Chef Clinic: Good Nutrition, Weight Control and Great-Tasting Food

Last Editorial Review: 6/4/2004

WebMD Live Events Transcript

Event Date: 07/27/2000.

Dr. John La Puma, a physician, chef, and researcher, discusses his comprehensive -- and great-tasting -- nutrition program.

The opinions expressed herein are those of the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live's World Watch and Health News Auditorium. Today we are discussing "Chef Clinic: Good Nutrition, Weight Control and Great-Tasting Food," with John La Puma, MD.

Dr.  La Puma is director of the Chef Clinic and teaches as a Professor of Nutrition at Kendall College in Evanston, Illinois. Dr. La Puma also follows the Clinic's own meal plan in losing and keeping off 30 pounds since 1992. The author of three medical books, over 250 papers, reviews and book chapters, Dr. La Puma also edits Alternative Medicine Alert, the leading newsletter for physicians in this field. The first physician in the country to complete the Professional Cooking curriculum at the Cooking and Hospitality Institute of Chicago, he has cooked regularly at internationally acclaimed restaurants since 1995. After graduating Phi Beta Kappa from the University of California in Santa Barbara, Dr. La Puma received his MD from Baylor College of Medicine in Houston, and trained in Internal Medicine at UCLA and at the West Los Angeles VA Medical Center.

Dr. La Puma, welcome to WebMD Live.

Dr. LaPuma: Thanks very much.

Moderator: How and why did you decide to become a chef?

Dr. LaPuma: I decided to become a chef because I wanted to know what went into a healthy diet and how to make it taste good. And I thought that, as a doctor, I should do more than prescribe medication or give my patients pamphlets. The way I became a chef was to go to school. I attended the Cooking and Hospitality Institute of Chicago, which has now been bought out by the Cordon Bleu, and worked at the Frontera Grill and Topolo Bampo for four years once a week on Friday nights.

Moderator: How do you define "good health?"

Dr. LaPuma: Good health is not just the absence of disease but, more importantly, a sense of vitality that is mental, spiritual, physical and social. People can have good health in any one of these realms or in all four.

marilyn21_webmd: What are some ideas you have for jazzing up diabetic cooking?

Dr. LaPuma: Diabetic cooking should be relatively low in calories, rich in polyunsaturated and monounsaturated fats and vegetable protein and especially lean in protein. The most important thing about diabetic cooking is that plant foods should be in the middle of the plate and animal foods should be on a side plate. Diabetics can eat wonderful, delicious meals. A friend of mine, Mary Abbott-Hess, has a great cookbook called, Desserts for Diabetics which outlines some special treats as well. We used to think that diabetics ought not to eat refined sugar. And it is true that sugar makes their blood glucose and blood insulin levels go up dramatically. Some diabetics are insulin-resistant and some people think that insulin resistance contributes or even causes obesity but, really, it's the other way around. Obesity in diabetics probably causes insulin resistance. Two other cookbooks that emphasize high-flavor techniques that diabetics can use include Stephen Raichlen's High-Flavor, Low-Fat Cooking and a book by Lorna Faff called Short-Cut Vegetarian.

dusty11_webmd: I'm a vegetarian, but I do eat fish. Trying to cut down on carbohydrates in order to lose weight. What do you recommend?

Dr. LaPuma: A really good fish book is by a man named James Peterson. The book is called, Fish and Shell Fish. You can lose weight by cutting down on carbohydrates ("carbs") if those carbs are highly refined and simple. An example of this is other people's baked goods (like doughnuts, cookies from 7-Eleven, many crackers). Most vegetarians who cut down on carbs can't (and shouldn't) follow a high-protein diet and so, the carbs that you can eliminate are just highly refined grains like those I just suggested. I think the way you're eating is just great.

dusty11_webmd: I work all day, and I buy lunch every day. What are easy things I can make the night before and bring to work?

Dr. LaPuma: Good for you for wanting to make something the night before. I think that's fabulous. Would you like to be my patient? (Laughs!) Here's what I tell my patients to bring to work. First, I tell them to try to cook for the week instead of just the night before because it's easier to cook in quantities than one or two meals at a time. It only takes a couple minutes longer to make an extra serving or two. Second, I suggest that my patients bring containers of yogurt; containers of good microwaveable soups, grains, and stews (I like Nile Foods, and Fantastic Foods, and Dr. McDougal Foods); and whole fruits of any kind. Third, if you want to cook the night before, I would make a Boca burger on a whole grain bun with lots of arugula and catsup and onions. Or, some guacamole with tortillas and jicama. Or, hummus with extra lemon and garlic plus some pita bread. Or, a couple of baked potatoes with some roasted or grilled vegetables on the side.

tina_tomcko_webmd: I am 5'-4" and weigh about 126 pounds. I need to lose a good amount of weight and was wondering what kinds of food would help me do this?

Dr. LaPuma: I understand that you feel like you'd like to lose weight, but actually, your weight is really healthy right now. In fact, you're not even technically overweight, although I understand you may feel like it. If you would like to redistribute a little of your weight and convert some of what is probably a healthy amount of fat into even more muscle, you might begin (if you don't already) an aerobic exercise program. You should pick an activity that you really like, regardless of what it is as long as you'll do it regularly. There really isn't a secret or magical food to help anyone lose weight. It really comes down to calories in and calories out. As I said, you don't really need to lose weight, in my opinion. But if you wanted to build more muscle, that would be a goal that I could happily endure, and the best way to do that would be with more exercise.

janewilson_webmd: Right now everyone is saying how bad pasta is for you, but I love pasta! How can I eat it and still lose weight?

Dr. LaPuma: I don't think 20 million Italians can be wrong. And in Italy, there is both semolina pasta (refined wheat), and whole wheat pasta. In my opinion, pasta is not bad for you. It's how much of it you eat and what else you eat with it that can put pounds on (and make you feel sluggish, tired, older and like you have no energy). The way I would eat pasta (and actually do eat pasta) is mixed in with a lot of other foods. Roasted green and yellow and red peppers with wagon wheels; chunky tomato garlic sauce with radiatore; roasted garlic sauce with roasted onions for spaghetti and fettuccini. In fact, in the May issue of Health magazine, I wrote a recipe for Ratatouille Pasta. I used whole wheat spaghetti and summer vegetables, but I used twice as many vegetables as you'd expect for two ounces of pasta. And, two ounces expands to a lot once it's cooked.

marilyn21_webmd: How do you feel about high-protein, low-carbohydrate diets for diabetics?

Dr. LaPuma: High-protein, low-carbohydrate diets are effective in the short term in helping people lose weight (and as weight goes down, blood sugar does down, too). They work because the body draws on its own store of glycogen while it is getting very little carbohydrate to make more glycogen. As glycogen is burned up, the body sends out water to pass it through the kidneys. So low-carbohydrate, high-protein diets help you lose weight because you lose water, not because you lose fat and not because you can permanently control your blood sugar this way. High-protein, low-carbohydrate diets went out of fashion in 1971 (they were popular then) and I think the same will start to happen next year. The reason is simple. They don't work for the long term, and no one can stay on them (even eating bacon and burgers and cheese without a roll, corn or a piece of fruit). It gets boring.

Moderator: So these types of diets were in vogue previously?

Dr. LaPuma: Yes, the high-protein diet was popular in 1969 and it died out in 1971. It cycles out every 30 years.

al_pavy_webmd: What are most Americans doing wrong when it comes to diet?

Dr. LaPuma: The answer to this is really unhappily simple. We eat too many highly refined convenience foods and don't cook enough. I think if we just had a few more cooking skills and people would enjoy it more, people like to do more things that they're good at. And, in our clinic, for example, we give everybody a chef's knife and teach them how to use it. That way they become good at chopping and they want to do more of it. So there are other simple answers, too. We don't eat enough whole foods; we eat too many refined foods. There is a Burger King on every corner. But the real answer is that if we just knew a little bit more about how to cook in quantity and shop for foods that are in season, then it would be just as easy to pick up a pear as it is to pick up a Cinnabon.

Moderator: Do you see any way to solve this problem in the future?

Dr. LaPuma: Yes. Actually, I think cooking is coming back, and one bit of evidence for that is the proliferation of farmers' markets. There is one near my house that I go to on Saturday mornings. And, the growers and farmers are always answering questions about where their squash is from or how they grew their cantaloupe, or what type of corn they brought to market, or where the cheese maker lives. I think if we make it easy for people to have access to more fresh fruits and vegetables and offer people the skills they need to cook a little more, then we can control more of this in our own kitchens.

column_webmd: What size servings should people eat?

Dr. LaPuma: I tell my patients to use a nine-inch plate for dinner and a five-inch plate for a side dish. A nine-inch plate is now called a salad plate. But, as plates have gotten larger, servings have gotten larger too. In fact, some family restaurants don't have plates. They just have platters. So I think if a nine-inch plate is filled (don't use the rim, that's not what it's for), then it's a good indicator of what an average meal might be like for most people. The side plate should have chicken, or fish, or cheese, or even red meat if you eat red meat. Just by switching the two places -- by that I mean putting what we might consider a center-of-the-plate food on a side plate and side dishes in the center of the plate -- you can eat more of the right things and less of something that has more calories and often, for me anyway, a little less flavor.

column_webmd: I hope this doesn't sound silly, but what's the key to making a good red sauce? One that doesn't taste "canned"?

Dr. LaPuma: Red sauces are as individual as cooks. My model for red sauces is Marcella Hazan, but there are lots of good other models. The way many Mediterranean tomato sauces start is with sauteing yellow onions in olive oil, adding garlic and then adding tomatoes and spices. This is a time tested way of cooking and works every time. I like to roast tomatoes under a broiler and roast red chilies under a broiler before blending them with onions and garlic and cooking them for 20 or 25 minutes until the fire from the chili is gone. The best cook I know of for this kind of red sauce is Rick Bayleff for whom I worked at Topolo Bampo for four years.

Moderator: And the chili recipe is pretty spicy?

Dr. LaPuma: Actually, it tastes more like the flavor of the chili than the spice. And, if you cook it as Bayleff does, as I've learned to do, a lot of the flavor of the chili remains and the heat or spiciness just remains in the background.

chartres_webmd: Is tofu really all that? Do you know any good tofu recipes? It seems so bland.

Dr. LaPuma: The best tofu cookbooks I know are This Can't Be Tofu! by Deborah Madison, and the book I mentioned previously by Lorna Sass. Tofu is bean curd and, by itself, it is about as appetizing as it sounds. But, in a book I'm working on (called RealAge Cafe with Michael Roizen), we have some baked tofu recipes that are excellent and a silken tofu dessert that really rocks.

chartres_webmd: So which is it for a perfect omelet? Two or three eggs?

Dr. LaPuma: It depends how many eaters. I use three egg whites for every single egg yolk. One whole egg, plus two egg whites. For me, that creates a lot of richness and also gives the omelet more lift than it might have if it was all egg yolks and egg whites.

column_webmd: How do you determine your particular caloric and dietary needs?

Dr. LaPuma: It depends on your age and your gender (and on any medical problems that you happen to have, plus any medical problems that you want to prevent). But, a simple way to start is by looking at several web sites, including that of the American Dietetic Association and of Tufts University. They both have basic, accurate nutritional information about calorie requirements and vitamin requirements. These are effectives requirements in preventing a lot of medical problems. I like Dr. Andrew Weil's new book called Eating Well For Optimal Health and I think it does a good job in outlining basic nutritional needs both for now and for the future. Actually, so does the book, RealAge by Michael Roizen, although we hope to improve on that in RealAge Cafe with some of Chef's Clinic recipes.

chartres_webmd: Were you a chef or an MD first? Those credentials are quite impressive.

Dr. LaPuma: You're very kind. I was an MD first and became a chef second. Now, I'm trying to do both. I went to medical school ten years before I went to cooking school. I practice medicine now and I love my patients. I like the kind of practice we're trying to build where we focus on people's real food and fitness needs.

chartres_webmd: Are there any cautions people should think about when eating sushi? How can you tell if the fish is fresh?

Dr. LaPuma: It's very hard, but fish that is fresh does not smell fishy. In fact, it usually does not smell at all. It has a clean, unscented, clear look and smell. So if your sushi smells like fish, send it back. In Japan, sushi chefs are very carefully trained and, in fact, have to apprentice for months or even years before being permitted to select fish. In America, unfortunately, we don't have those safeguards. And, although I just ate sushi yesterday (and loved it), I think you have to use your nose and your eyes. HACCP (Hazard Analysis and Critical Control Points) standards are now required in restaurants. These are standards that require proper refrigeration and cleanliness of all products, not just fish. But many restaurants don't adhere to them and so, unfortunately, even those aren't a guarantee. So, use your nose and your eyes and once you've decided to eat, enjoy it. In some parts of California, some health departments give restaurants sanitation grades and have them posted in the window. I like this idea and hope it becomes more widespread.

janewilson_webmd: Is honey better than sugar or is it the same, just in a different form?

Dr. LaPuma: Nutritionally it's the same. I think honey tastes better and its flavor depends on the kind of pollen that the bees used when creating it. But neither sugar nor honey is any place to look for nutrition, though they both have a role in cooking and baking.

dusty11_webmd: Thank you for your responses. Do you have any general tips for good health?

Dr. LaPuma: Try to eat in season. Buy what's fresh, what's colorful and what's easy. Number two, try to cook in quantity. Buy a really good chef's knife and take a simple class and learn how to use it. Number three, do something physically active every day, walk, bike, go outside. Number four, save some time for yourself, quiet time where you are away from distractions of all kinds. And, fifth, try to enjoy food, the more flavor the better.

Moderator: You recommend cardiovascular exercise?

Dr. LaPuma: Yes. I think both aerobic exercise and strength training have a role in fitness. We teach both in our clinic. People who want to lose weight should start, I think, with aerobics and add weight training. One of my patients is a body builder and came into the clinic more muscular than I'd seen any one in a couple of years, but he wanted to lose weight because he was 6'5" and 280, and even though much of that was muscle, he was carrying a spare tire. So, we actually increased his aerobic regimen and decreased his strength training regimen, and enticed him with Boca burgers and guacamole instead of steaks and beer. And, he can now spring up 14 flights of stairs without taking a deep breath (he's a firefighter).

Moderator: Where can we learn more about CHEF and your work?

Dr. LaPuma: Please come to or email us at [email protected] 

al_pavy_webmd: What are some of the more undervalued foods, as far as nutritional value?

Dr. LaPuma: Cruciferous vegetables, Swiss chard, kale, arugula, Brussels sprouts, all those things that you have no idea how to cook, but are really good for you. Also, a lot of whole grains are undervalued (quinoa, bulgur, even wheat berries). The problem with most of these foods is that they seem like they're from another world and they're not immediately convenient. But if you learn to cook them or even simple ways to recognize when they're fresh or in season, then it becomes a lot easier to do so.

Moderator: Dr. La Puma, thank you for joining us today. WebMD members, please be sure to check the events calendar for other upcoming live events.

The opinions expressed herein are those of the guest's alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

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