A Diet for the Heart

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in: Cooking

 

“Don’t cry darling. Nobody likes the army cook,” said my mother when I called her in tears. My co-workers and I had just cleared the dinner buffet, where one of the diners had said, “AH wouldn’t even trah to give that to mah DOWG.”

The year was 1980, the place, a lakeside resort called Horseshoe Bay, not too far from Austin, in central Texas. I had been hired by Dean Ornish, then a medical student at Baylor College of Medicine, to design and cook the menus for a landmark cardiovascular research study he had put together. He wanted to test his hypothesis that a lifestyle program that included an extremely low-fat vegetarian diet could reverse heart disease. He had recruited 24 cardiac patients from the Houston area to come to Horseshoe Bay for a month without their families to participate in his intervention.

Converting meat-eating Texans

I’d been thrilled when I’d gotten a call from Dean in April of 1980. I had always been a cook with a focus on health, and for some time had thought it would be interesting to work with heart patients. Ornish was looking for somebody to cook for his study and had gone to a large bookstore to peruse all of the vegetarian cookbooks. There he came across my recently published “The Vegetarian Feast.” It was clear from the book that I was no hair-shirt ascetic, yet my food wasn’t too rich either. I was just what he needed for his group of meat-eating Texans — somebody who could cook attractive, tasty vegetarian food. He flew me to Houston so that I could meet the other members of his research team and he could brief me on my menu-planning parameters. The diet he envisioned would be no more than 10 percent fat. We were allowed to include nonfat yogurt, but other than that it would be essentially vegan — a term that hardly existed back then — and, because the patients had high blood pressure, I would not be able to use any salt at all.

I worked on my preparations for the next three months, one of which I spent in a farmhouse in Provence writing meal plans and recipes. I was determined to prove that a vegetarian diet did not have to be boring, defined only by brown rice and steamed vegetables. I would give them gazpacho, tabouli and hummus, exotic curries and comforting, savory pastas, vegetarian chili and black bean enchiladas.

A month of preparation

The biggest challenge I faced was the salt ban. Salt is such an essential seasoning, and it’s especially important when you’re cooking vegetarian staples like beans. Bread without salt is tasteless, and I was going to be making all of the breads. I came up with some whole-wheat herb breads and a corn bread that would do. Tofu would be out as it would be too bland without soy sauce (that was probably a good thing, given our Texas subjects). I decided my remedy would be spices, herbs and condiments. If they couldn’t have salt, they would have salsa. During the very hot month of August preceding the September study, I spent most of my waking hours in a non-air-conditioned kitchen, canning salsas, chutneys, homemade ketchups and mustards; baking and freezing breads, 10 loaves a day (ironically, I rented a meat locker for storage); making lists and worksheets; organizing equipment rentals; and ordering 30 days’ worth of produce.

I hired two of my reliable, talented assistants who had worked for me in catering; I knew they could compose beautiful platters, and that would be important. The day before the start of the study I broke down my kitchen in Austin, filled boxes with a batterie of nonstick cookware and other equipment, as well as all of the supplies I’d been storing in various rooms of various friends’ houses, took the bread from the meat locker and drove out to Horseshoe Bay.

A colossal failure

Home for the next month would be a tacky lakeside condo. Our working kitchen was a tiny studio kitchen. Here we would be preparing three meals a day for 35 people, and on weekends, when the spouses were allowed to come, for 50. We moved all of the furniture out of the living room, set up rented work tables in that space, requisitioned some of the refrigerators from the condos of other staff members and turned the closets into pantries for food storage. The big difficulty was that the kitchen was on the ground floor, but the participant dining room was a conference room on the second floor. There was no kitchen in that space, so we would have to run all of the food upstairs for every meal. By the end of the project I was lean and wiry, stronger than I’d ever been; I actually loved the physicality of the job, running casseroles up stairs three times a day, lifting heavy pots, being on my feet 14 hours nonstop. The theatrics were an aspect of catering I enjoyed at that time in my life, and we had three curtain times a day.

When the patients arrived on Wednesday, hot and sad and sick, we had a spaghetti dinner waiting for them. Full of smiles, I was not prepared for their hostile reaction to the food. They hated it immediately. It hadn’t occurred to me to not put sprouts in the salad (“Yo’re not goin’ to trah to git me to eat sprouts, are ya? Mah daughter trah’d to git me to eat those thangs.”). At least half of them hated the spices and herbs they’d never tasted before. Nobody had ever seen whole-wheat spaghetti. Here I’d been knocking myself out for months developing interesting dishes that would prove that a vegan diet need not be dull or ascetic and that there were all sorts of flavors besides salty, and it was a bomb. They wanted dull. What these down-home folks really wanted and needed, I learned after three long days of negative feedback, was food they could recognize.

On the third night I gave them steamed vegetables and plain brown rice, the one thing it had been my goal to avoid, and they said it was great. I smiled and acted cheerful as one man told me that it was the first meal that didn’t make him gag, and another one told me that he didn’t even like the smell of the other food we’d had. After dinner I had my good cry and called my mother.

Rethinking the menu

Then I regrouped. Dean had been going crazy with worry that the people would leave (one woman had) and his study would be ruined. He kept asking me to change the menus, and we arranged a meeting with all of the patients, who asked that I do simpler dishes and serve the dressings on the side. They hated the dishes that were exotic to them, like hummus, and grains they’d never seen, like bulgur, but were clamoring for hot sauce and jalapeños. Some of them objected to garlic, so Dean asked me to chop the garlic and serve it — raw — on the side. To this day I’m convinced that they ended up eating a lot more garlic-as-condiment than they would have eaten had I cooked it with the food; I suspect that might even have had something to do with the fact that their blood pressure went down.

I began doing more down-home, familiar meals. I gave them okra with tomatoes, seasoned with a little cider vinegar, and rice for dinner, and they loved it. They went ape the next night when they got black-eyed peas, coleslaw and cornbread. The next day’s split pea soup — even without the ham hocks — and corn on the cob was also a hit. They began to like the food, to be nice to me and seek me out (each one seemed to have a suggestion) and to feel better. I took no further chances.

A triumphant finish

Two weeks into the study, all of the patients were making tremendous progress. Many had gone off their medications, they’d lost weight, and they were feeling good. Consequently, they began to enjoy the food. I made things they could relate to, but every once in a while I’d slip them something unusual like a fruit soup, and they’d love it. By the third week I was even receiving compliments. Sometimes they’d arrive after an hour of meditation or visualization exercises (part of the intervention) and I’d get smiles and comments like “I was visualizing black-eyed peas for lunch and we’re having them!”

On the last night of the project, there was a big party. We made a beautiful black bean chalupa buffet and they were all very happy. During the first weeks of the study they would have rejected everything on that table, but now they were filling their plates. They told me how fond of me they’d become, and that now they really liked the food. “Oh, we’d like a little salt on it,” they said (me too! I thought), “but we’re enjoying it and we’ll stick with the diet.”

The study was a great success for Ornish. All of the patients showed measurable improvement in their cardiac function. They could ride about 10 times longer than before the intervention on an exercise bicycle and their blood flow to the heart had improved. For me, cooking at Camp Heartbeat had been a tremendous learning curve, a crash course in regional eating habits. I learned how strongly people can feel about food, how averse they can be to foods they don’t recognize. If ever I did that kind of work again, wherever it was, I knew that I would have to spend time there first, to bone up on what the people in the area were used to eating before I began. Not having meat on the plate was bizarre enough for my Texans; chickpeas and bulgur were beyond the pale.


Zester Daily contributor Martha Rose Shulman is the award-winning author of more than 25 cookbooks. Her latest is “The Very Best of Recipes for Health,” published by Rodale.

Photo: Farmers market veggies.

Credit: manlevaudio / istockphoto

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