About Dr. Gourmet My name is Timothy Harlan and I am both a physician and a chef. This blog is a general collection of information and random ideas on eating great food and eating healthy.
You can find out more at the Dr. Gourmet web site. Eat well, eat healthy, enjoy life!
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Dear Dr. Gourmet,
 Q: I’m trying to follow a very strict DASH diet (1500mg sodium), controlling carbs (60g carbs per meal), and feed my family of 4 including 2 teenage boys. I’m getting pretty good at substituting lower sodium alternatives like using reduced fat swiss for other cheeses but I’m having a hard time setting up a meal plan for my family. The low sodium meals don’t seem to be very low sodium and many have added salt. I look for recipes that have a balance of percentage of calories with the percentage of sodium and your recipes just don’t seem to measure up. When I look at lunch choices I can use reduced fat swiss (60mg sodium per ounce) or goat cheese (320mg sodium per ounce) interchangeably. How do you determine sodium levels to keep around 2,400mg per day for my family?
A: There’s no doubt that great research has been done through the D.A.S.H. diet programs. We have over two decades of information from these studies. So much of the ongoing study has helped inform us of how powerful a healthy diet can be in both preventing and treating disease.
Following a 1,500 mg sodium diet can be a challenge for many folks. For those at higher risk this certainly can help prevent problems later in life. For those with congestive heart failure and some types of high blood pressure low sodium diets can be an important part of therapy. Most physicians prescribe a 2,000 mg sodium diet in such cases in trying to balance the ideal low sodium diet with what most folks can achieve as part of their daily lives. This is the target we have used for the Dr. Gourmet website and thus far have not worked on recipes for a very low sodium diet (1,500 mg and lower). Sodium in Dr. Gourmet Recipes
 Q: What is the difference between dry roasted and oven roasted nuts?
A: Dry roasting is just that — dry. Nuts are often roasted in oil which adds calories. Given that nuts are mostly fat, it makes it easy to roast them without any added fat.
Oven roasted could mean either oil roasted or dry roasted.
 Q: I went to lunch with my friends and we were at the salad bar choosing the various vegetables for our salads. When my two friends saw me putting peas & corn kernels on my salad (a small amount) they said both of those were very bad for you because they were loaded with starch. I understand the starch thing, but I read where they do have a lot of vitamins, minerals, folate, fiber and good carbs, as well as other nutritional benefits. I disagreed with them, telling them that foods high in starches, served in moderation, aren’t bad for you. Am I wrong or were the two of them over-reacting?
A: Your friends are completely wrong. Period. While corn and peas are carbohydrates, they are really good for you. Both are full of fiber and satisfying. While they are mostly carbohydrates (starches) it has long since been proven that low-carbohydrate diets are no better for you for losing weight. We now know that it is eating fewer calories that is the key and not limiting one particular type of food. Corn and Peas in Salad
Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.
Dr. Tim Says….
 The DASH Diet (Dietary Approaches to Stop Hypertension) is so successful because its foundations are drawn from research on the Mediterranean diet. Many of the researchers who took part in the initial DASH study were the same who detailed the benefits of the Mediterranean diet. If you look at them side by side it’s easy to see how similar they are.
The results of the initial DASH study found that those following the diet had both lower systolic and diastolic blood pressures in those without high blood pressure. The effect in those with hypertension was even greater, with blood pressure reductions of around 11 points. This was profound information at the time, but as researchers are prone to do, they thought that they might be able to do better.The DASH Diet and the Mediterranean Diet
Featured Recipe
Curried Shrimp and Coconut Rice Salad
 This recipe is a great way to use your leftover coconut rice. I love this recipe because it is a great way to plan your week. One night serve a dish with coconut rice, likeChicken Satay or Pork Chops with Black Bean and Pickapeppa Sauce, and make extra. Put it in the fridge for a great salad later in the week.
Ask Dr. Gourmet
 Q: My wife and I like Thai curry – but coconut milk is so high fat and saturated fat. Do you have a replacement suggestion? I’ve seen soy milk or evaporated milk suggested.
Also, I was wondering if in fact coconut milk’s saturated fat (and plant sources of saturated fat) were in fact healthy.
A: Coconut milk has gotten a bit of a bad rap because it is high in saturated fat. These types of fat are likely not as much of an issue as those saturated fats found in animal products.
That said, I always use light coconut milk in my recipes. It’s widely available now and far lower in fat and calories but with all the flavor of regular coconut milk (and more than enough creaminess).Coconut Milk
 I was at the store the other day looking for things to review when I saw today’s products from Emeril’s Cajun Creations displayed next to other local food lines. I’ve looked at the nutrition information on these other lines, and as is so often the case, the levels of sodium in these meals are just appalling. I’d assumed that this was also true of Emeril’s products as well, but for some reason I stopped and looked more closely.
I was surprised to see that the sodium levels on both of the meals we’ll review today are under 500 milligrams. That’s not bad at all – and if that means people can get the flavors of New Orleans out of the freezer case, this could be a real find. When I tell people that I live in New Orleans, they almost invariably tell me how much they love New Orleans food. How nice it would be to tell them that they could get good New Orleans food out of the freezer case! So I brought them home to our tasting panel for judgement. Emeril’s Cajun Creations
Cucumber and Chive Salad | Low Sodium Cucumber and Chive Salad | Coumadin Safe Cucumber and Chive Salad
 This is a light and wonderful salad that is full of flavor. I like the cucumbers with the peel on and with the seeds. (Note that the Coumadin Safe version of this recipe requires peeling the cucumbers.) The wonderful textures of the cucumbers and tomatoes combined with the creamy dressing makes this a perfect side dish for your summer cookout.
Fish Sandwiches with Sun Dried Tomato Tartar Sauce
 Tartar Sauce is, of course, the standard with your fish, but that doesn’t mean that you can’t change it up every now and then. This sauce works great on fish sandwiches, as well as with Oven Fried Fishand Mustard Cornmeal Crusted Fish.
For those who may not be aware, GERD (GastroEsophageal Reflux Disease) is a condition in which the acid inside the stomach goes up into the esophagus (essentially the tube from the mouth to the stomach), causing inflammation of the esophagus (esophagitis) and symptoms ranging from mild heartburn to severe chest pain. (Some people have actually thought they were having a heart attack!) Over time, untreated GERD can lead to damage to the esophagus and the risk of bleeding or even cancer. This damage is known as erosive esophagitis. What you may not know is that people can have GERD but have no symptoms (called asymptomatic ERD) or have NERD (Non-Erosive Reflux Disease), in which the esophagus is not yet damaged.
There are various lifestyle changes that we doctors recommend to those who have GERD, which include frequent small meals, keeping a food diary to determine your personal food triggers (to avoid them), not smoking, and weight loss (if needed). These changes are more a result of trial and error than determined through research, however.
Researchers in Japan, concerned about the increase in the number of Japanese who have been diagnosed with GERD, decided to approach the issue more clinically (Dig Dis Sci 2011;56:2857-2864). They recruited over 2000 men and women who were receiving a health screening from a physician at a Red Cross health clinic to participate in their study. GERD and Lifestyle
Dear Dr. Gourmet,
 Q: By reading the labels, I have learned that different types of salts (sea, iodized, table, black etc.) have different sodium levels. Do you know which salts have the least amount? I am not even sure how many different types of sodium based salts there are. Thanks!
A: You are correct that sea salt products will be lower in sodium. This is because the crystals are larger and more irregular and a teaspoon is less dense.
A teaspoon of table salt such as good, old fashioned Morton Salt in the round blue box weighs 6 grams. The Nutrition Facts on the box reports this as having 2,360 mg per teaspoon (the USDA database reports this as 2,325 mg in a teaspoon). Sodium in Salts
 Q: I have acid reflux and was told to try a Digestive enzynme? Do they work and what do you recommend?
A: There is no evidence from the literature that proves digestive enzymes are beneficial for GERD / Acid Reflux. Digestize enzymes and GERD
Q: What can be used to counteract too much salt used in a recipe?
A: There are a lot of old wives’ tales about this, but truthfully not much can be done. The myth that I grew up with was that putting a raw potato in the soup would work. Saving a Salty Recipe
Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.
Dr. Tim Says….
I had a question not too long ago about why we don’t have information about the DASH Diet on the Dr. Gourmet Web site. It’s a fair question and the answer is pretty simple.
For the most part, the DASH Diet is the practical application of the Mediterranean diet. The research in the 1970s and 1980s about Mediterranean diet laid the foundation for great quality nutrition research in the 1990s. The result was a large scale, multi-center trial of 459 adults age 22 years or older.
The goal of the research was to look at how diet might influence blood pressure. What is the DASH Diet?
Featured Recipe
Fish Sandwiches with Sun Dried Tomato Tartar Sauce
Tartar Sauce is, of course, the standard with your fish, but that doesn’t mean that you can’t change it up every now and then. This sauce works great on fish sandwiches, as well as with Oven Fried Fishand Mustard Cornmeal Crusted Fish.
Ask Dr. Gourmet
 Q: What’s the best way to store fish?
A: This question didn’t come via AskDrGourmet
@drgourmet.com but it was asked recently during a conversation that I was having with someone testing The Dr. Gourmet Diet Plan. She was asking about the number of seafood meals. She wasn’t concerned about eating so much fish and those of you who often read these columns know that eating seafood is really good for you. She wanted to know about storing fish and shellfish telling me that she couldn’t get to the fish store because she works until after it closes at 6:30.
Storing fish is something that I know a lot about because when I first moved to Virginia in 1994 I lived far enough outside of Washington D.C. that good quality fish wasn’t available in my small town. This isn’t as much of an issue as it used to be, but at the time I would drive an hour each way twice a week to shop for quality meats and fish.Storing Fish
 I have eaten at a Legal Sea Foods chain restaurant once and was not terribly impressed. This was about 6 years ago and the restaurant smelled like fish. Fish restaurants shouldn’t smell like fish. Seafood restaurants should smell like the ocean. My recollection was that the food wasn’t all that great. In spite of my previous experience, we elected to give them a try as part of our recent look at chain restaurants.
These guys have been around since the late 60’s and I remember visiting them in Boston in the 1970’s. They were one of the gold standard in seafood restaurants at the time. Their expansion in the 1990’s and early part of the century brings them to about 30 restaurants up and down the East coast.
I have gotten pretty good at deciphering menus for gluten content and asking about how things are made, and more restaurants today are helpful for those who need to avoid wheat gluten. There is increasing awareness at chain restaurants, but Legal Sea Foods was a very pleasant surprise. Legal Sea Foods
Cajun Barbecue Sauce
 Barbecue gets a bad rap. This is because people only think of ribs or other high fat cuts of meat. This sauce is great on shrimp, fish, lean pork chops or pork tenderloin. There’s no sodium in the sauce but you can add a little to the food you are cooking – about 1/8 teaspoon per serving.
 Curried Roasted Squash
This recipe is super simple and the curried squash comes out of the oven tasting as though you put butter on it. This is a great side dish with almost any main course.
Dear Dr. Gourmet,
 Q: Something you said in today’s newsletter article on peppers especially got my attention: “Like eggplants and tomatoes, peppers are a member of the nightshade family.”
I’m seeing a Physical Therapist for help recovering from a partially-torn tendon and chronic ankle sprain, plus sporadic episodes of severe foot to calf muscle cramps. For the muscle cramps, doctors have said to try more calcium, D, potassium, and magnesium. The PT recommends avoiding nightshade plants in my diet, and taking curcumin with black pepper extract, thinking that would reduce inflammation. Why would that make sense? I can’t see any inflammation. And we just put a dozen tomato plants out in pots!
A: There have been a few articles that indicate nightshades could be an issue but these are anecdotal and there is little sound science to back up the claims. The theory is that a chemical in nightshades, solanum, leads to inflammation. Some animal studies have supported this but the research has not been well replicated and there is no evidence that this is true in humans.Nightshade and Inflammation
 Q: My grandmother is on Warfarin and I am wondering if rhubarb wll affect the medication that she is on. I’m going to make rhubarb crisp and will baking rhubarb have any issues interfering with her meds?
A: Rhubarb has a moderate amount of Vitamin K. The USDA database reports that a stalk contains 15 micrograms (35 mcg per cup). Rhubarb and Coumadin (warfarin)
 Q: I am going crazy listening to all my friends (none of whom has celiac disease) about how we have to avoid gluten and how they will only eat “gluten-free” food. I bake all my own whole grain bread (I haven’t bought bread in two years) and some of the recipes call for added wheat gluten or the bread won’t rise at all. I am no more or less healthy/heavy/lethargic or anything else than any of them.
Is this Gluten-Free just another “craze” and people are just jumping on the band wagon or is this really a serious problem and wheat gluten is sending us all to an early grave?
A: Three years ago I might have said that people eating gluten free who were not diagnosed with celiac disease had no reason to do so. Now I am not so sure.
Celiac disease is an autoimmune condition where the presence of wheat gluten triggers the body to attack the lining of the small intestine is if it were a foreign body. No one is really sure of the cause, but it can result in major health problems. First and foremost is an inability to absorb essential nutrients, usually leading to weight loss, but it can also lead to iron deficiency anemia and other vitamin deficiencies. Gluten-Free “Craze?”
 Q: I have heard that it’s a good idea to take Vitamin D3. Can you please comment on that? Recommended dosage?
A: There is increasing evidence that many of us are Vitamin D deficient.
Here is an article about Vitamin D that we ran two years ago. Our knowledge has not changed much since then: “Vitamin D in Foods,” Dr. Tim Says… 05/31/10.
Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.
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