Richard Nixon’s Diet Was Extremely 70s, Even Less Appealing than Trump’s

Much has been said about how our current President eats ketchup with steak—but let’s take today to reflect on the culinary preferences of a past president, one who apparently ate ketchup with cottage cheese for breakfast (I’m not sure which of those is more messed up). With America’s current state of political turmoil leaving our brains more and more warped by each day’s horrors, we often don’t take time to reflect on the fact that plenty of other presidents were, in fact, Not Great either—and Trump certainly isn’t the first commander-in-chief with a questionable diet.

Consider that the fairly innocuous James Garfield apparently loved squirrel soup, while enthusiast of racist policy Andrew Jackson liked a dish called “leather britches” (that actually sounds better than its name suggests). But for now we’ll consider Richard Nixon, who was born on this day in 1913.

Before 45, Nixon was 37, eater of the ketchup curds. While Watergate remains Nixon’s ultimate legacy, let the former President also be remembered for his food habits—some of which are weird, others intriguing, and all of them a distinct look at an era of cottage cheese, meatloaf, and California dreaming.

A typical day in the Nixon White House, according to the Nixon Library, started with fresh fruit, wheat germ, coffee, and yes, cottage cheese topped with ketchup or black pepper. Wheat germ has fallen out of favor compared to more contemporary “healthy” grains like hemp and flaxseeds, but in previous decades, its high fiber content made it the OG buzzy breakfast topping.

Horrors of ketchup aside, cottage cheese was considered an absolute staple in the 1970s. While Henry Haller, former White House executive chef and author of The White House Family Cookbook, personally doubted the ketchup topping, he wrote that the “‘recipe’ became rather popular with the dieting American Public.” For the past many years, cottage cheese’s place in the dairy aisle has been overshadowed by yogurt and sour cream, but its popularity is on the up and up again, so you can imitate those confusing, pseudo-savory Nixon breakfasts to your heart’s content.

The Nixons are said to have loved cottage cheese so much that, on the night of Nixon’s inauguration, a member of the White House kitchen crew had to drive around in search of cottage cheese to satisfy the president’s requested dinner of four steaks and a bowl of cottage cheese.

For lunch, according to The White House Family Cookbook, Nixon opted for cold foods like cucumber mousse, cold poached salmon, and gazpacho. That habit of chilled, meaty foods was very au courant, as the 1970s were a time when gelatin-encased meats called aspics and jiggly fish mousse really got their shine. There was also, apparently, a creation called “spicy pepperoni salad.” Sadly, there aren’t any Nixon-specific recipes for pepperoni salad floating around the internet, but that may be a dish best left to the imagination.

Dinner, for the Nixons, cycled between options like the ever-popular lasagna and spaghetti; boiled corned beef and cabbage; and, once a month, Mrs. Nixon’s meatloaf. Haller says the President’s love of meatloaf was overblown in the media, but once his meatloaf habit was public knowledge, the White House received so many requests for the recipe that it was eventually circulated. The recipe looks… pretty standard, but if there’s anything we can conclude about the 1970s, it’s that people loved cottage cheese and meats shaped in molds.

Dinner is said to have ended with fruits flown in from California and Florida. The Nixon family favorite of “baked grapefruit” seems sort of like a waste of those far-flung fruits, but alas, a different era, one when any and all fruits were cooked to death. The Nixons were from California, so their continued affection for citrus was only natural. Plus, this was right around the time that California cuisine was really finding its footing—Nixon was President from 1969 until his resignation in 1974, and the pioneering restaurant of the genre, Chez Panisse, opened in 1971.

Sometimes food history makes you want to eat the foods of the past; other times, it makes you glad that cooled, gelled meats and cottage cheese are no longer menu staples. That said, if you want a remembrance worthy of the first American President to ever resign, go ahead—glug out a little ketchup on your curds.

The Sad, Stately Photo Of Nixon’s Resignation Lunch : The Salt : NPR

On the day that he announced his resignation, Richard Nixon ordered cottage cheese, pineapple slices and a glass of milk.

Robert Knudsen/Nixon Library

hide caption

toggle caption

Robert Knudsen/Nixon Library

On the day that he announced his resignation, Richard Nixon ordered cottage cheese, pineapple slices and a glass of milk.

Robert Knudsen/Nixon Library

On the quest for cottage cheese trivia this week for my story for Morning Edition, I asked our research department for help. Researcher Barclay Walsh sent me a photo that stopped me in my tracks.

Take a look. Notice the official White House emblem on the plate. The silver platter. The sculpted ball of cottage cheese encircled by slices of pineapple, perhaps canned. The glass of milk.

This is the lunch that President Richard Nixon ate on August 8, 1974, just before going on national television to announce that he was resigning. White House photographer Robert Knudsen captured it on film. The next day, Nixon boarded a plane for California.

By the standards of official White House photography, this image is spare and melancholy, almost shockingly so. Typical White House photography “is so people-focused,” says Jon Fletcher, an archivist at that National Archives who is responsible for the Nixon Administration photographs.

Fletcher could not remember offhand any other photo in the collection that is devoted to food itself. After our conversation, he did a search and came up with a few images from Nixon’s trip to China that featured tables filled with food that had been prepared for the visiting American president.

Those images, though, show occasions of promise and possibility. The pre-resignation meal is the opposite. Ryan Kellman, one of our photographers here at NPR, described it as “so sad, austere, stately, funny.”

It’s a humble meal at the seat of power, just as that power is slipping away. And the person who will eat this food is not in the picture. Soon, he will be gone from this place.

Which president liked ketchup on his cottage cheese? – JanetPanic.com

Which president liked ketchup on his cottage cheese?

Richard Nixon

Which president of the United States liked jelly beans?

President Reagan and his jar of Jelly Bellies. When Ronald Reagan ran for Governor of California in 1966, he began eating “Goelitz Mini Jelly Beans” as part of his successful attempt to give up pipe smoking.

What was Reagan’s favorite jelly bean?

Jelly Belly.” After Ronald Reagan became President in 1981, the general public became aware of his preference for Jelly Belly jelly beans. The company supplied Reagan with Jelly Belly jelly beans during his eight years of presidency.

What was the first flavor of jelly beans?

The original eight flavors of Jelly Belly beans introduced in 1976 were Very Cherry, Root Beer, Cream Soda, Tangerine, Green Apple, Lemon, Licorice and Grape.

Are jelly beans made out of bug poop?

Beetle poop is the secret ingredient that makes jelly beans shiny. The FDA calls this “shellac” and not beetle dump for some strange reason. Shellac is actually found in a lot more candy that just jelly beans like Hershey’s, Milk Duds, Junior Mints, Godiva Chocolate, and the candy everyone loves to hate: candy corn.

Do jelly beans have bug poop on them?

The disgusting fact is that shellac, used on jelly beans, is made from the excrement of beetles. In other words, beetle dung, or bug poop! The raw shellac, which contains bark shavings and lac bug parts, begins to liquefy, and the bark and bug bits are strained out.

What do jelly bean colors mean?

The Jelly Bean Prayer candy (Slogan: “Reaching The World, One Piece at a Time.”) has eight colors, and each represents a religious theme: Black = Sin Red = Jesus’ blood White= Clean Yellow = Heaven Green = Growth Purple = Royalty Pink = Thank you Orange = Lord. Green is for the grass He made.

What is the most common jelly bean?

1. Buttered Popcorn. It’s salty, it’s buttery and it’s officially the most popular jelly bean flavor in the country.

What is America’s favorite jelly bean flavor?

Using a decade of data and polls reaching over 12,000 people, the site has ascertained America’s favorite jelly bean flavors, including the bean that has taken the top spot. This year, buttered popcorn is the clear winner and has pushed last year’s favorite, black licorice, to the number two spot.

What flavor is a pink jelly bean?

strawberry flavor

What flavor is the red jelly bean?

Raspberry is the darkest transparent red with no spots or splashes of color. It can be tricky to differentiate from pomegranates that don’t have spots. Raspberry Jelly Belly jelly beans aren’t overly sweet and have an honest raspberry flavor.

What is the best jelly bean flavor?

Coffee, Watermelon, Root Beer, Cotton Candy and Orange round out the Top 10. California mirrored the national rankings with Cinnamon taking the top spot, followed by Buttered Popcorn. New Yorkers prefer sour jelly beans, but Buttered Popcorn also came in second.

What is the least favorite Jelly Belly flavor?

The popcorn ones taste like vomit. My favorite is either tangerine or cherry. Favourite is either peach or tutti frutti. Least favourite is definitely the buttered popcorn.

Are Jelly Bellys bad for you?

According to Find Any Answer, consuming too many jelly beans can cause several issues such as weight gain and obesity thanks to the amount of sugar in these candies coupled with a higher risk of heart disease, skin issues, and anxiety.

Why are red jelly beans the best ones?

In fact, studies show that just coloring a food red makes it “taste” about 10 percent sweeter. Jelly Belly says it’s crucial that the coloring of their beans perfectly reflects the bean’s flavor. “We want our candy to resemble the real life version of the flavor.

Who first made jelly beans?

William Schrafft

Why does it take a week to make a jelly bean?

It takes 7 to 21 days to make a jelly bean This is poured into bean-shaped starch molds and left to dry overnight. The next day, the starch is removed and the beans go through a steam bath and get sprayed with sugar. Finally, grains of sugar are poured in—this sugar creates the bean’s hard shell.

Why are there black jelly beans?

They’re a flavour enhancer, like salt or monosodium glutamate. The food industry uses black jelly beans as an additive – to make jelly beans taste better. This works because all sensations are experienced in contrast to what’s around them. Click to see full answer.

Can jelly beans kill you?

Here’s the deal: Two of the jelly beans on the stump are poisonous—you’ll die within 30 seconds of eating either one of them. But one of the jelly beans isn’t poisonous and won’t harm you at all.

Are black jelly beans safe to eat?

Black licorice is definitely safe to eat in small amounts. However, it is important to realize that black licorice is more than just candy. It contains glycyrrhizic acid, which can cause swelling and high blood pressure and deplete potassium and other electrolytes that may cause a cardiac arrhythmia or arrest.

Is there a black jelly bean?

YANKEETRADERS OLD FASHIONED BLACK LICORICE JELLY BEANS, 5 Pounds, Bulk.

What are black jelly beans made of?

Black Jelly Beans — an all time Favorite with a classic Black Licorice flavor. Ingredients: Sugar, Corn Syrup, Modified Food Starch (Corn), Cornstarch, Natural and Artificial Flavor, Carnauba Wax, Artificial Color (Red 3, Blue 1, yellow 6, Yellow 5), White Mineral Oil, Beeswax.

Are black jelly beans the same as black licorice?

To be fair: The black jelly beans weren’t to blame as much as the licorice they’re flavored with. Black licorice contains glycyrrhizin, which has been shown to cause high blood pressure and low potassium levels. Try eating the jelly beans that don’t taste of death.

What does a black jelly bean taste like?

What Flavor are Jelly Belly Black Jelly Beans? We currently offer only a single black jelly bean flavor: Licorice.

Amazon.com: Bacon Egg Cheese Salt Pepper Ketchup Breakfast Sandwich Love Premium T-Shirt : Clothing, Shoes & Jewelry

• Solid colors: 100% Cotton; Heather Grey: 90% Cotton, 10% Polyester; All Other Heathers: 58% Cotton, 42% Polyester
• Imported
• Machine Wash
• Great gear for people who love bacon fried or scrambled egg and cheese breakfast sandwich special from deli diner with salt pepper and ketchup. Food staple in New York, New Jersey, Staten Island, Brooklyn, Queens, Long Island or the entire tri state area
• Makes a great gift for your sister, brother, uncle or dad friend who moved down south or to the west coast and can no longer get their coveted bacon, egg and cheese. Hangover cure Apparel
• This premium t-shirt is made of lightweight fine jersey fabric
• Fit: Men’s fit runs small, size up for a looser fit. Women’s fit is true to size, order usual size.

18 Clever Ways to Eat Cottage Cheese — Eat This Not That

Cottage cheese is the “unsung hero of the cheese aisle,” says Palak Patel, chef at the Institute of Culinary Education.

“There’s a lot you can do with it, whether it’s something sweet or something savory,” she says, referencing the mild flavor and versatility of cottage cheese. “And, it’s healthier than a lot of other cheeses.”

Cottage cheese is low in calories, high in protein, and packed with nutrients like calcium. It’s attractive to athletes and a mainstay of high-protein diets like keto, says Malina Malkani, a registered dietitian nutritionist, spokesperson for the Academy of Nutrition and Dietetics, and creator of the Wholitarian Lifestyle. Cottage cheese can help regulate blood pressure and is essential for bone health.

Despite its health properties, cottage cheese has been overshadowed by yogurt in recent years, and many people still see cottage cheese as a diet food straight out of the 1970s. But, as yogurt sales are flattening, cottage cheese (made from separating the curds of pasteurized milk from the whey) is making a comeback.

Though it’s most commonly known as a pairing for fruit, there are so many more ways to enjoy it. Here are 18 creative ways to enjoy cottage cheese, straight from experts.

Shutterstock

The lumpy texture or cottage cheese can be off-putting for some, says Lisa Richards, a nutritionist and creator of the Candida Diet. If you’re looking to avoid those unsettling lumps, she recommends whizzing it through a food processor or blender to smooth it out.

Richards likes to mix 6 ounces of cottage cheese with a teaspoon each of vanilla extract and honey to spread on toast. She often makes extra to store in the fridge.

Courtesy of Palak Patel

Cottage cheese is commonly used in breakfast dishes, like pancakes, especially as people are cutting out white flour or embracing paleo or gluten-free diets, says Patel.

Patel’s banana pancakes recipe includes 1/2 cup of buckwheat flour, 1 tablespoon of baking powder, 1 tablespoon of apple cider vinegar, 1/2 cup of cottage cheese puree, 1 banana, 1 egg, 1 teaspoon vanilla, and 1 cup almond milk. Mix the dry and wet ingredients separately, then combine and let it sit for 10 minutes. Use 1/2 cup to ladle into a nonstick pan.

Shutterstock

Erin Kaese, managing editor of Athletic-Minded Traveler, swears by her “recovery bowl,” which she says she has been eating nearly every day for the past 15 years.

She makes the bowl by combining berries, diced apple, two spoonfuls each of cottage cheese and yogurt, high-fiber cereal and almond milk. She usually enjoys this bowl with a cup of coffee in the early afternoon.

“I love that it has protein, antioxidants, and fiber,” she says. “Most important, I love the taste. It’s food bliss for me.”

Courtesy of Lauren O’Connor

As a spin on the classic “peaches and cream,” Lauren O’Connor, a registered dietitian and owner of Nutri Savvy Health, says her lemon-blueberry swirl pairs cottage cheese with fresh or frozen blueberries, lemon, and honey. The “dessert-worthy treat” can be served as a side, a healthy snack, or on toast. Get the full recipe at Nutri Savvy Health.

Courtesy of Lauren O’Connor

Dips, both sweet and savory, are another natural fit for cottage cheese. O’Connor’s beet and berry dip combines both flavors, using a “double cream” base of cottage cheese and sour cream with balsamic beets and blackberries. Get the full recipe at Nutri Savvy Health.

Courtesy of Palak Patel

Patel says she enjoys making a variety of dips with pureed cottage cheese. A favorite is smoked salmon dip, with 1 cup of cottage cheese pureed in a blender or food processor, 12 ounces of chopped smoked salmon, 1/4 cup of fresh dill, 1 teaspoon dijon mustard, 2 tablespoons capers, juice of half a lemon, kosher salt to taste, and freshly ground black pepper. Combine all ingredients in a large bowl, and serve with cucumbers.

“These are super simple things, and people can just interchange the herbs, interchange what you put in, whether you want to make it vegetarian or if you want it put dried fish, smoked fish, clams, whatever fits your fancy,” Patel says.

Courtesy of Lauren O’Connor

Cottage cheese works well with savory flavors, and adding basil, pine nuts, and olive oil offers a protein-dense, pesto-flavored dish, O’Connor says. Get the full recipe at Nutri Savvy Health.

RELATED: Easy, healthy, 350-calorie recipe ideas you can make at home.

Courtesy of Lauren O’Connor

Small-curd or pureed cottage cheese adds extra creaminess to many different dishes, including potato salad. The addition of cottage cheese boosts the protein levels and lightens up the typically mayonnaise-heavy potato salad, O’Connor says.

She also suggests adding dijon mustard, green onions, celery, cottage cheese, and spices to make a tangy picnic staple with lots of texture. Get the full recipe at Nutri Savvy Health.

Shutterstock

Subbing cottage cheese for mayo makes chicken salad a little healthier, says Laura Licona, executive chef at Fairway Market. The cottage cheese also adds more protein. Add the chicken salad to whole wheat bread for a delicious and easy lunch.

Courtesy of Fit Foodie Finds

Cottage cheese in mac-and-cheese recipes adds creaminess, texture, and richness, while cutting some of the fat and calories that other cheeses contain, Patel says.

For a full recipe for cottage cheese mac and cheese, check out this one we love from Fit Foodie Finds.

Courtesy of Cookie + Kate

Cottage cheese can be used as a swap for ricotta in lots of different dishes, like lasagna or any creamy pasta sauce, Patel says.

For a lasagna recipe using cottage cheese, check out this recipe we love from Cookie + Kate.

Courtesy of Malina Malkani

Cottage cheese adds a creamy texture to soups, Malkani says. Also, a dollop of the cheese can be used as a topping for chili and stews. Malkani’s recipe for cucumber yogurt soup incorporates cottage cheese, yogurt, and crème fraiche for a light and refreshing meal.

Courtesy of Judy Kim

Layering toast with cottage cheese and tomato confit makes a great rustic snack or quick meal, says Judy Kim, a recipe developer who works with Hood Cottage Cheese. An even quicker version uses any prepared tomato sauce that may already be on hand. Get the full recipe here.

Courtesy of Judy Kim

Kim says herbed cheese bites, made with cottage cheese, are perfect for entertaining and are “a flavor bomb full of texture. “

“I like that the cottage cheese marries well with the other ingredients, like the sesame seeds and almonds, to create a lovely toothsome texture,” she says. Get the full recipe here.

Courtesy of Judy Kim

Desserts are a natural fit for cottage cheese, because it’s so often paired with fruit, and its creamy flavor goes well with raspberry compote, Kim says.

“The dessert comes together very quickly if you make the cookie base in advance, perfect for entertaining or on a weeknight,” she says. Get the full recipe here.

Courtesy of Palak Patel

Pairing chocolate and cottage cheese makes an easy no-bake mousse, Patel says.

For her recipe, she uses 1/2 cup of pureed cottage cheese, 1/2 cup of dark chocolate pieces, 1 tablespoon of coconut oil, sea salt, and cinnamon (optional). To make the mousse, melt the chocolate mixed with oil in a microwave-safe dish, add the chocolate to cottage cheese, and chill. Serve it cold, topped with berries, cinnamon, and sea salt.

Courtesy of Well Plated

Patel, who specializes in Indian cuisine, says cottage cheese can be substituted for paneer, a fresh cheese commonly used in Indian cooking. However, cottage cheese needs to be put through a cheesecloth to get rid of its extra moisture. The resulting dried cheese can be served with sautéed onion, garlic, and spices, like cumin and cayenne, and fresh cilantro.

“It’s actually a really great breakfast that we eat in India with scrambled eggs or an omelet,” she says.

You can try making this Tikka Masala recipe from Well Plated by simply swapping out the paneer for cottage cheese.

While there are plenty of cottage cheese products, making your own can be a fun, simple at-home science project, Licona says. She recommends this recipe from Food Network’s Alton Brown.

“It’s like a chemistry project right before your eyes and a cool way to understand the childhood curds and whey nursery rhyme we all grew up with,” Licona says.

HIV-Related CMV Retinitis in the Developing World

By Gabrielle Weiner, Contributing Writer
Interviewing David Heiden, MD, Gary N. Holland, MD, and Jeremy D. Keenan, MD, MPH

Download PDF 

Nearly 34 million people worldwide are currently infected with the human immunodeficiency virus (HIV), and 97 percent of them are in middle- and low-income countries. Ocular complications affect between 50 and 75 percent of these individuals at some point during the course of their illness. These complications include varicella-zoster and herpes simplex virus retinitis, ocular syphilis, ocular tuberculosis, cryptococcal meningitis, ischemic microvasculopathy, and ocular toxic or allergic drug reactions. But, by far, cytomegalovirus (CMV) retinitis is the most significant, causing more bilateral blindness in people with AIDS than any other condition.¹

Despite its profound impact, CMV retinitis is now the neglected disease of the AIDS pandemic, according to David Heiden, MD, at Pacific Eye Associates in San Francisco. Clinically, it usually goes undiagnosed and untreated until there is substantial visual loss. Policywise, it is absent from current World Health Organization (WHO) guidelines for the management of HIV in resource-poor areas. And WHO’s “Vision 2020” program doesn’t even mention CMV retinitis.²

“We have to increase awareness of HIV-associated ophthalmic diseases in the developing world,” said Gary N. Holland, MD, at the David Geffen School of Medicine at UCLA. “In resource-limited settings, the focus has been on improved survival with antiretrovirals, which have been provided to HIV-infected individuals by NGOs [nongovernmental organizations] and governments. There has been no focus on eye disease, yet CMV retinitis is a huge problem, especially in Southeast Asia. CMV retinitis is often not diagnosed until serious, irreversible damage has already occurred,” he continued. “This situation is particularly tragic because vision is essential for survival where people have little help with medical care or activities of daily living.”

Estimated Scope of the Problem

Ironically, although CMV infection is not mentioned in WHO’s policy recommendations, a 2001 review published in the Bulletin of the WHO warned of “an epidemic of blindness,” estimating that between 5 and 25 percent of all HIV-infected patients in the developing world could be expected to develop CMV retinitis.¹

With increased availability of highly active antiretroviral therapy (HAART), those numbers are now an overstatement, according to Dr. Heiden, because only patients with advanced HIV infection and low CD4⁺ counts (less than 50 cells/µL) are vulnerable to CMV retinitis. “But, unfortunately, what we have observed is that about 20 percent of patients in resource-limited settings, even where HIV testing and HAART are readily available, continue to present with advanced HIV infection and vulnerability to CMV retinitis,” he said.

Reported prevalence of CMV retinitis in people living with HIV in resource-limited settings is variable, ranging from less than 5 percent in southern Africa to over 30 percent in Southeast Asia.³ Traditionally, this discrepancy has been attributed to mortality among Africans who die from tuberculosis or other diseases before CMV retinitis can develop. However, recent observations suggest that this hypothesis does not completely explain the discrepancy, and the cause remains unclear.

A recent systematic review found no reduction in the prevalence of CMV retinitis over the past decade.³ “There is a steadily increasing cohort of young patients in middle- and low-income countries made healthy by successful treatment of underlying HIV, yet left permanently blind from undiagnosed or inadequately treated CMV retinitis,” Dr. Heiden said.

Differs From Western Experience

In Western countries, CMV retinitis is now very rare in people living with HIV, though the problem has not disappeared (see the January 2014 feature, “HIV and the Eye: Lessons Learned, Challenges Remain”). In the pre-HAART era, about one-third of patients with AIDS developed CMV retinitis; following the introduction of HAART—as well as widespread testing allowing early detection and treatment of HIV—the incidence of CMV retinitis declined by over 95 percent in the United States.⁴

The experience in high-income countries has led to a mistaken assumption that CMV retinitis will cease to be a major problem in developing countries as HAART slowly makes its way to them. But the current situation there is not analogous to that of Western countries in the pre-HAART era; it’s actually much worse, according to Dr. Holland: “A lot more patients don’t have access to eye care; there’s even more stigma associated with HIV than there was here [in the United States]; and anti-CMV drugs are unavailable.”

Drugs and IRU: a complex interaction. In the 1980s and 1990s, ophthalmologists in high-income countries didn’t have HAART yet, but they did have anti-CMV drugs. Today, in contrast, resource-poor areas are starting to get HAART but not anti-CMV agents. This exacerbates the problem of immune recovery uveitis (IRU).

If an individual has active, undiagnosed CMV retinitis, the infection continues to proliferate unchecked. If that person is diagnosed with HIV disease or finally treated with HAART—but not anti-CMV drugs—CMV will continue to be present even as the immune system recovers. The patient’s recovered immune system mounts an inflammatory response against the CMV in the eye, resulting in IRU.

“If one can limit the amount of CMV in the eye by diagnosing and treating the retinitis early with anti-CMV drugs, especially before immune recovery occurs, then there won’t be as much virus is the eye. Thus, it is likely that not as much inflammation will be stimulated,” said Dr. Holland.

Barriers to Progress 

The fundamentals of successful management of CMV retinitis are screening eye exams in patients with low CD4⁺ counts and effective anti-CMV treatment with ganciclovir and related compounds (valganciclovir), combined with potent antiretroviral therapy.

Resources lacking for diagnosis, treatment. Because CMV infection does not cause redness or pain, everyone with HIV infection requires routine retinal screening. But limited ophthalmological diagnostic skills and lack of accessible CMV treatment in most settings where HAART is available are major roadblocks. Related issues include health care delivery infrastructure and linkage to care. In addition, treatment is prohibitively expensive and may need to be administered using different approaches from those in the United States (i.e., intraocular ganciclovir injections rather than oral valganciclovir).

Overcoming Diagnostic Limitations

Although aggressive ocular screening is crucial, “the scarcity of ophthalmologists is a primary obstacle,” said Jeremy D. Keenan, MD, MPH, at the Proctor Foundation in San Francisco. “HIV providers rarely know how to examine the retina.”

Training HIV doctors to diagnose CMV retinitis. Reliable diagnosis of CMV retinitis can be made by simply dilating the pupil and looking at the retina with an indirect ophthalmoscope, said Dr. Heiden. “The infected retina has a singular, dramatic appearance, with nicknames like ‘cottage cheese and ketchup’ and ‘pizza pie retinopathy,’” he said. “Diagnosis is quick and simple, and no special tests are needed.”

Can HIV doctors be trained to use an indirect ophthalmoscope to diagnose CMV retinitis, instead of relying on an ophthalmologist? “Learning how to do the retinal exam doesn’t take long, and even if the doctor misses 20 percent of cases, we’re still 80 percent ahead of where we were before,” said Dr. Heiden, who has been working on different methods and curricula for teaching simplified eye skills to AIDS doctors in resource-limited settings throughout the world. There have been 16 four-day workshops to date, trying different methods.

Programs in action. In Myanmar, for example, in collaboration with Doctors Without Borders/Médecins Sans Frontières, Dr. Heiden’s team built a CMV retinitis screening program template. (It remains incomplete, however, because of the lack of ophthalmology back-up needed for patients who have complications such as retinal detachment.) The program works at the primary care level and is national in scope. In addition, said Dr. Heiden, “We’ve trained AIDS doctors who staff the infectious diseases hospitals in the three most affected provinces in China, responsible for 117 million people.”

He has also started work in Eastern Europe, the area in which the AIDS epidemic is increasing most rapidly, where “AIDS patients are unable to gain access to ophthalmologists because of AIDS stigma and because some behaviors (drug addiction and sex work) that can lead to infection are criminalized,” he said.

How telemedicine can help. Dr. Keenan is evaluating telemedicine as another way to improve access to screening. “I think HIV doctors recognize the need for routine screening, but there’s a linkage-to-care problem,” said Dr. Keenan. “In addition to training nonophthalmologists as screeners, it’s important to conduct the screening exams at the point of HIV care.”

In Northern Thailand, Dr. Keenan’s team has compared the diagnostic accuracy of indirect ophthalmoscopy by an ophthalmologist with fundus camera photographs taken by a nonclinician and transmitted to three experts in San Francisco and Los Angeles; the results show that telemedicine is feasible and reasonably accurate. “But even if telemedicine can be conducted by a nonclinician in a busy HIV clinic, the expense of currently available cam-eras—between $8,000 and $30,000 for the Topcon camera used in this research—is still a major limitation for retinal telemedicine in resource-poor settings,” explained Dr. Keenan.

iPhone solution. “Thinking outside the box, Todd Margolis [also at the Proctor Foundation in San Francisco] thought that if an iPhone could be adapted to take retinal photographs of sufficient quality, this might provide a much less expensive, and much more portable, option for telemedicine,” Dr. Keenan said.

His team enlisted the help of a biomedical engineer and medical student to develop an iPhone attachment housing an optical system and external illumination. The engineer also developed an app for taking the photos, which provides autofocus and auto-exposure control. This system provides wider-field images than have been obtained with other, currently available cell phone–based techniques; this is an important feature, as CMV retinitis can develop outside the vascular arcades. Its accuracy is now being tested against that of the Topcon camera Figs. 1, 2 to see whether this lower-cost method is feasible. “Certainly, in some cases, the iPhone has provided good enough quality for the diagnosis of CMV retinitis,” said Dr. Keenan, who hopes to have data to share within a year.

Making Treatment More Accessible

Reducing cost of medicine. Improving diagnosis is only half of the equation; treatment must also be within reach. The Medicines Patent Pool (MPP) is an international NGO that aims to make HIV treatment more affordable throughout the world by means of agreements with pharmaceutical companies. In August 2013, Roche, the manufacturer of valganciclovir—the easy-to-take oral anti-CMV agent—reached a supply agreement with the  MPP to increase access to the drug by making it up to 90 percent cheaper in 138 developing and emerging countries.⁵ “Unfortunately, the cost is still a barrier, but it’s a start,” said Dr. Heiden.

An intraocular alternative. In the meantime, he relies on the far less expensive ganciclovir intraocular injections and has trained a limited number of HIV doctors to administer these injections. “The injections are not technically demanding to teach or do—easier than starting an IV—but there are fundamental medical reasons why they are inadequate,” said Dr. Heiden. These problems include second-eye involvement and extraocular disease, he added. “Also, for obvious practical reasons, weekly intraocular injection is a much more difficult treatment strategy to reach all those in need of treatment, when compared with pills.”

Keys to Success

Regular screening for CMV retinitis in HIV-positive patients is the most effective way to reduce the blinding complications of the infection. “If we could achieve early diagnosis,” said Dr. Keenan, “we have all the knowledge we need to treat the retinitis effectively. We need to make screening the norm, then increase accessibility to anti-CMV medications.”

“We also need to focus on preventing the inflammatory damage that comes with immune recovery uveitis,” Dr. Holland added. “Getting patients through that period of immune recovery without more eye problems also relies on early diagnosis.”

___________________________

1 Kestelyn PG, Cunningham ET. Bull World Health Organ. 2001;79(3):208-213.

2 Heiden D et al. PLoS Med. 2007;4(12):e334. doi:10.1371/journal.pmed.0040334.

3 McCannel CA et al. Am J Ophthalmol. 1996;121(1):35-46.

4 Ford N et al. Clin Infect Dis. 2013;57(9):1351-1361.

5 Roche and the Medicines Patent Pool Sign Agreement [press release].

___________________________

David Heiden, MD, is a uveitis consultant and general ophthalmologist at Pacific Eye Associates and director of international ophthalmology at California Pacific Medical Center, in San Francisco; and medical director, AIDS Eye Initiative, Seva Foundation, in Berkeley, Calif. Financial disclosure: None.

Gary N. Holland, MD, is Jack H. Skirball Professor of Ocular Inflammatory Diseases at the David Geffen School of Medicine at University of California, Los Angeles. Financial disclosure: Is a member of medical advisory boards for Novartis and XOMA.

Jeremy D. Keenan, MD, MPH, is associate professor in residence at the Francis I. Proctor Foundation of University of California, San Francisco. Financial disclosure: None.

Cottage Cheese, Ketchup and The Family Proclamation – Cranial Hiccups

 My sister Wendy, before my time.

My only sister is ten years older than me. She left home at a young age, so during most of my childhood I described myself as an only child. I wasn’t disowning her or anything, that’s just how life felt.

Growing up, my mother assumed the ten year gap between Wendy and I was too much to bridge and did little to encourage bonding between us. Quite the opposite in fact. To add to the rift, my sister (who’s grown up nicely, by the way) was a cantankerous teenager. There was no way to relate to her in a positive way. I did try. Eventually I figured out I could either ignore her or tease her.

Being the angelic girl I was [insert angelic choir singing here] you can guess which way I went.

For example, when I was in the fourth grade I developed a taste for cottage cheese mixed with ketchup. I’d stir the two together until it looked like a concoction from Fear Factor.

I thought it was delicious.

My sister’s word for it was “disgusting.”

She was pretty dramatic about it too. Every time I’d have some she’d go on about how gross it was. I made a big show of each bite. Her reaction to my taunting did not disappoint. Months after I lost enthusiasm for this culinary delight I continued to request it just to get a rise out of my sister.

Like I said, angelic.

Fortunately, my sister and I are a lot closer now. She’s responsible, is a good listener, and knows just when I need a dose of big sisterly advice.

But we both feel like we missed out on something when we were younger. Buying birthday cards is a challenge, what with all their talk of “secrets we shared” and “laughs we had.”

We don’t have those kinds of memories.

Now, if Hallmark would make a card praising the torturous joy of ketchup and cottage cheese, we’d be in business.

Years later, when Wendy had her two sons, they’d bicker and get on each others nerves like brothers sometimes do. When the oldest would complain that his younger brother was bothering him, my sister would reply, “Well, that’s what younger brothers are for.”

I’d cringe every time I heard this.

She laughed when she said it, but she really meant it. Over the years her children acted more and more like the great purpose of one sibling is to pester the other.

In all fairness, my sister came by this philosophy honestly. I’m not sure I would feel any differently if it weren’t for watching my husband and his brother. I was surprised to discover just how deep the sibling relationship can be.

These two were tight. More than brothers. They were best friends.

When it came time for me to start a family, I made a conscious choice. I wanted my children to be close.

When I was pregnant with my second son (I have three boys, each two years apart), I prayed again and again for Heavenly Father to send my first son a friend. I have a testimony that he did. I’ve shared this with my children countless times.

From the time my children were born we encouraged a sense of belonging. The new baby didn’t just belong to mom and dad. The new baby belonged to big brother too. We encouraged them to play together. To have fun together. To comfort each other if someone got hurt or was sad. To share toys and treats. To be willing to help each other. To remember that while it’s good and important to have friends, that their brothers are their best friends.

I’ve said this over and over again.

I believe it.

So do my children.

I remember once asking my oldest child, “What’s your favorite toy?”

In all seriousness he replied, “My brothers.”

My boys playing in the rain.

Of course, it’s not all sunshine and lollipops over here. I’ve broken up my fair share of arguments and I’ve resorted to banning my children to separate rooms because I could not stand the bickering for one…more…second.

They’re children and just as likely to get on each others nerves as they are to get on mine.

Still, at the heart of it all, the foundation of their relationship is love, compassion and friendship.

Disputes come and go. Love remains.

I believe that’s what’s meant by that line in The Family Proclamation, the one that tells parents that among our many duties includes the responsibility to teach children to love and serve one another.

I don’t think we do that with Family Home Evenings or lectures or what have you. I think we do that with the way we live. The way we believe.

If we believe, truly believe, that sibling relationships are deep and rewarding, and if we regularly and spontaneously share those sentiments with our children, they will pick up on our conviction and tend to believe it too.

I realize some children may be at odds regardless of what parents do. My sister’s boys are very different from each other. “Complete opposites,” she used to say. She attributed their poor relationship to their opposing personalities.

This may sometimes be true. Still, I wonder. Because in the last few years I’ve witnessed a change.

Wendy stopped saying negative things about sibling relationships. She didn’t seem to expect contention between them and I no longer saw her make a big deal about how shocking it is when they actually got along.

Something settled in her. She became more positive.

And now her children are getting along much better.

These relationships are divine. There are few things more holy than the family. We’re meant to love one another. Blessings always, always flow when we embrace that truth.

I believe The Family Proclamation empowers us in this way. In those moments when our children are bickering to the point where we’d love to pelt them with a ketchup and cottage cheese concoction, we can be reassured.

If we teach them love, ultimately love will win.

***********************************

90,000 Russians were taught to choose the right ketchup: Social sphere: Economy: Lenta.ru

Roskachestvo experts gave Russians advice on choosing the right ketchup so that the sauce is the most delicious and high quality. Recommendations are published on the website of the organization.

All ketchups according to GOST are divided into four categories – extra, higher, first and second. On the label, the category is located next to the name.

The classic composition of ketchup should include only tomato paste, spices, salt and water, and the shorter the composition, the better it is.Products of the extra category fall under this definition, and it is not prohibited to add food additives, sweeteners, thickeners and preservatives such as benzoic or sorbic acid to the products of other categories.

Materials on the topic

00:01 – April 24

Worth its weight in gold

How much does the food actually cost in supermarkets in Russia, Europe and the rest of the world? Survey

00:03 – May 25

Negative growth.

The world economy is recovering, but everything is getting more expensive.Why it happens?

Extra category ketchup must contain at least 25 percent soluble solids. For the highest category, this figure is 23 percent, for the first – 18 percent, and for the second – 14 percent. The last two categories are Economy Class.

Experts noted that tomato ketchup can be produced both in accordance with GOST and TU, and in this case, the composition may contain preservatives, stabilizers, dyes, sweeteners. However, even products that do not comply with GOST may have a natural composition.

The consistency of ketchup can only be assessed in glass packaging. High-quality ketchup has a uniform consistency, the presence of tomatoes, vegetables, herbs and spices is possible, but the presence of air bubbles is unacceptable. It speaks of fermentation, which means a violation of the production process.

The best ketchup, according to the article, does not contain sweeteners, genetically modified components, starch and dyes. There should be no benzoic and sorbic acid either.Only products with at least 23 percent tomato paste claim for the Russian quality mark.

Earlier, experts from Roskachestvo found that every fourth brand of butter sausages in Russia is produced with safety violations, and a higher price does not always indicate better quality.

Fast delivery of news – in the “Feed of the Day” in Telegram

Calories Bavarian ketchup. Calve .. Chemical composition and nutritional value.

Chemical composition and nutritional analysis

Nutritional value and chemical composition

“Bavarian ketchup.Calve. “.

The table shows the content of nutrients (calories, proteins, fats, carbohydrates, vitamins and minerals) per 100 grams of edible part.

Energy value Bavarian ketchup.Calve. is 86 kcal.

Main source: Created in the application by the user. More details.

** This table shows the average norms of vitamins and minerals for an adult. If you want to know the norms taking into account your gender, age and other factors, then use the application
“My Healthy Diet”.

90,000 Cheese sauce with crayfish tails.Homemade sauces. Ketchup, adjika and others

Read also

Cheese sauce

Cheese sauce
White sauce – 1 cup Grated cheese – 2 tablespoons Black or red pepper and salt – to taste Method of preparation Add grated cheese, pepper and salt to the white sauce to taste and bring to

FUTOMAKI WITH SALMON AND CRYSTAL NECK

FUTOMAKI WITH SALMON AND CRYSTAL NECK

150 g of cooked rice, 3 nori leaves, 50 g of salmon fillet, 50 g of crayfish necks, 1 cucumber, 40 g of daikon, 1 avocado, wasabi.Put rice, strips of salmon fillet, cucumber, avocado, finely chopped daikon and crayfish tails on the nori. Roll up a roll,

Cheese sauce

Cheese sauce
Ingredients: 60 g of cottage cheese, 60 g of sour cream, 30 g of mustard, 50 g of cheese (any). Method of preparation: Cottage cheese is pounded, cheese is chopped. The ingredients are mixed with sour cream, whisked and seasoned with mustard.Ready sauce is served to

Cheese sauce

Cheese sauce
Butter ……………………….. 30 g Wheat flour ……………. …………. 30 g Milk …………………………….. .. 0,5 l Cheese ………………………………….. 150 g Lemon juice …………………….. 1-2 tbsp. l Salt ……………………………… to taste 1.In a small skillet, heat the butter and

29. Olivier salad with crayfish tails

29. Olivier salad with crayfish tails
20 crayfish • 2 potatoes • 2 carrots • 1 fresh cucumber • 100 g canned white beans • mayonnaise • 1 bunch of dill • 5-6 black peppercorns • salt. Boil potatoes and carrots, cool, peel, cut into small pieces.

Cheese sauce

Cheese sauce

White sauce – 2 cups, chopped cheese – 1/4 cup, salt – 1/4 teaspoon.
Add chopped cheese to the white sauce. Mix thoroughly and then place in oven at full power for 3 minutes. If you are using unsalted cheeses, then add 1/4 tsp.

Cheese sauce

Cheese sauce

Ingredients:
For 100 g of salad: grated cheese – 50 g, cottage cheese – 1 tbsp.spoon, sour cream – 1 tbsp. spoon, mustard – 0.5 tsp.
Method of preparation: Cottage cheese is thoroughly ground with whipped sour cream and mixed with mustard and cheese. Salad is seasoned with the prepared sauce and served to

Cheese sauce

Cheese sauce
• 80 g cheese • 100 g cottage cheese • 80 g sour cream • 40 g mustard1. Grind cottage cheese, grind cheese. 2. Combine the prepared ingredients with sour cream, whisk, season with mustard and mix.3. Serve the prepared sauce to the baked

Cheese sauce

Cheese sauce
Ingredients: 50 g margarine or butter, 1 tbsp. a spoonful of flour, 0.5 l of milk or broth, salt, caraway seeds, 100 g of grated cheese. Preparation: sauté flour in fat, dilute with broth or milk, add ground cumin, salt, grated cheese,

Salmon dumplings in creamy sauce with crayfish tails

Dumplings with salmon in a creamy sauce with crayfish tails
Salmon fillet – 500 g Dill – 30 g Cottage cheese or fetaki cheese – 150 g Eggs – 2 pcs.Salt, pepper For dough Flour – 700 g Milk – 250 ml Eggs – 3 pieces Ghee – 100 g Salt For sauce Crayfish necks – 1 can Butter – 100 g Shallots – 2

With mushrooms and crayfish tails

With mushrooms and crayfish tails
Required: 300 g yeast dough. For filling: 200 g porcini mushrooms, 50 crayfish, salt, spices, 10 g butter. Method of preparation.Cut the mushrooms into thin slices, lightly coat in flour and fry in butter. Cook crayfish in salted

Sterlet soup with crayfish tails

Sterlet soup with crayfish tails
Sterlet – 300 g, crayfish necks – 200 g, potatoes – 3 pcs., Onions – 1 pc., Carrots – 1 pc., White broth – 1.5 l, salt, spices, fresh herbs – to taste carrots, strips, potatoes, cubed, half out

Cannelloni with crayfish tails, baked with Emmental cheese

Cannelloni with crayfish tails baked with emmental cheese
Lasagne dough sheets – 8 pcs.Cream – 200 ml Butter – 150 g Emmental cheese – 250 g Olive oil – 30 ml Basil – 30 g Salt, pepper For filling Shallots – 100 g Champignons – 300 g Tomatoes – 5 pieces Crayfish necks

Chicken soup with crayfish tails

Chicken soup with crayfish tails
Ingredients: 1 kg of chicken, 70 g of boiled crayfish necks, 1 potato tuber, 50 g of butter, 1 celery root, 1 parsley root, bay leaf, 1 bunch of dill and parsley, salt, pepper.Cooking method: Root of celery and parsley

Diet for allergies – Treatment of allergies and asthma in Allergomed

Diet is very important in atopic dermatitis. If the diet is not followed, the rash will grow and cause more and more discomfort.

Food can be consumed:

• Cereals : rice, buckwheat, oatmeal.
• Porridge with half milk.
• Vegetables: cucumbers (without skin), potatoes (boiled, stewed), white cabbage (boiled, stewed), cauliflower (boiled, stewed), zucchini.
• Fruits: green apples, baked apples, pears.
• Berries: currants (red and white), gooseberries, watermelon
• Oil: butter, sunflower, olive.
• Dairy products: kefir, cottage cheese, curdled milk, yoghurts without preservatives.
• Meat: lean beef, turkey, chicken, rabbit.
• Soups: cereals, vegetables (in secondary vegetable broth, vegetarian).
• Tea, apple compote.
• White uncooked bread, biscuits, dietetic crispbread.

Recommended to be excluded from the diet:

• Fresh milk.
• Horseradish, radish, radish, tomatoes, eggplant, dill, parsley.
• Citrus fruits (oranges, lemons, grapefruit, lime, etc.)etc.), melon, pineapple, red apples, strawberries, strawberries.
• Vinegar, mustard, mayonnaise, garlic, ketchup and other spices
• Fish and fish products (fresh and salted fish, fish broths, canned fish, caviar, seafood, etc.)
• Chocolate and chocolate products, cakes, pastries, butter dough, sugar, honey. Coffee, cocoa, kvass, carbonated and alcoholic drinks (! Strictly prohibited ),
• Nuts (hazelnuts, almonds, peanuts and others).
• Smoked products, sauerkraut, mushrooms, eggs, meat broths.
• Products containing preservatives and dyes.

All products should be cooked boiled or stewed.

It is very important to know that with hay fever (seasonal allergies), a diet is also required, as as there is a cross-allergy.

The allergist will select the necessary therapy and an individual diet, taking into account the characteristics of the course of the disease.