By Dr. Victor S. Sierpina and Michelle Sierpina, Ph.D

Down here in Texas, barbecue is pretty much a religious ritual. You name it, from shrimp and seafood to the basic beef, pork, chicken and game meat, there is rarely a person who doesn’t love the smoky smells, social conviviality, and opportunity for creative cookery that grilling brings.

We love to soak wood chips, mesquite, cherry, apple or hickory and put them in a tray inside our gas-fired grill. The smoke smells so nice we usually open the screen to let it blow into the house for a “barbecue incense” experience!

Grilling is a fun, inexpensive form of home cooking, keeps the house cooler in the summer than cooking indoors, and can be a great time with family and friends. Sometimes, these intangible benefits are more important to our health and well-being than any other factor related to the foods themselves. Happiness and joy are good for our health.

On the other hand, perhaps grilling doesn’t strike you as the healthiest method of cooking. For example overcooking meats to a charred level increases release of nitrosamines and other toxins that are a risk for cancer. My wife taught me that wrapping your grilled foods, especially fish, in foil avoids the incineration and health risks of charring and keeps them moist. Not recommended for a Texas-style steak or burger, though!

Hot dogs, while popular, also serve up a high dose of sodium, saturated fats and nitrates that can negatively affect our health, but there are turkey dogs and even veggie versions. You can even find turkey and veggies sausages.

The other grilling favorite, burgers, are usually red meats, which in general are higher in pro-inflammatory fats than lean meats like chicken or fish. Selecting the leanest 90/10 percent lean to fat ground beef is definitely a healthier choice.

How about buffalo burgers, which are very lean and tasty? Ground turkey breast is also a wonderful option. Mix in an egg to make it stick together.

Also use canola or olive oil to keep the meat from sticking to the grill — both are omega-9 fatty acids, which are anti-inflammatory. For vegetarians, there are a lot of options like soy, lentil, black bean or other veggie burgers.

We know that many health conditions result from chronic, silent inflammation. These include heart disease, diabetes, dementia, cancer, arthritis, chronic pain and obesity. Those with these conditions or at risk for them will benefit from an anti-inflammatory diet.

Certain foods, like vegetables and fish are anti-inflammatory and help reduce this silent condition. Whole grains are also healthier than high glycemic white bread and potatoes.

Try to use more vegetables in your barbecue and whole grain breads for buns. We like the Ezekiel line of high fiber, whole grain breads. You can find whole grain buns for burgers and dogs.

Everyone at our house loves sweet potato fries, which are higher in antioxidants and food value than the more common white potato fries.

One of our favorite summer grilling choices is salmon. We season it with dill, lemon pepper, tamari and ginger or umami sauce and cook over an open flame.

It cooks flavorfully on a cedar plank or wrapped in foil or a cedar wrap to preserve the moisture. Salmon is particularly rich in anti-inflammatory omega-3 fatty acids. Get wild caught rather than farmed salmon if you can as the wild variety has higher concentrations of these healthy fats.

And what about vegetables?

We love to grill colored peppers, red, orange, green, and yellow as a side dish. Brush with olive oil, add a bit of seasoning and wow!

A couple other personal grilling favorites are Broccolini and asparagus. We roll these in olive oil, perhaps adding some organic citrus pepper seasoning. Then, we grill them for a couple minutes to bring out the flavor to perfection just as the main course is finishing.

Many other vegetables can be a candidate for grilling like Romaine hearts, purple onions, zucchini, tomatoes and portabella mushrooms. Slip them onto a metal skewer in a rainbow array of colors and you have yourself an antioxidant taste delight.

Some other suggestions to make your cookout healthier include:

• Use hummus as a tasty dip with vegetables or blue corn tortilla chips.
• Make vinegar based coleslaw, kale salad or fruit salad instead of high fat potato salad.
• Create a colorful pasta salad with whole grain pasta, chopped broccoli and broccoflower in purple, bright green, or sunny gold.
• Use olive-oil based mayonnaise. Ketchup is high in sugar so consider salsa instead.
• Grilling with a beer in hand is iconic. Enjoy it with a bit of lime or lemon for the antioxidants and use light beer for lower calories or even a non-alcohol beer. Remember too, the anti-inflammatory qualities of red wine. For a refreshing change from alcohol, we also like the antioxidants and flavor in iced green tea brewed with fresh mint leaves. It is delicious and has no calories.
• Desserts at the cookout can also be healthy. We like the cool tang of sorbets. They come in mango, blueberry pomegranate, blood orange, lemon, raspberry, pineapple, and more. Fresh chilled watermelon or cantaloupe are abundant this time of year and make a multicolored finish to your healthy feast.
Turkey Burgers
To a pound of fresh ground turkey breast, add a fluffy beaten egg and seasonings you love best: finely chopped onion, minced garlic, some black pepper and season salt. Form into evenly shaped patties, thin enough so that they cook through, and set into the refrigerator until they are firm. Brush lightly with olive oil before placing on the outdoor grill. Cook thoroughly, never medium-rare!
(You’ll see some recipes calling for breadcrumbs. Try to avoid the empty calories and if you need filler try raw oatmeal or refried black beans.)

Now get creative:
•To the basic recipe, add a small amount of mashed avocado and a bit of salsa.
•Kalamata olive paste and garlic, oregano, and basil and a sprinkle of oatmeal kneaded into the turkey makes a moist burger which, once grilled, is exactly the color of a beef burger.
•Another way to get the look of a beef burger, added protein, and yummy moisture is to add black refried beans.
•Finely purée zucchini with the onions and garlic add moisture to the burger (and use up all that squash you harvest every day).
•Add an Oriental zing with tamari sauce and finely chopped pineapples, but squeeze out the fruit’s moisture because too much will make the burgers fall apart.
•Add a little cool ranch dressing and a bit of oatmeal (to compensate for the extra moisture).
•Flavor the burger with pesto or seasoned hummus like black olive or roasted red pepper. If you need filler, use oatmeal instead of breadcrumbs.
•Can’t decide which enhancement suits your family’s tastes? Split the pound of ground turkey breast into four and offer a variety of unique taste treats.
Dress up your sizzling burgers just as you would ground beef burgers: sliced red onion, dill pickles, leaf lettuce or spinach leaves, fresh from the garden tomatoes, avocado slices, and sautéed mushrooms. Enjoy the “yum” of healthy summer grilling.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB. Michelle Sierpina, Ph.D., is the founding director of the Osher Lifelong Learning Institute at UTMB Health.