Culinary Waves: by Chef Mary Beth Lawton Johnson
Now more than ever, health practitioners are paying attention to the effects of food on medicines — specifically, which foods interfere with how medications work. The Harvard Health Letter has published a list of foods that interact with medications, and so have many websites. The message is clear: People on medications need to pay close attention to their diets because the food they eat can cause their medications to have an entirely unintended effect — or even no effect at all — on their bodies.
As chefs, we must be mindful of our guests’ health conditions and medications when we are planning their menu. For example, some guests are on low-sodium or “heart healthy” diets, so I pay special attention to any fillers or pumped-in brine that some manufacturers add to preserve their products and make them perk up or plump up. This is especially true around the holidays because ham, turkey and even chicken breasts are often injected with a plumper and/or filler -- and usually it is a sodium gluten mixture to keep the meat fresh and make it look fuller. So if there is a guest on board who is gluten intolerant or who has heart disease, stay away from plumped-up products. Read the labels carefully!
The problem for a chef is that we don't always know which foods might wreak havoc on a guest’s medications. I always pay attention when charter guests tell me about medications and health conditions, or list them on their preference sheets. Sometimes I will come right out and ask if there is a specific food they can’t have because they are on certain medications. (This should be on every preference sheet in the industry.)
If you have someone on board who suffers from edema or chronic urticaria (hives) with swelling in the tissues or joints, the last thing you want to do is feed them spicy food or barbeque. They are probably on a medication to decrease the swelling, and spicy foods such as cayenne, Tabasco, jalapeños or barbecue sauce would only aggravate the condition. It would be better to try using foods that combat the edema, such as turmeric, cinnamon, garlic powder and cumin.
If a guest has arthritis, feed them cherry juice and fresh cherries — they have anti-inflammatory properties.
If a guest is on digoxin, a medication for heart failure, avoid using salt substitutes, because the sodium found in regular salt has been replaced with potassium, which can interact with the medication enough to cause heart failure.
Interestingly enough, there is an amino acid called tyramine that is found in soy, fermented foods, chocolate, aged and mature cheeses, draft beer and many other foods. If you eat a lot of these foods, it can cause your blood levels to be high in tyramine, which can exacerbate high blood pressure.
Eating grapefruit while on statin drugs, antihistamines or drugs to regulate blood pressure or thyroid function can alter their effectiveness. Compounds in grapefruit called furanocoumarins are the culprits and they cause your body to metabolize the drugs differently, raising or lowering the levels in your blood.
Glycyrrhiza, found in black licorice, can break down blood thinners as well as interfere with blood pressure medications. I found out the hard way when I bought some for a friend who had A-fib (atrial fibrillation, or irregular heartbeat). I didn’t know at the time. Stay away from it if guests are on these types of medications. Glycyrrhiza also can deplete potassium in the body and cause it to retain sodium, resulting in edema. For those with congestive heart failure, especially if they are taking digoxin, it can cause arrhythmia in the heart and water retention, which actually magnifies the medication.
If a guest is on a blood thinner, such as Warfarin or Coumadin, anything containing vitamin K will interrupt with the anti-blood-clotting factor of the drug. This means green vegetables like broccoli, spinach, kale, cabbage and Brussels sprouts. Patients on blood thinners are advised by their doctors to limit their intake of such foods. Don’t fix it for them — or, if they insist, try to serve it only in small quantities.
Goals to get high blood pressure, diabetes or high cholesterol under control are almost impossible to reach without a healthy diet. Maybe you have a crew member on board who suffers from one of these diseases, or it might be your boss. I can't remember a time when I didn’t have special diets on board. I always opt for the freshest unprocessed foods to offer them so that not only do they avoid packing on the pounds and water weight, but they leave the yacht in better shape than when they came aboard. Special diets are an asset for chefs, and so are the preference sheets from guests who might suffer from a food that we use in our meals.
Don't just call yourself a chef — call yourself a “food pharmacist.” You offer a medically tailored culinary solution for people who require a little help with disease management when they come on board.
Mary Beth Lawton Johnson is a certified executive pastry chef and Chef de Cuisine and has worked on yachts for more than 25 years. Comments are welcome below.