“Pears are just so stinkin’ elegant.” –Half-Assed Kitchen

There are few things I love more than a perfectly-ripe pear—just soft enough that you could cut through the flesh with a spoon but not yet grainy or worse, mushy. But that moment seems to come and go so quickly. They sit there on the counter for a week after I buy them, flesh completely unyielding. If I dare to cut into one, it’s inevitably crisp as a good apple, but not nearly as sweet, not at all what I’m looking for in a pear. But then I  look away for a minute—check my e-mail, perhaps, or dare to fall asleep. And that’s it, I miss their few perfect hours. Next thing I know, I have three pears dissolving in my fruit bowl, just barely held together by their increasingly bruised skin.

Usually, at that point, I cut them up and throw them in a basic muffin batter with some powdered ginger. The bits of pear give the muffins an almost custardy consistency, like little pear and ginger-flavored bread puddings. But I got a little busy this week and ended up leaving them to degrade beyond the point where I could even dice them up.

So I realized that if I was going to get any use out of them at all, it was most likely going to be as part of the moist ingredients, more like the mashed banana in banana bread than the blueberries in a muffin. But most of the recipes I found for baked goods using pears asked for them grated or chopped or shredded, all of which would have required a starting structural integrity far beyond what these pears had. I thought about just substituting them in a recipe for applesauce bread until I came across this recipe which called for canned pears, but involved pureeing them in a blender or food processor. It also called for almond meal, which reminded me of the traditional French tart with thin slices of pear layered over a frangipane base. And although I’m sometimes a little skeptical about advice and recipes I find on About.com, the ultimate selling point was the note about how the recipe had been improved by the addition of baking soda to promote browning and off-set the acidity of the lemon juice. What can I say, I’m a sucker for science.

Which is not to say that I think baking is an exact science. I didn’t have quite enough almonds, so I substituted some ground flax meal. Even after I’d cored and peeled my three sad pears and pared away some of the worst bruising, I had a lot more pear than the recipe called for, so I left out some of the lemon juice. I added a little almond extract, in part to compensate for using less almond meal and in part because I just really like almond extract. And I added just a little cinnamon and nutmeg—not as much as I would have wanted in an applesauce bread, but just enough to give it a hint of spice. I only had one 4x8 loaf pan, so I used a 9x13 for the second loaf and had to leave that one in a little longer. Next time, I’ll probably substitute brown sugar for some or all of the white sugar.

It turned out lovely—the delicate flavors of pear and almond melding with a little brightness from the lemon and warmth from the spices. It’s moist and tender, not too sweet for breakfast or afternoon tea, and definitely better the  second (and third and fourth) day. Not, perhaps, quite as sublime or as elegant as a perfectly ripe pear, but not a bad result at all for pears so badly neglected.

Recipe, including explanations for some modifications in the method which are applicable to all quick breads and butter cakes, and pictures below the jump.Read more

In retrospect, this probably could have been an entirely separate article in the "things that won't kill you" series, as many people still believe that dietary cholesterol (i.e. cholesterol in food) is a bad thing. For example, the article that image was taken from claims:

If you get too much dietary cholesterol (over 300mg a day) the extra cholesterol will accumulate in the walls of the blood vessels, making your LDL (bad) blood cholesterol levels rise. Over time, your arteries will become narrower, which can cut off the blood supply to your heart (causing a heart attack), or your brain (causing a stroke).

However, that's pretty easily dismissed—even Ancel Keys, "Monsieur Cholesterol" himself, never argued that dietary cholesterol was related to serum cholesterol or heart disease. In a 1952 article in Circulation, the journal of the American Heart Association, Keys noted that although rabbits and chickens that eat high-cholesterol diets will develop high cholesterol and atherosclerosis, or hardening of the arteries:

No animal species close to man in metabolic habitus has been shown to be susceptible to the induction of atherosclerosis by cholesterol feeding…. Moreover, even in the favorite species for such  experimentation, the herbivorous rabbit, the necessary concentration of cholesterol in the diet is fantastically high in comparison with actual human diets. Moreover, there is reason to believe that man has a greater power of cholesterol regulation than does the rabbit or the chicken. From the animal experiments alone the most reasonable conclusion would be that the cholesterol content of human diets is unimportant in human atherosclerosis.

Two "moreovers" in one paragraph, people! “Most reasonable conclusion”! Moreover, five decades of subsequent research haven't given anyone any reason to think differently. In 1997, Keys was even more direct:

There’s no connection whatsoever between cholesterol in food and cholesterol in blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter unless you happen to be a chicken or a rabbit.

Research done in the interim on the relationship between diet and heart disease in humans like the Framingham and Tecumseh studies showed no relationship between cholesterol consumption and blood cholesterol or heart disease. I'm not even going to modify this with "probably" or "as far as we know": There is no reason to believe that how much cholesterol you eat has any effect on your health.

But that doesn’t stop the AHA from recommending that “most people…limit cholesterol intake to less than 300 mg per day” and claiming that “an egg can fit within heart-healthy guidelines for those people only if cholesterol from other sources — such as meats, poultry and dairy products — is limited.” Despite repeated studies showing that egg consumption is not associated with higher serum cholesterol, myocardial infarction, cardiovascular disease, or all-cause mortality.Read more

At past New Year’s Eve parties, we’ve mixed cocktails to order, and we never draw such a crowd that that’s a problem. However, I did find the Bon Appetit Foodist article about punch that would be less fizzy –spiked-pineapple-juice and more cocktail-in-a-bowl pretty compelling, both for ease of serving and because it enables you to make a drink that benefits from muddling and sitting and melding and chilling, all of which are either annoying or impossible to do on demand and to order. Also, I thought the recipe that called for little more than cognac, lemon juice, sugar, and sherry with a little nutmeg grated in sounded pretty delicious.

And it was. If I’d mixed three batches, it might…might have lasted until midnight. Of course, then we might all have been in too bad of shape to have any champagne.

As for sweets, I could have just relied on the candies I’d made for Christmas. Candies are useful for catering because they’re, by nature, practically non-perishable, sugar being a preservative and all. Additionally, they’re generally best served at room temperature, can be made weeks in advance, and rarely require flatware or cutlery. But candy just never seems totally satisfying as a dessert to me.

So the challenge was to find sweet fingerfoods that were elegant—most cookies don’t quite say “cocktail party” to me—but wouldn’t degrade too much sitting out for hours. I decided on a flourless chocolate-orange cake, cut into two-bite squares, and shortbread fingers filled with three different flavors of preserves. As a bonus for party-planning, both are best eaten the day after they’re made, so you can make them in advance, albeit not as far in advance as candy.

Flourless Chocolate-Orange Cake

 Shortbread Fingers

Recipes and more pictures below. Read more

Salt has been all over the news this week because of a study just published in The New England Journal of Medicine claiming that if everyone in the U.S. reduced their sodium consumption by 3 grams/day, there would be 32,000 fewer strokes, 54,000 fewer heart attacks, and 44,000 fewer deaths every year. The story that got my attention was:

That’s surprising, I thought. Everything I’ve read suggests that the relationship between salt consumption and cardiovascular disease is weak, inconsistent, and probably only valid for 20-30% of the population. So I expected the article to refer to some new research where, you know, “big benefits” were “seen.” As in observed. Like, in the world. And, given the claim about the magnitude, probably also measured.

To their credit, the authors of the study claim no such thing. The numbers are projections based on the application of several assumed effects of salt reduction, adjusted for different demographics and then applied to a model of the entire U.S. population. Thus, the title of the study: “Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease.”

The article seems to grasp the essentially speculative nature of the findings. The very first sentence uses the conditional tense:

…scientists writing in The New England Journal of Medicine conclude that lowering the amount of salt people eat by even a small amount could reduce cases of heart disease, stroke and heart attacks as much as reductions in smoking, obesity, and cholesterol levels.

The headline, on the other hand, seems to have confused the “scientists” with clairvoyants. Never mind doing any checking into the validity of their assumptions.

And the claim about how the benefits compare to smoking and obesity reduction led to a few headlines like this:

This crazypants idea initially sounds a lot like what the study’s lead author claims:

"The cardiovascular benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use, obesity, and cholesterol levels."

But the logic behind the claim is that a small improvement in the health of every single American would be as significant as a large health improvement in the health of every single smoker:

Dr. Bibbins-Domingo said that for many people the decrease in blood pressure would be modest, which is why, she said, “many physicians have thrown up their hands and said, ‘I’m not going to advise my patients to reduce salt because it’s too hard for patients and the benefits for any individual are small.’

“But small incremental changes in salt, such as lowering salt in tomato sauce or breads and cereals by a small amount, would achieve small changes in blood pressure that would have a measurable effect across the whole population,” she said. “That’s the reason why this intervention works better than just targeting smokers.”

For any given individual, there is no question about whether cutting salt is even close to “as good” as quitting smoking. The evidence for the link between smoking and lung cancer and death is strong, reliable, consistent, and has a clear causal mechanism (carcinogens). The link between salt and cardiovascular disease and death is weak, inconsistent, and still poorly understood.

That latter point starts to get at the problems with the study itself, and not just the headlines it inspired. A number of the assumptions the projection was based on are either demonstrably false or simply unsubstantiated. More on this some other time; for now, a few quotes and links to the essays they come from in Esquire and the medical journal Hypertension:

In a more recent statement, the founder of the American Society of Hypertension, Dr. John Laragh, goes further: "Is there any proven reason for us to grossly modify our salt intake or systematically avoid table salt? Generally speaking the answer is either a resounding no, or at that, at best, there is not any positive direct evidence to support such recommendations."

…

Studies show that 30 percent of the Americans who have high blood pressure would greatly benefit from a low-sodium diet. But that's about 10 percent of the overall population -- the rest of us are fine with sodium. And drastically cutting out sodium may actually hurt some people. ( "Go Ahead, Salt Your Food")

And:

The available data suggest that the association of sodium intake to health outcomes reflected in morbidity and mortality rates is modest and inconsistent. Therefore, on the basis of the existing evidence, it seems highly unlikely that any single dietary sodium intake will be appropriate or desirable for each member of an entire population.... The decision to adopt a low sodium diet should be made with awareness that there is no evidence that this approach to blood pressure reduction is either safe, in terms of ultimate health impact, or that it is as effective in producing cardioprotection as has been proven for some drug therapies. (Salt, Blood Pressure, and Human Health)

Life, as usual, gets in the way of finishing all the half-completed entries on cholesterol, trans-fats, cherry-almond oatmeal muffins, butternut squash soup, pie crust with and without lard, how to make your own sourdough starter, etc. It’s folly to start yet another series of entries I’ll never get around to finishing, but I tried cramming all the things I made for New Year’s Eve into one post, and I just couldn’t do it. 

Roughly clockwise from the upper left corner, that’s matzoh toffee, peppermint bark, spicy cheese straws, spiced nuts, goat cheese and fig jam crostini, smoked salmon rolls, more nuts and cheese straws, bacon-wrapped dates stuffed with chorizo, warm crab florentine dip with flatbread and sourdough, flourless chocolate-orange cake, shortbread bars with strawberry-raspberry, peach-apricot, and blueberry preserve fillings, more cheese straws and nuts.

There’s no way I could have made and served that many different things by myself if many of them couldn’t be made in advance. So that’s the theme of the first entry in the NYE 2010 series. These are all things that I made before Christmas. In most cases, I doubled or tripled the recipes and packed most of them into tins and boxes to give as gifts. But I set aside enough to put out on New Year’s Eve. In short, these are handy recipes to have, especially around the holidays.

More pictures and recipes below for Spiced Nuts, Matzoh Toffee, Peppermint Bark, and Spicy Cheese Straws. Read more

This is probably going to be an even harder sell than MSG, but I swear I'm not just trying to be contrary. It's true that all the major sources of public health and nutrition advice, including the Harvard School of Public Health, Mayo Clinic, CDC, and American Heart Association continue to refer to saturated fats as "bad fats" and suggest that people avoid them as much as possible, limit them to <7-8% of their total caloric intake, and replace them with "good," i.e. unsaturated fats, whenever possible. It's also true that there are a few studies that suggest that increased saturated fat consumption is correlated (albeit weakly) with cardiovascular disease (CVD).

However, many other studies have found no increase in CVD associated with saturated fat consumption. And several recent review articles have concluded that the evidence for a connection between saturated fat consumption and CVD is inconsistent, insufficient or nonexistent.

There are basically three things that have convinced me that saturated fat isn't independently responsible for heart disease or death:

1) groups of people who eat vastly more saturated fat than most Americans frequently have lower rates of CVD—or no apparent CVD at all

2) the study that first inspired many people to think saturated fat was a bad thing had a lot of obvious flaws and has been thoroughly discredited

3) there's no good evidence that the proposed mechanism actually works—briefly: saturated fat supposedly causes heart disease by raising serum cholesterol levels because cholesterol is what clogs arteries and causes heart attacks and strokes, but serum cholesterol turns out to be a really poor predictor of CVD 

1) The French (and Polynesian and Melanesian and Masai and Fulani and Sri Lankan) Paradox 

The most confounding phenomenon for the theory that saturated fat consumption causes heart disease (sometimes called the lipid hypothesis or lipid-heart hypothesis or diet-heart hypothesis) is the virtual non-existence of CVD in multiple populations that eat way more saturated fat than most Americans. This has primarily been documented in the Pacific islands where coconuts, which are very high in saturated fat, are a staple food. For example, before the 1970s, the inhabitants of the island Tokelau got an estimated 55% of their calories from saturated fat, but heart disease was virtually unknown (according to Gary Taubes and Stephen Guyenet; notably, since their diet has shifted to include less saturated fat but more sugars and refined carbohydrates, many health indicators have worsened). Read more