Sunday, February 10, 2019

Tom Kha Gai (Thai Chicken Coconut Soup)

Many of us received a not so warm welcome into 2019 as we faced record low temperatures throughout the country. Even my home in "Hotlanta" (please don't ever call it that) hit freezing.

Thankfully, the temps are back in the double digits (for now), but there will be many more cold winters in my future as I prepare to relocate to Rochester, NY for cardiology fellowship!

I obviously used this as an excuse to splurge on a new winter wardrobe and to create new cold weather recipes, such as Tom Kha Gai (Thai chicken and coconut soup). This ridiculously rich and fragrant soup is one of my all time favorites. If chicken noodle is the "Jewish Penicillin" of soups, then Tom Kha Gai is the "Thai Prozac." After getting the flu shot, this luxurious broth is all you need to get through the dreariest of winters. It is truly one of the most delectable wintery soups you can make.

The soup is surprisingly simple to make but is packed with brilliant flavors. It's a perfect combination of creaminess from the coconut milk, earthiness from the galangal root (more on this to come), tang from the lemongrass and lime, and umami-ness from the fish sauce and mushrooms. It also packs a bit of heat from the Thai chilis, just enough to bring a little zing to the palate.

Galangal root, called "Kha" in Thai (namesake of this soup) resembles ginger in appearance but is not interchangeable in flavor. Galangal has an earthy and citrusy flavor that is much stronger than ginger. Full disclosure, it was a little challenging to find initially, but was readily available at a nearby(ish) Asian market.

One final thought before getting to the recipe. A lot of the food I share fits within the parameters of a "heart healthy" Mediterranean diet, which emphasizes the consumption of unsaturated fatty acids from extra virgin olive oil and nuts. This recipe, on the other hand, uses coconut milk, high in saturated or "bad" fats thought to raise the risk of developing heart disease. So, why are these coconut products frequently marketed as "health foods?" The thought is that saturated fats from coconut oils are made of medium chain triglycerides, which may be metabolized differently than other "bad" fats.

Per my recent review of PubMed, the literature remains limited and inconclusive. While epidemiological data has not found a clear association between coconut oil consumption and heart disease, several small randomized trials showed that coconut oil does raise LDL ("bad") cholesterol. However, many of these studies failed to evaluate the effects on HDL ("good") cholesterol and there are no long term outcome studies. At this point, I don't think there's sufficient evidence to toot coconut oils as "healthy," but it warrants ongoing investigation. For now, I think it’s reasonable for healthy individuals to consume these products in moderation.

Tips/Tricks to the Perfect Tom Kha Gai

  • As always, the simpler the recipe, the more important it is to seek out the highest quality ingredients. These are the brands I recommend:
    • Arroy-D 100% coconut milk
      • Comes in a carton rather than a can and has no preservatives or additives
      • Wonderful taste and texture that feels closest to fresh coconut milk
      • At a minimum, try finding brands made in Thailand that only have coconut and water listed as ingredients
    • Red Boat Fish Sauce
      • It's salty with a nice fish flavor (that isn't fishy) and has a slightly sweet finish
    • Favorite store bought stock? "Thank you, next..."
  • Avoid boiling your coconut milk to prevent curdling! She's delicate!
  • There's enough natural sweetness from the coconut milk to balance the tanginess of the lime. If you want it sweeter, add a little palm sugar
  • Use the bottom of a heavy pot or a mortar and pestle to smash the hell out of your aromatics!
    • Smash the Thai chilis until their insides are oozing out a little
    • Bruising lemongrass will result in a more vibrant soup
  • Hit up your Asian market and stock up on the ingredients not readily available elsewhere (galangal, kaffir lime, good coconut milk, lemongrass, Thai chilis). Please let me know if you have trouble tracking them down. I'd be happy to help!

Serves 2-3 as main course

Tom Kha Gai Ingredients

  • 2 cups homemade chicken stock
  • 1 large stalk lemongrass
    • Ends trimmed, tough outer layer removed
    • Smashed, cut crosswise into 2-inch pieces
  • 2-inch piece of fresh galangal, sliced thinly into rounds
  • 5 large kaffir lime leaves, crumbled and torn to pieces (about 0.35 ounces)
  • 16.9 ounces full-fat coconut milk (500 mL or 2 generous cups)
  • 3 tablespoons fish sauce
  • 1 pound boneless, skinless chicken thighs, cut into bite sized pieces
  • 8 ounces fresh oyster mushrooms or other mild varieties, such as enoki or straw
  • 4 fresh Thai chilis, smashed
  • 4 tablespoons fresh lime juice, plus extra lime wedges for serving
  • Cilantro for garnish
  • Cherry tomatoes, halved for garnish (optional)

Preparing Lemongrass:

Tom Kha Gai Recipe

Combine chicken stock, lemongrass, galangal and lime leaves in a medium saucepan and bring to a boil over medium-high heat. Reduce heat and simmer, covered, for 30 minutes. Strain broth through sieve into a new saucepan and discard the solids.

Add the coconut milk and half the fish sauce and bring to a gentle boil over medium heat. Add the chicken and return to a gentle boil, then add the mushrooms and chilis. Reduce heat and simmer, uncovered, until chicken is cooked and mushrooms are tender (about 10-15 minutes).

Remove from heat. Tasting the soup, gradually add lime juice and the remaining fish sauce until a desired balance of tangy and salty flavors are reached. Cover the pot and allow the flavors to meld together off the heat for a few minutes.

Ladle the soup into a tureen or individual bowls and serve with lime wedges, cilantro, and other garnishes as desired.

Tuesday, April 3, 2018

Walnut and Pomegranate Khoresht-e Fesenjān

As a health-nut and fitness enthusiast, I can be as basic as they come. From my well-curated wardrobe of Lululemon activewear, to the "workout vitamins" I blindly purchase from my gym's health shop, I am guilty of sometimes buying into the latest health and lifestyle trends. If by nothing more than placebo effect, my diet rich in ultra-organic, non-GMO, cage-free, space-traveling, but at the same time, local and responsibly procured "superfoods" makes me feel energetic and deliriously healthy. However, as a physician and food blogger, there's no role for such Bro Science or "gym-lore" in the recipes that I share.

On the contrary, I strongly value evidence-based medicine and want to provide reliable, proven recommendations for maintaining a heart-healthy, and, of course, insanely delicious lifestyle. (Side note, the CDC ban on the term "evidence-based" is outrageous).

That's why I am so excited to finally share my recipe for Fesenjān, a traditional Iranian khoresh (or stew) made from ground walnuts and pomegranate molasses. This magical stew is typically accompanied by chicken or duck and served over saffron rice. As it simmers for hours, the oil begins to render out of the walnuts while the sauce thickens and darkens, taking on rich, complex flavors. The harmony of tangy and sweet ingredients gives this dish a brilliant depth of flavor. (It's even more delicious than it sounds).

I've made the dish for friends, family, and even my Medicine team (basically an extension of my family) and I guarantee that it will be all the rage at your next dinner party.

This recipe is a winner based on taste alone, but it also happens to be good for you. And sure, you can probably find walnuts and pomegranates listed as "superfoods" on a Google search, but honestly, does anyone actually know what that even means? I certainly don't...What we do know, however, is that Fesenjān is heart-healthy as part of a Mediterranean style diet, which can help lower the risk of heart attack and stroke!

*Insert generic, charming backstory about Fesenjān here* ...Or not...

I love tying my food together with personal anecdotes, but unfortunately, I don't have any cute stories to share about my grandma sweating over a hot stove all day making Fesenjān. The actual backstory behind this recipe is a lot less romantic...

It was back in November, during a busy ICU rotation, that I unknowingly embarked on this cultural immersion when a colleague recommended that I try Fesenjān. In general, I love the bold and distinctive flavors characteristic of Persian food, so I was quite eager to try out her recommendation.

Hmmm, perhaps "eager" was a bit of an understatement...

I had just completed a 30 hour MICU call, but instead of driving home and going to bed, I stayed in the hospital, manically researching the dish before stopping at the market to gather all the necessary ingredients. And later that evening...I enjoyed the first of many Fesenjān.

Over the next five months, I have tweaked and perfected my recipe, and in an attempt to give my version some credibility, I have become a (self-proclaimed) honorary Persian. Honestly, between my Iranian neighbors (the Zehavis), my childhood best friend (Abe), my college roommate (Mohammad) and med school roommate (Jakob), my transformation was inevitable. I now regularly drink rose water, cook with an abundance of Saffron, fight with my siblings over the last piece of tahdiq (scorched, crispy layer of rice), and add "-Joon" to the end of names.

Tips/Tricks to the Perfect Fesenjān

  • Different brands of pom molasses have different levels of sourness, so be sure to add ingredients slowly and adjust to taste
    • My friend Ladan swears by Zarrin brand
  • Replace the protein with 2 pounds of butternut squash for a great vegetarian option
    • Peal and cube squash, roast with olive oil, kosher salt and pepper at 400 degrees F for about 15 minutes
    • Add the squash to the stew when the chicken would have been added
    • Other veggie options are beets, quinces, carrots, or prunes
  • You can also try changing up the protein with duck breast, meatballs flavored with cinnamon and turmeric, or even fish
  • Saffron can either be dissolved in water or rose water
  • Don't be hasty when it comes to cooking time. You'll be pleasantly surprised by how the flavor matures over time
  • Especially at the beginning, the nuts are a high scorch risk. Mix frequently!
  • Serve with saffron-steamed rice

Fesenjān Ingredients

  • 4 cups walnuts (1 pound)
  • 2 pounds boneless, skinless chicken thighs (7-9 pieces)
  • 4-5 tablespoons olive oil
  • 2 large onions, chopped
  • 1/2 teaspoon ground turmeric
  • 1/2 teaspoon ground cinnamon
  • 1 teaspoon ground cardamom
  • 1/2 teaspoon saffron threads, steeped in 3 tablespoons boiling water
  • 2 cups chicken stock or water
  • 1/5 - 2 cups pomegranate molasses
  • 1 cup pure pomegranate juice
  • 1/2 tablespoon Muscovado or brown sugar
  • Arils of 1 fresh pomegranate (optional, for garnish)

Fesenjān Recipe

Roast and grind the walnuts:
Preheat the oven to 350 degrees F.

Spread the walnuts in a single layer on a sheet pan lined with parchment paper. Roast in the oven for 10-12 minutes, until nicely browned, mixing once or twice. Allow to cool slightly. Working in batches, place walnuts inside a kitchen towel, close the towel, and rub together between your palms to remove some of the outer skins. Transfer the walnuts to a food processor and pulse until finely ground. Set aside.

Brown the chicken:
Dry chicken pieces and season both sides with kosher salt and freshly ground pepper. Heat 3 tablespoons of olive oil in a heavy bottomed braising pan or dutch oven, such as Le Creuset, over medium-high heat. Sauté the chicken pieces in batches for about 3 minutes per side, until browned. Set aside.

Create walnut paste:
Over medium heat, add the remaining 1-2 tablespoons of olive oil to the pan. Add the onions and sauté for about 10-12 minutes, until browned. Add the turmeric, cinnamon, and cardamom to the onions during the last 2 minutes.

Add the ground walnuts. If additional roasting is desired, reduce heat to low and cook walnut-onion mixture for 3-5 minutes, mixing frequently to avoid burning.

Add 2 cups of water or chicken stock to the walnut-onion mixture. Bring to a gentle boil, then simmer on low heat, partly covered, for about 30 minutes until the oil begins to separate from the walnuts. Mix occasionally and monitor closely to avoid burning. Add more water if needed.

Balance sweet/tangy flavors and slow cook:
Preheat the oven to 250 degrees F.

Add saffron-water, 1 teaspoon of kosher salt, 1/2 tablespoon brown sugar, 1 cup of pure pomegranate juice, and 1 cup of pomegranate molasses.

Add remaining 1/2 to 1 cup pomegranate molasses to taste until desired tartness is reached. If stew is too tart, add more sugar. If too sweet, add more pomegranate juice.

Once the desired sweet/tangy ratio is reached, add the chicken pieces into the sauce. Bring to a boil, then simmer on low heat, covered, for about 60 minutes, until the stew develops a rich brown color and chicken softens. Stir occasionally, about every 30 minutes, to avoid burning.

Transfer the stew to the preheated oven, and cook for at least 2-3 hours, but preferably longer, allowing the chicken to tenderize and the sauce to mature.

Wednesday, November 8, 2017

"Israeli Good" Shakshuka with Saffron and Herbs

There's few things I love more than throwing a dinner party...picking out the menu, cocktails, tablescape, music...Oh, how grand. But it can also be rather stressful, especially with my demanding work schedule. That's why I've grown fond of the more casual luncheon.

As Patti LuPone would say,
"Here's to the ladies that lunch
Lounging in their caftans and planning a brunch
On their own behalf."

The more laid back lunch setting is about connecting with friends and not about frantically getting everything ready and perfect before guests arrive. (Often the scenario before a dinner party). In fact, I love handing friends a mimosa and putting them to work in the kitchen before the meal.

This mentality allows even the most ambitious menus featuring homemade quiches, tarts, and cured fish to be thrown together at the last minute without any fuss.

But as much as I love elaborate, multi course meals, nothing seems to be a bigger crowd pleaser than the one pot wonder, Shakshuka

That means less clean up and more fun..."I'll drink to that!"

Shakshuka originated in Tunisia and is essentially eggs poached in a spicy tomato sauce. This magical dish has grown wildly popular throughout North Africa and the Middle East and is a staple in my Libyan-Israeli household.

There are endless variations to the recipe, and I've tried many. One of my favorites (not surprisingly) is adapted from Ottolenghi's book, Plenty.

Peppers, onions and garlic are sautéed together and then slowly simmered with tomatoes to create an insanely addictive sauce. The depth of flavor is brilliant with the addition of toasted cumin seeds, fresh herbs, saffron and cayenne pepper.

The dish is beautiful served right out of the pot with some crusty bread on the side to soak up every bit of sauce. It's great served as breakfast, lunch, dinner, or even a midnight snack.

This savory and wholesome dish will truly satisfy your heart and soul with each bite. Shakshuka is not only heart warming and delicious, but also heart healthy. It's loaded with fresh vegetables (garlic, onions, peppers, tomatoes) and EVOO, making it a great addition to a Mediterranean style diet. Try it today. You won't be disappointed!

More on Heart Healthy Shakshuka

Eggs? Heart healthy? "What about the cholesterol?" you may ask

Yes, good question...We know that high levels of LDL-C or "bad cholesterol" in your blood can increase the risk of heart disease, so until recently, dietary guidelines published by the American Heart Association (AHA) and other societies recommended limiting dietary cholesterol. That's why many of us grew up learning eggs were bad. But things have changed...

The reality is that dietary cholesterol seems to have a minor effect on blood cholesterol levels and there's insufficient evidence to determine whether lowering dietary cholesterol reduces LDL-C. Consuming "bad" saturated fats, on the other hand, can significantly affect blood cholesterol. For example, diets composed of 5-6% saturated fat (compared to 14-15%) were shown to lower LDL-C by 11-13 mg/dL in 2 studies.

Based on this data, the most recent AHA guidelines removed the recommendation of limiting cholesterol intake to 300 mg per day. Instead, cholesterol should be consumed in moderation within a diet that emphasizes intake of vegetables, fruits, and whole grains (including fish, poultry, low-fat dairy, legumes, nuts), and limits sweets and red meats[1].

Tips/Tricks to Make the Perfect Shakshuka

  • It feels so wrong to say, but choose canned tomatoes over fresh
    • They're picked at the height of tomato season, making them reliable and superior in taste
    • Choose whole canned tomatoes rather than diced, which can taste artificial and unpleasant
  • Canned San Marzano tomatoes are considered the best...use them
    • Plum tomatoes grown in Italy and regarded for their superior flavor and texture
    • Find "DOP" (Denominazione d' Origine Protetta) on the label to ensure it's the real deal. Also should be grown in Italy
  • If you have in season, local tomatoes, try adding 1-2 roughly chopped, ripe tomatoes in with the canned ones
    • I like adding an heirloom tomato for some color and texture
    • Fresh tomatoes have high water content and will increase the cook time
  • Crack each egg in a dish before adding to the sauce to avoid breakage
  • Get your egg whites to set quickly so that the yolks are still runny and delicious
    • After adding the eggs, carefully spoon together some sauce with the egg whites to help them set
  • Serve with crusty bread
  • For a little extra richness, garnish with crumbled feta cheese while still hot
  • The sauce can be made days ahead, which is great to do before a breakfast/brunch
    • When ready to serve, reheat the sauce, add the eggs and cook according to recipe

Shakshuka Ingredients

  • 1/2 tablespoon cumin seeds
  • 3/4 cups good olive oil
  • 2 large onions, sliced
  • 2 red bell peppers, cored and cut into 1/2 inch strips
  • 2 yellow bell peppers, cored and cut into 1/2 inch strips
  • 2 jalapeño peppers, diced
  • 4 cloves garlic, chopped
  • 3 tablespoons chopped fresh parsley, plus extra for garnish
  • 2 tablespoons chopped fresh cilantro, plus extra for garnish
  • 1 teaspoon chopped fresh thyme leaves
  • 2 bay leaves
  • 4 teaspoons sugar
  • 1 (28-ounce) canned San Marzano tomatoes with their juices
  • 1/2 teaspoon saffron threads
  • 1 teaspoon sweet paprika
  • Cayenne pepper to taste (1/8 teaspoon for mild, 1/4 teaspoon for medium, 1/2 teaspoon for hot)
  • Kosher salt
  • Freshly ground black pepper
  • 8 large or extra-large eggs, preferably pasture raised
  • Feta cheese, for garnish (optional)

Shakshuka Recipe

In a large, heavy-bottomed skillet, such as a Le Creuset or seasoned cast iron, dry-roast cumin seeds for 2 minutes over high heat. Stir frequently to avoid burning.

Add the olive oil and onions and sauté for 5-7 minutes, until softened.

Add the bell and jalapeño peppers, garlic, cilantro, parsley, thyme, bay leaves, and sugar. Sauté on high heat for about 10 minutes, until peppers and onions are softened and taking on a nice color.

Add the canned tomatoes, cayenne, sweet paprika, saffron, 1/2 tablespoon kosher salt and several grinds of black pepper. Using the back of a large spoon, crush the tomatoes and stir to create a chunky, but homogenous sauce.

Simmer on medium-low heat for 15 minutes, adding small amounts of water if necessary to maintain a consistency of pasta sauce. As the sauce starts to thicken, season with more salt, pepper, and cayenne (if desired) to taste.

Using the back of a spoon, create evenly spaced divots within the sauce, placing an egg in each well. Sprinkle with kosher salt, cover pan, and cook very gently on low heat for 10-12 minutes. The egg whites should be just set and will continue to cook off the heat.

Garnish with parsley, cilantro, and feta cheese (if desired). Serve immediately with crusty bread.

1: Eckel RH et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014