If you noticed an absence of bread on my Instagram feeds of late, it’s because I’ve been experimenting with heritage grains in my sourdough bread. And let’s just say the results, until now, have not been not exactly picture worthy. Low rise, dense crumb, and a rock-hard crust. Reminds me of my days working in a summer camp kitchen, where I frequently overcooked the dinner rolls. My kitchen mates took to calling them hockey pucks and treated them accordingly by shoving them with push brooms across the bakery floor. Bigger than hockey pucks, my heritage grain breads were more like a discus, and while I was tempted to toss them across the room accordingly, I dumped them in the trash instead.

The problem with my heritage bread was, I believe, three fold. First, the whole wheat flour I was using was like a water sponge, and I wasn’t adjusting my hydration accordingly. Second, it’s a whole grain flour, meaning it has parts of the wheat berry, that while healthy, have sharp edges that cut through the forming gluten network. A good sourdough rise needs both high hydration and great gluten formation, and I was failing on both counts. Third, I was using a new recipe I’d never tried before, and now I was adjusting that recipe by using whole grain flour. Too many variables to introduce at once.

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For the levain, I used a whole wheat mix that I made one day while consolidating my pantry – equal parts Hechkner’s, King Arthur sprouted and One Degree sprouted whole wheat. For the final dough I used Red Fife Heritage Whole Grain Wheat Flour from Gianoforte Farms in upstate New York. I purchased the flour at GrowGrains NYC in the Union Square Farmers Market, a fabulous source for locally-grown grains and flour.

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Red Fife wheat, named for the farmer Dave Fife who first grew it on his farm in Peterboro Ontario in 1842, was once the dominant wheat used in Canadian baking. Legend has it that Fife first obtained the wheat from a friend who had accidentally dropped his hat into a load of the wheat sitting on a ship from Ukraine in the Glasgow Harbor. Finding the kernels in his hatband, he shipped them off to Fife, who planted them with success.

Red fife was the dominant wheat in Canada until the early 1900’s, when it was supplanted by new species cross-bred for disease resistance. It disappeared into plant breeders seed collections until 1988, when it resurfaced as part of a “Living Museum of Wheat” at a historic Grist Mill in Keremeos, BC. Since that time, production has grown, and Red Fife is now one of the darlings of the heritage grain and artisan bread movement not just in Canada and the US, but around the world.

More on Red Fife from 免费网络节点加速器

To make my bread, I needed to sift my whole grain Red Fife Flour to remove the larger sharper parts of the grain that threatened my gluten network. (Not quite what bread makers call High Extraction Flour, but a step in that direction.) I know – this defeats the whole purpose of using whole grain wheat, which is to get the health benefits of the entire kernel. But rest assured – the kitchen strainer I used didn’t strain out all the good parts – just the larger, sharper parts, which I can use later as a coating on my breads or as a topping for my oatmeal.

Other than that one step, I followed Tartine’s recipe and method, adjusting my timing based on the temperature, making both a boule and a batard. (See this previous post to learn how I do it.) The result was a delicious bread with a fabulous rise, an aerie crumb and a chewy crust.

I’ve ordered a set of mesh flour sieves from Breadtopia, and plan next to try my hand next using Red Fife in a 50% whole wheat loaf. I’ll let you know how it turns out.

Tartine Basic Country Bread with Red Fife Wheat

Don’t even think of making sourdough bread for the first time using just this blog post, as this is an extremely abbreviated version of the technique. If you really want to learn how to make this sourdough, you are best off working directly from Chad Robertsons’ book Tartine BreadUCloud优刻得cdn网络加速产品介绍及500+节点分布 – 老刘博客:大文件加速可伍将视频文件、游戏安装包、软件、补丁等需要下载的内容进行加速，为客户提供下载加速解决方案。 您只需要将大文件上传至最近的服务器节点，UCDN平台就能够智能地部署文件，分发到全国各地的节点，不仅解决了带宽不足的问题并且让您的用户体验到更快的下载服务。NY Times Tartine Bread recipe is a nice way to start. (That’s how I got hooked.).

Leaven (7 am Saturday)

• 25 grams active starter (My starter is fed with sprouted rye)
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• 200 grams of a 50/50 blend whole wheat (mixture described above) and bread flour (King Arthur Artisan Bread Flour)

Disperse the starter in the water, then stir in the flour till there are no dry parts. Cover and let rise till ready. I kept my leaven at about 80 degrees in a home-made proof box – an unplugged microwave with a pyrex cup filled with boiling water and a thermometer sitting next to the leaven, refreshing the water every hour or so – and it was ready in less than 6 hours. if you keep your leaven at cooler temps, you can prepare the leaven before bed and let it develop overnight.

Note that you’ll only be using about half the leaven in the final dough. The rest can serve as your starter in the future. Alternatively, halve the amounts of flour and water in the recipe above and use it all. Just remember to save your unused starter.

Mix and first rise (1 pm Saturday)

Before measuring it, sift the red fife wheat to remove the larger bran particles. Save these for dusting your bannetons.

• 200 grams leaven
• 900 grams white bread flour (I used King Arthur Artisan Bread Flour)
• 100 grams sifted Red Fife whole wheat
• 700 grams warm water (80 degrees) + 50 grams more (added with the salt)
• 20 grams sea salt

In a large bowl, disperse 200 grams leaven in 700 grams of warm water with your fingers. Whisk the flours together and add to the water/leaven till there are no dry bits of flour.

Let dough autolyse (rest) 45 mins. After the rest, lightly stir the salt into the remaining 50 grams of water (it does not need to dissolve) and add to the dough using your fingers. The dough will come apart, then come together again.

Let rise for 3-4 hours, turning every 30 minutes. (Here’s a video I made of the amazing Sarah Owens teaching us how to turn our dough during the rise.)

Pre-shape, Rest and Final Shaping (4:30 pm)

Pull dough out of bowl onto a very lightly floured surface. Pre-shape, rest for 30 mins, preparing bannetons while the bread rests. Perform final shaping. (Here’s another video of Sara Owens making bread that shows her shaping technique, which is what I use.) Place bread into bannetons, cover and proof overnight in the fridge.

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Preheat a bread cloche or covered dutch oven in an oven set to 500 degrees. When the oven temp reaches 500 degrees, take the bread out of the fridge, lightly dust the surface of the dough with rice flour and turn out gently onto a sheet of parchment paper. Score as desired.

Uncover the dutch oven or cloche. Holding the parchment paper, gently lower the bread onto the cloche or hot dutch oven. Cover and bake for 20 mins. Remove the cover and bake another 20-30 mins.

Lift the bread out of the pot onto a rack to cool. 美国节点的加速器for at least an hour, and ideally for 2-4 hours before cutting into it.

I’ve been making and loving this Creamy Tuscan White Bean Soup for years now.

Last night, I discovered that if you squeeze some fresh lemon juice into your bowl just before eating, this heavenly soup becomes truly ethereal. It’s even better a day or two later for lunch at the office. Just pack a lemon slice along with the soup, and you’re good to go.

You’re welcome. (有韩国节点的加速器. )

Mr TBTAM makes a mean sandwich. Perfect little combinations of meat and cheese, sometimes tuna salad, always topped with either fresh roasted peppers or some red pepper relish, just the right amount of mustard or mayo, and a perfectly placed lettuce slice.

He is quite proud of these sandwiches, so proud that he will often stop his lunch preparations to find me so he can show me the freshly cut edge of the masterpiece he is taking to work tomorrow morning. At this point I am required to ooh and aah and if I am lucky, he will make me a sandwich as well.

As much as he loves my thick sourdough boules, I know what Mr TBTAM really wants me to make is a sandwich bread. So when this spelt sourdough sandwich loaf from Maurizio Leo’s website The Perfect Loaf caught my eye this week, I knew I had to try it.

The Perfect Loaf is an award winning blog and the online bible for sourdough obsessives like myself. Maurizio, a software engineer turned bread baker, is truly going for perfection. Each recipe catalogues his trial and error efforts at finding just the right combo of freshly milled flour, water and salt to get that perfect slice of bread. I can lose myself for hours among his recipes, videos, photos, and musings about sourdough bread making.

I have to admit I was quite nervous about trying this bread. Spelt is one of the ancient wheats, the other two being Emmer and Einkhorn. Spelt is healthier (higher in protein, zinc and tryptophan, lower in gluten) and more flavorful than modern wheat, but its gluten performs much better than that of Einkorn and Emmer. However, Spelt is notorious for its wet, hard to handle dough, so you cannot just substitute it one for one for modern wheat in a bread recipe. You have to adjust your hydration accordingly, something you can only do by trial and error. Which means a fair amount of failure till you get it right.

Fortunately, Maurizio has done all that hard work for us, playing with multiple levels of hydration in one degree increments until he got this spelt bread loaf just right. A little OCD, perhaps, but I for one am grateful for it! I’m awed at his diligence and perseverance and grateful for this recipe.

I was so happy to see the oven spring on this loaf I was literally dancing around the kitchen! On second thought, however, you don’t really want a pan loaf to spring this much. I think I could have proofed it a bit longer in my box or scored it to control the spring a bit and keep the loaf more level. Or perhaps it’s simply that my pan is so shallow – only 2.75 inches tall. I’m gonna’ get me a deeper pan for my next try.

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Mr TBTAM decided he could not wait for lunch tomorrow to taste this bread. Since I had two nice marrow bones just finishing stewing in a pot of cabbage borscht, we decided to christen the bread with marrow. Heaven.

SOURDOUGH SPELT SANDWICH BREAD

I modified Mauritzio’s recipe to a total dough weight of 1200 grams to fit my 9.25″ x 5.25″ x 2.75″ loaf pan, and reduced the hydration to around 70% at his advice to spelt newbies.

Levain

• 5 g mature starter (my starter is a 1:2:2 starter/rye flour/water)
• 35 g water
• 35 g spelt flour

Mix ingredients in a clear jar. Cover and let sit out overnight at room temp (mid-70’s right now)

Dough Ingredients

• 605 g Spelt Flour (I used 美国节点的加速器app)
• 什么加速器有外国节点
• 32 g honey
• 32 g olive oil
• 14 g salt
• 76 g levain
• Rolled oats, sesame and poppy seeds (Optional Topping)

Technique

• In the morning, mix mature levain in a large bowl with flour, honey, extra virgin olive oil, salt and water till the dough comes together in a shaggy mass. (If working with spelt for the first time, hold back about 10 grams of the water until you are sure you need it – this can be a very wet dough, and different brands of spelt can behave differently. The amounts above worked fine for my flour.)

• Stretch and fold for 4-5 mins till smooth and elastic. Cover for a 3 1/2 hour bulk ferment, performing 4 stretch and folds – the first after the first 15 mins, then every 30 mins thereafter for three more folds – then let the dough rest for the remainder of the ferment time.

• Pre-shape dough into a taut round on an unfloured countertop using wet hands and a dough scraper, then rest uncovered for 20 mins.

• Lightly grease the pan with oil. Shape dough on a floured surface. If using a topping, spritz top lightly with water, roll in topping on a cloth towel, then place in the pan seam side down. Cover with plastic wrap and let proof 1-2 hours at room temp. (Confession – I had dinner plans and so I put the bread into the fridge in a plastic bag overnight, during which it did not rise much, then proofed it in the morning in my microwave proof setup* for 2 hours, where it rose to a perfect proof.)

• Towards end of proofing, place a metal pan on the over floor and preheat oven to 450 degrees Fahrenheit.

• When your dough is fully proofed, unwrap and place on rack in middle of the oven. Pour boiling water or toss a handful of ice cubes into the metal pan, spray water several times into the oven chamber with a handheld spray bottle and close the oven door. (My bread was quite moist from the microwave proof, so I did not spray the oven.)

• Drop the oven temp to 425°F and bake for 20 minutes, then remove steaming pan (careful!) and bake for an additional 25-30 minutes. When the bread looks well colored on top and the interior temp registers around 205°F, remove the loaf from its pan and finish baking in the oven directly on the oven rack for 5 minutes for more color. Remove fully cooked bread from oven and let cool 3-4 hours before slicing.

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Place your bread into the microwave with a large mug of boiling water then close the door. Don’t turn it on! (You can unplug to be on the safe side.) Monitor the temp so it does not go too high. Replace the boiling water as needed to maintain optimal temp.

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If you plan it just right, you can see a play, eat with friends, and get a lot of work done, including a full day at the office, all while making sourdough bread.

I started this loaf late Sunday morning, using my own modification of Tartine’s Country Bread recipe.

After mixing the leaven, I worked at the dining room table on charts and labs from last week’s busy office hours, then let the leaven continue to mature on the kitchen counter while we headed up to An Beal Bocht in Riverdale to see a wonderful production of Every Brilliant Thing at their Poor Mouth Theater (Aiofe Williamson was brilliant herself! ), followed by a rousing traditional Irish music session and a late lunch in the cafe with Paula and Tony.

When we got home at about 6 pm, I made the autolyse, mixed the bread and began the first rise with folds every 30 mins between completing even more charts and reviewing even more labs. (美国节点的加速器 that for every hour seeing patients a doc spends another two in the EMR documenting and such? Welcome to my weekend…)

By 11 pm, I was tuckered out. The bread had finished its second rise and was shaped and proofing in the fridge.

Today, while my bread sat in the fridge gathering its tangy flavor, I was at the hospital by 7 am for grand rounds, followed by a morning full of patients, and more charting, patient calls and meetings in the afternoon.

Home by about 6:30 pm, I set up the Dutch oven to preheat, then scored and baked the bread while we ate a delicious dinner of leftover chili from Saturday night’s dinner. By 10 pm, the bread was cool enough to slice

and for Mr TBTAM to make tomorrow’s lunches before going to bed. I’ll store the rest of the loaf cut side down on the bread board for another day or so, then slice it up and store it in the freezer for the rest of this week’s lunches. If Mr TBTAM doesn’t eat it all tonight….

Bottom line – If you do it right, sourdough bread making can fit into the busiest of schedules. It’s all in the timing.

Over the years, we’ve trash-picked quite a few wonderful items on the streets of New York City, including a lamp, a fan, a painting and a sofa. But this tops them all.

It’s a limited edition, certified Collector’s Guild lithograph of an original Picasso etching entitled Femme Nu de Dos. We found it in a broken old frame lying atop a bunch of trash bags placed for pickup on the street one evening, just as it was starting to rain. I imagine someone was cleaning out a departed loved ones things, saw the broken frame and tossed it out without realizing what it was.

I’m so happy we got to it before the rain did. We reframed it in a new black frame and hung it in the hall, along with the certificate of authenticity we found on the back of the original picture.

Now, this print was not run off by Picasso himself. But it’s the next best thing, having been printed from an original Picasso etching, with Picasso’s signature on the plate. (It’s backwards in the print.) After the artist had used the plate to run off his own limited edition, the Collector’s Guild in America bought the plate and the rights to print from it.

So, while our Femme was not printed by Picasso, she certainly was drawn by him.

When another print from this same Collector’s Guild edition showed up on PBS Antiques Road Show in 2013, admittedly in a much nicer frame, they valued it at $1500.

To me, it’s priceless.

Okay I admit it. I want to be French. And live in both New York and Paris. And spend my days making sourdough bread and amazing food and writing and filming about that. Just like Marie Constantinesco, whose charming web series “My Life in Sourdough” has captured my heart and my imagination.

My Life in Sourdough tells the story of Jeanne, a young French woman living in Brooklyn and traveling back and forth to Paris, who loves to cook and eat (and somehow stays thin). Failing to find love with the men she is dating, Jeanne gives her heart to her sourdough starter Fluffy and finds true love in making bread. Which I totally get, although for me its more like having an affair with my sourdough, since I’ve already found true love. Which may explain why I have yet to name my starter. Which is probably as bad as not naming your first child…

Anyway, each episode of My Life in Sourdough is accompanied by a filmed recipe. And there are tips for sourdough making. And videos with the likes of David Lebowitz. And shots of Parisian cheese shops and markets. I mean, this series has managed to capture five of the things I most dearly love – food, sourdough, bread, NYC, and Paris – in a series of small, beautifully filmed, tiny bites.

I’ve only seen two episodes and a few trailers so far, and am doling them out to myself slowly, to make it last. In between, I’m following Marie on her instagram account and still can’t get enough of vicariously living a life of sourdough, NYC and Paris.

Did I mention I want to be her?

This hummus recipe from Yoman Ottolenghi and Sami Tamini’s Jerusalem cookbook is hands down the best, creamiest hummus I’ve ever made or eaten.

The recipe uses dried chickpeas – which require an overnight soak – so you’ll need to plan ahead, probably the only downside to this amazing recipe. Lest you try to shortcut it, know that I’ve made this recipe with both canned and cooked chickpeas, and can attest that starting with dried chickpeas makes a superior hummus. It’s a lighter color and flavor, much softer and just plain better.

You can tweak the recipe to your taste by making it more or less garlicky or lemony – the recipe as I’ve written it has a bit more lemon and a tad less garlic than Ottolenghi’s original. If you want, you can also add a scant 1/4 tsp cumin, as I have done. Or not. It’s up to you.

Ottolenghi has strong feelings about hummus, which he most adamantly believes should not be made with olive oil. Rather, one reserves the olive oil for drizzling on the hummus when serving. He also recommends only Al Arz or Al Yaman tahini, which I did not use, but intend to order for future hummus making. And thankfully, gives a nod to my added cumin.

In the 国内网络节点加速器 of this basic hummus, Ottolenghi adds bicarbonate of soda during soaking as well as while cooking the chickpeas. For some reason, the Jerusalem Cookbook version (which is what I used) only adds the baking soda during cooking. It’s unclear to me what difference these two approaches would make in the final product, but it is clear that adding baking soda at some point in the cooking process is crucial to getting a soft cooked chickpea.

Deb Perlman argues that peeling the skin from the cooked chickpea makes for an even creamier hummus, so I tried that. She’s right. And it’s not hard – if you truly cook your chickpeas to softness, the skins literally float off into the water. Now you just need to pick them out, and peel an occasional errant unshed skin. If this still seems like to much work, as Deb tells us, you can buy pre-peeled Indian split chickpeas (called Dal), so that’s now on my list to try.

This hummus is so much more than just a place to dip your carrot sticks and pita chips. For instance, you can use it as a bed for lamb and zucchini meatballs. (Recipe modified from this.)

You can find various iterations of this recipe on 美国节点的加速器app Epicurious , the NY Times or the Guardian, but do yourself a favor and just get Jerusalem, the cookbook in which it originally appeared. You’ll get so much more than just an amazing hummus recipe.

JERUSALEM HUMMUS

This makes a rather large batch of hummus (about 3 cups). Feel free to reduce amounts by half if you don’t need so much. I’ve modified the original recipe by adding 1/4 tsp ground cumin, increasing the lemon juice from 4 to 6 tbsp, and cutting back on a clove of garlic. I served it with a scattering of toasted pine nuts, a sprinkle of sumac and a drizzle of olive oil.

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1 ¼ cups dried chickpeas (250 grams)
1 teaspoon baking soda
1 tsp salt
1 cup plus 2 tablespoons light tahini paste (270 grams)
6 tablespoons freshly squeezed lemon juice
3 large cloves garlic, crushed
1 1/2 tsp salt
6 1/2 tbsp ice water
1/4 tsp ground cumin
For garnish
1 tbsp olive oil
1 tbsp toasted pine nuts
1 tsp dried sumac

Instructions
Put chickpeas in a large bowl and cover with cold water at least twice their volume. Leave to soak overnight.

The next day, drain the chickpeas. In a saucepan, combine drained chickpeas and 1 tsp baking soda over high heat. Cook for about 3 minutes, stirring constantly. Add 6 1/2 cups (1.5 liters) water and bring to a boil. Cook at a simmer, skimming off any foam and any skins that float to the surface, till soft. (For me this took almost an hour.) Once done, they should be very tender, breaking easily when pressed between your thumb and finger, almost but not quite mushy.

Drain chickpeas. If you want, pick out and discard the skins, peeling the occasional chickpea as needed (or not). You should have roughly 3 cups of chickpeas. Place chickpeas in a food processor and process until you get a stiff paste. Then, with the machine still running, add the tahini paste, lemon juice, garlic and 1 1/2 teaspoons salt. Slowly drizzle in the ice water and allow it to mix for about 5 minutes, until you get a very smooth and creamy paste. The hummus may seem thin, but don’t worry – it will thicken as it rests.

Transfer hummus to a bowl, cover surface with plastic wrap, and let it rest for at least 30 minutes. If not using immediately, refrigerate until needed, up to two days. Remove from fridge at least 30 minutes before serving. Garnish with pine nuts, olive oil and a bit of dried sumac.

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More on Hummus

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• Yotam Ottolenghi’s Hummus Recipes. Also from the Guardian.
• Food52 has a nice video showing you how to make this hummus. And arguing against the need to peel the skins.
• 有韩国节点的加速器 serves his Ottolenghi hummus with Lamb Meatballs and Pomegranate Molasses
• 加速器怎么选择节点_图文_百度文库:2021-6-21 · 加速器怎么选择节点 不少网游网络加速器用户在下载安装好了网游网络加速器之后， 不懂如何选择节点， 或者选择的节点并没有加速效果，伍下是有关节点选择技巧和一些细节上需要注意的地方， 希望对大家选择节点有点启发，达到最优加速效果。 on the venerable chickpea and hummus making.

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Check out this boule made using Tartine’s Country Bread recipe, the holy grail of sourdough. It’s the first sourdough recipe I ever tried, and now the best I’ve ever made.

For those of you as new to this whole sourdough thing as I was just 6 months ago, Tartine is the bakery run by Chad Robertson in San Francisco, turning out small batches (only 240 loaves a day) of what many say is the best bread you’ll ever taste. Following in the footsteps of bakers like Nancy Silverton at La Brea Bakery in Los Angeles, Chad helped to put artisan sourdough on the map beyond San Francisco. By graciously sharing their expertise, he and others have inspired a whole crop of bakers across the nation and around the world who are making artisan sourdough bread. (Check out this UK local bakery just opened by a 15 year old baker and her dad who make sourdough using a starter “blossomed from a single apple in our garden”.) Add in folks passionate about using locally grown heritage grains to make healthier, more digestible bread (yes, gluten ain’t so bad if you make it right) and you’ve got a movement to bring healthy bread back to the masses.

I’m still in love with Jim Lahey’s No knead yeast bread, and if my time is limited, it’s my go to, never fail me bread. But given a free weekend and time to fold and shape, I’ll be tweaking my sourdough. I can’t wait to see what kind of rise I can get in the warmer weather, and I want to start using heritage grains, adding things like olives and sun dried tomatoes and cheese to my breads, and playing with the starter and leaven to get a sweeter flavor.

From what I’ve seen and am learning, sourdough bread baking is a never-ending journey. So stay tuned.

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Don’t even think of making the bread for the first time using just this blog post. But Robertson’s recipe make two loaves, and I wanted to have my own one-loaf version and also record my experience making this loaf. I’ve also added little tweaks that work in my kitchen, so I’ll remember them next time. (Welcome to sourdough, the perfect bread making technique for those with OCD.)

If you really want to learn how to make this sourdough, you are best off working directly from Chad Robertsons’ book Tartine Bread. If you don’t want that kind of initial investment, the NY Times Tartine Bread recipe is a nice way to start. (That’s how I got hooked.).

To make this loaf, I started the leaven at about 8 am, then packed it loosely in the car to allow it to ripen on the ride and at the cottage (temps were in high 60’s – very low 70’s). After dinner, I mixed the bread and did the first rise and folding for 3 hours. I rested and shaped the dough around 10:30, then placed it in a covered basket in the fridge and went to bed. I heated the oven, scored and baked the bread starting about 7:30 am the next morning.

Make the leaven (Saturday 8am)

• 1 tbsp starter (My starter is fed with sprouted rye)
• 100 grams warm (78 degree) water
• 100 grams of a 50/50 blend whole wheat and bread flour

Disperse the starter in the water with your fingers, then stir in the flour till there are no dry parts. Cover and let rise at a coolish temp overnight or for 8-10 hours. I had temps in the high 60’s to very low 70’s, Robertson recommends 65 degrees.

Mix and first rise (Saturday evening starting about 7 pm)

• 100 grams leaven
• 450 grams white bread flour (I used King Arthur)
• 50 grams whole wheat flour
• 350 grams warm water (80 degrees) + 25 grams more (added with the salt) I used Brita-filtered water from the fridge pitcher + a little warmer water straight from the tap to get it to the right temp.
• 10 grams sea salt

This is a 75% hydration dough. In a large bowl (mine was ceramic), disperse 100 grams leaven in 350 grams of warm water with your fingers. Whisk the flours together and add to the water/leaven till there are no dry bits of flour. It will be quite thick – but not to worry you are adding more water in a bit.

Let dough rest 30 mins. (Robertson says 25 -40 mins). After the rest, lightly stir the salt into the remaining 25 grams of water (it does not need to dissolve) and add to the dough using your fingers. The dough will come apart, then come together again.

First (Bulk) rise

Let rise for 3 hours, covered with a tea towel moistened with warm water after each turn. Every 30 mins give the dough a turn, becoming gentler as the dough becomes more billowy and aerated to avoid pressing out the gases.

Here’s video I made of the amazing Sarah C Owens turning her dough at a sourdough class I took with her on Far Rockaway last month.

When the dough is risen and ready, it’s time to pre-shape, bench rest and final shape it.

Pre-shape, Rest and Final Shaping (10:00 pm)

Pull dough out of bowl onto a very lightly floured surface. Fold the four sides of the dough onto itself, incorporating as little dough as possible into the dough. Roll the dough over, folded side down, and pull it around, tucking it under as you go to make a neat round package with a nice tight skin. Let it rest for 30 minutes to allow the gluten to loosen up for the final shaping,

Now slip the bench knife under the dough, flip it over and shape into a boule shape using a series of folds as you’ve learnt them. An explanation of this is beyond the scope of this post, but here’s a great video that shows pretty much exactly how I pre-shaped and final shaped my dough. (Shaping starts around 2:45 min.)

Using the bench knife, flip the shaped dough seam side up into a pre-floured unlined banneton, cover loosely with plastic wrap and then a tea towel and place in the fridge over night. You can use a cloth lined banneton if you prefer, but you won’t get those nice flour lines.

Score and bake (Sunday 7:30 am)

Preheat a covered dutch oven in an oven set to 500 degrees. Take out and uncover banneton, letting it sit on the counter while the oven preheats. When the oven temp reaches 500 degrees, lightly dust the surface of the dough with rice flour and turn out gently onto a sheet of parchment paper. Score as desired. I used kitchen shears to score this loaf, having left my bread lame (a hand held razor blade thingy) at home in NYC, and was pleased with the results.

Carefully pull the hot dutch oven out and uncover. Holding the parchment paper, gently lower the dough boule scored side up into the dutch oven. Cover, turn the heat down to 450 degrees and bake for 20 mins. Remove the cover and bake another 30 mins.

Lift the bread out of the pot onto a rack to cool. Let the bread sit and sing for at least an hour, and ideally for 2-4 hours before cutting into it.

What I learned from making this loaf

• I can make one loaf of Tartine bread at a time.
• It’s much easier to work with lower than higher hydration dough
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• I may try Jim Lahey’s trick of dusting the bread with wheat bran – it darkens very nicely.
• I LOVE SOURDOUGH!

As promised, here is recipe for the wonderfully delicious potatoes we served with La Cagouille’s Sea Scallops with Warm Vinaigrette. It’s a method of cooking potatoes totally new to me – in a pot on the stove with nothing but butter or olive oil, salt and garlic. So very French, don’t you think? Not to mention, a great tactic if you find yourself without a free oven to roast potatoes, and don’t want to mash them.

The recipe comes from Patricia Well’s Paris Cookbook, where we learn that when you buy first-of-the-season baby potatoes at the 美国节点的加速器app –

Each sack of precious potatoes comes with a tiny bag of the equally noble 免费全球节点加速器 the fine crystals of sea salt that are hand-harvested on the island of Noirmoutier, not far from the Nantes on the Atlantic coast.

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I wish I could say we used Noirmoutier fleur de sel in our potatoes, but sadly we did not. Even more sadly, we had recently used the last of our box of Maldon Sea Salt. This left us with just the Fine Sea Salt we buy from Costco, which for almost any purpose is more than fine. And the potatoes were delicious. But this recipe demands a good finishing salt. I really want to make them again, and I really want to use the eponymous Noirmoutier.

A bit of searching landed me on the website of 加速节点在美国的加速器, a wonderfully tiny store on Hudson street in the West Village that specializes in salt, and which carries Noirmoutier. Now I recall we visited the Meadows a few years back as part of a gastronomic tour of the Village, where I’d purchased a small block of Himalayan Salt that I still haven’t figured out how to grind. (The tiny hand grater I got with it doesn’t really do the trick) I’m pleased to see the place is still in business. On my to-do list now is a trip there to pick up some Noirmoutier salt and a better grater for my pink salt.

In the meantime, feel free to make these potatoes, as we did, with whatever salt you happen to have around.

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This recipe serves 4. We used a mix of olive oil and butter – next time I will try just the butter. Do use the garlic – those soft cloves are a gift. I increased the quantity of garlic from 3 to 4, so everyone gets a clove. By leaving the garlic unpeeled, their flavor does not overwhelm the potatoes.

• 2 pounds baby potatoes (fingerlings or small Yukon gold). Get the very smallest new potatoes you can find, and if not equally sized, cut up larger ones to match the smallest.
• 3 tbsp unsalted butter (or eEVOO)
• 4 plump, fresh cloves of garlic, unpeeled (optional)
• Coarse sea salt to taste
• Fleur de sel

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Cover and cook over lowest possible heat, turning from time to time, until the potatoes are tender when pierced with a fork and are browned in patches. Cooking time will vary depending on the potato size. Those potatoes up there took about 40 minutes, and I ended up turning up the heat just a tad from the lowest possible setting, which for us was practically off.

Using a slotted spoon, transfer the potatoes to a serving bowl. Serve, making sure everyone gets a clove of garlic with their potatoes, passing a small dish of fleur de sel at the table.

Resources

• Salt making on Nourmountier – Includes information about visiting the island.
• The Meadow – This NYC store also sells online. But it’s worth a visit if you’re in NYC.

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This evening, looking for a recipe to enjoy this little spring harvest with more than just my eyes and nose, I picked up one of my favorite cookbooks, The Paris Cookbook. by美国节点的加速器app. I’ve loved Patricia’s books ever since Jeffrey Miller, our wonderful wedding caterer, gave me her Food Lovers Guide to Paris as a gift on our wedding day. It was the perfect gift – our honeymoon was in Paris and Jeffrey knew we were foodies. This past summer, in one of those circle of life moments, Jeffrey happened to cater the wedding of my husband’s cousin’s son – who I had delivered with forceps some 20 odd years ago. (Before you ask, he graduated from MIT – so no harm was done by the forceps…) Anyway, I was hoping Jeffrey would be there for the wedding, but his catering business, which was just getting off the ground when I was married, is now long established and I’m sure he rarely attends the weddings he caters.

But I digress – back to Patricia Wells and The Paris Cookbook. This lovely little cookbook reads like a private tour of Patricia’s Paris – the chefs and restaurants she loves, the food markets and shops she frequents, the regular French folk and the foodie friends she has made over the years. Each recipe has a story and every one of them makes me want to move to Paris.

My chives found their perfect use in 美国节点的加速器 Sea Scallops with Warm Vinaigrette by chef Gerard Allemandou. Its a simple preparation that perfectly balances the richness of the scallops with a barely acidic sherry vinaigrette. Minced chives mingle with parsley and tarragon as a little show of spring.

Patricia recommends serving the scallops with Noirmoutier Potatoes with Fleur de Sel, and that’s what we did. I’ll post that recipe tomorrow.

La Cagouille’s Sea Scallops with Warm Vinaigrette

This recipe serves 4 as a first course and 2 as a main course, which was how we served it. If you want to serve four as a main course, I would increase the scallops to 16 ounces, but not the herbs or vinaigrette, as there will be plenty of both. Ms Wells uses a non-stick pan to saute’ her sea scallops. Not having such a pan, I used a stainless steel skillet with a little olive oil. Slicing the scallops in half horizontally is a nice trick to ensure that the scallops cook through and brown as well. Not to mention it doubles the amount of browned surface one gets to eat!

INGREDIENTS
6 large sea scallops (about 8 ounces total)
Sea salt
Freshly ground pepper
About 2 tbsp finely minced fresh chives
About 2 tbsp minced parsley
About 2 tbsp finely minced chervil or tarragon
Fleur de Sel or fine sea salt
Freshly ground white pepper (I only had black pepper)

The vinaigrette
1 tbsp sherry wine vinegar
Fine sea salt
8 tbsp extra virgin olive oil

DIRECTIONS
Rinse scallops and pat dry. Cut in half horizontally and set aside.

Prepare the vinaigrette: In a small jar, combine the sherry and the sea salt to taste. Cover and shake to dissolve the salt. Add the oil, cover and shake to emulsify. Taste for seasoning and set aside.

Heat 1 tbsp olive oil in a large saute pan. Add scallops and sear until they are just browned around the edges, about 1 minute each side to cooke them through, less if you like them less cooked. Season with salt and pepper after the first side has cooked.

Spoon 1-2 tbsp of vinaigrette and 1/2 tsp herbs onto each warmed dinner plate (I admit I did not warm our plates, but you’ll do that, won’t you?..). Transfer scallop halves to each of the prepared plates. Sprinkle with the remaining herbs. Season with Fleur de Sel and white pepper, and serve.

What do you make when you want something hearty but light? Something that will warm the cockles of your heart but not make you feel stuffed? That will work for a light and early pre-theater dinner after a not so light afternoon lunch with your sister who was just in for the afternoon? (What a treat!)

You make this soup.

The Umami is strong with this one

I love onion soup, but never found it satisfying on its own without being topped with a ton of cheese and bread.

This soup is different. Between the mushrooms, fennel and beef broth, it’s packed with umami. Add some shaved parmesan and you’re in an umami paradise, and satiated beyond what you might have expected from something this light.

What is Umami?

Umami is the so-called fifth taste, imparting a savoriness that harmonizes with other flavors and enhances the deliciousness and satiating effect of foods.

I love this definition of umami – It describes what all good food should do, and exactly how I felt after eating this wonderful soup.

“It’s something that’s kind to the body.. “It’s mild, and, after eating, it’s not heavy on your stomach. It helps you wake up better in the morning. That’s what deliciousness is about. It’s about feeling good after eating.”

The chemical in food responsible for umami is free glutamate, which occurs naturally in certain foods, especially Japanese kelp and seaweed, but also tomatoes, aged cheeses, fish and soy sauces, shrimp and certain other fish. Mothers milk is also rich in glutamate. Food proteins are rich in glutamate, but this glutamate cannot be tasted. However, if you ferment protein, proteolysis frees up the glutamate – so fermented foods are also rich in umami.

5′-Inosinate and 5′-guanylate have also been found to have umami. They are synergistic with glutamate, such that their combination with glutamate is much stronger than any of the the three are individually in triggering umami. It’s why beef broth (an inosinate source) made with glutamate rich foods such as onion, tomato and carrot tastes so much better to us than just plain beef broth.

Dried mushrooms are rich in 5′-guanylate. But soaking them in boiling water, as many recipes dictate, decomposes the guanylate. So soak them in cold water if you want them for umami. (Some argue mushrooms are best soaked in cold water 美国节点的加速器app, but that’s more advance prep than I can do.) Pair them with beef broth or onions to get that umami synergy.

Probably the richest Umami you can get is in the Kombu Dashi – a Japanese broth made from dried seaweed. Typically, dried tuna (bonito), sardine flakes or dried mushrooms are added to the broth – these foods are rich in 5′-Inosinate acid and 5-guanlylate. So Kombu dashi is pure umami.

Salt enhances umami, but only to a point, so don’t over-salt your foods.

Umami rich foods may enhance satiety, as evidenced by the fact that women eating soup enhanced with glutamate eat less at a subsequent meal than those whose soup does not have glutamate. (I can attest to this – this soup filled me so much that I was not hungry for much that entire evening.)

Glutamate rich foods may have other effects beyond mouth taste, mediated via glutamate receptors in the GI tract. For this reason, researchers in Australia are proposing a new category called “alimentary tastes” for newly discovered tastes such as umami and fat.  Given that even the basic tastes of salt and sweet also have actions throughout the body as well as in the mouth, I’m not sure that makes sense. But its an interesting point of view.

What about MSG?

Glutamate is the main ingredient in MSG (monosodium glutamate), a popular food additive.

Unlike natural glutamate-rich food, MSG has gotten a bad rap as a cause of migraine headaches and the so-called “Chinese restaurant syndrome”, though this connection has still not been entirely proven or debunked. In general, I take the approach that more is not necessarily better, and extracting and concentrating any food ingredient is never as good as getting it in its natural form. Plus, I suffer from migraines. So no MSG for me.

One of the strongest arguments against MSG use in my opinion is a recent study showing that use of MSG may attenuate natural umami taste, making eaters less sensitive to detecting the lower levels of natural umami in food.

Go for the Umami

This list of umami-rich foods is a great reference. I for one am going to be referring to it again to find ways to enhance the deliciousness of my foods.

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Carmelized Onion, Fennel and Mushroom Soup

I tweaked a recipe from Farideh Sadighen in Saveur by adding dried mushrooms and their broth (hello, umami…), substituting butter for half the olive oil for caramelizing, and suggest substituting vermouth for white wine. Next time I plan to use a beef broth made with some nice short ribs that I will cut up when cooked and add back to the soup.

Ingredients

• 1 ounce dried porcini mushrooms
• 1 cup water
• 3 tbsp. olive oil
• 2 tbsp butter
• 3 large yellow onions, thinly sliced
• 1 large bulb fennel, halved and thinly sliced lengthwise, fronds reserved
• 2 cloves garlic, minced
• 8 cups beef stock
• 1 lb. mixed mushrooms (I used shitake and crimini, roughly chopped)
• 1⁄4 cup dry white wine or vermouth
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• Shave Parmesan cheese for garnish (optional)

Instructions

Soak the dried mushrooms in 1 cup hot water for 20-30 minutes till softened. (If using cold water, you may need to soak up to 2 hours.) Remove the mushrooms, reserving the soaking liquid, and roughly chop them. Strain the liquid through a paper-towel-lined sieve before using.

In a large saucepan, heat 2 tablespoons olive oil and 2 tbsp butter over medium-high heat. Add the onions and fennel and cook, stirring, until soft and caramelized, about 45 mins to an hour. (I found this post and this video helpful in learning how to caramelize onions.) Add the garlic and cook, stirring, until fragrant, 2 minutes. Pour in the beef and mushroom stocks and bring to a simmer over medium heat.

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Scrape the mushrooms and wine into the soup and cook, stirring, for about 5 minutes. Season the soup with salt and pepper, ladle into bowls, and garnish with some shaved Parmesan and the reserved fennel fronds.

_____________________________________________________________________________________

More on Umami

• The Origin of the word Umami form NPR Science Friday
• Putting the “mmm: back in MSG – on the evolution of MSG from secret ingredient to nasty chemical to chef’s tables
• Two sides of the same coin: Umami and MSG from Stanford Neurosciences
• Umami the Fifth Basic Taste. Great summary of the science of Umami
• Umami as an Alimentary Taste. More on the Science of Umami.

If you want to know my perfect Saturday in NYC, here it is…

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across the West Side to Riverside Park

and the West Side Greenway.

If it’s a cold day in November, dress warmly – scarf, gloves – and don’t let the wind bother you, especially if the sun is out and the wind is keeping the crowds off the Greenway.

It’s just you and the joggers and bikers. And the folks debarking from their cruise ships.

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Turn off the Greenway at 16th St and head under the High Line

to the 免费网络节点加速器 for breakfast.

(An alternative here, if it’s warm enough, would be to park the bikes, pick up coffee to go from Blue Bottle and head up to the High Line to see if you can snag a recliner facing the Hudson. But today you need warmth, so it’s the Grey Dog.)

But wait – Look! There’s a new and marvelous antique garage across the street! What a find!

So much to see!

Wonder where you’d put those bendy manikins (maybe the living room sofa?)

or if the cast iron painted cow is too heavy for the ride home (yes it is).

Text a few pics to your friend Amy, who makes jewelry from found objects, to see if she wants you to buy anything for her. No – unfortunately the bakelite button molds have no holes for stringing. But you promise to see one another soon.

Now you head into the Grey Dog. Your latish start and antiquing detour means there’s a bit of a line. But it moves fast, and the gay couple sitting nearby has a one month old baby, so there’s plenty to ooh and aah about, and before you know it, you’re ensconced at a table with your Cappuccino and avocado, poached egg and salmon salad and the Saturday crossword, which promises to be a bear.

By the time you leave, crossword only halfway done (it is indeed a bear), the line is wrapped all the way to the door. Yep, you gotta go early to the Grey Dog…

Back on the bike, fighting to keep your eyes on the road and not on the gorgeous autumn sky,

your next stop is the Union Square Farmer’s Market. At the market, you pass Linda Rodin, but decide not to stop and pay homage. You are, after all, both New Yorkers. Plus, there was that time you ran into Bill Cunningham at the Union Square Market, and he seemed none too pleased to talk…

In addition to celebrity icons, there are cranberries and apples, of course.

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But mostly you are here to find celeriac, which is technically not a root vegetable though it sure looks like one, for tonight’s soup dinner.

There’s plenty of celeriac to be found, and you exchange soup recipes with the young man selling you yours. His co-worker tells you she eats raw celeriac like an apple, and that you can cook it like a potato if you want to. The most fun part of the farm market is talking with the growers and their staff, and today everyone’s in a talkative mood.

You also grab a honey nut squash to roast for tonight’s salad, along with some greens.

Then it’s back on the bike, to head east to the protected bike lane on First Avenue, then north towards home, with a quick detour to the Fairway on 32nd and 2nd for a slab of ham and some dried peas. It’s always a thrill to drive past the UN building (which looks great after its multiyear renovations),

and you’re pleased to realize that all those long bike rides this past summer have left you with the leg muscles to tackle the hills up to 42nd and 57th streets with nary a break.

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This evening, your friends will be coming over for dinner. You’ll serve said soup with the bread and a salad and then you will all walk to the neighborhood cinema for a movie (Can You Ever Forgive Me? – fabulous!). You’re home well before midnight, early enough to clean up the kitchen together before heading to bed for a well-deserved night’s sleep. Tomorrow is another big day – Chorus sectional in the morning, then brunch and theater with your book club (加速节点在美国的加速器 – I highly recommend it, and I’d see Christine Lahti in anything.)

So there you have it. A perfect Saturday. It doesn’t happen often, but I’m gonna’ do my best to be sure it happens again. And for sure I’m making this soup again.

Hope your Saturday was as fun as mine. What’s your idea of a perfect day?

Split Pea & Celeriac Soup

This is not that thick, meconium like paste most of us think of as pea soup. It’s what pea soup should be –  light, flavorful and satisfying. You don’t puree all the soup, so you get to taste all the individual ingredients, and the peas remind you from whence this soup comes. The celeriac acts like lemon does in a dish – brightens and enhances it. I’ll never make that goopy, heavy stuff again.

The recipe is modified from the Greens Restaurant Cookbook. I adjusted the oil and spices, replaced their croutons with ham and skipped the parmesan topping since I was serving it in the salad. If you’d rather forgo the ham, make the optional croutons at the end of this recipe and pass the Parmesan.

We served this with a salad of arugula, roasted honey nut squash, shaved parmesan, salted red onions and a lemon vinaigrette. And homemade bread.

Serves four to six.

Ingredients

• 1 cup dried green split peas
• 3 tbsp olive oil
• 1 bay leaf
• 1 tsp coarsely chopped fresh rosemary
• 2 garlic cloves, sliced
• 1 large yellow onion, cut into small dice
• 3 inner stalks celery, cut into small dice
• 1 celeriac, trimmed and cut into small cubes
• 1 tsp salt
• Fresh pepper to taste
• 1/2 cup dry white wine (I used a Savignon blanc)
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• 2 cups water
• 5 ounces cooked ham, cut into small cubes (I used smoked Italian ham)
• (Optional croutons) – 2-3 slices white bread, cubed. 4 more tbsp olive oil and a rosemary branch.
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Sift through the peas and pick out any stones or debris. Rinse well, place in a bowl and cover generously with boiling water. Soak for an hour.  (If you have time to soak the peas overnight, no need to boil the water and more power to you. I’ve never had enough foresight to overnight soak anything).

Gradually warm 3 tbsp olive oil in a soup pot with bay leaf and rosemary for about 3 minutes to flavor the oil. Add the garlic and cook over low heat another minute without letting it brown. Add the vegetables, salt and pepper and cook 5 minutes, stirring occasionally, over medium heat.

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Drain the peas and add them to the pot, tossing for a few seconds before adding the stock and the water. Bring to a boil, cover, and simmer until the peas are soft, about 1 1/2 hours.

Blend a few cups of the soup in a blender (or, as I did, transfer it to another smaller pot and puree using an immersion blender). Add the puree back to the soup pot, stir and season again if needed with salt and pepper.

Keep the soup warm while you saute the ham in its own fat in a small frying pan.Serve the soup, passing the sauteed ham around to be added to the bowls of the carnivores at the table.

Croutons and Parmesan for topping (optional for vegetarian version)

Warm 5 tbsp olive oil in a small skillet with a rosemary branch. When the oil is hot and fragrant, remove the rosemary and toss in crouton squares cut from 2-3 slices of white bread. Fry till crisp and golden. Remove to a paper towel to cool.

Save the oil to serve with the soup. Top with croutons and freshly grated parmesan. A little chopped parsely or chervil wouldn’t hurt either.

Leda Derderich wishes she had.

Dederich had stage IV breast cancer diagnosed at age 45, two years after she and her doctor discussed and dismissed the need for a routine screening mammogram while breastfeeding at age 43. That decision to delay screening mammograms may have meant that she lost the chance to find and treat her breast cancer before it had spread beyond the breast. It’s a decision she regrets now, and blames on the confusion around mammogram guidelines.

I have had a much harder time accepting that I was not screened for breast cancer before it was too late. Not because I couldn’t be bothered, was too anxious, or didn’t have health insurance, but because the guidelines for screening women in my age range are one hot mess of a controversy, and I fell through the cracks.

Two years before my diagnosis, when I was 43 years old, I asked my doctor if I should get a mammogram. I had a vague understanding that breast cancer screening protocols were in flux, but I wanted to be sure. My risk profile for the disease was very low. I was nursing my infant daughter, and I really did not want to stick my breasts in a vice grip (it’s not really that bad, but that’s how I was imagining it). My doctor told me that if I didn’t want a mammogram, I didn’t need to get one.

Her counsel was based on a set of widely used guidelines at the time that say having a mammogram is an “individual” decision for women under 50 at average risk for breast cancer. She had no reason to believe I was at risk, and I had no reason to believe I should question her judgement.

What I didn’t know, at the time, was that there are multiple and conflicting breast cancer screening guidelines for women between the ages of 40 to 49.

Dederich is right. There is controversy around what’s best for women in terms of screening mammograms, a controversy that began in 2009 when the US Preventive Services Taskforce rocked our world with their recommendation against knee-jerk, routine mammogram screening in all women between ages 40 and 49.

Now, almost a decade later, the guidelines for mammogram screening still vary, though not as much as you might think. With one notable exception. Allow me to summarize for you.

Screening Mammography Guidelines – Not as Out of Sync as You Think

With some minor differences in wording and nuance, the US Preventive Services Taskforce, American College of Physicians (ACP), American Academy of Family Physicians and 欧洲节点加速器 guidelines in essence recommend that women at average risk for breast cancer be offered mammogram starting at age 40, but make informed, individualized decisions about having mammograms depending on their individual risk, personal values and concerns. The frequency of mammograms, if women choose to have them, varies between one and two years. The American Cancer Society guidelines recommends individualized choice between ages 40 and 45, with all women starting screening at age 45.

Wrapped into those guidelines is the fact that delaying mammograms to age 45 or age 50 accepts a small but real increase in breast cancer deaths – on the order of around 1-2 extra deaths per thousand women. In return for delaying mammograms, women get less false positives and less unnecessary biopsies. It’s estimated that if you have an annual mammogram starting at age 40, you have a 60% chance of a false positive and a 7% chance of having an unnecessary biopsy, compared with a 40% chance of false positive and 5% chance of biopsy if you wait to age 50 to start routine mammos.

Also considered in the guidelines are the fact that mammograms do not prevent breast cancer and do not find all breast cancers at an early, curable stage. They miss about 10% of cancers, and may not detect rapidly growing cancers that arise between routine mammograms and spread beyond the breast almost from the get go. In addition, the cancers mammograms do find may be the slow growing kind that would never kill you anyway, or are not really cancer (we’re talking DCIS), but can lead to surgery, radiation and even mastectomy.

The American College of Radiologists continues to recommend annual mammograms for all women starting at age 40

The one group still recommending routine annual mammograms for all women starting at age 40 (ie, no individual choice) is the American College of Radiology (ACR). The ACR is now 国内网络节点加速器 to re-inform women about mammogram screening, putting their own spin on the data to get their message out to the public that the everyone else’s guidelines are just plain wrong.

Is the ACR right? Should the US medical profession just go back to telling all women to have a mammogram starting at age 40 ? If so, we’d be at odds with most of Europe, where women at average risk of breast cancer are not invited to screening till age 50, and where breast cancer deaths are not higher than those in the United States.

As a compromise, the ACP and ACR in 2012 issued a joint statement on points of agreement designed to ensure that mammograms remain affordable and available to all women starting at 40 who want them regardless of risk. But the differences in recommendations between the ACR and other organizations remains.

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Dederich regrets the decision that she and her doctor made, and feels that she did not have the information she needed to make the right choice for herself.  She feels that because the medical community is conflicted, our patients are confused and therefore misinformed.

Smart, dedicated people are deeply engaged in this issue. But while they compare data sets, grapple with the statistical significance of lives like mine, and churn out conflicting guidelines, far too many women are left confused and misinformed about what is best for our health and long-term survival.

This is exactly why my colleagues and I created Breast Screening Decisions*, a free website and Iphone App designed to help women make an informed decision about screening mammograms. Using BSD, a woman can determine her own risk of breast cancer (which, even among low risk women, is not zero), explore her own personal values around screening, learn about the benefits and harms of screening mammograms, and see for herself what the difference is between starting annual mammograms at 40 vs waiting till 50 or having them every other year vs. annually. There is a real difference in mortality, but it’s small, and we’ve created visuals to help you see it accurately.

Some women don’t care a hoot about false positives or unnecessary biopsies or the fact that their mammogram might detect a cancer that would never kill them but results in them undergoing surgery, even mastectomy. It will all have been worth it if they catch a cancer early. And even if they don’t catch it early, at least they feel they did everything they could have done to do so.

On the other hand, there are women who want to avoid mammograms at all cost. Perhaps they or a loved one had a bad experience with a false positive, or a biopsy that resulted in complications, or they just believe they will not get breast cancer and don’t want the harms of mammography.

What’s important is that women feel they’ve been given the information they need to make the choice that’s right for them.

Decisions are Not Easy

The hard thing about making decisions is that the decision we make today might be different than the one we’d make in hindsight, when we know how those odds we considered actually played out. I try when I can to tell my patients who are making choices to project themselves into future, having either a false positive, DCIS or a breast cancer diagnosis, and ask themselves if they would then regret the choice they are making today, whatever that may be. If their choice remains the same, it’s probably the right choice for them. If not, then they may want to rethink it.

____________________________________________________

* Breast Screening Decisions (BSD) is completely free as well as ad-free, was built using funding from the NIH, and is maintained using private unrestricted institutional donations.  I have no financial interest in BSD. 

More from TBTAM on Mammograms

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• New Mammogram Guidelines – What You Need to Know
• Dense Breasts on Mammogram – No Need to be Afraid

Do you think whoever named the cauliflower plant knew that one day we would evolve into overweight, carbohydrate-overloaded, gluten-intolerant creatures, who, in searching for a suitable lo-carb substitute would find their holy grail in that crucifer whose name is homonymous with the ground product of the very thing we both crave and shun?

Think cauliFLOUR.

Then go grind up a head of cauliflower in the food processor (or be lazy like me and buy Trader Joes riced cauliflower), steam or microwave it for 10 minutes, strain out the liquid in a tea towel, pour into a large bowl and add two egg whites, 1/4 cup hemp or flax seeds, 1/2 low fat grated cheese (Trader Jose’s Lite Mexican Blend works perfectly) and a tbsp of minced fresh herbs (I used thyme, rosemary, basil and oregano). Spread out onto an 8 x12 inch rectangle on a parchment paper-lined baking sheet. Bake it in a 450 degree oven for 15-20 minutes, toss a little more cheese atop and bake 5-10 mins more and Voila! You’ve got a delicious, healthy, low calorie, if somewhat floppy breadstick. I cut mine using a pizza cutter while still warm, and got 32 cracker size pieces at 25 calories apiece. (If you want yours crisper, after cutting them, turn the oven off and put them right back in for 1-2 hours to crisp up as the oven cools down.)

I served these tonight to accompany Cream of Mushroom Soup. The flavors complemented each other well.

In a well done and very interesting study in Lancet Oncology, Danish researchers have identified an association between use of estrogen-containing oral contraceptives in the three months prior to pregnancy or during pregnancy and the risk of childhood leukemia in the offspring of that pregnancy.

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How high is the risk?

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Because the overall risk of leukemias is low (most children do NOT develop leukemia), the actual risk translates to one extra case of leukemia for every 50,000 potentially exposed children, or in Denmark, about 4% of leukemia cases over the 9 years studied.

That’s not a large risk, but it is worth looking at.

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The risk for childhood leukemia was only found for use of estrogen-containing oral contraceptives in the 3 months just prior to pregnancy or during pregnancy. No association was found for non-oral preparations, but there were few cases of these.

No increase in risk was found for ever use of any hormonal contraceptive prior to the 3 months immediately preceding pregnancy.

No risk was found for use of non-estrogen containing hormonal contraception (think the mini-pill, levonorgestrel IUD and Depo-Provera) at any time, even immediately before or during pregnancy.

Is this really true?

Let’s be clear. Association is NOT causation. But it is a signal that warrants further study and a plausible explanation.

In this case there is a biologically plausible mechanism, in that estrogens can inhibit certain enzymes that protect DNA from cancer causing mutations. There are also other proposed mechanisms.

But there could be alternate explanations for the study’s results. For example, what if the mother carries and transmits to her child a genetic predisposition that not only increases the risk of leukemia, but also causes her to have heavy periods that necessitated her use of birth control pills? Or if by chance, in this study, more women with a genetic predisposition happened to take birth control pills? The researchers did not have genetic information on both mother and child, and that’s important.

Results of other studies exploring the birth control pill-leukemia link have been mixed.

So we need further studies.

But still, it begs the question – what should we do until we have the results of these further studies? After all that can take years, and women are getting pregnant now.

What should you do with this information?

What you should NOT do is let this study scare you away from using birth control pills to prevent pregnancy. Oral contraceptives continue to be among the safest, most effective ways to prevent pregnancy. Not to mention their benefits in treating irregular, painful or heavy menses, endometriosis, acne, hirsutism and in some women, PMS.

But until we have further data, I don’t see any harm in playing it safe – which means stopping estrogen-containing hormonal birth control and using either the mini-pill or a barrier method of birth control (such as condoms or diaphragm) in the 3 months prior to attempting pregnancy.  (Theres no reason to change to a long acting method such as Depo-Provera or the IUD for just 3 months.)

If you’re an inconsistent oral contraceptive user worried you may become pregnant due to missed pills, this may be another reason why you may want to change to a more effective method such as the IUD for long term use.

As they say, talk to your doctor.  

With my own patients, I tend to take an “If it’s not broken, don’t fix it” approach to birth control. Which means, if you are happy and healthy using estrogen-containing birth control, don’t let this be a reason to stop using it. But do have a plan for transitioning off when you want to become pregnant.

_______________________________________

References

• Pombo-de-Oliveira MS. Maternal hormonal contraception and childhood leukaemi. Comment. Lancet Oncology 19:10. p1261-1262. Oct 1, 2018.
• Hargreave M, Mørch LS, Andersen KK, Winther JF, Schmiegelow K, Kjaer SK.
  Maternal use of hormonal contraception and risk of childhood leukaemia: a nationwide, population-based cohort study.Lancet Oncology. 2018; (published online Sept 6. http://dx.doi.org/10.1016/S1470-2045(18)30479-0.)