until the milk is frothy. Add the maple syrup, oil, and pumpkin puree. Fold the wet ingredients into the dry ingredients, until everything is well mixed, but don’t over-stir (a few clumps are fine).
Pour the batter into the skillet. Place the skillet in the oven and bake for 25-30 minutes, or until the cornbread has set and a toothpick inserted into the center of the skillet comes out clean (if you use a square baking pan, the cooking time may be a bit longer). Cut into 10 wedges, and serve. Leftover bread will keep in a sealed bag or container in the fridge for up to four days, and it can be frozen for up to a month.
As luck would have it, I also had some roasted apple butter on hand (I used this recipe, replaced the butter with Earth Balance, and added some blackstrap molasses in place of sugar–hence the deep dark color!). What a perfectly autumnal pairing.
Yum. This is a perfect snack, a delightful light breakfast, or the ideal side for soup, stew, curries, baked beans, or chili. It’s going to be a regular in my home all through the fall and winter, and I hope it might end up on your table soon, too.
If you make it, I’d love to hear what you think. In the meantime, I’ll see you this weekend for weekend reading, and then for menu plan Monday after that! Enjoy the end of your week.
Soba noodle salads are one of those meals–like curries, grain salads, and tofu scrambles–that I’ve got on my list of super speedy dinner options for weeknights. They’re light but satisfying, and they take so little time to prepare, especially if you’ve got a nice dressing at the ready (and even if you don’t, because whisking a dressing together takes hardly any time). The range of toppings is endless, and you can make them as elaborate or as simple as you like.
This soba salad is relatively simple, a mixture of cooked noodles, steamed edamame (which is optional, but nice for added protein), and raw carrots, cabbage, and red pepper slices. Nothing fancy, but the dressing is delicious, and the addition of fresh basil and cilantro make it particularly flavorful. It was ready in about 30 minutes, which is exactly what I needed dinner to be last night.
When you make it–and I sure hope you do–feel free to modify it a bit based on what you have. It’s also worth saying that, while I love the earthy taste and soft texture of 100% buckwheat noodles, a buckwheat/wheat mixture, rice noodles, udon noodles, and pad thai noodles would all work here, too.
In the past, I’ve always made soba noodle salads with a rice vinegar/sesame oil vinaigrette or an almond/peanut butter sauce (similar to the one I used in these sweet potato noodles). Tahini was a nice change of pace–delicate, yet distinctively nutty.
This is a week full of 30 minute dinners–I whipped up a delicious curry tonight that falls into the same category! I look forward to sharing that soon, as well as a pumpkin skillet cornbread (yum) that’s perfect for enjoying all through the fall.
Can you tell I’m just a *little bit* excited for the change of seasons?
On that note, it’s time to start reviewing for my advanced nutrition class tomorrow. We’re moving from fiber to lipid metabolism, and even though much of it is review from biochem, I’m enjoying it. Even more enjoyable is my human development class; it’s incredible to learn about the nine months of pregnancy, both from a nutritional and epigenetic perspective!
Before I go, a quick note that the lovely Ali of Inspiralized is hosting a giveaway of Food52 Vegan on her blog right now. If you’re curious, she’s also sharing my recipe for French lentil salad with arugula and herbed cashew cheese.
I’m checking in with another glimpse at my weekly batch cooking and menu planning. This week’s plan is simpler than last week’s, mostly because I’ll be eating at home on fewer evenings (I’m traveling to D.C. on Saturday night for my cousin’s baby shower, and on Thursday I’m eating out). The same will be true of the following week; I’ll have my first two midterms, which will mean very simple dinners and hopefully some freezer leftovers.
But I’m getting ahead of myself. Even the busiest weeks–the ones that involve social commitments, traveling, or more work than usual–run more smoothly when you do a little planning. The planning may mean committing to a night of takeout or a frozen meal to give yourself a break from cooking, but that’s a plan nonetheless!
This week, my focus is on having adequate lunch staples ready to go, using freezer leftovers on Friday, and on creating two dinner recipes to carry me from tonight into Wednesday. Here’s what’s on the lineup.
Batch Cooking Staples:
•Quinoa (I’ve made this my batch-cooking grain three weeks in a row, which means I’m overdue for variety! It’s just so darn quick and easy…)
•Great northern beans
•Roasted carrot hummus (one of my favorites!)
•Creamy orange walnut dressing (very healthy and flavorful, and it’s been a while since I made it)
•Easy tahini soba noodle salad (recipe will be on the blog Tuesday)
•Golden butternut squash and chickpea curry (if the recipe turns out well, it’ll be on the blog on Thursday)
And here’s the weekly dinner plan:
Sunday: Leftovers from last week’s polenta casserole / salad Monday: Easy tahini soba noodle salad / steamed or roasted broccoli with creamy orange walnut dressing Tuesday: Golden butternut squash and chickpea curry over brown rice / salad with creamy orange walnut dressing Wednesday (dinner on campus): Curry leftovers over rice / spiralized zucchini and carrot with roasted carrot hummus Thursday: Dinner with Melissa Friday: Defrosted roasted tomato basil soup with rice / toast / salad with simple lemon vinaigrette Saturday: Dinner in D.C.
Should be a tasty five days, and I’m excited to be focusing in on root vegetables and fall flavors. I can’t wait to share the tahini soba salad and the curry with you.
In the meantime, I wish you a very happy start to a new week!
There are new Pop Tarts, and they are Limited Edition. I know this because it says “Limited Edition” in bold red lettering inside a yellow banner that circumscribes the box. For an unspecified but finite amount of time only, Pop Tarts are available in a seasonal palette and flavor: pumpkin pie.
Pumpkin-pie Pop Tarts sound disgusting, it’s true. But I may not have another opportunity to buy them.If panicked urgency isn’t enough to make me buy them, there’s also the appeal of authenticity: They are“made with real nutmeg, cinnamon, and clove.” Just like grandma used to make her Limited Edition Pop Tarts.
Advertisers know that we consumers of food believe that “real” means healthy. To some degree, it used to. “Real” meant whole foods not far removed from the ground, which meant they were less likely to contain added sugar and salt, more likely to contain fiber and deliver nutrients. But “real” has been repurposed by advertising and technophobia, to the point that it’s largely meaningless, if not misleading. Though it does still accomplish the ultimate goal in marketing, to make people feel things.
Kellogg’s spent $32 million last year in advertising Pop Tarts alone. Coca-Cola spent $269 million advertising its flagship product (Coca-Cola). Pepsi spent $150 million just to advertise the brightly colored sugar-water that is Gatorade. It’s the sugar water for people who do sports. These are numbers that Marion Nestle, professor of nutrition, food studies, and public health, highlighted in a lecture at New York University on Thursday night. “Think about what that money could do for education, for social welfare,” Nestle implored. “But that money is spent getting people to buy sugar.”
Effective advertising, Nestle reminds us, is supposed to be subliminal. You aren’t supposed to feel it. In the case of these Pop Tarts, I am meant to feel urgency and trust. The marketing should stop short of saying exactly what the box means to imply: Buy me now. I am wholesome, and I will make you look great. I will make you happy. Yes, happiness exists, and it is I, the Pop Tart.
On Thursday night on the campus of NYU’s Steinhardt School, I listened as four of the eminent professors of food-centric sciences of our time ostensibly told their audience “Why We Eat What We Eat.” The event was in honor of the school’s 125th anniversary. In 1890, it became the first school of pedagogy in New York, predicated on the idea that teachers should have some kind of training. The idea remains unfulfilled in much of the field of nutrition today, where so many people claim expertise.
But Nestle has the bona fides, billed by the university as “one of the world’s most powerful foodies.” Her latest book, Soda Politics, will be published October 5. She was joined on stage by Krishnendu Ray, the chair of her department at NYU, Gordon Shepherd, a distinguished professor of neurobiology at Yale, and Steven Shapin, a distinguished professor of the history of science at Harvard.
Half of our plates should be covered in fruits and vegetables, according to federal nutrition recommendations, Nestle reminded us. She then pulled up a slide showing the money that the government actually gave out from 2008 to 2012: Less than one half of one percent of all agricultural subsidies went to production of fruits and vegetables. Four times as much went to tobacco.
Despite the fact that fruits and vegetables are the only foods that experts encourage us to eat with abandon, all fruits, vegetables, and nuts are considered “specialty crops” by the U.S. Department of Agriculture. Less than five percent of land planted with food goes to growing fruits and vegetables. More than 50 percent goes to growing soybeans and corn, to feed animals and refine into sugar.
“If you go into a supermarket, you see that most of what’s lined up there is to sell sugar,” Shepherd noted. Some of that we pay for directly, and some of it we pay for in taxes that subsidize its production. Shepherd’s neurobiological research has been integral to understanding how the brain processes what we call flavor, which gets lost in the process. It’s a sensation that he says most people wrongly believe is driven by taste, only because taste happens in our mouths, and food goes in our mouths.
Rather, flavor is largely a matter of smell. Shepherd explained the critical role of something called retronasal olfaction, meaning that exhaling air pushes air over the food in a person’s mouth and up into their nasal cavity. From there, sensory signals spread throughout the neocortex, to areas associated with emotion, motivation, language, and more. All of this underlies future cravings. But none of this would happen if you held your breath or nose while eating. You taste almost nothing. You look childish.
The sensation of flavor is created when retronasal olfaction is augmented by taste and the other senses: The mechanical senses of texture and motion from the tongue, the appearance of food, and the sounds of crunching or sipping. Our brains evolved to what they are because of the flavors that drove us to consume certain foods, and the increasing capacity of our brains to appreciate flavors led us in agricultural directions that shaped politics, economics, and ecology. Still few of us, he believes, appreciate flavor.
“Very few of us ever taste real, flavorful food,” Shepherd said, disconcerted. He speaks with the empiricism of a neurobiologist rather than the elitism of a foodie, so it’s not off-putting. “Unless you go to a market in the summer and find produce that was grown locally and not flown in from Chile, you have never tasted things at their full flavor.” And he means it as a potentially consequential public-health issue. If people had easy access to that kind of flavor, how many people might choose to eat healthier foods and then, you know, become healthy.
When Shapin, whose expertise is in the sociology of knowledge itself, took his turn at the lectern, he apologized for his lack of Powerpoint. “I have no pictures for you. I couldn’t think of any pictures,” he said, in a stern tone that felt almost like a scolding. He has the moustache and countenance of Sam Elliott, if Sam Elliott lived in Boston, did all of his family’s cooking, and wrote a book called A Social History of Truth. “I couldn’t think of any bullet points,” he grumbled extemporaneously. “And that’s not for lack of imagination. ‘Why do we eat what we eat?’ To respect that question is to respect its staggering complexity. The question presupposes choice. For most of human history, the overwhelming majority of people did not have choice. At present, very many people do not have choice.”
That lack of choice is what led Nestle, who entered academia with a Ph.D. in molecular biology, to become a professor of sociology (among her other titles). It became clear to her that the most urgent barriers to a just American food experience were not matters of metabolism, but of access and inequality, of the politics of lobbying, of the language of marketing, and of the deeply funded and subsidized, strategically crafted emotional appeal of Pop Tarts.
Happy Saturday, folks! I’m getting weekend reading up a little early today in preparation of a busy two days ahead of me. This week has flown by, a combination of book excitement, some new nutrition client sign-ups, and my first set of exams for school around the corner (boy, those arrived fast).
But I haven’t been too busy to notice a few wonderful recipes from fellow bloggers.
Baking season is here, and Nicole’s lovely masala chai carrot muffins look like a perfect way to celebrate. What a great flavor pairing–and they’re gluten free, oil free, and vegan to boot.
They say a picture is worth a thousand words, and this particular image is enough to make me want to dive into Queen Sashy’s gorgeous mung bean salad with lemon zhoung vinaigrette. But the writing on Three Little Halves is always as rich as the images, and this post is no exception.
For dessert, I’m drooling over these pumpkin seed buttercups from So Munch Love. Just replace the butter with Earth Balance or coconut oil to create bite-sized vegan decadence!
1. I absolutely loved this article, written by a biology professor, about the lost art of drawing and illustration. The author, Jennifer Landin, has incorporated drawing into her class with wonderful interdisciplinary results, and I love the way she articulates how and why the skill has enriched her students’ experience.
2. Andrew Weil shares his perspective on why he loves to cook. So much of it resonated with me, but especially his statement that cooking is a meditative experience for him. He elaborates, saying
“…By that I mean that cooking gives you a chance to practice the esoteric art of manifestation — bringing something from the imagination into physical reality. You picture a perfect dish in your mind, not just its appearance but also its aroma, taste, and mouth feel. The challenge is to create in your kitchen a product that replicates as exactly as possible the one in your mind. Following recipes may help you as you begin this practice, but with experience, you should be able to free yourself from them and feel more confident about tweaking them, improvising, and creating ones of your own.”
Cooking has been an important part of my life since my mid-twenties, but during my post-bacc it became a kind of lifeline. It was both meditative–a chance to escape the stress and tedium of my coursework–and also a precious means of expressing creativity, which was not flourishing at that time in my life. I’m no longer as unhappy or stymied as I was back then, but cooking remains my main creative outlet and one of my most essential means of managing stress.
3. It’s a common assumption that low-income families consume a disproportionate amount of fast food–and it’s a false assumption. This article in The Atlantic breaks down the facts.
4. It’s titled “The Age of Loneliness,” but this thoughtful article is mostly a meditation on our relationship with nature in an increasingly manmade, technology-driven era–the era that many now label as the “Anthropocene.”
5. Monique of Ambitious Kitchen wrote an honest, heartfelt post this week about what she’s learned in four years of blogging–years that have included such tumultuous life experiences as grieving for a lost parent and struggling with an eating disorder. I really liked her thoughts on authenticity, on developing a healthful, heart-centered relationship with food/eating, and on the willingness to be vulnerable and real (which is, for me, what the most meaningful moments of blogging are all about). Congrats to Monique for her blog-iversary, and I hope that her post inspires anyone who’s thinking about starting a blog–or feeling “stuck” with with an existing blog–to dive in with passion.
On that note, I’m about to dive into a few less soulful projects than blogging, but I look forward to seeing you on Monday with my weekly vegan menu plan!
I like to think of this creamy, flavorful tomato basil soup as being a perfect “transition recipe”–a meal that can be carried easily from summer to into fall. Roasting the tomatoes for the soup brings out so much of their natural sweetness and depth of flavor, and the pureed soup that results is quintessentially summery.
At this point, it’s delightful on its own, but when I made the soup last weekend, I wanted to create something that was a little heartier than traditional tomato soup. I stirred in some cooked rice, and it turned out to be a felicitous addition. The result was a bowl that has the creaminess and bright flavor of roasted tomato soup, and the thick texture and stick-to-your-ribs appeal of an autumn stew; a soup that can serve as a meal, in other words.
Some tomato and rice soup recipes call for cooking the rice directly in the soup. I like the idea of this, and I’ll definitely try it in the future, but for this batch the rice was a game time decision: I had leftover basmati rice in the fridge that was begging to be eaten up.
You can use any leftover cooked grain in this recipe: barley and farro would be incredible, as would cooked quinoa or millet for a less chewy texture.
One of the nice bonuses of stirring in the cooked grain is not only a little extra nutrition and staying power, but also that the grains will help the soup to thicken up. This is especially true when you enjoy the leftovers (and the batch makes 6 servings, so hopefully there will be at least a few leftover portions for you to savor!). It’s a perfect soup for batch cooking and freezing.
With all of this said, you can create a lighter soup by leaving the rice out altogether, and enjoy the tomato flavors on their own. Here’s the recipe.
1 1/2 cups cooked white or brown rice (or cooked quinoa, barley, farro, or millet), optional
Preheat your oven to 400F. Place the tomatoes, cut side up, onto two large, foil- or parchment-lined baking sheets (a shallow casserole dish will also work well). Drizzle them evenly with two tablespoons of olive oil and then use your hands to coat them well. Sprinkle them generously with coarse salt and then a pinch of black pepper. Nestle the garlic cloves in between the tomatoes. Roast the tomatoes for 50 minutes, or until they’re browning and juicy. Remove them from the oven and set aside.
Heat the remaining half tablespoon of oil in a large Dutch oven or pot over medium high heat. Add the onions, along with a liberal pinch of salt and a tablespoon of sugar (if using — the sugar will help them to caramelize and also to mellow the acidity of the tomatoes). Saute for 10-12 minutes, or until the onions are golden, adding a few tablespoons of water as needed to prevent sticking.
Add the tomatoes, along with all of their roasting juices, to the pot, along with 3 cups of the vegetable broth and thyme. Mash the tomatoes up a bit with the back of a spoon to help release their liquid. Bring the whole mixture to a boil and reduce to a simmer. Simmer, uncovered, for 15 minutes.
Transfer the soup in batches to a blender, along with the basil, and puree till very smooth, or use an immersion blender to puree it. When it’s well pureed, return the soup to the pot. Check it for seasoning and add extra salt and black pepper to taste (I added an extra 1/4 teaspoon salt to the soup). Also check the soup’s consistency, and add the remaining cup of broth if needed–I like a thicker soup, but it shouldn’t look like marinara sauce. Finally, stir in the rice if using.
Divide soup into bowls and garnish with a drizzle of olive oil and a few basil leaves. Serve. Leftover soup will keep for up to five days, and it can be frozen for up to two months.
Steven dubbed this the “perfect fall soup”–he said it was hearty without feeling like a full on winter stew, which is exactly what I was going for.
He thought that toast was mandatory even in spite of the rice addition, which I understand: there’s just something about tomato soup and toast.
No matter how you serve it–with or without rice, with or without toast, as an appetizer or as a main–you’ll love the combination of sweet roasted tomato and garlic, all highlighted by the peppery basil. I hope you enjoy it.
On that note, I’m wrapping up a busy week of school and celebration of Food52 Vegan! Thank you for all of the support you’ve given the book; it means a lot to me. I look forward to seeing you all over the weekend for a new weekend reading.
In what appears to be his authentic OKCupid profile (recently deactivated), the 32-year-old New York entrepreneur Martin Shkreli listed his income at more than one-million dollars. If you were a suitor, and the seven figures were not the first thing you noticed, you might also notice his eyes, attitude, and confidence. Those were, at least, the three things listed under “Things People Usually Notice About Me.”
A fourth thing might be that he is the face of unapologetic profiteering from the suffering of humans. As CEO of Turing Pharmaceuticals, he acquired an anti-parasite medication called Daraprim and immediately increased the price from roughly $13.50 to $750. In the last 72 hours since that made national news, Shkreli’s attitude and confidence have been duly noticed, reminding Americans that we live in the only country where drug companies set their own prices for life-saving medications. His confidence is the kind of confidence that manifests as Burberry polo shirts and semi-ironic emulation of Flo Rida; conspicuous consumption that does not play well to those suffering toxoplasmosis-induced seizures, preventable with Daraprim.
With an easily dislikeable villain comes an easy shift in the national conversation toward pharmaceutical prices and predatory practices that exploit the sick. Because Shkreli has been called a “morally bankrupt sociopath,” a “garbage monster,” and “everything that is wrong with capitalism,” people have noticed the ground on which he stands. Also, his eyes. The question in both cases is what’s to be done about them.
For 72 hours, Shkreli’s response was well encapsulated in his tweet that said the media can have his middle finger. And then on Tuesday night, he did what no one expected: He stopped antagonizing his antagonists. He even locked his Twitter account, making it private. Shkreli gave one final interview to NBC News, in which he appeared to have conceded slightly in a passive-voice apology, saying, “I think that it makes sense to lower the price in response to the anger that was felt by people.” He did not specify the extent of that lowering, only that it might make sense to have “an affordable price.” He did manage to get headlines this morning to say that he had reconsidered, implying that he has a heart, or is at least responsive to public outrage. That remains to be seen, though it would be a small victory.
Shkreli already considered the price increase to $750 to be “not excessive at all.” Daraprim treats toxoplasmosis, which kills people with weakened immune systems, as in AIDS and during chemotherapy. The parasite Toxoplasmosis gondii lives inside of one third of all people, in little cysts that go unnoticed because they are quarantined in our brains and livers by our immune systems. When those defenses deteriorate, though, the parasite is unleashed and attacks the brain and eyes of its host, resulting in blindness, seizures, and loss of cognitive faculties. One study found that toxoplasmosis encephalitis affected 25 percent of AIDS patients, of which it killed 84 percent.
“I can see how it looks greedy,” Shkreli told CBS’s Don Dahler on Tuesday morning, after multiple infectious-disease specialists protested that the 5,500 percent price increase would make treatment unavailable to many people in dire need. “But,” he continued, “it actually has a lot of altruistic properties.”
“Altruistic?” Dahler raised both eyebrows.
“This is a disease where there hasn’t been one pharmaceutical company focused on it for 70 years,” Shkreli continued, the corners of his mouth angled upward. “We’re now a company that is dedicated to the treatment and cure of toxoplasmosis. And with these new profits we can spend all of that upside on these patients who sorely need a new drug, in my opinion.”
Of course, pyrimethamine (Daraprim) is usually an effective treatment for toxoplasmosis. The “we need to subsidize research” explanation is the important part of his argument, and this entire story. That’s the standard defense pharmaceutical companies use to justify high prices. And it almost makes sense.
Medical research is extremely expensive. Except that most of the key innovation is still coming from academic medical centers, funded by taxpayers. Pharmaceutical companies then take that innovation and turn it into a marketable product. That costs money, but not billions of dollars. How anything could justify a drug costing hundreds or thousands of dollars—in the case of the hepatitis C medication Sovaldi, which costs $84,000 for a 12-week course of treatment—while still clearing a 30-percent industry-wide profit margin is difficult to conceive. It might be easier to conceive if budgets were transparent. But, as Gregg Gonsalves, co-director of the Global Health Justice Partnership at Yale Law School emphasized to me, no major pharmaceutical company has ever been willing to disclose how much it actually spends on research and development.
Speaking Wednesday morning in Des Moines, Hillary Clinton shared her outrage over the Shkreli story, emphasizing her plan to implement a $250 cap on out-of-pocket payments for prescription medications. As long as medication costs remain high, though, that simply means that other Americans will be paying for those drugs, either through taxes or increased insurance premiums.
“We’re going to start holding the drug companies accountable to drive down the prices,” Clinton added. That will be more difficult. The power of pharmaceutical-industry lobbying kept price controls out of the Affordable Care Act. Even the power to negotiate prices and to create price competition between alternative products did not make it into the Affordable Care Act. Clinton’s plan would allow Medicare to negotiate for lower prices on medications and increase competition for generic versions of medications, which Medicare could do because of its substantial purchasing power. As it stands, a pharmaceutical company names its price, and it has at least 49 million older Americans, covered by Medicare, for whom the program (taxpayers) must pay that price. But even if allowance for price negotiation could get past lobbying interests, the remainder of the fragmented American health-care system would be left with little power to negotiate.
Clinton would also end tax breaks for televised advertising and require at least some investment in research and development by companies that are subsidized by tax money. By which she means directly subsidized, as opposed to subsidized by way of collaboration with subsidized academic medical centers.
The response of the pharmaceutical industry was predictable to the letter: “Secretary Clinton’s proposal would turn back the clock on medical innovation and halt progress against the diseases that patients fear most,” said John Castellani, head of the Pharmaceutical Research and Manufacturers of America. The argument is that competition in the industry would stifle innovation, which made sense to me in little more than syntax. Rather, as more generic competitors enter the market, prices do go down. More tax money can be directed to academic medical centers where scientific enterprise can flourish unencumbered by a need to work solely toward a marketable end product.
But how is it that a company can charge $750 for a medication when the patent expired decades ago?
I asked Alfred Engleberg, a patent attorney for whom the Engelberg Center on Innovation and Law Policy at NYU is named. He worked for decades challenging patents on behalf of generic-medication manufacturers. Engleberg does believe the Daraprim price increase is the direct result of the supply and demand problem, in that over the last decade the number of companies producing any given medication has fallen significantly, due to mergers and business failures. It takes two to three years and costs around $1 million to gain approval for a generic drug, assuming you can find a source of manufacture for the active ingredient, he explained.Many drugs are down to three or fewer manufacturers, creating oligopolies. When one or two of those competitors has a raw material interruption, an FDA-compliance problem, or for any other reason decides to stop producing the drug, a monopoly results. The company can charge anything it wants.
“A new breed of greedy CEOs is taking advantage of the rules of capitalism to make a killing,” Engelberg said. He explains that it’s simply not worth the investment for most companies to take up a low-volume drug that sells at a low price. Daraprim was a low-volume drug selling at a low price. If another company wants to start selling generic pyrimethamine, it could drive the price of brand-name Daraprim back down. But that generic company wouldn’t make much money, so why bother?
What can be done? Stop the mergers, Engelberg implores. It is when profits erode on established products due to competition that businesses will seriously invest in innovation; not when they are thriving monopolies. Loosen the regulatory process to make it possible for drugs approved in Europe, India, and elsewhere to be rapidly approved in the U.S. on a reciprocity basis to alleviate shortages or price gouging. Clinton’s plan does allow for this.
Shkreli was born in Brooklyn in 1983, according to The New York Times, but he may just as well be an imagined manifestation of national guilt over a broken health-care system, broken largely because of the costs of medications. The little red guy with a pitchfork on our collective arthritic shoulder, Shkreli is a product, not a cause. Defeating him is treating a symptom, not creating a cure. In mocking his hubris we mock a person for operating within a system that we created and continue to subsidize. It took a firestorm of public outrage stoked by every national news outlet and multiple presidential candidates to get Shkreli to remit. But there are many more Shkrelis, and there will continue to be more Shkrelis.
Last year at exactly this time, my small, New York City kitchen was a busy place. I was wrapping up all of the recipe development for Food52 Vegan at a record speed (most of it happened over the course of 6 weeks). Steven and I were awash in food, from butternut squash mac n’ cheese to vegan pot pie to mushroom lentil burgers. At any given moment, the oddest assortment of dishes could be found in the fridge–though, as anyone who’s tested recipes for a cookbook can tell you, we were also woefully and chronically short of useful grocery staples. It was culinary chaos, a blur of baking and sautéing and whisking and blending, and I loved every moment of it. (Well, almost every moment–my two failed pot pies weren’t exactly a high point.)
Food52 Vegan comes out today, and I’m so happy to be welcoming it into the world. I’m not always great about taking ownership of projects, but I’m proud of this book–not because of any one recipe or image or bit of text, but because I think that writing it made me a better cook.
As I’ve mentioned before, I didn’t grow up cooking. It wasn’t a big deal in my home–my hard-working single mom always got dinner on the table, but she didn’t always have energy to focus on the cooking process, or hand it down to me–and my anorexia got in the way of many of the years in which I might have been learning to feed myself. It really wasn’t until after I went vegan, and developed an interest in exploring vegan recipes, that I taught myself to cook.
Choosing Raw has really served as a chronicle of my growth as a cook. As you can see, my “style” now is very different and far-reaching than it was when I started blogging, for a variety of reasons, even if many of my favorite recipes and techniques have stayed the same. I don’t think that this new cookbook would have been possible without the years of exploration and culinary adventuring that I’ve shared with all of you, recipe by recipe.
When I look through the pages of Food52 Vegan, and I peruse such recipes as kabocha and tofu curry, spicy harissa mayonnaise, or millet tagine with eggplant and preserved lemon, I see flavor combinations and recipe ideas that I never would have tried even a few years ago. None of it would have been possible had I not had the incredible gift in my life of this passionate, food-loving community.
So, readers, thank you for helping me to grow, to expand my timid palate, to try new things, and to embrace an ever-evolving identity with food and cooking. I hope that this new cookbook will excite you, and that you’ll perhaps try and love and keep close to you some of the recipes. As you can see, they include such tasty highlights as a butternut squash mac n’ cheese, French lentil and arugula salad with herbed cashew cheese, gingered carrot bisque, kabocha and kale salad, go-to pancakes, chai spiced bread pudding, and vegan chocolate cake with “ganache” filling. All 100% vegan, often gluten free, and always gluten free optional.
In celebration of the book’s publication today, here’s a recipe to start with. It’s one of my favorites from the book, and it is a delightful dinner recipe to make for yourself, your family, and/or friends. It features hearty oyster mushrooms and spicy roasted cauliflower, and–if you can resist nibbling up all of the cauliflower before you plate the tacos–I think you’ll love it.
Cauliflower and Oyster Mushroom Tacos from Food52 Vegan (gluten free)
Yield: 4 servings
1 head cauliflower, cut into small florets (6 to 8 cups/600 to 800g)
4 tablespoons (60ml) olive oil
1 tablespoon chili powder
1 tablespoon smoked paprika
1 teaspoon ground coriander
1?2 teaspoon ground cumin
Pinch of red pepper flakes
Salt and pepper
1 cup (115g) thinly sliced Vidalia or Spanish onion
1 large or 2 small poblano chiles, thinly sliced
1?2 cup (75g) chopped red bell pepper
1 clove garlic, minced
6 ounces (170g) oyster mushrooms, thinly sliced
2 teaspoons freshly squeezed lime juice
8 (6-inch/15cm) crisp corn tortillas
1?2 cup (20g) chopped fresh cilantro, for garnish
Preheat the oven to 425°F (220°C).
In a large bowl, toss the cauliflower florets with 2 tablespoons of the olive oil until evenly coated. Sprinkle with the chili powder, paprika, coriander, cumin, red pepper flakes, and a generous pinch of salt. Toss again until the cauliflower is evenly coated. Spread the cauliflower on a rimmed baking sheet. Bake for 20 minutes, until crispy.
Heat the remaining 2 tablespoons of olive oil in a large skillet over medium heat. Add the onion, poblano, and red bell pepper and sauté until the onion is tender and a bit golden, about 15 minutes. Add the garlic and sauté for another minute. Stir in the mushrooms, then season with salt and pepper. Cook until the mushrooms are tender and crispy (5 to 8 minutes). Remove from the heat and stir in the lime juice. Taste and adjust the seasonings as desired.
For each taco, put 1/4 cup (60ml) of the mushroom mixture in a tortilla. Top with some of the roasted cauliflower and a tablespoonful of cilantro.
For more of my thoughts on how Food52 Vegan made me a better cook, check out my post today on the Food52 site. And I hope you won’t mind my sharing some fun news of the book’s publication this month. If you do get the book and try a recipe, I’d love to see it! You can tag me and use the #f52vegan hashtag to share your creations.