Body Fat Is Healthy Now? Fat Chance

by | Jun 29, 2009
1 lb Fat

1 lb Fat

Last week the New York Times and many other reputable news sources reported on a Canadian study that claims people with a normal body mass index (BMI) had a slightly increased risk of dying over a 12-year period than those with a BMI in the overweight range (25-29).

The use of the phrase “overweight was protective” landed this article just a hair’s width from being labeled Summer Tomato’s B.S. of the week on Friday. An observational study cannot determine cause and effect, as implied by the word “protective.” This study does not prove that extra body weight protects against all cause mortality, and saying so is irresponsible.

Studies (and reporting) like this have instigated wide-spread confusion about health and body weight. First people are told they are too heavy and should lose weight for health, then in the same breath they are told a little extra weight might not be so bad.

What is the average person supposed to believe? How should we act?

If you want to understand the facts it important to know exactly what the data does and does not say. Indeed, some studies (including one on Japanese men reported in the same issue of Obesity) have reported lower or equal risk of mortality for people with an overweight BMI compared to people of normal BMI (18.5-24). However, this is not the whole story.

First, the alleged benefit of being overweight has only been found in older individuals and does not apply to healthy, young people. Second, although it appears in some cases that overall mortality may be reduced, disease incidence is notably higher in overweight individuals compared to people of normal weight.

bmi-and-chd

To point, a study in the most recent issue of Obesity (same journal, 2 weeks later) examines the relationship of BMI with many measures of cardiovascular disease in healthy, athletic men. In this study, those on the lowest end of BMI in the normal range (18.5-22.5) had a much lower risk of dying from or developing cardiovascular disease than normal weight men with a slightly higher BMI (22.5-25).

Men with the lowest healthy BMIs also had lower risk of hypertension, lower cholesterol and half the risk of diabetes. While the length of this study was only 7.7 years (compared to the 12 years reported in the Times story), there were more than double the number of participants (28,776 vs. 11,834).

(Why did this story not make the news? My guess is that it makes for a less compelling storyline and people would rather not hear it.)

Mortality is certainly an important measure in any study, but it is arguably not the most relevant endpoint. Disease and excess body weight can severely impact quality of life, particularly for older individuals (as illustrated by another study in the latest issue of Obesity). While I cannot speak for everyone, it seems probable that quality of life is equally if not more important than longevity alone. Thus it is questionable how much stock to put into studies that ignore these other factors.

It is also critical to remember that BMI is a measure that was designed to describe people at a population level, not as individuals. While large cohort studies can tell us useful things about relative risk, they are not directly applicable to individual people.

The inconsistency of the data related to BMI and mortality may in fact be an indication of its inadequacy as a general measurement. Remember that BMI represents a ratio between height and weight, making it possible to compare people of various body sizes. Normalizing for height may, however, be deceptive.

Decades of data on caloric restriction consistently show that smaller body size (irrespective of body fat levels and, possibly, BMI) is associated with longer life and decreased risk of nearly all diseases. This is true in all animals from yeast, to worms and flies, to mice and monkeys. While humans are certainly different from all these model organisms, there is tremendous evolutionary precedent indicating smaller body size as the best for health.

The principle of parsimony tells us the simplest hypothesis–that smaller body size is beneficial–is probably correct. Substantial evidence must be accumulated before this hypothesis can be rejected, and I have yet to see that data.

Furthermore, while the research on the risk of overweight may be slightly ambiguous, the data on obesity is not. It is painfully clear that the dangers of obesity are profound and on par with those of smoking cigarettes. Overweight is a necessary step to becoming obese, and according to the National Population Health Survey nearly a quarter of Canadians who were overweight in 1994/1995 were obese by 2002/2003. Since overweight is still a substantial risk factor for becoming obese, misleading public health messages about the benefits of body fat are especially dangerous.

As a consumer of information, the most important thing you can do is be skeptical of what you read. Just because something is printed in the New York Times does not make it true. In fact, many of our most trusted sources of health information do not base their recommendations on rigorous scientific thinking, which is probably the reason for the health disaster we are currently facing.

Thanks to Jan from Quest for Health for sparking this discussion.

What does your gut tell you about the relationship between health and body fat?

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Farmers Market Update: What’s the point?

by | Jun 28, 2009
Green Tomatoes

Green Tomatoes

Healthy eating starts with fresh, seasonal produce, preferably from your local farmers market.

Years ago when I started my column at Synapse and began advocating seasonal vegetables as the best path to health, one of the most common questions I got was, “How do I know what’s in season?”

In response to this I wrote my first Farmers Market Update, and this has become one of the cornerstones of Summer Tomato.

There are many reasons I write these updates every week, but occasionally it is important to step back and make sure my objectives are met with each post.

Here are the main goals I aim to achieve with my Farmers Market Updates:

Education

As mentioned above, I hope that by reading these Farmers Market Updates you will get a feel for what is in season. Even if you are shopping at your local supermarket, seasonal produce is your best bet.

Follow along to get a general idea of what you should be eating this time of year.

Inspiration

For me just seeing the beautiful vegetables, fruit and other goodies at the farmers market makes me want to spend the rest of the weekend in the kitchen–and I’m not exactly the domestic type. With Farmers Market Updates I hope to inspire you to find your own local markets and look for the best seasonal produce you can find.

Going to the farmers market is by far the best part of my week and I wish you could all experience it with me. I realize not everyone has the Ferry Plaza Farmers Market to wake up to on Saturday mornings, but your own farmers market is still better than anything you will find at a big chain store.

There is nothing like spending a little time with the local farmers that grow the food you eat. Every meal you prepare with these ingredients is special, even if it isn’t exotic.

Demonstration

I’m the first to admit that cooking can be scary and the thought of it overwhelming. Most of us were never taught how to use a stove, let alone poach an egg. But we are extremely proficient at using Google to help us figure things out, right?

Cooking is no exception.

I make a point of finding things at my farmers market that I do not know how to cook. Why? Because exploring new foods is one of the most important things in making healthy eating fun and enjoyable. You can even rediscover foods you think you don’t like by buying them at the height of season and learning to cook them properly.

I promise, liking things is more fun than not liking things :D

I try to convey this sense of adventure in my Farmers Market Updates. This week, for example, I bought all the flavors I associate with Thai food even though I do not have a specific recipe in mind. I also purchased some lemon cucumbers simply because they looked cool.

You do not need to know how to cook something before you buy it. Vegetables are cheap, just get what looks good and figure the rest out later. Email me if you need suggestions!

———-

Farmers Market Update

Cucumbers

Cucumbers

Brown Turkey Figs

Brown Turkey Figs

Summer officially started this week in San Francisco (according to me). With melons and figs popping up all over the place, there is no way I can keep sitting here and telling you it is springtime.

Woohoo!

Thai Basil

Thai Basil

Purple & White Peppers

Purple & White Peppers

Summer tomatoes are already fabulous, summer squash are as sweet as can be (especially the yellow Zephyrs!) and who knew there were so many kinds of cucumber? Green garlic has morphed into the bulbous “fresh garlic.” Green beans are starting to appear and there are 2 kinds of basil. Not one, but two!

Darya is happy.

Cucumbers

Cucumbers

Fresh Garlic

Fresh Garlic

Check out my first Farmers Market Update video from my new apartment. It is just under 3 minutes.

Today’s Purchases:

What did you find at the market this week?

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For The Love of Food

by | Jun 26, 2009
For The Love of Food

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

Thanks to everyone who voted for me for A Really Goode Job! I ended up with over 100 votes in just a couple days, which is very flattering. The top 50 were announced this morning and I was not among them. I guess my other two jobs will have to suffice for now. ;)

This week around the internet I found several reminders of why heart disease is not the only reason to worry about excess body weight and how industrial food is a threat to your health. I also discovered a fantastic article about how psychological barriers prevent us from being healthy.

B.S. of the week, once again, goes to Diets in Review for promoting a new “tomato pill.” Because eating real tomatoes for health is SO 1909!

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. I am also experimenting with the social bookmarking sites StumbleUpon and Delicious, and would love to share articles with you there.

Submissions of your own best food and health articles are also welcome, just drop me an email using the contact form. I am currently accepting guest posts at Summer Tomato for any healthy eating and exercise tips.

For The Love of Food

What great articles did you read or write this week? Leave your links in the comments.

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Farmers Market Update: Veggie Hunting

by | Jun 21, 2009
Pluots

Pluots

I’m starting to remember how much self-control is necessary this time of year. Not only is the market exploding with a zillion varieties of perfect stone fruits (the kind with pits), but the vegetable options are still somewhat limited.

Stone fruits are wonderful, and I know that cherries and apricots will be gone in a few weeks. The problem is they are not cheap ($3.50 – $7/lb) and are not something you can base a meal around. Dessert, obviously, is another story.

Late spring is filled with gorgeous herbs and lettuces, and I am loving it. But I noticed last week that I was getting a little tired of eating salad for every meal. My limit is about 10 salads per week.

Baby Savoy Cabbages

Baby Savoy Cabbages

Summer Tomatoes

Summer Tomatoes

As a result I have been relying primarily on summer squash for my warm meals. Last week I bought some baby eggplant and made a delicious ratatouille. The baby savoy cabbages I got were wonderful pan-fried with spring onion and served on rice and lentils.

Artichokes are awesome right now, as are the fava beans, but both are a bit labor intensive.

I make an effort each week to buy some kale or chard so I have some nice hearty greens to eat.  Today I splurged on some squash blossoms, which are wonderful with eggs or stuffed with cheese and rosemary and fried tempura style.

Fresh Lavender

Fresh Lavender

Squash Blossoms

Squash Blossoms

I’m very much looking forward to the arrival of sweet bell peppers (a few did actually pop up this week at Happy Quail Farms), which I have no trouble eating every single day in the summertime. Mmmm….roasted peppers.

If you’re a flower person, now is the time to buy fresh lavender.

What vegetables are you finding at your farmers market these days? What do you do with them?

Today’s purchases:

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For The Love of Food

by | Jun 19, 2009
For The Love of Food

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

The food safety bill finally passed this week, I found 2 fabulous (looking) soup recipes and Lifehacker shares the best tools for storing them.

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page.

Submissions of your own best food and health articles are also welcome, just drop me an email using the contact form. I am also currently accepting guest posts for any healthy eating and exercise tips.

For The Love of Food

What great articles did you read or write this week? Leave your links in the comments.

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Food, Inc. Shows How Your Food Choices Can Change the World

by | Jun 15, 2009

foodincIt is fair to say I’m a bit obsessed with food.

To me this is perfectly natural, because few things are as important or bring as much pleasure to my life. I eat at least three times a day, and each meal is an opportunity to revel in the bounty of nature and ensure my health for (5? 6? 7?) decades. What confuses me is why more people aren’t so obsessed with food.

I admit that my personal history with food is long and intimate, but at this stage in my life what makes me passionate about eating well is what I know about the impact of my daily meal choices on myself and the world.

Food is the cause of almost every modern disease, and is in the midst of creating some new ones.

Food is destroying the planet faster than anything in human history.

Food threatens our national security and the health of the global economy.

But food is not all doom and gloom, nor should it be. Real food is a celebration of life and brings people together. Real food is an art. Real food is health.

My personal favorite reason to eat the way I do is that real food tastes amazing, nothing like the processed junk most of us grew up eating.

When it comes down to it, real food makes my life better.

If you are like most people I talk to, this all sounds wonderful but is a little too abstract to move you to action. Sure we would all love to make it to the farmers market this weekend, but when Saturday rolls around there are 1,001 excuses not to go. Right?

In my world though, the earth has to be collapsing for me to miss my market trip and even then I’ll probably find another one. I don’t see it as a choice. For me my weekly trip to the farmers market determines how well I will eat for the entire week. I know it is possible to eat healthy without going but it won’t taste nearly as good, is less exciting and more expensive. These things make it harder to eat healthy at all, and that is not okay.

My resolve comes from the knowledge that there is no more important decision I can make each week than where I buy my food.

If you aren’t convinced yet, you should definitely see the new film Food, Inc.

Food, Inc. will help you see food as a priority, a solution to and not the cause of our problems. It is a journey through our modern food system, how it works and the tremendous impact it has on our lives.

One of my favorite quotes comes early in the film as Michael Pollan, one of the film’s narrators and hero of the “real food” movement, describes the disappearance of seasonal produce at the grocery store. His quintessential example is the perfectly red, perfectly round tomatoes that can be found year-round in American supermarkets.

“Although it looks like a tomato, it is a notional tomato. It’s the idea of a tomato.”

This is because, as you all know by now, real tomatoes only exist in the summer.

Food, Inc. gives you an intimate look at where these artificial foods come from and the how they affect our lives. It also explores the government policies that have encouraged and protected these practices at the expense of good food and health.

If you have read (and you should) Michael Pollan’s landmark book, The Omnivore’s Dilemma, you will find many similarities in this film. However, Food, Inc. preferentially emphasizes the results of our food system and the toll it takes on our health and economy.

Central to Food, Inc. are the stories of people who were the honest victims of our toxic system. These stories are heartbreaking and will make you think twice the next time you are tempted to order a Quarter Pounder.

Importantly, Food, Inc. offers more than just criticism, it also gives us a solution: vote with your fork.

The message of the movie is almost entirely aligned with the philosophy of this blog: shop at farmers markets, cook your own meals, pass on the processed foods.

These simple acts are enough to change the way the system works, because ultimately consumers decide what is produced. If you stop buying it, they will stop selling it and find another way to satisfy your needs. We are the ones with the real power.

It is completely possible to opt out of our current food system by reducing and even eliminating processed, industrial foods from your diet. Amazingly, once you start on this journey you learn that you don’t actually give anything up in the process, but in fact regain a world of lost flavors and the joys of eating real food.

If you like Food, Inc. and want to know more there are numerous resources:

Have you seen Food, Inc. yet? What did you think?

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Farmers Market Update: Fruit Bonanza!

by | Jun 14, 2009
Red-Orange Apricots

Orange-Red Apricots

I was completely out of control at the farmers market this weekend. It’s embarrassing really. I have absolutely no self-control when it comes to NOT buying stone fruit and berries. None.

Consequently I spent way more money than I normally do at the market. But after thinking about this for a few hours I realized I would be crazy to have done otherwise.

Boysenberries

Boysenberries

Pluots

Pluots

There is no other time of year when you can get perfect, meaty, sweet and tangy cherries in 3 or 4 different varietals. Apricots come in all shape, sizes and colors, and a mushy one cannot be found among them. Plums and pluots are like the hand-picked candy of God herself. There are only a few weeks left in blueberry season, but boysenberries and blackberries demand your undivided attention. Strawberries are as sweet as they will ever be.

Strawberries

Strawberries

Rainier Cherries

Rainier Cherries

What else was I supposed to do?

But at $5-8 dollars a pound it put a serious dent in my wallet. The thing is though, these are real treats. I cannot buy them the rest of the year even if I wanted to. The cheaper ones at Safeway are not even worth discussing.

I easily spent $30 on fruit today, which I never do. Luckily the luscious kale I bought was only $1.75 and is 2-3 large servings. The baby savoy cabbages came in at under $2 as well.

The summer squash I bought last week from Lucero farms were ridiculously sweet and delcious, especially the yellow ones. They are even good raw! I bought a bunch more this week, as well as a few of the self-proclaimed “world’s best cucumber.”

Baby Eggplants

Baby Eggplants

Purple Onions & Cucumbers

Purple Onions & Cucumbers

A few eggplants are starting to show up too.

For those of you who are as excited about summer tomatoes as I am, Oliveto restaurant (Oakland) has started Tomato Watch 2009. Tomato Watch is an online video journal documenting the tomato crops of some of the best tomato farms in the Bay Area. Don’t miss the action!

For the first time I bought soy milk from Hodo Soy, the maker of my favorite tofu. I’m lactose intolerant and therefore prefer soy milk in my breakfast cereal and coffee (unsweetened, full-fat soy milk, of course). Traditionally I have bought Silk brand unsweetened soy milk, but I recently learned that since Silk was bought by Dean Foods they have switched from U.S. grown organic beans to conventional soy beans largely imported from China. I think it’s safe to assume everything from China is filled with lead and cyanide (kinda kidding, but kinda not), so I no longer buy Silk. I’ve been experimenting with Wildwood, but I thought I would try something new this week. I’m interested to see what Hodo can do.

There are so many amazing varietals of stone fruits at the market right now I can’t even pretend to keep up with them all.

Do you have any favorites? Please tell me about them in the comments!

Today’s purchases:

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For The Love of Food

by | Jun 12, 2009
For The Love of Food

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

We have lots of fantastic articles this week from Lifehacker‘s food week: Eat To Live. Also featured are several healthy shopping guides including ones for fish, seasonal produce and pesticide-free foods.

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page.

Submissions of your own best food and health articles are also welcome, just drop me an email using the contact form. I am also currently accepting guest posts for any healthy eating and exercise tips.

Note: If you have not received any Summer Tomato email updates this week please check your spam folder and mark my email address as “not spam” in your contacts. Please let me know if you have any problems with this adjustment.

For The Love of Food

What great articles did you read or write this week? Leave your links in the comments.

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Eco-Atkins Diet May Be Healthier Alternative for Weight Loss

by | Jun 10, 2009
Collards, Carrots and Lentils

Collards, Carrots and Lentils

A new study published yesterday in the Archives of Internal Medicine suggests that both weight loss and risk factors for heart disease can be improved following a vegan version of the low-carb, high-protein Atkins diet.

The “Eco-Atkins” diet focuses primarily on soy, nuts and wheat proteins (gluten) to increase the amount of vegetarian protein in the diet. Carbohydrates were restricted to 130 g/day, which is on the higher end of most low-carb diets. All starchy foods such as bread, baked goods, potatoes and rice were eliminated. Carbohydrates were provided in the form of whole, intact grains (barley and oats) and low-starch vegetables.

In a small (47 participants), short-term randomized controlled trial, this diet lowered bad LDL cholesterol by 20%, without negatively impacting good HDL cholesterol (statin drugs improve cholesterol levels by 30%). The diet also substantially lowered blood pressure and other markers of cardiovascular disease, such as triglycerides and apolipoprotein B.

The original meat-based Atkins diet has been shown to be effective for temporary weight loss (after 1 year the effects of the Atkins diet are diminished), but cardiovascular risk factors such as LDL cholesterol and blood pressure are not substantially improved under the traditional Atkins regimen.

Interestingly, a traditional Atkins-style diet based on animal protein was not used as a control in this study, so a true comparison of the diets cannot be made using the present data. Instead the researchers chose a control diet representative of a typical high-carb, low-fat vegetarian diet that included eggs and dairy products. Both diets tested in this study represented a 60% decrease in total calories.

Because of the study design, we cannot conclude that this diet is more effective than the Atkins diet for health, though you would predict it would be if future studies made this comparison. On the other hand, it does seem that a plant-based high-protein diet is more effective at improving health than a high-carbohydrate lacto-ovo vegetarian diet, at least in the short-term in a highly controlled environment.

This study took place over the course of 4 weeks, and all the food was provided for the particpants by the researchers. Thus, compliance in the program was very high. It is not clear if the participants would have had the same level of success if they were instructed to provide their own food to comply with the dietary programs.

Despite this, satiety levels were notably improved in the high-protein group and it would be expected that the increase in satiety would encourage greater compliance in a free living situation.

A small four week study, however, tells us very little about the effectiveness of this diet. While it is possible to improve risk factors such as cholesterol and blood pressure in such a short period of time, disease outcome is the true measure of a successful diet. Also, this study did not test the feasibility of the Eco-Atkins diet in the long-term, and it is likely many dieters would object to a strictly vegan regimen.

Interesting points raised by this preliminary study include:

  • Plant-based, high-protein diets may be more effective at improving cholesterol and other cardiovascular measures than traditional lacto-ovo vegetarian diets.
  • Short-term weight loss is primarily determined by the number of calories consumed, not macronutrient content.
  • Low-carb diets that include intact whole grains and plant-based protein can be effective at improving both weight and cardiovascular risk factors in the short-term.
  • Plant-based high-protein diets can increase satiety compared to high-carb vegetarian diets.

However, many questions must be addressed before this diet can be recommended to individuals trying to improve cardiovascular measures and lose weight.

New questions:

  • Can the Eco-Atkins diet be maintained in the long-term by normal individuals?
  • Does the Eco-Atkins diet continue to improve cardiovascular risk factors including weight loss after 4 weeks?
  • What would result from this study if beans and lentils were used instead of soy and gluten?
  • Does the Eco-Atkins diet improve disease outcome?
  • Does the Eco-Atkins diet extend life?
  • Does the Eco-Atkins diet affect quality of life?
  • Can these effects be attained through other diets that include some animal protein, more whole grains or more fat?
  • Is the effectiveness of the Eco-Atkins diet affected by an individual’s level of insulin resistance?
  • Can adding fish further improve the results of the Eco-Atkins diet?
  • Can a further reduction in carbohydrates improve the results?
  • Will you get these same results if the study is NOT funded by the soy industry?

In summary, the results of this study are interesting and encouraging, especially for those of us who think both carbohydrates and meat should be limited in a healthy diet. I very much look forward to future studies exploring this idea.

What concerns me most is the lack of marine omega-3 fatty acids (fish) in the Eco-Atkins diet, which could potentially improve cardiovascular measures even further. Fish is also important for cognitive health and may lower cancer risk.

I am also worried that a strictly vegan diet would not be feasible in the long-term for many Americans. Moreover, it is not necessarily the healthiest option available. Vitamin B12 deficiency is a particular concern, but could be addressed with supplements. Generally, however, I do not recommend relying on supplements for optimal nutrition.

Finally, this study was funded by a company that makes soy and gluten products. Personally I would have prefered to see these protein sources used in combination with other things such as beans and lentils. Many people question how much soy can be safely consumed and gluten intolerance is more common than ever, so wouldn’t it be interesting to know if there were safer alternatives? It really annoys me to see science being influenced by industry funding.

What do you think of the Eco-Atkins diet?

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Farmers Market Update: Late Spring

by | Jun 7, 2009
Summer Squash

Summer Squash

I do not want to call it summer just yet, but we’re certainly getting close. I was finally able to return to my beloved Ferry Plaza Farmers Market this weekend in San Francisco. What a delight!

Last time I visited cherries were just starting to get good and a few apricots and tomatoes were peeking out. Now stone fruits have completely taken over the market, tomatoes are abundant and summer squash have exploded in a way I don’t remember from years past. Truly breathtaking.

Larian & Rainier Cherries

Larian & Rainier Cherries

Organic Plums

Organic Plums

Strawberries are particularly sweet right now, while blueberries are the perfect combination of sweet, tart and crunchy. I saw raspberries for the first time today, but did not get a chance to taste them.

Another remarkable sight was the fresh herbs. Scents of basil, thyme, mint, oregano and lavender infuse the air with the unmistakable fragrance of the coming summer. I couldn’t help but buy all I could carry.

Oregano

Oregano

Spearmint

Spearmint

Some notable early spring items have also disappeared. There are no longer aspargus or *sniff* ramps. Citrus is also on it’s last legs.

Finally, today was the first time I have been to the market since plastic bags were banned. I bought a roll of the biodegradable kind from the CUESA information booth. Some vendors gave them out for free, but most did not. All around the experience is a little bit annoying (I accidentally spilled a bag of cherries on the ground because of the chaos in my shopping bag), but mostly manageable. I do wish there were a better solution, but I’m sure I will get used to the inconvenience eventually.

Salad Mix

Salad Mix

Garlic and Squash Blossoms

Garlic and Squash Blossoms

Today’s Purchases:

What did you find at the market today?

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