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Progress Report from a Fan

July 08, 2020 1 Comment

Hello Everyone -- and I hope you all had a happy fourth of July -- with plenty of hot dogs at just the right distance!

I had an exceptionally good weekend because I heard from a fan of Susie's Smart Cookie who has been on the Breakfast Cookie diet since the fall of 2017 when Woman's World first wrote about the cookies (and the diet) in their November 20th issue. The fan, Clarence Rife of Houston, Texas, a two-time heart patient, has gone from 280 to 206.5 pounds in those three years and says that he has never felt better. He said that all his doctors are impressed.

He thanked me "for making the best cookie ever" and for "keeping him alive for his grandchildren who are now three and one and a half". 

And I thank Clarence for taking the time to let us know about his success! 

But here's the funny thing. We didn't recognize Clarence as a customer, and it turns out that he isn't! He's been baking the Breakfast Cookies himself from the recipe that Woman's World asked us for when they ran the article.

So here's the recipe for all of you who would like to try it. Clarence's trick is that he bakes 36 -- or three batches -- at a time. I'll post a picture of Clarence as soon as he sends one.

And for all of you who would prefer the convenience of a packaged cookie, use the discount code: hatsofftoclarence to take 10% off your order.

Enjoy this strange Covid summer. Stay well and mask up,

Susie

 

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Lemon Squares with a twist: Flax Seed Meal

June 28, 2020

 I love lemon squares but rarely make them because they seem so totally lacking in nutritional value. (Now you know this about me if you hadn't gathered it already!). But the other day, I wondered what would happen if I added flaxmeal to the crust. Would it detract from the rich, tart lemonyness of these treats? I didn't add much -- I just substituted one quarter of a cup of the flour for one quarter cup of flaxseed meal and the result was every bit as good, better, in my mind. Omega-3 eggs and grass-fed butter also help with the Omega-6/Omega-3 balance.

 

  •  1 3/4  cups/256 grams flour, plus 1/4 cup/32 grams
  • 1/4 cup flaxseed meal
  • ½ cup confectioners' sugar/61 grams, plus 2 teaspoons
  • 1 teaspoon kosher salt
  •  1 cup/227 grams (2 sticks) unsalted butter, melted -- grass-fed, of course
  •  4 eggs, Omega-3 eggs of course
  •  2 cups/400 grams granulated sugar
  • ⅓ cup/80 milliliters lemon juice (from about 1 to 2 lemons)
  • ½ teaspoon baking powder
  • PREPARATION
  1. Heat oven to 350 degrees. In a medium bowl, whisk together 1 3/4 cups flour, flaxseed meal, 1/2 cup confectioners' sugar and salt. Add melted butter and stir to thoroughly combine. Spread with clean hands in an even layer into a 9-by-13-inch pan and bake for 25 minutes.
  2. Meanwhile, in a medium bowl, whisk together eggs, granulated sugar, lemon juice, baking powder and remaining flour. Pour onto the hot baked shell and bake for an additional 20 to 25 minutes, or until just set. Using a small, fine meshed sieve, sift remaining confectioners' sugar on top when cool. Cut into equal bars and eat immediately or store in the fridge.

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The Second paper on Omega-3s and the Immune System -- with particular reference to Covid-19

June 05, 2020

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Omega-3s and a Well-Functioning Immune System

June 02, 2020

Hello dear customers -- and I hope you are all staying well -- and sane,
I have -- with the help of my garden and family and friends -- but every day is a challenge!
I've been thinking about the connection Omega-3s and a healthy immune system ever since the coronavirus came to our shores but until now, I haven't written about it.
Inflammation is a complex response and I didn't want anyone to think that I thought that dealing with coronavirus is as simple as eating a Breakfast Cookie.
I do not.
However Omega-3s DO play key roles in inflammation and they are deficient (or insufficient) in the Western Diet. So when two recent papers appeared in my inbox, I thought I needed to speak out. I have copied and pasted the first of these here so you can be the judge of its import. I will send you the second paper, a commentary, in the next few days.
The bottom line: a healthy amount of Omega-3s in your tissues is more important than ever.
Stay well,
Susie

Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections

by Philip C. Calder 1,Anitra C. Carr 2,Adrian F. Gombart 3 andManfred Eggersdorfer 4,*
1
Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16-6YD, UK
2
Nutrition in Medicine Research Group, Department of Pathology & Biomedical Science, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand
3
Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University, 307 Linus Pauling Science Center, Corvallis, OR 97331, USA
4
Department of Internal Medicine, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(4), 1181; https://doi.org/10.3390/nu12041181
Received: 10 March 2020 / Revised: 14 April 2020 / Accepted: 18 April 2020 / Published: 23 April 2020
(This article belongs to the Section Nutritional Immunology)
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Abstract

Public health practices including handwashing and vaccinations help reduce the spread and impact of infections. Nevertheless, the global burden of infection is high, and additional measures are necessary. Acute respiratory tract infections, for example, were responsible for approximately 2.38 million deaths worldwide in 2016. The role nutrition plays in supporting the immune system is well-established. A wealth of mechanistic and clinical data show that vitamins, including vitamins A, B6, B12, C, D, E, and folate; trace elements, including zinc, iron, selenium, magnesium, and copper; and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid play important and complementary roles in supporting the immune system. Inadequate intake and status of these nutrients are widespread, leading to a decrease in resistance to infections and as a consequence an increase in disease burden. Against this background the following conclusions are made: (1) supplementation with the above micronutrients and omega-3 fatty acids is a safe, effective, and low-cost strategy to help support optimal immune function; (2) supplementation above the Recommended Dietary Allowance (RDA), but within recommended upper safety limits, for specific nutrients such as vitamins C and D is warranted; and (3) public health officials are encouraged to include nutritional strategies in their recommendations to improve public health.
Keywords: immune system; viral infection; influenza; COVID-19; micronutrients; vitamins; omega-3 fatty acids; minerals; vitamin C; vitamin D

1. Introduction

Acute respiratory tract infections are a major cause of morbidity and mortality across the globe, as illustrated by both seasonal influenza epidemics, and the recent outbreak of the coronavirus disease, COVID-19, caused by SARS-CoV-2 infection. The World Health Organization (WHO) estimates that worldwide, seasonal influenza alone results in 3–5 million cases of severe illness that require hospitalization, and 290,000–650,000 deaths annually [1]. In aggregate, acute respiratory tract illnesses were estimated to be responsible for approximately 2.38 million deaths worldwide in 2016 [2,3]. Indeed, severe lower respiratory tract infections were the most common cause of sepsis-related death globally from 1990–2017 [4].
A number of standard public health practices have been developed to help limit the spread and impact of respiratory viruses, such as regular hand washing, avoiding those showing symptoms of infection, and covering coughs [5]. For certain viruses, such as influenza, annual vaccination campaigns designed to prime the immune response in case of exposure exist in many countries. Influenza is caused by a single-stranded RNA virus, and as such exhibits high mutation rates and rapid evolution, which may allow these viruses to escape from pre-existing neutralizing antibodies in the host [6]. Vaccination programs therefore must make predictions each year as to which strains to vaccinate against, with varying degrees of success. In the US, the Centers for Disease Control and Prevention estimate the current year influenza vaccine to be 45% effective for preventing medically attended, laboratory-confirmed influenza virus. This is consistent with estimates from the previous years when the influenza vaccines were antigenically matched to the circulating viruses [7]. Since the 2011–2012 season, vaccine efficacy has ranged from 19%–54% [8].
The immune system is comprised of both the innate (fast, non-antigen specific) and adaptive (slower, antigen-specific) responses. The innate immune system is comprised of physical barriers that help prevent pathogen entry (e.g., skin, gut epithelium), antimicrobial peptides, the complement system, and a variety of phagocytic and other cells (e.g., neutrophils, macrophages, natural killer cells), that recognize the presence of pathogens via the expression of nonspecific pattern-recognition receptors [9]. The innate system moves quickly to recognize and destroy “non-self” threats, typically via inflammatory processes, and then resolve the inflammation and repair the damage caused by these events [9]. However, innate immunity does not increase efficacy or speed of response with repeated exposure to a pathogen. Subsequent to the innate response, the adaptive response is engaged. The adaptive response includes antigen-specific cells, e.g., T lymphocytes, subsets of which coordinate the overall adaptive response or kill virally-infected cells, and B lymphocytes, which can be activated to secrete antibodies specific to the infecting pathogen [9]. While slower to respond than the innate system, the adaptive system is responsible for generating immunological “memory”, whereby a repeated infection with the same pathogen will generate a vigorous, fast antigen-specific response [9]. The induction of immunological memory is the mechanism by which vaccines can provide protection against subsequent pathogen exposure.
Undoubtedly, public hygiene practices and, when available, vaccinations can be effective mechanisms to provide protection against infectious disease. However, vaccines can take years to create, are not available against all viruses (including the current coronavirus SARS-CoV-2), and provide varying levels of protection. The morbidity and mortality numbers cited above highlight the need for additional strategies to support the immune system, in order to reduce the impact of respiratory and other infections.

2. Nutritional Impact on Immunity

Often missing in public health discussions around immunity and infection are nutritional strategies to support optimal function of the immune system. This is surprising, given that the importance that nutrition plays in immune function is well established. Several vitamins, including vitamins A, B6, B12, C, D, E, and folate; and trace elements, including zinc, iron, selenium, magnesium, and copper, play important and complementary roles in supporting both the innate and adaptive immune systems. Deficiencies or suboptimal status in micronutrients negatively affect immune function and can decrease resistance to infections [10,11,12]. Indeed, with the exceptions of vitamin E and magnesium, each of these micronutrients has been granted health claims in the European Union for contributing to the normal function of the immune system [13]. Other nutrients such as omega-3 fatty acids also support an effective immune system, specifically by helping to resolve the inflammatory response [14].
The mechanistic roles that micronutrients play to optimize immune function have been well-described recently [10,12]. Most micronutrients exhibit pleiotropic roles in supporting immune function. With respect to innate immunity, the vitamins and minerals listed above collectively function to support the development and maintenance of physical barriers; production and activity of antimicrobial proteins; growth, differentiation and motility/chemotaxis of innate cells; phagocytic and killing (e.g., oxidative burst) activities of neutrophils and macrophages; and promotion of and recovery from inflammation (e.g., cytokine production and antioxidant activity). They also support adaptive immunity, via lymphocyte differentiation, proliferation and homing; cytokine production; antibody production; and the generation of memory cells. The roles that vitamins C and D play in immunity are particularly well elucidated. Vitamin C affects several aspects of immunity, including supporting epithelial barrier function, growth and function of both innate and adaptive immune cells, white blood cell migration to sites of infection, phagocytosis and microbial killing, and antibody production [10]. Many immune cells have vitamin D receptors that affect their function after ligand binding, and as such vitamin D profoundly influences immunity. For example, it promotes differentiation of monocytes to macrophages and increases their killing capacity; modulates the production of inflammatory cytokines; and supports antigen presentation. Furthermore, vitamin D metabolites appear to regulate production of specific antimicrobial proteins that directly kill pathogens, and thus are likely to help reduce infection including in the lungs [15,16].
As mentioned above, inflammation is a key component of the immune response. This response is caused by a variety of pro-inflammatory mediators, produced by several different types of cells, resulting in the influx of fluid, immune cells, and other mediators that function to eliminate the infection. Inflammation typically resolves quickly at the end of the immune response, due to activation of specific negative-feedback mechanisms. Among these, the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) present at the site of inflammation are enzymatically converted to specialized pro-resolving mediators (SPMs) known as resolvins, protectins, and maresins. These molecules, along with others, function together to orchestrate the resolution of inflammation and to support healing, including in the respiratory tract [14,17]. Notably, nutritional deficiencies in these essential fatty acids can result in delayed or suboptimal resolution of inflammation [17]. This could be very important in the context of severe COVID-19 which manifests as uncontrolled inflammation, the so-called cytokine storm [18,19], linked with acute respiratory distress syndrome (ARDS). A number of the SPMs formed from EPA and DHA have been shown in animal models to both protect against and resolve acute lung injury and ARDS [20,21,22,23,24]. Nutritional formulas containing antioxidants and rich in EPA and DHA have been used in several human trials of patients with ARDS. A recent Cochrane review of these trials identified a significant improvement in blood oxygenation and significant reductions in ventilation requirement, new organ failures, length of stay in the intensive care unit and mortality at 28 days [25]. Taken together, these findings suggest an important role for EPA and DHA in ameliorating inflammation and lung injury, perhaps acting via conversion to SPMs.
It is not surprising, then, that deficiencies and even suboptimal status of these nutrients can impair immune functions. Depending on the deficient nutrient or nutrients, there can be decreases in the numbers of lymphocytes, impairment of phagocytosis and microbial killing by innate immune cells, altered production of cytokines, reduced antibody responses, and even impairments in wound healing [12]. These functional impairments are, presumably, what lead to the clinical immune-related manifestations of deficiency. Indeed, people deficient in vitamin C are susceptible to severe respiratory infections such as pneumonia [10,26]. A recent meta-analysis reported a significant reduction in the risk of pneumonia with vitamin C supplementation, particularly in individuals with low dietary intakes [27]. In older patients, disease severity and risk of death were reduced with supplementation, particularly in the case where initial plasma levels of vitamin C were low [27]. Vitamin C supplementation has also been shown to decrease the duration and severity of upper respiratory tract infections, such as the common cold, and significantly decrease the risk of infection when given prophylactically in people under enhanced physical stress [26,28].
Likewise, vitamin D deficiency increases the risk for respiratory infection. Observational studies report an association between low blood concentrations of 25-hydroxyvitamin D (the major vitamin D metabolite) and susceptibility to acute respiratory tract infections [29,30]. Consistent with these findings, several recent meta-analyses have concluded that vitamin D supplementation can reduce the risk of respiratory tract infections in both children and adults [11,31,32,33,34,35]. In 2017, Martineau and colleagues performed a systematic review and meta-analysis of individual participant data (n = 10,933) from 25 randomized, double blind, placebo controlled trials of vitamin D supplementation with a specified outcome of acute respiratory tract infection (ARI). They found a 12% reduction for experiencing at least one ARI irrespective of dosing schedule [11]. They found a 19% reduction in individuals taking a daily or weekly dose without bolus doses and no benefit with bolus dosing. Among those receiving a daily or weekly dose, they observed a 25% reduction for those with baseline 25(OH)D levels ≥25 nmol/L (12 ng/mL) and a 70% reduction for those with baseline levels <25 nmol/L [23]. They concluded that daily or weekly vitamin D supplementation protected against ARI overall and that it was safe.
Clinical outcomes also demonstrate a role for vitamin E in respiratory tract infections. In a randomized controlled trial of 617 nursing home residents, daily supplementation for one year with 200 IU vitamin E reduced the risk of upper respiratory tract infections, but not lower respiratory tract infections [36]. Vitamin E enhances T cell-mediated immune function in the face of age-related decline [37]. In one study, supplementation of older adults with vitamin E improved natural killer cell activity, neutrophil chemotaxis and phagocytosis, and mitogen-induced lymphocyte proliferation [38]. In a second study, vitamin E supplementation improved T cell-mediated immunity as measured by increased production of antibodies to hepatitis B virus and tetanus vaccines [39].
Finally, marginal zinc deficiency can also impact immunity. Zinc is important for maintenance and development of cells in both the innate and adaptive immune systems. Zinc deficiency results in impaired formation, activation and maturation of lymphocytes, disturbs the intercellular communication via cytokines, and weakens the innate host defense [40,41]. Those deficient in zinc, particularly children, are prone to increased diarrheal and respiratory morbidity [42,43].
Furthermore, data from animal models and epidemiological studies in people indicate that deficiency in specific nutrients, particularly selenium and vitamin E, can lead to reproducible genetic mutations and increased virulence of certain viruses, including coxsackievirus, poliovirus, and murine influenza [44,45]. In a double-blind placebo controlled study, an increase of selenium intake by otherwise healthy subjects with relatively low levels of plasma selenium concentrations improved cellular immunity. Subjects receiving selenium cleared an oral live attenuated poliomyelitis vaccine more rapidly and sequence analysis of the viral genome showed lower numbers of mutations as compared to those receiving the placebo. These data suggest that suboptimal nutrient status in the host population could lead to the emergence of more pathogenic strains of viral diseases, thereby increasing the risks and burdens associated with these illnesses. Given the current situation, it may be beneficial to further pursue this line of investigation.
Optimal intake of all these nutrients ideally would be achieved through the consumption of a well-balanced and diverse diet, but this can be difficult to accomplish for the general population. Indeed, it is generally accepted that nutrient inadequacies and deficiencies are widespread [46,47,48,49,50] (and references therein). Biochemical markers of nutrient status are particularly useful in assessing inadequacy or deficiency, and lead to the conclusion that intakes often are not sufficient. For example, extensive data have been published, using blood 25-hydroxyvitamin D levels to assess vitamin D status. A systematic review involving 195 studies in forty-four countries reported that 37.3% of the studies found mean values lower than 50 nmol/L [51]. The US Institute of Medicine (IOM) committee that reviewed Dietary Reference Intakes (DRI) for vitamin D has suggested that those with concentrations less than this level are at risk for inadequacy, while those with concentrations between 50–75 nmol/L are considered sufficient [52,53]. Interestingly, while the highest vitamin D levels were reported in North America, data from the United States still indicate that 8% of the non-infant population was at risk for vitamin D deficiency, and 17% exhibited concentrations below the 25(OH)D level that is associated with desirable intake [53]. Other studies based on 25(OH)D levels indicate that vitamin D inadequacy or deficiency are also prevalent in Europe and China [54,55,56]. Similarly, a recent systematic review involving 132 studies of serum alpha-tocopherol status indicated that 13% of the values were below the threshold of deficiency (12 mmol/L). Deficiency was noted in the Americas, Asia Pacific, Europe, the Middle East and Africa [57]. The situation with vitamin C is similar. Currently, the most commonly used vitamin C cutoff levels are approximately ≤23–28 µmol/L for hypovitaminosis C and ≤11 µmol/L for deficiency [58]. The evidence indicates that vitamin C insufficiency or deficiency is common in low and middle-income countries (e.g., Mexico, Brazil, India), and not uncommon in high income countries (e.g., US, Singapore, New Zealand), particularly in at-risk subpopulations [53,59,60,61,62,63,64,65,66,67]. Furthermore, the WHO and the Food and Agriculture Organization (FAO) of the United Nations have described that, based on blood markers, vitamin A and iron deficiencies are widespread and of significant global concern [46,49,50]. Status data in the general population or specific subpopulations also reveal inadequacies or deficiencies in various countries, including in developed nations, for vitamins B6, B12, and folate, as well as zinc and selenium [53,59,60,68,69,70,71,72,73]. Finally, a global survey of EPA + DHA status in the blood, from 298 studies, found “low” or “very low” status (i.e., levels associated with increased risk of cardiovascular related mortality) of EPA + DHA in most of the countries assessed [74]. Collectively, the totality of these data strongly suggest that micronutrient and omega-3 inadequacies or deficiencies are prevalent around the globe.
It should also be noted that optimal nutritional support for the immune system can require intakes above the RDA for some micronutrients, while at the same time infections and other stressors can reduce micronutrient status in the body. Vitamin C levels, in particular, decrease during times of infection and higher intakes are required to restore normal blood levels [10,75]. These higher intakes and blood levels are associated with improved clinical outcomes. For example, supplementation of pneumonia patients with ≥200 mg/d vitamin C restored depleted plasma and cellular vitamin C levels, and resulted in decreased respiratory symptom scores and a dose-dependent decrease in hospital length of stay [76,77].

3. Recommendations and Conclusions

Thus, a set of clear nutritional recommendations is needed (Table 1). First, supplementation with micronutrients and omega-3 fatty acids is a safe, effective, and low-cost way to help eliminate nutritional gaps and support optimal immune function, and therefore reduce the risk and consequences of infections [10,12]. Intakes should follow recommended upper safety limits set by expert authorities, such as the European Food Safety Authority and, in the United States, the IOM. Thus, a multivitamin and mineral supplement that supplies the basic micronutrient requirements (e.g., RDA) for vitamins and minerals is recommended in addition to the consumption of a well-balanced diet.
Table 1. Recommended intakes of selected nutrients to support optimal immune function.
Table
Second, we recommend supplementation above the RDA for vitamins C and D. As noted above, recent meta-analyses concluded significant reductions in the risk and impact of both upper and lower respiratory tract infections such as the common cold and pneumonia, including disease severity and risk of death in older patients, with vitamin C supplementation [27,28,79]. Based on this evidence, a daily intake of at least 200 mg/day for healthy individuals is recommended. This level is above the US RDA of 75 and 90 mg/day for female and male adults, respectively [80]. It should be noted that vitamin C requirements depend on health status, and 1–2 g/day are recommended to restore normal blood levels in individuals who are sick, beginning at the onset of symptoms. These levels are within the US tolerable upper limit (TUL) for adults of 2 g/day (note that the upper limit for children aged 1–3 years is 400 mg/day) [80].
Several recent meta-analyses have concluded that vitamin D supplementation reduces the risk of respiratory tract infections in both children and adults [11,31,32,33,34,35]. Protective effects were seen with those receiving daily or weekly vitamin D, but not with less frequent bolus doses [11,32]. A daily intake of 2000 IU (50 µg) is recommended. This is above the US RDA of 400–800 IU (depending on age), but below the TUL for those over 1 year of age (2500–4000 IU) [52].
A third recommendation involves the omega-3 fatty acids EPA and DHA. An adequate intake supports the resolution of inflammation via the production of anti-inflammatory metabolites of these fatty acids, including in the respiratory tract [14,17]. An intake of 250 mg EPA + DHA per day is recommended, consistent with global, regional and national expert recommendations [81,82,83].
Public health practices, such as vaccinations and hygiene measures, are important measures that help limit the spread and impact of infections, including against acute respiratory viruses. However, the present situation with SARS-CoV-2 infection and severe outcomes of COVID-19 and the annual morbidity and mortality figures for respiratory infections overall make it clear that these practices alone are not sufficient. New strains of influenza continuously emerge, necessitating development of new vaccines with varying efficacy, and outbreaks of novel viruses can be enormously difficult to contain. As such, additional safe and cost-effective strategies are needed to support the immune system, and further protect individuals and populations from harm. One compelling strategy is to provide sufficient nutritional support for the immune system. As described above, optimal nutrient intake, including supplementing above the RDA for certain immune-supporting vitamins, promotes optimal immune function, helps to control the impact of infections, and could help limit the emergence of novel, more virulent strains of pathogenic viruses. We, therefore, strongly encourage public health officials to also include nutritional strategies in their arsenal to improve public health and to limit the impact of seasonal and emerging viral infections.

Author Contributions

The outline of the publication was developed with input from all authors based on an expert webinar meeting they held and the conclusions they reached concerning the role of the immune system to reduce risk for infections including viral infections; All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Conflicts of Interest

P.C.C. has research funding from BASF AS and Bayer Consumer Care; acts as an advisor/consultant to BASF AS, DSM, Cargill, Smartfish, Nutrileads, Bayer Consumer Care, and Pfizer (now GSK) Consumer Healthcare; has received reimbursement for travel and/or speaking from Danone, Fresenius Kabi, Baxter, Pfizer (now GSK) Consumer Healthcare, Abbott, Smartfish, Biogredia and the California Walnut Commission; and is President and member of the Board of Directors of the European Branch of the International Life Sciences Institute. A.C.C. has received research funding from Bayer Consumer Care and travel reimbursement from DSM. M.E. acts as an advisor for DSM and received travel reimbursement from DSM. He is member of the Scientific Board of PM International and President of the Gesellschaft für angewandte Vitaminforschung. A.F.G. has received research funding from Bayer Consumer Care and has acted as an advisor/consultant for and has received reimbursement for travel and/or speaking from Bayer Consumer Care.

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Country Rhubarb Cake

May 17, 2020

It's rhubarb season again and my thoughts turn, as always, to finding the perfect rhubarb cake. Something that has that wonderful balance of tart;sweet; and the richness of cake -- and is not too time-consuming to make. I love Melissa Clark's recipe for Rhubarb Upside-Down Cake from the New York Times' Cooking site but it is a real labor of love. So I've  been on the lookout for something a little quicker and simpler. This year, I think I found it. The recipe is also from the New York Times' site and is called a Country Rhubarb Cake. Julia Moskin found it in Reclaiming Ireland's Culinary Heritage, One Roast lamb or Sponge Cake at a Time. And I'm so glad she did! I used Omega-3 eggs to make it, of course, and grass-fed Kerry Butter (from Ireland), and I modified the recipe ever so slightly by replacing one third a cup of the flour with one third a cup of ground flax meal. I'm still searching for the right words to describe the result. Let me start by saying that I couldn't wait to have it again for breakfast. It is a perfectly cheerful dessert -- or breakfast --  for these -- or any times. Stay well. Susie

Time: 1 1/2 hours (but sixty minutes of that is for baking)
Yield: 8 servings
https://cooking.nytimes.com/recipes/1013099-country-rhubarb-cake

INGREDIENTS

2 2/3  cups all-purpose flour, more for work surface

1/3 cup ground flaxseed meal
1/4 teaspoon salt
1 1/4 cup granulated sugar, more for sprinkling
1/2 teaspoon baking soda
1 stick (4 ounces) butter (grass-fed), cut into pieces, at cool room temperature
2 eggs, Omega-3 eggs, of course
1/2 cup buttermilk ( I make this by adding 1/2 tsp vinegar to 1/2 cup milk)
1 1/2 pounds (about 8 stalks) rhubarb, thinly sliced
Light brown sugar and softly whipped cream, for serving

PREPARATION 

Heat over to 350 degrees. In a bowl sift or mix together flour, flax, salt, baking soda and 3 TBS of the sugar. With fingers, rub in the butter until the mixture is sandy. Beat one egg and add to the mixture. Add buttermilk and blend until a dough is formed. (It will be quite stiff and sticky). Turn out onto a floured surface and divide in two. Roll out each piece to fit a 10-inch baking dish. Line bottom of pan with one round allowing it to creep up the sides. 

Cover the dough with the rhubarb and sprinkle the rhubarb with one cup of sugar (don't skimp). Place the second round on the top and pinch together the edges. Pinch together any holes. Beat the remaining egg w. one teaspoon water and brush it on the dough.

Place in a pan or on a baking sheet (to catch the drips) and bake until the crust is golden, about 1 hour. Immediately sprinkle w. granulated sugar and serve warm with a sprinkling of brown sugar and whipped cream. (I forgot to sprinkle the cake with sugar -- and didn't miss it -- and used cream instead of whipped cream.) Delicious!

 

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Sloan Kettering runs on Susie's Smart Breakfast Cookies!

May 12, 2020

Just had to share these pics from Sloan Kettering and Northern Westchester, where the courageous staff are using Susie's Smart Breakfast Cookies as the satisfying (and delicious) meal replacements they were created to be. 

(fyi, I didn't ask for these pics but was so happy to see them. It makes me feel that our company is contributing in some small way to the tremendous effort of fighting the coronavirus.)

If you need a healthy meal replacement during these, or any times, please use the Discount Code Stayhealthy to take 10% off your order. 

Stay healthy,

Susie

Susie 

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Mother's Day in Quarantine

May 11, 2020

A Belated Mother's Day to all those mothers out there who are celebrating at a safe distance from the children they love. I celebrated by making myself a simple but very special dinner of scrambled eggs with just-gathered morels and just-picked asparagus. Yummy and safe, but no substitute in the long-term for real hugs.

The eggs, of course, were Omega-3 eggs which simply means that the chickens that laid these eggs were fed a diet that was rich in Omega-3s and had a good balance of Omega-3s and Omega-6s. Free-range chickens that forage for themselves naturally have an Omega-3 rich diet (think wild greens and insects) but those of us who do not have our own chickens have to make do with commercial eggs, whose layers have been fed a commercially-balanced diet, using flax, canola and sometimes fish meal. The best of these eggs have as many Omega-3s in them as a piece of salmon and are well worth their cost! 

Just thought I'd remind everyone of this everyday and affordable source of Omega-3s on a Mother's Day that we'll never forget.

Stay well,

Susie 

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Beer Bread Made Rich in Omega-3s

April 30, 2020

Hello Everyone -- and I hope that your quarantining is going well.

I know that many people are making bread during these crazy times.

I've been trying to move so haven't had the time -- UNTIL I saw this absurdly easy and quick recipe for Beer Bread in the New York Times. It is as good, toasted, as any English Muffin I've ever had. I used an old bottle of the Jamaican Lager: Red Stripe but think any bland beer would work equally well.

And, of course, I replaced 1/2 cup of the flour with ground flax meal to boost the Omega-3s!

Ingredients:

Unsalted butter, for greasing the pan

cornmeal, for dusting the pan

3 cups all-purpose flour

3 tsp baking powder

1 tsp kosher salt

2 TBS sugar

1 (12 oz) can or bottle beer (the blander the better)

Instructions:

Mix four, baking powder, salt and sugar in a bowl and stir in the beer. Place batter in pan. Bake at 375 degrees for about 35 minutes, or until the top is browned and a tester comes out clean.

Allow to cool completely before slicing and toasting. 

Enjoy and Stay well!

Susie

 

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Shipments of Susie's Smart Breakfast Cookies

April 27, 2020

Hello dear customers -- and I hope you are all continuing to stay well and practice your social distancing.

Michele learned that one of the cancer units at Memorial Sloan Kettering was recently turned into a Covid 19 unit. She has a friend who is a nurse there and told her that they were so busy, they had no time to eat. So now we're sending our Breakfast Cookies to Memorial Sloan Kettering, as well as New York Presbyterian and Northern Westchester Hospital Center on an "as needed" basis. It is the least we can do for the dedicated people who are protecting our health while risking theirs.

Again, please stay well -- and stay sane. We can get through this by working together.

Susie

Remember, if you need a supply of Breakfast Cookies during these unprecedented times, please use the Discount Code: CabinFever! to take 15% off your order.

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Cardamon variation of the Carrot Oatmeal Breakfast Cookie

April 21, 2020 2 Comments

Hello Everyone -- and I hope that you're still staying well -- and sane!

We need patience to get through this. A garden and good walking trails help. Hobbies and music do too.

As soon as I made the Carrot Oatmeal Breakfast Cookies -- and posted the recipe online -- I was eager to make a variation -- using cardamon instead of cinnamon. I loved the way it turned out -- slightly more savory than the cinnamon version -- and hope you do too! 

 

Ingredients:

1 cup honey

2/3 cup canola oil

2 cups grated carrots

2 eggs

3/4 cup flour

1/4 cup ground flaxmeal

2 tsp baking powder

1 tsp ground cardamon (seeds from about 10 pods pulverized in a mortar and pestle)

1/2 tsp nutmeg

1/4 tsp baking soda

1/4 tsp salt

6 cups oats

1 cup raisins

1/2 cup chopped walnuts

Directions:

1 Preheat oven to 375 degrees

2 Combine honey and canola oil in a large bowl. Beat with an electric mixer until creamy. Add carrots, eggs and mix well.

3. Mix flour; baking powder; ground cardamon nutmeg; baking soda and salt together in a large bowl. Add to wet ingredients and mix til well combined.

4. Drop large spoonfuls on a baking sheet and form into scone-like forms

5. Bake until tops are golden about 15 min.

Enjoy

 

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A quick and easy chocolate dessert

April 15, 2020

While quarantining over Easter, I didn't plan ahead for dessert.

When I had a sudden, intense chocolate craving (memories of too many chocolate Easter eggs over the years), I topped a Susie's Smart Cocoa Bite with chocolate sauce and chopped walnuts and heated it up for 30 seconds in the microwave.

Yum.

An emergency dessert for Easter -- or anytime.

Please stay well.

Susie

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Sending Breakfast Cookies to local hospitals

April 10, 2020

Hello dear customers -- and I hope you are all staying well.

Like so many, we've been wondering what we can do to help out in these times -- besides social distancing and staying home.

So we decided to ship cases of Breakfast Cookies to New York Presbyterian; Northern Westchester Hospital; and the Chesire Medical Center in Keene, NH (close to where the cookies are baked) on an "as needed" basis until we are out of the woods. It is the very least we can do for the brave people who are protecting our health and communities.

Please stay well -- and stay sane. We can get through this by working together. 

Susie

If you need a supply of Breakfast Cookies during these challenging times, please use the Discount Code: CabinFever to take 15% off your order.

 

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