At $43 per person (excluding drinks and desserts), Na’Brasa Brazilian Steakhouse is not the kind of restaurant we can afford to go to very often.  But after going there for the first time this weekend for a special occasion, I can say it’s easily one of my all-time favorite restaurants.  If you like meat, then you need to get yourself to Na’Brasa as soon as possible.  If you don’t like meat, what’s wrong with you?

There are two courses in a Na’Brasa meal.  The first course is the salad bar, which has a huge variety of foods, which are mostly not meat, at least not primarily.  But the real action is in the second course.  At your table, you have a small laminated card with a brown side and a yellow side.  When you’re ready for meat, you flip it over so the yellow side is facing up, which signals the waiters to come to your table.

But these aren’t just any waiters.  It’s a team of about 10 waiters, each carrying a giant skewer and a carving knife.  On each skewer is one particular kind of meat: filet mignon, picanha, pork ribs, beef short ribs, sausage, bacon-wrapped chicken, lamb chops, and many other varieties.  The waiters are constantly swarming the room, going from the kitchen past each table, looking for yellow cards.  When a waiter sees your yellow card, he stops and asks if you want the particular kind of meat that he’s carrying.  If so, he carves off a slice for you on the spot.  And each skewer typically has three or four different pieces of the same cut, so you can choose the level of doneness for your slice.

As long as you’ve got your yellow card showing, waiters will continually come by and give you more meat.  When you need a break, you flip your card over to the brown side.  Then flip back to yellow when you’re ready to feast again.

The meat was delicious.  The picanha, sausage, and beef short ribs in particular were simply amazing.  The picanha had a nice fat cap that was perfectly crisped.  The sausage and short ribs were ridiculously tender and richly flavored.  There was also salmon (technically part of the salad course, but it’s carried around the room and brought to your table like the rodízio meats) that was quite good.

And then there’s the desserts: you’re so stuffed that you can barely even think about them, but you made the mistake of checking them out online beforehand, so you have to get one.  I got the Peanut Butter Bomb and loved it.  I also had a bit of Travis’ Cheesecake Xango which was wonderful.

In addition to the food being excellent, these were some of the best waiters I’ve ever seen.  This guy was especially good:

He’s picanha guy, and he spent a lot of time at our table.  I wish I would have taken some photos of the meat slices before devouring them, but in that photo, you can at least see the picanha on the skewer.

Na’Brasa also helpfully labels everything on their salad bar to indicate which items are gluten-free, and 14 of the 17 meats are also gluten-free.  It’s nice to see a restaurant catering to this common food sensitivity, rather than worrying about silly fads like the low-fat diet.

Because, despite decades of government recommendations telling us what kind of diet we should eat (a low-fat, high-carb, grain-heavy one), there is actually very little science to support such claims:

Quoting The New York Times:

“We don’t know what the best diet is,” said Dr. Michael Lauer... When it comes to diet and heart disease, doctors -- and patients -- have been going on hunches. [...]

“Diets are an extreme case of accepting evidence we want to believe,” said Dr. J. Sanford Schwartz, a professor of medicine at the University of Pennsylvania.

That includes doctors, he added, who overlook that the evidence for the low-fat diets they often recommend is the sort “we would never accept in the practice of medicine.”

Those low-fat diets sound sensible -- eat fruits and vegetables, fish and lean meats.  Cut back on salt- and sugar-laden sodas and potato chips.  Cut or sharply limit most fats, including olive oil and nuts.  But such diets have not been tested in the way the Mediterranean diet was tested.

Doctors are in a bind, said Dr. Daniel J. Rader, a heart disease specialist at the University of Pennsylvania.  When patients ask what to eat, he said, “you have to give them something.”

“Given the importance of diets and given the decades of dietary recommendations we have given to people, you would think we would have had more dietary studies with hard endpoints to get at these questions,” Dr. Rader said.  But the best they have are studies that look at intermediate markers of risk, like cholesterol levels.  In the end, he said, “most doctors just give dietary platitudes.”

Actually, it’s worse than that: because the government decided to start giving out dietary advice before there was solid scientific evidence to support that advice, they now have a vested interest in keeping that narrative going even in the face of evidence against it, since the government can’t admit when it has made a mistake.

Steven Brill just published a long article called Bitter Pill: Why Medical Bills Are Killing Us.  It’s a good article and worth reading, despite being far too long at 11 pages.  There’s so much repetition that it probably could have been 5 pages instead, and it’d be a better piece for it.

It’s surprising to me, though, that the author fails to identify (or at least, fails to state) what is the clear cause of the outrageously expensive medical bills that he details in the article’s several anecdotes.

He spends a lot of time pointing out exactly how much profit is being accumulated by many "non-profit" hospitals, and how much they are paying to their executives and administrators.  It’s the same as the situation with "non-profit" colleges and universities: the term non-profit is purely a marketing term, and a deceptive one at that, since hospitals, colleges, and universities are among the richest organizations in the country.  They are making tons of profit -- tens of millions of dollars per year in many cases -- they just aren’t structured in a way that it gets distributed to shareholders.

The problem is that medical bills are insanely inflated, and the implication seems to be that the cause is these rich fatcats running the hospitals -- or at the very least, those rich fatcats are evil even if they aren’t actually the cause.

The author correctly identifies chargemaster prices as part of the problem.  He gives many examples of chargemaster highway robbery, such as pills or alcohol wipes that cost several dollars each in the hospital even though their actual price in the free market is pennies each.  And he recounts how administrator after administrator was unable to explain to him exactly where the chargemaster prices come from or why they’re so high.

He also goes into detail about Medicare and private insurance and their strengths and weaknesses, including how a lot of insurance is limited to a few thousand dollars of coverage while medical bills routinely reach tens of thousands, even hundreds of thousands.

Despite all the good reporting and detail provided on these many aspects of our health care system, nowhere does the author state the simple economic fact that is at the root of the problem: the decoupling of the customer from the payment.  In other words, the person receiving the service is not the person who pays the bill.

Whenever you insert a third party between a buyer and a seller, whether that third party is an insurer or the government, the result is an interruption of the price signal and a distortion of the market.  In many cases this leads to a bubble, as we’ve seen in housing and higher education.  When "someone else" is paying the bill, the buyer has no incentive to care about the price, which means that the seller -- whose goal is profit, after all -- will raise prices.

So when the government pumps billions of dollars into the housing market to "make housing affordable", the actual result is that prices skyrocket until the market is destroyed.  When the government pumps billions of dollars into higher ed to "make college affordable", the actual result is, again, skyrocketing prices as the bubble inflates.  And "making health care affordable", as Obamacare purports to do, by making it "free" for many people, outlawing copays, etc, will again in fact cause the opposite to occur: it will get more expensive.

There are many problems in the U.S. health care system, but none are more important or more fundamental than this one.  Hospitals, drug companies, and medical device makers can only charge outrageous prices because patients don’t pay them directly.  Further decoupling the patients from the prices will exacerbate the problem, not solve it.

The failure of politicians to understand this most basic economic principle has led to massive damage and suffering in our health care, housing, and education markets.

A new restaurant called A Ca Mia just opened in Walnutport, owned by a well-regarded chef with decades of experience.  Between that and the fact that the only other restaurants in the area are fast food, we were anxious to check it out.

The Food

I was very happy with my meal.  There was the traditional bread with dipping oil, then a salad with vidalia onion dressing, and Meat Sauce Bolognese for my entree: "Our traditional combination of veal, beef and pork meat slowly braised and cooked in a red wine tomato sauce."  For dessert I had the cannoli, which used puff pastry instead of the usual thin shell, and it was delicious.

You choose whichever kind of pasta you’d like in the Bolognese, and I chose penne.  The portion size was gigantic: I ate about a third of it, and took the rest home, where I weighed it to find it was nearly two pounds left over.

My only complaints are minor: the salad was served in a bowl that was just barely big enough to hold it, which means that it’s virtually impossible to mix after pouring on the dressing (which they serve on the side); the "dipping oil" for the bread was actually a mountain of minced garlic covered in a small amount of oil, which was so spicy from all the garlic that it was slightly painful to eat; and they don’t offer sweet iced tea, nor raspberry iced tea, to drink -- just soda and unsweetened tea (and of course water, milk, and hot drinks).

Kim’s meal, however, was disappointing.  She called ahead to ask whether they have any gluten-free meals, and they said yes.  But when we got there, our waitress told us that they could make pretty much any regular meal gluten-free upon request.  That might sound good at first, but in reality what it means is they haven’t actually put any time or effort into making good gluten-free meals.  Technically it’s true that they can make most of their meals gluten-free by serving them without the pasta, but that doesn’t mean the resulting meals are going to be any good (e.g. lasagna without noodles would be pretty pathetic, and not at all the same as lasagna with gluten-free noodles).

The chicken and broccoli that Kim got is a prime example of this.  I’m not sure exactly what it would have looked like in the regular version, but the gluten-free version was 3 large chicken breasts surrounded by some broccoli on a plate with a very watery white sauce.  The chicken did not seem to be seasoned nor seared at all, and the sauce was not creamy, not cheesy, just watery.

The Atmosphere

A Ca Mia probably didn’t have many good options for where to site the restaurant in the Walnutport area, through no fault of its own, of course.  But the location is quite small, and the tables are packed into it pretty tightly.  It’s a single room, and I believe it’s all tables, with no booths.  It feels crowded.  There was a waitress or busboy hustling past us pretty much the whole time.

The restaurant is also noisy.  Partly this was because of a large, rowdy group seated near our table, and partly it’s because it was a Saturday night (though it was 9:30 PM, nearly closing time) -- but it’s also partly because of the single-room layout and the lack of sound-dampening design features (particularly carpet) in the space.  It feels more like a cafeteria than a restaurant.

The Verdict

I would gladly eat at A Ca Mia again, despite its flaws.  The menu is expansive, with about 60 entrees (including a large seafood section) and over a dozen appetizers.  And as I mentioned, there are few if any other decent restaurants in the area, so it’s almost the only game in town.  They had a 45-60 minute wait around 6:30 PM so they seem to be doing well.

On the other hand, Bravo is only 20 minutes down the road.  And as much as I did like the food at A Ca Mia, it is just not in the same league as Bravo.  If it were considerably cheaper, that’d be one thing, but our meal (two entrees, two sodas, and two desserts -- no appetizers and no alcohol) was $50 before tip, which is the same price or more expensive than a meal at Bravo, or Outback Steakhouse, or P.F. Chang’s, etc.

And A Ca Mia just doesn’t have much to offer people with a gluten intolerance, which is a significant portion of the population, even if many of them haven’t discovered it yet.  The restaurant could certainly stand to take 5 of those 60 entrees and replace them with a few well-designed dishes that are truly gluten-free.

I am apparently a pizza snob.  I’d say at least 75% of the pizza I’ve had in my life has been utter crap.  So I’m really glad to have pizza that I can make at home, that’s not only delicious, but super easy, and gluten-free too.  There are only five ingredients:

Crust: "Three Cheese Pizza Shell" from Against The Grain Gourmet, in the freezer section at the grocery store; Wegmans has it.

Sauce: Rao’s "Dinner To Go" Italian Sausage & Mushroom Sauce.  Of course you can use pretty much any sauce you want, but this Rao’s sauce is amazing, it’s not all loaded up with sugar like so many sauces, and it’s got big chunks of sausage and mushroom, so if you like those, it’s a bonus three ingredients in one.

Cheese: Sargento Artisan Blends Whole Milk Mozzarella, pre-shredded in an 8oz bag, which is just the right size.  Probably any shredded mozzarella would do, just don’t get any low-fat garbage.

Spices: just garlic salt and oregano.

The recipe:

1. Pre-heat the oven to 400F.
2. Put the frozen crust directly on the oven rack and cook for ~10 minutes.
3. Take out the crust, top it with ~340g of sauce (which is half the bottle).
4. Sprinkle with garlic salt and oregano.
5. Cover with 8oz of shredded mozzarella.
6. Sprinkle with even more garlic salt and oregano.
7. Cook at 400F for ~13 minutes.

The crust will be crispy/crunchy and amazing, but if you prefer your crust soft, then a) what’s wrong with you, and b) just skip the step where you cook the crust by itself first, or shorten it to just a couple of minutes.

The Against The Grain crust (or "shell") is the key here.  Mozzarella is pretty much always amazing, and the sauce can be whatever kind of sauce you love, so you just need a good crust, and these guys have nailed it.

Some photos of the ingredients and the finished product:

(show full-size image viewer)

For most of my adult life I’ve gotten headaches regularly, about once or twice per week.  Typically these are not severe -- and I don’t think I’ve ever had a migraine -- but they’re bad enough to make me want a couple of ibuprofen pills, which virtually always cure the problem within a half hour or so.

When I discovered Fat Head and Paleo and started cleaning up my diet (mainly eating more natural fats and protein, and cutting back on grains, refined sugar, and vegetable oil), the frequency of my headaches decreased a bit, to maybe one per week, and sometimes making it through a whole week without a single headache.

More recently it occurred to me that a headache seems like a kind of inflammation, and should therefore respond favorably to an improved omega-3 to omega-6 ratio.  I had already made progress on that by cutting back the vegetable oils and trying to eat more omega-3-rich seafood like salmon, but even when I ate salmon every single week (which was rare) that was still essentially the only source of the anti-inflammatory omega-3 fats in my diet, whereas the pro-inflammatory omega-6 fats are in virtually everything.

Around the end of September I decided to make a more concerted effort to eat more omega-3.  I don’t like cooking, so it’s fortunate that there are a couple of delicious ready-to-eat sources of omega-3: sardines and salmon.  I especially like SeaBear Ready-To-Eat Smoked Sockeye Salmon, and Season Skinless and Boneless Sardines in Olive Oil; more recently I’ve found Crown Prince Natural Skinless & Boneless Sardines in Pure Olive Oil which are even better.  I stocked up and started eating one ~4-oz can or pack of those about 2-3 times per week, e.g. salmon on Monday, then sardines on Wednesday, and salmon on Saturday, etc.  (Update: two more delicious favorite omega-3 sources that I’ve found: Crown Prince Smoked Oysters, and several of the Bar Harbor brand varieties, especially Wild Herring with Cracked Pepper and Sardine Fillets In Maple Syrup.)

Amazingly, after having gotten a headache (and taking ibuprofen) about once a week for ~15 years, I went six weeks without a single headache after making this small, simple change to my diet.  After that, I was busy or distracted or something, and went 6 days with no salmon or sardines, and got a headache on about the 7th day.  I got back on the program and it’s now been about 2 more weeks headache-free.

Give it a try and see if it works for you.  It should also help with many other health issues, since most diseases are at least partially driven by inflammation.  A couple things to note: technically you can get omega-3 from plant sources such as flaxseed oil, but those are short-chain omega-3 fats, which your body can’t use without putting them through a very inefficient conversion process to turn them into the long-chain forms (EPA and DHA).  Only about 5% of those short-chain fats get converted to the long-chain forms, so it’s virtually impossible to eat enough of it to get any benefit, whereas omega-3-rich seafood already contains the long-chain forms.  Second, a lot of canned seafood is packed in nasty industrial seed oil -- aka vegetable oil -- like cottonseed oil, soybean oil, canola oil, etc.  Those are exactly the pro-inflammatory omega-6 fats we’re trying to avoid!  So watch out for that when buying seafood; it should be packed in olive oil, or something other than oil.

Quoting Dr. Barbara Bellar:

So, let me get this straight.  We’re going to be gifted with a healthcare plan that we’re forced to purchase and fined if we don’t, which purportedly covers at least 10 million more people without adding a single doctor but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, and signed by a President who smokes, with funding administered by a Treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government that has already bankrupted Social Security and Medicare, all to be overseen by a Surgeon General who is obese — and finally, financed by a country that’s broke. ... What could possibly go wrong?

Adjustable-height or "sit-stand" desks are popular now, since studies show that sitting for 8 hours a day is linked to various health problems.  Not to mention the fact that anyone who actually does spend all day sitting down knows it just gets uncomfortable after a while.  It’s a good idea to get up and take a 5-minute walk every hour or so, but being able to actually stand up for some of the work day, instead of only sitting, is even better.

But have you seen the prices of these adjustable desks?  They range from $800 or so up to several thousand dollars.  Why are they so expensive?  No good reason really, but part of the reason is that their design is kind of ridiculous: there’s literally a motor that you run to raise or lower the surface of the desk.

Despite the insane prices, I see people talking about these desks all the time.  I can’t believe more people don’t do the obvious thing: just buy or make a desk that’s at standing height, and then buy a tall chair (like a drafting chair) for when you want to sit down.

This is way better than an adjustable-height desk because you don’t have to adjust it.  Honestly, it’s hard for me to believe that there actually are people who, during the course of the day, just randomly get up and crank up their desk-motor and raise the desk... then an hour or two later, lower it back down... then raise it up again... come on!  That’s ridiculous.

The standing-height desk with drafting chair design takes advantage of the fact that your friggin’ body is already adjustable.  Just stand when you want to stand, and sit when you want to sit.  Genius!

It’s way cheaper, too: drafting chairs start at about $100, and you can use an $80 Ivar for your desk -- just cut the legs to your standing height and remove all but the top shelf.  I’ve been using Ivar as a desk for over 10 years now and he’s held up like a champ.  So, total cost: under $200.

If you don’t like the natural wood look of Ivar, or you already have a desk that you like, it’d be trivial to make ~foot-tall risers to go under the legs of your desk, using two-by-fours, or metal, or whatever you want.  Then your only real cost is the drafting chair.

I’ve been using my homemade sit-stand desk for almost two years now, and it’s great.  The only problem I’ve found is that when I stand, someone else usually swoops in and takes my chair: