And the beet goes on

So I know there aren’t a lot of beet lovers out there. I’m asking a lot to get you to like brussel sprouts AND beets. Let me say, however, that I am a fanatic. A freshly cooked beet tossed up with some lemon is the epitome of richness, sweetness and deliciousness. And not to get too grossly personal, but every time I eat beets, I think I have a urinary tract infection. My pee turns bright red. Does this happen to anyone else?

Studies show that yes, beeturia, as it is so lovingly referred to in the medical world, occurs in approximately 14% of the population. (On a side note, I just love how they named it beeturia. When you pee blood this is called hematuria; hemat- for blood and –uria for urine. I guess the medical term for beet…is beet!)

While having beeturia might seem of minor consequence, and the majority of the time it is, in some cases it can indicate something more serious. Back in the 60s when beets were groovy, British scientists studied the incidence of beeturia in patients that had no known medical problems, those with iron deficiency anemia, those with pernicious anemia (this is anemia from the inability to absorb vitamin B12 in the gut), and those with malabsorption syndromes1. They found that the incidence of beeturia was only about 14% in healthy people but around 40% for anemic or malabsorptive patients.

This phenomenon was further explored. After a group of scientists experimented on 100 impoverished grad students, starving them, feeding them liquid beets and collecting their pee in a jug, it was found that high stomach acidity and long stomach emptying time can greatly impede absorption of beet pigments2. The rest of this data was gathered through rat models. Other things that stop beet pigment absorption include intestinal iron compounds, which explain why anemia can cause beeturia3.

So, if you eat beets and you have beeturia should you freak out? Probably not; most people with beeturia have a genetic predisposition to it. If you are concerned however, you could go to your doctor and say that you read something on the internet written by a medical student that you might have anemia. Doctors love that. (Like the time in my second year of medical school that I was convinced that my fiancé had this horrible autoimmune disease ankylosing spondilitis which causes your back to fuse together and gives you horrible arthritis, just because he had back pain. He went to the doctor all freaked out, and of course he just had some muscular strain. He did two stretches and felt better.)

And if you’re not sure if you have beeturia, there’s only one way to find out. Only through experimentation of consumption can the truth be gained. So, I challenge you to make this colorful, fragrant beet recipe which is citrusy, nutty and creamy, and report back to me. Even if you hate beets, do it for the name of science.

Ingredients
4-5 medium beets
Juice of one lime and one lemon
2 tbs unsweetened almond butter (you can buy this at Trader Joe’s it’s like peanut butter but with almonds; if you can’t find it you could just use a couple of tablespoons of finely chopped up toasted almonds)
1 medium clove of garlic
2 tbsp olive oil
1 tsp salt (plus salt to cook the beets)
One ripe medium avocado

Rinse the beets (or scrub that) if they are particularly dirty. Fill a medium to large pot halfway with water. Salt the water. Cut beets in half and boil over medium high heat with covered lid for about 40 minutes or until beets are tender when pierced with a sharp knife. When beets are ready, rinse with cold water and peel with hands. Beets should peel easily and your hands will turn a beautiful crimson color (if they don’t peel easily use a vegetable peeler). Dice beets into medium sized cubes.

Dice avocados into medium sized cubes. To make dressing, mix lemon and lime juice with almond butter, garlic and salt in small bowl or glass. Then add olive oil. Dress salad and toss gently (don’t make too much fuss or the avocados will get mashed up). Enjoy!

1) WATSON, W., LUKE, R., & INALL, J. (1963). BEETURIA: ITS INCIDENCE AND A CLUE TO ITS MECHANISM. British Medical Journal, 2(5363), 971-3.

2) Watts, A., Lennard, M., Mason, S., Tucker, G., & Woods, H. (1993). Beeturia and the biological fate of beetroot pigments. Pharmacogenetics, 3(6), 302-11.

3) Eastwood, M., Nyhlin, H. (1995). Beeturia and colonic oxalic acid. QJM : monthly journal of the Association of Physicians, 88(10), 711-7.

a fortifying post--why cast iron is good for you

For my birthday this year, I proclaimed to my family "No more kitchen supplies!". It seems that when you develop a hobby, be it cooking, or knitting, or biking, then all of the sudden, that's all you get for Christmas, birthdays, or any other celebration. No longer is the longed for sweater, a good novel, or a funny DVD. Well thankfully, my sister didn't listen to my birthday demand, and in the mail (thank god for free shipping from Amazon) came a brand new cast iron pan. And bless her soul! Cast iron is genius.

If you don't have a cast iron pan, I strongly recommend that you get one. They are extremely affordable, they cook very evenly, you can put them in the oven without the handle melting off, and if you take care of them they will last forever. They do require a little more maintenance than your regular kitchen utensil. You have to season them which means initially scrubbing the pan with hot soap and water, heating the pan, and smoking hot oil into layers, but this makes a natural non-stick layer. There are many methods for seasoning and this and this are good instructional videos.

When my pan had gotten a little out-of-control sticky, I went on a search of how to re-season it. I stumbled upon resources mentioning that cast iron cooking can contribute to iron intake because elemental iron leaches into the food that we cook. They go even further to suggest that cast iron could be part of the treatment for anemia. Fascinating. Time to scour the evidence. Unfortunately, a lot of the original papers that discuss the amount of iron in different foods from cast iron cooking are from the 80s and not available online. It would seem a little overkill to go to the library and find the original articles for a blog that five people read (but thank you if you are one of them). Even so, the abstracts suggest that cast iron does contribute significantly to the iron concentrations in various foods (1,2).

Interestingly though, are more recent studies that use cast iron as an attempted treatment to prevent iron deficient anemia in underdeveloped countries, since anemia is endemic in many parts of the world. A study completed in Ethiopia in the 1990s distributed cast iron or aluminum pots to families of children with iron deficiency anemia and measured the difference in hemoglobin concentrations after 12 months(everybody in the study also took oral iron supplements) (3). They also measured the amount of iron available in Ethiopian foods cooked in various vessels. The findings showed a significant difference in hemoglobin concentrations in those children that received cast iron-cooked food versus aluminum or clay. Vegetables and meat best extracted iron from the food into a digestible form. Beans for some reason, did not do as good of a job. Similar experiments repeated in other countries have yielded similar results, showing an excellent and easy way to combat low blood counts (4,5)

Fortunately, we do not live with the daily threats of malaria, hookworm and starvation. Even so, iron deficient anemia is prominent in our population especially in women of menstrual age, pregnant women, and those that do not get enough through their diet. In attempts to perfuse your vital organs with rich, red blood built with the powerful iron element, I leave you with this recipe. (Caution: do not eat steak with butter everyday. That is NOT good for your blood)

New York Strip Steaks with Balsamic Glaze

2 thick NY strip steaks
1 tbsp butter
1 medium shallot
1 tbsp balsamic vinegar
salt and pepper to taste

1. Preheat your oven to 400 F
2. Preheat your cast iron pan to a medium-high/high heat
3. dry your steaks on a paper towel (the drier they are, the better sear you will get)
4. salt and pepper steaks generously on both sides
5. put half of the butter in the preheated pan and allow to melt
6. add steaks to pan
5. put steaks in pan; cook for about 4 minutes on each side
6. put steaks in oven for 2-5 minutes depending on how done you would like them
7. take steaks out of oven (be careful because the handle is very very hot) and put on a plate to rest, put the pan back on the stove over medium heat
8. with the pan drippings, put other half of butter (or if it too greasy for you already don't) and then saute shallot until transluscent
9. deglaze pan with balsamic vinegar. If the sauce is too dry add a bit of sherry or water
10. pour over steaks and serve

bibliography:

1.Burroughs, AL.; Chan, JJ. “Iron content of some Mexican-American foods. Effect of cooking in iron, glass, or aluminum utensils.” Journal of the American Dietetic Association, v. 60 issue 2, 1972, p. 123-6.

2.Brittin, HC.; Nossaman, CE. “Iron content of food cooked in iron utensils.” Journal of the American Dietetic Association, v. 86 issue 7, 1986, p. 897-901.

3. Adish, A., Esrey, S., Gyorkos, T., Jean-Baptiste, J., & Rojhani, A. (1999). Effect of consumption of food cooked in iron pots on iron status and growth of young children: a randomised trial. The Lancet, 353(9154), 712-6.

4. Borigato, E., & Martinez, F. (1998). Iron nutritional status is improved in Brazilian preterm infants fed food cooked in iron pots. The Journal of nutrition, 128(5), 855-9.

5. Geerligs, P., Brabin, B., Mkumbwa, A., Broadhead, R., & Cuevas, L. (2003). The effect on haemoglobin of the use of iron cooking pots in rural Malawian households in an area with high malaria prevalence: a randomized trial. Tropical Medicine and International Health, 8(4), 310-5.