Life Expectancy Rises Around World, Study Finds

A sharp decline in deaths from malnutrition and infectious diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a report published on Thursday, with far more of the world’s population now living into old age and dying from diseases mostly associated with rich countries, like cancer and heart disease.

Tony Karumba/Agence France-Presse — Getty Images

Children in Nairobi, Kenya. Sub-Saharan Africa lagged in mortality gains, compared with Latin America, Asia and North Africa.

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are striking: infant mortality declined by more than half from 1990 to 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

“The growth of these rich-country diseases, like heart disease, stroke, cancer and diabetes, is in a strange way good news,” said Ezekiel Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania. “It shows that many parts of the globe have largely overcome infectious and communicable diseases as a pervasive threat, and that people on average are living longer.”

In 2010, 43 percent of deaths in the world occurred at age 70 and older, compared with 33 percent of deaths in 1990, the report said. And fewer child deaths have brought up the mean age of death, which in Brazil and Paraguay jumped to 63 in 2010, up from 30 in 1970, the report said. The measure, an average of all deaths in a given year, is different from life expectancy, and is lower when large numbers of children die.

But while developing countries made big strides the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries’ female populations between 1990 and 2010. American women gained just under two years of life, compared with women in Cyprus, who lived 2.3 years longer and Canadian women who gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990. Life expectancy for American women was 80.5 in 2010, up from 78.6 in 1990.

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women formed later than men, are among the factors contributing to the stagnation, he said. American men gained in life expectancy, to 75.9 years from 71.7 in 1990.

Health experts from more than 300 institutions contributed to the report, which provided estimates of disease and mortality for populations in more than 180 countries. It was published in The Lancet, a British medical journal.

The World Health Organization issued a statement on Thursday saying that some of the estimates in the report differed substantially from those done by United Nations agencies, though others were similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries — representing about 15 percent of the world’s population — produce quality cause-of-death data.

Sub-Saharan Africa was an exception to the trend. Infectious diseases, childhood illnesses and maternity-related causes of death still account for about 70 percent of the region’s disease burden, a measure of years of life lost due to premature death and to time lived in less than full health. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

Globally, AIDS was an exception to the shift of deaths from infectious to noncommunicable diseases. The epidemic is believed to have peaked, but still results in 1.5 million deaths each year.

Over all, the change means people are living longer, but it also raises troubling questions. Behavior affects people’s risks of developing cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization.

Tobacco use is a rising threat, especially in developing countries, and is responsible for almost six million deaths a year globally. Illnesses like diabetes are also spreading fast.

Donald G. McNeil Jr. contributed reporting.

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Life Expectancy Rises Around World, Study Finds

A sharp decline in deaths from malnutrition and infectious diseases like measles and tuberculosis has caused a shift in global mortality patterns over the past 20 years, according to a report published on Thursday, with far more of the world’s population now living into old age and dying from diseases mostly associated with rich countries, like cancer and heart disease.

Tony Karumba/Agence France-Presse — Getty Images

Children in Nairobi, Kenya. Sub-Saharan Africa lagged in mortality gains, compared with Latin America, Asia and North Africa.

The shift reflects improvements in sanitation, medical services and access to food throughout the developing world, as well as the success of broad public health efforts like vaccine programs. The results are striking: infant mortality declined by more than half from 1990 to 2010, and malnutrition, the No. 1 risk factor for death and years of life lost in 1990, has fallen to No. 8.

At the same time, chronic diseases like cancer now account for about two out of every three deaths worldwide, up from just over half in 1990. Eight million people died of cancer in 2010, 38 percent more than in 1990. Diabetes claimed 1.3 million lives in 2010, double the number in 1990.

“The growth of these rich-country diseases, like heart disease, stroke, cancer and diabetes, is in a strange way good news,” said Ezekiel Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania. “It shows that many parts of the globe have largely overcome infectious and communicable diseases as a pervasive threat, and that people on average are living longer.”

In 2010, 43 percent of deaths in the world occurred at age 70 and older, compared with 33 percent of deaths in 1990, the report said. And fewer child deaths have brought up the mean age of death, which in Brazil and Paraguay jumped to 63 in 2010, up from 30 in 1970, the report said. The measure, an average of all deaths in a given year, is different from life expectancy, and is lower when large numbers of children die.

But while developing countries made big strides the United States stagnated. American women registered the smallest gains in life expectancy of all high-income countries’ female populations between 1990 and 2010. American women gained just under two years of life, compared with women in Cyprus, who lived 2.3 years longer and Canadian women who gained 2.4 years. The slow increase caused American women to fall to 36th place in the report’s global ranking of life expectancy, down from 22nd in 1990. Life expectancy for American women was 80.5 in 2010, up from 78.6 in 1990.

“It’s alarming just how little progress there has been for women in the United States,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation, a health research organization financed by the Bill and Melinda Gates Foundation at the University of Washington that coordinated the report. Rising rates of obesity among American women and the legacy of smoking, a habit women formed later than men, are among the factors contributing to the stagnation, he said. American men gained in life expectancy, to 75.9 years from 71.7 in 1990.

Health experts from more than 300 institutions contributed to the report, which provided estimates of disease and mortality for populations in more than 180 countries. It was published in The Lancet, a British medical journal.

The World Health Organization issued a statement on Thursday saying that some of the estimates in the report differed substantially from those done by United Nations agencies, though others were similar. All comprehensive estimates of global mortality rely heavily on statistical modeling because only 34 countries — representing about 15 percent of the world’s population — produce quality cause-of-death data.

Sub-Saharan Africa was an exception to the trend. Infectious diseases, childhood illnesses and maternity-related causes of death still account for about 70 percent of the region’s disease burden, a measure of years of life lost due to premature death and to time lived in less than full health. In contrast, they account for just one-third in South Asia, and less than a fifth in all other regions. Sub-Saharan Africa also lagged in mortality gains, with the average age of death rising by fewer than 10 years from 1970 to 2010, compared with a more than 25-year increase in Latin America, Asia and North Africa.

Globally, AIDS was an exception to the shift of deaths from infectious to noncommunicable diseases. The epidemic is believed to have peaked, but still results in 1.5 million deaths each year.

Over all, the change means people are living longer, but it also raises troubling questions. Behavior affects people’s risks of developing cancer, heart disease and diabetes, and public health experts say it is far harder to get people to change their ways than to administer a vaccine that protects children from an infectious disease like measles.

“Adult mortality is a much harder task for the public health systems in the world,” said Colin Mathers, a senior scientist at the World Health Organization.

Tobacco use is a rising threat, especially in developing countries, and is responsible for almost six million deaths a year globally. Illnesses like diabetes are also spreading fast.

Donald G. McNeil Jr. contributed reporting.

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Companies See High-Tech Factories as Fonts of Ideas

Heather Ainsworth for The New York Times

Workers at a G.E. battery plant in upstate New York. G.E. has researchers nearby, which allows for more collaboration.

SCHENECTADY, N.Y. — The Obama administration has long heralded the potential of American factories to offer good, stable middle-class jobs in an economy that desperately needs them. But experts say there might be another advantage to expanding manufacturing in the United States: a more innovative economy.

A growing chorus of economists, engineers and business leaders are warning that the evisceration of the manufacturing work force over the last 30 years might not have scarred just Detroit and the Rust Belt. It might have dimmed the country’s capacity to innovate and stunted the prospects for long-term growth.

“In sector after sector, we’ve lost our innovation edge because we don’t produce goods here anymore,” said Mitzi Montoya, dean of the college of technology and innovation at Arizona State University.

These experts say that in industries that produce complex, high-technology products — things like bioengineered tissues, not light bulbs — companies that keep their research and manufacturing employees close together might be more innovative than businesses that develop a schematic and send it overseas for low-wage workers to make. Moreover, clusters of manufacturers, where workers and ideas can naturally flow between companies, might prove more productive and innovative than the same businesses if they were spread across the country.

A General Electric facility in upstate New York provides a test case. In a custom-built facility the size of four football fields, workers are casting into thin tubes a kind of ceramic that G.E. invented. Those tubes get filled with a secret chemical “brownie mix,” packaged into batteries and shipped across the world.

The plant sits just a few miles down the road from the research campus where G.E. scientists developed the technology. That allows them to work out kinks on the assembly line, and test prototypes of and uses for the battery, the company’s scientists said.

“We’re not thinking about just one generation,” said Glen Merfeld of G.E.’s chemical energy systems laboratory, showing off a test battery his employees had run into exhaustion. “We’re working on the second, the third, the fourth, the fifth.”

The idea is to knit together manufacturing, design, prototyping and production, said Michael Idelchik, vice president for advanced technologies, who holds a dozen patents himself. “We believe that rather than a sequential process where you look at product design and then how to manufacture it, there is a simultaneous process,” Mr. Idelchik said. “We think it is key for sustaining our long-term competitive advantage.”

Economists and policy experts are now researching whether such strategies offer the same benefits for other businesses — and examining how those benefits might show up in national data on innovation, productivity and growth.

At the Massachusetts Institute of Technology, Suzanne Berger has helped to start the Production in the Innovation Economy project to study the subject. “It is something that’s very difficult to establish systematically,” said Professor Berger. “You really have to be willing to look at case-by-case evidence, qualitative evidence. That’s what we’re trying to do.”

Thus far, she said, the anecdotal evidence from about 200 companies has proved striking, with company after company detailing the advantages of keeping makers and thinkers together. That does not mean every business, she stressed. Companies with products early in their life cycle seemed to benefit more than ones with products on the market for years. So did companies making especially complicated or advanced goods, from new medicines to new machines.

“It’s the companies where the challenge of producing on a commercial scale requires levels of scientific activity that are just as complex as the original challenge of developing the technology,” Professor Berger said.

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In Cairo Crisis, Unheard Voice From the Poor

Tara Todras-Whitehill for The New York Times

In Boulaq, so long neglected that houses regularly collapse, there had been little expectation that leaders would provide. But the disregard of the new president has been harder to take. More Photos »

CAIRO — A faded poster of Hosni Mubarak hangs on a wall in a crumbling neighborhood here, reminding residents of an empty pledge to find jobs for young people. Down the street, a campaign banner for his successor, Mohamed Morsi, hangs across the road, a reminder of more recent promises unkept.

In the neighborhood, called Boulaq, so long neglected that houses regularly collapse, there was little expectation that Mr. Mubarak would provide. But Mr. Morsi’s disregard has been much harder to take.

“We had high hopes in God, that things would improve,” Fathi Hussein said as he built a desk of dark wood for one of his clients, who are dwindling. “I elected a president to be good for the country. I did not elect him to impose his opinions on me.”

Away from the protests and violence that have marked the painful struggle over Egypt’s identity in the run-up to a referendum on Saturday on a constitution, residents of Boulaq have their own reasons to be consumed with the crisis. The chants of the protesters, for bread and freedom, resonate in Boulaq’s alleyways. In many of its industrial workshops, passed from struggling fathers to penniless sons, disappointment with the president, his Muslim Brotherhood supporters as well as the leaders of the opposition grows daily.

There is a sense in Boulaq that the raging arguments would be better resolved in places like this, where most Egyptians live, carrying the burdens of poverty with no help from an indifferent state, and where the revolution’s promise of dignity is long overdue.

When he took office five months ago, Mr. Morsi seemed to understand. “He talked about the conditions of the poor, the people in the slums,” said Amr Abdul Hafiz, a barber. “He talked about the street vendors and the tuk-tuk drivers. We thought he felt for us.”

The barber and many of his neighbors were convinced that Mr. Morsi and the Brotherhood had earned their chance to rule. People remembered the Brotherhood’s charity after the earthquake in 1992, and its decades of struggle as an outlaw movement. In stages, though, doubts grew as the Brotherhood broke its promises and Mr. Morsi seized power, culminating in his decision to ram through his constitution. Boulaq’s residents, including the president’s supporters, bristled at the thought of being treated as subjects again.

“He became occupied with other issues,” Mr. Abdul Hafiz said. “They want power, to make up for all the injustice they suffered, as if we were the ones who inflicted the injustice on them.”

At night, the arguments rage at a storied cafe on Abu Talib Street, with an intensity that no one here recalls seeing before. By day, the arguments simmer, in a neighborhood whose former grandeur still peeks out from underneath the rot.

Everywhere, people tell stories about the government’s failures, suggesting that the new leaders had turned out no better than the old ones.

In the shadow of a fallen dwelling, one of many that make Boulaq look as if it suffered a war, a widow stood over workmen she had hired to fix a ruptured sewer pipe. The ministry assigned to handle such matters had ignored her calls for three months, so she and her neighbors collected the money to pay for the repairs themselves.

On Abu Talib Street, Mr. Abdul Hafiz fretted over the dangers facing his pregnant wife, whose belly was swelling with excessive amniotic fluid. An appointment to see a doctor at a private hospital, which would cost $80, was too expensive. The administrators at a public hospital told her she could see a doctor a month after she was supposed to give birth.

Security guards threw Mr. Abdul Hafiz out of the hospital when he pointed out how ridiculous that was.

He wanted a change from Mr. Mubarak, who had coverings placed over the houses in Boulaq during the public opening of a nearby building “to hide insects like us.” It was part of a pattern of neglect that stretched back for decades, when the land under the residents was sold to investors in shady deals that no one has untangled.

Mai Ayyad contributed reporting.

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Another Look at a Drink Ingredient, Brominated Vegetable Oil

James Edward Bates for The New York Times

Sarah Kavanagh, 15, of Hattiesburg, Miss., started an online petition asking PepsiCo to change Gatorade’s formula.

Sarah Kavanagh and her little brother were looking forward to the bottles of Gatorade they had put in the refrigerator after playing outdoors one hot, humid afternoon last month in Hattiesburg, Miss.

But before she took a sip, Sarah, a dedicated vegetarian, did what she often does and checked the label to make sure no animal products were in the drink. One ingredient, brominated vegetable oil, caught her eye.

“I knew it probably wasn’t from an animal because it had vegetable in the name, but I still wanted to know what it was, so I Googled it,” Ms. Kavanagh said. “A page popped up with a long list of possible side effects, including neurological disorders and altered thyroid hormones. I didn’t expect that.”

She threw the product away and started a petition on Change.org, a nonprofit Web site, that has almost 200,000 signatures. Ms. Kavanagh, 15, hopes her campaign will persuade PepsiCo, Gatorade’s maker, to consider changing the drink’s formulation.

Jeff Dahncke, a spokesman for PepsiCo, noted that brominated vegetable oil had been deemed safe for consumption by federal regulators. “As standard practice, we constantly evaluate our formulas and ingredients to ensure they comply with federal regulations and meet the high quality standards our consumers and athletes expect — from functionality to great taste,” he said in an e-mail.

In fact, about 10 percent of drinks sold in the United States contain brominated vegetable oil, including Mountain Dew, also made by PepsiCo; Powerade, Fanta Orange and Fresca from Coca-Cola; and Squirt and Sunkist Peach Soda, made by the Dr Pepper Snapple Group.

The ingredient is added often to citrus drinks to help keep the fruit flavoring evenly distributed; without it, the flavoring would separate.

Use of the substance in the United States has been debated for more than three decades, so Ms. Kavanagh’s campaign most likely is quixotic. But the European Union has long banned the substance from foods, requiring use of other ingredients. Japan recently moved to do the same.

“B.V.O. is banned other places in the world, so these companies already have a replacement for it,” Ms. Kavanagh said. “I don’t see why they don’t just make the switch.” To that, companies say the switch would be too costly.

The renewed debate, which has brought attention to the arcane world of additive regulation, comes as consumers show increasing interest in food ingredients and have new tools to learn about them. Walmart’s app, for instance, allows access to lists of ingredients in foods in its stores.

Brominated vegetable oil contains bromine, the element found in brominated flame retardants, used in things like upholstered furniture and children’s products. Research has found brominate flame retardants building up in the body and breast milk, and animal and some human studies have linked them to neurological impairment, reduced fertility, changes in thyroid hormones and puberty at an earlier age.

Limited studies of the effects of brominated vegetable oil in animals and in humans found buildups of bromine in fatty tissues. Rats that ingested large quantities of the substance in their diets developed heart lesions.

Its use in foods dates to the 1930s, well before Congress amended the Food, Drug and Cosmetic Act to add regulation of new food additives to the responsibilities of the Food and Drug Administration. But Congress exempted two groups of additives, those already sanctioned by the F.D.A. or the Department of Agriculture, or those experts deemed “generally recognized as safe.”

The second exemption created what Tom Neltner, director of the Pew Charitable Trusts’ food additives project, a three-year investigation into how food additives are regulated, calls “the loophole that swallowed the law.” A company can create a new additive, publish safety data about it on its Web site and pay a law firm or consulting firm to vet it to establish it as “generally recognized as safe” — without ever notifying the F.D.A., Mr. Neltner said.

About 10,000 chemicals are allowed to be added to foods, about 3,000 of which have never been reviewed for safety by the F.D.A., according to Pew’s research. Of those, about 1,000 never come before the F.D.A. unless someone has a problem with them; they are declared safe by a company and its handpicked advisers.

“I worked on the industrial and consumer products side of things in the past, and if you take a new chemical and put it into, say, a tennis racket, you have to notify the E.P.A. before you put it in,” Mr. Neltner said, referring to the Environmental Protection Agency. “But if you put it into food and can document it as recognized as safe by someone expert, you don’t have to tell the F.D.A.”

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Well: Life, Interrupted: My Mother's Cooking

Life, Interrupted

Suleika Jaouad writes about her experiences as a young adult with cancer.

For many of us, the holiday season triggers memories of food and family. That’s certainly the case for me. I can always tell when my mother, an artist who grew up in Switzerland, starts to feel nostalgic for home. It is the smell of the crispy apple tarts, the ginger cookies, and the creamy muesli full of nuts and fresh berries. The scent alone delivers a rush of childhood memories for me.

Food has always been an important part of my family. But since I was diagnosed with leukemia two years ago, food has taken on an especially central — and complicated — role in my life. My incredible doctors have been in charge of deciding which chemotherapy treatments and medications I will take. Their role has always been clear. But for my mother, who has always been in action to take care of me but often feels powerless against my mysterious disease, the prescription she draws upon is often a remedy from the kitchen.

My mother comes from a small village on the Lac de Neuchâtel where there is one bakery, one butcher and one grocery store. Even after decades in New York, she prefers home cooking to ordering in. So when I fell ill at the age of 22 and had to move back home with my parents, my mother tailored and amended the vaunted Swiss recipes from her childhood to make them as nutritious and immune system-boosting as possible. It wasn’t infrequent that a red lentil soup or zucchini stuffed with risotto was the highlight of a day otherwise spent in bed staring at my childhood bookshelves and pondering my future.

But my relationship with food has been complicated since my cancer diagnosis. Chemotherapy can wipe out the biggest appetite. It can render delectable food not only inedible, but downright unviewable, unsmellable, unthinkable. After my first hospitalization, a six-week stay in isolation, I quickly learned to be careful about which foods I chose to eat when I was in the depths of sickness. Some of my all-time favorites, like my mother’s rice pudding (extra cinnamon, with cardamon and grated almonds, plus my mom’s T.L.C.), no longer represented comfort food but triggered memories of nausea, the beeping of the I.V. machine and the fluorescent lights of the hospital room. Like other dishes, it has become a food casualty of chemo.

Having cancer changed the way I ate and thought about food. My symptoms dictated my eating habits. The sores in my mouth and the bouts of nausea, for instance, stole the pleasure of eating and made it an ordeal. At some points in my treatment, eating wasn’t even an option. During my bone marrow transplant last April, my only food came in the form of yellow-green liquid hanging from an I.V. pouch. It was the first time I considered how the physicality of eating — the cutting with a knife or slurping with a spoon or chewing of tender meat — was a big part of what I enjoyed about food. In the transplant unit, I remember wanting, more than anything, to bite into a stick of celery. I dreamt about the “crunch.”

Now, more than a year and a half since my first chemotherapy treatment, I’ve come up with a plan to preserve the memory and delight of my mother’s favorite recipes. I only eat the very best of her cooking when I am in-between chemotherapy treatments. I try to make sure not to mix nausea and my favorite foods — because I have found that it confuses not only the taste buds, but also the emotion and memory of eating itself.

As I continue to cope with the effects of cancer and treatment, I am determined to preserve one of my favorite things in life — my mother’s cooking and the many childhood memories that go with it. As a result, I have to refuse her cooking once in a while, saving her food for only my best days. I hope there are a lot of those ahead.

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Birchermuesli

The original “muesli” was invented by Dr. Maximilian Oskar Bircher-Benner (1867-1939), a Swiss physician who fed his patients a small portion of this dish before each meal in his health clinic near Zürich. Derided by his colleagues for his belief in the importance of fresh food for health, he is now considered the guru of the raw food movement. The original recipe has been adapted by muesli lovers all over the world, who have swapped in seasonally available and ripe fruit where appropriate. For individuals with dietary restrictions, oats can be replaced with spelt flakes, millet flakes or other grains. In Switzerland, muesli is simply called “bircher,” after its inventor, and many Swiss eat bircher every day for breakfast or as a light meal. Muesli, a word from the Swiss German dialect which means “little purée,” and mostly known today in its commercialized version, is very different from this homemade recipe. Use whatever fresh ripe fruit you like and is seasonally available to you.

1 cup rolled oats, soaked overnight or for several hours
1 1/2 cups whole, almond, soy or other milk, or orange or apple juice
1/4 cup dried fruit, such as raisins or diced dates
1/4 to 1/2 cup hazelnuts, walnuts or almonds, finely chopped
1 large apple, grated
1 banana, sliced
1/2 cup plain yogurt, plus additional to taste
1 tablespoon fresh lemon juice or more
Finely grated zest of organic lemon, to taste (optional)
1/4 cup fresh grapes, halved
1/2 cup raspberries, blackberries, blueberries or chopped strawberries, plus a few additional berries to garnish
1/2 orange or peach, chopped
1 apricot or kiwi, chopped
Brown sugar or stevia, to taste (optional)
1 tablespoon flaxseed oil (optional)

1. Soak the oats in milk overnight or for a few hours. In the morning, add the dried fruit, nuts, apple, banana, yogurt, lemon juice and zest, if using, and mix to combine. Add the grapes, berries, the remaining fresh fruit, brown sugar and flaxseed oil, if using, and gently fold the fresh fruit into the mixture. Garnish with a few fresh berries and serve.

Bircher, a raw food recipe, makes a great breakfast or snack, and will keep refrigerated for up to two days, and a day-old bircher is even better.

Yield: 4 to 6 servings

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Croûte Aux Champignons (Mushrooms on Toasts)

These mushrooms on toasts are delicious and work with any mix of mushrooms, but if you can find a mix of wild mushrooms, it makes the toasts particularly wonderful. Try serving them with a simple green salad or the “Carrot and Celery Root Salad,” below.

4 to 5 slices country or whole wheat bread, preferably day-old, or more slices from a baguette
2 to 3 tablespoons unsalted butter or olive oil
1/2 medium onion or 1 large shallot, thinly sliced
1 pound mixed mushrooms, sliced
1 cup white wine or stock
Fine sea salt, to taste
Freshly ground black pepper, to taste
1 cup heavy cream (optional)
Finely chopped flat-leaf parsley, for garnish
1/4 cup grated cheese, optional (see below)

1. In a large skillet set over medium high heat, melt the butter until foaming or warm the oil until shimmering. Add the onion or shallot, and cook, stirring, until transparent, about 4 minutes. Add the mushrooms, and cook until the mushrooms have released their liquid and the pan is dry, about 3 minutes. Add the wine or stock and cook until the liquid reduces by half, about 5 to 10 minutes. Season to taste with salt and pepper. Add the cream and cook, stirring, until the mixture thickens, about 5 minutes.

2. While the mushrooms cook, lightly toast the bread in the toaster. Spoon the mushrooms on toasted bread. Sprinkle with parsley and serve.

Optional: Heat the oven to 400 degrees with the rack positioned in the middle. Place the mushroom toasts on a shallow baking sheet and sprinkle with the grated cheese. Bake for 8 to 10 minutes, or until the cheese has melted and lightly browned. Garnish with more black pepper to taste, and serve immediately.

Variation: Replace mushrooms with spinach. Or use half spinach and half mushrooms, adding the spinach once mushrooms has softened. Cook until the spinach has wilted before adding wine or stock. Proceed with the rest of the recipe as written above.

Yield: 4 servings

 

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Carrot and Celery Root Salad

This crunchy and delicious salad makes for a great accompaniment to “Mushrooms on Toast.”

1 1/2 cups finely grated carrot (from about 8 ounces of carrots)
1 1/2 cups finely grated celery root (from about 8 ounces of celery root)
Fine sea salt, to taste
1 tablespoon apple cider vinegar
1 teaspoon mustard
3 tablespoons olive or toasted sesame oil
Freshly ground black pepper, to taste

Place the carrot and celery root in a large bowl and toss to combine. In a small bowl, add the salt to the vinegar and let sit for 1 minute for the salt to dissolve. Add the mustard and whisk to combine. Add the oil and black pepper, and whisk to combine. Pour the dressing over the vegetables and toss to combine. Serve immediately or refrigerate until ready.

Variation: Add 1 tablespoon grated hazelnuts or almonds, or 1 tablespoon or more of plain yogurt mixed with 1 teaspoon chopped chives.

Yield: 4 servings

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Lentil Soup With Tomato

1 cup red lentils, rinsed
1 dried bay leaf
1 tablespoon unsalted butter or olive oil
1 teaspoon ground coriander, plus additional to taste (see below)
1 teaspoon ground cumin or ginger
1/2 teaspoon curry powder
1 pinch cayenne pepper, plus more to taste
1 pinch sugar
1 pinch ground cloves
1 (7-ounce) can peeled tomatoes, chopped (or 2 fresh tomatoes, peeled and chopped)
Fine sea salt, to taste
1/2 cup sour cream (optional)
2 tablespoons finely chopped fresh flat-leaf parsley (optional)

1. Place the lentils in a medium pot set over medium-high heat, add 3 cups water and bay leaf, and bring to a simmer. Cook until the lentils are tender, about 10 minutes. Remove from heat and set aside.

2. In a large pot set over medium heat, add the butter or oil, coriander, cumin, curry, cayenne, sugar and cloves, and warm the mixture until the spices are fragrant, about 1 minute. Add the tomatoes, with their juices, and 1/2 cup water, and bring everything to a boil. Add the reserved lentils and their liquid, reduce the heat to low, and simmer about 5 minutes. Add salt to taste and purée the soup, in batches, in a blender, until smooth. If you prefer, you can thin the soup out with more water. If you like, mix the sour cream with parsley, and add ground coriander to taste. Serve the soup with a dollop of the herbed sour cream.

Yield: 4 servings

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Suleika Jaouad (pronounced su-LAKE-uh ja-WAD) is a 24-year-old writer who lives in New York City. Her column, “Life, Interrupted,” chronicling her experiences as a young adult with cancer, appears weekly on Well. Follow @suleikajaouad on Twitter.

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Well: Life, Interrupted: My Mother's Cooking

Life, Interrupted

Suleika Jaouad writes about her experiences as a young adult with cancer.

For many of us, the holiday season triggers memories of food and family. That’s certainly the case for me. I can always tell when my mother, an artist who grew up in Switzerland, starts to feel nostalgic for home. It is the smell of the crispy apple tarts, the ginger cookies, and the creamy muesli full of nuts and fresh berries. The scent alone delivers a rush of childhood memories for me.

Food has always been an important part of my family. But since I was diagnosed with leukemia two years ago, food has taken on an especially central — and complicated — role in my life. My incredible doctors have been in charge of deciding which chemotherapy treatments and medications I will take. Their role has always been clear. But for my mother, who has always been in action to take care of me but often feels powerless against my mysterious disease, the prescription she draws upon is often a remedy from the kitchen.

My mother comes from a small village on the Lac de Neuchâtel where there is one bakery, one butcher and one grocery store. Even after decades in New York, she prefers home cooking to ordering in. So when I fell ill at the age of 22 and had to move back home with my parents, my mother tailored and amended the vaunted Swiss recipes from her childhood to make them as nutritious and immune system-boosting as possible. It wasn’t infrequent that a red lentil soup or zucchini stuffed with risotto was the highlight of a day otherwise spent in bed staring at my childhood bookshelves and pondering my future.

But my relationship with food has been complicated since my cancer diagnosis. Chemotherapy can wipe out the biggest appetite. It can render delectable food not only inedible, but downright unviewable, unsmellable, unthinkable. After my first hospitalization, a six-week stay in isolation, I quickly learned to be careful about which foods I chose to eat when I was in the depths of sickness. Some of my all-time favorites, like my mother’s rice pudding (extra cinnamon, with cardamon and grated almonds, plus my mom’s T.L.C.), no longer represented comfort food but triggered memories of nausea, the beeping of the I.V. machine and the fluorescent lights of the hospital room. Like other dishes, it has become a food casualty of chemo.

Having cancer changed the way I ate and thought about food. My symptoms dictated my eating habits. The sores in my mouth and the bouts of nausea, for instance, stole the pleasure of eating and made it an ordeal. At some points in my treatment, eating wasn’t even an option. During my bone marrow transplant last April, my only food came in the form of yellow-green liquid hanging from an I.V. pouch. It was the first time I considered how the physicality of eating — the cutting with a knife or slurping with a spoon or chewing of tender meat — was a big part of what I enjoyed about food. In the transplant unit, I remember wanting, more than anything, to bite into a stick of celery. I dreamt about the “crunch.”

Now, more than a year and a half since my first chemotherapy treatment, I’ve come up with a plan to preserve the memory and delight of my mother’s favorite recipes. I only eat the very best of her cooking when I am in-between chemotherapy treatments. I try to make sure not to mix nausea and my favorite foods — because I have found that it confuses not only the taste buds, but also the emotion and memory of eating itself.

As I continue to cope with the effects of cancer and treatment, I am determined to preserve one of my favorite things in life — my mother’s cooking and the many childhood memories that go with it. As a result, I have to refuse her cooking once in a while, saving her food for only my best days. I hope there are a lot of those ahead.

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Birchermuesli

The original “muesli” was invented by Dr. Maximilian Oskar Bircher-Benner (1867-1939), a Swiss physician who fed his patients a small portion of this dish before each meal in his health clinic near Zürich. Derided by his colleagues for his belief in the importance of fresh food for health, he is now considered the guru of the raw food movement. The original recipe has been adapted by muesli lovers all over the world, who have swapped in seasonally available and ripe fruit where appropriate. For individuals with dietary restrictions, oats can be replaced with spelt flakes, millet flakes or other grains. In Switzerland, muesli is simply called “bircher,” after its inventor, and many Swiss eat bircher every day for breakfast or as a light meal. Muesli, a word from the Swiss German dialect which means “little purée,” and mostly known today in its commercialized version, is very different from this homemade recipe. Use whatever fresh ripe fruit you like and is seasonally available to you.

1 cup rolled oats, soaked overnight or for several hours
1 1/2 cups whole, almond, soy or other milk, or orange or apple juice
1/4 cup dried fruit, such as raisins or diced dates
1/4 to 1/2 cup hazelnuts, walnuts or almonds, finely chopped
1 large apple, grated
1 banana, sliced
1/2 cup plain yogurt, plus additional to taste
1 tablespoon fresh lemon juice or more
Finely grated zest of organic lemon, to taste (optional)
1/4 cup fresh grapes, halved
1/2 cup raspberries, blackberries, blueberries or chopped strawberries, plus a few additional berries to garnish
1/2 orange or peach, chopped
1 apricot or kiwi, chopped
Brown sugar or stevia, to taste (optional)
1 tablespoon flaxseed oil (optional)

1. Soak the oats in milk overnight or for a few hours. In the morning, add the dried fruit, nuts, apple, banana, yogurt, lemon juice and zest, if using, and mix to combine. Add the grapes, berries, the remaining fresh fruit, brown sugar and flaxseed oil, if using, and gently fold the fresh fruit into the mixture. Garnish with a few fresh berries and serve.

Bircher, a raw food recipe, makes a great breakfast or snack, and will keep refrigerated for up to two days, and a day-old bircher is even better.

Yield: 4 to 6 servings

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Croûte Aux Champignons (Mushrooms on Toasts)

These mushrooms on toasts are delicious and work with any mix of mushrooms, but if you can find a mix of wild mushrooms, it makes the toasts particularly wonderful. Try serving them with a simple green salad or the “Carrot and Celery Root Salad,” below.

4 to 5 slices country or whole wheat bread, preferably day-old, or more slices from a baguette
2 to 3 tablespoons unsalted butter or olive oil
1/2 medium onion or 1 large shallot, thinly sliced
1 pound mixed mushrooms, sliced
1 cup white wine or stock
Fine sea salt, to taste
Freshly ground black pepper, to taste
1 cup heavy cream (optional)
Finely chopped flat-leaf parsley, for garnish
1/4 cup grated cheese, optional (see below)

1. In a large skillet set over medium high heat, melt the butter until foaming or warm the oil until shimmering. Add the onion or shallot, and cook, stirring, until transparent, about 4 minutes. Add the mushrooms, and cook until the mushrooms have released their liquid and the pan is dry, about 3 minutes. Add the wine or stock and cook until the liquid reduces by half, about 5 to 10 minutes. Season to taste with salt and pepper. Add the cream and cook, stirring, until the mixture thickens, about 5 minutes.

2. While the mushrooms cook, lightly toast the bread in the toaster. Spoon the mushrooms on toasted bread. Sprinkle with parsley and serve.

Optional: Heat the oven to 400 degrees with the rack positioned in the middle. Place the mushroom toasts on a shallow baking sheet and sprinkle with the grated cheese. Bake for 8 to 10 minutes, or until the cheese has melted and lightly browned. Garnish with more black pepper to taste, and serve immediately.

Variation: Replace mushrooms with spinach. Or use half spinach and half mushrooms, adding the spinach once mushrooms has softened. Cook until the spinach has wilted before adding wine or stock. Proceed with the rest of the recipe as written above.

Yield: 4 servings

 

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Carrot and Celery Root Salad

This crunchy and delicious salad makes for a great accompaniment to “Mushrooms on Toast.”

1 1/2 cups finely grated carrot (from about 8 ounces of carrots)
1 1/2 cups finely grated celery root (from about 8 ounces of celery root)
Fine sea salt, to taste
1 tablespoon apple cider vinegar
1 teaspoon mustard
3 tablespoons olive or toasted sesame oil
Freshly ground black pepper, to taste

Place the carrot and celery root in a large bowl and toss to combine. In a small bowl, add the salt to the vinegar and let sit for 1 minute for the salt to dissolve. Add the mustard and whisk to combine. Add the oil and black pepper, and whisk to combine. Pour the dressing over the vegetables and toss to combine. Serve immediately or refrigerate until ready.

Variation: Add 1 tablespoon grated hazelnuts or almonds, or 1 tablespoon or more of plain yogurt mixed with 1 teaspoon chopped chives.

Yield: 4 servings

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Lentil Soup With Tomato

1 cup red lentils, rinsed
1 dried bay leaf
1 tablespoon unsalted butter or olive oil
1 teaspoon ground coriander, plus additional to taste (see below)
1 teaspoon ground cumin or ginger
1/2 teaspoon curry powder
1 pinch cayenne pepper, plus more to taste
1 pinch sugar
1 pinch ground cloves
1 (7-ounce) can peeled tomatoes, chopped (or 2 fresh tomatoes, peeled and chopped)
Fine sea salt, to taste
1/2 cup sour cream (optional)
2 tablespoons finely chopped fresh flat-leaf parsley (optional)

1. Place the lentils in a medium pot set over medium-high heat, add 3 cups water and bay leaf, and bring to a simmer. Cook until the lentils are tender, about 10 minutes. Remove from heat and set aside.

2. In a large pot set over medium heat, add the butter or oil, coriander, cumin, curry, cayenne, sugar and cloves, and warm the mixture until the spices are fragrant, about 1 minute. Add the tomatoes, with their juices, and 1/2 cup water, and bring everything to a boil. Add the reserved lentils and their liquid, reduce the heat to low, and simmer about 5 minutes. Add salt to taste and purée the soup, in batches, in a blender, until smooth. If you prefer, you can thin the soup out with more water. If you like, mix the sour cream with parsley, and add ground coriander to taste. Serve the soup with a dollop of the herbed sour cream.

Yield: 4 servings

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Suleika Jaouad (pronounced su-LAKE-uh ja-WAD) is a 24-year-old writer who lives in New York City. Her column, “Life, Interrupted,” chronicling her experiences as a young adult with cancer, appears weekly on Well. Follow @suleikajaouad on Twitter.

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After Deportation, John McAfee Returns to U.S.

MIAMI (AP) — John McAfee, the antivirus software pioneer, arrived in the United States on Wednesday night after being deported from Guatemala, where he had sought to evade police questioning in the killing of a man in neighboring Belize.

Johan Ordonez/Agence France-Presse — Getty Images

John McAfee at the airport in Guatemala City. He was deported from that country and arrived in Miami on Wednesday night.

A commercial jet carrying Mr. McAfee landed in Miami shortly before 7 p.m. Wednesday, said Greg Chin, a spokesman for Miami International Airport.

A short time later, a posting on McAfee’s Web site announced that he was at a hotel in Miami’s South Beach neighborhood. Mr. McAfee has frequently communicated through the Web site.

“I have no phone, no money, no contact information,” the post says. Reached by telephone at the hotel, Mr. McAfee said that he could not talk because he was waiting for a call from his girlfriend.

Other passengers on the flight said that Mr. McAfee, 67, was escorted off the aircraft before everyone else.

Maria Claridge, a 36-year-old photographer from Fort Lauderdale, Fla., said, “He walked very peacefully, chin up. He didn’t seem stressed.”

She said he was well dressed, in a black suit and white shirt, and appeared to be traveling alone.

An F.B.I. spokesman in Miami, James Marshall, said in an e-mail that the agency was not involved with Mr. McAfee’s return to the United States. Authorities from Customs and Border Protection, Immigration and Customs Enforcement, the United States Marshals office and the United States attorney’s office did not immediately respond to questions about whether Mr. McAfee would be questioned or detained. They said there was no active arrest warrant for Mr. McAfee that would justify taking him into custody.His expulsion from Guatemala marked the last chapter in a strange, monthlong odyssey to avoid police questioning about the November killing of American expatriate Gregory Viant Faull, who lived a couple of houses down from McAfee’s compound on Ambergris Caye, off Belize’s Caribbean coast.

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World Briefing | Middle East: U.N. Nuclear Inspectors Pay Visit to Iran

nuclear inspectors visited Iran for their first meeting since August, but they appeared to be no closer to resolving a dispute over their repeated requests to examine Parchin, a military site that the inspectors suspect was used for atomic weapons trigger tests. The head of the inspector delegation, Herman Nackaerts, deputy director of the International Atomic Energy Agency, based in Vienna, told reporters as the group left for Tehran that the purpose of the visit was to devise a way to satisfy the agency’s concerns over the Iranian program’s “possible military dimensions.” He also said his delegation still hoped the Iranians would allow a visit to Parchin. Some members of his group were seen carrying equipment that could be used for testing at Parchin.

Iran has insisted that its uranium enrichment program is peaceful and has dismissed as Western propaganda commercial satellite imagery that has shown cleanup work at Parchin. The inspectors’ visit came as new diplomatic efforts were under way by the six big powers that have been negotiating with Iran over its uranium enrichment to re-engage in talks, which have been stalled for months. Michael Mann, a spokesman for Catherine Ashton , the European Union foreign policy chief who is the lead negotiator for the six powers, said her deputy had discussed possible dates and locations for a new meeting with Iran’s deputy negotiator. “We hope that an agreement with Iran can soon be reached on how to continue the talks and make concrete progress toward addressing international concerns and finding a diplomatic solution,” Mr. Mann said.

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Top Executives End Opposition to Higher Taxes

Chip Somodevilla/Getty Images

White House officials have been pressing top business executives, like Lloyd C. Blankfein of Goldman Sachs, to support higher taxes on wealthy Americans.

A broad swath of the nation’s leading chief executives dropped its opposition to tax increases on the wealthiest Americans on Tuesday, while the White House quietly pressed Wall Street titans for their support as well.

Before Tuesday’s about-face, the Business Roundtable had insisted that the White House extend Bush-era tax cuts to taxpayers of all income brackets, but the executives’ resistance crumbled as pressure builds to find a compromise for the fiscal impasse in Washington before the end of the year.

“We recognize that part of the solution has to be tax increases,” David M. Cote, chief executive of Honeywell, said on a conference call with reporters. “That’s the only thing that allows a reasonable compromise to be reached.”

Even as the Fortune 500 leaders announced their shift, the White House continued to work behind the scenes to woo some of Wall Street’s most powerful financiers — a group that had largely abandoned President Obama in his bid for a second term after supporting him in 2008.

After seeking out corporate leaders from industrial companies last month, the White House has intensified outreach to Wall Street in December.

On Wednesday, several hedge fund managers, including Daniel Och, the billionaire founder of Och-Ziff Capital Management, will meet with Valerie Jarrett, a top adviser to the president, and members of the White House economic team.

Last Monday, White House officials sat down with a more than half a dozen top bankers and financiers, including Gary D. Cohn, president of Goldman Sachs, and Greg Fleming, head of wealth management at Morgan Stanley.

The differing strategies — highly public meetings with corporate America and private arm-twisting with Wall Street — both appear to be aimed at winning popular support for higher taxes on the wealthy. The trade-offs being roundly fought over in Washington, like what government programs may be cut and which entitlements may be spared, are less important in this effort to muster highly compensated chieftains whose support for tax increases will provide cover for Congressional Republicans wary of being seen as too quick to compromise on higher tax rates.

What’s more, the political symbolism of some of the wealthiest Americans’ saying they support higher taxes on the rich takes a bit of the sting out of the idea of raising rates, for both Democrats and Republicans. Indeed, by appealing to both camps and enlisting their support, President Obama hopes to neutralize potential critics, according to allies of the president on Wall Street.

President Obama’s supporters cited the example of Frederick W. Smith, the chief executive of FedEx. Last week, Mr. Smith signaled he was not angered by higher tax rates for the wealthiest individuals, a centerpiece of President Obama’s plan to reduce the deficit and a key sticking point for Republicans in Congress.

“If people who didn’t support the president believe the president is acting reasonably, they’re going to put pressure on the other side,” said Marc Lasry, a longtime supporter of the president who runs Avenue Capital. “You need both sides to be reasonable.”

For example, Mr. Lasry invited the real estate tycoon Barry Sternlicht, a onetime Obama supporter who raised money for Mitt Romney in the last election cycle, to the White House last week. Mr. Lasry, who has $13 billion under management, including $1.3 billion of his own money, is among a small group of Wall Street figures who stuck with the president before the election, even as those like Mr. Sternlicht deserted him.

This core group met with President Obama on Nov. 16, and included Tony James, president of the Blackstone Group, as well as Roger Altman, a Democratic stalwart who is executive chairman of Evercore Partners, and Robert Wolf, a longtime UBS executive who recently began his own firm, 32 Advisors.

Also in attendance were Blair W. Effron, co-founder of Centerview Partners, and Mark T. Gallogly, a Blackstone veteran who founded Centerbridge Partners in 2005.

Catherine Rampell contributed reporting.

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