Pulled Chicken Panini with Pickled Onions, Apple and Melty Cheese

February 11, 2015
Pulled Chicken Panini with Pickled Onions, Apple, and Melty Cheese - Inspired by Carolina-style barbecue, this sandwich gets plenty of zing from a spicy, vinegary sauce and quick-pickled red onions

I can't help but wonder the context (the date, time, and place) when the researchers at the Harvard School of Public Health decided to

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study the health consequences of women who choose to take oral contraceptives.

Were they sitting in a corner booth at a bar after work?  In a lab hovered over a microscope?  Conferring casually in one of their offices,  discussing a particularly baffling case?

The year was 1976, when 170,000 questionnaires began finding their way into mailboxes of registered nurses throughout the country.  Of these, 122,000 would respond, thus launching one of the largest and longest-running cohort studies .. ever.

The Nurses' Health Study

What began innocently enough, nearly forty years ago, continues to this day, with its outcome being far beyond what anyone could ever have imagined.  Researchers have not only gained insight into the effects oral contraceptives can have on a woman's body, but also a wealth of general information about the effects of lifestyle and dietary factors related to women's health.

Nurse 1-600x

Photo Credit: Pinterest.com

In its infancy, the study began gathering data via a straightforward questionnaire filled with questions about diseases and health-related topics, such as smoking, hormone use, and menopausal status.  Following the ever-inquisitive minds of researchers, it was natural that the data being collected would be expanded as the years passed.

One such milestone happened in 1980, as the set of questions grew to include many related to diet and nutrition — another in 1992, with the addition of those related to the quality of life.  A new questionnaire was released every two years.

It wasn’t only the questions being asked of the cohort members that grew larger over the years, so did the study itself.  The original Nurses’ Health study included married women who, in 1976, were between 30 to 55 years of age, and living in some of the most populous states.

In 1989, the Nurses’ Health Study II was founded, expanding upon the first to include a much younger generation, women between the ages of 25 and 42 years.  In 2010, the second expansion established the Nurses’ Health Study III.  This latest study is web-based and recruits its third-generation cohort nurses from a from across the entire United States as well as Canada.  Their ages range from 20 to 46 years old.

Pulled Chicken Panini with Pickled Onions, Apple, and Melty Cheese - Inspired by Carolina-style barbecue, this sandwich gets plenty of zing from a spicy, vinegary sauce and quick-pickled red onions

Through these studies, funded in part by the National Institutes of Health, researchers have gained powerful insights into health and wellness by examining the responses of these 238,000 women.

Some of the highlights include the harm and benefits of various factors, including specific foods in their diets.  To list all of the findings wouldn't be practical, although there certainly are many that stand out

  • Eating a Mediterranean type diet is linked to longer lifespans and better health
  • There’s a strong relationship between weight and the risk of coronary heart disease, as well as stroke
  • More physical activity, including walking, greatly reduces the risk of hip fractures
  • A family history of breast cancer, high breast density, high circulating hormone levels, and shift work, all increase the risk for breast cancer
  • Data suggests that a high dietary glycemic load from refined carbohydrates increases the risk of coronary heart disease, independent of other known coronary disease risk factors

Today the study is still going strong, with the nurses responding to new questionnaires approximately every two years.  While the prevention of cancer is still the primary focus, it has produced landmark data on cardiovascular disease, diabetes, and many other conditions.

Most importantly, the study has proven yet again the power that diet, physical activity, and other healthy lifestyle factors have in the promotion of better health

(This post is an excerpt from a paper I finished this week, an in-depth examination of the famous Nurses' Health Study.  To read more, its website is the best place to begin)

Pulled Chicken Panini with Pickled Onions, Apple, and Melty Cheese - Inspired by Carolina-style barbecue, this sandwich gets plenty of zing from a spicy, vinegary sauce and quick-pickled red onions

Slow cooker pulled chicken is one of the best things to have in the freezer for weeks like this one, when there isn't much time to spend in the kitchen.

This recipe is a wonderful way to use the chicken and make it feel different.  The sandwiches are a little sweet, a little spicy, with the onions and apples making the perfect complements.  We used thin slices of cheese, and they were enough to lend another dimension.

I served ours on gluten-free artisan bread flattened with a panini press.



~ Adapted from Fine Cooking

Pulled Chicken Panini with Pickled Onions, Apple, and Melty Cheese


  • ½ small red onion, cut into thin rings
  • 2 tsp. natural sugar (Sugar in the Raw or Turbinado)
  • 1 tsp sea salt + freshly ground black pepper, divided
  • ½ cup red wine vinegar
  • ½ cup cold water
  • ¼ cup honey (or liquid sweetener of choice)
  • 2 Tbsp apple cider vinegar
  • 2 tsp Tabasco sauce (more or less, depending on your tolerance for heat)
  • 3 cups pulled chicken (a cut up rotisserie chicken will work great)
  • ¼ cup chicken broth
  • 4 slices bread, cut into thick sandwich-sized pieces (gluten-free if you’re avoiding gluten)
  • 4 thick slices of your favorite melty cheese either smoked cheddar or smoked gouda are good)
  • 2 small Granny Smith apples, cored and thinly sliced


  • In a large bowl, toss the onion with the sugar, salt and pepper, and let sit for 10 minutes.
  • Add the red wine vinegar and water, pressing down with a plate to submerge the onion. Let sit for 30 minutes at room temperature.
  • In a small saucepan, over medium heat, warm the honey, cider vinegar, Tabasco, and ½ tsp pepper over medium heat until the honey melts (~ 2-3 minutes)
  • Add the chicken and broth, reduce the heat to medium-low, and cook, stirring occasionally, until the chicken has heated through and absorbed most of the sauce (~ 5 minutes).
  • At this point add more Tabasco if you'd like more heat
  • Assemble your sandwich with cheese, chicken, onion, and apples. Heat in your panini press until the bread is browned and the cheese has melted (~ 1-2 minutes).
  • Cut in half, and serve
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