Orlando Sentinel

Try this enticing new take on bran muffins — in a loaf

Study suggests it’s less of a worry for older adults than previously thought

- By Diane Rossen Worthingto­n Tribune Content Agency

Do you love bran muffins with your morning coffee or tea? It’s often my go-to breakfast on the go. So it was a total delight to discover that bran muffin batter could also be baked in a loaf pan.

My friend had been telling me about this recipe she had culled from a number of other recipes. The first time I tried it, I added too much water and it was what I call a happy accident. The loaf was as moist as could be and lasted four days. It was as good as the first day it was baked.

This reinterpre­ted breakfast favorite

Bran muffin loaf

Makes: (1) 9-by-5-inch loaf

Prep time: 25 minutes

Bake time: 40 minutes

2 cups wheat bran

¾ cup whole wheat flour

1 teaspoon baking powder

1 teaspoon baking soda

½ teaspoon salt

1 ½ cups dark raisins

2 cups water

½ cup buttermilk

½ cup packed light brown sugar

½ cup vegetable oil

1 large egg

1 egg white

1. Preheat the oven to 350 F. Grease and flour a nonstick 9-by-5-inch loaf pan. Reserve.

2. Sprinkle the wheat bran onto a parchment paper lined sheet pan evenly and bake for about 7 minutes or until it begins looks as enticing as a tea loaf. Make sure to toast the wheat bran so it adds an extra depth of flavor. I have tried it with dark or golden raisins, and both work well. The pureed raisins add a sweet addition so less brown sugar is needed. Always checking to see if my tasters agreed, I dropped slices off to a few of my muffin-loving pals. The resounding response was: “When can I have the recipe?”

The good news is that this is simple to prepare. It is now a weekly request by my husband. He likes it for breakfast, and an afternoon snack with coffee or tea and even for a sweet after dinner. Hope you enjoy this.

to lightly brown and smells fragrant. Stir a couple of times to evenly brown it. Cool and reserve.

3. Sift the flour, baking powder, baking soda and salt into a bowl. Reserve.

4. Meanwhile, combine 1 cup raisins and ½ cup of water in a glass measuring cup and microwave for 3 minutes. Let cool slightly.

5. Place softened raisins in a food processor and puree. To the raisin mixture add the remaining 1 ½ cups water, buttermilk, sugar, oil, egg and egg white and process until just blended.

6. Add reserved toasted wheat bran and flour mixture to the food processor and process until well blended. Add the ½ cup raisins and pulse just to combine, making sure not to break up the raisins.

7. Spoon the batter into the prepared loaf pan. Bake for about 40 minutes or until a toothpick comes out clean from the center of the loaf.

By Hannah Herrera Greenspan Chicago Tribune

Q: What should you do if your friend who has been vaccinated stops wearing a mask in public?

A: I like to ask reasonably intelligen­t people questions that might help me better understand their decision-making. So my initial interactio­n would be something like this:

1) “I understand you were recently vaccinated. Is that why you’re no longer wearing a mask in public?” If the response is in the affirmativ­e, I’d ask another question.

2) “Are you under the impression that since you’ve been vaccinated, you are no longer a risk for spreading or contractin­g COVID-19?”

To the second question, my friend might reply, “Yes, I’m vaccinated, so I can’t contract the illness.”

To that I would say, “By getting vaccinated you have significan­tly lowered the possibilit­y that you will contract COVID-19. However, you may already have COVID-19 but are one of those many people who exhibit no symptoms and, despite a vaccinatio­n, you could still be a risk for spreading it.””

— Jay Baglia, associate professor of health communicat­ion at DePaul University’s College of Communicat­ion

A: It’s important to wear a mask to show everyone in the community that you care about protecting them from becoming ill. If that wasn’t convincing enough, I’d try humor: “Your face is lovely, but not lovely enough to die for. Put on a mask!”

— Mercedes Carnethon, vice chair of preventive medicine at Northweste­rn University Feinberg School of Medicine

A few years ago, routine lab tests showed that Susan Glickman Weinberg, then a 65-year-old clinical social worker in Los Angeles, had a hemoglobin A1C reading of 5.8%, barely above normal.

“This is considered prediabete­s,” her internist told her. A1C measures how much sugar has been circulatin­g in the bloodstrea­m over time. If her results reached 6% — still below the number that defines diabetes, which is 6.5% — her doctor said he would recommend the widely prescribed drug metformin.

“The thought that maybe I’d get diabetes was very upsetting,” recalled Weinberg, who as a child had heard relatives talking about it as “this mysterious terrible thing.”

She was already taking two blood pressure medication­s, a statin for cholestero­l and an osteoporos­is drug. Did she really need another prescripti­on? She worried, too, about reports at the time of tainted imported drugs. She wasn’t even sure what prediabete­s meant or how quickly it might become diabetes.

“I felt like patient zero,” she said. “There were a lot of unknowns.”

Now, there are fewer unknowns. A longitudin­al study of older adults, published online recently in the journal JAMA Internal Medicine, provides some answers about the very common in-between condition known as prediabete­s.

The researcher­s found that over several years, older people who were supposedly prediabeti­c were far more likely to have their blood-sugar levels return to normal than to progress to diabetes. And they were no more likely to die during the follow-up period than their peers with normal blood sugar.

“In most older adults, prediabete­s probably shouldn’t be a priority,” said Elizabeth Selvin, an epidemiolo­gist at the Johns Hopkins Bloomberg School of Public Health in Baltimore and the senior author on the study.

Prediabete­s, a condition rarely discussed as recently as 15 years ago, refers to a blood-sugar level that is higher than normal but that has not crossed the threshold into diabetes. It is commonly defined by a hemoglobin A1C reading of 5.7% to 6.4% or a fasting glucose level of 100 to 125 mg/dL; in midlife, it can portend serious health problems.

A diagnosis of prediabete­s means that you are more likely to develop diabetes, and “that leads to downstream illness,” said Dr. Kenneth Lam, a geriatrici­an at the University of California, San Francisco, and an author of an editorial accompanyi­ng the study.

“It damages your kidneys, your eyes and your nerves,” he said. “It causes heart attack and stroke.”

But for an older adult just edging into higher blood sugar levels, it’s a different story. Those fearful consequenc­es take years to develop, and many people in their 70s and 80s will not live long enough to encounter them.

Selvin and her colleagues analyzed the findings of a continuing national study of cardiovasc­ular risk that began in the 1980s. When 3,412 of the participan­ts showed up for their physicals and lab tests between 2011 and 2013, they had reached ages 71 to 90 and did not have diabetes.

Prediabete­s, however, was rampant. Almost three-quarters qualified as prediabeti­c, based on either their A1C or fasting blood glucose levels.

These findings mirrored a 2016 study pointing out that a popular online risk test created by the Centers for Disease Control and Prevention and the American Diabetes Associatio­n — and accessible at doihavepre­diabetes. org — would deem nearly everyone older than 60 as prediabeti­c.

In 2010, a CDC review reported that 9% to 25% of those with an A1C of 5.5% to 6% will develop diabetes over five years; so will 25% to 50% of those with A1C readings of 6% to 6.5%. But those estimates were based on a middle-aged population.

When Selvin and her team looked at what had actually happened to their older prediabeti­c cohort five to six years later, only 8% to 9% had developed diabetes, depending on the definition used.

A much larger group — 13% of those whose A1C level was elevated and 44% of those with prediabeti­c fasting blood glucose — actually saw their readings revert to normal blood sugar levels. (A Swedish study found similar results.)

Sixteen percent to 19% had died, about the same proportion as those without prediabete­s.

“We’re not seeing much risk in these individual­s,” Selvin said. “Older adults can have complex health issues. Those that impair quality of life should be the

focus, not mildly elevated blood glucose.”

Dr. Saeid Shahraz, a health researcher at Tufts Medical Center in Boston and lead author of the 2016 study, praised the new research. “The data is really strong,” he said. “The American Diabetes Associatio­n should do something about this.”

It may, said Dr. Robert Gabbay, ADA’s chief scientific and medical officer.

The organizati­on recommends “at least annual monitoring” for people with prediabete­s, a referral to the lifestyle modificati­on programs shown to decrease health risks and perhaps metformin for those who are obese and younger than 60.

Now, the associatio­n’s Profession­al Practice Committee will review the study, and “it could lead to some adjustment­s in the way we think about things,” Gabbay said. Among older people considered prediabeti­c, “their risk may be smaller than we thought,” he said.

Defenders of the emphasis on treating prediabete­s, which is said to afflict a third of the U.S. population, point out that first-line treatment involves learning healthy behaviors that more Americans should adopt anyway: weight loss, smoking cessation, exercise and healthy eating.

“I’ve had a number of patients diagnosed with prediabete­s, and it’s what motivates them to change,” Gabbay said. “They know what they should be doing, but they need something to kick them into gear.”

Geriatrici­ans tend to disagree. “It’s unprofessi­onal to mislead people, to motivate them by fear of something that’s not actually true,” Lam said. “We’re all tired of having things to be afraid of.”

Weinberg, now 69, sought help from a nutritioni­st, changed her diet to emphasize complex carbohydra­tes and protein, and began walking more and climbing stairs instead of taking elevators. She shed 10 pounds that she didn’t need to lose. Over 18 months, her barely elevated A1C reading fell to 5.6%.

 ??  ??
 ??  ?? JAVIER ZAYAS PHOTOGRAPH­Y/GETTY
JAVIER ZAYAS PHOTOGRAPH­Y/GETTY
 ?? JENNA SCHOENEFEL­D/THE NEW YORK TIMES ?? Susan Weinberg on Feb. 18 at her California home.
JENNA SCHOENEFEL­D/THE NEW YORK TIMES Susan Weinberg on Feb. 18 at her California home.

Newspapers in English

Newspapers from United States