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October 1, 2011 -- Vegparadise News Bureau

Kaiser Physician Responds to Comments
About His Recipe for "A Healthier Burger"

Instead of responding individually to comments about his 183-calorie barbecued burger recipe in the Kaiser Permanente partners in health e-newsletter (see story below), Dr. Preston Maring, an obstetrician/gynecologist and administrator at the Kaiser Oakland Medical Center, addressed all of them with a statement at the beginning of his article "Fish tacos for the family."

Dr. Maring wrote, "Before we talk about delicious, healthy fish tacos, I wanted to address some comments we received about our "183-calorie burger" recipe in the July issue of Partners in Health e-newsletter. Even with a serving of vegetables, some didn't like that we excluded the bun in the calorie count, and others disagreed with mixing ground beef with ground turkey. And, others disagreed with even cooking meat on the grill.

Preston Maring "That recipe was something I had offered in the past on my blog, but you should consider either using all ground poultry instead of beef for burgers, or even buying a good veggie burger to cook. I admit -- I used to get excited when I saw the pepperoni pizza box with the grease coming through the bottom, but no more. Food choices change over time. Mine have.

"Try this month's fish tacos. They are the best. What's important is for each of us, no matter where we are on the broad spectrum of dietary choices, to move a little each day toward a healthier diet."

You, the reader, will notice that the doctor completely ignored our comments on the dangers of eating barbecued meats and the inaccuracy of the calorie count. Looking through the September issue, we discovered more reasons why we should not take Dr. Maring's advice about healthy recipes. Any sane dietitian would gag while reading the "new Thrive recipe library."

Some of these recipes contributed by guest cooks could lead THRIVE fans to make many more visits to their Kaiser family physicians:

The champion pot belly buster is Chef Mario Batali's "T-Bone Florentina with Sautéed Spinach." The chef recommends one 3 to 3 1/2-pound T-bone steak to serve 4 people. The recipe includes 5 tablespoons of olive oil and 2 tablespoons of salt. The nutritional information says that each person will ingest 252 calories (somebody can't count), a whopping 3959 mg of sodium (almost three-days worth), 21 grams of fat (3 grams saturated), and 0 cholesterol (somebody is lying or kidding). According to the USDA National Nutrient Database for Standard Reference, 3 ounces of lean, broiled T-bone steak, trimmed to "0" fat is 210 calories. If four people ate three pounds of steak, each person would be consuming 12 ounces or 840 calories. Those 12 ounces provide 54 grams of fat, not 21. That same quantity of steak offers 15 grams (not 3) of saturated fat and 135 mg of cholesterol. Those numbers don't count the at-least 150 calories each person would receive from the olive oil, and that doesn't enumerate the calories in the oil drizzle on the meat when it's served at the table.

"Anne Rosenzweig's Lobster Club Sandwich" is a heart attack waiting to happen. To make 4 sandwiches, Chef Rosenzweig uses 1 1/4 pounds of butter, 2 cups milk, 10 large eggs, 2 raw egg yolks, 1 1/2 cups soy oil, 16 slices of bacon, and 1 pound cooked lobster tail meat. Described as a "haute version of the old-fashioned ladies-lunch fare," this sandwich boasts 3,123 calories, 2946 mg sodium, 1047 mg cholesterol, and 229 grams fat (150 grams saturated). The chef's note advises, "This fresh mayonnaise includes raw egg yolks and, therefore, should be made with farm-fresh, salmonella-free eggs." To those eating this sandwich, we say, "If eating this creation doesn't demolish your arteries, the salmonella-filled raw yolks may destroy your entire body."

The "Roast Goose with Chestnut and Fruit Stuffing" emanates from famed chef James Beard. Beard begins with a 9-pound goose and stuffs it with apples and chestnuts. One serving has 2121 calories, 663 mg of sodium, 171 grams fat (50 grams saturated), 29 grams sugar, and 403 mg cholesterol.

And the list goes on to include "Flank Steak Thinly Sliced over Arugala with Garlic and Lemon Oil"--"Jarlsberg-Crab Fondue"--"Roast Lamb with White Beans." These dishes might be considered fine dining by some but not healthy food advocated by an organization that provides health care to thousands of people.

It is unconscionable for any health organization to endorse these unhealthful recipes on its website. When Kaiser Permanente signs up with an outside service like cookstr (The World's #1 Collection of Cookbook Recipes Online) it is giving its stamp of approval to these recipes from famous chefs who are more interested in creating rich tasting food than in providing healthful cooking suggestions.

We strongly urge Dr. Maring and his associates to reconsider posting these recipes on a website that wants its Kaiser Permanente members to THRIVE.

August 1, 2011 -- Vegparadise News Bureau

Kaiser Physician Provides Recipe
For "A Healthier Burger"

We've been members of Kaiser Permanente for eons. Whenever we have any medical problems, we journey to our nearby clinic and are pleased with the attention we receive.

Because we belong to this health plan, we are on the email list to receive online newsletters telling us how to THRIVE (Kaiser's motto). In July we opened another of our medical provider's cheery documents, partners in health e-newsletter, that offers all kinds of health advice. This issue recommended vaccinations for children, summer safety tips, and suggestions for keeping cool.

But the featured story "Enjoy a 183-calorie burger at your next barbecue" not only drew our attention but also motivated us to write this note of disappointment. (See recipe at the end of this article.)

Kaiser Health e-newsletter The recipe for this 183-calorie "A Healthier Burger" is the creation of Dr. Preston Maring, an obstetrician/gynecologist and administrator at the Kaiser Oakland Medical Center.

How about grilled cancer?
Wait a minute! Is our health provider now promoting barbecue burgers made from turkey or beef? We're almost certain the medical professionals at Kaiser are aware of the dangers of cooking beef or turkey at high temperatures as well as similar concerns about not cooking these meats at temperatures high enough to avoid dangers of E-coli or salmonella. And then there's the cholesterol added to the diets of people who don't need more, or who are taking statin drugs to reduce cholesterol.

As far back as 2005, The National Institute of Health warned of the dangers of barbecued meat . At that time the organization added heterocyclic amines to the list of cancer-causing agents. Heterocyclic amines are created during grilling, frying, or barbecuing meats containing muscle: beef, pork, poultry, and fish.

According to the Harvard Health Letter, a publication of the Harvard Medical School,

    "When meat is cooked at high temperatures, amino acids react with creatine to form heterocyclic amines, which are thought to cause cancer. That's why cooking meat by grilling, frying, or broiling is the problem.

    "Grilling is double trouble because it also exposes meat to cancer-causing chemicals contained in the smoke that rises from burning coals and any drips of fat that cause flare-ups. How long the meat is cooked is also a factor in heterocyclic amine formation; longer cooking time means more heterocyclic amines.

    "Depending on the temperature at which it's cooked, meat roasted or baked in the oven may contain some heterocyclic amines, but it's likely to be considerably less than in grilled, fried, or broiled meat."

PAH raked over the coals
A New York Times 2005 article, "The Claim: Grilled Meat Causes Cancer," adds another aspect to dangers of barbecuing meat. "At least one other group of chemicals, polycyclic aromatic hydrocarbons, which can also collect on meat cooked over hot coals, has been on the agency's [NIH] list since 1981. Much of the concern stems from epidemiological studies. In 1999, for example, researchers at the National Cancer Institute conducted a large study of colorectal cancer and found that the odds of developing the disease were tightly linked to consumption of red meat, particularly when grilled or well done."

Black Box Warning If we were distributing the recipe for "A Healthier Burger," we would add a Black Box Warning Label like the ones on some prescription bottles. The label might say, "WARNING: CANCER OR KIDNEY FAILURE. Not cooking these patties hot enough may give you a fatal E. coli infection, while cooking them well done at high heat may increase your risk for stomach, colon, or rectal cancer."

Examining the recipe, we began to wonder whether these burgers were really 183-calories. The recipe uses olive oil, but there's no indication of how much. We surmise that sautéing the spinach would require approximately one tablespoon, or possibly more. One tablespoon of olive oil would add 14g of fat and 120 calories to the recipe. We question whether Dr. Maring included the calories from olive oil when he calculated the nutritional analysis.

How to squeeze 183 calories out of a 4-ounce patty
Puzzling to us is squeezing 183 calories into a 4-ounce beef patty (11/2 pounds divided by 6 servings). The beef would have to be 95% Lean/5% Fat to be 140 calories. If it were 85% Lean/15% Fat, a 4-ounce patty would be 192 calories. If it were 80% Lean/20% Fat, the patty would be almost 210 calories. It would have been helpful if the recipe had indicated the fat content of the ground beef.

Achieving the 183-calorie goal doesn't sound possible with 93% Lean/7% Fat ground turkey that measures 176 calories in a 3-ounce patty. Add another ounce to create a quarter-pounder, and you are up to 235 calories, and don't forget the olive oil. These values can be found in the USDA National Database for Standard Reference.

Whether beef or turkey, you'll still be adding 90 mg of cholesterol to your daily intake as well as 10 mg of artery-clogging total fat, 3 of which are saturated.

The doctor admits that the nutritional information does not include additional toppings or the bun. The bun could increase the calories by 100 to 150, while a tablespoon of mayo would net between 50 and 100 calories. Most mustard is relatively low in calories unless you opt for honey mustard that might add about 50 calories for a tablespoon.

Eating Hamburger Gimme a good health move
If Dr. Maring had recommended a veggie patty like a 4-ounce burger made from Lightlife Gimme Lean Sausage, he could really be making a neat health move. That patty would lower the calorie bar to 120 calories and at the same time offer zero cholesterol and fat. He would also eliminate the cancer-causing muscle in his recipe. Instead of cooking the spinach in olive oil, he might want to follow Zel's advice to water sauté to reduce the calorie count significantly.

There are countless veggie patties that cut the calories, are cholesterol-free, and reduce cancer risk. We've published a few and would be more than delighted if Dr. Maring and his colleagues would share them with their patients who really want to THRIVE.

Here are a few links to those recipes:

More than ever Kaiser needs to pay more attention to what their subscribers are eating as a way to prevent chronic health problems. Certainly, the organization has made strides in offering weekly farmers' markets outside many of their clinics, but they need to do more in helping people get back into the kitchen to prepare healthful meals.

We commend Dr. Maring for being a strong advocate and pioneer of farmers' markets at Kaiser clinics and for being a promoter of using locally grown organic produce. And he cooks, too! His recipes using farm-fresh produce are featured on the Kaiser website. http://recipe.kaiser-permanente.org/category/recipes/

Our surprise and indignation is to find a prominent physician at our health organization recommending barbecued burgers when there are healthier alternatives available. We know he's not trying to promote more business for Kaiser clinics, but if the doctor says grilled burgers are OK, unhealthy patients will be on his doorstep at the hospital.

A Healthier Burger
Dr. Maring's Recipe

Serves 6


  • 1 1/2 pounds ground turkey or beef (or a mixture of both)
  • 10 ounces baby spinach leaves
  • zest of one lemon
  • 3 garlic cloves, minced
  • 1/2 tsp. salt
  • 1/4 tsp. freshly ground black pepper

Fire up the grill. Sauté the spinach in olive oil until it wilts. In a large bowl, mix the turkey or beef, spinach, lemon zest, garlic, salt, and pepper. You can make healthier quarter pounders using a half-cup measuring cup to get an equal amount per burger and flattening them on waxed paper. Grill the burgers until done. Serve them on whole-grain buns.

Nutrition Information Per Serving (does not include bun or additional toppings):
Calories: 183
Fat: 10 g
Saturated fat: 3 g
Trans fat: 0 g
Cholesterol: 90 mg
Carbohydrate: 2 g
Fiber: 1 g
Sodium: 338 mg
Protein: 21 g

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