It’s not health care, stupid, it’s the economy.

Despite the Republicans’ reading of the midterm elections as a call to arms to repeal or roll back the new health care law, a poll released on Tuesday by the Kaiser Family Foundation suggested people were not thinking first and foremost about health care when they cast their vote last week.

In contrast to exit polls taken after the election, Kaiser asked voters to explain why they voted the way they did and what factors influenced their decision. While voters cited a variety of factors, ranging from the economy and jobs to voting against a candidate from a specific party, health care ranked fourth on list, with 17 percent citing health care or reform as one of the top factors in how they cast their vote.

Those exit polls also indicated the economy, by far, played a critical role in the election, according to a story last week by our colleagues on the results.

Which is not to say health care was a plus for those Democratic candidates who supported the legislation. “To the extent people were thinking about health reform at the voting booth, it appears the law’s opponents had an advantage over its supporters,” according to the Kaiser analysis. Nearly six of 10 people who said health reform was one of the factors determining their vote also said they supported a Republican candidate for Congress.

The poll also found significant disagreement over how to change the new law, with about 40 percent of the public wanting to expand or leave the law as it is and about half wanting to repeal all or some of the legislation.

And there’s still significant confusion around the new law, according to Kaiser, with about half the public acknowledging confusion.

The Kaiser survey was conducted Nov. 3 through Nov. 6 among 1,502 adults, including 1,017 people who said they voted in the midterm elections. The margin of sampling error for the total sample and sample of voters is plus or minus 3 percentage points.

There is only “moderate’’ evidence that the newly approved prostate cancer drug Provenge helps patients, according to an analysis done for Medicare that was made public on Wednesday.

The analysis is part of a controversial review by the Centers for Medicare and Medicaid Services to determine whether to pay for Provenge, which costs $93,000 per patient and extended lives by about four months in clinical trials. Medicare advisers will meet next Wednesday to discuss the drug, which was developed by Dendreon, a Seattle-based biotechnology company.

Provenge is the first so-called therapeutic cancer vaccine – meaning it works by training the patient’s immune system to attack the tumor – to win F.D.A. approval. The treatment is made for each patient from his own blood. Sales have been small so far because Dendreon’s manufacturing capacity has been limited.

While Medicare generally pays for drugs that are approved by the Food and Drug Administration, its debate over paying for Provenge has raised concerns among some cancer patients, doctors and investors who say the government is sending a warning shot that it will not automatically pay for high-priced medicines.

“Not only is C.M.S.’s action contrary to Congress’s intent to ensure beneficiary access to drugs and biologicals used in an anticancer chemotherapeutic regimen, but it threatens to stifle future innovation and cancer research for years to come,’’ Dr. Al B. Benson III, president of the Association of Community Cancer Centers, said in a comment submitted to the Centers for Medicare and Medicaid Services.

But others say the health care system cannot afford to continue paying high prices for all therapies, particularly cancer drugs that extend lives by only a few months.

With expensive medicines there is already a sort of dual approval system, especially with private insurance companies. First a drug must get F.D.A. approval and then a manufacturer often must go through a lengthy process of persuading insurers to pay for the drug.

Medicare is not supposed to consider price when determining whether to cover a drug, however.

Some analysts have assumed that Medicare will pay for Provenge when used for the patients specified in the drug’s label – those with advanced prostate cancer that is resistant to hormone-deprivation therapy but who are experiencing no or minimal symptoms.

The Medicare review might be more designed to limit off-label use of the expensive drug, such as for patients who already have symptoms. The review for Medicare said there was insufficient evidence to judge whether Provenge would work if used off-label.

The F.D.A. declined to approve Provenge in 2007, setting off protests by patients and Dendreon investors. After Dendreon completed another trial, which reaffirmed a survival advantage for the drug, Provenge was approved this April.

But the analysis for Medicare said that there were issues in how the trials were designed that made it difficult to assess how effective Provenge really was. One big issue was that the placebo used in the control arm was not really inert.

Robyn Karnauskas, a biotechnology analyst at Deutsche Bank, said in a note to clients Wednesday that the assessment of moderate evidence in support of Provenge boded well for reimbursement. “Historically, moderate means that CMS will reimburse the product for its on-label indication,’’ she wrote.

Dendreon’s shares rose more than 5 percent in trading after the close of the market.

The assessment was done by a technology evaluation group at the Blue Cross and Blue Shield Association under contract to the government’s Agency for Healthcare Research and Quality.

Nature yields her secrets with the greatest unwillingness, and in basic research most experiments contribute little to further progress, as judged by the rarity with which most scientific reports are cited by others.

Basic research, the attempt to understand the fundamental principles of science, is so risky, in fact, that only the federal government is willing to keep pouring money into it. It is a venture that produces far fewer hits than misses.

Even the pharmaceutical industry, a major beneficiary of biomedical research, does not like to invest too heavily in basic science. Rather, it lets private venture capital support the small biotechnology companies that first try to bring new findings to market, and then buys up the few winners of this harsh winnowing process.

If basic research is fraught with such a high failure rate, why then does it yield such rich economic returns? The answer is that such government financing agencies as the National Institutes of Health and the National Science Foundation are like the managers of a stock index fund: they buy everything in the market, and the few spectacular winners make up for all the disasters.

But just as index fund managers often go astray when they try to improve on the index’s performance by overweighting the stocks they favor, the government can go wrong when it tries to pick winners.

This is why it was such a risk for California to earmark $3 billion specifically for stem cell research over the next 10 years. Stem cells are just one of many promising fields of biomedical research. They could yield great advances, or become an exercise in sustained failure, as gene therapy has so far been. By allocating so much money to a single field, California is placing an enormous bet on a single horse, and the chances are substantial that its taxpayers will lose their collective shirt.

Stem cell researchers have created an illusion of progress by claiming regular advances in the 12 years since human embryonic stem cells were first developed. But a notable fraction of these claims have turned out to be wrong or fraudulent, and many others have amounted to yet another new way of getting to square one by finding better methods of deriving human embryonic stem cells.

The major advances in stem cell biology have come from molecular biologists who study transcription factors, the master control switches that govern the cell’s operations. The Japanese biologist Shinya Yamanaka showed that with a mere four of these factors, which he cleverly guessed, he could force an ordinary cell to walk back to embryonic state.

But the finding illustrates what stem cell research is really about. It’s not about therapies and quick cures, it’s about understanding the basic nature of human cells and what makes one type different from another even though all have the identical genome. In other words, it’s a basic research program with little likelihood of producing therapeutic gains in the near future. Stem cell scientists, while generally avoiding rash promises themselves, have allowed politicians to portray stem cells as a likely cure for all the major diseases.

Strangely, for a project that is aimed at regenerative medicine, the arbiters of stem cell research have largely neglected the free lesson that nature is offering as to how regenerative medicine could actually work. Many little animals, like newts and zebra fish, do regenerate parts of their bodies. But their recipe is the reverse of that presented by the advocates of stem cell therapy. Instead of taking a stem cell and trying to convert it into a well-behaved adult tissue, animals like the zebra fish start with the adult cell at the wound site, and walk it backward into a stemlike state from which a new limb grows.

For the California Institute for Regenerative Medicine to invest its $3 billion in studying newts, rather than building new science buildings on every state campus, might seem the best way of understanding regeneration, but that would be hard to explain to California’s voters, who have been assured stem cell cures are just around the corner. Even if governments do better to avoid picking winners among basic research fields, they can play a necessary role in supporting specific scientific infrastructure that lies beyond the means of individual researchers or universities, like atom-smashers or the human genome project. But even these projects are not guaranteed success. More powerful atom-smashers let physicists explore new ranges of energy, but the expected new atomic particles are not always found there. The HapMap, a catalog of human genetic variation that grew out of the human genome project, was designed to uncover the genetic roots of common diseases and help develop new treatments. The project was well conceived and executed, but nature declined to provide many very useful answers. Still, there is nothing wrong with the National Institutes of Health having tried the experiment. The only shame would be in not having tried.

The same goes for the HapMap’s successor, the 1000 Genomes Project, which is an attempt to construct an even larger genetic catalog. It’s well worth trying, but success cannot be assumed — and should be the more applauded if attained.

To take scientific progress for granted is to underestimate the difficulties, professional and otherwise, that scientists must overcome. A researcher spends years in apprenticeship, mastering difficult techniques with a short useful life. He or she then has a few years to strike it lucky and become a lab chief, much of whose time is spent applying for grants and administering the work of the next generation of apprentice scientists.

It’s amazing that the system works as well as it does. But its successes are hard won, not the inevitable victories that scientific spokesmen sometimes suggest when on the fund-raising trail.

4 cups wild or baby arugula

2 cups grated carrots

2 tablespoons broken walnuts (1/2 ounce)

1/4 cup grated Parmesan or crumbled blue cheese (1 ounce)

1 tablespoon finely chopped fresh tarragon

For the dressing:

1 tablespoon fresh lemon juice

1 tablespoon sherry vinegar

1 teaspoon balsamic vinegar

Salt to taste

1 teaspoon Dijon mustard

1 small garlic clove, pureed or finely minced (optional)

1/4 cup extra virgin olive oil

2 tablespoons walnut oil

1. Combine the arugula, carrots, walnuts, cheese and tarragon in a salad bowl.

2. In a small bowl or measuring cup, combine the lemon juice, vinegars, salt and mustard. Whisk together, and add the garlic. Whisk in the oils.

3. Shortly before serving, toss the salad with the dressing.

Yield: Serves four to six.

Advance preparation: You can combine the salad ingredients several hours before serving and refrigerate in a covered bowl. The dressing will also hold for several hours, in or out of the refrigerator.

Nutritional information per serving (four servings): 259 calories; 25 grams fat; 4 grams saturated fat; 4 grams cholesterol; 8 grams carbohydrates; 2 grams dietary fiber; 146 milligrams sodium (does not include salt added during preparation); 4 grams protein

Nutritional information per serving (six servings): 172 calories; 16 grams fat; 2 grams saturated fat; 3 grams cholesterol; 5 grams carbohydrates; 1 gram dietary fiber; 98 milligrams sodium (does not include salt added during preparation); 2 grams protein

Martha Rose Shulman can be reached at martha-rose-shulman.com. Her latest book, “The Very Best of Recipes for Health,” was published recently by Rodale Books.

Unlike many other orange vegetables rich in beta-carotene, carrots are versatile in both their raw and cooked states. I grate raw carrots and use them in salads, cakes and breads. You can cook carrots quickly in a stir-fry, simmer them for soup, or give them a long roast in the oven. (Roasting will intensify their sweetness, while simmering will yield a delicious broth.)

Sometimes the texture of carrots is as important to a dish as their flavor — they really can bulk up a sauce or stew. And if you’re stumped trying to get more vegetables into your kids’ diets, carrots may be the answer, as most children like them raw or cooked.

Carrot and Sweet Potato Soup With Mint or Tarragon

This easy, beautiful purée makes a nice Thanksgiving opener, with the added benefit of extra doses of vitamin A, vitamin C, potassium and fiber. If you’re looking to get ahead with your meal, you can make this dish up to two days ahead of the big day.

1 tablespoon canola oil or unsalted butter

2 medium shallots, chopped

1 1/2 pounds carrots, peeled and diced

1 pound sweet potatoes, peeled and diced

6 cups water, chicken stock or vegetable stock

2 sprigs tarragon

A 1-inch piece of orange zest

Salt to taste

1 tablespoon minced fresh mint or tarragon

1. Heat the oil in a heavy soup pot or Dutch oven over medium heat. Add the shallots. Cook, stirring, until tender, three to five minutes. Add carrots. Cook, stirring often, for five minutes until they begin to soften. Add the sweet potatoes, water or stock, tarragon sprigs and orange zest, and bring to a simmer. Add salt to taste, reduce the heat, cover and simmer 45 minutes or until all of the ingredients are thoroughly tender. Remove the orange zest, and discard.

2. Purée the soup in batches in a blender, removing the stopper from the top and holding a kitchen towel tightly over the top to avoid splashing, or in a food processor fitted with the steel blade. Return to the pot, heat through, and adjust salt and pepper to taste. Stir in the mint or tarragon, and serve.

Yield: Serves four to six.

Advance preparation: This will keep for three to four days in the refrigerator.

Nutritional information per serving (four servings): 204 calories; 4 grams fat; 0 grams saturated fat; 0 milligrams cholesterol; 40 grams carbohydrates; 8 grams dietary fiber; 192 milligrams sodium (does not include salt added during preparation); 4 grams protein.

Nutritional information per serving (six servings): 136 calories; 3 grams fat; 0 grams saturated fat; 0 grams cholesterol; 27 grams carbohydrates; 6 grams dietary fiber; 128 milligrams sodium (does not include salt added during preparation); 2 grams protein

Martha Rose Shulman can be reached at martha-rose-shulman.com. Her latest book, "The Very Best of Recipes for Health," was published recently by Rodale Books.

1 1/2 cups (1/2 pound) unsalted toasted almonds

1/4 cup raw brown (turbinado) sugar

1 1/2 teaspoons baking powder

1/8 teaspoon salt

1 teaspoon cinnamon

1/2 teaspoon freshly grated nutmeg

2 teaspoons grated lemon zest

4 large eggs

1/3 cup organic white sugar

1 teaspoon vanilla extract

2 cups finely grated carrots (about 10 ounces)

1. Heat the oven to 350 degrees with a rack in the middle. Oil a 9-inch springform pan, and line it with parchment. Lightly oil the parchment.

2. Combine the almonds and the turbinado sugar in a food processor fitted with the steel blade. Blend until the almonds are finely ground. Add the baking powder, salt, cinnamon, nutmeg and lemon zest, and pulse together.

3. Beat the eggs until thick in the bowl of a standing mixer fitted with the whisk attachment, or with an electric beater. Add the organic sugar, and continue to beat until the mixture is thick and forms a ribbon when lifted from the bowl with a spatula. Beat in the vanilla. Add the almond mixture and the carrots in three alternating additions, and slowly beat or fold in each time.

4. Scrape the batter into the prepared cake pan. Place in the oven, and bake one hour until firm to the touch and beginning to pull away from the pan. A toothpick inserted into the center of the cake should come out clean. Remove from the heat, and allow to cool on a rack for 10 minutes. Run a knife around the edges of the pan, and carefully remove the spring form ring. Allow the cake to cool completely, then wrap tightly in plastic.

Yield: Serves 10 to 12.

Advance preparation: This cake is a good keeper if wrapped well. Refrigerate for up to five days.

Nutritional information per serving (10 servings): 209 calories; 13 grams fat; 1 gram saturated fat; 85 grams cholesterol; 18 grams carbohydrates; 3 grams dietary fiber; 135 milligrams sodium (does not include salt added during preparation); 7 grams protein

Nutritional information per serving (12 servings): 174 calories; 11 grams fat; 1 gram saturated fat; 71 grams cholesterol; 15 grams carbohydrates; 3 grams dietary fiber; 112 milligrams sodium (does not include salt added during preparation); 6 grams protein

Martha Rose Shulman can be reached at martha-rose-shulman.com. Her latest book, "The Very Best of Recipes for Health," was published recently by Rodale Books.

2 pounds carrots, peeled quartered or cut into sixths lengthwise (depending on the size), then into 2-inch lengths

3 tablespoons extra virgin olive oil

Salt and freshly ground pepper

1 teaspoon fresh thyme leaves, chopped

1/2 teaspoon oregano

3 tablespoons finely chopped flat-leaf parsley

1. Preheat the oven to 400 degrees. Oil a sheet pan or a baking dish large enough to fit all of the carrots in a single layer. Place the carrots in a large bowl, and toss with the olive oil, salt, pepper, thyme and oregano.

2. Spread in an even layer in the prepared pan or baking dish. Cover with foil, and place in the oven for 30 minutes. Uncover, and if the carrots are not yet tender, turn the heat down to 375 degrees and return to the oven for 10 to 15 more minutes until tender. Add the parsley, stir gently, and taste and adjust salt and pepper. Serve hot, warm or at room temperature.

Yield: Serves six.

Advance preparation: These will keep for four to five days in the refrigerator.

Nutritional information per serving: 123 calories; 7 grams fat; 1 gram saturated fat; 0 grams cholesterol; 15 grams carbohydrates; 4 grams dietary fiber; 106 milligrams sodium (does not include salt added during preparation); 1 gram protein

Martha Rose Shulman can be reached at martha-rose-shulman.com . Her latest book, “The Very Best of Recipes for Health,” was published recently by Rodale Books.

2 tablespoons extra virgin olive oil

1/2 pound carrots, peeled and finely diced (1/4 inch dice or smaller), or finely chopped in a food processor fitted with a steel blade (1 1/2 cups)

2 garlic cloves, minced

2 pounds tomatoes, seeded and grated, or peeled, seeded and chopped; or 1 (28-ounce) can chopped tomatoes, with juice

1/8 teaspoon sugar

1 sprig of fresh basil, if available

Salt to taste

1 tablespoon tomato paste

1/2 teaspoon dried oregano (optional)

1. Heat the oil over medium heat in a large, wide nonstick skillet or saucepan. Add the carrots. Cook, stirring, until tender, five to eight minutes. Add the garlic. Cook, stirring, for 30 seconds to a minute until the garlic begins to smell fragrant. Add the tomatoes and their juice, the sugar, basil sprig, salt, tomato paste and oregano. Stir, and turn up the heat. When the tomatoes begin to bubble, lower the heat to medium, and cook, stirring often, until thick and fragrant, 20 to 25 minutes. Remove the basil sprig, and wipe any sauce adhering to it back into the pan. Taste and adjust seasonings.

Variation: Substitute 1 teaspoon fresh thyme leaves or 1/2 teaspoon dried thyme for the basil.

Yield: 2 1/4 cups (about eight servings).

Advance preparation: The sauce will keep for four to five days in the refrigerator and freezes well.

Nutritional information per serving (per rounded 1/4 cup): 65 calories; 4 grams fat; 1 gram saturated fat; 0 grams cholesterol; 8 grams carbohydrates; 2 grams dietary fiber; 27 milligrams sodium (does not include salt added during preparation); 1 gram protein

Martha Rose Shulman can be reached at martha-rose-shulman.com. Her latest book, "The Very Best of Recipes for Health," was published recently by Rodale Books.

For years, employees have seen what they pay toward health care go up as companies ask them to contribute more to premiums and deductibles. But now, as people enroll in health plans for the coming year, the sticker shock is more jolting than ever because so many companies are passing on to their workers most, if not all, of the higher costs.

A worker’s share of a family policy is approaching $4,000 a year on average, and is most certainly going to keep rising through the next few years. For lower-salaried workers, those costs have only compounded their struggle in a brutal economy.

More and more companies in the last year or so have begun signaling their recognition of the added burden shouldered by workers in low- and middle-income jobs by varying the premiums they pay based on salary. Consultants say the trend is likely to continue, as employers devise various ways of spreading increased health care costs among their staff and balancing that side of the ledger against fewer raises and other compensation.

Vanderbilt University, for instance, has adopted a wage-based benefit program for 2011 under which premiums will remain the same for employees who make $50,000 or less, while everyone else will pay up to $75 more a month. “We’re trying to help those lower-paid employees cope with hard economic times,” said Jerry Fife, a vice chancellor. Even as companies warily eye the uncertain landscape of the new health care law, especially with the Republican midterm election gains at the federal and state levels, they also are seeking novel ways to deal with year-after-year increases in health care, because the share-the-pain era is coming to an end.

Corporations had absorbed some higher costs in recent years, along with their workers, but have recently passed all, on average, onto employees. In 2010 alone, a worker’s share of the cost of a family policy jumped an average of 14 percent from the previous year, according to a recent survey by the Kaiser Family Foundation. In real money, that is an additional $500 a year deducted from a paycheck.

“It feels so much worse this year than it has in prior years,” said Helen Darling, president of the National Business Group on Health, which represents employers providing health benefits.

Across the country, the percentage of workers with coverage in large companies whose premiums vary with their wages climbed to 17 percent in 2010, up from 14 percent two years ago. About 20 percent of employees who are covered by large companies in the Northeast, which has suffered from a combination of high unemployment and steep medical costs, have the premiums they pay tied to their wages, according to Kaiser.

“If health care reform hadn’t happened, there would be more companies going in this direction,” said Ms. Darling, alluding to the period between the law’s passage this year and 2014, when it is expected to take full effect.

Some corporations have gone further than others in trying to spare their lowest-paid workers, even as they increased the cost of premiums for everyone else. This year, for example, employees at Bank of America who make $100,000 or more a year will pay at least 14 percent more for coverage for 2011.

But workers who make less will actually see their contributions decrease, although their deductibles and co-payments will stay the same. Employees earning less than $50,000 could see as much as a 50 percent drop in the amount deducted from their paychecks, as compared to 2010. The bank says it is making up the difference.

”We’re obviously committed to helping our associates and their families manage rising health care costs,” said Kelly Sapp, a spokeswoman for the bank. At Vanderbilt, the university was mindful that employees had gone with no or small raises for the last two years. The university typically pays about 80 percent of the cost of coverage, with employees paying anywhere from $41 to $370 a month in premiums. The concept of tiered plans is not new, with employers that typically offer generous benefits, like universities, being quicker to try it. General Electric, for example, has long divided its work force into separate tiers to determine how much an employee has to contribute toward insurance coverage.

Often, companies will keep premiums steady or lower for low-income workers by asking them to pay less of the overall increase, while high-income workers will pay more to make up for the difference, according to Joshua Miley, a principal at HighRoads, a Woburn, Mass., health benefits management consultant. Faced with an overall increase of 9 percent, the company might ask the lower-paid workers to pay 4 percent more, while the higher-paid group would pay 14 percent more. “They’re doing it on the backs of the higher-paid,” he said.

Some companies may be reluctant to ask certain of their employees to pay more, especially if workers belong to unions that have negotiated a certain level of benefits for all their members.

Other companies could be wary of a system that could be viewed as unfair since salary may not be the best indication of household income. Some low-paid employees whose spouse is a high earner may not need the help, while a single person with a higher salary could. The other concern is not being able to move away from a wage-based benefit structure once it is in place.

For most workers, however, the trend has been very clear: the increase in health care costs has easily outstripped any rise in their incomes. Since 2005, while wages have increased 18 percent, workers’ contributions to premiums have jumped 47 percent, almost twice as fast as the rise in the policy’s overall cost, according to Kaiser.

Companies have also become increasingly creative in the ways they shift costs. Instead of simply raising premiums or increasing the size of the deductible workers must pay before their coverage kicks in, employers are increasingly asking their workers to pay more of the cost of coverage for their dependents, or to pay more of their share of a hospital stay or an emergency room visit. “Employers do a bit here and do a bit there,” said Gary Claxton, a policy expert at Kaiser.

The result is that employees may be paying more, but they may not know how much. Mark Rukavina, the director of the Access Project, an advocacy group, said, “You need multiple spread sheets to figure this out.”

During her company’s open enrollment period, Marilee Fisher, for example, tried to scrutinize the three plans being made available by her employer. She is liable for any medical bills she accumulates when her 5-year-old son, who has Down syndrome, has therapy more times than allowed under the specific plan.

More companies are adopting plan designs that require employees to pay more of their own medical bills under specific circumstances so workers are increasingly feeling the pinch. Companies “are taking the usual cost-trend reduction measures, but more of them are doing it,” said Beth Umland, director of health and benefits research at Mercer, the consulting firm.

This has clouded exactly how much more workers are paying. “Employers have shifted costs for the past 10 years,” Mr. Miley said. “The confusion allows them to push it further.”

When Jim Hewes, a San Diego painter and Vietnam veteran, received the diagnosis of colorectal cancer in February 2008, his wife, Libby, suddenly became his aide, therapist, homemaker and advocate — his everything. Through long months of chemotherapy, radiation and surgery, she dressed wounds, changed colostomy bags and tried to hold onto her own equilibrium.

Courtesy Libby Hewes Libby and Jim Hewes in the summer of 2005, before learning he had cancer.

“That first year, I was on the verge of a nervous breakdown, asking the social worker for a support group, some help, anything,” she said.

Spouses caring for cancer victims endure such trials. But a new report suggests the job can grow still more complicated and demanding when the people they care for are combat-era veterans with service-connected illnesses or disabilities.

“Because of the stresses during this period, his P.T.S.D.” — post-traumatic stress disorder — “came to the fore,” Mrs. Hewes said. “The anger, the road rage — it got scary for me at times.”

And frustrating. After she’d spent months in polite, protracted discussions with the Social Security Administration trying to get disability coverage for her husband, “They called here one day while I was at work, asking for paperwork, and Jim blasted them. They hung up.”

He stalked out of a clinic, too, when the wait got too long. “He’d get angry and explode, and I had to mop up the damage,” Mrs. Hewes said. Both had severe depression.

Gail Hunt, director of the National Alliance for Caregiving, knows plenty about the sacrifices caregivers make, in part because the organization regularly conducts nationwide research. But she was startled by the results of “Caregivers of Veterans: Serving on the Homefront,” an online survey of people caring for veterans with service-related disabilities suffered from the World War II era through Iraq and Afghanistan.

Of the 462 caregivers of veterans responding to an online questionnaire, 30 percent said they’d filled that role for a decade or more, and 68 percent called their situation “highly stressful.” The proportion of veterans’ caregivers who reported a high level of physical strain, who left their jobs or devoted more than 40 hours a week to caregiving — all were several times higher than figures reported in the past by caregivers of adults whose disabilities are not related to military service.

In part, this difference stems from the long duration of caregiving for veterans, who may be injured while young and then require decades of help.

But it also reflects what medical professionals call “co-morbidities.” High rates of depression, anxiety and other mental illnesses accompany vets’ physical injuries and disabilities, the caregivers reported.

While we may think of P.T.S.D. and traumatic brain injury as contemporary injuries (President Obama called them “the signature wounds of today’s wars”), more than half the vets in this sample who served in Vietnam or earlier conflicts also had P.T.S.D. and 14 percent had a traumatic brain injury, in addition to more common diseases like diabetes, cancer and Parkinson’s.

On Capitol Hill on Wednesday, representatives from the National Alliance for Caregiving and the United Health Foundation, which underwrote the survey, and from veterans’ organizations will hold a lunchtime briefing for Congressional staff members. “We want to let Congress know what we found,” Ms. Hunt said.

The recommendations the alliance and its partners will make, based on the survey and also on focus groups and phone interviews, are fairly modest: immediate training for caregivers, even while injured veterans are still in hospitals, so that they will know what to expect and what to do; mentoring programs and support groups, online and offline, that will connect veterans’ caregivers with others in similar situations; and legal advisers for families.

Compared with the medical costs of caring for veterans, these are not big-ticket items.

“I’d like to see an advocate, someone to walk us through the system,” said Betty Sullivan of Texas, who for three years cared for her husband, Charles, a Vietnam vet in the late stages of Parkinson’s disease at 71, in their home in San Antonio. “Everything with the government is overwhelming.”

Mrs. Sullivan reluctantly moved her husband into a residential center when she was no longer able to lift him or physically care for him. He is now in hospice care.

But Jim Hewes is cancer-free, his doctors say. And slowly he and Libby have regained their footing, in part because of a caregivers class she finally found this year — the kind the report recommends for any veteran’s caregiver.

“I learned so much,” Mrs. Hewes said. “It was life-changing for me. I could get off the roller coaster.”

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Stephen Scott Gross Pumpkin Dumplings With RadicchioStephen Scott GrossSilvana NardoneDelicious no-meat recipes for your holiday table.

When Silvana Nardone’s son Isaiah was diagnosed with gluten intolerance three weeks before Thanksgiving, the Brooklyn mom knew she faced a particularly challenging holiday meal. But as the owner of a bakery and founding editor of the food magazine Every Day With Rachel Ray, Ms. Nardone was up to the challenge.

“Cornbread was the first thing Isaiah wanted me to make,” says Ms. Nardone. “I tested it and failed. But once I finally got it, that was my platform for many other dishes.”

Gluten is a protein found in wheat, rye and barley, so it can be challenge to cook without it. Ms. Nardone’s adventures in gluten-free cooking are documented in her new cookbook, “Cooking for Isaiah: Gluten-Free & Dairy-Free Recipes for Easy Delicious Meals.”

For Well’s Vegetarian Thanksgiving series, Ms. Nardone offers three gluten-free vegetarian dishes that celebrate the season: pumpkin dumplings with radicchio, apple-pecan corn bread stuffing (made with her “double corn” cornbread,) and pumpkin muffins with crumble topping.

With a husband who is a vegetarian and a son who requires gluten-free food, Ms. Nardone has learned that cooking challenges can boost creativity in the kitchen.

“It forced me to be a better cook,” says Ms. Nardone, who blogs about gluten-free cooking at DishTowelDiaries.com. “It opens up a whole new way of cooking that you didn’t even know existed.”

See Ms. Nardone’s recipes below, and go to “Well’s Vegetarian Thanksgiving” to see all the dishes in the series that have been published so far.

Silvana Nardone’s
Gluten-Free Pumpkin Dumplings With Radicchio

Something to keep in mind when you make this recipe — it’s a lot easier than you think. The dumplings are super light and pillowy, but if you prefer a firmer texture, add more gluten-free flour, 1 tablespoon at a time, to the pasta dough.

1 15-ounce can pure pumpkin puree
2 large eggs, lightly beaten
1 cup store-bought gluten-free flour blend
Salt
2 tablespoons extra-virgin olive oil
1 medium onion, finely chopped
1/4 teaspoon crushed red pepper flakes
1 small head radicchio, sliced into 1/4-inch strips (about 2 cups)
2 tablespoons chopped fresh flat-leaf parsley

1. Bring a large pot of salted water to a boil. In a large bowl, combine the pumpkin puree, eggs, flour and 1 teaspoon salt to make the dough.

2. In a large saucepan, heat the olive oil over medium heat. Add the onion and red pepper flakes and cook until softened, about five minutes; remove from the heat and set aside.

3. When the water comes to a boil, use a teaspoon to scoop up the dough and form a dumpling, then carefully slide the dumpling off the spoon and into the boiling water. Continue forming dumplings until half the dough is used. Cook until the dumplings float, then simmer for about two minutes; remove with a slotted spoon and add to the saucepan with the onion. Repeat with the remaining dumpling dough.

4. Return the saucepan with the onion to medium-high heat. Toss in three-quarters of the radicchio and stir gently until just wilted, about two minutes; season with 1/2 teaspoon salt or to taste. To serve, divide the dumplings and sauce among four bowls and top with the remaining radicchio and parsley.

Yield: Serves 4.

Stephen Scott GrossApple-Pecan Cornbread Stuffing

Silvana Nardone’s
Gluten-Free Apple-Pecan Cornbread Stuffing

Instead of toasting the cornbread, you can spread out the pieces on a baking sheet and let them sit on your counter top overnight, uncovered, to dry out.

Double Corn Cornbread:
1 cup rice milk
1 tablespoon apple cider vinegar
1 cup cornmeal, preferably medium grind
1 cup store-bought gluten-free flour blend
1/4 cup sugar
1 tablespoon baking powder
1 teaspoon baking soda
1 teaspoon salt
2 large eggs, at room temperature, lightly beaten
1/4 cup vegetable oil
1 cup corn kernels (from about 1 ear of corn)

Stuffing:
2 tablespoons extra-virgin olive oil, plus more for greasing
1 small onion, chopped
2 stalks celery, thinly sliced
Salt
Pepper
4 cups Double Corn Cornbread (see recipe below), toasted and cut into 1-inch pieces
1 Granny Smith apple, peeled, cored and finely chopped
2 teaspoons dried herb blend, such as McCormick Italian Seasoning
1/2 cup chopped pecans

1. Prepare the cornbread. Preheat oven to 350 degrees Fahrenheit. Grease a 4 1/2-inch by 8 1/2-inch loaf pan. In a small bowl, stir together the milk and vinegar. In a medium bowl, whisk together the cornmeal, flour, sugar, baking powder, baking soda and salt. Stir in the milk mixture, eggs and oil until just blended; fold in the corn kernels. Pour the batter into the prepared pan.

2. Bake until golden and a toothpick inserted in the center comes out clean, about 45 minutes. Let cool completely in the pan set on a wire rack.

3. Prepare the stuffing. Preheat oven to 350 degrees. Generously grease an 8-inch square pan with olive oil. In a skillet, heat the olive oil over medium heat. Add the onion and celery and cook until softened, about five minutes; season with 1/2 teaspoon salt and 1/4 teaspoon pepper, or to taste.

4. In a large bowl, toss together the onion mixture, cornbread, apple and herb blend. Transfer to the prepared pan. Scatter the pecans on top and cover with foil; bake for 15 minutes. Remove the foil; bake until crispy and golden, about 20 minutes more.

Yield: Serves 6 to 8.

Stephen Scott GrossIsaiah’s Pumpkin Muffins With Crumble Topping

Silvana Nardone’s
Isaiah’s Pumpkin Muffins With Crumble Topping

If you make these muffins around the holidays, stir a handful of dried cranberries or 1/4 cup chopped walnuts into the batter. You can also make pumpkin muffin tops with this recipe — just use a muffin-top pan and bake for about 10 minutes.

Topping:
1/4 cup store-bought gluten-free flour blend
1/4 cup packed light brown sugar
1/4 cup granulated sugar
1/2 teaspoon pumpkin pie spice
4 tablespoons all-vegetable shortening
Confectioners’ sugar, for sprinkling

Muffins:
1 3/4 cups store-bought gluten-free flour blend
2 teaspoons baking powder
2 teaspoons pumpkin pie spice
3/4 teaspoon salt
2 large eggs, at room temperature
1 cup canned pure pumpkin puree
1 cup granulated sugar
1/2 cup vegetable oil
1 tablespoon pure vanilla extract

1. Preheat oven to 350 degrees Fahrenheit. Line a 12-cup muffin pan with paper liners.

2. Prepare the crumble topping. Whisk together the flour, brown sugar, granulated sugar and pumpkin pie spice in a medium bowl. Add the shortening and, using your fingers or a fork, blend together until coarse crumbs form.

3. To make the muffins: Whisk together the flour, baking powder, pumpkin pie spice and salt in a large bowl.

4. In a medium bowl, whisk together the eggs, pumpkin puree, granulated sugar, oil and vanilla until smooth. Add to the flour mixture; stir until just combined.

5. Fill each muffin cup almost full; top each with crumble topping. Bake until the muffins are springy to the touch and a toothpick inserted into the center comes out clean, 20 to 25 minutes. Let cool in the pan, set on a wire rack. Using a sieve, sprinkle with confectioners’ sugar.

Yield: 12 muffins.

5:38 p.m. | Updated Tara Siegel Bernard has just posted another interesting article on aging parents and their finances: “Stepping In When a Parent Can No Longer Cope.”

The Times published on Friday a special section devoted to the financial struggles of the “sandwich generation” — middle-aged adults who must support both children and aging parents. Three articles are likely to be of particular interest to New Old Age readers.

In “What’s a Pooled Trust? A Way to Avoid the Nursing Home,” Tara Siegel Bernard writes:

There is a little-known way for some people in certain states to receive home care through Medicaid, without requiring them to impoverish themselves first. Here’s how it works: a federal law established in 1993 allows disabled people to put their monthly income or assets — above the amounts Medicaid allows them to keep — into a special type of pooled trust. They can then use the money in the trust to pay for their basic monthly bills like rent, a mortgage payment or cable television. Medicaid, meanwhile, pays for the home care.

In “Ignore Long-Term Care Planning at Your Peril,” Your Money columnist Ron Lieber wades into the controversy over long-term care insurance:

You would think that there would be far more than seven million policyholders, given that costs for long-term care could easily reach seven (yes, seven) figures per individual 20 or 30 years from now.

As you dig deeper, however, you discover at least nine things standing in the way of consumers purchasing coverage, all of which are outlined below. They’re all complicated, with some reflecting outright ignorance and odd rationalizations rooted in emotion. But there is also a great deal of justified skepticism about the long-term care insurance industry.

Ms. Bernard tackles another kind of insurance in “Income Security in Your 80s, Bought in Your 60s” — longevity insurance.

At its core, longevity insurance is simply a deferred annuity: you hand over a pile of cash to an insurance company, usually around the time you retire. But the guaranteed payments begin much later, usually around 80 or 85, and last for the rest of your life. As with homeowner’s policies and other types of insurance, the idea is to give up a smaller amount of money now, for a potentially larger payout later.

Read more of the special section, “The Sandwich Generation,” and share your thoughts in the comments section.

That is where the anthrax is kept.

Senator Richard G. Lugar, Republican of Indiana, and a delegation of Pentagon officials visited the laboratories on Wednesday for the first stop on a three-country tour of East Africa to assess the next generation of American security concerns.

The team also visited the Uganda Virus Research Institute, where the Ebola and Marburg viruses are taken to study and kept in a spare room in a regular refrigerator near the bottom of the compound. Warning signs say “restricted access,” but the doctors there say that hardly means the area is secure.

The laboratories here in Entebbe, a warm and sleepy city on the shores of Lake Victoria, are part of what the delegation called the front lines of the struggle to counter terrorist threats around the world.

“We need to tighten the security of vulnerable public health laboratories in East Africa,” said Andrew C. Weber, assistant to the secretary of defense for nuclear and chemical and biological defense programs. “Preventing terrorist acquisition of dangerous pathogens, the seed material for biological weapons, is a security imperative.”

The rise of the Shabab, the powerful Islamist insurgent group that claimed responsibility for deadly suicide bombings in Uganda as crowds gathered to watch the final match of the World Cup, has refocused attention on East Africa as a frontier in American security interests.

In 2004, Congress expanded the mandate of the Nunn-Lugar program, which originally focused on dismantling warheads in former Soviet states, to include geographic regions like this one. Now, Mr. Lugar’s trip will take the delegation to Uganda, Burundi and then Kenya.

Uganda, a longtime military ally of the United States, may be the most vivid illustration of the concerns. Warm, wet and on the equator, Uganda is a biological petri dish. Anthrax has killed hundreds of hippopotamuses in recent years. In 2008, a Dutch tourist died from Marburg disease after visiting a cave in a national park. In 2007, an Ebola outbreak killed more than 20 people.

This is the stuff of “The Hot Zone” and “Outbreak” books that have dramatized the dangers of viral outbreaks. But the underlying threat, American officials contend, is that lax security at the poorly financed labs that collect and study these diseases pose a bioterrorism risk.

Ugandan officials also say the country’s push to create new federal districts, part of what the government calls an effort to decentralize the country, has spread the bureaucracy so thin that disease samples can take weeks to make it to a laboratory, or never arrive at all.

“It makes it difficult to report new cases,” said Dr. Nicholas Kauta, a commissioner at the Ministry of Agriculture. “We don’t know what is around us.”

The laboratories at the Ministry of Agriculture, built in the 1920s, have broken windows, and a chain-link fence surrounding the compound is ripped. According to the commissioner, there used to be over 200 technical staff members, but now there are only six. In the anthrax laboratory, one doctor showed how to use a cellphone camera placed on top of a microscope to study the bacteria, a demonstration of the lack of proper equipment.

“These are cries for assistance that the U. S. is eager to provide,” Mr. Lugar said.

At the Uganda Virus Research Institute, there are state-of-the-art facilities run by the Centers for Disease Control and Prevention, an American agency, but not at all of it. The deadliest agents, including Ebola, are still kept downstairs in a room intended to handle lesser infectious diseases like influenza.

“This is the end-state,” said Lt. Col. Jay Hall, from the Defense Threat Reduction Agency, pointing out the disease control agency laboratories upstairs. “This is where we want to get all other labs.”

Stephen Scott Gross Pumpkin Dumplings With RadicchioStephen Scott GrossSilvana NardoneDelicious no-meat recipes for your holiday table.

When Silvana Nardone’s son Isaiah was diagnosed with gluten intolerance three weeks before Thanksgiving, the Brooklyn mom knew she faced a particularly challenging holiday meal. But as the owner of a bakery and founding editor of the food magazine Every Day With Rachel Ray, Ms. Nardone was up to the challenge.

“Cornbread was the first thing Isaiah wanted me to make,” says Ms. Nardone. “I tested it and failed. But once I finally got it, that was my platform for many other dishes.”

Gluten is a protein found in wheat, rye and barley, so it can be challenge to cook without it. Ms. Nardone’s adventures in gluten-free cooking are documented in her new cookbook, “Cooking for Isaiah: Gluten-Free & Dairy-Free Recipes for Easy Delicious Meals.”

For Well’s Vegetarian Thanksgiving series, Ms. Nardone offers three gluten-free vegetarian dishes that celebrate the season: pumpkin dumplings with radicchio, apple-pecan corn bread stuffing (made with her “double corn” cornbread,) and pumpkin muffins with crumble topping.

With a husband who is a vegetarian and a son who requires gluten-free food, Ms. Nardone has learned that cooking challenges can boost creativity in the kitchen.

“It forced me to be a better cook,” says Ms. Nardone, who blogs about gluten-free cooking at DishTowelDiaries.com. “It opens up a whole new way of cooking that you didn’t even know existed.”

See Ms. Nardone’s recipes below, and go to “Well’s Vegetarian Thanksgiving” to see all the dishes in the series that have been published so far.

Silvana Nardone’s
Gluten-Free Pumpkin Dumplings With Radicchio

Something to keep in mind when you make this recipe — it’s a lot easier than you think. The dumplings are super light and pillowy, but if you prefer a firmer texture, add more gluten-free flour, 1 tablespoon at a time, to the pasta dough.

1 15-ounce can pure pumpkin puree
2 large eggs, lightly beaten
1 cup store-bought gluten-free flour blend
Salt
2 tablespoons extra-virgin olive oil
1 medium onion, finely chopped
1/4 teaspoon crushed red pepper flakes
1 small head radicchio, sliced into 1/4-inch strips (about 2 cups)
2 tablespoons chopped fresh flat-leaf parsley

1. Bring a large pot of salted water to a boil. In a large bowl, combine the pumpkin puree, eggs, flour and 1 teaspoon salt to make the dough.

2. In a large saucepan, heat the olive oil over medium heat. Add the onion and red pepper flakes and cook until softened, about five minutes; remove from the heat and set aside.

3. When the water comes to a boil, use a teaspoon to scoop up the dough and form a dumpling, then carefully slide the dumpling off the spoon and into the boiling water. Continue forming dumplings until half the dough is used. Cook until the dumplings float, then simmer for about two minutes; remove with a slotted spoon and add to the saucepan with the onion. Repeat with the remaining dumpling dough.

4. Return the saucepan with the onion to medium-high heat. Toss in three-quarters of the radicchio and stir gently until just wilted, about two minutes; season with 1/2 teaspoon salt or to taste. To serve, divide the dumplings and sauce among four bowls and top with the remaining radicchio and parsley.

Yield: Serves 4.

Stephen Scott GrossApple-Pecan Cornbread Stuffing

Silvana Nardone’s
Gluten-Free Apple-Pecan Cornbread Stuffing

Instead of toasting the cornbread, you can spread out the pieces on a baking sheet and let them sit on your counter top overnight, uncovered, to dry out.

Double Corn Cornbread:
1 cup rice milk
1 tablespoon apple cider vinegar
1 cup cornmeal, preferably medium grind
1 cup store-bought gluten-free flour blend
1/4 cup sugar
1 tablespoon baking powder
1 teaspoon baking soda
1 teaspoon salt
2 large eggs, at room temperature, lightly beaten
1/4 cup vegetable oil
1 cup corn kernels (from about 1 ear of corn)

Stuffing:
2 tablespoons extra-virgin olive oil, plus more for greasing
1 small onion, chopped
2 stalks celery, thinly sliced
Salt
Pepper
4 cups Double Corn Cornbread (see recipe below), toasted and cut into 1-inch pieces
1 Granny Smith apple, peeled, cored and finely chopped
2 teaspoons dried herb blend, such as McCormick Italian Seasoning
1/2 cup chopped pecans

1. Prepare the cornbread. Preheat oven to 350 degrees Fahrenheit. Grease a 4 1/2-inch by 8 1/2-inch loaf pan. In a small bowl, stir together the milk and vinegar. In a medium bowl, whisk together the cornmeal, flour, sugar, baking powder, baking soda and salt. Stir in the milk mixture, eggs and oil until just blended; fold in the corn kernels. Pour the batter into the prepared pan.

2. Bake until golden and a toothpick inserted in the center comes out clean, about 45 minutes. Let cool completely in the pan set on a wire rack.

3. Prepare the stuffing. Preheat oven to 350 degrees. Generously grease an 8-inch square pan with olive oil. In a skillet, heat the olive oil over medium heat. Add the onion and celery and cook until softened, about five minutes; season with 1/2 teaspoon salt and 1/4 teaspoon pepper, or to taste.

4. In a large bowl, toss together the onion mixture, cornbread, apple and herb blend. Transfer to the prepared pan. Scatter the pecans on top and cover with foil; bake for 15 minutes. Remove the foil; bake until crispy and golden, about 20 minutes more.

Yield: Serves 6 to 8.

Stephen Scott GrossIsaiah’s Pumpkin Muffins With Crumble Topping

Silvana Nardone’s
Isaiah’s Pumpkin Muffins With Crumble Topping

If you make these muffins around the holidays, stir a handful of dried cranberries or 1/4 cup chopped walnuts into the batter. You can also make pumpkin muffin tops with this recipe — just use a muffin-top pan and bake for about 10 minutes.

Topping:
1/4 cup store-bought gluten-free flour blend
1/4 cup packed light brown sugar
1/4 cup granulated sugar
1/2 teaspoon pumpkin pie spice
4 tablespoons all-vegetable shortening
Confectioners’ sugar, for sprinkling

Muffins:
1 3/4 cups store-bought gluten-free flour blend
2 teaspoons baking powder
2 teaspoons pumpkin pie spice
3/4 teaspoon salt
2 large eggs, at room temperature
1 cup canned pure pumpkin puree
1 cup granulated sugar
1/2 cup vegetable oil
1 tablespoon pure vanilla extract

1. Preheat oven to 350 degrees Fahrenheit. Line a 12-cup muffin pan with paper liners.

2. Prepare the crumble topping. Whisk together the flour, brown sugar, granulated sugar and pumpkin pie spice in a medium bowl. Add the shortening and, using your fingers or a fork, blend together until coarse crumbs form.

3. To make the muffins: Whisk together the flour, baking powder, pumpkin pie spice and salt in a large bowl.

4. In a medium bowl, whisk together the eggs, pumpkin puree, granulated sugar, oil and vanilla until smooth. Add to the flour mixture; stir until just combined.

5. Fill each muffin cup almost full; top each with crumble topping. Bake until the muffins are springy to the touch and a toothpick inserted into the center comes out clean, 20 to 25 minutes. Let cool in the pan, set on a wire rack. Using a sieve, sprinkle with confectioners’ sugar.

Yield: 12 muffins.

Mike AnthonyDelicious no-meat recipes for your holiday table.

When executive chef Michael Anthony from New York City’s Gramercy Tavern added a series of vegetable tasting dishes to the celebrated restaurant’s menu, he wasn’t trying to attract vegetarian diners.

“It’s not a way to pull a niche market into the restaurant, nor is it designed to be an escape from regular food,’’ Mr. Anthony explained. “It’s meant to be a celebration of vegetables, and a great snapshot of what’s available in the farmers’ market and what’s growing in family farms around our area.’’

As a result, Mr. Anthony says he was eager to “show off” vegetables as part of the Well Vegetarian Thanksgiving series.

“There is this notion of reconsidering the role that proteins play in the conception of the dish,’’ he says. “It makes for good eating to reconsider and create dishes that let vegetables play a major role.’’

The seasonal menu offered by Mr Anthony includes buckwheat and black kale, a soup made with celery root and chestnuts and a salad of sunchokes and apples.

“The nature of these dishes is that you let them steal the show,” he said. “You don’t eat it and think, ‘Boy, this would be good with duck.’ You just say, ‘This is so delicious.’ ”

Read all of Chef Anthony’s recipes below, and click to explore all the dishes in Well’s Vegetarian Thanksgiving series.

Michael Nagle for The New York Times

Michael Anthony’s
Buckwheat and Black Kale With Brussels Sprouts

Chef Anthony has long been fascinated with the aromatics and flavor of buckwheat, and the marriage of buckwheat and kale is delicious, he says. “This for me is American food,” he says. “It would have a home on my grandmother’s table in Indiana.” You can find buckwheat at the Union Square market, online at Burkitt Mills or at Whole Foods or Indian food specialty stores.

3 medium onions, minced
3 cloves garlic, minced
1 tablespoon olive oil
3 cups buckwheat
Salt
Pepper
6 cups water
1 bunch black kale, blanched and finely chopped
2 parsnips, diced and blanched
1 tablespoon whipped cream
1 tablespoon chopped parsley
1 small red onion, sliced and sautéed
12 large shiitake mushrooms, quartered and sautéed
12 brussels sprouts, quartered or split into leaves (roasted in 375 degree oven until just tender).

1. In a saucepan over medium heat, sweat the onions and garlic by cooking them in 1 tablespoon oil until they release some of their moisture and become slightly translucent, about 5 minutes. (“Sweating” vegetables means slowly softening them over gentle heat to draw out the flavor without browning them.)

2. Add buckwheat, and season with salt and pepper to taste. Cover with water and bring to a simmer for approximately 5 minutes. Remove from the heat and let buckwheat rest in water for approximately 10 minutes. Strain excess water.

3. Once the buckwheat has been drained, immediately add kale and parsnips. Add whipped cream and parsley, and stir gently. Garnish by topping with shiitake mushrooms, onions and roasted brussels sprouts.

Yield: Serves 8.

Michael Nagle for The New York Times

Michael Anthony’s
Celery Root and Chestnut Soup With Brussels Sprouts

As you dig into this soup, with its white, soft and silky base, each bite has a whole new texture, Mr. Anthony explains. “This really complex soup is beautiful and delicious,” he says, “and a great example of what’s falling from the trees and coming out of the garden.”

For the soup:
1 medium onion, diced small
1 stalk celery, diced small
1 medium leek, white and light green parts only, diced small
2 cloves garlic, minced
1 teaspoon olive oil, plus more for sweating the vegetables
1 large bulb celery root, peeled and diced (about 2 1/2 cups)
4 cups milk
Salt
Pepper
Juice from 1 lemon (about 2 tablespoons, or to taste)

For the chestnut puree:
5 shallots, sliced thin
2 cloves garlic, smashed
1 sprig thyme
12 chestnuts, peeled and roughly chopped
1/2 ounce Calvados
Salt
Pepper
2 cups water

To garnish the soup (per serving):
1 tablespoon celery root, diced and blanched
1 teaspoon carrots, diced and blanched
3 turnip pieces, quartered and blanched (about three tablespoons)
2 chestnuts, roasted and diced
2 brussels sprouts, steamed and cut into dice or split into leaves

1. Prepare the soup. Sweat the onions, celery, leeks and garlic in a small amount of olive oil until soft without browning, for about 5 minutes. Add celery root and sweat for 4 minutes. Season with salt and pepper.

2. Add milk and then add water to cover, and simmer for 45 to 50 minutes.

3. Puree the milk mixture in a blender with 1 teaspoon olive oil and lemon juice. Strain through a fine mesh strainer.

4. Prepare the chestnut puree. Saute shallots, garlic, thyme and chestnuts over medium heat for 1 minute. Deglaze the pan by adding the Calvados. Season with salt and pepper to taste. Add water and simmer until tender. Puree the mixture in a blender, adding water to adjust consistency.

5. To plate (per serving): Pour 5 ounces (5/8 cup) of celery root soup and 1/4 cup of chestnut puree into each bowl. Garnish each bowl with diced celery root, carrots, turnips, roasted chestnuts and brussels sprouts.

Yield: Serves 8.

Michael Nagle for The New York Times

Michael Anthony’s
Sunchoke and Apple Salad

In the fall, sunchokes are crunchy and watery, like a water chestnut, or like a pear that’s not sweet, says Mr. Anthony. “They are a wonderful way to bring texture and crunch to a salad,” he says.

12 sunchokes
Olive oil to coat the sunchokes
4 apples, sliced
2 tablespoons toasted pumpkin seeds
Mixed greens: radicchio, bok choy, mizuna, celery leaves
1/2 cup celery, minced
1 tablespoon shallot, minced

Apple cider vinaigrette:
1 cup apple cider
2 Tablespoons apple cider vinegar
1 teaspoon Dijon mustard
1 tablespoon maple syrup
1/2 cup olive oil
1/4 cup lemon juice
Salt to taste
Pepper to taste

1. Prepare the sunchokes. Wash sunchokes with the skin on. Slice 2 sunchokes, raw, into thin strips using a mandoline; set aside. Roast the remaining sunchokes. Preheat oven to 375 degrees. Place them in a pan with olive oil, and roast for about 40 minutes.

2. Toss the hot sunchokes with the remaining salad ingredients.

3. Prepare the cider vinaigrette by combining all the vinaigrette ingredients; dress the salad and season with salt and pepper to taste. Garnish with raw sunchoke slices.

Yield: Serves 8.

Martin Mistretta/Getty Images

Could sports drinks be improved with the addition of protein? That question has long gripped physiologists and nutritionists. It’s well established that the carbohydrates (sugars) that sweeten most sports drinks aid performance. They provide immediate fuel for straining muscles, keep blood-sugar levels stable and allow you to work out for a longer period of time or at a higher intensity, or both, than if you don’t swallow any extra fuel. But why wouldn’t taking in protein, together with carbohydrates, during a workout or race make you even more speedy and durable? Protein, after all, is what muscles fundamentally are made of, so it seems reasonable to imagine that adding it to sports drinks could provide some additional benefit.

But to date most studies have not shown that to be true. Some earlier experiments that did find athletic-performance benefits from protein-enhanced sports drinks used protein beverages that contained more calories than the carbohydrate-only versions and, as some critics pointed out, the extra calories rather than the protein, per se, probably provided the benefit. More typically, most studies came to the same conclusion as one published earlier this year in the journal of the American College of Sports Medicine. For that study, cyclists consumed a carbohydrate sports drink or one enriched with whey protein while they warmed up with two hours of steady-state cycling and then completed a strenuous one-hour time trial. The researchers found no benefit from the protein drink. The cyclists downing it didn’t produce more power while pedaling or cover more miles during the time trial, nor did they harbor fewer markers of muscle damage the next day. The protein didn’t hurt their performance, but it didn’t help in any measurable fashion, either.

The researchers themselves weren’t surprised, said Dr. Asker Jeukendrup, a professor in the school of sport and exercise sciences at the University of Birmingham in England and senior author of the study. “No one has a clue why protein would work,” he said. “Protein is a poor fuel.”

But a few scientists (and athletes and sports-drinks-makers) can’t shake the notion that protein can and should do something during exercise, and a new, narrowly defined study published last month in the Journal of Strength and Conditioning Research may give them some ammunition. For this study, researchers at the University of Texas at Austin recruited 15 competitive cyclists and had them complete two grueling exercise sessions in a lab. During each session, the cyclists rode for three hours, with the pedaling varying, on a set schedule, from languid to draining. At the end of the three hours, the pedaling resistance was upped considerably, and the volunteers were told to ride until they barely could turn the pedals.

Throughout the sessions, the riders swallowed either a typical sports drink or one that had been supplemented with whey protein. Importantly, this protein-enriched drink was low-calorie, with half as much of the carbohydrate sweetening as the sports drink. “Not everyone needs or wants all of those calories from sports drinks,” pointed out Dr. John Ivy, a professor of kinesiology and health education at the University of Texas and senior author of the study. “I personally think we take in far too many calories that way.”

But can you still get benefits from a low-calorie drink? In Dr. Ivy’s experiment, a certain subset of the riders did. Those who pedaled during the final few, exhausting minutes of the experiment at a pace just below their ventilatory threshold (the point at which the muscles simply cannot get enough oxygen) and who swallowed the low-calorie protein drink rode a precious few moments longer than riders at the same intensity who drank only carbohydrates. The riders, however, who strained through the final ride to exhaustion above their ventilatory threshold got no clear benefit from protein.

What does this finding mean for those of us trying to decide on a sports drink? Frankly, no one knows. “We don’t know” why or how protein would operate on muscles during exercise, Dr. Ivy said, or why it might provide benefits when calories are cut or why it was effective only for riders who pedaled at certain intensities. “Protein is composed of amino acids, and they have many different effects on metabolism,” he said.

Other scientists remain skeptical. “I just don’t see a viable mechanism” for protein to work as a fuel during exercise under almost any conditions, said Dr. Martin Gibala, chairman of the department of kinesiology at McMaster University in Hamilton, Ontario. His lab has studied protein ingestion during exercise extensively and found no discernible performance benefits. “It’s possible that if you reduce calories substantially,” so you’re taking in “suboptimal” levels of carbohydrates, maybe, somehow “the protein is converted” to fuel, he said. But that’s a very artificial situation. “You don’t do endurance exercise that way,” he said. Someone who can ride a bike vigorously for three hours or more is probably not someone who needs to worry unduly about weight loss. “The science just isn’t there for an acute effect” of protein in sports drinks, he said.

Which means that, for now, you can probably skip adding protein powder to your Gatorade. (The flavor would be ghastly anyway.) “I have a hard time” believing “that protein would have any effect,” Dr. Jeukendrup concluded. The topic may continue to draw attention from scientists and athletes hoping for a simple, liquid means of getting themselves to the finish line faster, but he said, “I am convinced that protein in carbohydrate drinks during exercise will soon be out of fashion.”

Over the years in my quest to lose weight, friends, family members and, most recently, readers of this blog, have been generous with their advice. They tell me, often with a passion that borders on the fanatical, that the key to weight loss is (fill in the blank).

The feedback goes something like this:

You can’t be healthy until you lose weight. You need to accept your body as it is.

All calories are the same. No calorie is the same

Stop eating carbs. Stop eating fat. Eat anything you want, in moderation.

Forget the vegetarian thing; you need to eat meat. Forget the vegetarian thing; you need to be vegan.

Keep track of your weight. Never get on a scale again.

I’ve learned that weight loss may be tied to things I’d never considered: fatty livers, leptin deficiencies, sleep patterns, breathing. I’ve been told to fast, juice cleanse, attend Overeaters Anonymous, track my progress on Twitter, listen to weight-loss podcasts, grow my own food, spend more time at the beach. One friend took the fear route and told me that if I don’t lose weight now, I’ll be in diapers by the time I’m 60.

I want to seriously consider every morsel of weight-loss advice, from crackpot plans to holistic approaches, in order to make up my own mind about what will work for me and my body. But the more advice I get, the more convinced I am that there’s only one person to whom I really need to listen: myself.

If there is anything good that can come from the struggle to lose weight, it’s the fact that you learn a lot about yourself in the process.

I know that for me, exercise remains my biggest challenge. I’m not exercising at all now, other than walking to work, and I know that needs to change. I just need to find the regimen that appeals to me, and that I really believe I can stick to long-term. Am I lazy? I don’t think so, but I’m willing to reconsider. I do know that telling me to “just do it,” as one marathon-running, skinny-since-birth friend of mine recently opined, won’t make it happen. I’m still trying to figure out what will.

I also know that I have a love-hate relationship with food. At several points in my life — birthdays, New Year’s Eve, random Mondays — I’ve said, “This is the day I’m going to start eating healthy and exercise more,” only to return, tail between legs, to bad habits a month later. Perhaps I get bored easily, or let my emotions drive my diet and exercise habits. Whatever the reason, I still need to learn more about the emotions that accompany my eating.

Finally, I know that for me, being a vegetarian is more important than losing weight; I won’t consider an eating plan that includes meat no matter how much weight it might help me to lose. For me it’s an ethical choice — about killing animals, mostly — that is far too integral to who I am as a person to suddenly change. My light-bulb moment happened at age 16, the day a loud-mouthed classmate gasped and pointed at the blood-filled vein sticking out of a chicken leg I was about to gnaw on. I stopped eating animals over the course of the next few months, and lost about 10 pounds as a result. My meat-loving mother once joked: “I’m fine with you being gay. But when is this whole vegetarian phase going to be over?” It’s not.

I recently returned from a two-week vacation in Brussels, Amsterdam and Paris. At times, my only vegetarian options were butter-bursting croissants and heavy cheeses. But I lost five pounds.

Maybe it was all the walking, or the small portions. The trip spurred me to start seeing a nutritionist, who can help me integrate what I learned about how Europeans eat, and what it means to be an urban vegetarian with a weight-loss goal. And I’m hoping that by talking — and writing — about eating, I can keep on listening to myself and start making smarter choices.

I was having lunch with another nurse outside the hospital when I spotted a former patient of mine.

I jumped up to hug him, and marveled that he had hair. Jeff is an English professor and we have mutual friends who teach at a nearby university. I had the good fortune of first meeting Jeff at a dinner party long before he became a patient in my hospital. The next time I had seen him was in the hospital. He had been diagnosed with lymphoma and was undergoing treatment.

Jeff Swensen for The New York Times Theresa Brown, R.N.

“Hey, Theresa,” he called out, walking in the hall, holding his I.V. pole, bald, dressed in a hospital gown. “It’s Jeff.”

I could not place him, and he reminded me how we had met. I realized that the unease I felt was because I try to keep my work life separate from my “real” life. Even more, I like to believe that keeping these worlds separate helps keep cancer from affecting anyone I know.

Jeff stayed for just 19 days. While I was only his nurse for a brief time during his stay, I was often stationed near his room. We would talk, not about cancer or his transplant, but about a literature class he was preparing and some writing he’d done for a magazine. For me it was refreshing, a dip back into the life of the mind I had left behind at the university. For him I imagined it was a way to feel like a person rather than only a patient.

And then several months later, there he was, having lunch in the same restaurant where I was dining with my friend.

It happens sometimes — I see a patient out and about in the real world following treatment in the hospital. Every time they appear to me like a mythical being, someone newly human just formed out of clay.

Seeing Jeff emerge from the short flight of stairs as he arrived at the restaurant also brought to mind the story of Orpheus and Eurydice. In that well-known tale, Orpheus was a musician, deeply in love with Eurydice, who died after being bitten by a snake. Heartbroken, Orpheus used his music to charm his way into the underworld and convince Hades to bring Eurydice back to life. Orpheus was warned not to look back at Eurydice until they both climbed up the steps from the Underworld, but Orpheus could not resist a glance back. Having broken the rules, he watched helplessly as she dissolved and disappeared.

I’ve always thought this was one of the crueler stories in Greek mythology. Surely the gods could have some sympathy for Orpheus’s sense of disbelief that his lost love had come back to life.

That was the feeling I had when I saw Jeff, fully solid, with hair on his head, eating out in a restaurant, looking like a professor instead of a patient. As he and I talked, I kept touching his elbow, wanting to assure myself that he was real.

I told him he looked great, which really meant that he didn’t look like a patient any more.

A couple weeks later I saw him again, in the public library. This time I didn’t need to keep touching his elbow; two sightings had convinced me he wouldn’t dissolve. We talked some about his health, but most of our conversation focused on books, his writing and teaching.

Jeff has given me permission to tell his story, if only as a reminder to patients that things do get better. He still has some lung issues caused by his immune system being over-reactive. A relapse of his disease is a bigger worry. But he’s teaching, writing, reading and running again for exercise when his lungs don’t slow him down. He loves Prince, so his daughter bought them tickets to a concert at Madison Square Garden this December. The option to attend a concert is just one more sign that his life is returning to normal — no longer immune-suppressed and fragile, it’s safe for him to be part of such a large crowd.

There’s no denying that cancer is still on his mind, but having successfully made his trip up the stairs, the rest of his life is, too.