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By Barbara Beltrami

As June winds down, parties rev up to celebrate graduations, weddings, showers, reunions and everything in between. While hors d’oeuvres from supermarket and warehouse freezers are wonderful and handy, on a hot day nobody really wants to be stuck sliding trays in and out of an oven while everybody else is playing Marco Polo in the pool. Chips with salsa or guacamole may be the default munchies, but, because they are just that, they’re not fare for special occasions. Here are two recipes for hors d’oeuvres that are special but easy to put together and sure to please your guests. Each has at least one popular ingredient and makes a festive presentation as well as a delicious nibble. Picture bruschette with fresh tomatoes and arugula, ham rolls with melon and radishes and endive leaves stuffed with herbed goat cheese.

Bruschette with Fresh Tomatoes and Arugula

Bruschette with Fresh Tomatoes and Arugula

This is the go-to hors d’oeuvre with or without the arugula in many parts of Italy. It is pronounced “broo-skeh-tay.”

YIELD: Makes 12 bruschette

INGREDIENTS:

2 medium ripe tomatoes, seeded and chopped

12 basil leaves, chopped

Coarse salt and black pepper, to taste

¼ cup extra virgin olive oil

12 fresh arugula leaves

12 slices crusty Italian bread

3 garlic cloves, peeled

DIRECTIONS: In a medium bowl combine tomatoes, basil, salt and pepper. Place mixture in a strainer or colander and let stand at room temperature at least one hour to drain remaining juices. Place back in bowl, add olive oil and mix thoroughly. Preheat broiler, grill or oven. Toast bread until lightly browned and crisp on both sides, 5 to 10 minutes depending on heat temperature. Remove from heat and immediately rub each slice with garlic clove. Heap tomato mixture onto bread and place an arugula leaf on top. Serve warm or at room temperature with a chilled light and dry white wine, prosecco, iced tea, lemonade, beer, cocktails or sparkling water with lemon or lime.

Ham Rolls with Melon and Radishes

This is a takeoff on the ever popular melon and prosciutto. The saltiness of the ham, the sweetness of the melon and the crispness and heat of the radishes complement each other.

YIELD: Makes 18 rolls

INGREDIENTS:

18 very thin slices Virginia or Black Forest ham or prosciutto

18 half-inch-thick sticks cantaloupe or honeydew melon

2/3 cup shredded or finely chopped radishes

½ cup chopped basil

DIRECTIONS: On a tray, platter or board, lay out the ham slices, a few at a time. Place a melon stick at one edge of each slice, sprinkle with radishes and basil and roll tightly, starting at filled edge. If necessary insert one or two toothpicks to hold each roll together. Stack on plate or platter. Cover and refrigerate until ready to serve. Serve with beer, cocktails, rose or Beaujolais wine, sangria, iced tea, lemonade or flavored sparkling water.

Endive Leaves Stuffed with Goat Cheese and Herbs

Endive Leaves Stuffed with Goat Cheese and Herbs

This hors d’oeuvre is good in all seasons but especially in the summer when herbs are freshly picked and have intense flavors.

YIELD: Makes 18 to 24 pieces

INGREDIENTS:

Two endives

One 3- or 4-ounce log plain goat cheese, softened

3 to 4 ounces whipped cream cheese, softened

2 tablespoons cream or milk

¼ cup chopped fresh chives

2 tablespoons chopped fresh thyme

¼ cup chopped Italian flat leaf parsley

Salt and black pepper, to taste

DIRECTIONS: Tear or cut the endive leaves from the head; wash and dry. Arrange on platter. In a medium bowl, beat together the goat cheese, cream cheese, cream, herbs and salt and pepper. Spread mixture evenly among leaves. Cover and refrigerate until ready to serve. Serve with chilled dry white wine, cocktails, iced tea, lemonade, white sangria or chilled sparkling water with lemon or lime.

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By Matthew Kearns, DVM

The weather is warming up and the days are getting longer. This can only mean one thing: kittens, kittens, kittens and more kittens! All these kittens need homes, but care should be taken in introducing them to your home if you have other cats. The two most common diseases that we worry about before introducing cats to our households are the feline leukemia virus (FeLV) and the feline immunodeficiency virus (FIV).

Just to be clear: These viruses are no risk to humans — these viruses are species specific, cat to cat only (even dogs are safe). However, healthy looking kittens could be carrying (and potentially infecting other cats) with these viruses. Also, the prevalence of these viruses is low (both less than 10 percent in multiple studies) in kittens adopted from shelters and rescues.

FeLV and FIV are in a family of viruses called Retroviridae, or retroviruses. All retroviruses have the unique ability to incorporate themselves into the DNA of normal cells. This means once infected, always infected, and the diseases these viruses cause in cats are always fatal. FeLV causes leukemia and other forms of cancer (e.g., lymphoma) as well as suppresses the immune system.

FIV is similar to the human immunodeficiency virus (HIV) in that the virus over time destroys the immune system and the most benign infections eventually become lethal. To compound the problem a kitten or cat may be positive for infection and negative for any symptoms for months or even years.

The nice thing about the tests that are available are that they are point of care tests, or tests that can be run at the shelter/rescue/animal hospital and have results within less than 15 minutes, as well as these tests also rely on antibodies against these viruses.

Kittens that are infected with FeLV or FIV will produce antibodies and test positive long before they start showing signs of disease. The flip side of this equation is there is a lag time between when the kitten was infected and when they produce enough antibodies to produce a positive on the test.

It takes about four weeks after infection to test positive on the test for FeLV and could take three to four months to test positive after infection for FIV. Most kittens are adopted between eight to 10 weeks of age so there is a window where a healthy-looking kitten could be carrying the virus.

Someday we will have effective medications to cure these diseases but, for now, we don’t. The best thing we have is testing and, if positive, isolating the kittens that are positive to reduce the risk of spreading infection.

Make sure that before introducing a new kitten to your household, there is proof that he has been tested. If testing was not done (even if the mother or littermates tested negative), I recommend testing each individual kitten through your own veterinarian before introducing the kitten to your other cats.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

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Gal Gadot tackles the role of Wonder Woman in Warner Brothers new superhero flick. Image courtesy of Warner Bros.

By Daniel Dunaief

Remember those Mad Libs games? You’d insert an adjective, a noun, a verb, adverb, a command, perhaps, into a premade sentence and then you’d read it back, laughing or pondering the combination of words thrown into the structure of a familiar narrative?

Superhero movies, particularly those about the origin of a character we all know, are like a game of Mad Libs. Few superheroes start out life with a cape, a star or a penchant for helping society and standing up against supervillains. Superheroes start out not knowing their fate, or some secret about themselves, and then have to learn the truth along the way.

“Wonder Woman,” the film version from Warner Brothers Studios based on the DC Comics, provides an enjoyable Mad Libs experience, sticking, for the most part, to a familiar structure. The movie, which has been flying high at the box office despite the lack of an invisible plane, executes on its premise well, while offering a few moments of levity scattered through its mix of high-action battle scenes.

Played by the easy-on-the-eyes Gal Gadot, to whom the movie’s other characters react with the kind of awe and attraction the audience might have if they met her, Wonder Woman tells the tale of Diana, the Amazonian princess of Themyscira. We meet her as a young girl, on a picturesque island full of woman who are forever training to fight a battle against man, who may discover their island some day despite remaining hidden from view.

Diana’s mother Hippolyta, played by Connie Nielsen, doesn’t want her daughter to be a warrior, which, of course, means that Diana’s primary focus is on developing her battle skills.

Enter Steve Trevor, an American spy played by Chris Pine, whose plane penetrates the fog that renders the island invisible. Now grown up, Diana races to save Trevor, who crash lands off shore. Trevor, unfortunately, brings an armada of Germans to the beach, where the first of many battles occurs. Diana is determined to end the War to End All Wars by returning to the outside world and fighting an enemy Trevor doesn’t see. While Pine’s Trevor doesn’t understand much about Diana and the island, Diana, in turn, finds the American warrior confounding and slightly amusing.

The interactions between Diana and Trevor throughout the film are amusing, filled with a blend of Trevor’s humorous awe and Diana’s unrelenting sincerity in her quest to end the war.

Complete with the Mad Libs collection of damaged heart-of-gold band of merry men, which fits conveniently into the superhero plot, Diana, Trevor and company seek out the evil General Ludendorff, played by Danny Huston, who seems bent on using a toxin Dr. Maru, Elena Analya, is creating.

The best parts of the film are when Diana, who is unaware of the broader conflict around her, drives the action. She races out of the trenches to try to save a town held by the Germans, followed by the reluctant heroes-despite-themselves band, including Trevor. Movie aficionados have focused on the glass ceiling shattered by director Patty Jenkins, who set a box office record for a movie directed by a woman. Jenkins has blended character development, high energy and an enjoyable script to create a worthwhile comic book movie. Her direction, with battle scenes alternating with the ongoing quest to end the war, kept the pace of the movie. The interaction among the main characters — friend and villain alike — made this Mad Libs origin story a success.

Now playing at local theaters, “Wonder Woman” is rated PG-13 for sequences of violence and action.

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Buddy

MEET BUDDY! Poor, poor Buddy. He once had a family to call his own … until they decided they did not want him anymore. Buddy was surrendered to a high kill shelter in Texas, where he had little chance at survival. Unfortunately, he suffers from a previous injury on his front right leg that healed wrong due to his first owners not getting him the medical attention he needed. With the amount of energy and happiness this guy has, you would never expect him to have had such a rough start to life. That’s all behind him now and he is currently at Kent Animal Shelter looking for his real forever home.

All this handsome boy wants is to just love and be loved. A 3-year-old Australian Cattle Dog mix, Buddy gets along well with other dogs and would prefer to be in a home without children. Buddy comes neutered, microchipped and is up to date on all his vaccines.

Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Buddy and other adoptable pets at Kent, please call 631-727-5731 or visit www.kentanimalshelter.com.

Update: Buddy has been adopted!

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Priya Sridevi with her golden doodle Henry. Photo by Ullas Pedmale

By Daniel Dunaief

Priya Sridevi started out working with plants but has since branched out to study human cancer. Indeed, the research investigator in Cold Spring Harbor Laboratory Cancer Center Director David Tuveson’s lab recently became the project manager for an ambitious effort coordinating cancer research among labs in three countries.

The National Cancer Institute is funding the creation of a Cancer Model Development Center, which supports the establishment of cancer models for pancreatic, breast, colorectal, lung, liver and other upper-gastrointestinal cancers. The models will be available to other interested researchers. Tuveson is leading the collaboration and CSHL Research Director David Spector is a co-principal investigator.

The team plans to create a biobank of organoids, which are three-dimensional models derived from human cancers and which mirror the genetic and cellular characteristics of tumors. Over the next 18 months, labs in Italy, the Netherlands and the United States, at Cold Spring Harbor Laboratory, expect to produce up to 150 organoid models.

The project officially started in January and the labs have been setting up the process through June. Sridevi is working with Hans Clevers of the Hubrecht Institute, who pioneered the development of organoids, and with Vincenzo Corbo and Aldo Scarpa at the University and Hospital Trust of Verona.

Sridevi’s former doctoral advisor Stephen Alexander, a professor of biological sciences at the University of Missouri, said Sridevi has had responsibilities beyond her own research. She was in charge of day-to-day operations in his lab, like ordering and regulatory reporting on radioactive material storage and usage, while he and his wife Hannah Alexander, who was Sridevi’s co-advisor, were on sabbatical. “She is hard working and determined,” said Alexander. “She knows how to get things done.”

In total, the project will likely include 25 people in the three centers. CSHL will hire an additional two or three scientists, including a postdoctoral researcher and a technician, while the Italian and Netherlands groups will also likely add another few scientists to each of their groups.

Each lab will be responsible for specific organoids. Tuveson’s lab, which has done considerable work in creating pancreatic cancer organoids, will create colorectal tumors and a few pancreatic cancer models, while Spector’s lab will create breast cancer organoids.

Clevers’ lab, meanwhile, will be responsible for creating breast and colorectal organoids, and the Italian team will create pancreatic cancer organoids. In addition, each of the teams will try to create organoids for other model systems, in areas like lung, cholangiocarcinomas, stomach cancer, neuroendocrine tumors and other cancers of the gastrointestinal tract.

For those additional cancers, there are no standard operating procedures, so technicians will need to develop new procedures to generate these models, Sridevi said. “We’ll be learning so much more” through those processes, Sridevi added. They might also learn about the dependencies of these cancers during the process of culturing them.

Sridevi was particularly grateful to the patients who donated their cells to these efforts. These patients are making significant contributions to medical research even though they, themselves, likely won’t benefit from these efforts, she said. In the United States, the patient samples will come from Northwell Health and the Tissue Donation Program of Northwell’s Feinstein Institute of Medical Research. “It’s remarkable that so many people are willing to do this,” Sridevi said. “Without them, there is no cancer model.”

Sridevi also appreciates the support of the philanthropists and foundations that provide funds to back these projects. Sridevi came to Tuveson’s lab last year, when she was seeking opportunities to contribute to translational efforts to help patients. She was involved in making drought and salinity resistant rice and transgenic tomato plants in her native India before earning her doctorate at the University of Missouri in Columbia.

Alexander recalled how Sridevi, who was recruited to join another department at the University of Missouri, showed up in his office unannounced and said she wanted to work in his lab. He said his lab was full and that she would have to be a teaching assistant to earn a stipend. He also suggested this wasn’t the optimal way to conduct research for a doctorate in molecular biology, which is a labor-intensive effort. “She was intelligent and determined,” Alexander marveled, adding that she was a teaching assistant seven times and obtained a wealth of knowledge about cell biology.

Sridevi, who lives on campus at CSHL with her husband Ullas Pedmale, an assistant professor at CSHL who studies the mechanisms involved in the response of plants to the environment, said the transition to Long Island was initially difficult after living for six years in San Diego.

“The weather spoiled us,” she said, although they and their goldendoodle Henry have become accustomed to life on Long Island. She appreciates the “wonderful colleagues” she works with who have made the couple feel welcome.

Sridevi believes the efforts she is involved with will play a role in understanding the biology of cancer and therapeutic opportunities researchers can pursue, which is one of the reasons she shifted her attention from plants. In Tuveson’s lab, she said she “feels more closely connected to patients” and is more “directly impacting their therapy.” She said the lab members don’t get to know the patients, but they hope to be involved in designing personalized therapy for them. In the Cancer Model Development Center, the scientists won a subcontract from Leidos Biomedical Research. If the study progresses as the scientists believe it should, it can be extended for another 18 months.

As for her work, Sridevi doesn’t look back on her decision to shift from plants to people. While she enjoyed her initial studies, she said she is “glad she made this transition” to modeling and understanding cancer.

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The ‘Stella d’Oro’ daylily blooms all summer and into the fall. Photo by Ellen Barcel

By Ellen Barcel

This is the final article in a three-part series.

In the past two weeks, we’ve taken a look at plants with the word “lily” in their name that aren’t true lilies and then true lilies. Now, what about daylilies?

The daylily is in the genus Hemerocallis. The flowers of some daylilies are edible and are used in Asian cooking. Hemerocallis are perennials and are grown for their gorgeous flowers, which resemble true lilies. Since, for the most part, the flower opens at sunrise and only lasts until sunset, to be replaced by another the next day, they are commonly called daylilies. In fact, the term Hemerocallis translates as “beauty for a day” from the Greek.

Daylily blooms generally last just a day. You can see the spent flowers above, along with today’s blooms and buds waiting to open.

Daylilies come in a wide variety of colors. There are bi-colors (like ‘Moussaka’ with its white and maroon flowers) and ruffled flowers (like ‘Bestseller’ with its lavender and yellow-green, frilled petals). ‘French Lingerie’ has lavender-pink petals edged in gold.

The American Hemerocallis Society was formed for the perpetuation and study of daylilies. According to the society, Hemerocallis are extremely popular because of their wide variety of shapes, sizes and colors, their drought tolerance and pest and disease resistance. There are varieties that bloom from late spring until autumn and are suited to a wide range of climates.

They are natives of Asia and, as with Easter lilies, were brought to the west around the 1930s. Since then hybridizers have worked to improve them, resulting in the large variety of colors, petal shapes and sizes. Hardiness varies depending on variety with some being extremely hardy and others quite tender. Always check the tag that comes with your plant.

There are literally thousands of daylily cultivars. I’ve read over 80,000 but can’t confirm this number. Daylilies, as their name implies, produce flowers that just last a day but will continue producing flowers for a number of weeks. Since there are so many cultivars, it would be impossible in this column to go into detail about even a few of them, but several come to mind since they are so popular.

Tiger lilies

• Tiger lily (Hemerocallis fulvas) one of several lilies known collectively as tiger lilies. It is native to North America. Tiger lilies can be found growing along the roadside, hence the nickname “Ditch Lily,” as well as in cultivated gardens. They do well in moist soil, which explains why they grow well in ditches where water tends to collect. They are hardy from zones 3 through 9. Like Easter lilies, keep tiger lilies away from cats since it can cause a variety of symptoms including kidney failure.

• ‘Stella d’Oro’ is a compact rebloomer, comes in shades of yellow-gold and forms dense clumps, so dense that it can be used as a ground cover. They bloom practically all summer and into the fall.

• H. ‘Purple d’Oro’ is a dwarf reblooming daylily that looks great planted in clusters as ‘Stella d’Oro.’ It blooms in late spring to late summer and does well in sun and part shade. It comes in shades of dark purple and yellow.

Remember, the easiest way to tell lilies from daylilies is to look at the leaves. True lilies have leaves and flowers on the same stems and the flowers last for many days. Daylilies have flowers on a separate stem and last just a single day. Daylilies, unlike true lilies, have long, slender, fibrous roots and no true bulb. Since daylilies last just for a day, they are usually not used in floral arrangements.

For further information on daylilies, go to The American Hemerocallis Society at www.daylilies.org or lidaylily.org.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.

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By Elof Axel Carlson

Elof Axel Carlson

Science is a way of interpreting the universe in the era in which we live. One of the realities of our lives is that we do not know how much of the world we think we know is really incomplete.

Think of it this way — If you grew up when the American Revolutionary War was being fought, you would not know a lot. You would not know your body is composed of cells. You would not know that heredity is transmitted by genes located on chromosomes present in nuclei of cells because no one knew there were nuclei, chromosomes or genes.

You would also not know there are biochemical pathways that carry out your metabolism in cell organelles because no one then knew there was such a thing as metabolism, biochemical pathways or cell organelles. And you would not know that infectious diseases are associated with bacterial and viral infections nor would you know that your body is regulated by hormones. If you created a time line of scientific findings in the life sciences, the cell theory was introduced in 1838. Cells were named in 1665, but Robert Hooke thought they accounted for the buoyancy of cork bark. He drew them as empty boxes.

When Schleiden and Schwann described cells, they were filled with fluid; and Schwann thought nuclei were crystallizing baby cells being formed in a cell. The cell doctrine (all cells arise from pre-existing cells) did not come until Remak and Virchow presented evidence for it. Mitosis, or cell division, was not worked out until the late 1870s; and meiosis of reproductive cells (sperm and eggs) was not worked out until the 1990s.

Fertilization involving one sperm and one egg was first seen in 1876, while most cell organelles were worked out for their functions and structure after the invention of the electron microscope in the 1930s. There was no organic chemistry before Wöhler synthesized molecules like urea in 1823, and biochemical pathways were not worked out until the 1940s.

DNA was not known to be the chemical composition of genes until 1944, the structure of DNA was worked out in 1953, molecular biology was not named until 1938 and the germ theory was worked out in the 1870s and 1880s by Pasteur and by Koch, who both demonstrated bacteria specific for infectious diseases. Embryology was worked out in 1759 by Wolff, while hormones were first named and found in 1903 by Bayliss and Starling.

What the history of the life sciences reveals is how dependent science is on new tools to investigate life. Microscopes up to 30 power came from Hooke’s efforts in 1665. A better microscope by Leeuwenhoek distinguished living organisms (“animalcules”) at up to 500 power.

It was not until the 1830s that microscopes were able to overcome optical aberrations and not until the 1860s that a stain technology developed to see the contents of cells. This boosted observation to 2000 power. For the mid-20th century, cell fractionation made use of centrifuges and chromatography to separate organelles from their cells and work out their functions.

Experimental biology began in England with Harvey’s study in 1628 of the pumping action of the heart. Harvey was educated in Padua, Italy, where experimental science had been stressed by Galileo and his students who began applying it to the motion of the body relating bones and muscles to their functions. No one alive in 1750 (or earlier) could have predicted DNA, oxidative phosphorylation, the production of oxygen by plants, Mendel’s laws of heredity or the role of insulin in diabetes.

But what about the present? How complete is our knowledge of life processes? Are there major findings in the centuries to come that will make our present understanding look as quaint as reading the scientific literature in the 1700s?

We can describe what we would like to know based on our knowledge of the present and likely to be achievable. We cannot predict what may turn out to be new functions or structures in cells. At best (using what we do know) we can hope to create a synthetic cell that will be indistinguishable from the living cell from which it was chemically constructed. But that assumes the 300 or so genes in a synthetic cell will account for all the activities of the vague cytoplasm in which metabolism takes place.

For the level of viruses there are no such barriers and the polio virus has been synthesized artificially in cell-free test tubes in 2002 (an accomplishment of Eckard Wimmer at Stony Brook University).

Within a few years ongoing studies of bacteria and of yeast cells with artificial chromosomes, may resolve that question for the genome of a eukaryotic cell. I hope that an artificial cytoplasm will be worked out in that effort. That might be more of a challenge than presently assumed.

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Strawberry Layer Cake

By Barbara Beltrami

Here it is the middle of June and finally the weather has caught up with the calendar. Despite all the rain and unseasonably cold weather that descended upon us at the beginning of the month, local strawberries, undaunted, have made their timely appearance, thank goodness.

Like most other fruits and vegetables, our local strawberries are so much more flavorful than the imported ones we get throughout the year. More sweet and juicy, they easily lend themselves to being eaten without any adornment. But if you insist, a little sugar and some heavy cream poured over them suffices. And if you want to make them the focus of a fancier dish, there are always plenty to choose from.

Although there are many who swear that strawberries are good in savory dishes such as strawberry risotto, strawberry-tomato soup, and strawberry-jalapeno-avocado salsa, give me a strawberry layer cake or a strawberry cheese tart with chocolate crumb.

Strawberry Layer Cake

Strawberry Layer Cake

YIELD: Makes 6 to 8 servings

INGREDIENTS:

5 to 6 egg whites (depending on size of eggs)

1/8 teaspoon salt

½ teaspoon cream of tartar

½ cup sifted cake flour

¾ cup sugar, sifted

1 quart strawberries, washed and dried

3 tablespoons sugar

¼ cup orange juice

1 pint heavy cream

¼ cup sugar

½ teaspoon vanilla extract

1 pint strawberry ice cream, slightly softened

DIRECTIONS: Preheat oven to 350 F. Grease a 10- by 5- by 3-inch loaf pan. Beat egg whites until frothy and just stiff enough to form peaks, but not dry; sprinkle salt and cream of tartar over top. Gradually and gently sift in ¾ cup of sugar with flour. Gradually add mixture into egg whites, folding it in as you do so. Turn into ungreased loaf pan and bake for 25 minutes or until done. Invert pan onto rack and let stand for one hour or until cool.

Meanwhile hull and slice half the strawberries (leave the remaining half whole but cut off stems); mash the sliced ones with 3 tablespoons sugar and orange juice. Using an electric mixer or egg beater, whip the cream with ¼ cup sugar and vanilla extract. Slice the cake into three layers; spread the mashed strawberries over one layer, then place second layer over them; spread the strawberry ice cream over that layer and top with the third layer. With a spatula spread the whipped cream over top and sides of cake and place whole strawberries, pointed end up, on top. Serve immediately with hot coffee or tea or ice cold milk.

Strawberry Cheesecake with Chocolate Crumb Crust

Strawberry Cheesecake with Chocolate Crumb Crust

YIELD: Makes 8 servings

INGREDIENTS:

Nonstick cooking spray

¾ stick unsalted butter, melted

1 ounce semisweet baking chocolate

One 9-ounce package chocolate wafers, finely crumbled

One 8-ounce package cream cheese, softened

One 14-ounce can sweetened condensed milk

1/3 cup freshly squeezed lemon juice

1 teaspoon vanilla extract

1 quart fresh strawberries, washed, dried and hulled

1/3 cup melted red currant jelly

DIRECTIONS: Spray a 9-inch pie plate with nonstick cooking spray. In double boiler, melt butter and chocolate. In medium bowl, combine mixture with cookie crumbs. Press into pie plate. Refrigerate for one hour. In another medium bowl, gradually whisk together the cream cheese and milk; add lemon juice and vanilla and stir thoroughly. Pour into chilled pie crust; top with whole strawberries, pointed end up. Brush with jelly. Refrigerate for at least 3 hours before serving with coffee, tea or milk.

Strawberry Margaritas

Strawberry Margaritas

 

YIELD: Makes 4 margaritas

INGREDIENTS:

1 quart fresh strawberries, washed, dried and sliced

2½ cups crushed ice

½ cup freshly squeezed lime juice

¼ cup sugar

5 lime wedges

¼ cup orange liqueur

¼ cup coarsely ground sea salt

4 sprigs of mint

DIRECTIONS: In a blender, combine strawberries, ice, lime juice, sugar and orange liqueur. Pulse until smooth. Rub rim of each glass with a lime wedge, then turn glass upside down and dip in salt to coat. Pour into four cocktail glasses and garnish each glass with a lime wedge and sprig of mint. Serve with pesto crostini, salsa and tortilla chips, a wedge of manchego cheese, tacos, burritos or empanadas.

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LIVING THE BEACH LIFE Jay Gammill of East Setauket captured this image of a piping plover at West Meadow Beach in Stony Brook on May 3. The shorebird, which derives its name from the bell-like whistled peeps it uses for communication, is considered threatened due to human activity, receiving protection under the Endangered Species Act (ESA) in 1985.

Send your Photo of the Week to [email protected].

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Studies show that wine may have heart benefits in well-controlled patients with type 2 diabetes.
Wine — yes, wine — may have benefits

By David Dunaief, M.D.

Dr. David Dunaif

Soda has a lot of sugar, with 39 grams per 12-ounce can. Not surprisingly, soda is associated with increased risk of diabetes. However, the drink with the lowest amount of sugar is wine, red or white. Even more surprising, it may have benefits in reducing complications associated with diabetes. Wine has about 1.2 grams of sugar in five ounces. I know what you’re thinking: These different drinks are based on different quantities; however, per ounce, soda has the most and wine has the least.

Why is this important? Well, it wouldn’t be if diabetes were going the way of the dodo bird. Instead, the prevalence of diabetes has continued to climb over three decades in the United States at an alarmingly rapid rate to its current level of 12 to 14 percent (1). The even scarier news is that more than one-third don’t know they have diabetes. The number of patients with prediabetes (HbA1C of 5.7-6.4 percent) is greater than one in three in this country.

So where do we stand? Only recently did the United States Preventive Services Task Force (USPSTF) and the American Diabetes Association (ADA) converge on screening guidelines. However, originally, the USPSTF recommended that asymptomatic patients not be screened for diabetes since the evidence is inconclusive and screening may not improve mortality. Now they give the evidence a grade of B, which means there is a moderate amount of evidence, not even a grade of A. ADA guidelines suggest testing those who are overweight and who have one or more risk factors for diabetes and all of those who are over 45 (2, 3).

It turns out that, for those with diabetes, cardiovascular risk and severity may not be equal between the sexes. In two trials, women had greater risk than men. In one study, women with diabetes were hospitalized due to heart attacks at a more significant rate than men, though both had substantial increases in risk, 162 percent and 96 percent, respectively (4). This was a retrospective (backward-looking) study. The same result was found in a second study (5). In this meta-analysis (a group of 19 studies), there was a 38 percent greater increased risk of cardiovascular events in women than men. The latter was presented as a poster, not fully published data.

What may reduce risks of disease and/or complications? Fortunately, we are not without options. Several factors may help. These include timing of blood pressure medications, lifestyle modifications (diet and exercise) and wine.

Diet trumps popular drug for prevention

All too often in the medical community, we are guilty of reaching for drugs and either overlooking lifestyle modifications or expecting that patients will fail with them. This is not only disappointing, but it is a disservice; lifestyle changes may be more effective in preventing this disease. In a head-to-head comparison study (Diabetes Prevention Program), diet plus exercise bests metformin for diabetes prevention (7). This study was performed over 15 years of duration in 2,776 participants who were at high risk for diabetes because they were overweight or obese and had elevated sugars.

There were three groups in the study: those receiving a low-fat, low-calorie diet with 15 minutes of moderate cardiovascular exercise; those taking metformin 875 mg twice a day; and a placebo group. Diet and exercise reduced the risk of diabetes by 27 percent, while metformin reduced it by 18 percent over the placebo, both reaching statistical significance. While these are impressive results that speak to the use of lifestyle modification and to metformin, this is not the optimal diabetes diet.

Wine is beneficial, really?

Alcohol in general has mixed results. Wine is no exception. However, the CASCADE trial, a randomized controlled trial, considered the gold standard of studies, shows wine may have heart benefits in well-controlled patients with type 2 diabetes by altering the lipid (cholesterol) profile (6).

Patients were randomized into three groups, each receiving a drink with dinner nightly; one group received five ounces of red wine, another five ounces of white wine, and the control group drank five ounces of water. Those who drank the red wine saw a significant increase in their “good cholesterol” HDL levels, an increase in apolipoprotein A1 (the primary component in HDL) and a decrease in the ratio of total cholesterol-to-HDL levels compared to the water drinking control arm. In other words, there were significant beneficial cardiometabolic changes.

White wine also had beneficial cardiometabolic effects, but not as great as red wine. However, white wine did improve glycemic (sugar) control significantly compared to water, whereas red wine did not. Also, slow metabolizers of alcohol in a combined red and white wine group analysis had better glycemic control than those who drank water. This study had a two-year duration and involved 224 patients. All participants were instructed on how to follow a Mediterranean-type diet.

Does this mean diabetes patients should start drinking wine? Not necessarily, because this is a small, though well-designed, study. Wine does have calories, and these were also well-controlled type 2 diabetes patients who generally were nondrinkers.

Drugs — not diabetes drugs — show good results

In the May 11, 2017 column I wrote that taking blood pressure medications at night may control blood pressure better than only taking these medications in the morning. Well, it turns out this study also shows that taking blood pressure medications has another benefit, lowering the risk of diabetes (8). There was a 57 percent reduction in the risk of developing diabetes in those who took blood pressure medications at night rather than in the morning.

It seems that controlling sleep-time blood pressure is more predictive of risk for diabetes than morning or 48-hour ambulatory blood pressure monitoring. This study had a long duration of almost six years with about 2,000 participants.

The blood pressure medications used in the trial were ACE inhibitors, angiotensin receptor blockers and beta blockers. The first two medications have their effect on the renin-angiotensin-aldosterone system (RAAS) of the kidneys. According to the researchers, the drugs that blocked RAAS in the kidneys had the most powerful effect on preventing diabetes. Furthermore, when sleep systolic (top number) blood pressure was elevated one standard deviation above the mean, there was a 30 percent increased risk of type 2 diabetes. Interestingly, the RAAS blocking drugs are the same drugs that protect kidney function when patients have diabetes.

We need to reverse the trend toward higher diabetes prevalence. Diet and exercise are the first line for prevention. Even a nonideal diet, in comparison to medication, had better results, though medication such as metformin could be used in high-risk patients that were having trouble following the diet. A modest amount of wine, especially red, may have effects that reduce cardiovascular risk. Blood pressure medications taken at night, especially those that block RAAS in the kidneys, may help significantly to prevent diabetes.

References: (1) JAMA 2015;314(10):1021-1029. (2) uspreventiveservicestaskforce.org. (3) Diabetes Care 2015;38(Suppl. 1): S1–S94. (4) Journal of Diabetes and Its Complications 2015;29(5):713-717. (5) EASD 2015; Poster #269. (6) Ann Intern Med. 2015;163(8):569-579. (7) Lancet Diabetes Endocrinol. Online Sept. 11, 2015. (8) Diabetologia. Online Sept. 23, 2015.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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