Pistachio Cake with White Chocolate Cream Recipe, Spotlight on Pistachios, Grinding Nuts, Protecting the Brain, and New Stroke Prevention Guidelines

Looking for a sweet change from that box of chocolates for Valentine’s Day? My cake combines tender pistachio chiffon layers and a rich but not overly sweet cream filling. It’s a showstopper to cap off any celebration. While most of the attention around February 14 is on the heart, I’m sharing important advice for nurturing your brain to stave off two health threats—dementia and stroke.

Pistachio Cake with White Chocolate Cream

• Pistachio Cake with White Chocolate Cream

  Pistachio and white chocolate are two luscious ingredients whose unique tastes enhance each other. This cake is not only delicious but can also be up made up to two days in advance. For the white chocolate, choose a brand that’s 35% cacao and in bar or disc form, not chips, which won’t melt smoothly.

  Ingredients

  For the cake:

  • 4 large eggs 
  • 1 cup cake flour 
  • 1/2 cup ground unsalted pistachios (see Healthy Ingredient Spotlight and Quick Kitchen Nugget in weekly newsletter)
  • 1/2 teaspoon baking powder 
  • 1 cup sugar, divided use 
  • 1/2 cup extra virgin olive oil 
  • 1 teaspoon vanilla
  • 1/3 cup room-temperature water 
  • 1/4 teaspoon fine sea salt
  • 1/2 teaspoon cream of tartar 

  For the filling and garnish:

  • 4-1/2 ounces white chocolate
  • 1-1/2 cups heavy cream, divided use
  • 2 tablespoons confectioners’ sugar
  • 2 pints raspberries
  • 1/4 cup unsalted pistachios, coarsely chopped
  • Optional: edible dried rose petals 

  Directions

  Step 1

  Make the cake: Separate the yolks from the whites when the eggs are cold and allow them to come to room temperature. 

  Step 2

  Place one of your oven racks in the center of the oven; preheat to 325°F. Line a 17-by-13-inch rimmed sheet pan with parchment paper (do not grease it). 

  Step 3

  In a small bowl, whisk together the flour, ground pistachios, and baking powder; set aside. In a large bowl or the bowl of a stand mixer fitted with the whisk attachment, beat the egg yolks and a 1/2 cup of the sugar at medium speed until pale, about 2 minutes. Mix in the olive oil, vanilla, and water. On low speed, fold in the flour mixture. If you have only one stand mixer bowl, transfer the batter to another bowl and wash the stand mixer bowl and whisk thoroughly—any fat will prevent the egg whites from whipping.

  Step 4

  In a separate large bowl or the cleaned bowl of the stand mixer fitted with the whisk attachment, beat the egg whites on medium-low speed until foamy, about 30 seconds. Add the salt, cream of tartar, and remaining 1/2 cup sugar. Slowly increase the speed to high and beat until you achieve a glossy meringue that holds firm peaks, 5 to 8 minutes depending on your mixer.

  Step 5

  Add a 1/4 of the meringue to the batter and mix thoroughly to incorporate (this will lighten it). Add the remaining meringue in 3 batches, gently folding after each addition until only a few streaks of meringue remain (err on the side of undermixing to keep the batter billowy).

  Step 6

  Transfer the batter to the sheet pan and smooth out with a large offset spatula; be sure to get into the corners of the pan. Bake for 10 minutes, then rotate the sheet pan in the oven for more even baking. Continue baking until the top is golden brown and springs back when gently pressed, 10 to 15 minutes more. 

  Step 7

  Remove the sheet pan from the oven and slide the cake and parchment paper onto a wire rack to cool. After 10 minutes, invert the cake onto another rack and gently peel off the parchment paper. Let the cake cool completely. 

  Step 8

  Make the filling: Melt the white chocolate and a 1/3 cup heavy cream in the microwave in 1-minute increments at power 4 until just about melted. Use a small spatula to stir until completely smooth; let cool to room temperature.

  Step 9

  Place the rest of the cream in a large bowl or the clean bowl of the stand mixer fitted with the whisk attachment. Whisk until thick, then with the mixer running on low speed, add the cooled melted white chocolate. Increase the speed and whip until peaks form. Chill in the fridge for 15 minutes for easier spreading.

  Step 10

  While the cream is chilling, trim the edges of the cake. Sprinkle on the confectioners’ sugar and use your hands or a pastry brush to spread it out. Cut the cake into 3 sections, each about 12 inches long and just over 5 inches wide. Rinse the raspberries and pat them dry. Reserve 20 berries and lightly mash the rest in a bowl. 

  Step 11

  To assemble the cake, place one layer on a rectangular serving plate and spread on 1/3 of the filling, then press in half the mashed berries. Repeat with another layer of cake, another 1/3 of the cream, and the rest of the mashed berries. Top with the final cake layer and spread the rest of the cream on top. Garnish with the whole berries, chopped pistachios, and, if desired, rose petals.

  Yields 8 servings

Healthy Ingredient Spotlight

Pistachios

With good amounts of protein, fiber, healthy fats, potassium, B vitamins, and assorted phytochemicals, pistachios are great to include in dishes—from baked goods to salads—and make a smart snack. 

For baking, choose unsalted pistachios and, to bring out their flavor without losing their green color, toast for just a few minutes at a low temperature. Preheat your oven to 300°F. Place the shelled pistachios on a rimmed sheet pan and into the oven for about 5 minutes. Once the nuts cool down a bit, rub them between your hands to remove some of the skins. Wait until the nuts reach room temperature to grind or chop them as needed for your recipe.

Quick Kitchen Nugget

Grinding Nuts

As with almonds, ground pistachios are easy to make at home in a nut or coffee bean grinder. I prefer a grinder and working in batches to using a food processor, unless the goal is to achieve more of a nut butter. To keep ground pistachios light and powdery for a cake, add nuts until the grinder is about half full and process in spurts. Stop the machine as soon as you no longer hear any chopping noise. It typically takes about 2 ounces of shelled nuts to yield a 1/2 cup of nut flour.

For Your Best Health

Protecting the Brain

A recent study supported by the National Institutes of Health and published in Neurology^®, the medical journal of the American Academy of Neurology, looked at a new potential harm of processed and unprocessed red meat: negative impacts on brain health.

“Red meat is high in saturated fat and has been shown in previous studies to increase the risk of type 2 diabetes and heart disease, which are both linked to reduced brain health,” said study author Dong Wang, MD, ScD, of Brigham and Women’s Hospital in Boston. “Our study found processed red meat may increase the risk of cognitive decline and dementia, but the good news is that it also found that replacing it with healthier alternatives, like nuts, fish, and poultry, may reduce a person’s risk.”

The researchers defined processed red meat as bacon, hot dogs, sausages, salami, bologna, and other processed meat products, and unprocessed red meat as beef, pork, lamb, and hamburger. A serving of red meat is 3 ounces, about the size of a deck of cards.

The first part of the research involved 133,771 people with an average age of 49 who did not have dementia at the start of the study. Participants completed a food diary every 2 to 4 years, listing what they ate and how often, enabling the researchers to calculate how much red meat each person ate on average per day. They were followed up to 43 years. Of this group, 11,173 people developed dementia.

To see the effects of processed red meat, they divided the participants into three groups: The low group ate an average of fewer than 0.10 servings per day (think of this as less than 1 serving a week); the medium group ate between 0.10 and 0.24 servings per day (less than 1 to less than 2 servings a week); and the high group, 0.25 or more servings per day (roughly 2 or more servings a week). After adjusting for age, sex, and other risk factors for cognitive decline, researchers found that participants in the high group had a 13% higher risk of developing dementia compared to those in the low group.

To see the effects of unprocessed red meat, they compared people who ate an average of less than half a serving per day to people who ate 1 or more servings per day; they did not find a difference in dementia risk.

The researchers also looked at both subjective cognitive decline and objective cognitive function. Subjective cognitive decline is when a person reports memory and thinking problems before any decline is large enough to show up on standard tests. Objective cognitive function, which can identify decline, is how well your brain works to remember, think, and solve problems. To evaluate meat’s potential effects on subjective cognitive decline, they looked at a different group of 43,966 participants with an average age of 78 who took surveys rating their own memory and thinking skills twice during the study.

After adjusting for age, sex, and other risk factors for cognitive decline, the researchers found that participants who ate an average of 0.25 or more servings per day of processed red meat had a 14% higher risk of subjective cognitive decline compared to those who ate an average of fewer than 0.10 servings per day. They also found people who ate 1 or more servings of unprocessed red meat per day had a 16% higher risk of subjective cognitive decline compared to people who ate less than a 1/2 serving per day.

To evaluate meat’s potential effects on objective cognitive function, the researchers looked at a third group, 17,458 female participants with an average age of 74 who took memory and thinking tests four times during the study.

After adjusting for risk factors, the researchers found that eating more processed red meat was associated with faster brain aging in global cognition with 1.61 years with each additional serving per day and in verbal memory with 1.69 years with each additional serving per day.

Finally, researchers found that replacing 1 serving per day of processed red meat with 1 serving per day of nuts and legumes was associated with a 19% lower risk of dementia and 1.37 fewer years of cognitive aging. Making the same substitution for fish was associated with a 28% lower risk of dementia and replacing with chicken was associated with a 16% lower risk.

“Reducing how much red meat a person eats and replacing it with other protein sources and plant-based options could be included in dietary guidelines to promote cognitive health,” said Dr. Wang. 

A limitation of the study was that it primarily looked at white health care professionals, so the results might not be the same for other race, ethnic, and non-binary sex and gender populations. “More research is needed to assess our findings in more diverse groups,” he concluded. 

Fitness Flash

New Stroke Prevention Guidelines

Each year, over half a million Americans have a first stroke. According to the American Stroke Association, a division of the American Heart Association, up to 80% of strokes may be preventable. Its “2024 Guideline for the Primary Prevention of Stroke” outlines steps that people and their doctors can take to protect against this devastating brain event, including screening people for stroke risk factors and increasing the public’s awareness and knowledge about healthy lifestyle changes to reduce the risk. 

“The most effective way to reduce the occurrence of a stroke and stroke-related death is to prevent the first stroke—referred to as primary prevention,” said the guideline writing group chair, Cheryl D. Bushnell, MD, MHS, FAHA, professor and vice chair of research in the Department of Neurology at Wake Forest University School of Medicine in Winston-Salem, NC. “Some populations have an elevated risk of stroke, whether it be due to genetics, lifestyle, biological factors, and/or social determinants of health, and in some cases, people do not receive appropriate screening to identify their risk.”

The guideline replaces the 2014 version and provides evidence-based recommendations for strategies to support brain health and prevent stroke throughout a person’s life. “This guideline is important because new discoveries have been made since the last update 10 years ago. Understanding which people are at increased risk of a first stroke and providing support to preserve heart and brain health can help prevent a first stroke,” said Dr. Bushnell. 

Modifiable risk factors for stroke, such as high blood pressure, overweight and obesity, elevated cholesterol, and elevated blood sugar, can be identified with physical exams and blood tests. These conditions, the guideline states, should be addressed with healthy lifestyle and behavioral changes and may include medications. A new recommendation is to consider GLP-1 receptor agonist medications, which are FDA-approved to reduce the risk of cardiovascular disease in people who are overweight or obese and/or have type 2 diabetes.

The most common lifestyle behaviors that can help reduce stroke risk include healthy nutrition, regular physical activity, avoiding tobacco, getting healthy sleep, being at a healthy weight, controlling cholesterol, and managing blood pressure and blood sugar. The guideline recommends that adults with no prior cardiovascular disease, as well as those with increased risk, follow a Mediterranean dietary plan. Mediterranean dietary programs have been shown to reduce the risk of stroke, especially when nuts and olive oil are eaten.

The guideline also includes some new specific recommendations for women. Health professionals should screen for conditions that can increase a woman’s risk of stroke, including use of oral contraceptives, high blood pressure during pregnancy, other pregnancy complications such as premature birth, endometriosis, premature ovarian failure, and early onset menopause. For instance, treating elevated blood pressure during pregnancy and within six weeks of delivery is recommended to reduce the risk of maternal intracerebral hemorrhage.

“Most strategies that we recommend for preventing stroke will also help reduce the risk of dementia, another serious health condition related to vascular issues in the brain,” said Dr. Bushnell.

According to the American Stroke Association, it’s also important to remember the warning signs of stroke with the acronym FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911.

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Cold Avocado and Cucumber Soup Recipe and The Mediterranean Diet for Longevity

Members of the Fresh-Pressed Olive Oil Club are well aware of the benefits of extra virgin olive oil as part of the world-famous Mediterranean diet. Dozens of studies have assessed its health effects and its link to longevity, most commonly attributed to its improving heart health. But how the Mediterranean diet works its magic hasn’t been thoroughly understood. Investigators from Brigham and Women’s Hospital in Boston recently published the results of a long-term study that helps unravel this mystery. I’m thrilled to share their findings. And to start, here’s a recipe that highlights the plant-based approach that underscores the Mediterranean way of living. 

Cold Avocado and Cucumber Soup

• Cold Avocado and Cucumber Soup

  There’s nothing more refreshing than a chilled soup for lunch or dinner during the dog days of summer, especially when there’s no cooking needed. I like to add a different kind of heat with a fresh hot pepper, but you can omit it if you aren’t a fan!

  Ingredients

  • 2 pounds cucumbers, about 2-3 large ones
  • 1 small jalapeño, halved and seeded, optional
  • 2 ripe Hass avocados
  • 2 cups plain nonfat Greek yogurt or skyr
  • 3 large scallions, trimmed
  • 3 garlic cloves, peeled 
  • 1 cup packed of fresh parsley, dill, and chives 
  • 1/4 cup extra virgin olive oil, plus more for drizzling 
  • 1/2 cup water, more as needed
  • 1 tablespoon sherry or red wine, more to taste
  • Coarse sea salt, to taste
  • Freshly ground black pepper, to taste
  • Optional garnishes: thin slices of avocado, a dollop of yogurt or skyr, more fresh herbs

  Directions

  Halve the cucumbers lengthwise and use a large spoon to scoop out and discard most of the seeds; leave on the peel. Cut the cucumbers into chunks for easier puréeing. If using the pepper, halve it, scoop out the seeds and veins, and discard them along with the stem. Scoop all the flesh out of the avocados.

  Step 2

  Working in batches as needed, add the cucumbers, avocados, pepper if using, yogurt, scallions, garlic, herbs, olive oil, water, and vinegar to your food processor bowl or blender and process until puréed—the mixture should be fairly thick. If it’s too thick, add more water, 2 tablespoons at a time, until it’s pourable. Taste and season with salt and pepper as desired. Chill in the fridge for about an hour.

  Step 3

  To serve, ladle portions into soup bowls or glasses, garnish as desired, and drizzle with more olive oil.

  Yields 8 servings

For Your Best Health

The Mediterranean Diet for Longevity

The study: “Mediterranean Diet Adherence and Risk of All-Cause Mortality in Women,” JAMA Network Open,2024.

The health benefits of a Mediterranean diet, on its own and when compared to other healthy ways of eating, are so strong that US dietary guidelines have repeatedly designated it as the healthiest recommended diet. It’s also gotten the nod from many health organizations around the globe, including the American Heart Association, European Society of Cardiology, and Australian National Heart Foundation. While these benefits aren’t in doubt, how it achieves them hasn’t been completely understood. This new study sought to better explain the various ways in which the body responds to the diet—how exactly closely following it lowers mortality risk. What’s more, the more than 25,000 participants were American women. In general, women aren’t included in the same numbers as men in most studies, and regarding research on the Mediterranean diet in particular, most studies have been done in the countries surrounding the Mediterranean Sea, where the diet is more of a way of life than in the US.

For the study, researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, followed the women, who were all healthy at the start of the study, for up to 25 years. They found that participants who followed the diet most closely had up to 23% lower risk of all-cause mortality…and found evidence of biological changes to help explain why. They were able to detect and evaluate changes in approximately 40 biomarkers representing various biological pathways and clinical risk factors, both traditional ones and novel ones that hadn’t been used in prior studies. Biomarkers of metabolism and inflammation made the largest contribution, followed by triglyceride-rich lipoproteins, adiposity, and insulin resistance. Smaller contributions were seen from biological pathways relate to branched-chain amino acids, high-density lipoproteins, low-density lipoproteins, glycemic measures, and hypertension. 

“For women who want to live longer, our study says watch your diet!,” said senior author Samia Mora, MD, a cardiologist and the director of the Center for Lipid Metabolomics at the Brigham. “The good news is that following a Mediterranean dietary pattern could result in about one quarter reduction in risk of death over more than 25 years with benefit for both cancer and cardiovascular mortality, the top causes of death in women (and men) in the US and globally.”

“Our research provides significant public health insight: Even modest changes in established risk factors for metabolic diseases, particularly those linked to small molecule metabolites, inflammation, triglyceride-rich lipoproteins, obesity, and insulin resistance, can yield substantial long-term benefits from following a Mediterranean diet,” said lead author Shafqat Ahmad, PhD, an associate professor of epidemiology at Uppsala University Sweden and a researcher in the Center for Lipid Metabolomics and the Division of Preventive Medicine at the Brigham. “This finding underscores the potential of encouraging healthier dietary habits to reduce the overall risk of mortality.”

How the Study Was Conducted

At the start of the study, blood samples, biomarker measurements, and dietary information were taken from the participants, who self-reported demographics and filled out a validated food-frequency questionnaire. The data collection period was from April 1993 to January 1996, and data analysis took place from June 2018 to November 2023.

Each participant was given a score for Mediterranean diet adherence, which ranged from 0 to 9. Eating a higher-than-median amount of each of a list of foods—vegetables (excluding potatoes), fruits, nuts, whole grains, legumes, and fish—earned 1 point. So did eating a good ratio of monounsaturated-to-saturated fatty acids such as olive oil compared to butter, a less-than-median amount of red and processed meat, and having an alcohol intake within the range of 5 to 15 grams a day (one 5-ounce glass of wine, a 12-ounce can of regular beer, or 1.5 ounces of liquor). Participants were then categorized into one of three levels: 0-3 or low, 4-5 or intermediate, and 6-9 or high. Women with scores of 6 or greater had a 23% lower relative risk of all-cause mortality than did women who scored 3 or less. 

“The health benefits of the Mediterranean diet are recognized by medical professionals, and our study offers insights into why the diet may be so beneficial. Public health policies should promote the healthful dietary attributes of the Mediterranean diet and should discourage unhealthy adaptations,” said Dr. Mora.

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