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Black pepper can worsen reflux in some people, but the small amount in this recipe (less than 1/8 teaspoon per serving) is likely tolerated by many with GERD. If you prefer to always avoid black pepper, please tap it and change its rating to Red.


Stir the breadcrumbs and milk together in a large mixing bowl and let stand for 5 minutes until the breadcrumbs have absorbed the milk and formed a soft paste (a panade).
Add the ground beef, ground pork, eggs, Parmesan, garlic, parsley, oregano, salt, black pepper, and red pepper flakes, if using, to the bowl. Mix with your hands just until the ingredients are evenly combined — stop as soon as no streaks of egg or breadcrumb remain; do not overwork the mixture.
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