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The U.S. government is poised to withdraw longstanding warnings about cholesterol. 

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The nation’s top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption.


Time to put eggs back on the menu? 

The group’s finding that cholesterol in the diet need no longer be considered a “nutrient of concern” stands in contrast to the committee’s findings five years ago, the last time it convened. During those proceedings, as in previous years, the panel deemed the issue of excess cholesterol in the American diet a public health concern.

The finding follows an evolution of thinking among many nutritionists who now believe that, for healthy adults, eating foods high in cholesterol may not significantly affect the level of cholesterol in the blood or increase the risk of heart disease.

The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.

The new view on cholesterol in food does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.

While Americans may be accustomed to conflicting dietary advice, the change on cholesterol comes from the influential Dietary Guidelines Advisory Committee, the group that provides the scientific basis for the “Dietary Guidelines.” That federal publication has broad effects on the American diet, helping to determine the content of school lunches, affecting how food manufacturers advertise their wares, and serving as the foundation for reams of diet advice.

The panel laid out the cholesterol decision in December, at its last meeting before it writes a report that will serve as the basis for the next version of the guidelines. A video of the meeting was later posted online and a person with direct knowledge of the proceedings said the cholesterol finding would make it to the group’s final report, which is due within weeks.

After Marian Neuhouser, chair of the relevant subcommittee, announced the decision to the panel at the December meeting, one panelist appeared to bridle.

“So we’re not making a [cholesterol] recommendation?” panel member Miriam Nelson, a Tufts University professor, said at the meeting as if trying to absorb the thought. “Okay … Bummer.”

Members of the panel, called the Dietary Guidelines Advisory Committee, said they would not comment until the publication of their report, which will be filed with the Department of Health and Human Services and the Department of Agriculture.

While those agencies could ignore the committee’s recommendations, major deviations are not common, experts said.

Five years ago, “I don’t think the Dietary Guidelines diverged from the committee’s report,” said Naomi K. Fukagawa, a University of Vermont professor who served as the committee’s vice chair in 2010. Fukagawa said she supports the change on cholesterol.

Walter Willett, chair of the nutrition department at the Harvard School of Public Health, also called the turnaround on cholesterol a “reasonable move.”

“There’s been a shift of thinking,” he said.

But the change on dietary cholesterol also shows how the complexity of nutrition science and the lack of definitive research can contribute to confusion for Americans who, while seeking guidance on what to eat, often find themselves afloat in conflicting advice.

Cholesterol has been a fixture in dietary warnings in the United States at least since 1961, when it appeared in guidelines developed by the American Heart Association. Later adopted by the federal government, such warnings helped shift eating habits — per capita egg consumption dropped about 30 percent — and harmed egg farmers.

Yet even today, after more than a century of scientific inquiry, scientists are divided.

Some nutritionists said lifting the cholesterol warning is long overdue, noting that the United States is out-of-step with other countries, where diet guidelines do not single out cholesterol. Others support maintaining a warning.

***

The forthcoming version of the Dietary Guidelines — the document is revised every five years — is expected to navigate myriad similar controversies. Among them: salt, red meat, sugar, saturated fats and the latest darling of food-makers, Omega-3s.

As with cholesterol, the dietary panel’s advice on these issues will be used by the federal bureaucrats to draft the new guidelines, which offer Americans clear instructions — and sometimes very specific, down-to-the-milligram prescriptions. But such precision can mask sometimes tumultuous debates about nutrition.

“Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome,” John P.A. Ioannidis, a professor of medicine and statistics at Stanford and one of the harshest critics of nutritional science, has written. “In this literature of epidemic proportions, how many results are correct?”

Now comes the shift on cholesterol.

Even as contrary evidence has emerged over the years, the campaign against dietary cholesterol has continued. In 1994, food-makers were required to report cholesterol values on the nutrition label. In 2010, with the publication of the most recent “Dietary Guidelines,” the experts again focused on the problem of “excess dietary cholesterol.”

Yet many have viewed the evidence against cholesterol as weak, at best. As late as 2013, a task force arranged by the American College of Cardiology and the American Heart Association looked at the dietary cholesterol studies. The group found that there was “insufficient evidence” to make a recommendation. Many of the studies that had been done, the task force said, were too broad to single out cholesterol.

“Looking back at the literature, we just couldn’t see the kind of science that would support dietary restrictions,” said Robert Eckel, the co-chair of the task force and a medical professor at the University of Colorado.

The current U.S. guidelines call for restricting cholesterol intake to 300 milligrams daily. American adult men on average ingest about 340 milligrams of cholesterol a day, according to federal figures. That recommended figure of 300 milligrams, Eckel said, is ” just one of those things that gets carried forward and carried forward even though the evidence is minimal.”

“We just don’t know,” he said.

Other major studies have indicated that eating an egg a day does not raise a healthy person’s risk of heart disease, though diabetic patients may be at more risk.

“The U.S. is the last country in the world to set a specific limit on dietary cholesterol,” said David Klurfeld, a nutrition scientist at the U.S. Department of Agriculture. “Some of it is scientific inertia.”

***

The persistence of the cholesterol fear may arise, in part, from the plausibility of its danger.

As far back as the 19th century, scientists recognized that the plaque that clogged arteries consisted, in part, of cholesterol, according to historians.

It would have seemed logical, then, that a diet that is high in cholesterol would wind up clogging arteries.

In 1913, Niokolai Anitschkov and his colleagues at the Czar’s Military Medicine Institute in St. Petersburg, decided to try it out in rabbits. The group fed cholesterol to rabbits for about four to eight weeks and saw that the cholesterol diet harmed them. They figured they were on to something big.

“It often happens in the history of science that researchers … obtain results which require us to view scientific questions in a new light,” he and a colleague wrote in their 1913 paper.

But it wasn’t until the 1940s, when heart disease was rising in the United States, that the dangers of a cholesterol diet for humans would come more sharply into focus.

Experiments in biology, as well as other studies that followed the diets of large populations, seemed to link high cholesterol diets to heart disease.

Public warnings soon followed. In 1961, the American Heart Association recommended that people reduce cholesterol consumption and eventually set a limit of 300 milligrams a day. (For comparison, the yolk of a single egg has about 200 milligrams.)

Eventually, the idea that cholesterol is harmful so permeated the country’s consciousness that marketers advertised their foods on the basis of “no cholesterol.”

***

What Anitschkov and the other early scientists may not have foreseen is how complicated the science of cholesterol and heart disease could turn out: that the body creates cholesterol in amounts much larger than their diet provides, that the body regulates how much is in the blood and that there is both “good” and “bad” cholesterol.

Adding to the complexity, the way people process cholesterol differs. Scientists say some people — about 25 percent — appear to be more vulnerable to cholesterol-rich diets.

“It’s turned out to be more complicated than anyone could have known,” said Lawrence Rudel, a professor at the Wake Forest University School of Medicine.

As a graduate student at the University of Arkansas in the late 1960s, Rudel came across Anitschkov’s paper and decided to focus on understanding one of its curiosities. In passing, the paper noted that while the cholesterol diet harmed rabbits, it had no effect on white rats. In fact, if Anitschkov had focused on any other animal besides the rabbit, the effects wouldn’t have been so clear — rabbits are unusually vulnerable to the high-cholesterol diet.

“The reason for the difference — why does one animal fall apart on the cholesterol diet — seemed like something that could be figured out,” Rudel said. “That was 40 or so years ago. We still don’t know what explains the difference.”

In truth, scientists have made some progress. Rudel and his colleagues have been able to breed squirrel monkeys that are more vulnerable to the cholesterol diet. That and other evidence leads to their belief that for some people — as for the squirrel monkeys — genetics are to blame.

Rudel said that Americans should still be warned about cholesterol.

“Eggs are a nearly perfect food, but cholesterol is a potential bad guy,” he said. “Eating too much a day won’t harm everyone, but it will harm some people.”

***

Scientists have estimated that, even without counting the toll from obesity, disease related to poor eating habits kills more than half a million people every year. That toll is often used as an argument for more research in nutrition.

Currently, the National Institutes of Health spends about $1.5 billion annually on nutrition research, an amount that represents about 5 percent of its total budget.

The turnaround on cholesterol, some critics say, is just more evidence that nutrition science needs more investment.

Others, however, say the reversal might be seen as a sign of progress.

“These reversals in the field do make us wonder and scratch our heads,” said David Allison, a public health professor at the University of Alabama at Birmingham. “But in science, change is normal and expected.”

When our view of the cosmos shifted from Ptolemy to Copernicus to Newton and Einstein, Allison said, “the reaction was not to say, ‘Oh my gosh, something is wrong with physics!’ We say, ‘Oh my gosh, isn’t this cool?’ ”

Allison said the problem in nutrition stems from the arrogance that sometimes accompanies dietary advice. A little humility could go a long way.

“Where nutrition has some trouble,” he said, “is all the confidence and vitriol and moralism that goes along with our recommendations.”

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A new CRISPR breakthrough could lead to simpler, cheaper disease diagnosis

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Scientists say SHERLOCK is a ‘game changer’

Scientists say SHERLOCK, a new CRISPR breakthrough and diagnosis tool, could be a game changer for the ability to identify infectious diseases like Zika.

The controversial laboratory tool known as CRISPR may have found a whole new world to conquer. Already the favored method of editing genes, CRISPR could soon become a low-cost diagnostic tool that could be used practically anywhere to determine if someone has an infectious disease such as Zika or dengue.

CRISPR — which stands for Clustered Regularly Interspaced Short Palindromic Repeats — is basically a bacterial immune system that uses “molecular scissors” to snip away genetic material from invasive viruses. Early in this decade, researchers figured out how to exploit the natural system to craft a relatively cheap, remarkably easy-to-use technology for editing genetic codes almost as readily as using a word processor to revise a paragraph.

On Thursday, Feng Zhang, one of the pioneers of CRISPR, and 18 colleagues published a paper in the journal Science showing how they had turned this system into an inexpensive, reliable diagnostic tool for detecting nucleic acids — molecules present in an organism’s genetic code — from disease-causing pathogens. The new tool could be widely applied to detect not only viral and bacterial diseases but also potentially for finding cancer-causing mutations.

CRISPR has been a sensation in the world of molecular biology, but the powerful tool has incited fears that it could be misused. Ethicists earlier this year released a report saying it should be limited in humans to treating diseases or disabilities, and with special caution when genetic changes would involve eggs, sperm or embryos and potentially be inherited by future generations. But CRISPR is already widely used in laboratory studies and has shown great promise in revealing the genetic origins of diseases, including cancer. This new application would propel CRISPR into the much less controversial realm of point-of-care disease diagnosis.

The new study has a whiff of marketing about it: Zhang and his colleagues have named their new tool SHERLOCK — for Specific High Sensitivity Enzymatic Reporter UnLOCKing.

“Nature is really amazing. Over the course of billions of years, it’s come up with all these very powerful enzyme systems, and by studying the basic biology of these systems, some of them will give rise to important applications — like genome editing, like diagnostics,” Zhang, of the Broad Institute of MIT and Harvard, told The Washington Post.

Co-author Jim Collins, also of the Broad Institute, said, “In this diagnostic application we are really harnessing the power and diversity of biology. … I view it as a potentially transformative diagnostic platform.”

In essence they have taken the virus-recognition properties of the bacterial CRISPR system and turned it into a technique for telling if someone’s blood, urine, saliva or other bodily fluid contains genetic markers of a pathogen. The earlier gene-editing tool used a molecule called CRISPR Cas9, but this one uses another enzyme, characterized for the first time only a year ago, and now dubbed Cas13a.

They report that their technique is highly portable and could cost as little as 61 cents per test in the field. Such a process would be extremely useful in remote places without reliable electricity or easy access to a modern diagnostic laboratory.

“We showed that this system is very stable, so you can really put it on a piece of paper and it will survive. You don’t have to refrigerate it all the time,” Zhang said.

“My head is spinning a little bit because this looks very, very provocative. And exciting,” said William Schaffner, a professor of infectious diseases and preventive medicine at Vanderbilt University Medical Center, who was not involved in the new research. “If you had something that could be used as a screening test, very inexpensively and rapidly, that would be a huge advance, particularly if it could detect an array of infectious agents.”

Collins said the scientists behind SHERLOCK have filed for patents on the technology, and are discussing ways to move their new tool from the laboratory to the clinical arena.

Zhang is one of the key figures in the CRISPR patent fight between the Broad Institute and the University of California at Berkeley, the latter the homebase of CRISPR pioneer Jennifer Doudna. The patent board ruled in favor of Zhang and Broad earlier this year. Doudna and another researcher had published their CRISPR discoveries first, but Zhang took the technique another step, into cells with nuclei, and the patent board ruled that the second step was sufficiently different that both could be eligible for patent protection. On Thursday, Berkeley and other interested parties filed an appeal of that ruling.

Scott Weaver, an infectious disease researcher at the University of Texas Medical Branch at Galveston, who was not involved in the new research, said after reading the study, “It looks like one significant step on the pathway which is the Holy Grail, which is developing point-of-care, or bedside detection, which doesn’t require expensive equipment or even reliable power.”

Harvard geneticist George Church is one of the lead researchers propelling CRISPR, a breakthrough gene-editing technique, into the future.
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CRISPR is capable of preventing congenital disease.
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20 percent of patients with serious conditions are first misdiagnosed, study says

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More than 20 percent of patients who sought a second opinion at one of the nation’s premier medical institutions had been misdiagnosed by their primary care providers, according to new research published Tuesday.

Twelve percent of the people who asked specialists at the Mayo Clinic in Rochester, Minn., to review their cases had received correct diagnoses, the study found. The rest were given diagnoses that were partly in line with the conclusions of the Mayo doctors who evaluated their conditions.

The results are generally similar to other research on diagnostic error but provide additional evidence for advocates who say such findings show that the health-care system still has room for improvement.

“Diagnosis is extremely hard,” said Mark L. Graber, a senior fellow at the research institute RTI International and founder of the Society to Improve Diagnosis in Medicine. “There are 10,000 diseases and only 200 to 300 symptoms.”

Graber was not involved in the Mayo Clinic research, which appears in the Journal of Evaluation in Clinical Practice.

 In 2015, the National Academy of Medicine reported that most people will receive an incorrect or late diagnosis at least once in their lives, sometimes with serious consequences. It cited one estimate that 12 million people — about 5 percent of adults who seek outpatient care — are misdiagnosed annually. The report also noted that diagnostic error is a relatively under-measured and understudied aspect of patient safety.

According to previous research cited in the new study, diagnostic errors “contribute to approximately 10 percent of patient deaths” and “account for 6 to 17 percent of adverse events in hospitals.” Graber estimates that the rate of misdiagnosis, although difficult to determine, occurs in 10 percent to 20 percent of cases.

“Diagnostic error is an area where we need more research, more study and more information,” said James M. Naessens, a professor of health services research at the Mayo Clinic, who led its study. “The second opinion is a good approach for certain patients to figure out what’s there and to keep costs down.”

The researchers looked retrospectively at 286 patients who had seen primary-care physicians, physician assistants and nurse practitioners in 2009 and 2010. Nearly two-thirds were younger than 64, and most were female.

With or without the help of their initial provider, those people sought additional advice from the Mayo Clinic’s internal medicine department. That makes the group somewhat different from the general population, Naessens said, because their conditions were serious enough to merit another look by some of the best physicians in the country.

 “It’s not going to be 20 percent wrong every time” a patient goes to see a doctor, Naessens said.

In 62 cases (21 percent), the second diagnosis was “distinctly different” from the first, the researchers reported. In 36 cases (12 percent), the diagnoses were the same. In the remaining 188 cases, the diagnoses were at least partly correct but were “better defined/refined” by the second opinion, according to the study.

Naessens and Graber said a second opinion is valuable any time a patient is told he or she has a serious condition, such as cancer, or needs surgery — even if an extra visit initially means more expense. In the long run, additional advice can save lives and money, they said.

“Doctors are humans, and they make the same cognitive mistakes we all make,” Graber said. “If you are given a serious diagnosis, or you’re not responding the way you should [to medication], a second opinion is a very good idea. Fresh eyes catch mistakes.”

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Before I Go: A Stanford neurosurgeon’s parting wisdom about life and time

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Paul Kalanithi savors a moment with his daughter, Cady

In residency, there’s a saying: The days are long, but the years are short. In neurosurgical training, the day usually began a little before 6 a.m., and lasted until the operating was done, which depended, in part, on how quick you were in the OR.

A resident’s surgical skill is judged by his technique and his speed. You can’t be sloppy and you can’t be slow. From your first wound closure onward, spend too much time being precise and the scrub tech will announce, “Looks like we’ve got a plastic surgeon on our hands!” Or say: “I get your strategy — by the time you finish sewing the top half of the wound, the bottom will have healed on its own. Half the work — smart!” A chief resident will advise a junior: “Learn to be fast now — you can learn to be good later.” Everyone’s eyes are always on the clock. For the patient’s sake: How long has the patient been under anesthesia? During long procedures, nerves can get damaged, muscles can break down, even causing kidney failure. For everyone else’s sake: What time are we getting out of here tonight?

There are two strategies to cutting the time short, like the tortoise and the hare. The hare moves as fast as possible, hands a blur, instruments clattering, falling to the floor; the skin slips open like a curtain, the skull flap is on the tray before the bone dust settles. But the opening might need to be expanded a centimeter here or there because it’s not optimally placed. The tortoise proceeds deliberately, with no wasted movements, measuring twice, cutting once. No step of the operation needs revisiting; everything proceeds in orderly fashion. If the hare makes too many minor missteps and has to keep adjusting, the tortoise wins. If the tortoise spends too much time planning each step, the hare wins.

The funny thing about time in the OR, whether you frenetically race or steadily proceed, is that you have no sense of it passing. If boredom is, as Heidegger argued, the awareness of time passing, this is the opposite: The intense focus makes the arms of the clock seem arbitrarily placed. Two hours can feel like a minute. Once the final stitch is placed and the wound is dressed, normal time suddenly restarts. You can almost hear an audible whoosh. Then you start wondering: How long till the patient wakes up? How long till the next case gets started? How many patients do I need to see before then? What time will I get home tonight?

It’s not until the last case finishes that you feel the length of the day, the drag in your step. Those last few administrative tasks before leaving the hospital, however far post-meridian you stood, felt like anvils. Could they wait till tomorrow? No. A sigh, and Earth continued to rotate back toward the sun.

But the years did, as promised, fly by. Six years passed in a flash, but then, heading into chief residency, I developed a classic constellation of symptoms — weight loss, fevers, night sweats, unremitting back pain, cough — indicating a diagnosis quickly confirmed: metastatic lung cancer. The gears of time ground down. While able to limp through the end of residency on treatment, I relapsed, underwent chemo and endured a prolonged hospitalization.

I emerged from the hospital weakened, with thin limbs and thinned hair. Now unable to work, I was left at home to convalesce. Getting up from a chair or lifting a glass of water took concentration and effort. If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: The day shortened considerably. A full day’s activity might be a medical appointment, or a visit from a friend. The rest of the time was rest.

With little to distinguish one day from the next, time began to feel static. In English, we use the word time in different ways, “the time is 2:45” versus “I’m going through a tough time.” Time began to feel less like the ticking clock, and more like the state of being. Languor settled in. Focused in the OR, the position of the clock’s hands might seem arbitrary, but never meaningless. Now the time of day meant nothing, the day of the week scarcely more so.

Verb conjugation became muddled. Which was correct? “I am a neurosurgeon,” “I was a neurosurgeon,” “I had been a neurosurgeon before and will be again”? Graham Greene felt life was lived in the first 20 years and the remainder was just reflection. What tense was I living in? Had I proceeded, like a burned-out Greene character, beyond the present tense and into the past perfect? The future tense seemed vacant and, on others’ lips, jarring. I recently celebrated my 15th college reunion; it seemed rude to respond to parting promises from old friends, “We’ll see you at the 25th!” with “Probably not!”

Yet there is dynamism in our house. Our daughter was born days after I was released from the hospital. Week to week, she blossoms: a first grasp, a first smile, a first laugh. Her pediatrician regularly records her growth on charts, tick marks of her progress over time. A brightening newness surrounds her. As she sits in my lap smiling, enthralled by my tuneless singing, an incandescence lights the room.

Time for me is double-edged: Every day brings me further from the low of my last cancer relapse, but every day also brings me closer to the next cancer recurrence — and eventually, death. Perhaps later than I think, but certainly sooner than I desire. There are, I imagine, two responses to that realization. The most obvious might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions. Part of the cruelty of cancer, though, is not only that it limits your time, it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. But even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder, some days I simply persist.

Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described, hold so little interest: a chasing after wind, indeed.

Yet one thing cannot be robbed of her futurity: my daughter, Cady. I hope I’ll live long enough that she has some memory of me. Words have a longevity I do not. I had thought I could leave her a series of letters — but what would they really say? I don’t know what this girl will be like when she is 15; I don’t even know if she’ll take to the nickname we’ve given her. There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past.

That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.

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Goat meat, the final frontier

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In 30 short years, we have watched goat cheese morph from a high “ick” factor to an outright cliche. Goat’s milk and goat butter have become supermarket staples, no longer relegated to health-food stores. Yet goat meat sits out on the horizon, with trendspotters periodically informing us that it’s the next big thing.

Pam Adams, head of the Maryland-Pennsylvania-West Virginia Meat Goat Producers Association, says demand for the goods from the group’s 64 farms has increased 20 percent over the past five years.

“I’ve even had to band growers into collectives to keep up with the requests,” she said from her Bridgestone Manor Farms in Eldersburg, Md. “I’ve got an order for 60 goats right now to go down to North Carolina. I’m scrambling.”

This does, in fact, reflect a national trend. Goat meat production is ramping up in the United States. The number of goats slaughtered has doubled every 10 years for the past three decades, according to the USDA. We’re closing in on 1 million meat goats a year — and still growing, despite the economic downturn.

It’s no surprise. Goat meat’s cultural caveats are few, as it can be kosher and halal as well.

Nutrition-wise, goat meat is a wonder. A similarly sized serving has a third fewer calories than beef, a quarter fewer than chicken and much less fat: up to two-thirds less than a similar portion of pork and lamb; less than half as much as chicken.

More good news: Goats represent sustainability, without the curse of factory production. They are browsers, not grazers.

“The meat’s better for you, and the animals are easier on the land,” Adams says. “I can put at most two steers on an acre, but at least 10 goats. Maybe more.”

Out in California in 2008, Bill Niman originally fielded a herd to tend his cow pastures. The goats would even out what the cows mangled, chewing down the less-desirable weeds, giving the plants a haircut before the bovines tromped about.

The founder of Niman Ranch, a well-respected network of farmers who produce humanely raised pork, beef and lamb, soon found that meat goats were for more than just lawn-mowing. He is now on the cusp of doing for goat what he did for pork years ago: putting together a consortium of ethical, mindful farmers and ranchers who can demand a higher price for a superior product.

That said, goat farming is still not big business. “People call me up and ask if they can have goat meat at their dinner party this weekend,” Adams says. “I have to tell them it still doesn’t work that way.” It’s akin to putting in reservations for kid goats being born, or lucking into a goat someone no longer wants.

Which is, in truth, a good thing. If you want to try goat, you’ve got to get local. Kathy Weld raises the critters at Sugarloaf’s Breezy Valley Farm in Frederick County. The farm nurtures the animals for at least six months, then takes them to a processing plant. You pick up meat from the plant that you custom-ordered (whole animal, half, leg, etc.), vacuum-sealed or paper-wrapped.

Or you can head to a local butcher shop. Your best bet is halal markets, such as the Madina Super Halal Market in Gaithersburg. The store gets twice-weekly goat deliveries from local suppliers. You can be assured of the meat’s quality because you’re speaking directly to a butcher, not staring into the meat case at a supermarket.

So why has this sustainable, locavore, world-class meat remained below the radar for most of us? Some people have had bad experiences, perhaps offshore during a winter cruise. Caribbean cultures often prize the rankest, toughest bucks beyond their first rut. It’s the meat from mature male goats that has the characteristic pungent barnyard aroma.

“I have a Jamaican friend,” Weld says, “who always tells me he’ll take any bucks off my hands.”

Generally, though, people don’t want that for dinner. The best meat comes from goats that are slaughtered early, usually at six, maybe nine months. They might yield 40 pounds of meat, nose to tail, which is another reason goats escape the industrial food chain. Meat-mammal processors are geared for monster hogs and beefy cows. Weld has had a hard time finding a facility to take one of her animals.

“They tell me they don’t butcher rabbits,” she laughs.

During the past year, while developing recipes for our all-goat book, “Goat: Meat, Milk Cheese” (Stuart, Tabori & Chang), we often wondered about supply. But we were never stymied. A quick Internet search led us to dozens of suppliers within an hour’s drive of our rural Connecticut home. We kept it local and got what we needed every time.

Goat meat is savory and not as sweet as beef. It’s neither buttery nor beef-tenderloin tender, but it offers a wider palette for culinary foreplay in the kitchen. It works well with bold, big flavors, particularly spicy and sour notes.

Cuts of goat meat can be easily divided into two categories: quick-cooking and long-braising. The short list of quick-cookers includes rib chops, loin chops and the tenderloin, which is something of a rarity in many butcher shops, weighing in at only three or four ounces. All of those can be handled in a fast saute; with a hot sear with good caramelization; or grilled in minutes. The meat on the back legs, too, lends itself to one quick-cooking technique: It must be sliced off into strips and pounded thin before battering and frying, about as you would cube steak for chicken-fried steak.

The rest of the animal yields the long-braising cuts: front shoulders and neck slices to back shanks, and almost everything in between. Most of the meat is laced with lots of interstitial collagen, which must break down to create a satisfying, rich stew, braise, curry or tagine. In other words, the meat is a boon to ragu, as well as hearty soups and stews. Lots of connective tissue around the bones translates to more flavor in the pot.

And there are lots of bones. There’s a smaller ratio of meat to bone on, say, goat shoulder chops than on similar cuts from cows, pigs or even lambs. But that’s actually a good thing, because bones mean culinary flavor at every turn.

Unless you’re “going island” with a dish from a big buck, most of the goat meat you’ll find comes from smaller animals, which is a plus. A pot of four shanks isn’t a daunting dinner, as it can be with beef or pork shanks.

However, we’d be remiss not to offer one warning: Goat is still the Wild West of butchering in this country. While other animal carcasses are cut up based on standardized charts, goat has, by and large, escaped the bureaucracy. One butcher’s goat roast can be another’s goat steaks.

While we were writing the book, we discovered that the hard way. We found that one local farmer near us tossed the liver into his ground goat meat because he didn’t think anyone would notice. (The liver is delicious and milder in flavor than calf’s liver, but you wouldn’t want it in your hamburger.) Another carved the quick-cooking rib chops into big hunks that were still attached to the long-braising breast.

So when you go to buy goat, you need to ask questions. Which cut? How was it cut, and when? Step up to the butcher counter informed, with a willingness to learn more. If the guy back there seems surly or uninformed, take your business elsewhere. It’s your dinner.

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A pioneer of humanely raised meat is betting the farm on Blue Apron

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Bill Niman in front of his cattle at Bolinas Ranch.

BOLINAS, Calif. — A few hundred feet from Bill Niman’s modest ranch house is a barn he built to house pigs. It was the late 1970s. Niman already had been raising hogs for a few years outdoors when he got his hands on National Hog Farmer magazine. “I thought, man, this stuff is cool,” he said. “You put pigs in buildings. They don’t have to be outside in the weather. It’s easy to maintain. You push a few buttons and can run the whole . . . thing from your kitchen table.” He went to Iowa, toured a few farms and came back and built the barn. “Then I realized what madness it was. We never put a pig in there.”

The barn is now a storage facility for a local artist and a winemaker, and Niman is now synonymous with humanely raised meat. Over the years, his customers have included restaurants from Chez Panisse to Chipotle. Though it has been a decade since he had any involvement with Niman Ranch — the company that bears his name is now owned by chicken giant Perdue — Niman, 72 with two young sons, is preparing for his next, and perhaps his last, act.

Niman has sold BN Ranch, his boutique cattle and heritage turkey operation, to the meal-kit pioneer Blue Apron. As part of the February deal, he will join the company to build a pasture-centric supply chain for all the beef, pork, turkey and chicken that Blue Apron ships in its 8 million meals each month.

The deal provides financial security for his family, Niman says. But it’s also a chance to complete his life’s mission: restoring a more sensible way of raising animals. “I haven’t finished this yet,” he said. “I’m in a position now to have influence, and through the association with Blue Apron we can do it at scale and have a serious impact.”

Niman’s 206-acre property does not look like the kind that could scale up, at least not in the way that most ranches do, by creating vast feedlots to fatten thousands of steer on grain. Emerald hills unfurl to the Pacific Ocean, and there’s a whiff of eucalyptus and salt on the breeze. On a sunny day in January, the pasture was thick with a mix of rye, clover and alfilaria, which were tufty, almost bouncy underfoot. The area, just 17 miles from San Francisco as the crow flies, is idyllic to more than cattle: Susie Tompkins Buell, the philanthropist and founder of clothing company Esprit, has a home here, as do director Joel Coen and his wife, Frances McDormand.


Bill Niman and Matt Wadiak in Tasmania in 2016. 

Bolinas wasn’t always this way. In 1969, when Niman arrived, the town was a haven for hippies and dropouts. The son of a Minnesota grocer, Niman had come to teach school, his way of supporting President Lyndon Johnson’s War on Poverty. The first pigs he raised were to feed himself and his first wife, Amy, and to barter with the few neighbors who grew vegetables. (For many Bolinas residents, the primary crop was marijuana.) Bolinas was, and remains, according to Niman, perfect for folks who find Berkeley a little too right wing.

By the mid-1970s, raising hogs had somewhat surprisingly become a small business. Niman and his partner, Orville Schell (better known as a China expert and writer for the New Yorker,) got their big break when Mendocino chef Margaret Fox started to buy their meat and list the name of the ranch on the menu. It wasn’t long before they were selling to others, including Chez Panisse in Berkeley and Zuni Cafe in San Francisco. “It was unusual back then for a restaurant to say where their meat was from. It was a commodity world,” Niman said. “It wasn’t something we asked for. It just happened.”

Soon restaurants were clamoring to put Niman Ranch on their menus, and it wasn’t just white-tablecloth eateries. Steve Ells, founder and chief executive at Chipotle, came to Niman in search of pork that would boost sales of the chain’s carnitas. Niman took him on a tour of Iowa farms, patiently explaining how different protocols produced better-tasting meat. After switching to Niman’s pork, Ells was forced to raise the price of carnitas — a no-no in the world of fast food, but sales climbed nevertheless.

“Bill was instrumental in helping to establish the principles by which we purchase our food,” Ells said. “One million customers a day benefit from his really important vision to make this food available.”


Chef Mike Isabella, reflected in the work surface of his home kitchen, prepares a meal sent to him by Blue Apron, the online meal delivery service, in 2015. 

But there was a problem. Niman Ranch was losing money: nearly $3 million annually, according to Jeffrey Swain, then CEO of Natural Food Holdings, which took a controlling stake in 2006 and purchased the brand three years later. At the time, Niman told the San Francisco Chronicle that he had consciously deferred profitability to expand the brand; today he blames much of the losses on an executive who embezzled funds. Either way, the decisions that the new owners made — shipping cattle to commercial feedlots, for example — were unacceptable to Niman. “The people who bought us were conventional meat guys,” Niman said. “They offered me money to play Colonel Sanders for Niman Ranch. I wasn’t interested in that, so I left.”

The rift was heartbreaking. In 2008, Niman announced he would raise goats, and hoped to popularize the lean and sustainable meat. (He later abandoned that idea for cattle, his first love, and turkeys.) But he spent much of the next several years focusing on his new, growing family. His second wife, Nicolette, an environmental lawyer (and vegetarian), had their first son in 2009 and a second in 2013. Living in Bolinas, they were spoiled with “year-round, wholesome choices,” Niman said, but having children reinvigorated his desire to fix meat.

A Blue Apron grass-fed beef recipe, seared steaks and mashed potatoes with roasted Brussels sprouts and steak sauce. 

The opportunity came when he met Matt Wadiak, Blue Apron’s co-founder and chief operating officer. Wadiak had known of Niman for decades; he remembers seeing him arrive at Oliveto, a renowned Oakland restaurant where he was cooking, with a pig slung over his shoulder. Blue Apron began buying meat from BN Ranch, and Wadiak peppered Niman with questions about how he could create a system that did more than just tick the right boxes but reflected what consumers think of as “sustainable.” Soon, the two were taking trips together to U.S. farms and as far afield as New Zealand and Australia. Last year, Wadiak says, the pair spent about 100 days together on the road.

Under Niman’s direction, Blue Apron will raise only grass-fed, grass-finished cattle. To provide the marbling that Americans expect, he will mandate British breeds, such as Black Angus and Hereford. The company will also require that animals are raised only in areas, such as Northern California and New Zealand, where grass thrives year-round. (If you were to raise cattle in, say, Vermont, the cattle must be fed forage and grain in the winter when there is no grass to eat.)

“Hyperlocal isn’t always a good thing,” said Wadiak. “We wouldn’t try to grow lemons in New York state. So why is it we’re not thinking about growing beef with the same thoughtfulness that we are growing lemons?”

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Not everyone agrees. Chez Panisse’s Alice Waters has long supported Niman, though the two did famously fall out in the early aughts when she decided that she would serve only grass-fed beef and Niman’s was, at that time, finished on grain. Waters doesn’t like the idea of eating beef from halfway round the world, no matter how well it’s raised. “I’d rather go without beef” when it’s not in season, she said. “This country that wants beef every day is destroying the planet. So we need to make those decisions. And I think they are easy and delicious to make.”


Matt Wadiak, Matt Salzberg and Ilia Papas, co-founders of the recipe delivery service Blue Apron, at their office in New York City. 

Most Americans, though, are not ready to give up beef for most of the year. Niman is confident that with the right partners, scale is possible without ugly environmental trade-offs. “Only the right thing is good enough for Matt,” he says of Wadiak. “That’s what drives me.”

As compelling to Niman is that, in partnership with Blue Apron, he has the potential to bring down prices, making his kind of meat affordable. Where restaurants and retailers tend to want certain parts — pricey pork loins or rib-eye steaks — Blue Apron can buy the entire animal and write menus to use every piece: pesto meatballs one week for all that ground beef, and steak au poivre the next.

Buying the whole animal substantially lowers the cost of meat. But so do the enormous quantities that Blue Apron buys. This year, the company will purchase tens of thousands of grass-fed cattle, enough to fill big trucks for transport and gain access to large slaughterhouses. “The genius here is we are raising animals like a small farmer but gaining access to the most efficient processing and distribution,” Niman said.

“I have miles to go before I sleep on this one,” he added. “But we’ll get there.”

Source:www.washingtonpost.com