BODY. Wisdom In Mediterranean Food Pairing.

Whenever I land in a European airport, one of the first things I note are the number of delicious pastry counters. And following, the size of the people - still generally quite smaller than the average American. How the heck is that possible with their acumen in sweet treats?

During my time in Turkey, I observed that while not so much as a strong pastry scene as France or Italy, sweets are still enjoyed. A new favorite discovery was the combination of tahini with grape molasses to make tahin pekmez - sweet, nutty, creamy and rich. We ate it by the spoonful at breakfast, or smeared it on bread. I was reminded by someone of the wisdom of food pairing when he mentioned the brilliance of this combination: the fat of tahini helps to slow down the glucose spike of the molasses. A similar trend was also reiterated with the amount of cheese (fat, protein) with honey or fruit (carbohydrate).

When I counsel patients with pre-diabetes on labwork, that is a hemoglobin A1C over 5.6%, I discuss this concept of food pairing: protein, fat, fiber first and carbohydrate last. To drive the point home, especially for those visual learners, I show them the side-by-side comparison below of my own continuous glucose monitor. I batch cook my lunch and dinner weekly to ensure I have a good meal to come home to at the end of a long day. The particular week of this data collection was salmon, brown rice, roasted vegetables.

The picture on the right is when I consumed the rice first, veggies next and fish last. The initiation of a meal with a simple carbohydrate, such as rice, fruit, potato, bread, etc., spiked my blood sugar up the highest I saw it during my two weeks of monitoring. The right side picture shows when I began with the salmon, followed by veggies and lastly the rice. Same meal, and a totally different profile by a significant 55 points.

So that mix of fat-rich tahini with the sweet grape molasses, at the end of a meal, is likely not wreaking havoc on blood sugar as much as ice cream before bed.

But what about those European breakfast pastries consumed in the morning, usually without protein? While I only have theories, I think my best working one is another blood sugar management tool that is baked into European culture: walking. Oftentimes in Europe, the pastry is followed by a walk to work, the train station, etc. The movement of muscles demands the need for fuel, and your body wants the most convenient source. If it is in the blood stream from a recent meal, it will pull the sugar from there and drop your blood sugar levels. Medically, this is called post-prandial movement. In Italy, it is called passeggiata - to go for a stroll.

So if you are going to have a sweet treat, best to follow it up as much of the world is acculturated to: take a stroll. While not required to be strenuous, it needs to be something more than washing dishes or folding the laundry. Think about a walk around the block vs. sitting on the couch after dinner.

There’s always a lot be learned from other cultures and also traditional foods - even the sweet ones - and I loved being reminded of these concepts while experiencing the food culture of Turkey.