ACG Culinary Connections Collection

Gastronomy and GI:

the Culinary Connections Collection From the pages of ACG MAGAZINE

Edited by: Christina A. Tennyson, MD, Alexander Perelman, DO, and Vani Paleti, MD

Contents Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Good for The Gut and The Soul . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Cultural Perspectives to Inform Your Palate

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warm and wonderful . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Spring Into Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Farm Fresh from the Farmer’s Market . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

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Contributors Chau Che, MD Dr. Che is a gastroenterologist at Temple Health in Philadelphia, PA, with a passion for the intersection between cooking, eating, and GI, and is a member of the ACG Women in GI Committee.

Edwin K. McDonald, IV, MD Dr. McDonald is Assistant Professor of Medicine at the University of Chicago Department of Medicine. He completed culinary training as a chef and his interests focus on improving health through nutrition education.

Jonathan A. Erber, MD Dr. Erber is a private practice gastroenterologist in Brooklyn, NY, with interests in endoscopy, colorectal cancer, inflammatory bowel disease, and celiac disease.

Vani Paleti, MD Dr. Paleti is a gastroenterologist at Baylor Scott & White Health who is a Diplomate in Lifestyle Medicine from the American Board of Lifestyle Medicine and in Obesity Medicine from the Obesity Medicine Association. She is also a certified plant-based culinary coach and is currently getting certified in Culinary Medicine.

James D. Haddad, MD, FACP Dr. Haddad is a GI fellow at University of Texas Southwestern Medical Center, pursuing a career in interventional endoscopy. He is a U.S. Navy veteran.

Magnus Halland, MD, PhD, MPH, FRACP Dr. Halland is a consulting gastroenterologist at Mayo Clinic with an interest in esophageal diseases and plant-focused nutrition.

Victoria A. Jaeger, DO Dr. Jaeger is a second-year GI fellow at Baylor Scott & White Health in Temple, TX.

Parastoo Jangouk, MD Dr. Jangouk is a gastroenterologist and certified trauma-informed wellness coach who practices at Austin Gastroenterology in Austin, TX.

Janese S. Laster, MD Dr. Laster is a private practice gastroenterologist in Washington, DC, and is board-certified in internal medicine, gastroenterology, obesity medicine, and nutrition.

Dale Lee, MD, MSCE Dr. Lee is Medical Director of Clinical Nutrition, Director of the Celiac Disease Program, and Associate Professor at Seattle Children’s Hospital.

Alexander Perelman, DO, MS Dr. Perelman practices at Vanguard Gastroenterology in New York, NY. He is a member of the ACG Professionalism Committee.

Tatiana Policarpo, MD Dr. Policarpo is a first-year gastroenterology fellow at Thomas Jefferson Hospital in Philadelphia, PA.

Supriya Rao, MD Dr. Rao is a gastroenterologist and obesity medicine specialist at Integrated Gastroenterology Consultants in North Chelmsford, MA, and is a Diplomate of the American College of Lifestyle Medicine.

Jordan M. Shapiro, MD Dr. Shapiro is an Assistant Professor of Gastroenterology at Baylor College of Medicine in Houston, TX, where he specializes in the transition from pediatric to adult care.

Christina A. Tennyson, MD Dr. Tennyson is a gastroenterologist at Augusta Health Gastroenterology in Fishersville, VA. She is a Diplomate of the American College of Lifestyle Medicine, a Physician Nutrition Specialist, and is trained in culinary coaching.

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Foreword Gastronomy and GI: the Culinary Connections Collection WHEN THE COVID-19 PANDEMIC BEGAN, the lives of gastroenterologists were disrupted. Elective endoscopic procedures were canceled, in office patient visits were converted to telehealth visits, and physicians assisted in other areas. During this isolating and difficult time, gastroenterologists found opportunities to connect with colleagues virtually including on social media via #GiTwitter. We regularly shared our day-to-day struggles and successes. During lockdowns, cooking at home became a part of our collective experience and something many enjoyed. Through the use of social media, we learned tips, supported each other, and frequently exchanged recipes. Our connections with each other grew and we formed a community of gastroenterologists interested in gastronomy.

According to the Oxford English dictionary, gastronomy is the “practice or art of choosing, cooking, and eating good food.” Gastronomy incorporates and celebrates different cultures and traditions. As gastroenterologists, we appreciate the importance of diet for health and we are learning more about the effects of food on the microbiome.

ACG has supported our community of gastroenterologists with a recurring series called Culinary Connections in ACG MAGAZINE. The series has featured gastroenterologists sharing personal stories about their culinary experiences and providing a favorite recipe. Contributors have been from diverse backgrounds and in various stages of their careers. This series has expanded our understanding of others in our field and has provided flavors to savor!

Thank you to all who have contributed to the series and have made it a success. This e-book includes a compilation of delicious and plant-forward recipes from the Culinary Connections series. We invite you to explore these recipes and share them with your patients and colleagues. Consider contributing your own culinary pursuits by using the #ACGfoodies on social media or by writing an article to a future issue.

Bon appetit!

Christina, Alex, and Vani

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Culinary Connections:

Good for the and the Gut Soul

By Vani Paleti, MD, Alexander Perelman, DO, Christina A. Tennyson, MD

 FOOD IS EMOTIONAL; FOR SOME, IT'S AN AMALGAM OF VARYING EMOTIONS. From the time we are born, our life’s journey and experiences are intricately connected to food. What we eat and how we eat influences our physical health, mental health (gutbrain connection), and general well-being.

Food has also provided a way to connect with others and develop a community.

During the pandemic, as a community of gastroenterologists, we have been able to celebrate and support each other through our love of food.

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VANI PALETI, MD

Baylor Scott & White Health, Killeen, TX

All of my childhood happy memories revolve around food and fresh produce.

I have vivid memories of walking the bustling streets of Kothaval Chavadi, one of the largest fresh fruit and vegetable markets in Chennai, India.

Bargaining with vendors for fresh fruits and vegetables was second nature. I started learning basic cooking and knife skills, helping my full-time, working mother of four. It started with cleaning and the simple chopping of vegetables in third grade to weekly meal prep by middle school. During summer holidays, we were assigned a small patch to grow vegetables and herbs. This laid the foundation for my love for gardening vegetables and herbs at home. Like all mothers and grandmothers, my mom taught me her home remedies, including those for a simple cough or a starchy fermented broth after a bout of viral gastroenteritis. Family and friends gathered around home-cooked meals and shared whatever food we had at home. We connected and bonded over the dinner table at the end of the day and during festivals.

As a medical resident, a GI fellow asked why I wanted to study gastroenterology. I explained my interest in several organs working in harmony with the sole purpose of digesting food, eliminating toxins, and nourishing our bodies. A disease affecting any of one of these processes can cause a myriad of gut health issues. An optimally functioning GI tract goes a long way in disease prevention and recovery from illnesses.

This, in addition to the procedural aspect of the field, sparked my interest.

Our changing world and fast-paced culture are fueled by highly processed and refined foods. This contributes to increasing numbers of preventable chronic medical illnesses, a leading cause of morbidity and mortality.

As physicians, we need to be more involved and lead the change towards healthier lifestyle choices. I am certified in obesity medicine, lifestyle medicine, plant-based nutrition, and am currently completing culinary medicine certification to focus on integrative approaches to meet the needs of our patients.

I want to bring awareness to healthy food choices and how to best incorporate sustainable, cost-effective foods, particularly for patients affected by food deserts and food insecurity.

Social media has offered me a platform

g

SUMMERY SALAD – 1 servin  Ingredients

• 1 cup baby kale • ½ cup cooked or canned chickpeas

into • 1 medium cucumber, cut es cub ½ inch half • 7 cherry tomatoes, sliced in led pee • 1 small sweet orange, • ½ green or red bell pepper, cut into ½ inch cubes d • 10 pitted green olives, slice in half • ½ tablespoon lime juice • Salt and pepper, to taste

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 Steps

minutes 1. Massage baby kale for 1-2 erness) bitt s ove (rem s ertip with fing e for 1 rins as, 2. If using canned chickpe salt ss exce minute to remove in a large 3. Combine all ingredients salad bowl, toss gently juice 4. Mix in ½ tablespoon of lime flavors) y tang like you if e mor d (ad nd 5. Add salt and freshly grou mill, to per pep a from peppercorn e tast

I eat it) or Note: Can be served as-is (how ice (be cho r served with dressing of you ) ries mindful of added calo

to express my love for gardening, sharing healthy recipes and educating communities with evidence-based gut health information. In 2020 during the pandemic, I shared on Instagram (@gastromom_md), 50 simple and healthy #planter2table recipes using herbs, vegetables, and greens from my backyard planter garden. I was warmly surprised to meet a like-minded GI Twitter family involved in evidence-based, integrative, and holistic approaches to GI practice, alongside a neverending love for food and the nuances of cultural aspects connected to food.

Enjoy This “Plant-Forward” Salad I would like to share one of my favorite simple, plant-forward salads loaded with plant protein and prebiotics, just in time for summer. I usually use kale, cucumber, tomatoes, and bell pepper from the backyard planter garden.

ALEXANDER PERELMAN, DO

Vanguard Gastroenterology, New York, NY

I’m sure we have all at some point lived this moment: during a long shift, the attending opened the door to “paradise,” also known as the attending lounge. As the K-cups poured and the over-processed snacks filled our bellies, the air was filled with stories of life outside of the hospital. It was never about the bad coffee or snacks; it was about community.

Breaking bread has always been about the duality of food; it serves the nutritional needs of the body while nurturing the relationships built around the table. From the ancient Qesem Cave near Tel Aviv to the schoolyard snack exchanges, food continues to connect us.

When I started sharing my food with the world on social media, I found so many who share my love of cooking.

On social media there is a wonderful niche community of physicians and clinicians that

enjoy spending time in the kitchen and garden, exploring the culinary arts while building bonds with their kids, partners, and friends.

Before We Break Bread, We Must Bake Bread One of the relationships I formed through the online community of physicians and clinicians who cook started when, just before the pandemic, I expressed a desire to learn breadmaking. I was inspired by beautiful artisanal breads and an episode of Michael Pollan’s Cooked. I tried my hand with a sourdough starter, without success. After it failed to take hold, Dr. Dmitriy Kedrin (@GI_Pearls) offered to send me some of his, and the rest was history. I spent the last year working on my recipe for sourdough bread, kneading it to perfection, folding and resting it. I woke to feed it early and make sure the temperature was just right. Yet, with my recent move, the starter died. I began again, with a

goal to share the journey with you to contribute to our cooking community, by nurturing the spirit and providing sustenance. After all, before we break bread, we must bake bread.

My bread started with the leavening agent; in regular bread, this is commercially available yeast, while in sourdough we utilize naturally occurring yeast. Typically, this is done by combining flour and water, allowing the natural yeast in flour to take hold. I prefer sourdough with its tangy flavor and more natural feel. It takes about a week to cultivate a starter and bring it to baking shape. If you’re not in the mood or are short for time, a local bakery will often gladly share some of its active starter. The good part is that once it is active, it is resilient and can last for years and even generations; just remember to feed it!

Since food is for sharing, when baking I always make two loaves: one for home and one for loved ones. The process, as you’ll see in the recipe, takes about a day but the end result

SOURDOUGH BREAD – 1 loaf (for 2  Ingredients

• 3 cups + 2 Tbsp (500 g) allpurpose/bread flour

• 1 ½ cups (375g) water • ½ Tbsp (10g) salt • ½ cup (125 g) starter

 Steps 1. Combine water and starter in a bowl, mix, then add flour

is incredibly worth it. The bread doesn’t always rise as high and the holes are not always perfect, but the reward is a chance to sit down at the table with family and fresh bread and share a moment. Take a look at the recipe and give it a try. When it cools, slice, break, share, and most of all, enjoy! Let me know how it comes out (@ PerelmansPearls).

CHRISTINA A. TENNYSON, MD

Indiana University Health, Muncie, IN (locum tenens)

I grew up in a primarily Italian-American family where food is of the utmost importance. Food is a way for our family to connect, care for each other, and to celebrate. It has also been a way for me to do all of these things with my patients and my family of gastroenterology colleagues, particularly during the pandemic.

My interest in food and nutrition led me to a career in gastroenterology. During

loaves, double amounts) 6. After the 6 rests, allow dough to proof at room temperature for 90 minutes.

7. Place the dough on a floured surface and knead a bit to “knock back” the air inside.

8. If making two loaves, this is the time to divide the dough.

4. Dissolve salt in a small amount of water and add to dough, kneading for 5-10 minutes

9. Make a final fold to shape the dough and place in a well-floured proofing basket. Cover with a towel or parchment paper and place in the fridge. If you don’t have a proofing basket, you can line a large bowl with a towel and flour it generously.

10. Proof for around 12 hours in the fridge, less if at a higher temperature 11. Remove bread from the refrigerato r, allowing it to come closer to room temperature

5. Rest the dough for 5-6 30-minute intervals, folding the dough on itself each 30 minutes. Pull the dough up and fold over, rotate the bowl 90°, and repeat for each corner

12. While bread comes to temperature, preheat the oven to 450°F, placing a pot of water on the lower shelf, and the vessel you plan to bake in inside on the shelf above the pot of water

2. Once combined, slowly mix by hand or use a mixer with a bread hook for ~10 minutes until you reach a smooth, stretchy consistency 3. Cover bowl with a damp towel and rest for 30 minutes, covered by a moist towel (Autolyse)

13. After the oven is preheated, transfer the dough to the baking pan (I use parchment paper to line it, but you can use cornstarch as well) 14. Score the dough lightly with a knife and place in the pan in the oven 15. Bake at 450°F for 30 minutes, then decrease to 425°F and cook for 20-30 minutes longer. Avoid opening the oven to check on the bread 16. Once cooked, rest for 1 hour and enjoy. Feel free to preslice and freeze; toasting lightly will bring it back to a “fresh-baked” state  Remember to feed the starter! 1 cup flour and ⅔ cup water weekly if kept in the fridge. Remove from fridge the day before baking and feed as just instructed.

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fellowship, I incorporated rotations on the nutrition support service and intestinal transplant team, later receiving certification as a physician nutrition specialist. After fellowship, I found treating and educating patients with celiac disease highly rewarding, especially working at a center as part of a team with experienced registered dietitian Suzanne Simpson. She taught me about the struggles of living with celiac disease, how it impacted my patients’ lives, and the importance of having patients learn to cook nutritious food. I subsequently worked in a New York City community gastroenterology practice and later performed locum tenens work in rural locations. These experiences gave me a deeper understanding of food, food systems, and introduced me to delicious foods across the country.

At the same time, as my own family enjoyed food (and often lots of it) we experienced heart disease, diabetes, cancers, and obesity, like many other families. As a working mom to three young children, I’ve also struggled cooking healthy meals, particularly ones that everyone would eat! I developed

POLENTA WITH GREENS, BEANS,  Ingredients

• 4 cloves garlic, minced • 2 cloves garlic, thinly sliced • 1 medium onion, finely chopped • 2 cans (28 oz.) crushed tomatoes • 2 cups cooked cannellini white beans (or 16 oz. can, rinsed)

an interest in lifestyle, integrative, and culinary medicine, eventually completing additional training and certification in these areas.

We need to not only take care of our patients but also ourselves and our families. There are numerous advantages to eating fewer processed foods and more diverse whole plant foods. This can be achieved without spending a lot of money, being overly restrictive, or having to adopt a completely vegan or vegetarian diet. This benefits our microbiota and decreases the risks of other common diseases, including colon cancer and fatty liver disease. We have a small amount of time with our patients and we need to empower them to make significant lifestyle changes. This can start with small steps, support, and developing healthy, delicious alternatives. As gastroenterologists, we are best equipped to help patients when we make positive changes and learn to cook for ourselves.

During the pandemic, we have connected with like-minded gastroenterology colleagues, registered dietitians, and patient

 Sauce

1. Add 3 tablespoons olive oil to a saucepan over medium heat and add the onion. Cook until translucent, approximately 5 minutes. Add 2 cloves of thinly sliced garlic and cook for another 3 minutes 2. Add 2 cans crushed tomatoes and 2 teaspoons of basil, then stir 3. Bring to a simmer and then reduce heat to low

• 1 cup polenta • Olive oil, basil, salt, pepper, crushed red

4. Stir occasionally until thickened, approximately 45-60 minutes

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CONNECTING, CARING, AND CELEBRATING During the COVID-19 pandemic, food has provided a way to connect, care for each other, and celebrate in an otherwise bleak time. Thank you to ACG for giving the three of us the opportunity and platform to share our love for food and all things gastronomical with our gastroenterology community. We look forward to bringing delicious and healthy foods from all parts of the world and invite you to connect with us! #ACGfoodies Have a personal connection with GI and gastronomy? Contact ACG at acgmag@ gi.org to share your story with the ACG community.

AND SAUCE – 2 servings

• 2 heads Tuscan kale, stems removed, chopped

pepper

advocates virtually, particularly with the use of #GITwitter. As a global community, we have shared healthy recipes, conducted challenges to eat at least 30 plants per week, encouraged each others’ indoor and outdoor gardens, and—most importantly— had fun! Like in my Italian-American family, food is of the utmost importance for our GI family and can improve our own health and the health of our patients.

 Polenta

1. Place 4 cups water and 1 teaspoon salt in a heavy-bottomed pot over medium-high heat 2. Once boiling, slowly whisk in the polenta 3. Reduce heat to low, stirring frequently until the mixture thickens, approximately 15 minutes 4. Remove from heat.

If desired, whisk in 2 tablespoons of plantbased milk or olive oil for added creaminess

 Greens and Beans

1. Saute 4 cloves of minced garlic with 2 tablespoons of olive oil over medium heat 2. Add chopped kale and ½ teaspoon salt. If desired, add a ¼ cup of water while cooking 3. Cook for another 5-8 minutes until softened 4. Add beans (and crushed red pepper to taste, if desired)

Divide polenta among plates, top with marinara sauce, and arrange greens and beans around the polenta. Top with grated pepper and fresh basil.

Optional: Top with another cooked protein, if desired

CHAU CHE, MD

Temple Health

Culinary Connections:

Cultural Perspectives to Inform Your Palate  FALL IS A SPECIAL TIME OF THE YEAR. The days become shorter, the air crisper, and the summer greenery transforms into a kaleidoscope of colors in the plants around us. It is a time for harvest, traditions, and gatherings filled with delicious food. As we all have different experiences and backgrounds, the foods we eat with our families at our celebrations reflect this. In this issue, we are excited to share the stories (and recipes!) of three gastroenterology colleagues from diverse backgrounds within the American College of Gastroenterology. They each have focused on nutrition and incorporate different plants and flavors into their cooking. They also advocate for a healthy lifestyle for their own families and patients. Food nourishes us

Food is the centerpiece of any culture. My parents immigrated from Vietnam to the United States before I was born. They worked tirelessly to preserve their culture and instill it in our family. Although we ate everything growing up, my childhood was filled with Vietnamese food. My mother made a three-course dinner every night: soup, protein, and vegetables. My job was to prep the garlic, onions, and shallots because every meal would include these ingredients. It explains my affinity for cooking with these items! Dinner would end with my mom peeling fruit at the table for dessert. She is an amazing cook so my standards for eating were set high at an early age.

As a gastroenterologist, I play an important role in helping patients improve their lifestyle. Food is a big part of this.

I recognize the importance of eating in moderation and that is the approach I take with my patients. Food makes up a culture and if you don’t understand the culture, it’s hard to counsel patients. When a culture’s diet primarily consists of white rice, telling a patient to not eat white rice, the very

and brings us together.

AU CHE)

VEGETABLE GRATIN (DR. CH  Ingredients

• Sweet potatoes • Yukon gold potatoes • Turnips • Shallots (finely chopped) • Salt • Pepper • Heavy cream • Toasted panko breadcrumbs

sted Panko 4. Continue repeating step  Toa Breadcrumbs #3 with the potatoes, 1. Preheat oven to 375 F. 1. Set pan on medium-high sweet potatoes, and use or ly thin heat. gies veg in.

2. Slice turnips aga a mandoline.

2. Add olive oil and 5. Cover baking dish with breadcrumbs.

3. In a baking dish, arrange foil. Place in the oven on tly sligh s, t. the turnip slice top of a baking shee 3. Stir until breadcrumbs are overlapping in a single , golden brown.

6. Cook for 30 minutes layer. Sprinkle salt, 45 then covered, and pepper, and shallots onto minutes uncovered. ugh eno r this layer. Pou heavy cream so it slightly 7. Top with panko breadcrumbs. covers the turnips.

 Gratin

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essence of their diet, is not practical advice. Instead, I try to offer a sustainable solution, like mixing white and brown rice together. The best diet is a sustainable one. Small changes can have big impacts. A lifetime of small changes can have a tremendous impact over time.

If I were not a gastroenterologist, I would be a chef. My love of gastronomy has only grown. To marry these interests, I am pursuing my certification in culinary medicine.

These days, I am a chef to my personal party of five. A home-cooked meal was so important to my childhood that I wanted to continue that tradition with my family. I am consumed with eating and finding the best possible foods. What we put in our body matters and it should be the best, most flavorful food possible, whatever that may mean for each person. At my house, nothing is off-limits, but I strive toward feeding my family a balanced diet that is heavy in vegetables. Like in my childhood, I want to give my

children the opportunity to learn about different cultures through food. I may not be able to cook three courses nightly like my mom did, but our meals are well-rounded. Every night, we have dessert like I did growing up; homemade chocolate chip cookies for dessert may be followed by nights of fruit to balance things out.

As a working mom, it is hard to get dinner on the table in a timely manner! Since my medical training began, I always wanted to share my cooking with the world and recently started on Instagram (@drchautime).

My goal is to show that a healthy, balanced, homemade meal can be done nightly. Many of us are planners and, with a busy schedule, that same mindset needs to occur when it comes to feeding our families. With planning, practice, and foresight, a homecooked dinner is within everyone’s grasp. Since starting my endeavor, I have received an outpouring of support from colleagues. We have been able to share our collective experiences as gastroenterologists and lovers of gastronomy.

ROASTED SWEET POTATO (DR. MAG NUS  Ingredients

• 2 sweet potatoes or 1 whole pumpkin (butternut squash works well) • Spices: 1 Tbsp paprika, 1 tsp smoked paprika, ½ tsp cayenne, ½ tsp ground oregano, ½ tsp garlic powder • Lemony white miso tahini chickpea topping: • 1 can chickpeas • 2 Tbsp white miso paste • 2 Tbsp tahini • 1 tsp of white vinegar • 1 clove of garlic • 1 lemon • Greens: • Fresh herbs – parsley and coriander work well • Sliced cucumber or steamed broccoli • Sesame seeds for topping

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For four of the past five years, we have hosted Thanksgiving dinner for our families. I am sharing one of my favorite side dishes with you. As someone who cannot eat cheese, I love this dish because I can finally enjoy a gratin! It only has a few ingredients, including shallots—a family favorite! Shallots are essential in infusing flavor throughout the dish. Use this recipe as a guide; any root vegetable can work as a substitute. Bon appétit!

MAGNUS HALLAND, B.MED, B.MED.SCI, MPH, PHD, FRACP

Mayo Clinic, Rochester

As a gastroenterologist and avid cyclist with an interest in swallowing medicine and nutrition, food is at the forefront of my mind, both at work and at home. While all living beings require nutrients for survival, food and shared meals represent so much more than a mere supply of energy.

It is not by chance that food features prominently in nearly all social events, family gatherings, and celebrations!

HALLAND)

 Steps 1. Pre-heat oven to 375F. 2. Mix spices with either lemon juice or olive oil.

3. Cut the sweet potatoes in half.

If using pumpkin, cut this in half and remove seeds – carefully “Hasselback” the pumpkin by cutting thin slices almost, but not completely through – leave the skin on.

4. Paint the sweet potatoes with spices and bake – time will vary depending on size – but 35 min to 55 min is a rough guide.

5. Make the topping: a. Mix the miso paste and tahini— add a few Tbsp of water until smooth. b. Add finely chopped garlic and juice from ½ the lemon, along with the vinegar. c. Rinse the chickpeas and add to the mixture.

6. Serve up: a. Place the baked sweet potato on a plate. Gently pierce with a fork so the topping will soak in. b. Add a generous amount of miso chickpea topping. c. Add greens: fresh herbs and lemon zest go on top— chopped cucumber or steamed broccoli goes well on top as well. I add some chili-flakes and sesame seeds for extra flavor as well.

My personal journey with food started in Norway, growing up in a family that encouraged participation in the kitchen from an early age.

This was fortunate as I was a very picky eater, but by actively making food, my courage to introduce more fruits, vegetables, and flavors grew over time. I don’t think anyone who knew me 30 years ago would have predicted that I would end up eating a predominantly whole-food plantbased diet. The change was gradual but was kicked into gear a few years back when I recognized how little I knew about nutrition, despite being a gastroenterologist, and how profound the impact of food choices we make have on health. From there I avidly starting learning about and integrating evidence-based nutrition into my personal life, as well as patient care.

My number one tip for people who would like to move towards a wholefood plant-based lifestyle is to focus on flavors and colors. By eating a variety of colored fruits, wholegrains,

“I hope you will take the time (perhaps on a weekend) to make this roast dinner of sweet potatoes. If your current insurance plan requires pre-authorization for sweet potato, the lower-tier pumpkin can be prescribed as a substitute.”

—Dr. Magnus Halland

WITH FENNEL ROMAINE AND ARUGULA SALAD  Ingredients

Buttermilk Dressing • 1/2 cup buttermilk (can use pea milk for vegans) • 1 Tbsp dijon mustard • 2 Tbsp apple cider vinegar • 2 Tbsp plant-based mayo, mayo, or creme fraiche • 2 Tbsp olive oil • 1 tsp agave nectar • 1⁄4 tsp garlic powder • Kosher salt • Freshly ground black pepper

beans/lentils, and vegetables you obtain a diverse amount of nutrients and colorful plates are also way more appetizing!

Many people also have to re-train their tastebuds! Processed and fast foods typically contain too much salt, sugar, and fat. Such foods distort the baseline of flavor perception. When eaten frequently, we lose the ability to detect many of the flavors and nuances in healthier foods— thankfully, this process is reversible.

I hope you will take the time (perhaps on a weekend) to make this roast dinner of sweet potatoes. If your current insurance plan requires pre-authorization for sweet potato, the lower-tier pumpkin can be prescribed as a substitute. When using pumpkin, you can even go fancy and cut them Hasselback-style. This type of preparation takes a bit of time and knife skills, but nothing an endoscopewielding gastroenterologist can’t handle, and the result is totally worth it! I have included a recipe for one of my favorite toppings, but many other variations will work—be creative!

AND A BUTTERMILK DRESSING

Salad • 1.5 oz arugula (~2 cups) • 5 oz. romaine lettuce, torn into bite-sized pieces (~4 cups) • Salt and pepper, to taste • 1⁄2 cup cherry tomatoes, diced • 1⁄4 red onion, thinly sliced • 1⁄2 small bulb fennel, halved lengthwise, cored and thinly sliced • 10 basil leaves, thinly sliced or chiffonaded • Grated Parmesan cheese

(DR. EDWIN MCDONALD)

 Steps

To make the dressing: small bowl 1. Whisk all the ingredients in a and salt until combined. Season with . side the to pepper to taste. Set For the salad:

lettuce 2. Place the arugula and romaine leaves. the Mix l. bow ing in a large serv and salt with ce lettu the on Seas Add freshly ground pepper to taste.

Mix el. fenn and ns, the tomatoes, onio with salad the s Dres ts. the ingredien grated the dressing. Serve with freshly ns, vega For Parmesan cheese on top. sed t-ba plan a nutritional yeast or cheese are a good substitute.

a ¼ cup of 3. teaspoon salt. If desired, add water while cooking until 4. Cook for another 5-8 minutes softened

pepper to 5. Add beans (and crushed red red) desi if , taste

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EDWIN K. MCDONALD, IV, MD

University of Chicago

Many of my favorite memories from childhood involve food. Unlike many children, I enjoyed Thanksgiving more than Christmas. There was something magical about sharing a delicious meal with friends and family. I vividly remember helping my grandmother in the kitchen— breaking the ends of snap peas and preparing the dining room table for Thanksgiving dinner. I treasure these memories much more than a toy truck or video game I received as a Christmas gift. Celebrating with food profoundly impacted my appreciation for cooking by highlighting the connections between food, love, and culture. These connections inspired me to work in restaurants, host barbecues, and attend culinary school.

Despite the joy that food gave me in my youth, my childhood was also replete with numerous examples of the negative impact of food on health. While attending churches on the south side of Chicago, I vividly remember hearing pastors implore congregations to pray for church members struggling with diabetes, kidney disease, and heart attacks. As I aged, my awareness of the relationship between food and these chronic diseases gradually increased.

Embracing the joy of food and witnessing deleterious results of unhealthy eating motivated me to become the nutrition-focused gastroenterologist I am. I am currently the Associate Director of Adult Nutrition at the University of Chicago. I also am board-certified in obesity medicine and teach culinary medicine to medical students, residents, patients, and community members. As much as I love treating patients with gastrointestinal problems, my focus on nutrition provides extra satisfaction. Helping patients navigate food deserts, food swaps, and the taste preferences associated with living in these environments gives me an additional sense of purpose. Teaching healthy eating also allows me to put my culinary training to use.

12 | CULINARY CONNECTIONS

“Celebrating with food profoundly impacted my appreciation for cooking by highlighting the

Now that I am a culinary-trained physician in charge of preparing Thanksgiving dinner for my family, my perspective on Thanksgiving has evolved.

Previously, I solely tried to pay homage to my grandmother's recipes and make the food as tasty as possible. Now I juggle these efforts with incorporating new flavors/techniques and cooking a healthy meal.

My diet is predominantly plant-based, unlike many of my family members.

Being mindful of my family’s preferences, I cook a variety of dishes. These dishes include traditional Thanksgiving items such as turkey, mac & cheese, and sweet potatoes. But I also cook a variety of vegetable-based dishes. I frequently take a multicourse meal approach by starting the Thanksgiving meal with a soup or salad.

This salad with arugula, romaine lettuce, fennel, and a homemade buttermilk dressing is one of my Thanksgiving favorites. I love it because it incorporates multiple vegetables and flavor profiles. Fennel’s freshness and the dressing’s creaminess and acidity balance the arugula’s bitterness.

connections between food, love, and culture.”

—Dr. Edwin McDonald



Have a personal connection with GI and gastronomy? Contact ACG at acgmag@gi.org to share your story with the ACG community.

Culinary Connections:

warm and wonderful

WHAT STARTED AS A COMMON LOVE FOR FOOD ON #GITWITTER by Dr. Vani Paleti, Dr. Alexander Perelman, and Dr. Christina Tennyson during the start of the COVID pandemic is now into its third series of #ACGfoodies culinary connections, with immense support from our ACG team. We are very excited to bring you “Warm & Wonderful” as we look forward to gathering with family and friends during this holiday season.

Holidays are filled with love, joy, and memories-in-the-making. Let’s come together to celebrate safely (yay for vaccines!). We thank Dr. Supriya Rao, Dr. Jordan Shapiro, and Dr. Tatiana Policarpo for sharing their culinary connection journeys and recipes for dishes that speak to their souls and bring a smile to their faces.

Culinary Connections | 13

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SUPRIYA RAO, MD

Integrated Gastroenterology Consultants, North Chelmsford, MA

Growing up in a South Indian family, food was not just an important part of life, it was an expression of love. I would watch my mom exchange recipes with her friends and family members like she exchanged hugs. Family gatherings and dinner parties were synonymous with culinary adventures. Like in most cultures, coming together over food was a social and cultural celebration.

I was raised a vegetarian and was introduced to a variety of plants at a young age. Leafy greens, okra, brassicas, squashes, root vegetables, beans, and lentils were in common rotation at the dinner table. Over the years, I became my mother’s apprentice and learned everything I could about Indian cooking, mixing turmeric and cumin with ginger and chili powder and eating highly flavorful food that was healthy and nourishing.

I must admit, I wasn’t the healthiest during my college and training years. Away from my mother’s cooking, I fell into a highly processed vegetarian diet.

Late nights studying and on-call nights in the hospital led to poor eating choices—something very common for my peers, myself, and anyone at that stage in training. I watched colleagues start antihypertensives and statins, and I knew that my lifestyle had to change.

After becoming a gastroenterologist and seeing patients full time, I got a firsthand glimpse into how our lifestyle, especially our diet, affects our health. We know that food can affect how we feel

“We know that food can affect how we feel and that there is a strong connection between the brain, gut, and microbiome.”

—Dr. Supriya Rao

and that there is a strong connection between the brain, gut, and microbiome. Highly processed and palatable foods wreak havoc on our microbiome and our moods. I saw this not only in patients with functional GI disorders, but also in patients with GERD and NAFLD. Even colon cancer is linked with diet. I wanted to be able to provide the necessary toolkit for patients to improve their lives with small, sustainable changes. This desire led me to seek further education. I became board certified in obesity medicine and am pursuing further training in lifestyle medicine. I wanted to make changes in my patients’ lives and ended up making some in my own life, as well.

I currently am plant-based and raise my children this way. I have involved them in preparing meals from a young age. I’ve learned that kids are excited to learn where their food comes from and want to partake in cooking. We aim for a high-fiber diet that is full of vegetables and fruits, whole grains, and plant-based protein.

Our goal is to have a wide range of colors in our meals, and we often count the number of plants present. We aim for at least 30 unique plants per week to improve microbiome diversity.

As we enter the colder months, I find myself making a lot of soups and stews. It’s an easy way to get in a lot of vegetables and have leftovers for later in the week. This lentil soup is a family favorite—warm and hearty and even better with a hunk of crusty bread. Over the last several years, I’ve rediscovered the habits that I had growing up in a plant-based household. I want to teach my

NOURISHING LENTIL VEGETABLE SOUP  Ingredients

• ¼ cup olive oil • 1 onion, diced • 2 cloves garlic, minced • 2 carrots, chopped • 2 stalks celery, chopped • 1 potato, diced • 1 cup French or brown lentils • Couple of handfuls baby spinach • 4 cups vegetable broth • 2 cups water

Spices • 2 tsp cumin • 1 tsp coriander • 1 tsp thyme • 1 tsp turmeric • ½ Tbsp salt • 1 tsp freshly ground black pepper, to taste 14 | CULINARY CONNECTIONS

 Steps

7. Add in the baby spinach and let it 1. Heat up the olive oil in a Dutch wilt in the soup. over pot oven or other heavy-based medium heat.

8. Add more salt and pepper to taste. soft are they until onions the Sauté 2. and translucent, about 5 minutes If you have an Instant Pot, you can do steps 1–5 in the Instant Pot and cook at 3. Add in the garlic along with the c, turmeri er, coriand , spices (cumin high pressure for 15 min. thyme) and stir for about 1 minute 4. Add in the carrots, celery, potato and lentils. Stir until well combined, about 2 minutes.

5. Pour in the broth and water, add in salt and pepper. Bring to boil, then cover and turn the heat down to medium to allow for a gentle simmer.

6. Cook for about 25 minutes until the lentils are soft but hold their shape.

kids how to eat so that they will carry these habits forward and make good choices for their health and wellness.

TATIANA POLICARPO, MD Thomas Jefferson Hospital, Philadelphia, PA

Sharing a meal is a great way to bring people together. For me, I grew up in a Brazilian household, and food was central to our life. I have fond memories of coming together for weeknight dinners with my family and Sunday afternoon barbecues with family and friends. Our traditional dinners were always accompanied by rice and black beans with a side salad. When I reminisce about the Brazilian foods I grew up with, I’m reminded of rich, flavorful comfort dishes. Some of my favorites were feijoada (black bean stew), Brazilian stroganoff (a creamier twist on the traditional Russian dish served over rice and topped with potato sticks), and desserts that prominently featured sweetened condensed milk such as brigadeiro (fudge balls) and pudim de leite condensado (Brazilian style

“Through my own research and an inspiring social media community of doctors interested in culinary medicine, I’m learning more about nutrition and trying to incorporate more plants and fewer processed foods into my own diet.”

—Dr. Tatiana Policarpo

flan). My Brazilian background has influenced my cooking style, particularly my love of beans and my soft spot for sweetened condensed milk desserts.

As a first-year gastroenterology fellow, I’m learning more about how food is such an important part of digestive health. I think it’s important for gastroenterologists to be comfortable discussing diet and nutrition with our patients. Through my own research and an inspiring social media community of doctors interested in culinary medicine, I’m learning more about nutrition and trying to incorporate more plants and fewer processed foods into my own diet. I love learning new recipes that highlight fruits, veggies, whole grains, and legumes.

Although I love to cook, as a busy GI fellow and mom to a small child, I often struggle to find time to cook healthy meals for myself and my family. I try to prioritize meals that are quick to assemble and can be prepared ahead of time. Here is one of my go-to recipes in the fall and winter—the harvest bowl. I like that it’s a warm and filling meal that I can prep in advance (make a big batch of rice early in the week, roast veggies ahead of time). The harvest bowl is very versatile—I often swap out ingredients for whatever I have on hand.

HARVEST BOWL  Ingredients

• 1 butternut squash, cubed (can buy pre-cubed for faster prep) • 1 cup cooked chickpeas (I used cann ed chickpeas to save time. Could also use any bean or cooked lentils) • 4 Tbsp extra virgin olive oil • salt and pepper • 3 cloves garlic, minced • 2 bunch of kale (any variety), chop ped • juice of 1 small lemon • 2 cups cooked brown rice (or anot her whole grain like quinoa) • 1 apple, thinly sliced • 1/4 cup roasted almonds, chopped (for topping, other good options include any chop ped nuts, dried cranberries, pomegranate seeds, pepit as) Tahini sauce • 1/2 cup tahini • juice of 1 small lemon • 1/3 cup water • 2 garlic cloves, minced • 1/2 tsp salt • 1 tsp maple syrup or honey (optional)

 Steps 1. Preheat the oven to 400°F and line baking sheet with parchment paper.

2. Toss the butternut squash and chick peas with 2 tablespoons of olive oil and 1/2 teaspoon salt. Roast for 30–40 minu tes, until squash is soft.

3. While the squash and chickpeas are roasting, heat 2 tablespoons olive oil in a large sauté pan over medium heat until shimmering, then add garlic and cook 1 minute until fragrant.

4. Add kale to the pan and stir, cook ing until kale is wilted (~5 min), then stir in the lemon juice and add salt and pepp er, to taste.

5. Mix all tahini sauce ingredients in a small bowl until combined. Add additional water to thin if necessary.

6. Assemble individual bowls with brow n rice, squash, chickpeas, kale, apple slices, and chopped almonds. Drizzle tahini sauce on top, to taste.

Culinary Connections | 15

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to the need for a different SIM card than the one I’d used in Mumbai. I started wondering which of the four venomous snakes of the area (common krait, banded krait, king cobra, and Russell’s viper) I would run into first. I sat down to rest and a group of people surrounded me. A man named Vinod stepped forward and said, “Sir, you seem to have a problem. Is it language?” Vinod was a local English teacher. He took me to a tea stand, bought me a cup of chai, and waited to help me onto the last bus of the evening. I was dropped off on the side of the highway and walked into the jungle with cup of chai in-hand for half a kilometer until I reached my destination—where I was welcomed with another cup of chai!

In many ways, making chai is a spiritual practice. I approach the stove with intention to nourish myself so I can nourish others. I prepare the offerings for the pot. As I add to the pot, I mumble old Sanskrit verses meant to acknowledge that our food can be medicine.

And as I strain the tea, there is a newness that emerges out of the ancient culture from which chai originates.

Chai is a refreshing way to take the best of old with us into the new day.

JORDAN M. SHAPIRO, MD

Baylor College of Medicine, Houston, TX

Chai means “tea” in Hindi.

While the term chai can refer to any tea, it most often refers to tea taken with milk and spices.

Chai is the national beverage of India and is much more than a tasty, caffeinated beverage.

Chai is a shared cultural experience of all of humanity throughout the Indian subcontinent.

No two cups or chaiwalas (chai vendors) are the same. One has a bit more ginger. Another is sweeter. And the man on the corner uses more elaichi (cardamom). Chai may be served in glass cups, metal cups, or traditional clay cups.

Despite the variations on the national beverage of India, chai brings together people of all walks of life. All are welcome.

I have made homemade chai nearly daily since my first trip to India at age 19 and have countless chai memories. In the mountains, tea stands broke up long hikes and helped slow the ascent to reduce the risk of ascending too quickly. I would wake up in the mornings to the chaiwalas yelling, “Chai ready!” outside of my door. My favorite tea stand was “India’s Last Tea Shop” in Mana Village, just 20 kilometers from the Tibetan border. Years later in medical school I lived and worked for several months in a remote village in Gadchiroli, Maharashtra.

I arrived at the local bus station with the sun setting and my phone rendered useless due

MASALA CHAI – MAKES 2 CUPS  Ingredients

• 1 cup water • 1 cup milk er root • 1 inch peeled fresh ging black tea leaf e • 2 tsp Red Label loos s pod m amo • 10 green card • 2 threads saffron • 4 tsp sugar

—Dr. Jordan Shapiro 

We would love to hear from you if you have personal connections with GI and gastronomy. Contact ACG MAGAZINE staff at acgmag@gi.org to share your story with the ACG community. You can also tweet using #ACGfoodies to connect with the community.

Wishing you all a very safe and happy holidays from our culinary connections #ACGfoodies team.

s 8. Strain and pour into cup

 Tips

1) boiling • Speed the process up by and/or 2) water with an electric kettle m milk war ly using two pots to slow er, and ging er, wat the g while preparin s of tent con the ng bini com tea, then the two pots. buffalo • Traditional chai is made with is ncy siste con al ition milk. The trad  Steps or 2% with ined atta y ilarl sim most and bring to a boil 1. Grate ginger into water chai can whole cow’s milk. However, minutes 3–5 p stee let and tea k 2. Add blac h as soy, suc ives rnat be made with alte to medium to 3. Add milk and turn heat water The . milk p hem and almond, oat, bring to a slow boil and I er high n ofte is e thes of content into powder with 4. Crush cardamom pods to 1 ratio of would recommend using 2 pot to add tle, pes and a mortar er. wat milk alternatives to and pestle, add 5. Grind saffron in a mortar t into a pot • Straining the final produc to pot es it mak lip ring pou d goo a with 6. Add sugar narrower with easier to fill travel mugs boil 7. Stir and bring to a slow openings.

16 | CULINARY CONNECTIONS

“Despite the variations on the national beverage of India, chai brings together people of all walks of life. All are welcome.”

Culinary Connections:

Spring Into Health

AS THE WINTER HOLIDAYS HAVE COME AND GONE, we now begin anew; refreshed, reinvigorated, and reconnected.

As the world thaws from the snow and ice, here is some inspiration to help us "spring into health.” We start in Alabama, travel the aisles of a supermarket in Madrid, and end in New York.

Through these globetrotting stories you will hear some common threads, mainly of love for family, for friends, and for food.

We hope you enjoy and feel inspired to share your own culinary journeys with us. ­—Dr. Alexander Perelman for the #ACGFoodies (Dr. Christina Tennyson and Dr. Vani Paleti) Reach out by email to Dr. Perelman, Dr. Tennyson, and Dr. Paleti if you want your culinary creations featured in the pages of ACG MAGAZINE using acgmag@gi.org.

Culinary Connections | 17

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DALE LEE, MD, MSCE

Seattle Children's Hospital, University of Washington, Seattle, WA

Growing up, food and health were forefront in many family conversations. Early in my pediatric gastroenterology fellowship, I distinctly remember my first encounter with the power of food in the form of exclusive enteral nutrition therapy (EEN).

I observed a hospitalized patient with Crohn’s disease and malnutrition improve steadily on EEN with improvement in symptoms, objective markers of inflammation, and weight gain trajectory. I now primarily care for children and adolescents with inflammatory bowel disease and celiac disease.

For IBD, immunosuppressive medications are the primary focus, and the role of food has been rising in prominence. For celiac disease, the converse is true with a gluten-free diet recognized as the only effective therapy, but with much momentum increasing for drug therapies.

Food is always on my mind—in my professional and personal life. I am the medical director of clinical nutrition at Seattle Children’s Hospital and director of the Celiac Disease Program. Following my pediatric GI fellowship, I did a fellowship in nutrition and had the opportunity during this time to form relationships with food scientists at Penn State University. There, I began to learn about the science behind designing and producing foods—something clinicians generally do

“As GI clinicians and scientists, we play a unique role in guiding patients and shaping the landscape of dietary recommendations. On a personal level, I want to know what I am eating and how it impacts me, and this is a question that is important to our society.”

—Dale Lee, MD, MSCE

FAVORITE EASY CHOPPED SALAD  Ingredients • 4 Persian cucumbers, cut

lengthwise, then sliced into semicircles • 1 red bell pepper, cut into ½ inch pieces • 1 yellow bell pepper, cut into ½ inch pieces • 1 cup grape tomatoes, halved • ½ orange, cut into ½ inch pieces • ½ pear, cut into ½ inch pieces • 1 medium avocado, cubed • 2 hard-boiled eggs (exactly 8 minutes boiled), peeled and sliced • Balsamic vinegar, to taste

18 | CULINARY CONNECTIONS

 Steps

1. Wash then cut all produce into approximately ½ inch size pieces/cubes 2. Add all vegetables to a bowl

3. Bring water to a boil in a small pot, and gently add eggs (using a spoon) • Remove eggs after 8 minutes, then transfer to cold water (this will provide a hard-boiled white with a slightly creamy yolk) 4. Add orange, pear, avocado, and egg to bowl 5. Pour a small amount of balsamic vinegar to lightly coat the salad

not learn about in their training. This has helped form my appreciation for food and an awareness of the strong science guiding food production.

I do not have any dietary restrictions, but I try to minimize refined sugars and highly processed foods. Though I’m familiar with recommendations for macro and micronutrient intake, I believe that food goes beyond its constituent nutrients. Processed food and the “Western diet” has been implicated in numerous disease processes, including IBD, but food processing is challenging to define and has become ubiquitous in our food supply. Though valuable in preserving food and maintaining shelf stability, numerous untoward effects are likely.

My research on food additives and the intake of processed foods has led to more questions than answers and has demonstrated the complexity of studying diet and food. Preclinical models have suggested that specific food additives may be harmful to the gut epithelium and predispose to intestinal inflammation, but much work remains to be done to better understand the exposures and effect of foods in humans.

As GI clinicians and scientists, we play a unique role in guiding patients and shaping the landscape of dietary recommendations.

On a personal level, I want to know what I am eating and how it impacts me, and this is a question that is important to our society. I live in a busy household, and we value food that is delicious and quick to prepare. One of my goto dishes is a chopped salad that can adapt to both winter and summer produce. In the winter, citrus fruit and pears provide tang and sweetness while in the summertime berries can be incorporated. The produce, together with precisely boiled eggs and the simple splash of a good balsamic vinegar, brings the dish together.

JANESE S. LASTER, MD

“As I share with my patients, plant-based meals can be cool too!”

—Janese S. Laster, MD

Washington, DC

I grew up in Birmingham, Alabama, with a huge family, so every event was centered around food with each family member bringing their best dish. Food was used as a show of love! And I wanted in and couldn’t

wait to be old enough to help my mom, aunts, and grandmother in the kitchen. It was definitely a rite of passage to finally make a dish that got the familial stamp of approval. For me, this then led to experimenting with flavor, texture, and implementing additional cultures into dishes as well.

Throughout my life my parents both instilled eating whole foods with very little processed foods being available in our home, much to my chagrin. I joke with them now about the distress this caused in not being one of the cool kids with the famed Lunchables for field trips. They also loved gardening and gifting excess fruits and vegetables before it was cool. I found them a little embarrassing to say the least.

Fast forward 20 years and I’m a plant-based gastroenterologist specializing in nutrition, obesity medicine, and bariatric endoscopy. I have found common correlations in many gastrointestinal complaints, excess weight, and metabolic syndrome with excess processed foods, which I counsel patients to modify. Since I live in the city with little outdoor space, I even have a hydroponic indoor garden to grow greens, herbs, fruits, and vegetables…Can we say full circle? I guess they rubbed off on me a bit.

During my bariatric endoscopy training in Madrid, I fell in love with roaming the aisles of the beautiful fresh food markets and enjoying all of the traditional dishes. One common dish is jamón (ham), which I

ARROZ AL HORNO  Ingredients • 1 ½ cups jasmine rice

• ¾ cup chopped mushrooms • ¾ cup finely diced green, red, oran ge bell peppers • ¼ cup finely diced yellow onion • 2 whole bulbs of garlic • 1 large tomato, cut into ½ inch slices • 1 cup of chickpeas • 1 large potato, peeled and cut into ½ inch slices • Extra virgin olive oil • 1 ½ cups vegetable broth • Sea salt, black pepper, cumin (garl ic and onion powder optional)

 Steps 1. Preheat oven to 400˚F.

2. Warm casserole dish in the oven, then set aside.

3. Sauté mushrooms, bell peppers, onions, and 4 cloves of minced garlic with 2 Tbsp of olive oil.

4. Cook chickpeas (soak overnight for dried chickpeas or use low-sodium canned chickpeas ) on the stovetop and add sea salt, black pepp er, and cumin to taste.

5. Remove sautéed vegetables and place potatoes in the same oil and leftover seasoning in the pan. Add a pinch of sea salt and black pepper to taste. Fry on both sides until soft and golden, then remove.

6. Add rice to the same pan and fry for 5-10 mins in the same seasoning and oil. Make sure it is coated or add 1-2 additional Tbsp of olive oil, if needed.

7. Combine sauteed vegetables and drained chickpeas in a bowl.

8. Add fried rice to the casserole dish, then the chickpea and vegetable mixture, distr ibuting evenly, 9. Layer potato slices, then sliced toma toes on top.

10. Pour vegetable broth over the dish, making sure the rice is covered.

11. Place a whole garlic clove in the center.

12. Place in the oven and bake for abou

t 20-30 mins or until the broth has evaporate d. Taste a few grains of rice, as they should be soft.

13. Remove from the oven, let sit for 5-10 mins, then enjoy!

Culinary Connections | 19

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don’t eat and was often met with concern and confusion when I didn’t partake. But my colleague and mentor, Dra. Inmaculada Bautisa Castaño, hosted a cooking lesson and dinner for us to learn to make Tortilla de Patatas and Arroz al Horno. Weeks later, COVID hit, and we were placed on a strict lockdown. Needless to say, we all had to get creative in our meals and I decided to put my vegetarian spin on Arroz al Horno and got photographic approval from the master herself!

Arroz al Horno translates to “baked rice” and is typically made in a casserole with stock left over from the pork for flavoring. It is also beautifully garnished with a garlic in the middle. However, in lieu of pork, I transitioned the recipe to a plant-based alternative and used onions, garlic, bell peppers, and mushrooms as the base stock for added flavor. As I share with my patients, plantbased meals can be cool too!

I hope you’ll enjoy the Spanish aromas coming from your oven!

“I have always loved to prepare some of my dishes for holidays and special occasions, so I seized the opportunity and challenge of making healthy recipes that look as good as they taste.”

—Jonathan A. Erber, MD

JONATHAN A. ERBER, MD

Brooklyn, NY

As a busy practicing gastroenterologist, I don’t often find myself with too much time to spend in the kitchen. However, when time permits, I enjoy preparing some of my “favorites” for family and friend get-togethers, holiday celebrations and, of course, sporting events I love to watch—Michigan football (for all you Georgia Dogs out there, yes, we did get crushed by you in that Orange Bowl!).

These past few years, with COVID looming over us, I found myself with more spare time on my hands. One silver lining of COVID was that I got to spend some more of that time with my family doing things we all love: spending quality time together, cooking, and of course, watching Michigan football. Game day meal prep has become one of my new favorite Fall Saturday traditions. I have always loved to prepare some of my dishes for holidays and special occasions, so I seized the opportunity and challenge of making healthy recipes that look as good as they taste.

BUFFALO TOFU WINGS  Ingredients • 1 16-oz pack super firm tofu

iry milk • 1 cup unsweetened non-da bs • 1 cup panko breadcrum (gluten-free) ioca flour • ½ cup cornstarch or tap • 2 tsp Italian seasoning • 1 tsp garlic powder • 1 tsp onion powder • ½ tsp black pepper ce (or • 1 cup Frank’s Red Hot Sau

any of your favorites)

 Tips

won’t it have to press water out of include • Non-dairy milk options , or any soy , oat t, onu almond, coc milk. iry -da non ed ferr pre r of you l wel k • Panko breadcrumbs wor when not cooking with oil.

• Super firm tofu best, as you

20 | CULINARY CONNECTIONS

 Steps and 1. Preheat oven to 420˚F

line baking sheet or dish with parchment paper al 2. Slice the tofu into 6 equ

h width slabs, then slice eac ise of those pieces lengthw into 3 slices (18 tofu sticks)

ls: In the

3. Set out three separate bow

ch, garlic first bowl add the corn star black and der, pow n onio powder, milk into the the r Pou . mix and per pep third small second small bowl. In the rumbs and adc bre ko pan bowl, add the . mix and ing son Italian sea and coat in 4. Take each tofu “wing” milk, and n the flour mixture, the the adcrumbs. bre ko pan the finally coat in k onto the stic tofu d ade bre h Place eac prepared baking sheet. e for 25 5. Place in the oven and bak brown. en gold t ligh minutes until add them and gs win tofu the 6. Remove the buffalo r to a large mixing bowl. Pou gs and win tofu sauce over the baked gs are win tofu the all il gently toss unt o the ont k bac tofu the e Plac . covered and n, ove baking sheet, return to the s. ute min bake for another 20

ry sticks and

7. Serve with carrots or cele

g. ranch or blue cheese dressin

My son Dylan has celiac disease. Since we both enjoy eating “gastropub” food together like wings, fries, chips, and dips, we worked hard to perfect a menu that encompassed quality, healthy ingredients without compromising flavor. We did all of this by adapting recipes that work with a gluten-free diet.

We also concluded that these “gastropub” foods don’t have to be laden with fat, meat-centric, or fried. With a few simple ingredient substitutions, it was easy to prepare and enjoy a more plant-based and gluten-free diet.

These meals tasted GOOD as we watched the game while also being GREAT for the Gut! My favorite dishes listed below are quick and easy to prepare.

They require minimal prep and cooking time with ingredients that are easy to find in your local market. Three of my favorites to prepare and eat while watching the big game at home are Buffalo Tofu Wings, Stuffed Dates (aka Devils on Horseback), and Mediterranean 7-Layer Dip.



We would love to hear from you if you have personal connections with GI and gastronomy. Contact ACG MAGAZINE staff at acgmag@gi.org to share your story with the ACG community. You can also tweet using #ACGfoodies to connect with the community.

Wishing you all good health and great meals from our culinary connections #ACGfoodies team.

YER DIP MEDITERRANEAN 7-LA  Ingredients

oz., mmus (about 16 • Container of hu nts die re to other ing or proportional ) er lay to e us er you and the contain d pe op se, ch • 1 cup feta chee opped ry tomatoes, ch er ch or e ap Gr • he tional to ot r (amount propor can eyeball this) ingredients; you ped d cucumber, chop • 1 medium-size opped • ¼ red onion, ch dded re sh • 1-2 carrots, , chopped lks sta y • 1-2 celer d a olives, choppe • ½ cup Kalamat d pe op ch l, dil sh • Handful of fre ips, • Bag of pita ch

 Steps

d mus into a roun 1. Spread hum all gh for dish, deep enou er. lay to s nt die re ing cheese over a fet ad re Sp 2. hummus. layer all other 3. Continue to e order ingredients in th olives e above, up to th er. ov all l 4. Sprinkle dil mperature. te om ro 5. Serve at

fresh pita, or u anything else yo desire to dip

STUFFED DATES  Ingredients • 24 Medjool dates

• 4 oz. goat chee se • 3 Tbsp pistachio s • Smoked paprika • Sea salt and fre sh ground black pepper • Honey (option al)

 Tips • If you can, buy pitted

dates to avoid pitting them your self • Use room temp goat cheese or warm with your hands • The smoked pa prika

flavor of bacon

simulates the

 Steps 1. Use a knife to

split the date lengthwise. Remo ve pit, if using unpitted dates. Us e a spoon or your hands to fill with goat cheese.

2. Crush the pis tachios with a rolling pin (or my way: put into ziploc bag and cru sh with mallet or back of a spoo n).

3. Sprinkle each date with black pepper, sea salt, and small amount of smok ed paprika and pistachio dust.

4. Optional: add a tiny drizzle of honey to the top.

5. Serve at room temp or yo

u can warm for a few m inutes in oven or toaster at very low heat.

Culinary Connections | 21

IN THE SUMMER, COLORFUL PRODUCE FILLS GARDENS, farms, and markets. Fruits and vegetables at the peak of ripeness are bursting with flavors and provide vitamins, phytonutrients, and, importantly, fiber. The delicious culinary possibilities are endless!

Unfortunately, the diets of most Americans are markedly deficient in fiber and do not contain a wide variety of plants. As gastroenterologists, we regularly advise our patients to increase fiber intake. Importantly, consuming a wide variety of plants also has been associated with diversity of the microbiome.

In this edition of Culinary Connections, “Farm Fresh from the Farmer’s Market,” we are excited to feature the personal journeys and recipes of three more #ACGfoodies from different backgrounds. Enjoy their stories and tips on bringing more produce to the plate. We hope this serves as inspiration shopping in your local famer’s market, cooking in your kitchen, and counseling patients in the clinic.

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Culinary Connections:

Farm Fresh from the Farmer’s Market

By Vani Paleti, MD, Alexander Perelman, DO, and Christina A. Tennyson, MD

JAMES HADDAD, MD, FACP

UT Southwestern Medical Center Dallas, TX

I grew up in an Italian-Lebanese family and no matter where you turned, someone was always trying to feed you. At a young age, I began helping in the kitchen, learning not just recipes, but discipline, focus, and a healthy respect for tools; skills which—little did I know—would translate well into the world of endoscopy years later.

As gastroenterologists, patients naturally expect us to be knowledgeable about nutrition, which is unfortunately, as we know, under-represented in medical education. This is an enormous, missed opportunity, because an astounding amount of illness and chronic disease is directly influenced by what we put—or don’t put—into our bodies. The good news is that it is literally never too early (or too late) to begin to learn cooking. As with any other habit (such as exercise), I recommend patients gradually ease into the practice rather than overwhelm themselves by trying to transition directly from a convenience food diet to entirely self-prepared meals.

My wife and I are voracious travelers, typically booking walking food tours of the cities we visit, and often bringing home a recipe or two as keepsakes; when we later prepare one of these dishes, it helps us relive our travel experiences. Cooking a variety of foods regularly allows me to better connect with patients from diverse cultural backgrounds and help patients make healthier choices that work for them (rather than issue blanket recommendations). On a

“Cooking a variety of foods regularly allows me to better connect with patients from diverse cultural backgrounds and help patients make healthier choices that work for them (rather than issue blanket recommendations).”

—James Haddad, MD, FACP

personal level, I have come to see cooking as a rewarding experience, rather than a chore, and I enjoy it even after a long day at work. Cooking is an expression of love through nourishment, whether it’s a weeknight dinner with my wife, a meal with visiting friends, or a special holiday with family.

I chose the following recipe to share because it’s the perfect showcase for summer vegetables you might find at a farmer’s market, while being simple enough for a beginner and requiring only a few ingredients you can find at your local grocery store year-round. Inspired by elements of Mediterranean cuisine, it also happens to be plant-forward and uses lowFODMAP ingredients that can be easily substituted, so it can fit into just about any diet. This recipe is customizable and versatile, and can be served as an appetizer, side dish to a lean protein or fish, or you can replace the zucchini with meatier eggplants for a main course. I served these roasted zucchinis on a beautiful platter alongside some homemade lamb kofta, and it was a home run.

OVEN ROASTED ZUCCHINI WITH HALOUMI [SERVES 3-4]  Ingredients

• 3 medium zucchinis, topped & halved lengthwise • 2 Tbsp olive oil (or cooking spray) • 8oz. Haloumi cheese, grated (can substitute Havarti, mozzarella, or Swiss cheese according to your taste) • 6-8 cherry tomatoes, quartered (or grape tomatoes, halved) • 1 tsp smoked paprika • Fresh cracked pepper, to taste • Salt, to taste • ¼ cup of fresh basil, chopped • Juice of half a lemon

 Steps

1. Preheat oven to 450°F and line a medium-sized baking sheet with parchment paper.

2. Arrange the zucchini cut side up on the parchment paper and brush or spray with olive oil.

3. Sprinkle each zucchini half with a small amount of salt and fresh cracked pepper.

4. Roast for 30-35 minutes until cooked through and golden brown before removing.

5. Top each zucchini section with cheese, arrange tomatoes along each section, and sprinkle with smoked paprika.

6. Return to the oven under the broiler (if not available, use the highest heat setting) for 3-5 minutes to melt and brown the cheese and blister the tomatoes. This step requires supervision as there is a thin line between browning and burning!

7. Sprinkle with chopped basil and drizzle with lemon juice prior to serving.

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// CULINARY CONNECTIONS

VICTORIA JAEGER, MD Baylor Scott & White Health Temple, TX

One month into my intern year, I was a firsttime mom. I was struggling to learn how to be a physician and a mom at the same time. I knew that I needed to start putting an emphasis on my own health and wellbeing before I burned out. My role as a mother and a physician was to set the best example of healthy living. Despite the overwhelming fatigue, I started exercising regularly and focusing on my own health.

In medicine, I found myself using the term “lifestyle changes” when counseling patients for a vast number of chronic health conditions.

It was so easy to say, but what did that really mean? If I didn’t have all the answers, how would my patients know what to do? The diet industry is full of contradictory information and patients often floundered in what to do. I read books on lifestyle changes, delved into the evidence, listened to podcasts, and became passionate about what healthy living really meant. Two key themes were woven through the information—exercise and nutrition. I was determined to put the information I had learned into practice. I needed to “practice what I preach,” right? If I was going to make an impact on my patients’ lives and educate them about “lifestyle changes” I needed to do these things myself. At home, my daughter

“Figuring out what ‘lifestyle changes’ meant and felt like, I became passionate about emphasizing, educating, and counseling patients on how they, too, could make these changes in the most simple, effective way.”

—Victoria Jaeger, MD

was growing, and I didn’t want her to live the standard American life and end up with the standard American diseases. As a mom and a physician, I wanted to set an example.

Movement was my first step towards health, and nutrition quickly became my next focus. We started by eliminating processed foods. We emphasized eating whole, real food in our home. By the end of residency, my three-year-old daughter, my ultramarathon running husband, and I were all thriving on a whole food plant-based diet. The symptoms of reflux, heartburn, and restless legs my husband had perpetually complained about were gone. My daughter eliminated her constipation woes (and chose to become an ethical vegan). My overall energy level drastically improved. We embraced our new lifestyle together and never looked back. Finally figuring out what “lifestyle changes” meant and felt like, I became passionate about emphasizing, educating, and counseling patients on how they, too, could make these changes in the most simple, effective way.

Since the beginning of my health journey, meal time has become an important time for us to be together as a family. With busy schedules, sitting down each evening and enjoying our food together is a highlight of the day. As a physician mom, there is little time for meal planning, grocery shopping, and cooking.

Over the past three years, I have discovered budgetfriendly, kid-approved, healthful, quick meals that are my go-to. This recipe is one of my favorites because it can be customized for taste preferences, is full of fiber and nutrients, and is super simple. If you are wanting to eat more plant-forward, try starting with this recipe.

Tray bakes are one of the easiest and most delicious meals for the whole family.

ROASTED VEGGIE TRAY BAKE  Ingredients (choose 4-6) • Broccoli • Cauliflower • Butternut squash • Acorn squash • Potatoes (russet, sweet, purple, red) • Brussels sprouts • Carrots • Asparagus • Bell peppers • Beets • Zucchini • Corn (canned or fresh from the cob) • Onions (red, yellow, or white) • Chickpeas • Tempeh

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 Steps 1. Pick 4-6 veggies from the ingredient

list and chop into bite size pieces.

2. Add a can of chickpeas (drained and rinsed) or cut up some tempeh.

3. Place the veggies and beans on bakin g sheets lined with baking paper.

4. Spray with a light dusting of olive oil.

5. Season with whatever spices you’d like (salt, pepper, garlic powder, turmeric, red pepper flakes, cayenne pepper, nutritional yeast, etc.). Our favor ites are garlic powder, onion powder, turmeric, salt and pepper.

6. Bake at 400°F for about 25 minu tes.

7. Enjoy the bake alone or with som e kale

or mixed greens. Add some lemon juice or vineg ar (apple cider, red wine, malt vinegar) for extra flavor.

PARASTOO JANGOUK, MD Austin Gastroenterology Austin, TX

“My goal is to help people understand that, despite everything going on in the outer and inner world, we still have a lot of control over our health.

And the biggest changes always start with us.”

You cannot be Persian or have Persian friends and not love “Tahdig.” Tahdig is the famous Persian crispy rice. One of my Persian friends recently posted the picture of a greeting card saying, “You’re the Tahdig to my rice.” This alone shows you the significance of Tahdig in Persian cuisine.

As a kid growing up in Iran, we had access to fresh food on daily basis. I remember I would go to the local grocery store with my mom every day to buy the ingredients she needed to cook. The local grocery store was a hole-in-thewall selling organic natural produce.

Persian main dishes consist of cooked meat and vegetables served with rice. The key part of the meal, however, is the side dish. You can always find a platter of fresh herbs, a bowl of pickled vegetables (called Turshi), or Greek yogurt served with cucumber and dill.

I remember during my childhood I developed a conflicted relationship with our food. I found it boring, heavy, and not delicious. Like a lot of kids my age, I was craving the greasy Western food. It wasn’t until the recent years when I started my plantbased journey that I started to reconnect with

LOUBIA POLO (GR

Persian food and appreciate the myriad of health benefits it provides. Today in my practice as a gastroenterologist, I deal with the consequences of poor dietary choices on my patients’ health, and I always encourage them to kickstart their healthy lifestyle by adding more plants to their diet.

My goal is to help people understand that, despite everything going on in the outer and inner world, we still have a lot of control over our health. And the biggest changes always start with us. Becoming plant-based is one of the best gifts one can give themselves. It requires curiosity and openness. Reminiscing on those good old days, I’m grateful that I was raised in a country where healthy eating was engrained in the culture. I hope the footprints of those healthy days are still alive somewhere within my gut microbiome.



—Parastoo Jangouk, MD

We would love to hear from you if you have personal connections with GI and gastronomy.

Contact ACG MAGAZINE staff at acgmag@gi.org to share your story with the ACG community. You can also tweet using #ACGfoodies to connect with the community. Wishing you all good health and great meals from our culinary connections #ACGfoodies team.

DIG AND A SIDE OF FRESH EEN BEAN RICE) WITH CRISPY TAH

 Ingredients • 2 cups basmati rice • 2 cups green beans • 4 Tbsp tomato paste • 1 large potato • 1 medium onion • 2 cloves garlic

• 1-2 Tbsp cinnamon powder • 2 Tbsp turmeric • ½ Tbsp saffron • ½ Tbsp salt and pepper • Vegetable oil

 Steps Sauce lic and sauté in vegetable oil 1. Finely chop onion and gar 2. Add the tomato paste er; season with turmeric, 3. Add 2 cups of boiled wat n salt, pepper, and cinnamo 1-inch pieces and sauté into ns 4. Chop the green bea le oil until nicely browned them separately in vegetab 2 Tbsp of boiled water and 5. Add minced saffron to add it to the sautéed beans

ron 6. Add the beans and saff and garlic sauce

to the tomato, onion,

HERB PLATTER (SERVES 2-4)

Rice 1. Wash the rice

add salt 2. Bring water to boil and er wat ing boil the 3. Add rice to r after 3-5 minutes when nde cola a in rice 4. Drain the

soft on the outside and firm

in the center

Layering and Tahdig ium-thick slices 1. Chop the potato into med

pan to coat the bottom of the 2. Add 1-2 Tbsp of butter s slice ato pot with pan 3. Cover the bottom of the — cover with a layer of sauce 4. Add a layer of rice and repeat until done n kitchen towel 5. Line the lid with a clea

r low temperature with the

ove 6. Steam for 45 minutes lid on

Herb Platter • Radish • Basil • Spring onion • Mint ned, and chopped as All washed in cold water, clea needed. al with 12 plant points.

Voila! Enjoy this healthy me

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