A Clinical Perspective on Colorful Berries

Conventional wisdom recognizes that increasing dietary intake of fruits and vegetables high in antioxidant activity is important for healthy living and aging. A class of fruits that is increasingly popular due to the increasing awareness of its numerous health benefits, rich nutritional value, unique organoleptic properties and diversity of formulation and marketing options, is berries. Such attributes have helped position berries as “superfruits.” Further, considerable research supports a host of health benefits:

• Antioxidant Effects: reduction of neurological aging, potential memory enhancement, reduction of oxidative stress
• Blood Vessel Protection: reduction of vascular permeability and fragility, preventing glycoprotein accumulation, stimulation of vasodilator gas nitric oxide (NO), antioxidant of peroxide and peroxinitrite free radicals
• Cardiovascular Protection: preventing oxidation of low-density lipoprotein (LDL) cholesterol, reducing plaque formation, increasing plasma's antioxidant capacity
• Eye Health: potential regeneration of rodopsin, preventing eye lens oxidation-cataracts, increasing blood flow and strengthening micro-capillary blood vessels reducing incidence of macular degeneration
• Anti-Diabetic Effects: reducing diabetic angiopathy, improving digestion of starch
• Antiviral Properties: reduction of common cold onset and/or recovery time
• Antimicrobial Effects: protection from Helicobacter pylori, reduction of re-occurring urinary tract infection, general antibacterial

Although the exact active ingredients responsible for all these health benefits in berries have yet to be determined, it has been speculated that anthocyanins are a key class of compounds present acting singly or synergistically with other constituents causing this pluralistic effect. These are present in the form of glucosides (attached with sugar moieties) either singly, as monomers, responsible for the intense red colors noted with berries, or combined (proanthocyanins), which are colorless and serve as copigments or exhibit antimicrobial activity depending on the degree of polymerization.

Anthocyanins react with atmospheric oxygen or light, which can polymerize the compounds, losing their color and causing the browning of the fruits. The actual chemical composition of various berries obviously varies; however, common constituents exist and their relative quantities among berries are as follows: water (approximately 80 percent w/w); sugars (approximately 15-18 percent, mostly fructose, glucose, pectin and fiber); fat (mostly in seeds); and small amounts of protein, minerals, vitamins and flavonoids.

Botanically, berries are fruits, meaning they originate from mature ovaries of flowers that have been pollinated. Specifically, berries originate from single flowers with one superior ovary with one or more seeds that entirely ripens to an edible pericarp. A berry then can be described as a fleshy/pulpy fruit of specific origin with embedded seeds that remain undischarged (indehiscent). Berries have been used as drug preparations in Europe for treating various inflammatory and circulatory conditions associated with vascular health, specifically for treating venous inflammation (edemas and tiredness of lower limbs), treating capillary fragility of skin and soft tissue (gum and nose bleeding) and treating acute attack of piles and circulatory disorders of the retina.

Presently, there are numerous products in the market based upon various berries that exhibit variable consistency as measured for total phenolic compounds, anthocyanin content and antioxidant capacity. Such inconsistencies have caused a lack of trust toward suppliers and manufacturers and their offerings ranging from quality (potency, purity and adulteration) of the ingredients used to finished products not meeting label claims. Such quality issues range from poor testing procedures that lack specificity for the active principles (ORAC values or total phenolic content) to outright adulteration of expensive berries, such as in the case of bilberry adulteration. Complicating the situation further is an effort by various vendors to combine several different berries into products in order to increase the spectrum of actives with the anticipation that synergistic effects may be observed making the product more effective. While this is not necessarily a bad practice, it does increase the complexity in identifying the product’s active principles.

Adding further complexity to the situation is the fact that many berries are available in a range of product forms to meet specific marketing or formulation needs. Consider cranberry, which is available as a fruit juice concentrate, fruit concentrate liquid, fruit powder, fruit concentrate powder and powder extract, just to name a few forms. This raises the question, which form is to be chosen for a clinical evaluation regarding cranberry and its specific health benefits? How can the outcomes from one clinical study using one cranberry preparation be compared with those of another clinical study that used a different preparation?

Such inconsistencies have contributed to the variable outcomes of clinical studies performed with various preparations of berries. Further exacerbating this mosaic of variables is the ever-changing chemical composition of the berries due to environmental factors such as sunlight, temperature, air quality, cultivars, fruit size and storage conditions. Nevertheless, attempts have been made to standardize berry preparations using test methodologies that are specific and can profile a range of actives looking for specific ratios among them in order to improve their consistency and efficacy. However, the adoption of such methodologies is yet to become conventional among the various vendors.

This plethora of parameters that ultimately influence the outcome of clinical studies can evidently be categorized in two classes of variables; one pertinent to human and the other to nature's intervention:

• Human Intervention
• Supplier issues (lack of trust)
• QC issues (lack of standardization or standardization to a marker not the active, nonspecific test method)
• Combination of berries in one product
• Multiple offerings of raw materials from one berry
• Variable dosing (effective dose undefined)

Nature's Diversity

• Multiple actives (anthocyanins, acids, flavonols, lectins, tannins and oils)
• Synergy of actives (increases complexity and purification can diminish the effect)
• Unknown actives
• Changes in composition of actives (highly dependent on berry's condition)

There are additional challenges in conducting clinical trials with nutritional compounds. For example, when testing for antioxidant activity of a specific berry preparation, the outcome may be different when conducted on individuals under stress compared to healthy participants. This is due to the body’s homeostasis capacity that can metabolize nutrients differently depending on the body’s stress level. In this instance, the health condition of the individual can have a direct impact on the clinical outcome and invariably producing outcomes that are contradictory. It is clear that additional precautions need be considered when undertaking a clinical study regarding a nutraceutical preparation.

For more in-depth coverage of various berries, visit the following recent articles by Dr. Papadimitrou:

• Cranberries—A Clinical Perspective
• Chokeberries—A Clinical Perspective
• Blueberries—A Clinical Perspective
• Black Currant—A Clinical Perspective
• Bilberries— A Clinical Perspective
• Elderberry—A Clinical Perspective
• Wolfberry—A Clinical Perspective

Green, Black Tea Reduce Stroke Risk

Drinking at least three cups of green or black tea made from the plant Camellia sinensis a day can significantly reduce the risk of stroke, according to a new UCLA study published in the online edition of Stroke: Journal of the American Heart Association.

UCLA researchers conducted an evidence-based review of all human observational studies on stroke and tea consumption found in the PubMed and Web of Science archives. They found nine studies describing 4,378 strokes among nearly 195,000 individuals, according to lead author Lenore Arab, professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

“By drinking three cups of tea a day, the risk of a stroke was reduced by 21 percent. It didn't matter if it was green or black tea," Arab said, adding that the effect appears to be linear. For instance, if one drinks three cups a day, the risk falls by 21 percent; follow that with another three cups and the risk drops another 21 percent.

Developing medications for stroke victims is particularly challenging, given that the drug has to get to the stroke-damaged site quickly because damage occurs so fast. Arab said by the time a stroke victim gets medical care, it's nearly too late to impede the damage.

"That's why these findings are so exciting," she said. "If we can find a way to prevent the stroke, or prevent the damage, that is simple and not toxic, that would be a great advance."

Though no one is certain which compounds in tea are responsible for this effect, researchers have speculated that the antioxidant epigallocatechin gallate (EGCG) or the amino acid theanine may be what helps.

"We do know that theanine is nearly 100-percent absorbed," Arab said. "It gets across the blood-brain barrier and it looks a lot like a molecule that's very similar to glutamate, and glutamate release is associated with stroke. It could be that theanine and glutamate compete for the glutamate receptor in the brain.”

Rising Star Chefs 2009

Michael Mina, Loretta Keller and Charles Phan all have at least one thing in common: In the early stages of their careers they were singled out as Rising Star Chefs in The Chronicle.

For the past 17 years, we've given annual recognition to a group of talented young chefs in their 20s or very early 30s, and we've had a pretty good track record. Does Mourad Lahlou, Traci Des Jardins or Wendy Brucker ring a bell? These past winners have shaped the Bay Area dining scene - and this year Brucker and Keller have each mentored one of the young chefs.

This year's group is just as promising and diverse as their predecessors: One is of Chinese descent, another is from Brazil, and a third from France. Then we have two country boys - one from Ukiah and the other from Louisiana. The diversity in their backgrounds - and cooking styles - promises to give depth and breadth to the dining scene.

Inside we profile the chefs and share a recipe that reflects their style. As with all Food & Wine section recipes, we've tested them in The Chronicle kitchen to make sure they'll work for the home cook. Our wine matching expert Lynne Char Bennett then worked with each chef's restaurant sommelier to come up with perfect wine pairings.

Like their mentors, we think the following five chefs will shape the Bay Area dining scene in years to come.

The restaurants

Aziza, 5800 Geary Blvd. (at 22nd Avenue), San Francisco; (415) 752-2222 or aziza-sf.com.

Cafe Majestic, 1500 Sutter St. (at Gough, in the Hotel Majestic), San Francisco; (415) 441-1280 or thehotelmajestic.com/restaurant.html.

Corso, 1786 Shattuck Ave. (near Delaware), Berkeley; (510) 704-8003 or trattoriacorso.com.

Gitane, 6 Claude Lane (at Bush), San Francisco; (415) 788-6686 or gitanerestaurant.com.

Moss Room, 55 Music Concourse Drive (in Golden Gate Park), San Francisco; (415) 876-6121 or themossroom.com.

"I've been making some things here for six months, and only now I'm finding ways of making them better."

Melissa Chou

Aziza, San Francisco

Can't live without: Her dad's old radio, which keeps her company as she cooks.

"The ambiance in the kitchen here is different than it is in France - less competitive, more respectful."

Lisa Eyherabide

Gitane, San Francisco

Can't live without: A cataplana, the Portuguese copper hinged steamer. "I use it at the restaurant for several different dishes."

"What's most important is simplicity, not manipulating food or flavors."

Justin Simoneaux

Moss Room, San Francisco

Can't live without: Preserved lemons. "I just love the flavor."

"There's nothing more satisfying than watching people eat your food and having the plates come back clean."

Rodrigo Da Silva

Corso, Berkeley

Can't live without: My cleaver. "It's my second hand."

"I don't do red wine, bananas and beef. My mind doesn't work like that. Some people can pull it off, but it's not for me."

Louis Maldonado

Cafe Majestic, San Francisco

Can't live without: My Masamoto knife. "Chef Quinn Hatfield (formerly of Cortez)

Competition for restaurant jobs is increasing

JAMES LENZI, a chef who is opening a restaurant near Columbia University, recently posted an ad on Craigslist for an assistant. Salary: $25,000 a year with no benefits.

“The résumés started pouring in,” he said. “Hundreds of them. Chefs, managers, people who’ve worked at the best restaurants in New York.”

Nine of the 300 applicants had Ph.D.’s., he said. “I can’t stop thinking about what’s going to happen to them.”

In New York City, chefs, owners and workers say they cannot remember a time when so many restaurants were closing or struggling, so many restaurant workers were looking for jobs and so few places were hiring. According to the New York State DepartmentricaLabor, after adding 50,000 jobs in less than seven years, the New York City restaurant business lost more than 10,000 jobs between October 2008 and January 2009.

The economy is obviously a factor, but some in the business say they’re also seeing the results of a decade of exuberant, possibly unsustainable expansion.

“Suddenly the restaurant business looks not so different from the financial and real estate markets,” said Joseph Bastianich, a co-owner of 12 restaurants in New York and nationwide. “When expansion is fueled by unfounded optimism, you get a balloon that doesn’t exist in reality.”

In September 2007 the chef Fabio Trabocchi was brought in from suburban Washington with much publicity to take over Fiamma in SoHo. Its handmade pastas were praised to the skies, and Frank Bruni gave it three stars in The New York Times that November. In January its owner closed it.

“A boom is exciting, and it raises the level of the food for everyone,” Mr. Trabocchi said. “It’s too soon to say if it was a bubble, but at the end there is only a certain number of people to eat in your restaurants.”

Fiamma is one of the few high-end closings in New York, but owners say business is down 10 to 30 percent.

In just the last five years, Jimmy Haber and his chef and partner, Laurent Tourondel, have opened 14 BLT restaurants, 5 of them in Manhattan.

“Everybody was out there celebrating life,” Mr. Haber said. Now, he said, business is down 10 to 20 percent from its peak in 2007.

Many restaurateurs suspect there may have been too much celebration.

“People with euphoria and momentum and money stepped into the business,” said John McDonald, an owner of Lever House and Lure Fishbar. “Landlords thought they could charge crazy rents anywhere in Manhattan.”

Soon, he said, many restaurants with 200 seats to fill each night and $20,000 in rent to pay each month will be in trouble. “I am just hoping to hold on to my best people and hunker down until business gets better,” he added.

Bad times aren’t confined to Manhattan. Federal Labor Department figures show the restaurant industry has cut more than 100,000 jobs nationally since September; in the same time a year before, the industry added almost 50,000 jobs.

In the last decade, the luxury restaurant boom went national, as hotels expanded and brought in prestigious chefs like Daniel Boulud, Eric Ripert and Tom Colicchio. Across the country, the contraction has already begun. Gordon Ramsay recently sold his share in his restaurant in Los Angeles after less than a year of operation.

Joachim Splichal, the chef of the Patina Restaurant Group, which runs more than 30 restaurants in the United States, said people like him were the reason for the boom in high-end restaurants in places like Las Vegas and New York.

“I was one of the celebrity chefs who started opening more and more restaurants, and now we are totally overbuilt,” he said, referring to the industry.

“People are coming to L.A. from Las Vegas looking for work,” he added. “They are leaving here to go to the Midwest, they are going from the Midwest to Florida. The business is going to look completely different after this.”

Elizabeth Blau, who worked with Steve Wynn to bring many top chefs to Las Vegas and is a partner in four restaurants there, said that with restaurant business plunging since September, the market is being tested. Michelin-starred chefs, she said, are not the draw that they were a year ago.

“Las Vegas is like the subprime mortgage market of restaurants,” she said. “This may be a healthy correction.”

New York restaurants are not yet feeling as much pain as those in Las Vegas, but even people with jobs here are sending out résumés.

Timothy Reardon was a sous-chef at L’Atelier de Joël Robuchon in Midtown when he “saw the writing on the wall” after a round of layoffs last fall. “I knew I was next,” Mr. Reardon said; he began actively looking for a job, and landed one as executive chef at the Core Club in Midtown. “It’s not Robuchon, but it’s my own kitchen,” he said.

Some of New York’s most experienced restaurant workers are taking work that might have been considered beneath their abilities a year ago. Nicole Kaplan, who was the top pastry chef at Eleven Madison Park and Del Posto — and, briefly, at the Plaza — is working as a part-time cooking instructor. “An executive pastry chef is an investment that a lot of people don’t want to make right now,” she said.

Colin Alevras, who was the chef and owner for 10 years of the Tasting Room in the East Village, and a branch in NoLIta, has closed his restaurants and decided to seek more stable work within the industry. He is pouring wine at DB Bistro Moderne in Midtown, part of the chef Daniel Boulud’s empire.

“We have a family to support, so I was happy to accept the reduction in ego in exchange for stability,” Mr. Alevras said of himself and his wife, Renée. Johnny Iuzzini, the pastry chef at Jean Georges, said he had never received so many offers from experienced cooks to do unpaid internships in his kitchen. “A lot of people are using unemployment as an educational opportunity, and of course to build their résumé,” he said. “I’ve never seen anything like this.”

Even those willing to work for free are having a hard time. “Everybody’s on the edge, and I don’t need people hanging around my kitchen messing with the morale of the paid guys,” said Michael White, the chef and an owner of Alto and Convivio and, soon, Marea. “Let them go to Italy, learn to make pasta, and wash their clothes in a bucket like I did for seven years.”

Alexandra Raij, a chef and co-owner of Txikito, a tapas bar in Chelsea, said that it used to be impossible to find skilled cooks who wanted to work in her tiny, two-electric-burner kitchen. Now, she said, the situation is so desperate that cooks push résumés through the security gate late at night.

Chefs say they are willing to try anything to hang on in the industry. On a recent snowy Sunday morning, a record number of applicants waited on the sidewalk in front of CraftSteak in the meatpacking district to try out for the next season of the culinary-competition show “Top Chef.”

The line, which grew to more than 150 people, started to form at 5 a.m., five hours before the auditions began. There was a Culinary Institute of America graduate overwhelmed by student loan debt and working as a barista; a line cook laid off from three successive New York hotel kitchens in the last nine months; and Caroline McDaniel, who has cooked in New York for more than 30 years and who said she had never wanted to cook on television before.

“At this point all of us would do anything to protect our jobs,” she said, gesturing to her fellow cooks. Until the end of last year, she said, she earned enough by catering parties and private dinners. But after Election Day, she said, $28,000 in the holiday bookings she counts on were canceled by nervous clients.

Cutting the staff can be a last resort, said Josh DeChellis, the chef at the new La Fonda del Sol in Midtown. “If you want to maintain quality,” he said, “there is a threshold that can’t be crossed.”

Yet some chefs are quietly jubilant that layoffs put top talent on the market.

Terrance Brennan, the chef and an owner of Artisanal and Picholine, said that a year ago he was “dismayed” by the quality of cooks applying for junior positions in his kitchens. “Now I’m overwhelmed by it,” he said.

Andrew Carmellini, who is opening a restaurant with the actor Robert DeNiro, said the best cooks used to be spread too thinly. “When I moved to New York in 1991, there were maybe 10 restaurants with brigades of serious cooks,” he said. “Now there are 50 — but not all of them will survive.”

He said he has 100 high-quality candidates to choose from for his brigade.

“Our kitchen is going to be sick,” he said — fantastic in chef parlance.

Michael White said the New York restaurant scene was due for a “cleansing.”

“This is a good time for those of us who are serious about cooking, and a good time for those who are serious about eating,” Mr. White said. “Now the cream will rise to the top.”