This Week in Health and Fitness

Welcome to this week’s Health and Fitness. This is an Open Thread.

Tuberculosis: Drug-Resistant Strains Still Spreading at Deadly Rates, W.H.O. Report Says

Drug-resistant tuberculosis killed about 150,000 people in 2008, and half of all the world’s cases are thought in be in China and India, the World Health Organization said in a report last week.

No one knows the exact number of cases of the two types of drug-resistant TB, called MDR and XDR for multidrug-resistant and extensively drug-resistant.

A few places, like Peru and Hong Kong, have fought the disease effectively, as New York City did in the early 1990s. Progress has been made in parts of Siberia, but in another region of Russia, more than a quarter of all cases are drug-resistant. And in Africa, a vast majority of cases have probably not even been diagnosed, the report said.

Even standard tuberculosis takes six months to cure with a four antibiotic cocktail. But the drugs cost only $20 and are relatively easy to take. Drug-resistant forms can take two years and require dangerously toxic drugs that cost $5,000 or more per person; they usually emerge when public health officials fail to ensure that patients with regular TB take their drugs daily.

As is now custom, I’ll try to include the more interesting and pertinent articles that will help the community awareness of their health and bodies. This essay will not be posted anywhere else due to constraints on my time. Please feel free to make suggestions for improvement and ask questions, I’ll answer as best I can.  

General Medicine/Family Medical

Patterns: Nonmelanoma Skin Cancer Cases Soar

The most common cancer in the United States is nonmelanoma skin cancer, but the exact number of cases is unknown because they are generally not tracked by cancer registries. Now, a new study reports that Americans are developing those cancers at record numbers, with 3.5 million cases a year in 2 million people, as of 2006. (Patients with a skin cancer often develop another one within the year.)

Among fee-for-service Medicare beneficiaries alone, the number of skin-cancer-related procedures nearly doubled over 14 years, to 2 million in 2006, up from 1.1 million in 1992, according to the study, published in the March issue of Archives of Dermatology.

Spring Allergy Relief Can Be Hard to Find Survey Shows Most Americans Have Limited Success From Common Treatments

By Jennifer Warner

WebMD Health News

Reviewed by Laura J. Martin, MD

March 24, 2010 — As the snow melts, seasonal allergy sufferers may be heading for relief indoors rather than enjoying the springtime weather.

A new survey shows 60% of people with springtime allergies have limited success treating their itchy eyes, sinus pain, and scratchy throat. For nearly one in five seasonal allergy sufferers the symptoms are so bad that they miss work.

Many of the respondents said none of the main strategies for coping with allergy symptoms, including avoidance, prescription drugs, or over-the-counter medications, were completely successful at relieving their allergy misery. The survey did not include questions about allergy shots (immunotherapy).

Researchers say despite the millions of dollars spent on direct-to-consumer marketing that promises instant relief from seasonal allergy symptoms, the answer is rarely that simple.

“Seasonal allergies affect all parts of the upper respiratory system plus the eyes,” says Marvin Lipman, MD, chief medical adviser at Consumer Reports, which conducted the survey, in a news release. “There’s usually no single magic bullet.”

Vaccine deal could save 900,000 lives by 2015

(Reuters) – Drugmakers Pfizer and GlaxoSmithKline signed a landmark 10-year deal on Tuesday to supply 60 million doses a year of cut-price pneumococcal vaccines to developing nations.

The deal, brokered by the Geneva-based Global Alliance for Vaccines and Immunization (GAVI), is the first under a new scheme called an Advance Market Commitment (AMC) which guarantees a market for vaccines supplied to poor nations but sets a maximum price drugmakers can expect to receive.

Obesity tied to poorer colon cancer survival

NEW YORK (Reuters Health) – Obese people are known to have a higher risk of colon cancer. Now, a new study suggests they may have poorer long-term survival odds than their thinner counterparts if they do develop the disease.

The latest findings, reported in the journal Clinical Cancer Research, suggest that excess weight may particularly affect male survivors’ long-term prognosis.

Medicare to pay for “fillers” in HIV patients

Reuters) – The U.S. Medicare program will pay for the use of facial filling treatments in certain HIV patients with sunken cheeks and other similar problems who are also depressed, the government said on Tuesday.

The move impacts dermal fillers such as BioForm Medical’s Radiesse and Sanofi-Aventis SA’s Sculptra. Merz GmbH & Co acquired BioForm last month.

Cardiovascular ills could hurt economic development

(Reuters) – Rising cardiovascular disease rates in developing nations could threaten economic development and a concerted effort by governments, business and aid groups is needed to address the problem, the National Academies Institute of Medicine said in a report on Monday.

“Something has to be done very rapidly because if not, this will have a tremendous impact, economically speaking,” said the chairman of the committee that prepared the report, Dr. Valentin Fuster of Mount Sinai Heart, Mount Sinai School of Medicine in New York.

Plavix benefit found in heart failure patients

(Reuters) – Patients with heart failure who have had a heart attack but not had artery-clearing angioplasty treatment are less likely to die early if they take Sanofi-Aventis and Bristol-Myers Squibb’s drug Plavix, study data showed on Monday.

The study by Danish scientists published in the Journal of the American College of Cardiology was the first to look at the effect of the anti-clotting drug Plavix, known generically as clopidogrel, on death rates in specific high-risk patients with heart failure and heart attack.

Heart failure is a type of heart disease in which the heart is unable to pump enough blood around the body. Angioplasty is a non-surgical procedure to clear blocked arteries.

Poor, minority heart transplant patients fare worse

NEW YORK (Reuters Health) – Lower-income and minority heart transplant recipients may have a poorer long-term outlook than white or more-affluent patients, a new study suggests.

In a study of 520 adults and children who received heart transplants at one of four Boston centers between 1996 and 2005, researchers found that those from the most disadvantaged neighborhoods were more likely to die or need a new transplant over the next five years.

C. diff Infection Rate May Overtake MRSA Study Shows More Cases of Clostridium difficile in Community Hospitals Than MRSA

By Jennifer Warner

WebMD Health News

Reviewed by Laura J. Martin, MD

March 22, 2010 — A new superbug may be sneaking up on hospitals already struggling to lower infections from another, more well-known antibiotic-resistant bacterium.

A new study shows rates of infection from the bacterium Clostridium difficile (C. difficile) are now surpassing those associated with methicillin-resistant Staphylococcus aureus (MRSA) infections in community hospitals.

Researchers found that while MRSA infection rates are decreasing thanks to stepped-up prevention efforts within hospitals, infections caused by C. difficile have increased each year since 2007.

C. difficile, also known as C. diff, is a multidrug-resistant bacterium that most often causes diarrhea; in severe cases the infection can cause a potentially deadly inflammation of the colon. Two antibiotics are now available to treat the infection, and relapses are common during treatment.

Sex virus blamed for rise in head and neck cancers

Reuters) – The number of head and neck cancers linked to a virus spread by oral sex is rising rapidly and suggests boys as well as girls should be offered protection through vaccination, doctors said Friday.

Despite an overall slight decline in head and neck cancers in recent years, cases of a particular form called oropharyngeal squamous cell carcinoma (OSCC) have increased sharply, particularly in the developed world.

This growth seems to be linked to cancers caused by the human papillomavirus (HPV), scientists said in a report in the British Medical Journal.

Moderate drinking may slow arthritis progression

NEW YORK (Reuters Health) – Some studies have suggested that moderate drinkers have a lower risk of developing rheumatoid arthritis, and now new findings link the habit to a slower progression of the joint disease.

In a study that followed 2,900 adults with rheumatoid arthritis (RA), Swiss researchers found that light-to-moderate drinkers showed slower progression in their joint damage compared with non-drinkers. Heavy drinkers, on the other hand, showed the greatest progression.

The findings, reported in the journal Arthritis & Rheumatism, are based on X-ray evidence of patients’ joint damage and its progression over an average of four years.

Busy hospitals have lower death rates: study

(Reuters) – Want to survive a heart attack, heart failure or pneumonia? Go to a busy hospital.

Researchers reported on Wednesday that patients suffering from the three common health problems were less likely to die when treated in hospitals that frequently handle those illnesses.

Pneumonia patients treated at larger-volume hospitals were 5 percent less likely to die in the first month than patients treated at hospitals that handled few cases. The death rate for heart failure was 9 percent lower for busy hospitals and 11 percent lower for heart attacks.

Dr. Joseph Ross of the Mount Sinai School of Medicine in New York and colleagues studied Medicare claim data from 2004 through 2006 for their study, published in the New England Journal of Medicine.

U.S. panel sees anemia drug risks in kidney patients

(Reuters) – Use of controversial anemia drugs made by Amgen Inc and Johnson & Johnson at high levels likely worsen heart problems and possibly chances for survival in kidney patients, a U.S. Medicare advisory panel said on Wednesday, calling for more study.

Outside experts on the panel told the Centers for Medicare & Medicaid Services (CMS) that they were confident that use of the blockbuster drugs, called erythropoiesis-stimulating agents (ESAs), in chronic kidney disease patients could cause harm.

“I haven’t heard anything that says higher dosing — all things being equal — is good,” said panelist and Dartmouth Medical School Professor Robert Steinbrook.

H1NI/Seasonal Flu

Resistance can develop fast with swine flu: report

(Reuters) – The H1N1 swine flu virus can develop resistance quickly to antivirals used to treat it, U.S. doctors reported on Friday.

Government researchers reported on the cases of two people with compromised immune systems who developed drug-resistant strains of virus after less than two weeks on therapy.

Bacteria quickly develop resistance to antibiotics, which must be used carefully. Viruses can do the same and doctors worried about resistance had recommended against using antivirals for flu except in patients who really needed them.

Swine flu virus not so new, study finds

(Reuters) – The H1N1 swine flu virus may have been new to humanity in many ways but in one key feature its closest relative was the 1918 pandemic virus, researchers reported on Wednesday.

Their findings could point to better ways to design vaccines and help explain why the swine flu pandemic largely spared the elderly.

“This study defines an unexpected similarity between two pandemic-causing strains of influenza,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a statement.

Women’s Health

For women, battle of bulge just got tougher

(Reuters) – Women need to get at least an hour a day of moderate exercise if they hope to ward off the creep of extra pounds that comes with aging, U.S. researchers said on Tuesday.

The weekly total of 420 minutes is nearly triple the 150 minutes of moderate daily exercise currently recommended by U.S. health officials and illustrates the challenge American women face in maintaining a healthy weight.

Caesarean births hit record high in 2007

(Reuters) – Nearly 1.4 million babies born in the United States in 2007 were delivered by Caesarean section, a record U.S. high and a larger number than in most other industrialized nations, health officials said on Tuesday.

In 2007, nearly one-third of all births were Caesarean deliveries, the U.S. Centers for Disease Control and Prevention said in a report, noting large rises in all racial, ethnic and age groups over 10 years.

Trans fats may promote endometriosis

(Reuters) – Women who eat lots of tuna, salmon and other foods rich in essential omega-3 oils might be less likely to develop endometriosis than those whose diets are loaded with trans fats, U.S. researchers said on Tuesday.

Endometriosis, which has no cure, can cause infertility. In endometriosis, pieces of the uterine lining grow outside the womb, sometimes sticking to other organs.

The type of fat in a woman’s diet, rather than the total amount, may be a risk factor for endometriosis, an often debilitating and painful condition, researchers said in a study published online in the journal Human Reproduction.

The more kids, the lower moms’ suicide risk

NEW YORK (Reuters Health) – Supporting the theory that parenthood offers a buffer against suicidal behavior, a new study finds that the more children a woman has, the lower her suicide risk.

There is a long-standing theory that the historically lower suicide rates seen among married versus unmarried women reflects a “protective effect” of motherhood, rather than advantages of marriage per se.

Weight counseling plus drug may help female smokers

NEW YORK (Reuters Health) – For female smokers worried about gaining weight if they quit, a combination of specialized counseling and the anti-smoking drug Zyban may boost their chances of quitting — at least for a while, researchers reported Monday.

Many smokers gain weight when they quit — typically 5 to 15 pounds — and research suggests that women who are highly worried about that prospect have a particularly tough time giving up the habit.

Rheumatoid arthritis increasing in white women

NEW YORK (Reuters Health) – After decades of decline, rheumatoid arthritis is on the rise among white women in the US, new research shows.

While the study wasn’t designed to investigate why this is happening, the speed of the change points to environmental, rather than genetic, factors, Dr. Sherine E. Gabriel of the Mayo Clinic College of Medicine in Rochester, Minnesota, one of the study’s authors, told Reuters Health. “It’s pretty unlikely that the genetic makeup of a population changed that quickly.”

A healthy diet may trim breast cancer risk

NEW YORK (Reuters Health) – A woman may not be able to change her family history of breast cancer, but she can typically control what she eats and drinks. And consuming more vegetables and whole grains — and less alcohol — just might trim her chances of getting the disease, according to an analysis of published studies.

“As the incidence of breast cancer continues to rise, with many of the risk factors for the disease non-modifiable, potentially modifiable risk factors such as diet are of interest,” Dr. Sarah Brennan of Queen’s University Belfast in Northern Ireland, who led the analysis, noted in an email to Reuters Health.

Men’s Health

Infertility linked to prostate cancer

NEW YORK (Reuters Health) – Infertile men may have an increased risk of developing aggressive prostate cancer, researchers reported on Monday in what could be an important move toward identifying those who will benefit from screening for the disease.

Prostate cancer is one of the most common cancers in men, affecting about 160 per 100,000 every year and killing 26. While doctors can screen for it, many prefer not to do so because most tumors grow slowly and never cause any harm.

Pediatric Health

Food-allergic kids should carry two ‘epi’ doses

NEW YORK (Reuters Health) – Children with a history of food-induced allergic reactions may need more than one shot of epinephrine to halt a severe reaction, a study has confirmed.

Among a group of children treated for food-related “anaphylactic” reactions over 6 years, 12 percent needed a second epinephrine dose, according to a report out today in the journal Pediatrics. Anaphylaxis is a severe allergic reaction that develops quickly, within seconds or minutes of exposure, causing potentially life-threatening symptoms like difficulty breathing.

Prior studies found similar results. One found that nearly one in five severe food-induced allergic reactions will require more than one epinephrine shots.

Refusing to Vaccinate Affects Other Kids, Too. Study: Vaccine Refusal Fueled San Diego Measles Outbreak

By Daniel J. DeNoon

WebMD Health News

Reviewed by Louise Chang, MD

March 22, 2010 — A CDC investigation shows a measles outbreak in San Diego was fueled by kids whose parents refused to vaccinate them, thus endangering children too young to be vaccinated.

Measles is one of the world’s most highly contagious viral diseases. Thanks to high vaccination rates, the dangerous disease stopped circulating in the U.S. But now there are ominous signs it may come back.

The reason: Pockets of parents who believe the measles/mumps/rubella (MMR) vaccine is more dangerous than the diseases. Such beliefs led to a drop-off in MMR vaccination in England — and the subsequent return of measles.

Body-checking safe in preteen hockey players: study

NEW YORK (Reuters Health) – You may not need to worry as much about young kids body-checking each other on the ice, according to a new study.

Allowing kids as young as 9 years old to use body-checking during ice hockey may be safe if rules are strictly enforced, Canadian researchers said Monday in a report that adds to a long-standing controversy.

High protein diet won’t harm young women’s bones

NEW YORK (Reuters Health) – Young women who eat a typical high protein Western diet need not worry that their protein consumption will harm their bone health.

According to research published in the latest issue of the American Journal of Clinical Nutrition, a higher intake of protein does not have a deleterious effect on bone density in premenopausal women.

After-school exercise helps overweight girls

NEW YORK (Reuters Health) – Two-years of after-school physical activity helped lessen the number of overweight and obese fourth- and fifth-grade girls, but not boys, and led to declines in cholesterol levels in girls and boys, report researchers from Spain.

This suggests that Spanish children, who are among the most overweight in the world, generally benefit from supervised physical activity beyond that obtained in physical education class, Dr. Vicente Martinez-Vizcaino, at the Universidad de Castilla-La Mancha in Cuenca, and colleagues report in the Journal of Pediatrics.

Study doubts breastfeeding benefit for eczema

NEW YORK (Reuters Health) – Breastfeeding is often advocated as a way to help prevent allergies in babies at high risk, but a new study finds that infants breastfed for longer periods may actually be more likely to develop the allergic skin condition eczema.

The study followed 321 infants who were at increased risk of allergies because their mothers had a history of asthma. Researchers found that among those who were breastfed exclusively for more than six months, 55 percent developed eczema by age 2.

Childhood physical abuse linked to later migraines

NEW YORK (Reuters Health) – Adults and teenagers who suffered physical abuse as children may have a heightened risk of migraines, two new studies suggest.

In one study, Canadian researchers found that migraines were twice as common among adults with a history of childhood physical abuse compared to those who reported no such abuse.

Teenagers are programmed for risk, study finds

(Reuters) – Teenagers are programed to take risks because they enjoy the thrill of dangerous situations more than others, British scientists said on Wednesday.

The findings may explain why adolescents engage in activities like drug-taking, fighting and unsafe sex.

“The onset of adolescence marks an explosion in ‘risky’ activities — from dangerous driving, unsafe sex and experimentation with alcohol, to poor dietary habits and physical inactivity,” said Sarah-Jayne Blakemore of University College London’s Institute for Cognitive Neuroscience, a co-author of the study.

What Motivates Kids Who Are Bullies? Study Shows Children Who Bully Are Trying to Boost Their Popularity

March 25, 2010 — Class bullies are often thought of as outcasts whose actions lead to rejection by their peers, but new research shows that many are actually popular kids who raise their social standing by picking on others.

As many as half of all children are bullied at some point during their school years, and at least one in 10 is a frequent target of bullies, surveys suggest.

In an effort to better understand what makes bullies bully, researchers in the Netherlands questioned close to 500 grade-school children between the ages of 9 and 12.

The researchers found that children who bullied were often motivated by a desire to increase their popularity and that they chose generally unpopular victims to avoid losing social status.

Boys who bullied tended to seek the approval of other boys; girls who bullied sought the approval of other girls.

When boys bullied girls they chose victims who were disliked by other boys, with little concern about what the girls thought. Girls did the same when they bullied boys.

The study appears in the March/April issue of Child Development.

Aging

Supplement May Give Older Athletes an Edge Boosting Nitric Oxide May Increase Exercise Capacity in Cyclists Over 50

By Denise Mann

WebMD Health News

Reviewed by Laura J. Martin, MD

March 26, 2010 — Cyclists who are 50 and older may be able to ride farther and faster if they take a commercially available supplement containing the amino acid arginine and antioxidants that help boost the body’s natural exercise capabilities, according to new research in the Journal of the International Society of Sports Nutrition.

“The loss of exercise capacity with age often results in a reduction in physical fitness and more rapid [cell death],” says researcher Zhaoping Li, MD, of the University of California at Los Angeles. “A dietary supplement that increases exercise capacity might help to preserve physical fitness by optimizing performance and improving general health and well being in older people.”

Nutrition/Diet/Healthy Recipes

Pepsi to cut salt, sugar and saturated fats

(Reuters) – PepsiCo Inc said on Sunday it would cut the levels of salt, sugar and saturated fats in its top-selling products.

The company, which owns the Pepsi, Frito-Lay and Quaker brands, said it plans a reduction of 25 per cent the average sodium per serving in major global food brands in key markets by 2015.

It also would reduce the average saturated fat per serving by 15 percent by 2020, and cut the average added sugar per serving in key global beverage brands by 25 percent by 2020.

Meanwhile, it will increase whole grains, fruits and vegetables, nuts, seeds and low-fat dairy in its product portfolio.

Brewing a Gentler Java Scientists Discover Substances in Coffee That Cause Stomach Irritation

By Bill Hendrick

WebMD Health News

Reviewed by Laura J. Martin, MD

March 22, 2010 – Scientists in Europe say they’ve pinpointed several components of coffee that may cause many people to suffer stomachaches and heartburn.

The researchers say their discovery of “culprit” substances could lead to a new generation of stomach-friendly brews with the rich taste and aroma of regular coffee but without the acid-producing chemicals that cause irritation.

Veronika Somoza, PhD, of the University of Vienna in Austria, and Thomas Hofman, PhD, of the Technische Universitat Munchen in Germany, say their finding “is going to help a lot of people who suffer from coffee sensitivity” and that, as coffee lovers, they’re “very excited about this research.” Many people are already wondering about Coffee and Health – Positive or Negative? This seems to confirm one side, but if those who love their daily brew can still have access to it then all the better for them.

Curry ingredient shows promise against liver damage

(Reuters) – A compound found in the common curry spice turmeric appears to delay the liver damage that eventually causes cirrhosis, scientists said on Wednesday.

In a study published in Gut, a British Medical Journal title, Austrian scientists found that feeding the compound curcumin to mice reduced the types of inflammation that can cause liver cell damage, blockage and scarring.

Previous research has suggested that curcumin, which gives turmeric its bright yellow color, has anti-inflammatory and antioxidant properties which may be helpful in fighting disease.

Hazards: Lead Found in Indian Spices and Powders

Lead has been found in house paint and imported toys, and now it appears Indian spices and ceremonial powders may contain lead at levels that may be hazardous to children.

Sindoor, the vermillion powder applied along the hairline or as a dot on the forehead, had the highest contamination levels of some 157 products tested by Boston researchers, with some samples consisting of almost 50 percent lead, according to a paper published early online in the journal Pediatrics on March 15.

Bean and Cabbage Soup

A thick, simple soup for a chilly afternoon, this dish is easy to make and tastes even better a day later. The Parmesan, which can be pricy, is optional – the soup will be great without it.

1 heaped cup red or white beans (1/2 pound), rinsed and picked over

2 quarts water

2 tablespoons extra virgin olive oil

1 onion, chopped

2 to 4 garlic cloves (to taste), minced

1 stalk celery, chopped

1 carrot, chopped

1/2 head cabbage (about 1 1/4 pounds), cored and shredded

1 14-ounce can chopped tomatoes, with juice

1/4 to 1/2 teaspoon crushed red pepper flakes, or 1/8 to 1/4 teaspoon cayenne

A bouquet garni made with a few sprigs each parsley and thyme, a bay leaf, and a Parmesan rind

Salt to taste

Freshly grated Parmesan for serving (optional)

1. Combine the beans and water in a large saucepan or pot. Discard any of the beans that float. Bring to a boil, reduce the heat and simmer one hour. Season to taste with salt.

2. In a large, heavy soup pot, heat the olive oil over medium heat, and add the onions, celery and carrot. Cook, stirring, until tender, five to eight minutes. Add the garlic, stir together for 30 seconds to a minute until fragrant, and add the cabbage and a generous pinch of salt. Cook, stirring often, for five to 10 minutes until the cabbage has wilted. Stir in the tomatoes, salt to taste and the red pepper flakes or cayenne, and continue to cook, stirring, until the tomatoes have cooked down and the mixture smells fragrant, about 10 minutes. Add the beans and their liquid. If the vegetables aren’t covered with liquid, add more so that they’re just covered. Add the bouquet garni, bring to a boil, reduce the heat, cover and simmer 45 minutes to an hour. The beans should be soft. Taste and adjust seasoning. Serve, passing Parmesan if desired to sprinkle on.

Yield: Serves six.

Advance preparation: The cooked beans will keep for four days in the refrigerator. The soup also will keep for that long and can be frozen.

Pasta With Broccoli and Chickpeas

1 pound broccoli, broken into florets, the stems peeled and cut in small dice

Salt

2 tablespoons extra virgin olive oil

2 garlic cloves, minced

1/4 teaspoon red pepper flakes (optional)

1 1/2 cups cooked chickpeas, or 1 (15-ounce) can, drained and rinsed

3/4 pound fusilli, bow-ties or orecchiette

1/4 cup freshly grated Parmesan (optional)

1. Bring a large pot of water to a boil. Fill a bowl with ice water. Meanwhile, prepare the broccoli, and separate the stems and the florets. When the water comes to a boil, salt generously and add the broccoli stems. Boil for five minutes and then remove from the water with a slotted spoon. Add the florets, and boil for three minutes. Transfer to the ice water, drain and chop medium-fine, so that some of the florets are falling apart. Return the pot to the heat.

2. Heat 1 tablespoon of the olive oil in a wide, heavy skillet over medium heat. Add the garlic and red pepper flakes (if using), and cook, stirring, until fragrant, about 30 seconds. Stir in the broccoli florets and the stems, season with salt and cook, stirring, until nicely seasoned and coated with the oil, just a minute or two. Add the chickpeas, and stir everything together.

3. Bring the pot of water back to a boil, and add the pasta. Cook al dente, following timing instructions on the package but checking to see if the pasta is done about a minute before the stated time. Add 1/2 cup of the pasta cooking water to the pan with the broccoli. Drain the pasta, and toss at once with the broccoli mixture and another tablespoon of olive oil. If desired, sprinkle on the Parmesan. Serve at once.

Note: If you can’t find chickpeas, substitute another type of bean, like white beans, kidney beans or red beans. If you can’t find fresh broccoli, substitute frozen.

Yield: Four generous servings.

Advance preparation: You can make the topping a few hours before cooking the pasta and hold it on top of the stove.

Spaghetti With Edamame, Parsley, Garlic and Olive Oil

1 large garlic clove, finely minced (more to taste)

Leaves from 1 bunch parsley

2 tablespoons extra virgin olive oil

1 1/3 cups frozen shelled edamame, preferably organic, or frozen peas

3/4 pound whole grain spaghetti if available, or regular spaghetti

1/4 cup freshly grated Parmesan (optional)

1. Begin heating a large pot of water for the pasta. Meanwhile, turn on a food processor fitted with the steel blade, and drop in the garlic. When it’s chopped and adhering to the sides of the bowl, stop the machine and scrape down the bowl with a spatula. Add the parsley to the bowl, and process until finely chopped. With the machine running, drizzle in the olive oil. Transfer the mixture to a large pasta bowl. (You can also use a mini-chop for this task.)

2. When the water in the pot comes to a boil, salt generously, add the edamame or peas and cook five minutes. Remove from the pot with a strainer or a slotted spoon, and place in the bowl with the parsley.

3. Add the spaghetti to the boiling water, and cook al dente following the timing instructions on the package. Checking for doneness about a minute before the stated cooking time. When the pasta is cooked, remove 1/2 cup of the cooking water and add to the bowl with the herbs and edamame or peas. Drain the pasta, and toss with the mixture in the bowl. Add Parmesan if desired, and serve.

Yield: Serves four.

Advance preparation: This isn’t a dish to do in advance, but the whole thing can be made while you’re waiting for the water to boil.

White Beans With Swiss Chard and Rice

3/4 pound Swiss chard (1 small bunch)

2 tablespoons extra virgin olive oil

1 onion, chopped

2 to 4 garlic cloves, minced

1/2 pound (1 1/8 cups) white beans, washed and picked over

1 bay leaf

1 Parmesan rind (optional but recommended)

Salt

1 cup rice

Freshly ground pepper

A few drops of fresh lemon juice (optional)

1. Stem the Swiss chard, and wash both the stems and the leaves in at least two changes of water until thoroughly clean. Dice the stems if they’re wide, and set aside. Stack the leaves and cut in wide ribbons or chop coarsely. Set aside separately from the stems.

2. Heat the oil in a large, heavy soup pot or Dutch oven over medium heat, and add the onion and diced chard stems. Cook, stirring often, until the onion softens, about five minutes. Add half the garlic, and stir together for 30 seconds to a minute until fragrant. Add the beans, bay leaf, Parmesan rind (tie the bay leaf and rind together with a kitchen string to make retrieval easier) and 2 quarts water. Bring to a gentle boil, reduce the heat and simmer one hour. Add the remaining garlic and salt to taste, and simmer for another 30 minutes to an hour until the beans are tender.

3. Add the rice and pepper, and simmer 15 minutes until the rice is tender. Stir in the chard leaves, and simmer another five to 10 minutes until the chard is tender but still bright. The mixture should be soupy but thick. Season to taste with salt and fresh black pepper. Squeeze on some fresh lemon juice – 2 to 3 teaspoons – if desired, and serve in wide soup bowls.

Yield: Serves four.

Advance preparation: You can make this through step 2 up to three days ahead. Bring to a simmer and proceed with step 3.

Black Bean Soup With Cumin and Tomatoes

2 tablespoons extra virgin olive oil

1 medium onion, chopped

4 large garlic cloves, halved

1 cup dried black beans, washed and picked over

6 cups water

1 14-ounce can tomatoes, drained

2 teaspoons lightly toasted cumin seeds, ground

1 canned chipotle pepper, rinsed, or 1 serrano pepper, coarsely chopped (optional)

1. Heat one tablespoon of the olive oil in a large, heavy soup pot or Dutch oven over medium heat. Add half of the onion. Cook, stirring, until tender, and add two of the garlic cloves. Cook, stirring, until fragrant, and add the beans and the water. Discard any of the beans that float, and bring to a boil over medium-high heat. Reduce the heat, cover and simmer 1 1/2 hours until the beans are tender.

2. While the beans are simmering, combine the remaining onion, drained tomatoes, cumin, chile and remaining garlic in a blender, and blend until smooth. Heat the remaining oil in a medium skillet over medium-high heat until hot enough for a drop of the puree to sizzle upon contact. Add the puree, and cook, stirring, for five to 10 minutes until the mixture is thick and leaves a canal when you run a spoon or spatula down the center of the pan. Stir in a cup of liquid from the beans, and simmer over medium heat for five to 10 minutes until thick and fragrant. Scrape into the beans with a rubber spatula. Season the beans with salt, and simmer another 15 to 30 minutes. Taste and adjust the seasonings.

3. Blend the soup coarsely using an immersion blender or in batches in a blender (cover the top with a towel to avoid hot splashes) or a food processor fitted with a steel blade. Return to the pot, and heat through, stirring. Serve with warm corn tortillas.

Yield: Serves four.

Advance preparation: The soup will keep for three or four days in the refrigerator.

13 comments

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    • Edger on March 27, 2010 at 9:05 pm

    I caught it and I thought it was just a bad cold till I woke up one day and coughed about a cup of blood up. I took the drugs for nine months altogether, and have extensive lung scarring now. It’s like a flesh eating bacteria that literally dissolves the inside of the lungs… and dissolves other things too (like your brain) if it’s allowed to spread.

  1. I wonder what “moderate” is defined as…. I usually walk 10 minutes do my little run and walk another ten minutes and by the end my HR is well in the upper zone. When I lift weights I row for 15 minutes before to loosen up my muscles. Sometimes I just hit the hour mark.

    Hate to say this but I think most people do not push themselves appropriately when they exercise. Unless one has an underlying condition that precludes it you should be kinda sweaty with an increased HR for age. And the thing is you have to work up to it. I did not run quickly at all today and I passed several people younger than me who probably thought they could just go out and run a 5K with no prep.

    Walking is great exercise but people often do not do it briskly enough to get the benefit.

    Nor can you tell what kind of conditioning people are in by their body size. There were some women who looked to have larger than ideal BMIs running much faster than I today. I have a friend who is a bit “bottom” heavy and she plays a killer game of tennis three times a week and frequently beats men.

    All those hollywood actresses who are a size 0 have personal chefs and personal trainers and all this other crap. I don’t use them as my ideal.

    • Edger on March 28, 2010 at 3:39 am

    When someone in palliative care stops eating and won’t wake up… is  there an average time frame?

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