Doctor & Gourmet Chef Rani Polak of “Hadassah Optimal” in Jerusalem Illustrates how to eat safely without sacrificing taste
The statistics are alarming – in the United States over 1,000,000 new cases of diabetes are diagnosed each year, and there are over 250,000 diabetes-related fatalities annually. While the disease is often treatable, for many adapting to the new and healthier lifestyle required to ensure survival proves impossible. Perhaps most challenging are changes in diet; habits are hard to break, convenience and cravings hard to ignore, and food addictions hard to kick.
In his new book Delicious Diabetic Recipes: The Gourmet Cookbook for a Healthy 
Diet, Dr. Rani Polak, the Founder and Director of the Center for Healthy Cooking at “Hadassah Optimal”, a subsidary of Hadassah University Hospital in Jerusalem , and Le Cordon Bleu-trained chef, offers practical information and advice coupled with innovative and tasty alternatives that educates readers while exciting their palates. The book covers a range of topics from making smarter starch choices to reducing fat without losing flavor to the smart way to use sugar substitutes. But it is the fabulous recipes that are the core of the book. Each is worthy of a great restaurant meal, and each is safe for every diabetic, and yet will be a terrific meal for the entire family and friends.
Known internationally as “Dr. Chef”, Polak introduces readers to a range of cuisines from exotic to comfort food. The book includes healthy, yet gourmet-worthy cuisine such as Grilled Eggplant Moussaka with Roasted Pepper Cream, Vietnamese Shrimp Dim Sum in Ginger and Lemon Sauce, Roast Sirloin with thick Mushroom Sauce; and alongside family dinner staples such as hamburgers and pasta. From turkey to tofu, pizza to “pub grub”, the book contains numerous beef, chicken, fish, and vegetable dishes, as well as soups, salads, spreads and dips.
And saving the best for last, Delicious Diabetic Recipes dispels the myth that diabetes and desserts don’t mix. Sweet-tooth lovers will be delighted with choices ranging from banana crepes to biscotti, along with numerous other baked goods and fruit-filled treats.
Each page is filled with step-by-step instructions, beautiful photographs, and vitally important detailed nutritional information. Presented in classic cookbook style, it’s sure to find its way onto the shelves of foodies, nutritionists, and families who want to eat healthier without sacrificing taste.
Bonus – Includes the American Diabetes Association Exchange Charts and the new Carb Counting for Managing Glucose.
About Rani Polak, MD:
RANI POLAK, MD, is the Founder and Director of the Center for Healthy Cooking at Hadassah University Hospital in Jerusalem. A Cordon Bleu-educated chef, Dr. Polak received the 2005 Hebrew University Kaye Innovation Award for the healthy cooking workshops he designed for people with special dietary needs. He is a member of the Board of Directors of the Israeli Forums for Prevention of Cardiovascular Disease, has worked with the Israel Institute for Integrated Medicine, and is currently a lecturer both at the Hebrew University’s School of Nutritional Sciences and at the School of Culinary Arts, Hadassah College.
Delicious Diabetic Recipes
The Gourmet Cookbook for a Healthy Diet
by Rani Polak, MD
Hardcover • 7 1/2 x 9 1/6 • 256 Pages • All-Color
September 2009 • Imagine • $24.95 US/ $32.50 CDN
ISBN 10: • ISBN 13: 978-0-9822939-7-3
For more information about Delicious Diabetic Recipes, or any Imagine Publishing books please contact: Kim Swanstrom, kswanstrom@bookmasters.com, 888.537.6727 x 1162
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Jerusalem – Hadassah researchers have demonstrated that Colostrum, the milk produced by cows immediately after calving, enriched with insulin antibodies, dramatically lowers the level of sugar and insulin resistance in mice with a model of fatty liver disease. They treated mice with fatty liver disease with Colostrum enriched with insulin antibodies, administered orally for four weeks, which showed positive results.
Dr. Tomer Adar and Dr. Gadi Lalazar of Hadassah’s Department of Internal Medicine headed the team that conducted the research in the laboratories of the Liver Unit at the Hadassah University Hospital- Ein Kerem in Jerusalem. They will present their findings in Boston today at the annual conference of the American Association for the Study of Liver Diseases (AASLD).
More than 7,000 researchers from 55 countries attend the conference. 8 Hadassah doctors will present there 14 of their works.
Earlier this year, Hadasit, the technology transfer arm of the Hadassah Medical Organization, and Immuron, an Australian biopharmaceutical company, signed an agreement to develop the Hadassah research. The collaborative effort combines Hadassah’s oral immune modulation approach with antibodies produced by Immuron. The result appears to directly affect the activity level of regulatory T cells, a type of immune cell known to have a profound effect on controlling the inflammation caused by many diseases.
Fatty Liver Disease is characterized by the development of surplus of fat in the liver cells. It is caused mainly by obesity, diabetes and hyperlipidemia – elevation of lipids in the bloodstream – mostly tryglicerides. Insulin Resistance, the relationship between these factors and the disease, occurs when cells do not react normally to insulin, increasing the level of sugar and hyperlipidemia in the body. Fatty liver disease is the most common liver disease in the western world and is becoming increasingly prevalent in other parts of the world as well.
Colostrum is known to be rich in materials that contribute to the development of systems in the body, such as the immune system and the digestive system. Hadassah researchers showed that the use of Colostrum enriched with insulin antibodies, affected cells that regulate inflammation (Regulatory T cells) in the liver and fat tissues, lowering the level of sugar and improving insulin resistance.
Prof. Yaron Ilan, Head of Hadassah’s Department of Internal Medicine A, who serves as the medical director of Immuron, developed the new technology. “We were able to demonstrate dramatic improvement in the levels of sugar and hyperlipidemia on an animal model with fatty liver disease. These encouraging results reinforce our ability to investigate the use of this concept on other inflammatory processes”, he said.
Hadassah researchers will initiate a clinical trial to test the safety and efficacy of the new treatment on human patients with fatty liver disease within a few months.
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Advocacy Alert!
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-On September 15, 2009, the United Nations Fact Finding Mission on the Gaza Conflict, led by Judge Richard Goldstone, released its report, commonly referred to as the “Goldstone Report.” This report accuses Israel of committing “war crimes” during its defensive operation last winter against Hamas terrorists in Gaza. The notoriously anti-Israel U.N. Human Rights Council endorsed the Goldstone Report and recommended U.N. General Assembly consideration. Labeling the report “deeply flawed”, the United States opposed this measure. Libya and the Palestinians are now pressing for U.N. Security Council action.
Members of the House of Representatives have introduced a resolution (H.Res. 867) urging the Obama administration to oppose “any endorsement or further consideration” of the Goldstone Report. The resolution was introduced by House Foreign Affairs Committee Ranking Member Ileana Ros-Lehtinen (R-FL), Chairman Howard Berman (D-CA), Rep. Dan Burton (R-IN) and Rep. Gary Ackerman (D-NY). The resolution denounces the “irredeemably biased” Goldstone Report and expresses support for Israel’s right to self-defense. The resolution is expected to be considered by the full House of Representatives in the next few weeks.
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Hadassah’s Jerusalem Crisis Intervention Center
Hadassah International reports: Prof Esti Galili shares Hadassah’s work in treating children with post traumatic stress disorder.
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R2-D2, M.D.
By Wendy Elliman
The latest addition to the Hadassah surgical team has four arms and a computer console and provides more precise, safer and less invasive surgery than ever before.
If you were undergoing surgery at the Hadassah–Hebrew University Medical Center in Jerusalem and able to look down at yourself, your first instinct may well be to shout to your surgeon, “Hello-o-o! I’m over here!”
Instead of standing over you, capped, gloved, gowned and murmuring “Scalpel, please” to the surgical team, your surgeon is sitting at a computer console three feet away, back turned firmly in your direction.
Alarming as it looks, however, you can rest assured that not only are you central to the event, you are also receiving more precise, safer and less invasive surgery than ever before. As for the three-foot distance between the patient on the table and the surgeon at the console: The system he is using was, in fact, designed for surgeons on Earth to operate on astronauts in space.
“Intergalactic surgery has yet to be performed, but this remote robotic surgical system has been successfully used between continents,” says Dr. Yoav Mintz, senior surgeon at Hadassah and head of its Robotic Assisted Surgery Service. “It was launched in September 2001 [two days before 9/11], when a surgeon in New York removed the gallbladder of a patient in France.”
Developed by NASA and then passed to the United States military for use in Iraq, the system’s patent was then bought by the California-based company Intuitive Surgical. It received Food and Drug Administration approval in 2000. Intuitive named it the da Vinci® Surgical System, with a nod to Leonardo, credited with designing the world’s first robot, a humanoid automaton he sketched in 1495.
When commercial manufacture of the da Vinci® began, surgical robotics was little more than a medical curiosity. Today, it is an established tool that significantly improves clinical outcomes and helps patients rapidly return to active and productive lives.
“Robotics is, of course, a misnomer,” says Dr. Mintz. “The da Vinci® is not designed as autonomous and has no decision-making software. It is a computer system meant to seamlessly replicate the movement of the surgeon’s hands with the tips of microinstruments. It is a super tool for laparoscopic or keyhole surgery, operated by the surgeon.”
Dr. Mintz learned this very different kind of surgery during a two-year fellowship in Minimally Invasive Surgery and Robotic Assisted Surgery at the University of California in San Diego. At the same time, his colleague, Hadassah urologist Ofer N. Gofrit, was in a minimally invasive urologic oncology fellowship program at the University of Chicago Medical Center. Both surgeons, highly experienced in open surgery, were quickly convinced of the potential of the technique, and they called Dr. Shlomo Mor-Yosef, director-general of the Hadassah Medical Center.
“I said that Hadassah had to have a da Vinci®,” says Dr. Mintz. “I told him: ‘It’s the future of surgery. We can’t call ourselves a leading surgical center without it.’ He didn’t need persuading. With his blessing, I got in touch with Intuitive.”
Some 1,200 da vinci® systems have been sold to hospitals in the United States and Europe. Israel, however, has only one. It arrived at Hadassah last year and came into operation early in 2009.
“It comprises a computer console and a cart with four robotic arms, which stand next to the patient,” says Dr. Gofrit. “One arm controls a dual-lens camera that transmits to the console, showing three-dimensional images of what is happening inside the patient, magnified 12 times. This sidesteps the main disadvantage of traditional laparoscopy, which provides only two-dimensional images.”
The other three arms manipulate surgical instruments—scalpels and scissors—which the surgeon controls with two foot pedals and two hand controls. He or she thus performs surgery seated at the console, eyes on the screen, rather than standing for hours over the patient.
But the system offers far more than the surgeon’s comfort. “There’s always a degree of tremor in the human hand when manipulating long instruments,” says Dr. Mintz. “The da Vinci® electronically filters the movements of the surgeon’s hands to eliminate tremors and then scales those movements down. That is, the surgeon’s hand movements are translated into micromotions in the da Vinci®’s arms, so I can turn a two-inch movement I make at the console into one of less than half an inch inside the patient. The surgeon controls the degree of translation from one to one, up to one to five.”
In addition to steadying and scaling the actions of the surgeon, the da Vinci® gives unprecedented flexibility. “It is designed to improve on conventional laparoscopy, in which we operate standing over the patient, looking up at a two-dimensional video monitor, using hand-held, long-shafted instruments that have, essentially, two movement options,” explains Dr. Mintz.
Conventional laparoscopic instruments have pincers at the end that can be opened and closed, and the instrument as a whole can be rotated—although inside the patient, rotation is restricted. The da Vinci®, however, allows wrist movement that is even fuller than that of a surgeon’s hand in open surgery. The shaft rotates, and so do the pincers on the end. More than that, the pincers have two joints, each able to turn 90 degrees.
“There is so much freedom of movement, you need the computer software to operate it,” says Dr. Gofrit. “Your surgical skills are enhanced to the point that you have the hand of Superman!”
As a urologic surgeon, Dr. Gofrit uses the da Vinci® principally in kidney and prostate surgery. “It gives all the advantages of laparoscopic surgery,” he says. “Hospital stays of 24 hours rather than a week or more. Tiny incisions rather than openings large enough to accommodate the surgeon’s hands [a quarter-inch compared with 8 or 9 inches], which means less trauma, less blood loss, quicker healing time, and infection is almost unknown.”
It is in prostate surgery that the da Vinci® truly comes into its own. “Not all prostate cancer is treated surgically,” explains Dr. Gofrit. “But in many patients there are clear advantages to surgical removal of the diseased tissue.”
When conventional laparoscopy was initially developed during the early 1990s, it proved unsuitable for prostate removal. “Laparoscopic radical prostatectomy is very difficult,” notes Dr. Gofrit. “The gland is deep in the pelvis, in front of the rectum and below the bladder, and it can be approached only from above. With two-dimensional images, this is so difficult as to be impossible. So, we continued using open surgery in prostate removal—until the da Vinci®. When you can see what you are doing on a 3-D screen, it becomes easy and very successful surgery, resulting in rapid return of both continence and sexual function. In the United States, the da Vinci® is used for 70 percent of prostatectomies.”
Hadassah is currently extending the use of the multipurpose da Vinci® system from general and urologic surgery to gynecology.
Dr. Mintz, who is director of Hadassah’s Minimally Invasive Surgery Learning Center, is training Hadassah gynecologist Avi Benshushan in the technique. The use of the da Vinci® in hysterectomies in the United States—200,000 a year—is even greater than for prostatectomies, notes Dr. Mintz. The next steps in Israel will probably be the system’s use in both otolaryngology and cardiac valve repair.
Meanwhile, Hadassah uses the da Vinci® no more than twice a week because Israel’s health insurance funds have yet to catch up with it. As with much else that Hadassah has introduced into Israel over the years, the medical center is initially subsidizing the innovation.
“Using the da Vinci® is more expensive than conventional surgery,” says Dr. Mintz. “Its maintenance costs run to about $150,000 a year, and with each procedure we use around $1,000 more of disposables than in conventional laparoscopy. Add to that hospital stays are reduced from seven nights to one—health insurers reimburse the hospital for each night’s stay—and it’s clear why we’re losing money with every da Vinci® patient.”
Hadassah Hospital, however, has always been about more than balancing its books. “Our mission is excellence—pursuit of the best in people, in knowledge and in tools,” says Dr. Mintz. “The reimbursement issue will be settled, and then we’ll be able to use the technique as extensively as it warrants. Meanwhile, we are promoting our shared vision of where surgery and our medical center are headed.”
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WUJS Israel
Hadassah WUJS Israel is a six month immersive program for post college Jewish adults, aged 22 – 35. WUJS is a venue for young adults to “try Israel on to see if it fits”. The program is based in Jerusalem and Tel Aviv and provides four tracks: learning, interning, social justice, arts and culture. Volunteering is an important component of the activities. Everyone enjoys the weekly trips, classes on Zionism, ulpan and group activities. MASA grants (scholarships) are available.
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Hadassah International News
All pediatric patients in the Hadassah Medical Center’s Pediatrics Department attend the Hadassah Hospital School and learn a unique curriculum that fortifies them to understand and deal with their illness.
Accredited by the Israeli Ministry of Education, the school includes courses about the anatomy of blood vessels and the process of taking blood samples, road safety and the cause of traffic accidents, and baking. In the blood vessel course, the children can actually “draw blood” from a rubber arm filled with red-tinted water. They learn to confront their fears about having blood taken from them, and often become fascinated by the procedure. The road safety course, taught in collaboration with specially trained police officers, focuses on driving correctly to avoid accidents.
In the baking course, the children learn to bake all kinds of cookies and cakes, which are then distributed to the pediatric patients and staff alike.
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Human Embryonic Stem Cells Successfully Slows Progress of Retinal Degeneration in an Animal Model
Researchers from the Hadassah University Medical Center in Jerusalem have transplanted pigment-containing visual cells derived from human embryonic stem cells, successfully preserving the structure and function of the specialized light-sensitive lining of the eye in an animal model with retinal degeneration.
Their findings, published in the October issue of the journal Cell Stem Cell, represent a significant step towards the 
transplantation of human embryonic stem cells (hESCs) to treat and prevent age-related macular degeneration (AMD), a disease that causes millions of people worldwide to lose their sight. In AMD, dysfunction of the retinal pigment epithelium (RPE), a layer of cells underlying and supporting the retina, leads to damage in the central area of the retina, the macula. The macula is responsible for high resolution vision, and is crucial for activities such as reading, driving, watching television and recognizing faces.
Prof. Benjamin Reubinoff, Director of the Hadassah Human Embryonic Stem Cell Research Center, and Prof. Eyal Banin, Director of the Hadassah Center for Retinal and Macular Degeneration, led the research team, creating unique laboratory conditions for deriving RPE cells from human embryonic stem cells.
They found that nicotinamide (vitamin B3, NIC) and Activin A, a factor that plays an important role in differentiation of the RPE during embryonic development, can augment and direct the differentiation of hESCs into RPE also in the culture dish. When transplanted into the eyes of rats with retinal degeneration caused by malfunctioning RPE cells, they were able to delay deterioration of retinal structure and function.
Age-Related Macular Degeneration is the leading cause of blindness in adults over 50 in the western hemisphere, with 30 million affected around the world. The disease is caused by the dysfunction, degeneration and death of pigment-including retina cells (retinal pigment epithelium – RPE). This layer of cells lies between the retinal visual cells that absorb and react to light (photoreceptors), and the nourishing blood vessels in the back of the eye. The RPE provides essential support for the photoreceptors and is critical for normal vision. Dysfunction of the RPE also underlies some types of retinitis pigmentosa, a group of diseases that cause progressive loss of vision at earlier ages and often lead to blindness.
“Although there are a variety of therapeutic approaches under development to delay the degenerative process”, explains Prof. Reubinoff, “the grim reality is that many patients eventually lose their sight. Cell therapy to replenish the degenerating RPE cells may potentially halt progression of the disease.”
“Our findings are an important step towards the potential future use of human embryonic stem cells to support and replenish failing RPE cells in diseases that result in blindness,” Prof. Banin stated.
Working with Cell Cure Neurosciences Ltd., the researchers are anticipating testing their findings in clinical trials. Cell Cure Neurosciences Ltd. is a company of Hadasit Bio-Holdings, a subsidiary of Hadasit, Hadassah’s technology transfer arm. Prof. Reubinoff is the chief scientist of Cell Cure. Headed by Dr. Charles Irving, Cell Cure is currently raising funds to advance the research towards clinical trials. Experimental transplantation of RPE cells in human patients is expected in two to three years.
The research was partially funded by grants from the Israel Science Foundation, the Israel Ministry of Health, and the Yedidut Research Fund.
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Hadassah Trauma Unit in Action
Hadassah National: News You Can Use
A young Israeli soldier was injured when a Palestinian attacked and stabbed him at a road block near Shu’afat in northern Jerusalem. The soldier was taken by MDA ambulance to the Hadassah Ein Kerem trauma unit, located in the Judy & Sidney Swartz Center for Emergency Medicine. The knife was still stuck in his neck when he arrived; that is the protocol in cases such as this. Any attempt to pull the knife out could result in additional damage. This should be done in a hospital.
The soldier was lying silently on the bed. He was fully conscious. He seemed a bit panicked, but was able to answer questions, and even to smile a little. The area around the knife was cleaned and therewas no bleeding.
It was very quiet in the trauma unit. Prof. Avi Rivkind, head of Surgery and the trauma unit, spoke softly with the soldier and Hadassah staff, almost whispering. With him were trauma head nurse Eti Ben-Yaacov, surgeon Dr. Mahmud Abu-ghazallah, laryngologist Dr. Ophir Ilan, and ER nurse Einet Levin.
Prof. Rivkind ordered an x-ray. Reviewing it, the doctors saw that no major blood vessel was damaged. Dr. Mahmud Abu-Ghazallah pulled the knife very gently and, within a couple of minutes, it was out.
The soldier is fine.
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