Sous Vide Salmon with Lemon-Butter Sauce

A great way to thaw out that salmon belly

Whether it is the frozen fillet salmon from Alaska or Costco - Sous Vide cooking presents a simple way to make spectacular salmon - and in this case with a lemon-butter sauce.

You can use this with individual salmon fillets or with a half a salmon as shown above that are frozen. Whether you get a fresh and wild salmon (my preference) or a farm raised salmon - having a frozen salmon works well.

But if you look at the hundreds of recipes for them they are all rather difficult, cumbersome and involve a lot of things you don't need to do.

Here is the simple recipe:
frozen salmon in the bag - put in the sous vide - it should be ready in anywhere from 30 minutes to an hour and you won't over cook it

First here are a few myths about salmon that you should think about:

Myth 1: You need to place the salmon in a marinade to get the flavor - 
You don't.  So, don't think you have to thaw out the salmon and put it in some herb/shallot/butter/ginger/soy/lemon mixture for whatever length of time.  You want the salmon to stand alone with its pure flavor and the sauce should simply provide a balance to the rich, fatty flavor of the fish.

Myth 2: You need to brine the salmon to avoid the whitish albumin that comes out in Sous Vide - 
The albumin is a simple protein that when it is heated will compress and be white. If you put the salmon in a brine the chlorine will alter the delicate flavor of the fish. It will keep the albumin from coagulating (because the chloride ions will separate the proteins).  The salmon comes pre-brined in mother nature's ocean - you don't need to risk losing the flavor of the salmon

Sous Vide Prep

Heat the water to 125 degrees F.
Take the frozen salmon - already in the bag - and place into the Sous vide.
It will thaw in about 20 minutes and be ready in 30 minutes to an hour.  The joy of Sous Vide- you really won't over cook this fish (some have salmon at 140 degrees - and that is great for people who don't care about flavor).

Lemon-Butter Sauce

Ingredients
1 lemon (this will translate into about 6 tablespoons of lemon juice if you don't happen to have a tree in your backyard or access to lemons).
1/2 cup of butter
2 cloves of garlic- minced (or pre-minced garlic about 2 teaspoons)
1 tablespoon of salt (if you use unsalted butter, if you use salted 2 teaspoons)
ground pepper to taste (about 1/2 teaspoon)
2 tablespoons of chopped chives

Heat a sauce pan, add the butter and let it melt.  You want it to melt slowly- so medium-low heat works best. If it is burned then toss it and try again. Once melted add the garlic and stir for about 30 seconds. Add the juice from one lemon and whisk it in.  Add the salt and pepper.  Put on a simmer.  Before you are ready to put over the salmon add the chives (cut to about 1/8 inch) - you can omit chives if you don't have them handy.

The sauce can be kept at a simmer  until you are ready.

Frying the salmon (its the skin)
Heat a skillet and once hot add some grape seed oil.

Remove the salmon from the Sous Vide. Cut the plastic so it opens completely and if you need to cut the fillets do so. Have some paper towels ready to place the salmon on and get rid of moisture.
Add the fillets to the skillet and allow the skin to crisp (about 2 minutes).  You do not need to turn the salmon to finish - it is already cooked.
Plate the salmon

For those who don't like crisp skin or don't want to fry

If you don't like crisp skin, or don't like skin at all- you can use a fish spatula to gently separate the skin from the salmon and place the fillets  on a plate.

Add the sauce on top of the salmon. Always good to garnish this with some chives from the garden or some lemon.

The lemon butter sauce was used for the salmon as well as the green beans

Vegetable Additions:

Total preference.
My mom would have some boiled potatoes (small) and use the sauce on them in addition or just butter. This is a very Norwegian way to eat fish - and I like it.

In my case I had some nice beans in a microwave steam pack that I added on the side (for the color). It made for an amazingly easy meal

Baked Salmon with Dijon

This is a great time of year because the salmon are running. In late spring the Red Salmon arrive at the Copper River, the King salmon are getting closer.  All summer long there will be an abundance of one of the most savory proteins out there.

I grew up eating salmon- it was our "local" then.  When I moved to "the south" for college (for us Alaskans the south was the lower 48) I was sick of salmon, I had eaten it so much that I thought I couldn't stand it anymore.
Then I went home one summer and I asked mom what she was making, "Baked salmon with this new mustard."

My first reaction was to think "salmon again - damn." Being a dutiful son we didn't swear in the Simpson house in front of mom (she had a few choice words, and if she said them, they were ok). Second, you never underestimated mom's cooking- because she was a whiz. Still, I was skeptical.

The mustard, this new stuff called Gray Poupon, provided a tang and flavor that balanced well with the salmon.  The other thing I discovered, I loved salmon.

Here is her recipe

Salmon Filets
1 Tablespoon Dijon Mustard
1/3 cup of olive oil
Herbs from the garden - mom used just chives and parsley but we added some basil and a bit of sweet mint.
Salt (non -iodized prefer sea salt)
Pepper
Juice from 1/2 lemon

Preheat the oven to 425 degrees

Mix the olive oil, mustard, and lemon into a bowl to form a nice slurry. Add the chopped herbs.

Remove any scales and pin bones from the salmon. Best way to remove pin bones is either tweezers or needle nose pliers.

Gently season the salmon with a bit of salt and pepper (not too much, salmon is naturally a bit salty)

Place some foil over a baking sheet. Place the salmon - skin side down on the foil and cover with the slurry of herbs, mustard, olive oil.

Put some Panko bread crumbs on top

Place in the center of the oven oven for 12-15 minutes (if your fillet is one inch thick it will take about 15 minutes).  It should be flakey in the middle when done, or between 122 and 140 degrees with a quick read thermometer

If the bread crumbs are not brown- put the fillet under the broiler and broil for two minutes.

If you use a fish spatula, the spatula will slide between the skin of the fish and the meat. Discard the skin (feed to dog or cat).

Take them out, let them sit on the counter for at least five minutes.

Squeeze remaining lemon and serve.

The ingredients for this are simple. Fresh herbs, mustard, olive oil, Panko, and salt and pepper for seasoning.

Pre-heat the oven to 425 degrees

Cover a baking sheet with foil. Remove any pin bones from the salmon. Gently season the salmon with salt - you need very little, and some pepper.

Mix the olive oil and mustard and lemon juice together to make a fine paste. Into that paste place your chopped herbs

Using your fingers or a fork, put the paste over the fillets.  Then sprinkle some bread crumbs on top - gently
Bake in the oven, center rack,  for 12-15 minutes. If the Panko isn't seared - place under broiler for 2 minutes

Once cooked a fish spatula will easily slide between the skin and the bely

Forms a nice crust

Loved it

The Challenge- eating well

The competitors: Chris Brogan and Myself

Lets do this Chris -

The bet:
Which one of us can lose the most inches around in the abdomen

Measured: 
one inch above the abdomen
We chose this because scales are often inaccurate, and vary from place to place. We can't use pant sizes because- well - you see. My pant size depends on my clothes: if I wear my "Lucky" brand jeans I wear a 33 inch. If I wear Nordstrom I have a 35 inch pant size, but one inch above the abdomen - 45 inches. That is the place where the weight will be lost.

There is a reason we don't use belt size

How Will I Do It?
Menu planning, eating at home, and increasing activity.

You can see it here:
Chris's girlfriend is a personal trainer, a nutrition aficionado, and his muse for personal health. She will be guiding him, as she has, through his journey. They gave an inspiring talk at the #140conf  #140You this year, and I talked a bit about my weight loss journey and how I have turned in my surgical scrubs for a chef's apron.

My Journey:
Ten years ago I found myself in a personal health crisis: my weight was up, my blood pressure was up, and I had little energy.

I was set for weight loss surgery, having done it for years. I had my surgeon picked out in a different city, and was ready for the process. Then I looked at my own patients who had lost weight and kept it off. I started to ask them what had changed. If I was going to have weight loss surgery, I wanted to set myself up for success.

What changed in them was the opposite of what I was doing.

I realized that over a period of three years I had gained eighty pounds by eating too often at restaurants. I was not eating at great restaurants, but chain restaurants. I had stopped cooking because I thought I didn’t have time. So I decided to see what would happen if I went back to cooking at home and away from restaurants. I didn’t want to loose all the weight at once. I wasn’t going on a diet⎯I was changing my life. I gave myself a year to change my life- and I did it! I kept going and didn’t need weight loss surgery.

I began to examine other patients who had surgery, patients who had clogged arteries, who had bad backs, who had bad knees. One universal theme to all who had shown improvement was that they were eating at home.

With the exception of the year my wife was pregnant, every year I have lost five or ten pounds. My blood pressure is low-normal and my weight is below where anyone would operate on me for surgery. I am still working at eating fresh, healthy, whole foods, and my energy is through the roof.

This is not a diet program. It’s just a way to live that is simple and easy. If a busy surgeon can do this, so can you.

Measure It and Manage It:
If you don't measure what you do, you cannot manage it. So I measure my food- I have a scale, and everything that I cook and eat is measured, there is not an issue with eye-balling the portion size.

If you don't measure it- you cannot manage it

My Menu Plan:
It is important to plan out what you are going to eat- so there is no question about what you will eat, and what you will shop for. Here is what I am doing today. A few words about the menu plan: I use soy milk because I have a lactose intolerance.  I use steel cut oatmeal because, unlike rolled oats, it is less processed and produces less of a glycemic reaction.

Breakfast Lunch Dinner Snacks Soy Milk Steel cut Oatmeal Raisins Banana Coffee Turkey sandwich apple Tea Salmon Apple Broccoli Fruit salad Tea Yogurt Almonds Raisins Smoked Salmon Blueberries Strawberries

The bread I use for my sandwich is Ezekiel bread - a true grain bread and quite filling. In fact for my weight loss surgery patients this is the only bread that I allow them.

For tea I drink Yorkshire Gold - there simply is no other. I add a "splash of milk."

The salmon I will get from the market today. I insist on fresh salmon, and if it isn't fresh I will get a different fish. It is expensive to get fresh and wild salmon - but I refuse any other. I like baking salmon- and I use herbs from my garden.

The smoked salmon is from Alaska- a good friend of mine, Dave (@gneicco) was generous with his.

Smoked salmon from Alaska- a favorite snack

Yogurt is a problem, because many yogurts are nothing but unfrozen ice cream -they are sugar filled snacks. So I am quite picky about the yogurt I pick, and often get Greek Yogurt-  I realize there are a lot of yogurts out there, so read the label.

If you want to see the recipes- you can find them at my site TerrySimpson.com

Activity:
I monitor my activity using the Nike Fuel band. Using Nike Fuel points I can see throughout the day if I have made my goal. It inspires me to walk the dog, take the stairs, and park farther away. It is the little bits of increasing activity every day that matter.I did discover that my 2 year old is great for increasing activity - just keeping up with him....

Hospital Cafeterias: They should be a place of rehabilitation and teaching, not serving junk food

It always amazes me that hospitals have a "tobacco free campus" program but in their cafeteria they sell junk food

Hospital Cafeterias Should Be Used for Rehabilitation and Healing
Every hospital  has a shortage of space, and every hospital uses its space to maximum ability to help patients.  But the most under utilized space for patient health is the hospital cafeteria. While hospitals have dietitians, which they use to help determine patients nutritional status, I've never seen a hospital use their chef to teach people to cook. 

But what I do see in many hospitals is junk food in their cafeteria.

Teaching patients to cook is the one simple thing we can do to help patients avoid the hospital again. 

A chef can teach a patient with heart disease how to cook a meal with less salt. A chef can teach a cancer patient how to make tasty vegetables that have the phytochemicals in them that help fight cancer. A chef can teach a patient how to portion meals, and fill the plate with healthy alternatives.

But these chefs are not utilized in hospitals for health, for rehabilitation, for preventive teaching. Hospital chefs are well trained, most love to teach, but instead are relegated to making meals for some patients, and the staff.

The Current Reality of Most Hospitals

I've had more meals in hospital cafeterias than I care to. In training, living in the hospital for days at a time meant that hospital food was all I had.  On days when I operate on patients, the hospital is where I take my lunch. Now, I am on the board of a couple of hospitals and here is what we really face with hospitals: they have no clue about the power of positive teaching and the message of junk food in a place of healing.

The Hospitals Have no Idea that the Best Resource for Helping Patients is in their Cafeterias

The hospital governing board meeting was getting started when a new item was added to the agenda, to make the hospital a junk-food free campus. We had, several years before, and with a lot of work, made the hospital and the campus a tobacco free campus, but it was time to go after the next major killer in America- obesity. You would think this would be a "slam dunk" for the hospital - but it wasn't.

As a physician I was shocked - how could we, as a hospital and health-care system, preach health and yet in our cafeteria was the very food that was causing the rising epidemic of obesity that came with a rising incidence of diabetes. They then told me something shocking, "we need guidelines, as to what food is classified as junk food and which isn't." Imagine a hospital dietician not knowing simple guidelines about healthy eating!

The hospital CEO asked for time to work with this and come back with a plan.

The next meeting the hospital dietitian showed us a new "energy drink" that would take the place of cola. While she was presenting this drink I did a quick on-line search of it: it had the same numbers of calories as coke, it had slightly more caffeine.  I raised my hand, again, in shock as to how a dietitian would think this was healthy, when, a quick internet search as she was presenting the data, showed it was no better than cola, and perhaps a bit worse.

Utilize this Space and These People

One hospital in Phoenix, Good Samaritan,  boasts that it has a physician cafeteria with a wonderful chef who makes their doctors great meals. When the hospital was trying to get me to bring my patients there the "business vice presidents"  told me that this was one of the "benefits" of bringing my patients to that hospital. I asked if their chef would be available to come to group meetings with my patients to teach them to cook, or if my patients could meet in that cafeteria and have the chef make food and teach them how to do that. This vice-president looked at me with a blank stare, "I have never once been asked that."

Food Should be Therapy

On the very ill patients hospitals are great at getting dietitians involved to help sort out the therapy they need for feeding patients through an iv, or through a tube. But when it comes to teaching patients what to eat, what to avoid- hospitals fall short, and the hospital is the best place to teach a a patient.

Hospital classrooms are used for support groups for cancer, for weight loss surgery, for cardiac rehabilitation classes, for AA meetings. Hospitals are generous with their space- but one of the single best uses could be cooking classes.

We Spend More Time Teaching Cooking than Operating
More and more physicians are teaching patients how to cook. We spend more time teaching patients to cook than operating on them. It is time for hospitals to assist in this effort.  Today when hospital performance is measured by re-admission rates acutely, but tomorrow hospitals will be defined by who keeps them out not just in 30 days but longer.

Teaching patients how to cook, and what to cook, and what to eat- is the best step modern hospitals can take.

Pigs and GMO: do pigs that eat GM feed get more stomach issues - Nope.

Pigs that eat genetically modified foods have less inflammation than pigs that eat normal- the opposite of what the news reported

Pigs and GMO
So you read the headlines, or the news article and you see that pigs fed GMO had more stomach problems than pigs that were not fed GMO. Except that isn’t really what the article results show.

The results show that pigs have a lot of stomach problems- regardless of the stuff that is fed to them.
From Table 3 of their study:

Pigs who were fed non GM foods had more erosions, more pin point ulcers than pigs fed GM foods.
(1) Of all ulcers there were equal numbers in both GM fed and non GM fed pigs.
(2) In terms of inflammation – all types – there were 69 in the non GM fed group and 64 in the GM group.
(3) If you look at nil inflammation (meaning zip) – pigs who ate genetically modified foods had much less inflammation than pigs who ate "organic" food.
(4) If you add the "nil inflammation" the numbers are 73 with inflamed stomachs of pigs who ate non genetically modified foods and 72 pigs who ate genetically modified foods had inflamed stomachs.

As a surgeon, who does a lot of stomach surgery – I would say that this study shows really no difference between the two groups of pigs- but when it comes to the severe issues there appear to be a lot more severe issues among the pigs that ate non-genetically modified food than the pigs that ate genetically modified foods.

What does this whole thing prove:
(1) GM and non GM are no different
(2) Pigs have a lot of stomach problems – who knew
(3) Journalists don’t read papers and analyze them, they instead read abstracts where the comments may not equal the results

It is sad that the Journal of Organic Systems – which says it is peer reviewed, but its agenda is not science, its agenda is organic farming and systems. A fine agenda, but when you allow the abstract and conclusion to read the way they did - you simply decrease the value of your journal.

As for you journalists out there - try reading and analyzing the data before reporting it.

Gordon Ramsay Steak, Las Vegas. Quality, Consistency, Delicious

Sitting in Gordon Ramsay's Steak in Las Vegas - pure Brit and pure Ramsay

Gordon Ramsay Steak was everything you would want from a restaurant: amazing service, delicious food, and an atmosphere that is upbeat. But I was a bit hesitant to go to a restaurant that might be a chain- I am glad we went.

When does a restaurant group become a chain?

 I ask that a lot as many chefs are putting their names on restaurants, especially in Las Vegas. Is there a number beyond which the "chef"  looses control?  Simon Majumdar, food writer, critic, tv personality says, "I don't think it's a specific number, but it is once corporate strategy takes over from dining vision." 

Ramsay is obsessive about service, food quality, and the patron's experience. When he opens a new restaurant he takes an experienced crew and they train, and they make the food again, and again, and again - until they have it so consistently they are ready to open. That consistency comes through.

Gordon Ramsay Steak in Vegas

Located in Paris Paris, the restaurant sign is visible throughout the casino. Easy to find is a plus, given how many casinos want you to wander aimlessly by,  Ramsay insisted on visibility - and after walking a mile to get there, I appreciated it.  But a place called Paris- for a Brit?

As the hostess takes you in you go through a small tunnel, and they are quick to point out, "This is our representation of the chunnel- taking you from France to Britain."  

Clearly in Britain, the neon lights are an artists interpretation of Gordon Ramsay's hand movements

 Chef Christina Wilson, winner of Hell's Kitchen, taking time to say hi to my wife @producergirl

A wine list that isn't Vegas

Many wine lists in Vegas are too predictable.  Without looking at most wine lists frequent restaurant patrons can guess the wines as well as vintages they will have in stock. Wine sommeliers are a bit predictable - talking about "fruit forward," at which point you know they are full of it.  But here I was pleasantly surprised.

The sommelier asked the flavors I liked

Chose a lovely new wine from Washington, Doubleback, apparently former  football quarterback Drew Brees has made a great wine- 

The choices:

It is difficult to go to a steak house and not think about ordering steak, especially when you see the lovely product they have. But the choice was made more difficult when they offer the tasting menu, that has a lot of Hell's Kitchen favorites. Besides, how many times do you see Ramsay send back scallops with his famous, "Its raaaaawwwww." 

Thankfully, we not only ordered the tasting menu, but had a steak split between us. It was a great choice. 

To sum it up:

The food was executed perfectly, and the night was busy - but, as our waiter told us, every night is Saturday night. The service impeccable, and the atmosphere upbeat. When in Vegas there are a lot of places to get food, there are a lot of celebrity restaurants, but if you like steak, or want a taste of Hell's Kitchen, this is the place to go. 

Advice to Hell's Kitchen Contestants:

If you are serious about winning Hell's kitchen and working in Ramsay's restaurant group, go to this restaurant, taste everything. Then go home and make it again and again until you have it done perfectly. I'm shocked that none of the contestants do this.  Ramsay's restaurants prove it: if you want to do it perfectly, it takes practice - and he doesn't put it out to the customer until his chefs can do it perfectly. 

A steak house has to have a great presentation

It is so difficult to choose - reminds me of the Alaska Native wheel of life

The Amuse Bouche - a Scotch Egg with berkshire pork sausage, and red wine braised cabbage 

Fennel seared ahi, pea shoots, asparagus, and candied rhubarb

A seared scallop (perfectly cooked), spring mushroom risotto, and mushroom puree

What's next?

It was not on the Tasting menu, but looked so delicious we had to order the prime, aged rib caps - as you can see, nothing like a bit of steak

Who wouldn't get Beef Wellington from Ramsay. It was perfectly prepared, delicious, and I wonder why more restaurants don't make this 

Brown butter filled blueberry tarts, vanilla bean anglaise, warm blueberry compote, citrus infused vanilla ice cream, micro mint

Even the water is imported from Wales - why not?

5 Myths about GMO: and what you should really be concerned about

Non-GMO corn from the market 

MYTH 1:

GMO seeds mean you will have more pesticides and herbicides used in the environment

Reality:
Just the opposite is true. GMO plants have saved farmers in Illinois, Wisconsin, and Iowa billions of dollars the last two decades in those toxic chemicals.  The GMO plants are designed to use less chemicals than other seeds
The round-up ready crops have been criticized because they are resistant to "Round Up" - however, Round Up is probably the least toxic of the herbicides used today.

What You Should Be Worried About:

While less herbicide is used (weed killer) the weeds are getting resistant to the herbicides currently and new super weeds are being found. Weeds use natural selection (the first type of genetic engineering) so that those weeds that survive the herbicide grow and reproduce.

MYTH 2:

The toxins engineered in the plants, like Bt, are deadly to humans and cannot be washed off

Reality:

Bt toxin (produced from the bacteria Bacillus thuringiensis) has been extensively tested and is not toxic to humans or other animals. In fact, Bt, a toxin made by bacteria, is used widely by organic farmers because it is a natural way to control pests. While some have reported animals that have died in fields of Bt cotton or corn, when autopsies of the animals were done other causes were found. In fact, many deaths from farm animals occur in places all the time-

This same Bt toxin has been used to decrease mosquito outbreaks in Africa, to decrease malaria and dengue fever.
Other strains of the Bt toxin are being examined for activity against leukemia and breast cancer.

What You Should Be Worried About:

In spite of an impressive array of safety, all toxins have some downside. No matter which pesticide, or how safe, there will collateral damage - Monarch butterflies who feed on milkweed, for example, do not do as well when they are near corn that pollinates with Bt toxin.
As much as science searches for a perfect toxin, this certainly is not it. On the bright side new research into pheromones that are scents that keep pests away are being tested.

MYTH 3:

Monsanto will have a monopoly on seeds and this is bad

Reality:

Monsanto does sell the most seeds of any of the major seed makers, but does not have a monopoly.  Since the 1940's farmers have found purchasing seed was easier than raising their own and proprietary seed makers have become an industry.  Monsanto sells 23% of the GM seeds in the US, currently. There are a number of other seed makers that sell GM seeds, as well as non-GMO seed suppliers. Having a number of suppliers insures a more stable market.

What You Should Be Worried About:

Biodiversity is a major issue, and while genetic engineering represents a rapid way to alter crops in case of a major new pest, blight, drought, it is important to have a large seed repository available. GM seeds or not, biodiversity has been rotated out of our crops and is a major issue moving forward. Biodiversity has been an issue for all crops since humans harvested, and continues to be a major issue to our food supply.

MYTH 4:

They engineered tomatoes to withstand cold by putting the gene in from an Arctic fish, which is why tomatoes taste bad 

Reality:

There is no tomato-fish. While this was an experiment, it never came to market. The reason most tomatoes from the store are mealy is they are picked before they are ripe. They do not ripen as a normal tomato would, and thus have an off taste- especially to those who know what a fresh, garden ripened tomato tastes like.


What You Should Worry About:

Genetically engineered salmon that will be farm raised are coming, and like most farm-raised salmon will have less flavor, less beneficial omega-3 fatty acids, and cause more pollution that the wild salmon. Many fish are over-fished and present a danger to our food supply - farm raised fish are not as sustainable as wild fish.

Grizzly bears digging for clams in Alaska. Mother and cub

MYTH 5

Animals know better- when given a choice they don't eat GMO

Reality:

The photographs of the corn, and others that are circulating are all doctored photographs- they are fake. Humans have very sophisticated taste buds, much more than a squirrel or birds. The photographs have been put up as "proof" when in fact, all studies contradict them. In addition, why is it that they blame GMO for killing some animals, when there are fields adjacent with non-GMO feed.  They get tripped up in their own arguments.

Total doctored photograph - and if you know corn, you would look and see that the one labeled organic really isn't

What You Should Worry About:

If you are eating at a lot of chain restaurants, or a lot of processed foods, you are probably obese, and should be eating more whole foods, plant based diets.  If you like meat, you should be eating meat from specialty farms where they are raised on grass instead of grain.


In the war about our food and how we grow it, and its ability to feed a planet with little damage- there is more hyperbole than facts. Eat fresh, grow what you can, enjoy great food- and don't trust a restaurant where they get food from a freezer.

GMO and Allergies

Are GM Corn and Crops responsible for increasing allergies?

The Claim:

Since GMO the number of allergies and food allergies has gone up.

Bottom Line:

Yes, food allergies and allergies have climbed but it is correlated but not caused by GMO - see below

Allergies - what are they?

An allergic reaction is an inflammatory response  to a protein. That protein is something that is harmless and that is what makes little biologic sense.  Common proteins that cause typical allergic reactions include pollen, dust mites, animal dander, and some mold proteins.For example: my body reacts violently to tree pollen from the Juniper tree.

Pollen is a protein, and when my body comes in contact with Juniper, a pollen protein,  it results in a runny nose, a cough, aggravates my asthma, and gives me inflamed, dry eyes. There is nothing intrinsically bad about Juniper pollen, it is that my body over-reacts to it. So much so that I had to seek medical attention and that column is here.

A severe over reaction to an allergy can be deadly. For most people getting stung by a bee is a nuisance, if you are allergic to the bee sting it can kill you. If you are allergic to a drug, such as Penicillin, and you take some- it can also cause death.

Death from allergies, and the severe reaction that can lead to death is called anaphylaxis. It is the bodies "overreaction" to the allergen and that reaction kills. That reaction can start with hives and itching all over, shortness of breath, tightening of the throat, or tingling.

Specifics - the immunology:

First the body comes into contact with the protein: breathe it, swallow it, get it on the skin and it sets off a very specific cascade of events:

The body begins to produce an antibody, IgE, that will bind the allergen. Think of IgE as the fuse, it is the key to the entire overreaction. The IgE that is formed is very specific to a protein, and fits it like a lock fits a key. There is no "loose lock" in the immune system, where any key can fit it- these are precise fits from the IgE to the protein causing the allergy (allergen).

The antibodies, IgE, or the fuse,  attach to a blood cell, called a mast cell. Mast cells are found not only in the blood, but throughout the body- nose, throat, lungs, gut.  Mast cells are like a dynamite. The more mast cells you have, the worse the reaction.

The allergen  be it pollen, bee venom, or any protein that the IgE has built antibody against,  lights the fuse- the IgE, and if it is attached to a mast cell then you have an explosion.

When the allegen (Juniper pollen in my case) is bound to the IgE that is attached to the mast cell, the mast cell cell releases a ton of chemicals - but the one that bothers most is histamine.  It is histamine that causes the major effect of allergic reactions: runny nose, sneezing, coughing, worsening asthma, hives, etc.

But some allergies do more than give you runny nose, dry eyes, or asthma:

Some people have an allergy to proteins proteins you eat, such as gluten. For those allergic to gluten the allergy occurs in their gut.  If you feed someone with celiac disease a wheat thin  their guts will go into spasm and they will feel rotten for a while.  Prolong that exposure and eventually they will have loss of tissue of their small bowel, won't be able to absorb critical nutrients very well, and lead to iron deficiency anemia, calcium deficient osteoporosis, and a series of other reactions that we are still defining.

Foods contain many proteins, and we can test for allergenic potential of those proteins. But 90-95% of all food allergies are from ten different foods (peanuts being the most famous). Of the remaining foods that cause allergies, there are about two hundred foods that cause them all.

When food is eaten it goes through the digestive system, which means the food is chewed, bathed in the stomach acid, broken down by various enzymes in the stomach and small bowel and exposed to the IgE in the gut. To imitate this scientists have come up with protocol to mimic the gut, in vitro (outside the body). This is in addition to testing in humans.

We can test for Allergies:

You can be tested for allergies fairly simply. It is a skin test - where an amount of the protein is scratched into your skin, and if you react to it then we know that you have an allergy to this. Skin test checks the body's reaction to the protein. Blood tests can also determine if your body has developed IgE against a specific protein. But just because you have IgE against a protein does NOT mean you have an allergy to it. The body produces IgE to a lot of proteins, and the majority of them do not cause reactions.

Testing for allergies is simple, safe, and done frequently.

Are there more Allergies today than before?

This seems to be a contention of many people- that we have more allergies today than we did years ago.  Some of this belief is based on a bit of evidence like this: Phoenix, Arizona use to be a place that people would go to get away from allergies. Now it has some of the worst allergy seasons in the world. Does this mean more allergies? No- it just means that when Phoenix was a small town in the Sonoron desert there wasn't much that grew here. But as more people moved in they discovered that the desert could grow anything here, with water, and so as people moved here they planted their favorite things.

So now we have high concentrations of olive trees, grass, Cottonwood, Juniper, and Mulberry - none of which are native to Phoenix. As a result Phoenix has become one of the allergy capitals of the world where it previously was not.

It is a causation - we have more allergies in Phoenix because now people are planting more trees, grasses, and other vegetation that have proteins that cause allergies.

Are these allergies because of GMO? Well, no. I am not allergic to any part of corn or corn pollen, nor am I allergic to Pima cotton, or even Bt that is grown with the Pima Cotton. I am allergic to Juniper. Since so many people brought Juniper to Phoenix, I have more allergies than I ever did.

That same phenomenon - people planting non-native plants, some of which are allergenic, is happening in many cities.

Proteins and Allergies

The vast majority of GMO plants have been bred or engineered by modifying proteins already found in that plant. Not making new proteins.  In times of drought a farmer will find plants that survive on less water. Farmers or scientists study the hearty plants, and either cross-breeding, which has been the method for centuries, or by isolating the genes for the proteins that keep plants hearty in dought and getting the plant to produce more of that protein.

The possibility that a GMO plant could increase allergies is not impossible but most GMO plants only differ by  one or two proteins, and the way to check for allergies to these proteins are straightforward. When a new GMO plant is approved the allergenic potential is checked for. Meaning, people - like you and I, are paid to have a scratch test as well as a blood test, and if we have a positive reaction to that protein, the plant will not be approved for mass production.

Food Allergies

Food allergies have been on the rise for years, and long before GM crops came into being. But to be specific: a food intolerance is not a food allergy.  Over 70% of the population does not have the ability to break down lactose, a milk sugar, as a result they don't digest the milk sugar but bacteria do - leaving them with bloating and an irritable bowel. That is not an allergy. But there are true allergies to milk- where the body has developed the IgE against a milk protein.

Food allergies have been on the rise for years before GMO. The rise is steady but not "sky rocketing."  Of all of the experts in this field, none of have attributed it to GMO. (see reference section for a complete list of current hypothesis).

Potential for Food Allergies in GM Crops

Remember that to develop an allergy to food the body has to produce IgE against a protein. Without that, there can be no cascade of events to elicit the allergic reaction.  Proteins can be divided in a number of families whose members closely resemble one another  - where the key (protein) can fit the lock (IgE) and set off the allergic cascade.  Food allergens are typically members of one of three large "groups" of proteins.  If a protein is not a member of one of these three groups, it is highly unlikely to ever become an allergen.  Of the proteins made in  commercial GM crops  there are no proteins that belong to the group of proteins that cause the great majority of the plant food allergens.   Regulators do not approve crops when there is any concern about allergenicity.

All GMO Foods are Tested

It turns out that all GM foods are tested for allergies. The testing is done by the Federal government, and by other governments. 

BT and allergies

BT stands for a bacteria called Bacillis thuringiensis.  The idea of using different species to control weeds and pests is at the heart of organic farming and has been used for a couple of thousands of years. It was discovered that this bacterium destroyed silk larva in great numbers.  Later it was found that it could protect flour against the flour moths.  Ultimately the protein responsible for killing the pets was isolated and sold commercially in the United States after approval from the Environmental Protection Agency in 1961.

Bacillis thuringiensis also produces proteins that are effective against some forms of leukemia and cervical cancer.

Before BT protein was isolated, the bacteria that made BT was grown in large batches and sprayed on fields. This is a practice that is used in many organic farms to this day. As with any bacteria, the bacteria can have proteins that cause an allergic reaction, and some people with immunodeficiency who were field workers did get an infection from the bacteria.

The protein that causes death of the pests was isolated, and inserted into corn and cotton crops. As a result the total amount of pesticide used has decreased dramatically. Bt protein has been widely tested in animals and humas, and has not caused an issue.

But what about the protein. There is not a single protein that a person does not develop an immune response to. Your body will build an immune response to all proteins- but it has to decide which protein it will build the arsenal against.  Once you have IgE antibodies, then you have the potential to get severe allergic reactions.  There is not one place in the literature where BT has elicited an IgE antibody in a human.

GM Soy 

There was a popular story about taking the protein from the Brazil nut and placing that into soy plants. When the crop was made, they took patients who were allergic to the Brazil nut and tested them. The reason you use people who are allergic to the protein is because they have built up antibodies. If you then give them this new product and it is allergic, then there will be a major allergic reaction.  If you want to scam the data - that is, if you wanted to avoid that, you would take people who are not allergic to Brazil nut and test them. However, scientists are generally a pretty reliable group, and they always test with people who are positive to the antibody.

This soy bean was never marketed, never eaten by another human being once the genetically modified portion was determined to cause an allergy in some people. The project was stopped, and the GMO were destroyed.  This is good- this is how we want science and genetic modification to work - if there is a problem, the GMO is destroyed.

Even while this process was well documented, and the process elucidated - the story is found on a number of websites with the claim that this soy is out there being planted. It isn't.

My role and disclaimer

My initial investigation of GMO came from a background in genetic engineering and as a physician who spends more time teaching patients to cook than I do operating on them.  I have received no money from any industry in the food or agricultural business, or any funding to do any research.

What I discovered in doing this research is there is fear about GMO, and much of that fear is deep seated and unscientific. Much of what is put out on the internet for anti-GMO sites is hyperbole, not factual, and designed to evoke fear. This is to the point where the one side is easily dismissed by science types.

Labeling of GMO foods should be, in my opinion,  universal and transparent. The testing done for the foods should be transparent and funded not directly by industry, but an independent group who receive an excise tax to test GMO.

What Should You Do?

If you have concerns then I highly recommend you grow your own fruits and vegetables as much as you can. First, they will taste much better, and second, they may be healthier. If you think you have an allergy to any proteins, you should get tested by an allergist. From my own personal research, I am not concerned about the current GMO crops. What should frighten people is not the highly regulated GMO industry that we have today - what should frighten people is the technology to do this will be readily available and can be done in a garage. It is the unregulated role that, in the future, may cause harm. But that is about 15 years away- plenty of time for you to learn to garden.

REFERENCES:

The mammalian safety of Bacillus thuringiensis- based insecticides. J. Invert. Pathol. 77:13-21Siegel JP (2001).

Safety and advantages of Bacillus thuringiensis-protected plants to control insect pests. Regulatory Toxicology and Pharmacology 32:156-177. A key review which summarises the uses of Bt proteins to control insect pests in agriculture. Importantly provides key data substantiating the ~million-fold safety margins for Bt proteinsBetz FS, Hammond BG, and Fuchs, RL. (2000).

Bt: Mode of action and use Archives of Insect Biochemistry and Physiology Whalon ME and Wingerd BA (2003)., 54: 200-211

Arthropod pest management in organic crops Zehnder, G-F , Gurr GM, Kuehne S, Wade MR, Wratten SD and Wyss E (2007).. Annu Rev Entomol. 52: 57-80

Allergenicity assessment of genetically modified crops: what makes sense?  Goodman RES, Vieths S, Sampson HA, Hill D, Ebisawa M, Taylor SL and  van Ree, R. (2008). Nat. Biotech. 26: 73-81.

Risks of allergic reactions to biotech proteins in foods: perception and reality.Lehrer SB and Bannon GA (2005). Allergy, 60: 559–564

Structural, biological, and evolutionary relationships of plant food allergens sensitizing via the gastrointestinal tract.Mills ENC, Jenkins JA, Alcocer MJC and Shewry PR (2004). Critical Reviews in Food Science and Nutrition, 44:379–407

Identification of a Brazil-nut allergen in transgenic soybeans. Nordlee JA, Taylor SL, Townsend JA, Thomas LA and Bush RK (1996).N. Engl. J. Med., 334:688–92.

Bacillus thuringiensis A genomics and proteomics perspective Mohamed A Ibrahim, Natalya Griko, Matthew Junker, and Lee A Bulla1,Bioeng Bugs. 2010 Jan-Feb; 1(1): 31–50.PMID: 21327125

A multi-laboratory evaluation of a common in vitro pepsin digestion assay protocol used in assessing the safety of novel proteins. Thomas K, Aalbers M, Bannon GA, Bartels M, Dearman RJ, Esdaile DJ, Fu TJ, Glatt CM, Hadfield N, Hatzos C, Hefle SL, Heylings JR, Goodman R E, Henry B, Herouet C, Holsapple M, Ladics GS, Landry TD, MacIntosh SC, Rice E A, Privalle LS, Steiner HY, Teshima R, Van Ree, R, Woolhiser M, and Zawodny J (2004).  Regul Toxicol Pharmacol 39:87-98.

Risks of allergic reactions to biotech proteins in foods: perception and reality. Lehrer SB andBannon GA  (2005) Allergy, 60: 559–564.

Food-specific theories question if our diets have changed in subtle ways, maybe with nutrients that push more toward allergic responses. Others note that eating more or maybe even less of specific allergenic foods is to blame. Some theories even center on how a food is processed. For example, maybe roasting peanuts makes them more allergenic than boiling or frying, a common preparation in Asia, where peanuts are frequently eaten but peanut allergy rates appear lower, says Scott H. Sicherer, MD. He is associate professor of pediatrics at the Jaffe Food Allergy Institute, Mount Sinai School of Medicine in New York. Other theories blame a lack of sun exposure and decreased vitamin D, he adds, noting data indicating that more people with anaphylaxis live in northern climates.

The hygiene theory also is popular. Some experts say society is too clean, keeping kids' immune systems from maturing as they did in the past. "The hygiene hypothesis says that we are oversanitizing the early environment of the child," Dr. Bassett says. "The immune system has less exposure to dirt, germs and bugs."

In support of this perspective, researchers point to Eastern Germany before the fall of the Berlin Wall. "They had much lower rates of allergy," Dr. Field says. "As they were westernized, they had more."

Maybe a little dirt is not so bad, Dr. Rosenstreich says. "In the farm studies, children who live on farms in close proximity to animals and are exposed to endotoxins have fewer allergies. And it looks like a pet in the home in the first year of life may well protect children from asthma. This is the opposite of what we've been teaching." - quoted from 

Allergic reaction: Food allergies increasing, especially among children

■ Treatment and management present a challenge for physicians KATHLEEN PHALEN TOMASELLI amednews correspondent — Posted Dec. 29, 2008