Alcohol as an institution



At the Belhaven pub, Dundee, near the fireplace


I am nine days into a dry January. We all seem to be rethinking alcohol these days, and that can only be a good thing. But, speaking only for myself, I don’t think the time has come for me to give up alcohol.

A lot of ink has been spilled of late after the Powers That Be reversed course and told us that even light drinking has no health benefits. Most of what has been written, though, has a one-size-fits-all tone and seems to forget three important things.

The first thing is that, genetically, one size does not fit all. There are genetic differences in how people metabolize alcohol. This is a little complicated, but it’s worth understanding. The differences have to do with how quickly a certain enzyme cracks apart the alcohol molecule, and how quickly a different enzyme detoxifies the cracked-apart byproduct.

The second thing is that, genetics aside, we are all very different. How old are we? How healthy are we? How stressed are we? Do we tend more toward bad habits, or more toward good habits? When we drink, what do we drink, and how much?

These are all factors that change throughout our lives. The day probably will come when, at a certain age, I will stop drinking because of my age, just as I have realized that, because of my age, I should drink less. Consider Queen Elizabeth II. Her doctors advised her, at the age of 95, to stop having her evening cocktail. She was 96 when she died. I seriously doubt that alcohol shortened her life or impaired her health, even though, on average, Britain, like most countries, has a big drinking problem.

The third thing is that alcohol is an institution. Institutions provide social glue. Alcohol as an institution has many forms — a glass of champagne at a celebration, a pint at a pub with a friend, wine with dinner, cocktails at a reception. The growing of grapes and the making of wine are an art as well as an economic institution, as is the making of fine whiskey and the brewing of beautiful ales. Pubs are a social institution of which I highly approve. These institutions are ancient. People have been making alcohol for at least 10,000 years. Even the most important of Christian sacraments requires wine.

The genetic mutation that allows humans (and some other primates) to efficiently metabolize alcohol was definitely a good thing. That mutation occurred about 10 million years ago, and it allowed our ancestors to eat fallen fruit that had started to ferment. Other fruit-eating animals can metabolize alcohol — birds, for example. Dogs are not fruit-eating animals, and they don’t have the mutation. Bees, because they consume nectar, can metabolize alcohol, and to do it they use the same enzymes as humans.

In short, for humans and some other animals, it would be perfectly correct to think of alcohol as a kind of food, even though it’s an optional food and clearly not something that we can make a diet of.

As for my dry January, my goal is January 25, not January 31. That’s because January 25 is Burns Night, an annual Scottish institution (with toasts!) that I’ve been happy to adopt. Burns Night marks the death of Robert Burns, January 25, 1759. Burns was only 37 when he died. But I don’t think it was alcohol that did him in.

The 2024-2025 Covid and flu vaccines



The influenza B virus. Source: Wikimedia Commons.

I had not had a Covid vaccination since 2021, and I had never had a flu shot (though, lucky for me, it has been more than 30 years since I’ve had the flu). Because I’m going to be on two long flights and two long train rides next month, I figured it was time to go get some shots.

At first I thought it was strange when my doctor’s office said that they don’t have the vaccines. They referred me to the dominant pharmacy chain here, CVS. Then I realized that it’s probably not efficient for small rural practices to keep those vaccines when the pharmacies are doing the job with greater efficiency. I’d never had a shot at a pharmacy before; this is new to me. But I understand that, since 2009, all fifty American states have given pharmacists the right to vaccinate. The pharmacist who gave me the shots said I was her 40th flu shot that day.

I went to a CVS in the little town of Walnut Cove at 6 p.m. on a Friday. The sign said that walk-ins are welcome. I had some questions, and I found that the pharmacist was very well informed. She answered all my questions. Though proof of immunization is not required at present for airline passengers, I asked for some documentation just in case. She gave me two printouts. For the Covid vaccine, I got the “MODERNA 2024-2025 COVID 12YR+,” in which the 12YR+ means that it’s the version of the vaccine for people older than 12. For the flu vaccine, I got the “FLUAD TRIVALENT 2024-2025 SYR,” from a company named Sequirus, Inc. This vaccine is optimized for people over 65. It includes something called MF59, an oil-in-water emulsion that, for reasons not fully understood, increases the effectiveness of the vaccine, which may be important for older people whose immune systems aren’t what they used to be.

The shots cost me nothing. My Humana Medicare Advantage coverage paid for it. I can see online in my Humana account that Humana paid CVS $89.71 for the flu shot and $156.13 for the Covid shot.

As expected, the next day I didn’t feel exactly sick; malaise is probably the best word. I had a low-grade fever of 99.7 the day after, but my temperature was back to normal on day 2. My upper arm is a little sore, but only a little. That’s just what we are told to expect. It’s OK to get the Covid vaccine and the flu vaccine at the same time, but you probably want to time it so that you have a couple of days off to deal with the after-effects.

Modern medicine is a miracle. Yes, drug companies want to gouge us where they can. But I also think that vaccine technologies are far more advanced and far safer than lovers of conspiracy theories will ever admit. The flu and Covid vaccines are products of international cooperation. In addition to the American Centers for Disease Control and Prevention, there is the World Health Organization and the health agencies of other advanced countries, all cooperating on the science and delivery of these vaccines. There is a huge amount of global research on vaccines and their effectiveness.

I have never had Covid. And, by the way, you can still get four free Covid test kits from the U.S. Department of Health & Human services by going here.

Almost ice cream


You do have an ice cream machine, don’t you? They actually work, and they’re not very expensive.

I’d be lying if I claimed that I can make a frozen dessert that’s just as good as ice cream but healthier. But it’s possible to make satisfactory substitutes, and with less work, too. Making real ice cream is a big job. You have to cook a custard, then chill it for hours, then freeze it. And the ingredients are heart-stoppers — egg yolks, cream, and sugar.

Bananas work remarkably well to make no-cream ice cream smoother and less icy. The ice cream in the photo is made from a banana, some dried dates, plain soybean milk, a touch of nutmeg, and a few drops of vanilla. Whiz it in the blender, then put the mixture in the ice cream machine.

The mystery of ketoprofen


I don’t often use medications, but there is one — now hard to get — that is like a miracle for me. It’s ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID) which I assume, given the -profen suffix, is a relative of medications such as ibuprofen.

Back in the 1990s, ketoprofen was available without a prescription. It was sold over the counter as Orudis KT. In my working days, I often had tension headaches. Aspirin, acetominophen, and ibuprofen would barely touch my headaches. One day I saw a TV commercial for Orudis KT, advertising it as a miracle headache remedy. I went out and bought some.

One Orudis KT tablet was a tiny 12.5 milligrams. For comparison, one aspirin is 325mg, one acetominophen tablet is 500mg, and one ibuprofen tablet, such as Aleve, is 220mg. I could take one Orudis KT tablet for a worst-case headache, and 30 minutes later I’d forget I ever had a headache. There were never any side effects. I called them my “little green pills,” and people I worked with would often come to me to beg for one if they had a headache. How could a tiny 12.5 milligrams of something be so effective?

Then in 2005 Orudis KT was taken off the over-the-counter market and was available only by prescription. Clearly I was not the only person who found it remarkably effective. Some of the last remaining bottles of it sold for very high prices on eBay — $30, $40, $50 and more. After that I couldn’t get Orudis KT anymore.

A few years ago a friend in California gave me some ketoprofen that his doctor had prescribed after surgery. Each capsule was a ridiculous 200mg, more ketoprofen than I would ever dare — or need — to take. A few capsules lasted me several years. I’d open the capsule and take out just enough of the powder to come to 12.5 milligrams. Then that ran out.

A couple of weeks ago, I asked my doctor if he’d prescribe some ketoprofen, just so I’d have it for minor aches and pains. I told him how effective it was in small doses and said, “Surely I’d be better off with 12.5 milligrams of ketroprofen rather than 220 milligrams of ibuprofen?” He agreed. He also said that he didn’t know why the drug company took it off the over-the-counter market, but his guess was that it was a way of making more money from it. “Most people don’t know about ketoprofen,” my doctor said. I believe ketoprofen is much better known in Europe and Canada than in the U.S.

When I took the prescription to the drug store, they didn’t have ketoprofen. The pharmacist said they had not stocked it for years and that it was available only in bulk in far larger quantities than the pharmacy would ever be able to sell. The pharmacist referred me to a “compounding pharmacy,” a specialized sort of pharmacy that mixes drugs and doses to order, particularly drugs that are not common. I got my ketoprofen!

From Googling I’ve learned that ketoprofen is very much used as a veterinary drug, particularly in cattle. It is very effective for fever and respiratory diseases in cattle, as well as for mastitis. This has been a problem in a few countries in Asia, including India and Bangladesh. There are about ten NSAID drugs which, when given to cattle, and if one of the cattle dies out in the open from whatever it’s being treated for, and if a vulture then eats it, the vulture’s kidneys may be fatally damaged. Apparently it’s only Asian vultures that are susceptible. Ketoprofen is actually used as a veterinary drug with chickens, ducks, and quail, as well as pet birds such as parakeets. As far as I know, no species of animal in the U.S. or Europe is harmed by ketoprofen.

Outsourcing is now an option



I grew the tomatoes on the upper shelf. The tomatoes on the lower shelf were part of my weekly vegetable pickup.

Technically, where I live is a food desert. The nearest grocery stores are about twelve miles away. A shocking number of rural people get most of their food these days from dollar stores such as Dollar General. Dollar General stores are everywhere. This makes it easier for me to believe the terrifying statistic that 70 percent of the American diet these days comes from ultra-processed foods.

It’s shocking how few rural people have vegetable gardens. And why should they? They don’t eat that stuff anymore. With transplants it’s a different story.

I’ve always had a garden, for better or for worse, in the fifteen years I’ve lived here. However, I do not enjoy — at all — summer gardening. It’s the heat, the humidity, the bugs, the ticks, the weeds, the briars, the gnats in the eyes. No matter how energetic my start in the spring, by summer the garden is always a wreck.

This summer I have an entirely new option. A young couple who live about two miles away (transplants from the Chicago area) have taught themselves to be superb gardeners. When they first moved here, they had day jobs. But this year they’ve quit their jobs and are making a living with their garden. Mostly they sell on Saturdays at an upscale farmer’s market in Greensboro. But, for a few local people like me, they started a weekly pickup of an assortment of vegetables — community supported agriculture. I was able to downsize my own garden this summer to a very manageable one row of nothing but tomatoes and basil, both of which are easy to grow and neither of which I’d be able to live without in summer.

These two young people taught themselves to garden, mostly by watching a lot of videos. In retrospect, I can see what a good idea that is. Old hands like me tend to garden the way we saw it done as children, and though we may experiment with newer methods, we never reach the state of the art. Whereas the garden I’m buying from this summer is a sight to behold. I’ve never seen anything like it other than at Monticello, or an abbey garden on Iona in Scotland. Almost half the garden is in flowers. They don’t till. Everything is perfectly mulched and well watered. The climbing system for such things as beans and cucumbers is ingenious, not to mention tall. They make their own compost, partly from the compostables they collect from their customers in Greensboro as part of the business. They even make enough wine for their own consumption, from native varieties of grapes.

There may well be some local young people — that is, young people who were born here and grew up here — who are interested in doing this kind of thing. But I don’t know of any. The reason for this, as I see it, has everything to do with the cultural decline of the rural deplorables. In a county that voted 78 percent for Trump in 2020, it’s safe to assume that 78 percent of the calories are coming from Dollar General and fast food from the nearest towns — Walnut Cove and Madison. These people — the people who are making America great again — eat their burgers and chicken sandwiches in the car and throw the bags, wrappers, and empty cups out the window onto the road.

Show me someone who lives otherwise, and the odds will be greater than 78 percent that that person is a liberal.


The nearby gardeners, at their booth at a Greensboro farmer’s market


Feasting your inner pet



Lentil-barley burger with fixin’s

Just in the last ten to twenty years, we’ve gotten a whole new insight into how to use food to keep ourselves healthy. That new insight has to do with our microbiome. For much longer than that, we’ve known that antibiotics will do serious harm to our digestive systems. Even so, we didn’t appreciate just how important the microbiome is and how to take care of it. We also know now why, beyond the stomach, we have a two-stage digestive system. Cows have four stages, but we humans don’t eat grass. Still, we humans are omnivores (except for grass), and now we know much more about why we require a two-stage digestive system. The first stage in humans is about the enzymes, and all that, which break down our food and feed us. The second stage is all about feeding the microbiome. And feeding the microbiome is all about fermentation.

The favorite food of the microbiome is soluble fiber. That’s what ferments best, that’s what is most nutritious to the microbiome, and that’s what creates the nutrients that we need but that we can’t acquire directly from our food. One of the key signs of a healthy microbiome is a low level of inflammation everywhere in the body. That’s because of the nutrients that only the microbiome can produce. Unsurprisingly and conversely, one of the key signs of a poorly fed microbiome is inflammation everywhere in the body. We probably notice it first in our joints. We don’t notice it in our arteries — a very dangerous place indeed for inflammation.

I’ve started thinking of the microbiome as a kind of inner pet, a pet that we should take care of as carefully as we take care of our cat. One of the things we’ve learned is that the makeup of our microbiome can change very quickly, based on what we eat. There’s also an inertia in the microbiome, because our inner pet adjusts to what we eat, and, once adjusted, wants to go on eating the same thing. If you’re living on pizza, doughnuts, and TV dinners, then that’s very bad news, because that’s what your microbiome will crave. But if you have a well-fed microbiome, then what you crave will be healthy food. There are many references in the literature to a brain-gut connection, but I’m not sure we know yet how that really works. Presumably the microbiome creates substances that are carried by the bloodstream to the brain and tell us what to crave.

Two of the foods highest in soluble fiber are lentils and barley. The two of them together, with seasonings, make mighty fine burgers for feasting for both stages of your digestive system.

I use organic green lentils, which I buy in bulk from Whole Foods. I make barley flour by grinding organic hulled barley, using an old Champion juicer with a milling attachment. Organic hulled barley is hard to find locally, but you can get it from Amazon. I believe that every well-equipped kitchen should have a grinder for flour. I buy unbleached wheat flour already ground. But I use my grinder for whole wheat flour and barley flour.

Just as your cat nags you when it wants to be fed, your microbiome will nag you, too. It will nag you for more of whatever you’ve been eating lately. If you feed your microbiome lots of soluble fiber, I can testify that that’s what it will nag you for. I eat fiber because it’s good for us. But I also eat it — no kidding — because that’s one of the main things that my microbiome nags me for.

But I still like a nice slice of pizza a few times a year.

Must we rethink alcohol?



From “Masterpiece Endeavour,” Season 2: Morse in a pub

Only a few years ago, the “experts” told us that a certain amount of alcohol actually was good for us — say, two glasses of wine a day. In the last year or so, that has reversed, and now we encounter article after article saying that alcohol has no health benefits and that the ideal amount of alcohol is — none.

The experts can go hang.

In my lifetime, the record of the experts has been abysmal. Meat is good for you. Then it’s not. Eggs are good for you. Then they’re not. Margarine is healthier than butter. Then no amount of margarine is healthy. Vegetable shortening is better than lard. Then no amount of vegetable shortening is healthy. The ideal diet is starvingly low in fat. That’s disproven, and carbs become the culprit. It would seem that the best course is to always be skeptical of what the experts tell us and to use our own good sense.

As I understand it, the experts’ mistake concerning alcohol was a classic error of causation. It seems that people who drink one or two glasses of wine a day are in fact healthier. But the alcohol probably isn’t the cause of that. Maybe it’s because healthy people don’t have to give up alcohol for health reasons, or because people who can afford wine can afford an all-around better diet, or because people who drink wine tend to be better educated, and education correlates with health. So it seems to be — at least in the new thinking — that people who drink wine sparingly are indeed healthier, but the wine is not the cause of that.

For those of us who are healthy and like to drink, then what does it all mean? I think we all have to decide for ourselves. But my own thinking is that, partly because of my age, I need to drink less than I drank two or three decades ago when I was younger, quite healthy, living in San Francisco, and used alcohol as self-medication for work-related stress. Back then, I head a stress headache several times a week. Now I don’t think I’ve had a headache in the 15 years I’ve been retired. Obviously my stress is lower. I’m still healthy, but I’m also older. I also realized that it’s not healthy, or even pleasant, to have alcohol in my system at bedtime. That means drinking earlier in the day (which feels decadent at first) and never drinking (or, for that matter, eating) after 5 p.m.

In the past few weeks, I’ve watched the first eight seasons of “Masterpiece Endeavour.” Starting tonight, I’ll watch the last season, season 9. “Endeavour” is set in the late 1960s up until, I think, 1971. It is shocking — and in a way funny — to watch them drink. They keep Scotch and glasses in their offices at work. They drink at their desks, though clearly it’s considered proper not to start too early. In pubs, they may have a glass of Scotch along with a mug of ale. They serve Scotch in big tumblers, and four or five ounces seems to be the standard single serving. A pint of ale with lunch is perfectly normal. Did people — or at least the English — really drink that much then? Though everyone in “Endeavour” drinks heavily as far as I can tell, Morse gradually becomes an alcoholic. For those who may not have watched this series and who might want to watch it, I won’t say how that fits into the ongoing plot because it would be a spoiler.

A recent article in The Atlantic by Emily Oster has this headline: “Is a Glass of Wine Harmless? Wrong Question. The latest alcohol advice ignores the value of pleasure.” I’m with Emily. People have been drinking alcohol for thousands of years. Wine, Scotch, and ale are amazing products — agricultural products, really. Since too much alcohol is pretty obviously harmful, then the trick is to be sure that one’s relationship with alcohol is not causing any harm.

I will continue to do my share to support Scotland’s Scotch industry and California’s wine industry.

Big savings on both money and pain


My old WaterPik died after eight years of service. I ordered a new one from Amazon. The new models have some small improvements. The lid pops up and stays put rather than coming off completely. The water tube curls up inside the case when it’s not in use, saving a little space. I don’t yet know what the “massage” setting is, but my guess is that it drives the little rotating toothbrush that was included with the WaterPik. I can’t wait to try that out.

I’m a faithful flosser. But I learned that unless I use a WaterPik daily in addition to flossing, it’s hard to always get the numbers one wants in the periodontal gum scores done by your dental hygienist — that is, all 1mm, 2mm, and 3mm. I found that, with flossing alone, I tended to get a 4mm or two around a molar. WaterPiks finish the job that flossing and brushing begins.

Many people don’t realize that more teeth are lost to gum disease than to tooth decay. There also is a mysterious connection between inflammation of the gums and inflammation elsewhere in the body, including the arteries. As far as I know, no causal connection has been proven. But the odds are that if you have healthy gums, you also have healthy arteries and joints. WaterPiks pay for themselves many times over not only in savings at the dentist’s office, but also in misery avoided.

Country-style seitan



Country-style steak made from seitan

I have bought seitan in the past (it’s very expensive), and I didn’t really like it. Homemade seitan is a whole ′nother thing. The key ingredient is gluten flour. Gluten alone would be impossibly rubbery, so a certain amount of ground legumes (I used garbanzo beans in the seitan in the photo) is needed to optimize the “bite” of the seitan. And because gluten and legumes alone wouldn’t have much flavor, sauce and seasoning are very important.

I feel sorry for those who can’t tolerate gluten (most people can) or who avoid gluten for some reason. My suspicion is that gluten takes the rap for the downsides of white flour. And, in my view, even white flour has its essential uses, in moderation. Personally, I love gluten, and I have no reason to suspect that gluten has done me or my digestive system any harm. Quite the opposite, I would testify. Gluten is a good source of vegetarian protein.

Anyway, here is a good basic recipe for seitan. That recipe uses 3 parts gluten to 2 parts legume. That’s too much gluten, in my opinion. Even 1 to 1 seems a little high on gluten, so you should experiment with the proportions. The recipe in the link uses lentils. I usually use cooked chickpeas. But any legume would work. Varying the type of legume would vary the spin of the seitan. If you want something more chickeny, use chickpeas. For something more beefy, use blackbeans. Recipes differ on how to cook the seitan. I shape the dough and simmer the seitan in stock. That seems simplest, plus the seitan absorbs flavor from the stock.

I welcome the trend toward fake meats. However, after my initial enthusiasm, I find that I’m not all that interested in fake meats. For one, they’re just too meaty. I prefer vegetarian alternatives that are high in protein but that don’t pretend to be anything other than what they are. Though, according to Wikipedia, the word “seitan” is new, wheat gluten has been eaten in Asia for hundreds of years. The Chinese word translates to “dough tendon,” which is a fine description of the texture of gluten unless you cut the gluten with something that isn’t so rubbery.

Is gluten a processed food? I would argue that it is not. Even old water-powered mills could produce flour from the germ of the wheat. They called it “shorts” flour and sold it as food for pigs. Separating the germ from the bran from the white endosperm after milling was just a matter of sifting, as far as I know.

Seitan is very absorbent, so it loves sauces and gravies. For Asian dishes, I’d suggest cutting it into thin strips (and giving the seitan a quick stir-fry) as though you were making beef and broccoli. Seitan steaks, with dark gravy, naturally, lie at the Western end of the seitan spectrum. I rolled the seitan steak in seasoned flour and lightly fried it, the better to simulate country-style steak.

Seitan is high in protein and low in carbs. It’s also low in fiber, so I think it’s a good idea to serve it with high-fiber foods. I kneaded grated carrots and chopped onions into the seitan in the photo, not only to increase the fiber but also to improve the bite.