Healthy Food & Healthy Living by Dr. Ayala

Our health report card for 2009: Are we making progress?

2009-11-30T06:00:00-05:00

As 2009 winds down and the season for gratitude is upon us, this is a great time to reflect on our progress and contemplate the road ahead. This year especially, with the ongoing debate over public-policy directions for the U.S. health-care system, the collective state of our health deserves our attention.

America`s Health Rankings’ 2009 report came out just recently, and as a two-decade continuous assessment of our nation’s health, it’s a great tool for checking how we’re doing and—I hope—springing us into some action.

The longest-running annual assessment of the nation`s health on a state-by-state basis, the rankings urges all populations and communities to take action to improve health.

There are some bright spots in the report: Over the past 20 years, our nation has seen improvements in the reduction of infant mortality (a 33 percent drop), infectious disease (down 53 percent), prevalence of smoking (down 33 percent), cardiovascular deaths (29 percent fewer incidents), violent crime (a drop of 23 percent), air pollution and children in poverty (8 percent reduction), and there has been an increase in immunization rates of 42 percent.

We deserve a very light tap on the back for these advances since our progress has been slow. Even smoking cessation efforts, which have been the focus of a very large public health effort, has left nearly one in five Americans still smoking. Childhood poverty—which had been going down consistently—has gone up in the past year by a percentage point.

The past 20 years have also been very challenging in two important measures of public health: Obesity prevalence has increased by 129 percent since 1990, and the rate of uninsured Americans has increased by 14 percent, and now stands at about 15 percent. And yes, obesity rates are still climbing and have gone up since 2008.

Let’s take a closer look at obesity.

Obesity rates are climbing fast. The average American man has added about 17 pounds in the past 20 years and the average American woman has gained about 15 pounds. About a third of Americans are obese, and if obesity continues to grow at the same rate, the report predicts 43 percent of Americans will be obese by 2018, and since excess weight drives health-care costs, our collective weight gain will add $344 billion to our health bill bottom line.

There’s also great disparity among different ethnicities, with minority groups showing overall higher rates of both obesity and smoking compared to non-Hispanic whites.

National and international comparisons

The report ranks states’ healthfulness taking into account a multitude of measures from high school graduation, violent crime rates, health funding and prenatal care to obesity, smoking, binge drinking, and cancer and cardiovascular deaths.

The state-by-state assessments add a nice sense of competition, and I’m sure you’d like to see how your state ranks in health compared to others (after you finish reading my post!). Ranks go from 1 (healthiest) to 50 (least healthy). The winner is Vermont, up from 4th last year, with its low rates of kids in poverty, low obesity rates ('only' 23% of the Vermont’s population), a high rate of high school graduation, and low smoking rates (8th in the nation). Vermont’s downside: a high rate of binge drinking and low immunization rates.

At the very bottom of the list is Mississippi, which has won the dubious rank of least healthy state in the nation eight times in a row. Mississippi remains uninsured, poor, uneducated, the most obese of the states and one of the highest consumers of cigarettes (44th in the nation).

The thinnest state is Colorado.

My home state of Pennsylvania is ranked 28th—making us totally in the middle and unremarkable—with a 2 point improvement from last year. Pennsylvania’s main strengths are a high rate of high school graduation (7th in the nation) and a relatively low rate of uninsured (7th in the nation). The challenges are air pollution and a high rate of infectious diseases, and of course obesity (36th in the nation)—that goes without saying, as all American states suffer from high rates of obesity. Even Colorado.

Besides encouraging a healthy sense of rivalry, these comparisons are a great resource to draw upon, and see how we can learn from other states and implement best practices for good health.

But the comparison to other developed countries is what deserves our greatest attention.

When we measure ourselves against other countries, the conclusion is obvious—and there’s no softer way to put it—we simply aren’t the best.

Healthy life expectancy is the number of years a newborn can expect to live a healthy and productive life. The Japanese are at the top, and enjoy 76 healthy years on average. We in the US rank 30th, are on par with the Czech Republic and Chile, and our average healthy lifespan is 70 years. We rank #37 in infant mortality among 193 countries rated.

We spend more on health care than any other country in the world yet have a lower life expectancy, less access to care, less patient safety and definitely less equity than many other countries.

A short quote from the report:

“Based on two decades of consistent tracking, the 2009 Rankings calls for the nation to change unhealthy behaviors that are contributing to preventable, chronic diseases as the key to improving our nation`s health. Trends cite smoking as the greatest health challenge of the past 20 years and warn obesity is likely to be the next national health battle. When it comes to our national pursuit of health, Americans have benefited from disease treatment while preventable illnesses continue to decrease quality of life for many. With focused attention, change is possible.”

The way ahead

As the U.S. health care-reform debate continues, we’re becoming increasingly aware of the staggering cost of treating disease.

But prevention and improving public health are still very much missing in the general conversation.

I’m not referring to screenings (and I definitely don’t want to get into the mammograms schedule issue); screening is usually aimed at early detection and timely treatment of disease, which is a very important, but quite different from prevention.

What I’m talking about is modification of risk factors and prevention of disease through simple and proven changes in lifestyle. Smoking, poor eating habits and inactivity contribute to chronic diseases in a big way, and we’ll have to put some serious effort toward modifying these risk factors in order to slow the rise in chronic illness and truly reform our health-care system.

The incidence of diabetes has doubled in a decade, and we know that improved diet, obesity prevention and physical activity are the key to reversing this trend in type 2 diabetes, which is costing us both unnecessary suffering and lots of money.

The late Ted Kennedy said this in 1994 about health-care reform: "What we have in the United States is not so much a health-care system as a disease-care system."

Not much has changed in the past 15 years. Although disease treatment has progressively improved, preventable illnesses prevalence is still rising, causing a lot of suffering and impairing the quality of life for many.

Please check out the useful Take Action resource section in the report, which can help individuals, employers, community leaders and health care professionals take concrete steps toward the goal of changing unhealthy behaviors and preventing disease.

There’s much we can do, both individually and as a nation, to improve our health and prevent disease.

Dr. Ayala

Recipes for a healthy and happy Thanksgiving

2009-11-23T06:03:00-05:00

Thanksgiving is a time to give thanks, celebrate fall, and enjoy the bounty of nature and the company of family and friends.

I love this holiday because it’s so important to take a break from focusing on all the problems in our world and in our lives, and spend time reflecting on the good in the world. There’s much to be grateful for, even in hard times.

As a vegetarian cook I follow the traditional Thanksgiving meal quite loosely. The palette of my presentation will definitely abide by the customary colors: the oranges, browns and reds of squashes, pumpkins, cranberries and chestnuts; the typical green of green beans or a fresh salad; and the lovely yellow of corn and corn meal. But otherwise, I let the quality seasonal produce I find show me the way, and I allow myself freedom in interpreting the Thanksgiving classics.

This week, I want to share a few of my healthy Thanksgiving recipes, most of which can be prepared well in advance and require minimal “finishing touches” right before the big meal.

Wishing you a happy and healthy holiday,

Dr Ayala

Roasted squash and chestnut soup with mulling spices

This is a terrific fall soup, perfect for the Thanksgiving holiday. It’s easy to make, and requires no pre-prepared soup stock. The aroma of the mulled spices is festive and somewhat surprising in a soup.

Ingredients:

• 2 butternut squash, peeled, halved lengthwise and cored
• 1 large onion
• 1 tablespoon canola oil
• 1 pound peeled roasted chestnuts (you can find peeled chestnuts sold in jars)
• 1-2 tablespoons honey
• Salt and freshly ground pepper to taste

For the mulling spices:

• 2 cinnamon sticks
• 1 teaspoon whole allspice
• 1/2 teaspoon whole cloves
• 5 cardamom pods, bruised
• Orange peel zest (the outer colorful skin of the orange peel)--about half an orange

Preparation:

Preheat the oven to 350 degrees F.

Place the squashes, cut-side down, on a baking pan and bake until tender, about 30-40 minutes. Cut into large chunks.

Gather the mulling spices into a muslin bag, tea ball or cheesecloth pouch. (The orange peel and cinnamon sticks can be allowed to roam free in the pot; they’ll be easy to fish out.)

In a large soup pot, over medium-high heat, sauté onions until translucent.

Add the chunks of roasted squash, honey, salt, pepper, and half the chestnuts.

Add water to cover by 1.5 inch and bring to a boil, then lower to a simmer.

Add the mulling spices, including the orange peel and cinnamon sticks.

Simmer over moderate heat for 20 minutes. Remove from heat. Remove the mulling spices, orange peel and cinnamon sticks.

Puree the soup with an immersion blender. (This is an inexpensive kitchen tool that saves a lot of cleanup. Immerse the blender into the pot in which the food has been cooked, and easily puree it with a switch of a button. If you don’t have an immersion blender you can use a blender or food processor.)

Crumble the remaining chestnuts into the pureed soup.

Taste and correct seasoning by adding ground cinnamon, more salt or some more freshly ground pepper.

To serve:

Garnish with freshly toasted pumpkin seeds (an excellent source of omega 3), and/or a cinnamon stick.

Serves 8-10.

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Roasted red and golden beets, with reduced balsamic vinegar

Beets are easy to find, especially between spring and fall. They make for a very simple, delicious, healthy dish that epitomizes fall color to me.
If you can find golden beets, they make for a delightful color contrast with the red beets. They also taste really great.

Ingredients:

• 3 medium red beets, rinsed, not peeled
• 3 medium golden beets, rinsed, not peeled
• 1/2 cup balsamic vinegar for reduced balsamic glaze
• Fresh herbs to garnish (chives, parsley or tarragon)
• Salt and freshly ground pepper to taste
• Optional - fresh goat cheese (chèvre)

Preparation:

Preheat the oven to 400 degrees F.

Wrap each beet in aluminum foil and place in pan in the oven.

Roast until tender and easily pierced with a fork, about 45 minutes to 1 hour.

Remove from the oven and let cool.

When beets are cool enough to handle, peel and slice them. (Red beets can be peeled and sliced in advance. Golden beets change color when exposed to air, so slice just before serving.)

To make reduced balsamic glaze: In a small pan over high heat, bring vinegar to a boil, then reduce heat to medium, and evaporate balsamic until quantity halves and turns to a light syrup.

Drizzle reduced balsamic over the beets.

Season with salt and freshly ground black pepper.

Garnish with fresh herbs, and add goat cheese if desired.

Serves 8-10 as a side dish.
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Wheat berry salad

Whole grains are important part for healthy nutrition. Wheat berries are the most wholesome and least processed wheat grain and include the entire wheat kernel—the bran, germ and endosperm. (For comparison, white flour is comprised only of ground endosperm.)
Look for wheat berries in the health food store or in the natural foods section of the supermarket. (Whole Foods usually sells them in bulk, which is great!) I like the hard red wheat berries, which are very high in protein, very nutritious, and have a sweet nutty flavor and a lovely chewy texture.

The trick with hard wheat berries is to plan ahead and soak them overnight. These grains are very hard indeed, and will require a very long cooking time if they’re not well-soaked.

This is a very simple recipe, and a dish everyone seems to love.
Ingredients:

• 1/2 cup wheat berries, soaked overnight
• 1 large ripe mango (can be replaced with oranges or persimmon), cut into cubes
• 3-4 celery stalks, with the fibery outer parts peeled and diced
• 10 dates, pitted and finely chopped (can be replaced by another dried fruit)
• A handful of dry cranberries
• A handful of nuts, such as roasted almonds, candied pecans or walnuts

Dressing:

• 1 tablespoon of a fine sweet and interesting marmalade. I use organic Adriatic fig spread (sold at Whole Foods)
• 2 tablespoons extra virgin olive oil
• 1 tablespoon balsamic vinegar
• 1 sprig of thyme, finely chopped

Preparation:

Cook the wheat berries by covering them with two inches of water, then bring them to a boil, lower the temperature to simmer, and cook until chewy—about 20-30 minutes. Drain and let cool.

Add all other salad ingredients besides the nuts.

Combine dressing ingredients.

Add the nuts and dressing right before serving.

Serves 6-8 as a side dish.
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Roasted French string beans with toasted sesame

Ingredients:

• 1 pound French string beans, both ends removed
• 2 tablespoons olive oil or toasted sesame oil
• 2 tablespoons sesame seeds
• Freshly ground black pepper and salt to taste
• A pinch or two of red pepper flakes (optional)

Preparation:

Preheat the oven to 400 degrees F with the oven pan in the oven.

Toss the string bean with the oil and spices.

Spread the beans in one layer on the pre-warmed oven pan.

Bake for 3-5 minutes, until beans become slightly brow and are sizzling, but are still very crunchy and vibrant.

Correct the seasoning by adding salt or pepper.

Serve hot, or at room temperature.

Serves 8-10 as a side dish.
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Pecan yeast “roses” cake

Pecan yeast “roses” cake is a perfect indulgence for the close of the Thanksgiving meal and a fresh take on pecan pie.
This isn’t a difficult recipe--yeast dough is actually easy to work with. The only real challenge is mastering the patience. You’ll have to factor in the rising time the dough needs to fully develop.
The “roses” part of this cake’s name comes from the delicate shapes formed on the individual cakes.

Ingredients:
For basic sweet yeast dough:

• 3 1/2 cups unbleached flour (I use King Arthur’s bread flour. All-purpose is fine too. Bread flour is a high-gluten flour called for in many bread and pizza crust recipes where you want the loftiness or chewiness that the extra gluten provides. All-purpose flour is made from a blend of high- and low-gluten wheats, and has a bit less protein than bread flour.)
• 1/2 cup sugar
• 1/2 cup milk
• 1/2 cup heavy cream
• 3 tablespoons melted unsalted butter
• 2 yolks
• 1 envelope rapid-rise yeast
• 1/2 teaspoon salt

For the pecan filling:

• 2 cups pecans, finely chopped (in the food processor or blender)
• 1 cup sugar
• 2 tablespoons butter
• 2/3 cup milk

Preparation:

To make the dough:

If you happen to own a bread machine, put all the ingredients in the mixing bowl and use the dough setting.

If kneading by hand: Put all the dough ingredients in a bowl, combine to make dough, and knead for about five minutes, until the dough is soft and elastic and not sticky at all. (Add a bit of extra flour or milk if you haven’t reached a really workable dough within five minutes, but that rarely happens with this recipe.)

Cover the bowl with a clean kitchen towel, and let sit for an hour and a half in a warm place, until the dough doubles its volume.

To make the filling:

Combine milk, sugar and butter in a small pot and bring to a boil, then lower to a simmer.
Add the nuts, and continue stirring on low heat for a minute or two.

Remove from heat and let chill completely. (The filling may seem too watery for handling when warm. Don’t worry. Its consistency will improve as it cools down.)

Putting it all together:

Roll the dough on a lightly floured surface to a rectangle, about 25 by 20 inches. Don’t be lazy! If you fail to roll it big enough the cake will have fewer leaves and too much dough between the nut layers. Rolling to a thin sheet is really important!

Spread the pecan filling on the dough and roll the dough.

Cut the roll crosswise into 2 inch pieces and place on a greased 10-inch spring pan, cut side up (will make 12-15 rolls).

Let rise again for about one hour.

Heat the oven to 350 degrees F.

Bake in the heated oven for 25 to 30 minutes, until golden brown.

Remove from oven and let chill on rack.

Serving suggestions:
The cake can be cut to slices (my preference) or separated into its rolls by hand.
This cake pairs very nicely with apple sauce, fresh berries or more simply, a steaming cup of herbal tea.

Serves 14-20
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How do low-carb diets affect mood?

2009-11-16T06:03:00-05:00

The promise of many popular diets often includes not just weight loss, but a happier outlook. Yet, a new study shows that the expected mood improvement—the added perk usually seen when losing weight—seems to be short-lived in successful dieters on a low-carb diet.

The low-carb diet debate is one that doesn’t seem to want to fade away. The diet itself is an old one. The idea that eliminating most carbs as a weight-loss strategy is an idea that preceded Dr. Atkins by more than a century. There are many types of low-carb diets with varying restrictions on the types and amounts of carbohydrates permitted. Just like other diets, they work as long as you eat fewer calories.

Their relative popularity is at least partially because proponents find low-carb diets easier to follow: It may be that a low-carb diet produces more satiety and reduces appetite, and the initial weight loss might be greater than with other diets (although some of that initial weight loss advantage is probably explained by greater water loss).

Whether a low-carb diet is a sustainable plan is a whole different issue.

In order to lose weight on low-carb diet one needs to reduce total calories and do so over the long-term. Unfortunately, low-carb diets generally aren’t easier to stick to over the long run and the long-term weight outcomes of low-carb diets are no different than those of other diets. In fact, a large study published in the New England Journal of Medicine compared low-carb and low-fat diets and found that after a year, people dropped out of both diets at similar rates.

Many experts also worry that a low-carb diet, which replaces carbohydrates with foods containing a higher percentage of proteins and fats and especially saturated-fats, isn’t a healthy way to eat over a long period of time. Studies of low-carb diets continue to examine their effect on a multitude of end results, from heart health, atherosclerosis and kidney function, to Alzheimer’s, cognition and now—mood.

A recent study in the Archives of Internal Medicine compared participants’ long-term mood and cognition when undertaking low-carb and low-fat diets.

A total of 106 overweight and obese participants were randomly assigned to either a low-carb or low-fat diet for one year. Both diets were similar in calories and only moderately energy-restricted, with an average of about 1,400 calories for women and about 1,700 for men.

Mood was checked four times throughout the study year using validated questionnaires and looking at many aspects of mood, including tension, anxiety, depression, dejection, anger, hostility, vigor, fatigue and confusion. Cognitive function was also tested.

And the results:

• Eight weeks into the diet both groups reported similar marked improvement in mood.

• After the initial eight weeks, mood scores started to differ significantly and the low-fat group clearly outperformed the low-carb group in mood scores.

• In the low-fat diet group the majority of mood measures, including the measures for anger, depression and confusion improved long-term and mood was generally better than it was at the beginning of the diet.

• In the low-carb diet group, after an initial improvement in mood the majority of mood measures, including the measures for anger, depression and confusion returned to baseline level (before weight loss), and the positive mood lift was short lived.

• Both groups achieved similar weight-loss results.

• Cognitive functioning tested working memory and speed of processing, and both groups scored similar scores at one year.

Psychological well-being is one of the many health perks one gets from dieting, and at least in this long-term study, the low-carb diet didn’t achieve the sustained elevated mood that the regular low-fat one did.

The authors offer a few hypotheses to explain their finding:

Western diet eating patterns rely on carbs—bread, pasta, rice and fruit are quite central to our cuisine. Low-carb diets are far removed from our normal eating habits, and may create a sense of food preoccupation, social eating impairment and isolation, and may therefore result in a bad mood.

The other explanation is quite intriguing: low-carb diets may change the brain’s chemistry. Low serotonin levels in the brain are known to be linked to depression and anxiety (many antidepressant drugs work by making serotonin more available in the brain). A high-carb diet may increase serotonin production, and a fat- and protein- rich diet may reduce serotonin concentrations in the brain. Therefore, a low-carb (which is also high in protein and fat) diet may decrease serotonin levels and have a negative effect on moods. Serotonin may be only one of the brain chemicals affected by a low-carb diet.

Who is the fairest of them all?

The weight-loss industry is huge—we spend $40 billion a year on weight-loss and diet advice just in the U.S.; the diet business, unlike the American people, is always in great shape.

Each diet boasts its superior results, ease of use and testimonials from happy thin people, exemplifying the most positive outcome possible with no mention of the average results achieved by most dieters, so I think some reality checks are always welcome.

Whenever I see so many products on the market, it’s a clue that maybe none of them has a clear advantage. While all diets that prescribe an energy deficit—fewer calories consumed than calories expended—should work, the problem remains that only five percent of dieters manage to maintain their lower new weight for very long; most dieters typically slowly return to baseline weight in three to five years. In other words—all diets work but actually none of them really does. Our old eating habits are comfortable, and we are prone to fall back on them.

So which is the best diet? You’ll get many different answers and plenty of advice from experts. My point of view isn’t based on personal experience—I don’t diet—but rather on general health advice and common sense: I prefer diets that promote healthy eating habits, moderation, are balanced nutritionally, and resemble habits you can see yourself adopting long-term.

A better diet plan is one that’s both healthy in the long-term and sustainable. The more the weight-loss diet resembles the weight-maintenance diet habits you need to adopt in order to remain at your new weight, the better it is, as acquiring new eating habits is the ultimate challenge.

These general rules of course exclude fad and crash diets, such as the cookie, milkshake and cabbage soup diets, as well as extremely low-calorie diets. Any diet with “miracle” or “easy” label on it should be highly suspect—there are no miracles (sorry!) and losing weight and keeping it off is never easy.

And because losing weight and keeping it off is so difficult, we need to emphasize obesity prevention. Good eating habits, physical activity and a healthy food environment are the best tools to minimize the chances of ever needing to diet.

Dr. Ayala

Are we exercising less or eating more?

2009-11-09T06:07:00-05:00

There are many compelling reasons to exercise. Regular physical activity has been shown to reduce the incidence of heart disease, diabetes and hypertension. It improves mental health, fosters strong muscles and strong bones. It also makes most participants happier and improves our looks.

Physical activity also burns calories. In the past few decades exercise has therefore become one arm of the two pronged approach to combat overweight and obesity. Exercise is the calories expended in the equation; food intake is the calories we take in. Any change in the balance of calories in and calories out that leaves us calorie depleted would, assumingly, lead to weight loss. The best approaches to overall health and weight maintenance employ both increased exercise and calorie restriction.

Inactivity has also been blamed for our weight gain. Our life has indeed become much more sedentary, as the car replaced walking, as convenience and mechanization crept into every aspect of our lives and as we started spending hours without end watching TV.

But blaming inactivity has also become a way for the fast food and processed food industry to escape any responsibility for the highly palatable and calorie-dense foods they produce and promote. It’s of course inconvenient for food manufacturers and for us individually to admit that we’re eating too much; it seems we’d all like to believe that we can just burn a lot more calories through physical activity and allow the party to go on.

Blame games are generally useless, but if we are to address the obesity crisis rationally perhaps it's worthwhile to look at the relative contribution of inactivity and overeating to our weight gain.

Surprisingly enough, there are now serious questions emerging about whether inactivity has contributed to the expanding American waistline in any significant way.

A new study in Obesity Reviews looked at adolescents’ activity levels and asked two questions:

Are American adolescents getting enough physical activity?

And

Have adolescents become less active over the past fifteen years or so?

The reviewers examined nationally representative Youth Risk Behavior Surveillance Surveys taken since 1991, which provide information on adolescents’ physical activity (such as swimming, soccer, running, etc.), physical education at school and sedentary behaviors, such as watching TV and playing video games. Sample sizes were large, ranging from about 11,000 to 16,000 participants each year.

Let’s start with the not-so-great news:

• Only a minority—about a third—of our adolescents met the recommended daily levels for physical activity. (Optimal physical activity is any activity that makes a person increase their heart rate and breathe hard for at least 60 minutes, at least five days a week.) More boys met these criteria than girls, as did more Caucasians compared to minority youths.
• Most participants—about two-thirds of the study population—reported what this study defines as “sufficient vigorous physical activity”—activity that makes a person increase their heart rate and breathe hard for at least 20 minutes, at least three days a week.

On the other hand, the data shows that American adolescents have not decreased their level of physical activity; physical activity levels have been quite stable over the past 17 years. During the same period of time studies show that obesity rates in kids had more or less doubled.

There were also a few encouraging trends:

• Physical education class attendance and engagement have improved.
• TV viewing time had decreased significantly in the past few years (although that doesn’t mean TV hasn’t been replaced by other media, such as the Internet and computers).

The authors, led by Youfa Wang, summarize by saying: “Reduced PE (physical activity) is not likely the major explanation of the recent increase in obesity among U.S. adolescents.”

Another recent study in the American Journal of Clinical Nutrition looked at the relative contributions of food and exercise habits to the development of the obesity epidemic, and concluded that the rise in obesity in the United States in the last three decades was virtually all due to increased energy intake.

These studies, and several others, suggest that the main driver of the obesity epidemic is increased food intake. Increasing physical activity has to be part of the solution because exercise is so very good for health and helps us lose weight, but in order to address the obesity crisis head-on, we have to face the fact that the main target of our efforts needs to be reducing our caloric intake.

We probably can’t—as a society—increase our energy expenditure to compensate for our levels of food consumption. We’d better be realistic about this.

The American Journal of Clinical Nutrition study cited above suggests that to get U.S. kids back to the mean weights we saw in the 1970s, kids would need to decrease their average daily intake by 350 calories/day, or walk an extra two and a half hours daily (while eating the same amount, which is no easy task since exercise drives hunger). Both options seem difficult, but the latter appears totally implausible.

Please don’t misunderstand me; I know the importance of physical activity and truly believe in its critical value. Exercise does help in weight loss and improves health, even if no weight is lost.

But I don’t think physical activity without a serious look at what and how we eat will likely get us and our kids out of the obesity crisis.

Dr. Ayala

Reposted as part of Food Renegate's Fight Back Fridays--go join the food fight!

Walnut yeast “roses” cake: a delicious indulgent dessert

2009-11-02T06:03:00-05:00

If the photo of this golden, brown delicacy wasn’t enough to whet your appetite, let me describe the smell: It’s the essence of childhood dreams, the aroma of pleasure itself. At least for me.

Clearly I’m digressing this week from veggie and whole grain recipes and the science of healthy living to the aroma of baked cakes. Well, I do make desserts, and am very much into indulgent ones. I don’t serve dessert every day but I’ll conclude every festive weekend meal with one, and I’ll always leave room for dessert when we eat out.

So for those of you who’ve asked what’s in my pantry besides the obvious healthy foods—I always have butter, heavy cream and the best baking chocolate I can find. I don’t replace the classic ingredients with anything else and never have. I believe that a reasonably small portion of a heavenly dessert will satisfy without breaking your calorie budget and is well worth its saturated fat.

Walnut yeast “roses” cake is just that type of creation.

This isn’t a difficult recipe, but I want to start with a note on yeast dough.
Yeast dough actually is easy to work with; the only real challenge is mastering the patience.

In fact, yeast dough teaches an important life lesson: Sometimes, all you need to do is let a little time pass.

You don’t need to wait passively; the dough won’t rise when you’re watching it. The patience of yeast dough is of the “let go, and things will happen” type. Leave your dough alone and go about your day. You’ll later find the yeast were hard at work for you and doubled your dough. Waiting for the yeast has been a good lesson for me—I tend to be a whirlwind of activity, and learning to wait has served me well as a parent, friend and doctor.

Working with yeast has also deepened my understanding that real food is part of the natural world around us. As such, there’s lots of variability, and each kitchen adventure won’t be exactly the same. I always manage to make reasonably good yeast dough, but even with the apparently same ingredients I find there are good dough days, and days when the dough is more of a challenge. Humidity, temperature, the physical action of kneading the dough and the yeast’s liveliness all affect the final outcome.

So here goes.

Ingredients:

For basic sweet yeast dough:

• 3 1/2 cups unbleached flour (I use King Arthur’s bread flour. All-purpose is fine too. Bread flour is a high-gluten flour called for in many bread and pizza crust recipes where you want the loftiness or chewiness that the extra gluten provides. All-purpose flour is made from a blend of high- and low-gluten wheats, and has a bit less protein than bread flour.)
• 1/2 cup sugar
• 1/2 cup milk
• 1/2 cup heavy cream
• 3 tablespoons melted unsalted butter
• 2 yolks
• 1 envelope rapid-rise yeast
• 1/2 teaspoon salt

For the walnut filling:

• 2 cups walnuts, finely chopped (in the food processor or blender)
• 1 cup sugar
• 2 tablespoons butter
• 2/3 cup milk

preparation:

To make the dough:

If you happen to own a bread machine, put all the ingredients in the mixing bowl and use the dough setting.

If kneading by hand: Put all the dough ingredients in a bowl, combine to make dough, and knead for about five minutes, until the dough is soft and elastic and not sticky at all. (Add a bit of extra flour or milk if you haven’t reached a really workable dough within five minutes, but that rarely happens with this recipe.)

Cover the bowl with a clean kitchen towel, and let sit for an hour and a half in a warm place, until the dough doubles its volume.

To make the filling:

Combine milk, sugar and butter in a small pot and bring to a boil, then lower to a simmer.

Add the nuts, and continue stirring on low heat for a minute or two.

Remove from heat and let chill completely. (The filling may seem too watery for handling when warm. Don’t worry. Its consistency will improve as it cools down.)

Putting it all together:

Roll the dough on a lightly floured surface to a rectangle, about 25 by 20 inches. Don’t be lazy! If you fail to roll it big enough the cake will have fewer leaves and too much dough between the nut layers. Rolling to a thin sheet is really important!
Spread the walnut filling on the dough and roll the dough.

Cut the roll crosswise into 2 inch pieces and place on a greased 10-inch spring pan, cut side up (will make 12-15 rolls).

Let rise again for about one hour.

Heat the oven to 350 F.

Bake in the heated oven for 25 to 30 minutes, until golden brown.

Remove from oven and let chill on rack.

The cake can be cut to slices (my preference) or separated into its rolls by hand.

Serving suggestions:

This cake pairs very nicely with apple sauce, fresh berries or more simply, a steaming cup of herbal tea.

By the way, the “roses” part of this cake’s name comes from the delicate shapes formed on the individual cakes.

Enjoy,
Dr. Ayala

Other dessert posts:
Healthy summer frozen treats and the dreaded brain freeze
Whole wheat banana bread with mint sauce

Reposted as part of Food Renegate's Fight Back Fridays--go join the food fight!