Hearty Healthy Ukrainian Borscht
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In the West, borscht is often thought of as Russian, but it is Ukrainian in origin and popular throughout much of Eastern Europe, with many local variations. Today’s borscht is a vegetarian (and vegan, depending on your choice of cooking fat) borscht from Kyiv, and it’s especially good for the gut, heart, and blood sugars.
You will need
- 1 quart vegetable stock; ideally you made this yourself from vegetable offcuts you kept in the freezer, but failing that, your supermarket should have low-sodium stock cubes
- 4 large beets, peeled and cut into matchsticks
- 1 can white beans (cannellini beans are ideal), drained and rinsed
- 1 cup sauerkraut
- 1 large onion, finely chopped
- 1 green bell pepper, roughly chopped
- 1 large russet potato, peeled and cut into large chunks
- 3 small carrots, tops removed and cut into large chunks
- 1 tbsp tomato paste
- ½ bulb garlic, finely chopped
- 2 tsp black pepper, coarse ground
- 1 bunch fresh dill, chopped. If you cannot get fresh, substitute with parsley (1 bunch fresh, chopped, or 1 tbsp dried). Do not use dried dill; it won’t work.
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point, though that latter shouldn’t be necessary here if you are attentive with the stirring. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has arguably too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
- On standby: a little vinegar (your preference what kind)
Salt is conspicuous by its absence, but there should be enough already from the other ingredients, especially the sauerkraut.
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a large sauté pan (cast iron is perfect if you have it), add the onion and pepper, and stir until the onion is becoming soft.
2) Add the carrots and beets and stir until they are becoming soft. If you need to add a little more oil, that’s fine.
3) Add the tomato paste, and stir in well.
4) Add a little (about ½ cup) of the vegetable stock and stir in well until you get a consistent texture with the tomato paste.
5) Add the sauerkraut and the rest of the broth, and cook for about 20 minutes.
6) Add the potatoes and cook for another 10 minutes.
7) Add the beans and cook for another 5 minutes.
8) Add the garlic, black pepper, and herbs. Check that everything is cooked (poke a chunk of potato with a fork) and that the seasoning is to your liking. The taste should be moderately sour from the sauerkraut; if it is sweet, you can stir in a little vinegar now to correct that.
9) Serve! Ukrainian borscht is most often served hot (unlike Lithuanian borscht, which is almost always served cold), but if the weather’s warm, it can certainly be enjoyed cold too:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Eat More (Of This) For Lower Blood Pressure
- No, Beetroot Isn’t Vegetable Viagra. But Here’s What It Can Do
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal
Take care!
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Mental Health Courts Can Struggle to Fulfill Decades-Old Promise
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GAINESVILLE, Ga. — In early December, Donald Brown stood nervously in the Hall County Courthouse, concerned he’d be sent back to jail.
The 55-year-old struggles with depression, addiction, and suicidal thoughts. He worried a judge would terminate him from a special diversion program meant to keep people with mental illness from being incarcerated. He was failing to keep up with the program’s onerous work and community service requirements.
“I’m kind of scared. I feel kind of defeated,” Brown said.
Last year, Brown threatened to take his life with a gun and his family called 911 seeking help, he said. The police arrived, and Brown was arrested and charged with a felony of firearm possession.
After months in jail, Brown was offered access to the Health Empowerment Linkage and Possibilities, or HELP, Court. If he pleaded guilty, he’d be connected to services and avoid prison time. But if he didn’t complete the program, he’d possibly face incarceration.
“It’s almost like coercion,” Brown said. “‘Here, sign these papers and get out of jail.’ I feel like I could have been dealt with a lot better.”
Advocates, attorneys, clinicians, and researchers said courts such as the one Brown is navigating can struggle to live up to their promise. The diversion programs, they said, are often expensive and resource-intensive, and serve fewer than 1% of the more than 2 million people who have a serious mental illness and are booked into U.S. jails each year.
People can feel pressured to take plea deals and enter the courts, seeing the programs as the only route to get care or avoid prison time. The courts are selective, due in part to political pressures on elected judges and prosecutors. Participants must often meet strict requirements that critics say aren’t treatment-focused, such as regular hearings and drug screenings.
And there is a lack of conclusive evidence on whether the courts help participants long-term. Some legal experts, like Lea Johnston, a professor of law at the University of Florida, worry the programs distract from more meaningful investments in mental health resources.
Jails and prisons are not the place for individuals with mental disorders, she said. “But I’m also not sure that mental health court is the solution.”
The country’s first mental health court was established in Broward County, Florida, in 1997, “as a way to promote recovery and mental health wellness and avoid criminalizing mental health problems.” The model was replicated with millions in funding from such federal agencies as the Substance Abuse and Mental Health Services Administration and the Department of Justice.
More than 650 adult and juvenile mental health courts were operational as of 2022, according to the National Treatment Court Resource Center. There’s no set way to run them. Generally, participants receive treatment plans and get linked to services. Judges and mental health clinicians oversee their progress.
Researchers from the center found little evidence that the courts improve participants’ mental health or keep them out of the criminal justice system. “Few studies … assess longer-term impacts” of the programs “beyond one year after program exit,” said a 2022 policy brief on mental health courts.
The courts work best when paired with investments in services such as clinical treatment, recovery programs, and housing and employment opportunities, said Kristen DeVall, the center’s co-director.
“If all of these other supports aren’t invested in, then it’s kind of a wash,” she said.
The courts should be seen as “one intervention in that larger system,” DeVall said, not “the only resource to serve folks with mental health needs” who get caught up in the criminal justice system.
Resource limitations can also increase the pressures to apply for mental health court programs, said Lisa M. Wayne, executive director of the National Association of Criminal Defense Lawyers. People seeking help might not feel they have alternatives.
“It’s not going to be people who can afford mental health intervention. It’s poor people, marginalized folks,” she said.
Other court skeptics wonder about the larger costs of the programs.
In a study of a mental health court in Pennsylvania, Johnston and a University of Florida colleague found participants were sentenced to longer time under government supervision than if they’d gone through the regular criminal justice system.
“The bigger problem is they’re taking attention away from more important solutions that we should be investing in, like community mental health care,” Johnston said.
When Melissa Vergara’s oldest son, Mychael Difrancisco, was arrested on felony gun charges in Queens in May 2021, she thought he would be an ideal candidate for the New York City borough’s mental health court because of his diagnosis of autism spectrum disorder and other behavioral health conditions.
She estimated she spent tens of thousands of dollars to prepare Difrancisco’s case for consideration. Meanwhile, her son sat in jail on Rikers Island, where she said he was assaulted multiple times and had to get half a finger amputated after it was caught in a cell door.
In the end, his case was denied diversion into mental health court. Difrancisco, 22, is serving a prison sentence that could be as long as four years and six months.
“There’s no real urgency to help people with mental health struggles,” Vergara said.
Critics worry such high bars to entry can lead the programs to exclude people who could benefit the most. Some courts don’t allow those accused of violent or sexual crimes to participate. Prosecutors and judges can face pressure from constituents that may lead them to block individuals accused of high-profile offenses.
And judges often aren’t trained to make decisions about participants’ care, said Raji Edayathumangalam, senior policy social worker with New York County Defender Services.
“It’s inappropriate,” she said. “We’re all licensed to practice in our different professions for a reason. I can’t show up to do a hernia operation just because I read about it or sat next to a hernia surgeon.”
Mental health courts can be overly focused on requirements such as drug testing, medication compliance, and completing workbook assignments, rather than progress toward recovery and clinical improvement, Edayathumangalam said.
Completing the programs can leave some participants with clean criminal records. But failing to meet a program’s requirements can trigger penalties — including incarceration.
During a recent hearing in the Clayton County Behavioral Health Accountability Court in suburban Atlanta, one woman left the courtroom in tears when Judge Shana Rooks Malone ordered her to report to jail for a seven-day stay for “being dishonest” about whether she was taking court-required medication.
It was her sixth infraction in the program — previous consequences included written assignments and “bench duty,” in which participants must sit and think about their participation in the program.
“I don’t like to incarcerate,” Malone said. “That particular participant has had some challenges. I’m rooting for her. But all the smaller penalties haven’t worked.”
Still, other participants praised Malone and her program. And, in general, some say such diversion programs provide a much-needed lifeline.
Michael Hobby, 32, of Gainesville was addicted to heroin and fentanyl when he was arrested for drug possession in August 2021. After entry into the HELP Court program, he got sober, started taking medication for anxiety and depression, and built a stable life.
“I didn’t know where to reach out for help,” he said. “I got put in handcuffs, and it saved my life.”
Even as Donald Brown awaited his fate, he said he had started taking medication to manage his depression and has stayed sober because of HELP Court.
“I’ve learned a new way of life. Instead of getting high, I’m learning to feel things now,” he said.
Brown avoided jail that early December day. A hearing to decide his fate could happen in the next few weeks. But even if he’s allowed to remain in the program, Brown said, he’s worried it’s only a matter of time before he falls out of compliance.
“To try to improve myself and get locked up for it is just a kick in the gut,” he said. “I tried really hard.”
KFF Health News senior correspondent Fred Clasen-Kelly contributed to this report.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Everything you need to know about cervical cancer
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Every year, around 11,500 new cases of cervical cancer are diagnosed in the U.S. While cervical cancer used to be one of the most common causes of cancer death for U.S. women, the vaccine against the human papillomavirus (HPV), and increased early screening and detection have resulted in a decrease in rates.
“Cervical cancer is almost always preventable and typically diagnosed in patients who have either never had a screening test or have gone many years without one,” says Fred Wyand, director of communications at the American Sexual Health Association, which includes the National Cervical Cancer Coalition.
January is Cervical Cancer Awareness Month, so we spoke to experts to learn more about what it is, its symptoms, and what you can do to prevent it.
What is cervical cancer?
Cervical cancer is a type of cancer that starts in the cervix—the lower part of the uterus that connects the vagina to the uterus. Cervical cancer can affect anyone with a cervix but is most frequently diagnosed in women ages 35 to 44, according to the American Cancer Society.
There are two types:
- Squamous cell carcinoma: Cervical cancer that starts in the thin squamous cells on the outside of the cervix. This is the most common type of cervical cancer.
- Adenocarcinoma: Cervical cancer that starts in glandular cells that line the inside of the cervix. This type of cervical cancer is less common.
In some cases, cervical cancer has features of both types.
What causes cervical cancer?
Almost all cases of cervical cancer are caused by high-risk cases of HPV, a virus that is spread through sexual activity or other close skin-to-skin contact. But don’t panic: HPV is very common, and getting HPV doesn’t always mean you’ll get cervical cancer. Around 85 percent of people in the U.S. will get an HPV infection in their lifetime, but for most people, the virus clears on its own.
However, there are many strains of HPV, and some are linked to cervical cancer. In those cases, when the virus does not clear on its own and the HPV infection persists, it can cause a range of cancers in both men and women, including cancers of the cervix, anus, penis, throat, and vagina.
That’s why HPV vaccination is so important for all people: It can help prevent many types of cancer, including cervical cancer caused by those high-risk HPV infections.
What are the symptoms of cervical cancer?
Cervical cancer doesn’t usually have symptoms in its early stages, but once cancer begins to spread, the symptoms can include:
- Vaginal bleeding between periods, after sexual intercourse, or after menopause.
- Heavier and longer menstrual periods than usual.
- Vaginal discharge that has a strong odor and is watery.
- Pelvic pain or pain during sexual intercourse.
In more advanced stages, symptoms of cervical cancer can include:
- Leg swelling.
- Difficult or painful bowel movements or bleeding during a bowel movement.
- Blood in urine or difficulty urinating.
- Back pain.
“Most women present with no symptoms,” Dr. Kristina A. Butler, gynecologic oncologist at Mayo Clinic, tells PGN. “Therefore, the checkups with visualization of the cervix, speaking with your provider, and having a Pap smear are so important.”
How can you help prevent or reduce your risk for cervical cancer?
Vaccination: Cervical cancer is highly preventable. The most effective way to help protect yourself from it is by getting the HPV vaccine. The HPV vaccine is most effective before a person is first exposed to HPV, typically before becoming sexually active.
“If we are able to vaccinate children before they become adults [and] are subsequently exposed, those individuals are maximally protected against the [worst effects] of the virus, which could ultimately be cancer,” Butler adds.
You’re eligible to get the vaccine if you’re between 9 and 45 years old, but there are specific guidelines for each age group. The Centers for Disease Control and Prevention recommends HPV vaccination for children ages 11 or 12 (though it can start at 9 years).
The CDC says that you can get catch-up doses until you’re 26 if you didn’t get vaccinated earlier, but if you’re between 26 and 45 years old, you should talk to your health care provider about your individual risk for HPV and to see if you should get the vaccine.
Screenings: This is another effective way to prevent cervical cancer.
Dr. Deanna Gerber, a gynecologic oncologist at NYU Langone’s Laura and Isaac Perlmutter Cancer Center, tells PGN that regular screenings can catch HPV before it has a chance to become cancer.
“Now that we’re encouraging people to see their gynecologist and get screening more regularly, we’re catching cancer at earlier stages,” she says.
Screenings for cervical cancer include:
- Pap smear: During a Pap smear, also known as a Pap test, cells are collected from your cervix to find precancerous or cervical cancer cells. Pap smears should start at 21 years old, regardless of when you start having sex.
If you’re between 21 and 29, you should get a Pap smear every three years. If you’re 30 to 65 years old, it’s recommended you get one every three years, a Pap and HPV test together every five years, or an HPV test alone every five years.
- HPV test: During an HPV test, cells are collected from your cervix to look for infection with high-risk HPV strains that can cause cervical cancer. If you’re between 21 and 30 years old, it’s only recommended that you get an HPV test if you had an abnormal Pap smear result. After 30, an HPV test is recommended with a Pap smear every five years, as long as other results were normal.
(People over 65 years old should talk to their health care provider about whether they need screening.)
Not smoking: Avoiding smoking can reduce your risk of developing cervical cancer because “HPV and smoking tobacco work together to accelerate the negative effects of HPV,” says Gerber.
Wearing condoms: Although condoms don’t completely prevent HPV infection, they provide some protection. And according to the CDC, the use of condoms has been associated with a lower rate of cervical cancer.
There is hope with early detection
There is hope for people diagnosed with cervical cancer. “Compared to the survival [rates] 10 years ago, women survive much longer now with the great treatments we have,” adds Butler.
Some of those treatments and advances include radiation, chemotherapy, and surgical therapy.
And while there may be some stigma surrounding sexual health, it’s important to advocate for yourself, says Gerber.
“Being comfortable and bold talking to your doctor about your health or any concerns that you have, feeling comfortable with your provider by asking all these questions is really the best thing you can do.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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What does it mean to be transgender?
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Transgender media coverage has surged in recent years for a wide range of reasons. While there are more transgender television characters than ever before, hundreds of bills are targeting transgender people’s access to medical care, sports teams, gender-specific public spaces, and other institutions.
Despite the increase in conversation about the transgender community, public confusion around transgender identity remains.
Read on to learn more about what it means to be transgender and understand challenges transgender people may face.
What does it mean to be transgender?
Transgender—or “trans”—is an umbrella term for people whose gender identity or gender expression does not conform to their sex assigned at birth. People can discover they are trans at any age.
Gender identity refers to a person’s inner sense of being a woman, a man, neither, both, or something else entirely. Trans people who don’t feel like women or men might describe themselves as nonbinary, agender, genderqueer, or two-spirit, among other terms.
Gender expression describes the way a person communicates their gender through their appearance—such as their clothing or hairstyle—and behavior.
A person whose gender expression doesn’t conform to the expectations of their assigned sex may not identify as trans. The only way to know for sure if someone is trans is if they tell you.
Cisgender—or “cis”—describes people whose gender identities match the sex they were assigned at birth.
How long have transgender people existed?
Being trans isn’t new. Although the word “transgender” only dates back to the 1960s, people whose identities defy traditional gender expectations have existed across cultures throughout recorded history.
How many people are transgender?
A 2022 Williams Institute study estimates that 1.6 million people over the age of 13 identify as transgender in the United States.
Is being transgender a mental health condition?
No. Conveying and communicating about your gender in a way that feels authentic to you is a normal and necessary part of self-expression.
Social and legal stigma, bullying, discrimination, harassment, negative media messages, and barriers to gender-affirming medical care can cause psychological distress for trans people. This is especially true for trans people of color, who face significantly higher rates of violence, poverty, housing instability, and incarceration—but trans identity itself is not a mental health condition.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity, or their internal sense of gender. A 2021 study of trans adults pursuing gender-affirming medical care found that most participants started experiencing gender dysphoria by the time they were 7.
When trans people don’t receive the support they need to manage gender dysphoria, they may experience depression, anxiety, social isolation, suicidal ideation, substance use disorder, eating disorders, and self-injury.
How do trans people manage gender dysphoria?
Every trans person’s experience with gender dysphoria is unique. Some trans people may alleviate dysphoria by wearing gender-affirming clothing or by asking others to refer to them by a new name and use pronouns that accurately reflect their gender identity. The 2022 U.S. Trans Survey found that nearly all trans participants who lived as a different gender than the sex they were assigned at birth reported that they were more satisfied with their lives.
Some trans people may also manage dysphoria by pursuing medical transition, which may involve taking hormones and getting gender-affirming surgery.
Access to gender-affirming medical care has been shown to reduce the risk of depression and suicide among trans youth and adults.
To learn more about the trans community, visit resources from the National Center for Transgender Equality, the Trevor Project, PFLAG, and Planned Parenthood.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Many Health Benefits Of Garlic
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The Many Health Benefits of Garlic
We’re quite confident you already know what garlic is, so we’re going to leap straight in there with some science today:
First, let’s talk about allicin
Allicin is a compound in garlic that gives most of its health benefits. A downside of allicin is that it’s not very stable, so what this means is:
- Garlic is best fresh—allicin breaks down soon after garlic is cut/crushed
- So while doing the paperwork isn’t fun, buying it as bulbs is better than buying it as granules or similar
- Allicin also breaks down somewhat in cooking, so raw garlic is best
- Our philosophy is: still use it in cooking as well; just use more!
- Supplements (capsule form etc) use typically use extracts and potency varies (from not great to actually very good)
Read more about that:
- Short-term heating reduces the anti-inflammatory effects of fresh raw garlic extracts
- Allicin Bioavailability and Bioequivalence from Garlic Supplements and Garlic Foods
Now, let’s talk benefits…
Benefits to heart health
Garlic has been found to be as effective as the drug Atenolol at reducing blood pressure:
It also lowers LDL (bad cholesterol):
Benefits to the gut
We weren’t even looking for this, but as it turns out, as an add-on to the heart benefits…
Benefits to the immune system
Whether against the common cold or bringing out the heavy guns, garlic is a booster:
- Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey
- Supplementation with aged garlic extract improves both NK and γδ-T cell function and reduces the severity of cold and flu symptoms: a randomized, double-blind, placebo-controlled nutrition intervention
Benefits to the youthfulness of body and brain
Garlic is high in antioxidants that, by virtue of reducing oxidative stress, help slow aging. This effect, combined with the cholesterol and blood pressure benefits, means it may also reduce the risk of Alzheimer’s and other forms of dementia:
- Antioxidant health effects of aged garlic extract
- Effects of garlic consumption on plasma and erythrocyte antioxidant parameters in elderly subjects
- Garlic reduces heart disease and dementia risk
There are more benefits too…
That’s all we have time to dive into study-wise today, but for the visually-inclined, here are yet more benefits to garlic (at a rate of 3–4 cloves per day):
An incredible awesome recipe using lots of garlic:
- Take small potatoes (still in their skins), cut in half
- Add enough peeled cloves of garlic so that you have perhaps a 1:10 ratio of garlic to potato by mass
- Boil (pressure-cooking is ideal) until soft, and drain
- Keeping them in the pan, add a lashing of olive oil, and any additional seasonings per your preference (consider black pepper, rosemary, thyme, parsley)
- Put a lid on the pan, and holding it closed, shake the pan vigorously
- Note: if you didn’t leave the skins on, or you chopped much larger potatoes smaller instead of cutting in half, the potatoes will break up into a rough mash now. This is actually also fine and still tastes (and honestly, looks) great, but it is different, so just be aware, so that you get the outcome you want.
- The garlic, which—unlike the potatoes—didn’t have a skin to hold it together, will now have melted over the potatoes like butter
You can serve like this (it’s delicious already) or finish up in the oven or air-fryer or under the grill, if you prefer a roasted style dish (an amazing option too).
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- Garlic is best fresh—allicin breaks down soon after garlic is cut/crushed
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Coffee, From A Blood Sugar Management Perspective
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Our favorite French biochemist (Jessie Inchauspé) is back, and this time, she’s tackling a topic near and dear to this writer’s heart: coffee ☕💕
What to consider
Depending on how you like your coffee, some or all of these may apply to you:
- Is coffee healthy? Coffee is generally healthy, reducing the risk of type 2 diabetes by improving fat burning in the liver and protecting beta cells in the pancreas.
- Does it spike blood sugars? Usually not so long as it’s black and unsweetened. Black coffee can cause small glucose spikes in some people due to stress-induced glucose release, but only if it contains caffeine.
- When is it best to drink it? Drinking coffee after breakfast, especially after a poor night’s sleep, can actually reduce glucose and insulin spikes.
- What about milk? All milks cause some glucose and insulin spikes. While oat milk is generally healthy, for blood sugar purposes unsweetened nut milks or even whole cow’s milk (but not skimmed; it needs the fat) are better options as they cause smaller spikes.
- What about sweetening? Adding sugar to coffee, especially on an empty stomach, obviously leads to large glucose spikes. Alternative sweeteners like stevia or sweet cinnamon are fine substitutes.
For more details on all of those things, plus why Kenyan coffee specifically may be the best for blood sugars, enjoy:
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Want to learn more?
You might also like to read:
- The Bitter Truth About Coffee (or is it?)
- Caffeine: Cognitive Enhancer Or Brain-Wrecker?
- 10 Ways To Balance Blood Sugars
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
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The Food For Life Cookbook – by Dr. Tim Spector
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We’ve previously reviewed Dr. Spector’s “Food For Life”, and while that was more of an “explanatory science” book, this one takes that science (reiterating it more briefly this time, by way of introduction) and makes a cookbook of it.
The nutritional emphasis in these recipes is on two things: maximizing fiber, and maximizing plant diversity. The recipes are not all vegan or even vegetarian, but they are plant-centric, and if the reader is vegetarian/vegan, then substitutions are easy to make.
The recipes themselves are simple without being boring, and are easy to follow, with full-page photos to accompany them. The science parts are very clear, accessible, and pop-science in style.
Bottom line: if you’d like to incorporate more fiber and more plants into your diet without it being a burden, this book is great for that.
Click here to check out the Food For Life Cookbook, and get cooking for life!
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