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. [...]]]> Dear 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 and Shellfish

Q: How long we can keep a baked Mac & Cheese in refrigerator (<10°C) and how long in freezer (frozen)?

A: You should be safe to keep your baked Macaroni and Cheese in the refrigerator for about 48 to 72 hours. Keep it in a tightly covered container and let it cool, uncovered, for about 10 or 15 minutes before covering it and putting it in the fridge.

It will be safe to keep it frozen for about 2 months. I like to use freezer bags and divide meals like this into portions before freezing so that I can pull out what I need later.

Q: I really enjoy trying some of your recipes; I am a cancer survivor and am always looking for healthier food ideas. Your recipe forSalmon in Parchment with Mangoes – is it possible to use foil for the pockets instead of parchment?

A: Certainly you can use foil instead of the parchment. There may be a subtle difference in the meal in that the parchment breathes a little more so I generally add a little less liquid. My rule of thumb is to add 25% less liquid when I use foil.

One thing to keep in mind is to open the pockets carefully because the steam is hot, hot, hot. Foil Instead of Parchment

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

A: I love this sort of question because it lets me discuss how science works.

Dear Dr. Gourmet,

Q: I understand that vinegar may help lower blood sugar levels. Will lemon juice be just as helpful?

A: I love this sort of question because it lets me discuss how science works.

I have been skeptical about patients who come in and tell me that they are taking vinegar for their health. This is usually apple cider vinegar and it just seemed silly to me but I have also felt that this is like so many supplements – probably not harmful but probably not helpful. However, it appears that this “silly” idea may have some merit. Diabetes, Vinegar and Lemon Juice

Q: With total vitamin K set at 80-120 micrograms, how do you calculate this? Is it as adding up the amounts in different foods and their quantity, or are there factors for what the body can metabolize vs. input?

My wife unexpectedly had to get a pacemaker this past weekend. No symptoms, only a preop ECG, then an echo, and the Holter confirmed Bradycardia and AF. A cath ruled out any other problems except SSS. This has been a real stressful week, as she is just 51. We are trying to read everything we can, but there are many contradictions in opinions; I felt like you would be a great source, since you know both sides of the issue.

Our cardiologist is a great guy and we both trust him (I used him first), but he said you had to quit this and that, but most of those are the things that we used to trim up our waist lines and get “fit”. My wife now wonders about that one. We are ordering your cookbook and list, but I would like to know the answer to my questions. I think consistency is more important than what you eat that contains vitamin K.

A: There are factors other than simply the amount of Vitamin K you consume that can have an effect on its availability in the blood stream. For instance, many of the bacteria in your intestines create Vitamin K and taking antibiotics that change the balance of those organisms can have an effect on Coumadin (warfarin).Which is more important: amount or consistency?

Q: Are we eating too many high oxalic acid foods?

The available information on oxalic acid is confusing and varies with every source. According to one source our regular breakfast (oatmeal, dried figs, blueberries, wheat germ, flaxseed, and soy milk), our favorite dinner vegetables (spinach, beets, okra, and beans), and our regular snacks (almonds, peanuts, and berries) ALL contain high levels of oxalic acid.

Aside from the danger of getting kidney stones, most sources are undecided about the effect of high levels of Oxalate in one’s diet. Some say that it prevents absorption of calcium, iron, and other minerals but the extent of this problem is uncertain.

A: For most folks high oxalic foods are not an issue. There are some people who are prone to calcium oxalate kidney stones and there’s a feeling that limiting foods high in oxalate might help with treatment. The general recommendation for those people is no more than 50 mg of oxalic acid per day. Oxalates in the Diet

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Dear Dr. Gourmet,

Q: My question is really how much should I weigh? I’m a girl. Almost 13. I’m 5′3″ – almost 5′4″, and my weight is different every day! It’s from 114-118! It changes so much! Can you tell me why, as well?

A: This is a great question. There’s a lot of ways to look at weight but one of the most reliable guidelines that we use is the Body Mass Index or BMI. While the BMI works pretty well for adults, in children and teenagers it is something we use a bit more cautiously. This is because as you grow so much changes. There’s a difference in the amount of body fat as we grow, and boys and girls don’t grow in quite the same way. The Right Weight for Teens

Q: My doctor suspects I might have metabolic syndrome. She advised me to lose weight, which I am in the process of doing: 11 pounds so far. Is there a particular diet that would be better for me, i.e., diabetic diet, Mediterranean diet? Are there any foods I ned to cut out forever? One article I read said not to eat corn, butter beans, beets, and anything white.

A: I love this question because recently there is excellent research to prove that the optimum diet for metabolic syndrome is Mediterranean style diet. This is a recent article that reinforces the conclusions from the last 20 years of research:http://content.onlinejacc.org/cgi/content/abstract/57/11/1299

All Dr. Gourmet meal plans and the foundation of our mission at DrGourmet.com is to translate Mediterranean diet principles for the American kitchen. The Best Diet for Metabolic Syndrome

This postscript came to us as part of an Ask Dr. Gourmet question and we realized that we don’t have a place where we address information about HON code certification.

Q: PS: In looking for your email address I noticed the HONcode logo and glanced at their claim of 8 principles of conduct. Is this a valid claim on their part? Or at least a step in the right direction? I remember growing up thinking the Good Housekeeping Seal of Approval was a big deal.

A: Yes, the HON code certification is something you can rely on for accurate health information on the internet. Before a website is allowed to claim that they are certified, the Health On the Net organization scrutinizes the website in question very carefully to make sure that the health information on the site is accurate, reliable, and appropriately attributed – which is why you’ll always see us citing the medical journals we use for Nutrition Bites, for example. Then the organization returns on at least a yearly basis to re-assess the site, and they’ll yank certification if the website no longer meets their standards. What is HON-Code Certification?

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Dear Dr. Gourmet,

Q: I have to ask if you think it is wise to propose using aluminum foil at all given the possibility of it perhaps, after long usage, contributing to Alzheimer’s? Apparently there is some concern about pots made from aluminum.

A: There does not appear to be a link between use of aluminum foil or aluminum pots and pans with Alzheimer’s Disease. In the late 1980’s there was some question of this because the lesions found in the brains of Alzheimer’s patients contained high levels of aluminum. Alzheimer’s Disease and Aluminum

Q: I am very worried about my father’s health. He eats a hamburger, french fries and Coke almost every day and he rarely eats any vegetables. He has incredibly high cholesterol and blood pressure, type II diabetes, liver and kidney problems and an alleged potassium deficiency that occasionally causes his legs to not be able to support his weight. He is 52 years old. He is 5′ 8″ and about 200 lbs.

He claims that all of his health issues are hereditary and not influenced by his diet. I do not believe that. He claims that taking a daily multi-vitamin is an acceptable substitute for eating fruits and vegetables. He is well-researched on nutritional topics, but seems to be very delusional.

What EVIDENCE can I use to convince him that his diet is unhealthy? Do you agree that consuming the amount of red meat, fried foods and cola that he does, without eating hardly any vegetables, is likely a major contributing factor to his health problems?

A: Well, I’d like to think that you’ve come to the right place.

Your father could not be more wrong about health issues being only hereditary. There is clearly a factor of how our family history can and does affect our health but this can certainly be overcome by eating healthy and maintaining a reasonable weight. The best place for you to get started is with information on a Mediterranean style diet. Evidence for Eating Healthy

Q: I have a salad dressing recipe that calls for food starch, but I have no idea what that is. I tried making the recipe without it, but it was way too thin.

A: It is unusual that your recipe calls for food starch. This is a term usually used by food manufacturers to indicate a starch added to a food that is generally used as a thickening agent. The starch can be made from wheat, potato, rice, corn or tapioca. Food Starch

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A: One of the [...]]]> Dear Dr. Gourmet,

Q: How many milligrams of potassium would be acceptable in a recipe if you are trying to bring your potassium levels down?

A: One of the most common areas where we have folks restrict potassium is when they have kidney problems. The most common diet that is recommended in such cases is 2 grams of potassium per day (2,000 milligrams). All of the Dr. Gourmet recipes now include potassium levels in the Nutrition Facts section. Daily Potassium Levels

Q: What are the foods to avoid for a person with diverticulitis?

A: A good healthy Mediterranean style diet is all you need. The higher the fiber the better. Here’s a link to a recent answer to this question from our Ask Dr. Gourmet Newsletter: Diverticulitis

Q: Lately I have been hearing a lot about the benefits of pomegranate juice from helping with prostate cancer to weight loss and lowering cholesterol. Is this the new “wonder food?” Also, cinnamon seems to be another fabulous supplement, lowering blood sugar is the main claimed help. I am wondering if any of these claims have any medical proof?

A: There is no “wonder food.” It’s a shame, because it would make our lives a bit easier, but it just isn’t true.

There is some evidence that pomegranate juice contains a lot of antioxidants, and we know that consuming antioxidants can help prevent disease. In most research, however, it’s difficult to make substantial claims without having large controlled trials. Time and again, small trials have shown positive results only to be disproven with large scale studies. While pomegranate juice has some encouraging small studies, it requires much larger research to prove this.

There is better evidence for use of cinnamon in folks with diabetes. These are also smaller trials, and there is actually conflicting research, with other researchers not being able to duplicate the results. Pomegranate Juice and Cinnamon

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions – over 500 questions already answered!

A: Certainly there’s good research to [...]]]> Dear Dr. Gourmet,

Q: I am interested in the Mediterranean Diet but I am allergic to fish and shellfish. What can I substitute for the fish/shellfish? I don’t particularly like meat.

A: Certainly there’s good research to support including fish in one’s diet, and this is a basic finding in Mediterranean diet studies. That said, there are a lot of folks who are allergic or simply don’t like seafood. The menu plans in the The Dr. Gourmet Diet Plan software provide 6 days of seafood meals in a 2 week cycle.

There are a lot of choices for you in creating balance and still following the other Mediterranean diet principles. First and foremost, remember that the goal is to follow more of the 9 basic principles but that doesn’t mean you have to be rigid. Moderate alcohol intake is one of the principles, for example, but I don’t tell patients to begin drinking if it is not something they are interested in doing. Substituting for Fish Dishes

Q: Just was wondering if there is a good substitute for pine nuts as they are so expensive. There are a lot of recipes that I come across that call for them and they look wonderful, but the price is a tad on the high side. Any suggestions?

A: I like using slivered almonds in recipes a lot and they work great in place of pine nuts. Sliced almonds can work as well, but they don’t offer the same crunchy texture that pinenuts do.

Q: I’ve found great recipes that I want to try out but they contain sesame seeds and they don’t sell sesame seeds here in Panama. Can you substitute sesame seeds with sesame oil? If so, how much oil for seeds?

A: This very much depends on the recipes. Sesame seeds are generally added to recipes for both flavor and texture. Sesame oil won’t add quite the same flavor or texture. For instance, adding sesame oil to breads that call for sesame seeds might change the flavor and texture dramatically. A fish dish that calls for sesame seeds might work great with sesame oil, however.Substituting Sesame Oil for Sesame Seeds

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A: Even though that glass of wine has about 150 calories, those who drink [...]]]> Dear Dr. Gourmet,

Q: Does having a glass of wine every night affect weight loss?

A: Even though that glass of wine has about 150 calories, those who drink alcohol on a regular basis have a lower risk of being obese. In a study published in 2005, Drs. Ahmed and Rohrer looked at over 8,000 participants in the Third National Health and Nutrition Examination Survey. 46% of the respondents were classified as “current drinkers.” This group was much less likely to be obese. In another study of Danish adults, researchers found that those having between 1 and 7 drinks per week had the smallest waist circumference. Wine and Weight Loss

Q: Is there a substitute for red wine? Perhaps grape juice made from grapes rather than concentrate? I do not drink alcohol at all and would not do so even for the benefits of red wine.

A: There is good evidence that drinking grape juice has many of the same benefits as drinking red wine. The antioxidant polyphenols in red grape juice have been shown to have positive effects on cholesterol in the same way as red wine. Much of the research that has been done is in the test tube and there are not large scale trials in humans to support this yet. That said, the action of the red grape juice acts very much like red wine.Wine vs. Grape Juice

Q: What is the percentage of alcohol in Balsamic Wine Vinegar – Modena Brand?

A: There is no requirement by the FDA or the USDA that manufacturers report alcohol content of their products (except for wine, beer and spirits).

Because vinegar is made in a two step process, first by fermenting alcohol and then by fermenting the alcohol to acetic acid, there will be some residual alcohol in vinegars. It is, however, very little. Alcohol in Vinegar

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Dear Dr. Gourmet,

Q: Since I have high blood pressure one of my major concerns is salt content. Some recipes (like eggplant parmesan) call for salting items like eggplant, zucchini, and cucumber to either cut down on bitterness or excess water.

I have usually skipped the salting because I am concerned that it significantly increases the sodium content of the recipe, even if the salt is rinsed off the vegetable after the soaking. Does covering the vegetables in salt result in significant absorption of sodium? If it does, are there alternative methods that will achieve the same goals?

A: I never salt eggplant (or other vegetables, for that matter) in the way you describe. There are two suggested reasons for doing this. One is to remove moisture and the other bitterness. My experience is that moisture is fine for eggplant and helps keep it tender. Salting Eggplant

Q: Do grits have any nutritional value?

A: Grits are a great choice for your breakfast or as a side dish for dinner. I love white grits but I like polenta even better.

Grits are coarsely ground dried corn. Prior to being dried the hull and germ of the kernel is removed. The resulting “hominy corn” is often bleached prior to grinding resulting in the white grits found in America. Polenta is the unbleached version. The larger of the ground kernels becomes grits and the finer is cornmeal (polenta).Grits

Q: Recently I received my cholesterol numbers and they were high. I enjoy mozarella cheese but have been hearing of the health benefits of quark.

Is eating mozzarella cheese going to affect my cholesterol numbers? What are the advantages of eating quark?

A: Eating healthy and controlling cholesterol is not really about a single ingredient but making choices to cook fresh food using great ingredients. Both of the cheeses you mention are fantastic choices.

Italians call mozzarella pasta filata – cheeses that have been scalded and kneaded prior to ageing. Ricotta and provolone are also pasta filata cheeses. Originally made in Naples from the rich milk of water buffalos, the cheese available outside of Italy that is labeled mozzarella can be made from any type of milk. Quark vs. Mozzarella Cheese

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Dear Dr. Gourmet,

Q: I am currently caring for my dad who uses Coumadin and is diabetic. I am looking for menus/recipes with regards to his conditions. Menus would be helpful, as I work during the day.

A: We now know that the Mediterranean style diet is the best diet for diabetics. Here’s an article on the newest evidence on the best diet for type 2 diabetics.

All of the recipes on the Dr. Gourmet website are based on Mediterranean style diet principles. There are hundreds of Coumadin (warfarin) safe recipes at DrGourmet.com, and each recipe is labeled as to whether it is safe for Coumadin users, those with GERD, those who are lactose-intolerant or allergic to wheat gluten. Diabetes and Coumadin (warfarin)

Q: Some cakes need up to 8 eggs… Can half of them be replaced with starch and will there be a big difference in taste?

A: Reducing the amount of eggs in baking can be a challenge. One can’t really simply eliminate eggs from a recipe and replace it with another ingredient and expect the same result. This is not so much a matter of changing the taste of the cake or muffin but the texture. Eggs in Baking

Q: My 15 year old daughter just had surgery for a kidney stone. Her maternal grandfather suffered with these all his life, so we feel it is hereditary. It is unusual for such a young girl to have a kidney stone. She runs cross country and we also feel she has hydrated enough on a daily basis. The doctor told us to reduce her protein intake as her stone was a uric acid stone. What types of things should be cut out of her diet? Do you have recipes that are low protein for a lifestyle change?

A: There are a number of types of kidney stones and it is not unusual for children to have them. They are the most common type of kidney stone in kids. This is one of the better articles on the web that can help you understand how the stones form:http://www.emedicine.com/ped/topic2361.htm

Diet can also play a role and reducing the amount of proteins that are high in purines is key to avoiding more stones. This is the same sort of diet that those with gout will follow (gout is also caused by high levels of uric acid in the blood stream). This is not all proteins and since your daughter is an athlete it’s important that you make sure that she gets enough protein. Kidney Stone Prevention

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A: No, it doesn’t appear that there are [...]]]> Dear Dr. Gourmet,

Q: I presume from your comments on Pradaxa that all the dietary restrictions for those taking Coumadin would also apply to someone using Pradaxa. Is that correct?

A: No, it doesn’t appear that there are any interactions of food with Pradaxa (dabigatran) as there are with Coumadin (warfarin). For those taking this new medication there won’t be concerns over consuming foods high in Vitamin K. Likewise, there are fewer interactions with other medications. You can read more information online.

Keep in mind that as of now this medication is only approved for certain types of atrial fibrillation. Check with your physician to see if this medication might be right for you.

Q: Is sushi high in cholesterol?

A: Sushi in general should not be high in cholesterol. The fish used does contain cholesterol. For instance, a 1/2 ounce piece of tuna that would be served in a typical nigiri sushi contains about 7 milligrams (mg) of cholesterol. Salmon and other fatty fish served at sushi bars like mackerel, eel and abalone can be higher in cholesterol in the range of 10 – 15 mg per piece. Sushi and Cholesterol

Q: I was told to go on a low salt diet. Are the salt substitutes a good alternative, or are they just as bad for you?

A: There are a lot of different salt substitutes on the market, and you can find these in the same aisle as the spices and the salt. Most of them use forms of potassium that do a fair job at mimicking how sodium binds to the salt taste buds. There are also some herb preparations that call themselves salt replacements but they usually rely on lemon, which can help. Salt Substitutes

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A: Two fantastic books deal with this [...]]]> Dear Dr. Gourmet,

Q: I’m undergoing chemotherapy for B cell lymphoma. Are there any tasty recipes you can recommend that are high in calories to help stop the weight loss?

A: Two fantastic books deal with this issue. My favorite is Healthy Eating During Chemotherapy.

The book has great background information and each of the recipe sections is broken down by food textures and temperatures to help users through each phase of chemotherapy. Eating During Chemotherapy

Q: I have read in a couple of places that scrambled eggs are not good for you. One site said that by scrambling them, the cholesterol will oxidize. I love scrambled eggs so I hope this is not true.

A: The idea that oxidization of dietary cholesterol might be an issue comes from a number of sources. The problem is that none of these has been specifically linked to scrambled eggs. Scrambled Eggs and Oxidized Cholesterol

Q: I have been looking at your amazing website. I just want to know – I normally have a glass of hot water and lemon juice in the morning. Would this affect my INR level, since I take my warfarin the night before?

A: This should not be a problem, especially if it is something you do on a consistent basis. Read more Ask Dr. Gourmet questions about Coumadin (warfarin).

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His diet recommendations counter many items in the Mediterranean Diet. See this excerpt from [...]]]> Dear Dr. Gourmet,

Q: I just read CNN’s latest article highlighting Dr. Caldwell Esselstyn Jr.’s plant-based diet to prevent heart attacks and reverse heart disease.

His diet recommendations counter many items in the Mediterranean Diet. See this excerpt from his website and please clarify! Now I’m really unsure what to eat. Fish? No fish? Nuts, no nuts? Olive oil, or no oils whatsoever? No avocados?

A: It has long since been proven that the type of diet that Dr. Esselstyn advocates is not substantially more beneficial for you than the Mediterranean Diet. The science is based partly on research that looks at vegetarian diets and partly on Dean Ornish’s work. In fact, due to the extreme nature of the low fat regime, it may actually be more harmful.

Is this healthier than the Mediterranean diet? Probably not. The research is clear that extremely low fat diets do not prevent heart disease. The Heart Attack Proof Diet

Q: I am concerned about the accuracy of the Vitamin K information in the foods you report on your website to Coumadin takers. You report that pistachios have 0mcg of Vitamin K, but on the USDA website and several other dietician and hospital websites, it shows that pistachios do have Vitamin K. Specifically, from the USDA, “Nuts, pistachio nuts, dry roasted, with salt added,” 1 ounce (47 nuts) has 3.7mcg of Vitamin K. I think this is very important because if someone thinks there is none in a food, then they might eat several throughout a day or week thinking they are a “safe” food, but then wonder why their INRs cannot balance.

A: Sometimes the information from the USDA web site can be challenging and it is key to make sure one is looking carefully at the choice of ingredient – comparing apples to apples and not apples to oranges. USDA Information and Vitamin K Information Accuracy

Q: Is the product Vitamin Water Zero a hoax or does it have some redeeming value?

A: My opinion is that this is a scam. There’s no reason to take multivitamins except in some very specific cases and there’s no health benefit proven from drinking vitamins.

Here’s the statement released in mid-June 2010 as part of the new dietary guidelines for Americans.

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Dear Dr. Gourmet,

Q: A new school year is coming and with it concerns about sending healthy lunches for my middle schooler. Any suggestions would be great! (They do not have any way to heat their lunches).

A: This is always a tough question. So much depends on your child and what he or she likes to eat.

Step 1. There is good research that suggests not forcing kids to eat foods they don’t like helps with their eating habits in later life. So, it’s a pretty good idea to involve them in planning for lunches.Lunch Box Ideas

Q: My husband has had pancreatitis for many years and now has been diagnosed with diabetes. The doctors are still trying to “figure things out” with him, but I’m wondering if you could possibly send me a list of foods that he should eat and those he should avoid. He mostly needs “snack” foods because he has a feeling of hunger quite often (it seems especially in the middle of the night), but I’d also like meal ideas. Anything you can send me would be much appreciated. Thanks for your help.

A: First and foremost, it appears that a low fat diet is key and you should be focusing on a much lower ratio of saturated to unsaturated fat. While in general we believe that low fat diets are not the best choice for overall health, there are a few cases where it is a better choice and chronic pancreatitis is one. Pancreatitis

Q: I am trying to better my diet and eat healthier. I see that you say we should be eating fish or seafood 3 times a week. I don’t like fish or seafood, I can’t eat it.

I pretty much eat chicken and wheat pasta and vegetables. I eat some red meat on occasion. I do take Omega 3 pills every day, so that should help with the health benefits of eating fish.

How many times a week should I eat chicken?

A: This is a great question. We have folks that are allergic to fish or shellfish and there are those like you who simply don’t like fish. The research does show that using fish oil capsules may be almost as good as having fish 3 days a week, so using these is a good idea.

The rule of thumb is to eat fish three days a week, red meat one time and for the other three days have about half and half poultry and vegetarian. Instead of Fish

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A: Hemochromatosis (for those readers who [...]]]> Dear Dr. Gourmet,

Q: I’ve been diagnosed with hemachromatosis. Can you recommend a diet that is low in iron and iron retaining content?

A: Hemochromatosis (for those readers who are unaware of this issue) is a genetic condition where the body doesn’t store iron properly. The result is iron overload in the body that can lead to many problems including liver and heart damage. It is actually a fairly common condition with some research showing 1 – 6% of the population having some degree of problem. Hemochromatosis

Q: I am very worried about my father’s health. He eats a hamburger, french fries and Coke almost every day and he rarely eats any vegetables. He has incredibly high cholesterol and blood pressure, type II diabetes, liver and kidney problems and an alleged potassium deficiency that occasionally causes his legs to not be able to support his weight.

He claims that all of his health issues are hereditary and not influenced by his diet. I do not believe that. . . . What EVIDENCE can I use to convince him that his diet is unhealthy? Do you agree that consuming the amount of red meat, fried foods and cola that he does, without eating hardly any vegetables, is likely a major contributing factor to his health problems?

A: Well, I’d like to think that you’ve come to the right place.

Your father could not be more wrong about health issues being only hereditary. There is clearly a factor of how our family history can and does affect our health but this can certainly be overcome by eating healthy and maintaining a reasonable weight. The best place for you to get started is with information on a Mediterranean style diet. Diet vs. Heredity

Q: I have had Hepatitis C for 20 years. Is the Mediterranean Diet good for my liver?

A:The Mediterranean Diet should be a great choice for you with Hepatitis C. While I have not been able find any specific research regarding this type of diet and viral hepatitis, the diet should be very safe for you as it is very healthy. We know that weight control is important and this will certainly help you manage your weight. The Mediterranean Diet has been shown to help reduce inflammation so it might be helpful in this respect as well.

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A: There [...]]]> Dear Dr. Gourmet,

Q: My husband’s borderline diabetes is compounded with a high potassium count. This makes it very difficult to maintain a Mediterranean diet. Do you have recipes or advice for this particular problem?

A: There can be a number of reasons for high potassium levels in the blood. With diabetes issues, changes in kidney function and medications are the two most common reasons and it’s important to make sure that these and other causes have been fully evaluated.

Depending on the recommendations of your physician, limiting foods that are high in potassium is the first step. High Potassium and Diabetes

Q: There seems to be growing evidence that horse chestnut is good for veins, with EBSCO adding that benefits may include “sealing leaking capillaries, improving the elastic strength of veins, preventing the release of enzymes (known as glycosaminoglycan hydrolases) that break down collagen and open holes in capillary walls, decreasing inflammation, and blocking other various physiological events that lead to vein damage.” Several studies have tested it for chronic venous insufficiency and varicose veins.

I have mild to moderate post-thrombotic syndrome and don’t want it to get any worse. However, I’m on Coumadin for life (or until they come out with better alternatives). Is it possible to take horse chestnut while on Coumadin? Like many drugs, there are warnings the combo could increase bleeding risks.

A: There has been some evidence for horse chestnut being beneficial for vein conditions such as venous insufficiency. Here isan abstract from 2002.

Q: Please help! My boyfriend is 51. He works outside and leaves very early in the morning. He has a regimen for breakfast and lunch that he wants to be healthful but quick, with breakfast holding him til lunch. He makes oatmeal every morning. However, in an effort to add protein he adds one pre-cooked Jimmie Dean Sausage patty to it. He also eats Oscar Mayer Deli-Fresh Smoked Turkey lunch meat for lunch. Every day. Six days a week. I’m concerned about the cumulative effects of that processed meat day after day, year after year. Is there a more healthful protein alternative he could add to his oatmeal? Are my concerns warranted?

A: There is great evidence that combining a good quality carbohydrate such as oatmeal with some protein in the morning can really help with staving off hunger through the morning. The choice of sausage is, however, a very poor protein source.

The same is true for lunch. By having a sandwich with whole wheat bread and combining it with a quality protein source it’s clear from research that satisfaction is better sustained throughout the afternoon. The choice of processed turkey is a poor one. Better Protein Choices

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions – over 500 questions already answered!

A: In the [...]]]> Dear Dr. Gourmet,

Q: I have heard from doctors or nurses that if you are prediabetic you are really a diabetic. Or if you are taking metaformin that you are diabetic. Is that true?

A: In the last few years the criteria for diagnosing diabetes has become much more stringent. This is because we know now that even modest elevations in blood sugars can have a devastating effect in the long term. Presently, the diagnosis is made when the morning fasting blood sugar is greater than 126 mg/dL.

We are, however, concerned when fasting blood sugars are consistently greater than 100 mg/dL. Likewise, those with fasting blood sugars that are higher than 110 mg/dL are considered by some to be “prediabetic.” Prediabetes

Q: First of all, thank you for your fantastic warfarin meals and recipes. I have been on this for about 8 wks now. Have lost about 23 lbs and my warfarin doses have actually changed from 47 1/2 to 37 1/2 per week. It is so seldom that I actually see recipes directed at warfarin users, especially the salads. I do still have one question. I eat the blueberry muffins and also include blueberries and blackberries in my alloted fruits per week. Is this safe or are the berries considered off limits for regular servings of fruit? It seems like I have seen questions or articles in favor of both. Thank You.

A: Wow! We’re really excited for you here at Dr. Gourmet World Headquarters. It’s always great to hear about weight loss such as yours and that you like the recipes!

Blackberries and blueberries do have higher amounts of Vitamin K than some fruits, but in an amount might be considered as moderate and not off limits. Each has around 28 micrograms of Vitamin K per cup.

At the same time we know that these berries are great choices for a lot of reasons, including their high proportion of great quality vitamins and antioxidants. Eating Blueberries and Blackberries on Coumadin (warfarin)

Q: I attended a health seminar where you mentioned how important it is to reduce the sodium and not have more than the daily recommended value. You gave a few examples of the amount of sodium in some fast food and chain restaurant meals and how the daily maximum could quickly be reached. If I do have these items will drinking extra water counteract the increase in sodium?

A: This is a great question.

There may be a slight effect but, sadly, drinking more water won’t likely offset a high sodium diet very much. The regulation of water volume as well as sodium, potassium and other electrolytes in the body is quite an elegant mechanism. The kidneys are quite efficient at holding on to electrolytes and filtering water. Water and High Sodium Foods

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions – over 500 questions already answered!

A: One of the most common [...]]]> Dear Dr. Gourmet,

Q: How many milligrams of potassium would be acceptable in a recipe if you are trying to bring your potassium levels down?

A: One of the most common areas where we have folks restrict potassium is when they have kidney problems. The most common diet that is recommended in such cases is 2 grams of potassium per day (2,000 milligrams). All of the Dr. Gourmet recipes now include potassium levels in the Nutrition Facts section. Daily Potassium Levels

Q: What are the foods to avoid for a person with diverticulitis?

A: A good healthy Mediterranean style diet is all you need. The higher the fiber the better. Here’s a link to a recent answer to this question from our Ask Dr. Gourmet Newsletter: Diverticulitis

Q: Lately I have been hearing a lot about the benefits of pomegranate juice from helping with prostate cancer to weight loss and lowering cholesterol. Is this the new “wonder food?” Also, cinnamon seems to be another fabulous supplement, lowering blood sugar is the main claimed help. I am wondering if any of these claims have any medical proof?

A: There is no “wonder food.” It’s a shame, because it would make our lives a bit easier, but it just isn’t true.

There is some evidence that pomegranate juice contains a lot of antioxidants, and we know that consuming antioxidants can help prevent disease. In most research, however, it’s difficult to make substantial claims without having large controlled trials. Time and again, small trials have shown positive results only to be disproven with large scale studies. While pomegranate juice has some encouraging small studies, it requires much larger research to prove this.

There is better evidence for use of cinnamon in folks with diabetes. These are also smaller trials, and there is actually conflicting research, with other researchers not being able to duplicate the results. Pomegranate Juice and Cinnamon

Q: Couldn’t I just substitute 250 mg Resveratrol capsules for my daily 8 mg dosage of Warfarin? Why should I, age 61, who also take 14 units of Lantus insulin for my diabetes, not benefit from the new findings about resveratrol?

A: Resveratrol is one of the substances that is found in wine and grape juice. There is a feeling that this might be a chemical that contributes to the benefits of drinking these beverages. The molecule has been isolated and is being tested in all kinds of non-human subjects now. While some of that research is encouraging, there is only a single human research study that is even close to positive. That is a small research study but did show some mild lowering of blood sugar. Substituting Resveratrol for Coumadin (warfarin)

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions – over 500 questions already answered!

You can always check to see if your question, or [...]]]>

We’ve had a lot of new subscribers recently (welcome!), and I thought it might be helpful for us to share a few of our “greatest hits” or most frequently-asked questions on a variety of topics.

You can always check to see if your question, or a similar one, has already been answered by visiting the Ask Dr. Gourmet section on our web site.

Coumadin

Q: How much Vitamin K is in…?

A: There’s an easy way to find out about the nutrition content of any food. Just use the USDA National Nutrient Database. By entering an ingredient and following the steps, this web site will report the complete nutritional values of any ingredient and many prepared foods. The Vitamin K content is the last listing at the bottom of the Vitamins section. If it is not there, the food or ingredient that you searched on doesn’t contain enough Vitamin K to be reported.

Q: Can I use nutritional supplements while on Coumadin? What about acai juice / berries / Mona Vie or Resveratrol?

Q: Should you avoid cranberry juice on Coumadin (warfarin)?

Browse all Ask Dr. Gourmet Questions about Coumadin (warfarin).

Weight Loss / The Dr. Gourmet Diet Plan

Q: Is Body Mass Index accurate for everyone?

Q: Is cutting down on carbohydrates a healthy way to lose weight?

Q: Is there any cost involved in The Dr. Gourmet Diet Plan or the Dr. Gourmet web site?

Q: How can I lose weight if I can’t exercise?

Browse all Ask Dr. Gourmet Questions about Weight Loss and The Dr. Gourmet Diet Plan.

Miscellanous

Q: Should I be concerned about the level of mercury in the fish I eat?

Q: Does sea salt have less sodium in it than regular salt?

Q: Would adding baking soda to chili to make it GERD-friendly ruin the taste of the chili?

Q: Do you have diet plans for those with Type 2 diabetes?

Q: Are seeds really a problem for those with diverticulitis?

Browse all Ask Dr. Gourmet Questions about Health Conditions.

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions – over 500 questions already answered!

Dear Dr. Gourmet,

Q: I was told not to have caffeine because of my a-fib. Since dark chocolate is good for you and I love dark chocolate, do you think I can eat it even though it contains caffeine? If yes what should be the amount?

A: There is inconclusive data regarding whether caffeine has an effect on those with atrial fibrillation. It appears that it does not:Dr. Gourmet’s Health and Nutrition Bite: Caffeine and Atrial Fibrillation

There have been case reports of people consuming excessive amounts of caffeine and ending up with atrial fibrillation. In the most recent report the patient did convert back to a regular rhythm. In another case a 19 year old woman “abusing” chocolate ended up in a-fib (but she was also using asthma medications).Dark Chocolate and A-Fib

Q: I was watching CSI tonight and learned that peach pits contained cyanide. I started checking into it on the internet and found out it is true. I assume it would take a lot of pits to be deadly. My question is in regard to an old family recipe for peach pit jelly. I make this jelly every summer from the skins and pits of the peaches that I can. I cover them in water and cook them down for about 20 to 30 minutes, strain the juice and make jelly. We have always eaten this jelly and seem to be okay, but are we in any danger from this?

A: Peach pits do contain “cyanide” but it’s in a form called amygdalin. You can find out about this here: Peach Pits and Cyanide

I have searched for information regarding making the jelly from the peach pits and skins and can’t find any information that it is dangerous. The fact that you and others have been making it for years and have not had any adverse effects is comforting. I can’t find any report of people having problems with peach pit jelly.

Q: How much dark chocolate should a person eat in one day?

A:This is so open ended and I will admit that I don’t have an answer for it. Chocolate is very high in calories with the average candy bar (about 1 ounce) having 150 calories.

If you are on a diet, not active, diabetic or have other health issues, you should not be eating any candy on a daily basis as this is likely to have too many calories and too much sugar for you. Save your chocolate for special occasions.

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

It’s here! Get your copy of Just Tell Me What to Eat!

I’m so excited that my new book,Just Tell Me What To Eat!: The Delicious 6-Week Weight Loss Plan for the Real World is now available. This is a 6 week plan that I’ve built over the last decade of working with patients to help them lose weight and improve their health. The program includes 6 weeks of menus, with recipes and all the information that you need to transform your health.

Get your copy today through your local bookstore, or buy online:
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Dr. Harlan will be signing copies of his books at The Garden District Book Shop, 2727 Prytania Street in New Orleans, on Thursday, June 30,from 5:30pm to 7:00pm. Taste food from the book and sip a glass of wine as you visit with other Dr. Gourmet fans. Hope to see you there!

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Dear Dr. Gourmet,

Q: I have some goat cheese and I want to make a cheese spread or cheese ball. Can I substitute the goat cheese for the cream cheese which is in the recipe?

A: Goat cheese makes a perfect substitute for cream cheese. There’s about the same amount of saturated fat and calories in an ounce of goat cheese as there is in reduced-fat cream cheese.

Q: I am concerned about the use of aluminum foil. I’ve heard that it is an unsafe metal and it leaks into foods when cooked with. What do you think, do you have any information on this metal?

A: Aluminum will react with certain foods, especially those that are more acidic. In some cases this can result in a metallic flavor to your dish or possibly discoloration of food.

There was evidence as early as 1965 showing a link with aluminum and Alzheimer’s disease. The main source for concern were brain lesions in those who had died of Alzheimer’s Disease. Alzheimer’s and Aluminum

Q: We’ve been eating Smart Balance buttery spread with extra virgin olive oil. Am really confused by what we should and should not be eating. This has palm fruit oil along with a lot of other ingredients. Is it wiser to eat butter, which has only pasteruized cream and natural flavorings, or Smart Balance which has an extended list of ingredients? Thank you.

A: Choosing what fat to use can be a challenge, but first and foremost it’s important to not get too stressed about it. I love butter and I love olive oil and I think that spreads are OK.

I keep spreads like Smart Balance or Promise Buttery Spread on hand but don’t use them very often. That said, I am cautious in my use of any fat, whether it’s butter, spread, olive oil or bacon.Butter, Spread, or ??

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

1) Is it true that fruits have to be eaten on their own – not together with other foods [...]]]> Dear Dr. Gourmet,

Q: I have a few questions about the correct way of eating fruits and veggies.

1) Is it true that fruits have to be eaten on their own – not together with other foods (e.g bread, tea or even vegetables) to be able to get the maximum benefit from the fruits? The rule – Fruits to be eaten on their own as they get digested much easier than any other food.

2) Are fruits to be eaten on an empty stomach to maximise its life giving nutrients?

3) Can you have water with your regular meals or do we have to wait for 30 mins for digestion before drinking water as it supposedly interferes with digestive juices.

A: These types of “rules” about eating are simply old wives tales and have no basis in science. There’s no evidence to support that eating fruit with or without food makes any difference. When to Eat Fruit and Drink Water

Q: I have been wondering if substituting brown sugar for refined sugar is beneficial or is it the same. I would like to reduce my consumption of sugar in my baking, and I do know that you can reduce the amount used with little effect on the baked item.

A: There is no significant difference between granulated sugar and brown sugar. Traditionally brown sugar was the crystals that were the last step in the refining process before the final “white sugar” refinement. These days the brown sugar that you purchase in grocery stores today simply contains molasses (3.5% for light brown sugar or 6.5% for dark brown sugar). Sugar

Q: There is only one of me, the recipes keep setting up for 2, I am tring to lose weight, myself and a bunch of us grouchy old buzzards that live alone, are a bit tired of eating out, and cook meals at home. We all live and eat at different places, but if we get together for a Sunday, or something that’s cool. If we do a covered dish get together, then we all watch what we bring because most are diabetics, on Coumadin, or blood pressure meds, well you get the idea.

I’m just old, fat, and lazy, so I would like to lose wght, but I only want 1 serving, and the recipes are complex enough that it doesn’t look feasible. You have any simple 1 people meals?

A: The Dr. Gourmet Diet Plan is designed to create menus for single people. We worked very hard on the programming to accomodate those who live alone. The planner delivers meals with two servings but gives suggestions for using those leftovers. This should allow you to have dinner one night and use the leftovers for lunches (1/2 dinner serving = 1 lunch serving) or for dinners on subsequent nights. Recipes for Single People

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Dear Dr. Gourmet,

Q: Is there a substitute for red wine? Perhaps grape juice made from grapes rather than concentrate? I do not drink alcohol at all and would not do so even for the benefits of red wine.

A: There is good evidence that drinking grape juice has many of the same benefits as drinking red wine. The antioxidant polyphenols in red grape juice have been shown to have positive effects on cholesterol in the same way as red wine. Is Grape Juice a Substitute for Red Wine?

Q: I have just finished reviewing The Dr. Gourmet Diet Plan. I am considered obese, 50 pounds over my ideal weight, as is my husband. I also have two children, 5 & 6 1/2. How can I adjust these servings to accommodate their growing bodies so that I am making one main meal each evening or is it necessary?

A: The average 5 to 8 year-old needs about 40 calories per pound of weight, or 1,800 – 1,900 calories per day. Activity is going to have a lot to do with this, however. If your child is less active, they might need only 1,400 calories, and if they are very active, they will need more.

Most dieticians recommend more than just three meals per day for kids. A good strategy is to use the 1,500 calorie level as a guide and then supplement with nutritious snacks for your children when they are active. This means that your kids can eat the same healthy diet as you with adjustments for healthy snacks. Can My Kids Participate Safely in The Dr. Gourmet Diet Plan?

Q: My husband has been on warfarin for almost 15 years, and eats a huge salad each day. His Coumadin rarely needs to be regulated other than the dose he is currently on. I have become very concerned that the medication dose could be lowered if he stops eating the salads each day.

I serve all the K no no’s regularly. Should I stop? He was told years ago that since greens are a regular part of his diet he should continue eating as always.

A: While limiting Vitamin K is one strategy for keeping the INR stable while taking Coumadin® (warfarin), being consistent is just as important.

By having a salad every day, your husband is getting the same amount of Vitamin K every day from the greens, so the intake is consistent. This allows your husband’s doctor to adjust his Coumadin dose relative to that stable intake of Vitamin K. This is a great way to get healthy greens and take Coumadin at the same time. As long as his salad consumption is uniform he should continue to do as well as he has in the last 15 years. Keeping Your Dosage Stable

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Pre-Order Just Tell Me What to Eat! and Get Free Shipping!

You can now pre-order my new book, Just Tell Me What To Eat!: The Delicious 6-Week Weight Loss Plan for the Real World. This is a 6 week plan that I’ve built over the last decade of working with patients to help them lose weight and improve their health. The program includes 6 weeks of menus, with recipes and all the information that you need to transform your health.

Pre-order the book for the discounted price of just $19.99 (regular price: $25.00) and when it’s released on June 7, 2011, it will be shipped to you FREE (Free shipping within the United States only. Shipping costs will appear in cart, but will not be charged). Find out more about Just Tell Me What to Eat!

A: We doctors [...]]]> Dear Dr. Gourmet,

Q: I have heard there are some cheeses that will not cause a problem for those who are lactose intolerant. Can you tell me some?

A: We doctors have an expression about the effect of medications on the body: “dose dependent.” By this we mean that people will sometimes not have side effects to a certain medication or substance until they consume more than a certain amount. The side effects are dependent on thedose. Cheeses for the Lactose Intolerant

Q: I know fish has many well-known benefits. But here’s the problem: I hate fish. Absolutely hate it. No matter what kind and how you dress it up and what you try to do to it. Would taking fish oil in a capsule do the trick?

A: The best research we have says yes. For those who simply don’t like fish, like you, taking fish oil capsules is a great choice. The recommendation is 1000 mg two or three times a day. This will give you more than adequate amounts of Omega 3 fats. If you are allergic to fish, there’s some good evidence that using flax seed oil is a good alternative to fish oil. Fish Alternatives

Q: I’ve had chicken piccata in restaurants, but didn’t realize the sauce was wine based. I’d like to try yourChicken Piccata recipe but since I abstain from alcohol I’m concerned about the wine content. Is all the alcohol cooked out of the sauce or is there an alternative to using wine?

A: Usually Picatta recipes use wine or an alcohol. Not all do. With the cooking process the alcohol is evaporated for the most part.

Not to diminish your wanting to abstain, but in a tablespoon of wine there’s not a lot of alcohol to start with. There’s about 2 cc of alcohol (240 cc in a cup / 16 Tablespoons / 14% alcohol). That’s less than a half teaspoon. And the alcohol is pretty volatile and evaporates faster than the water. Wine in Chicken Piccata

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

A: Pink salmon is one species and [...]]]> Dear Dr. Gourmet,

Q: What is the difference between pink canned salmon and red canned salmon? Is one better for you than the other?

A: Pink salmon is one species and is also known as the humpback salmon. Red salmon, on the other hand, is a common nickname for sockeye salmon. Both are Pacific salmon and are generally caught in the wild and not farmed as most of the Atlantic salmon on the market today. There is some difference in the varieties of salmon with the main difference being the amount of fat. Pink vs. Red Salmon

Q: In looking for your email address I noticed the HONcode logo and glanced at their claim of 8 principles of conduct. Is this a valid claim on their part? Or at least a step in the right direction? I remember growing up thinking the Good Housekeeping Seal of Approval was a big deal.

A: Yes, the HON code certification is something you can rely on for accurate health information on the internet. Before a website is allowed to claim that they are certified, the Health On the Netorganization scrutinizes the website in question very carefully to make sure that the health information on the site is accurate, reliable, and appropriately attributed – which is why you’ll always see us citing the medical journals we use for Nutrition Bites, for example. Then the organization returns on at least a yearly basis to re-assess the site, and they’ll yank certification if the website no longer meets their standards. HON Code Certification

Q: Almost anyone who has grown zucchini has had ones that got very big and mature – I’m talking 3 inches or more in diameter. Do you have any good recipes for these? I’ve used them for zucchini bread, but wonder if there are other uses; the more zucchini they use the better.

A: You’re right about growing zucchini. The last time I planted some it almost took over my garden. By the end of the season I did have a number of large ones.

Larger zucchini tend to be a bit on the drier side and the texture slightly coarse. When I am shopping for zukes in the market I generally don’t purchase ones that are much more than about 1 1/2 inches in diameter. What to do with those big zucchini

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Cooking School Scholarship Available

Do you know someone who wants to be a chef? Are they a resident of the New Orleans area? The John Besh Foundation is offering a full scholarship to The French Culinary Institute. This an amazing opportunity that includes tuition, travel and living expenses for a minority student interested in one of the finest culinary educations available today.

Get the details atwww.chefsmove.org or watch a video of John Besh discussing this opportunity. Forward this email to anyone you know who might be interested!

Calling all success stories!

Many of you have written to us with nice words about what we do here at Dr. Gourmet. We love hearing from you and it really makes all our hard work worthwhile. Thank you!

If you have had success with The Dr. Gourmet Diet Plan, made use of the information we share or have enjoyed the recipes on the web site, we’d like to hear from you. Won’t you write us atsuccess@drgourmet.com and tell us your story? It would really make our day!

A: I would avoid all green [...]]]> Dear Dr. Gourmet,

Q: Is green tea extract effective in controlling blood glucose? Is it better just to drink a cup of green tea daily?

A: I would avoid all green tea extract products. They have been clearly associated with liver failure. There’s no guarantee that the company making them has quality controls in place to make sure of no contaminants. Likewise, many have been taken off of the market by the FDA because of the inclusion of pharmaceutical-grade medications. There are very poor controls on the supplement industry and I never recommend any of these sorts of products to anyone for any reason. Green Tea Extract

Q: Lately I have been hearing a lot about the benefits of pomegranate juice from helping with prostate cancer to weight loss and lowering cholesterol. Is this the new “wonder food?” Also, cinnamon seems to be another fabulous supplement, lowering blood sugar is the main claimed help. I am wondering if any of these claims have any medical proof?

A: There is no “wonder food.” It’s a shame, because it would make our lives a bit easier, but it just isn’t true.

There is some evidence that pomegranate juice contains a lot of antioxidants, and we know that consuming antioxidants can help prevent disease. In most research, however, it’s difficult to make substantial claims without having large controlled trials. Time and again, small trials have shown positive results only to be disproven with large scale studies. Pomegranate and Cinnamon

Q: Thank you for your informative article about multivitamin use and breast cancer. I just started taking multivitamins a week ago because I am vegan, live in the Pacific Northwest, and am trying to conceive so I need B12, vitamin D, and folic acid. Would you say that I could interpret this new study to say that I should toss the multivitamins and just take individual supplements for those ingredients I listed above? I would really appreciate your input in this matter as I have PCOS and Endometriosis and therefore have an abundance of estrogen which would seem to place me in higher risk according to this study.

On a side note, are you familiar with the work of Dr. Neal Barnard and his studies on vegan diets and reducing or eliminating diabetes? I read his book and am curious to hear from a nutritionally informed physician (sadly, there are few to call upon) on his validity within the medical community.

A: In a case such as yours it would be good to consult with your Obstetrician about which are the best vitamins to take. You are correct that making sure to get enough folate and Vitamin B12 is both important for women of childbearing age but especially so for you, since you are a vegan. This is the sort of case that the new guidelines speak to…. Pregnancy Supplements

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Calling all success stories!

Many of you have written to us with nice words about what we do here at Dr. Gourmet. We love hearing from you and it really makes all our hard work worthwhile. Thank you!

If you have had success with The Dr. Gourmet Diet Plan, made use of the information we share or have enjoyed the recipes on the web site, we’d like to hear from you. Won’t you write us atsuccess@drgourmet.com and tell us your story?

Q: I have Charcot in my left foot and I have been staying off of it for going on 3 months now. I am a diabetic and have been told no [...]]]> Dear Dr. Gourmet,

Two related questions:

Q: I have Charcot in my left foot and I have been staying off of it for going on 3 months now. I am a diabetic and have been told no weight bearing on the foot. What can I do to exercise?

Q: I am a 52 year old female who in 1996 suffered a massive brain anuerysm/stroke. I was 99 pounds at the time, but by the time I was released from rehab I had ballooned to a whopping 246! I have managed to get down to 175 but I am stuck there. I’m just at a total loss and any advice you can provide me would be greatly appreciated. I am no longer confined to a wheelchair, so I do walk daily, although not fast and not far. I live alone so anything you suggest would have to be able to be done solo.

A: Since exercise is not my area of expertise, I referred these two questions to our exercise expert, Jacques Courseault. He’s written a fantastic article on How to Exercise with Disabled or Weak Legs that should help you design an exercise regimen based on what you can do.

Q: I cannot stay on a diet. I have gained 40 lbs in 2 years and my doctor wants me to only eat 850 calories per day. I crave sweets and cannot pass them by at work, so I am gaining more. I have high cholesterol, total 358, take Zocor, 80 mgs, I walk 1 mile every day and take blood pressure medicine. What can I do? I need help. I read your website and agree with everything I read, but are there some people who cannot lose weight?

A: One reason that you might not be able to stay on a diet is that many diets are so drastic. For instance, we now know that an 850 calorie diet is just too few calories and will set you up for failure. Once you eat under about 1,000 calories per day the body metabolism slows and weight loss becomes very difficult.

There are five steps to eating healthy and losing weight. The first is to assess where you are and how many calories you should be eating to lose weight. A Reasonable Diet

Q: How can you say that Body Mass Index is “a good tool” when it doesn’t apply to everyone? Lots of athletes and body builders have a BMI in the overweight range (according to your chart), but they have very low body fat. Are you saying these people are fat?

A: You’re correct that there are those who have a Body Mass Index (BMI) that is in the overweight range (or even obese), but they are actually healthy. This because they are very fit and their weight is more in muscle mass than fat mass. This is, unfortunately, the exception to the rule and most folks who have high BMI are overweight and at risk.

Keep in mind the BMI is a guide that we use on an individualbasis. Waist to hip ratio is another good guide that, like the BMI, we use in assessment. The two are complementary but are only a guideto whether your weight is a problem or not. BMI and Fitness

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

I use raw milk [...]]]> Dear Dr. Gourmet,

Q: I have celiac disease, and I keep reading that celiacs should stay away from dairy because it promotes inflammation. But dairy has always been one of my main “foods.”

I use raw milk (from a friend’s “pet” cow) and make my own kefir, yogurt, butter and cheese in addition to just drinking it.

Is raw milk as bad for celiacs as processed milk? Also, would I need to stay away from yogurt and kefir? (I cannot take probiotics in capsule form.)

A: There is some research that indicates many celiac patients may be intolerant of diary products. There is, however, more than one explanation for this. Celiac Disease and Lactose Intolerance

Q: I have had all the clinical signs of hypothyroid for decades but my “numbers” are always within “normal” range. I’ve heard a lot over the years about use of natural thyroid supplements and now iodine but only if it contains iodide (see the following link). Should I try this supplement?

A: As you may know, I don’t often comment on supplements. There are not many that are necessary and taking supplements has, in some cases, been associated with poorer health outcomes.

The supplement that is described on the page you pointed me to is iodide. As with many such supplements, the science is faulty and the use of high doses of iodide can be a problem. Thyroid Supplements

Q: I have been on Coumadin for 3 yrs since having a heart valve replacement. Lately, I am sleepy all the time. Seems like I can’t watch a movie or work on the computer without falling asleep. I think I am low on iron, but what can I do about eating foods rich in iron without it affecting the Coumadin?

A: While most people think of spinach and other greens as being high in iron, there are a lot of other great choices. Here’s a list of foods that are high in iron.

Note that there’s only a few items on this list that are high in Vitamin K.

If you believe that you are iron deficient, call your doctor and make an appointment today. He or she would want to know if you are not feeling well while taking Coumadin. Being iron deficient can be a sign of blood loss and for those on Coumadin we are very concerned about such things. Call now.

A: Like yogurt, cheese is made by adding live bacteria to milk. The resulting fermentation gives off gasses and it is the bacteria that is used in making [...]]]> Dear Dr. Gourmet,

Q: Why does swiss cheese have holes in it and other cheeses do not?

A: Like yogurt, cheese is made by adding live bacteria to milk. The resulting fermentation gives off gasses and it is the bacteria that is used in making Swiss cheese that is responsible for the large holes. One of the three bacteria used in Swiss cheese is Propionibacter shermani. For some reason this bacteria makes the the cheese’s distinctive larger holes. Swiss Cheese

Q: I’m trying to calculate the calories in a recipe that has a marinade. Since you don’t actually eat all of the marinade, how much of the calories are you supposed to count?

A: This is a great question and I don’t think that it has an answer (well, not a perfect answer at least).

I calculate calories using a computer program and when I am working on a recipe that calls for a marinade I assume that all of the marinade will be eaten and post those results. This can lead to an overestimate of the nutrition information but I am not sure that some cooks won’t brush the remaining marinade on the food as it cooks. Calories in a Marinade

Q: I’m definitely a fan of your site and the ideas you are promoting: good eating and healthy living. I’m still a bachelor for the next eight months and am trying to find healthy recipes that will keep for the better part of five days that I can return to for leftovers. I love to cook but am increasingly finding I have less time for it. Do you have any recommendations for bulk meals that I can make once a week and reuse several times?

A: Thanks for your nice words about the Dr. Gourmet web site. There are a lot of recipes on the Dr. Gourmet site that will work well for you.

One approach is to make casserole type recipes. Here are some links to recipes.

Also can I [...]]]> Dear Dr. Gourmet,

Q: I want to know if Fiber One cereal from General Mills is OK to eat when you have gout. I need to eat it every day because I have Diverticulosis.

Also can I eat microwave kettle corn popcorn with gout?

A: Cereals such as Fiber One shouldn’t be a problem for your gout. We know that the main issue where food will affect uric acid levels are those ingredients higher in protein, especially ones that contain more purines. Gout and Grains

Q: I work a lot, and am not thrilled with cooking. I’ve been thinking of trying the Nutrisystem plan. Would that be safe if I’m on Coumadin?

A: I get questions pretty frequently about the safety of prepared meals for those taking Coumadin (warfarin). This is a challenging issue and one that I don’t have a definitive answer for (but read on anyway).

As you may know from reading information on DrGourmet.com there are two approaches to consumption of Vitamin K containing foods when taking Coumadin. One is to eat about the same amount of Vitamin K containing foods each day. This can be challenging for many as there’s a wide variation between kale or other such greens (very high in Vitamin K) and carrots or iceberg lettuce (lower in Vitamin K). The other option is to eliminate all foods that are very high in Vitamin K. Coumadin, Convenience Foods and Nutrisystem

Q: My doctor suspects I might have metabolic syndrome. She advised me to lose weight, which I am in the process of doing: 11 pounds so far. Is there a particular diet that would be better for me, i.e., diabetic diet, Mediterranean diet? Are there any foods I ned to cut out forever? One article I read said not to eat corn, butter beans, beets, and anything white.

A: I love this question because recently there is excellent research to prove that the optimum diet for metabolic syndrome is Mediterranean style diet. This is a recent article that reinforces the conclusions from the last 20 years of research. Diet for Metabolic Syndrome

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

A: There [...]]]> Dear Dr. Gourmet,

Q: Find your website incredibly valuable and recommend it frequently. Thank you so much. My question: Is there a connection between obesity and sleep / insomnia?

A: There is a clear link between poor sleep habits and obesity. In the last few years there have been a number of studies that support those who don’t sleep much because they are busy or because they have insomnia are at much higher risk of becoming overweight and obese. There have been a lot of studies on those who work at jobs that requires rotating shifts or shifts where they have to work overnight. Not all of them are conclusive but some do show an association with working through the night and weight issues. Sleep and Obesity

Q: What type of salt (maybe sea salt), do you recommend to use for weight reduction, reducing blood pressure, and healthy eating?

A: It’s clear that diets that are high in sodium lead to health problems including high blood pressure and heart disease. Salt for Weight Loss

Q: Regarding Walmart’s recent announcement that they are going to reduce sodium in their foods:

It’s not surprising that Walmart recognizes the huge group of aging baby boomers by taking a major step in making foods healthier. In my area (rural northeastern Washington, between Spokane and Canada) Walmart is a MAJOR grocery supplier, and therefore a big influence on people’s diets.

One major concern I have over foods labeled as low sodium: One of my husband’s meds has a warning about not using salt substitutes. I’ve never bought one, but recently noticed that a lower-sodium prepared soup has potassium chloride in it. I’ve had to start re-reading labels all over again. I’m concerned that this may be the strategy as Walmart reformulates their house brands. Walmart also plans to add pressure to their suppliers, so the issue could mushroom.

I’m hoping Walmart’s test kitchen lowers sodium by reducing salt and boosting flavor without using chemicals. I applaud Walmart’s business decision based on doing the right thing; I am hoping that doing the right thing goes beyond the superficial and out to the detail level.

A: I agree with you that Walmart’s involvement in creating healthier products and bringing them to market could have a powerful effect on the health of America. There’s clear evidence that when people are given the choice of a “healthy” meal vs. a “traditional” one, they will most often say that the healthy version tastes better. That is, when they don’t know which is which. By having Walmart create an environment of better foods we could see a major shift in food production (both manufacturers and in the home). Walmart and Sodium

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

A: For some folks exercising can be a trigger for GERD (acid reflux). As with most triggers [...]]]> Dear Dr. Gourmet,

Q: Can you exercise if you have GERD / Acid Reflux?

A: For some folks exercising can be a trigger for GERD (acid reflux). As with most triggers exercise may affect some and not others. The general recommendation is to not exercise too soon after eating. Start slow with something simple like walking and keep a diary of your symptoms. Exercising with GERD

Q: Is sushi OK to eat if experiencing some acid reflux or heartburn?

A: The one issue with many sushi and sushi rolls is that they will often contain wasabi. Wasabi root is quite spicy and could provoke symptoms of acid reflux in some. Interestingly, much of the wasabi paste served in Japanese restaurants today is actually made from horseradish. GERD and Sushi

Q: I have been diagnosed with acid reflux/heartburn. As I understand it, changing your diet will heal the sphincter area and then gradually go back on trigger foods, one at a time.

Do you have such a comprehensive diet that could help me get started?

A: You are correct that making lifestyle change might help treat issues caused by gastroesophageal reflux disease (GERD).

At this time there is no definitive research about how well diet can actually heal the inflammation caused by GERD triggers. All we have is anecdotal evidence regarding this. What the research shows us is that the acid reflux triggers are very much individualized from person to person. Healing GERD

Q: For several months I have been looking for low-acid tomato canned products. I read someplace that you can buy these items, but there was no source given. Have you heard of this?

A: At this time there is no low-acid tomato sauce on the market that I am aware of. I do know that some companies have explored this but in my research I have not found any that have put this on the market yet. We have a Low Acid Tomato Sauce recipe on the Dr. Gourmet web site to help you.

Get The Dr. Gourmet Diet for People with GERD / Acid Reflux

Complete with six weeks of meal plans and grocery lists, The Dr. Gourmet Diet for People with GERD / Acid Reflux will help you eat healthier, maintain a healthy weight, and manage your GERD / Acid Reflux. Flavorful, delicious food that you’ll love!

Buy the Paperback Book – $19.95 + s/h (via Lulu.com)
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A: When creating our lists for Vitamin K content we reviewed many sources. We looked at the recommended [...]]]> Dear Dr. Gourmet,

Q: What are the ranges of mcg of vitamin K for low, medium, and high classifications?

A: When creating our lists for Vitamin K content we reviewed many sources. We looked at the recommended daily allowance (RDA) of Vitamin K as well as a grouping of ingredients by amounts. Low, Medium, and High Vitamin K

Q: Your website is terrific. My husband is a heart patient (bypasses, heart failure and atrial fibrilation plus Type 2 diabetes), so I turn to your website often. I have Type 2 diabetes and grew up in a Greek (Mediterranean) home with veggies, fruits, and very little meat. I have tried to maintain this in my own home and would like your advice as to how you rate some of the Mediterranean recipes that are in the more popular Greek Cuisine cookbooks. I would like to go on your diet plan because we could also lose about 20 pounds apiece, but I find it difficult to switch to more American-style foods such as are in your diet plan. Can you advise me?

A: Certainly, Greek cuisine is the foundation of Mediterranean style diet. If I have a choice of any restaurant, it would almost always be Greek. The challenge for the recipes in popular cookbooks is that the meals will often contain more calories than needed — great ingredients but just too much of them. This is true whether the cookbook is Greek or some other cuisine. Evaluating Greek Recipes

Q: I have a labral tear and I’m contemplating arthroscopic hip surgery, a relatively new procedure. I have read on the “Men’s Health” forum about the risks of this surgery and also about using foods such as greens and omega 3, 6 and 9s to repair cartilage. Is there any truth to the eating greens will cause hip cartilage to repair or re-grow? Does glucosamine/chondroitine work?

A: This is another example of claims made on the internet without much good science to back it up.

There have been some research studies that show improved function in those with arthritis when they consume a healthy diet. A variety of nutrients have been looked at including various fats (Omega-3 and Omega-6), antioxidants, vitamins and minerals. Cartilage-Supporting Supplements

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Dear Dr. Gourmet,

Q: I sometimes like to go to the movies and wonder, what are the best, healthy snacks that can be found at the concession stand to nosh on while watching the latest blockbuster?

A: This is a HUGE challenge (pun intended). Movie theaters are not the best for snacking but it is something that we all think we should be part of the experience. My best suggestion is to not eat snacks at all. I realize that this is pretty un-American but the snacks at movie theaters have an amazing amount of calories. Theaters were, in many ways, the beginning of supersizing with super big buckets of popcorn and oversized candies. The Best Choices at Movie Theaters

Q: I have been successfully following the Dr. Gourmet plan (I use mostly the Mediterranean Diet) for over 10 months. It has changed my life! I now face being caretaker for my 24 yr. old son, who is having major back surgery. He has been in chronic pain for four years, following an injury, and his lack of mobility has not been good for his weight. He is 6′6″ and 275 lbs, and will benefit greatly from losing weight during his recovery and physical therapy program. I will be providing all his meals, and he wants to do this, but I’m not sure what the best plan for him would be.

What plan would you recommend, and how many calories should I aim for for him?

A: This is certainly a challenge for your son. At 6′6″ his ideal body weight would certainly be a lot lower. The issue is that one can’t go completely by Body Mass Index (BMI) for those who are very muscular given that muscle is much denser than fat. Being sedentary your son will likely not require as many calories. With normal physical activity his daily caloric requirement would be somewhere in the 2,400 calorie range. Supporting Surgical Recovery

Q: My question is about spinach and specifically, what are the attributes in spinach that makes one’s tongue and teeth feel “funny” after eating? I love spinach, but I don’t like this after effect and recently I thought, “Hmm, I wonder if Dr. Gourmet knows what causes this?”

A: I have asked a few experts on this and performed a literature search. Neither of these were very revealing for a definitive answer but there are three possible explanations that came up more than once in my questioning. Spinach

A: I don’t normally answer questions not related to diet and [...]]]> Dear Dr. Gourmet,

Q: Any comments about the new drug that has just been approved by the FDA and supposedly will take Warfarin’s place – Pradaxa?

A: I don’t normally answer questions not related to diet and nutrition, but many of our readers are Coumadin (warfarin) users so I will make an exception.

This medication has been approved by the FDA only for prevention of stroke in patients with atrial fibrillation. Dabigatran has been on the market for some time in Europe. I actually had a few patients in the clinical trials before approval (they did well, by the way). It was shown to be slightly more effective than warfarin and slightly lower risk of major bleeding and hemorrhagic stroke. Pradaxa

Q: I was very interested in your article: Hot Chocolate for High Blood Pressure? as I drink hot chocolate after taking innulin every evening at bedtime. I note you state “not hot chocolate mix” and I wonder why this is? I use Nestle Carnation Light brand made with water and this has 45 calories. Skim milk would add 60 calories but this stuff tastes so good I don’t need to use milk.

A: I put this cautionary statement in the conclusion because many hot chocolate products have very little actual cocoa in them. They will often be milk powder combined with artificial chocolate or cocoa flavorings. Because the study was done with real cocoa products, simply saying “hot chocolate” might not offer the same benefit.

Q: I am watching my glucose numbers. Should I be more concerned about a food’s glycemic index or the amount of fiber in a food? It seems that a food with a good amount of fiber also has a higher glycemic index.

A: This is a fantastic question. There has been a lot of good research about the impact of a higher fiber diet on helping control blood sugars. We have less information about the impact of glycemic index (GI) on diet and diabetics but what we have is getting better. One study in 2008 compared a low glycemic index diet with a high cereal fiber diet and the diabetics on the low GI diet did slightly better. Fiber vs. Glycemic Index

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Over and over again the one thing to remember in the coming year is [...]]]> We’ve had a lot of great questions come in this year and I wanted to share some of the best with you.

Over and over again the one thing to remember in the coming year is that if it sounds too good to be true, it is too good to be true. This is certainly the case with weight loss and diet. Smart, delicious, sensible weight loss is the key.

Thanks so much for letting all of us here at DrGourmet.com be a part of your day.

Timothy S. Harlan, M.D.
Dr. Gourmet

Dear Dr. Gourmet,

Q: My brother thinks that drinking Fresca is the same as drinking water. He is diabetic and takes pills to control his numbers. He is about 30 or more pounds overweight and he drinks about 6 cans of Fresca each day. I told him he could drop at least 15 pounds if he didn’t drink so much Fresca. His doctor told him that drinking fresca is the same as drinking water. Is that True?

A: According to the Coca Cola Company, Fresca products have about 2 calories in an eight ounce serving. A can of Fresca is 12 ounces so 6 cans per day would be only 18 calories. While this is more than water, at zero calories, it is not significant. 18 calories is slightly more than a single teaspoon of sugar. Diet Soda: Same as Water?

Q: I have read so much conflicting information about eating fruit before and after meals. I’ve read that I shouldn’t eat fruit 30 minutes before or after a meal, and another article that said I should wait up to 6 hours! What do you recommend? Also, I recently read an article that recommended avoiding bananas and raisins while on a low calorie diet since they are high in calories. Is this true?

A: What we do know is that eating fruit helps people lose weight. There are numerous studies that support this. For instance, in one study women who ate three apples or pears per day lost weight. In another study participants eating grapefruit 30 minutes before meals had an easier time losing weight. The Timing of Fruit

Q: Recently I read an article about MSG (monosodium glutamate). It claimed that MSG causes weight gain based on a study done by university of Carolina. Is this true?

A: There have been animal models showing that MSG has an effect on the hormones that influence weight gain. A group of researchers at North Carolina did indeed look at whether such changes might be linked to weight gain in humans. MSG and Weight Gain

Dr. Gourmet has just released our first iPhone app! Studies show that using a Food Diary to track what you eat can help you lose more weight and maintain your weight loss more easily. With the Dr. Gourmet app on your iPhone, you can track your calories (along with your total fat, protein, carbohydrate, sugar and fiber intake) as well as your exercise from anywhere you are!

Future updates of the app will allow you to interact with The Dr. Gourmet Diet Plan on the Dr. Gourmet web site, so you can check your meal plan and access your shopping lists. Get the FREE Dr. Gourmet iPhone app today!

It’s a fair question and there is some cause for concern. On the one hand, we know [...]]]> I get asked this question pretty regularly: “I know I should eat fish, but what about the mercury contamination?”

It’s a fair question and there is some cause for concern. On the one hand, we know that eating fish is the best way to get the omega-3 fatty acids that are so good at helping you avoid heart disease. On the other hand, mercury poisoning can damage the brain, kidneys and lungs, and there’s some evidence that mercury poisoning is associated with an increased risk of heart disease. To eat fish, or not to eat fish? That’s the question.

Dear Dr. Gourmet,

Q: I was told not to have caffeine because of my a-fib. Since dark chocolate is good for you and I love dark chocolate, do you think I can eat it even though it contains caffeine? If yes what should be the amount?

A: There is inconclusive data regarding whether caffeine has an effect on those with atrial fibrillation. It appears that is does not: Dr. Gourmet’s Health and Nutrition Bite: Caffeine and Atrial Fibrillation.

There have been case reports of people consuming excessive amounts of caffeine and ending up with atrial fibrillation. Dark Chocolate and Atrial Fibrillation

Q: How much dark chocolate should a person eat in one day?

A: This is so open ended and I will admit that I don’t have an answer for it. Chocolate is very high in calories with the average candy bar (about 1 ounce) having 150 calories.

If you are on a diet, not active, diabetic or have other health issues, you should not be eating any candy on a daily basis as this is likely to have too many calories and too much sugar for you. Save your chocolate for special occasions.

More on Chocolate

Plant Sterols in Chocolate
I’m sure you’ve seen them at the supermarket: foods that have been enriched with plant sterols. These compounds have been shown to help improve cholesterol scores – so much so that the FDA has approved the use of a health claim about it on foods that contain plant sterols.

Hot Chocolate for High Blood Pressure?
It’s a good idea for those with high blood pressure to make sure they’re getting enough fruits and vegetables in their diet. Not just for overall health, but because the polyphenols, or flavonoids, in fruits and vegetables have been linked with reduced blood pressure and lower risk of heart disease. Yet the foods with the largest amounts of polyphenols are not foods at all but beverages – tea and cocoa.

Dear Dr. Gourmet,

Q: I drink one cup of green tea daily. I am wondering if taking green tea capsules would give me much more of the health benefits of green tea. Is one cup daily enough to improve blood sugar levels?

A: Green tea does appear to be good for you. There’s no great evidence that green tea can help control blood sugar. In fact, a recent research article showed that drinking green tea with breakfast had no effect on blood sugars up to two hours later. Green Tea

Q: I was plagued with Gout for a while until I discovered and began taking Cherry Fruit Extract. I had no flareups while on that.

But now I’m on Coumadin (Warfarin), and was told to stay off Cherry Fruit Extract, along with CoQ10 and Vit C. What are your thoughts on me going back to Cherry Fruit Extract while on Coumadin?

A: I am glad that your physician told you to not take these supplements. He or she was right to tell you that.

There is no evidence that cherry fruit extract helps with gout. There is some evidence that eating cherries decreases plasma urate levels. A good study in The Journal of Nutrition investigated this in 2003. While this is good evidence, there is no reliable evidence to support that eating cherries prevents gout (only that there are lower urate levels). Gout, Coumadin and Cherry Fruit Extract

Q: My boyfriend’s mother suffers with Crohn’s Disease (although fortunately she is not needing medication at the moment). She has started to take Linseed oil after hearing it may help with her symptoms. She adds a couple of tablespoons a day to yoghurt, cereal etc.

She has asked whether there are any bad effects of taking Linseed and what the evidence is for its use. My initial feeling is that as she feels it is having a positive effect, it doesn’t matter whether it is placebo or not but was wondering whether you had any information and thoughts about it?

A: There have been some reports that healthy oils such as fish oil and flax seed (linseed) oil might have benefit in those with Crohn’s Disease. That evidence is not all that great and there is no recommendation at this time for people with Inflammatory Bowel Disease to take such supplements. Crohn’s Disease and Linseed (Flaxseed) Oil

Dear Dr. Gourmet,

Q: I see in this question about oatmeal how much oats we should not consume. What I don’t see there is what is the recommended amount is per day. Any ideas?

A: The rule of thumb for a serving of oatmeal is 1/2 cup before cooking. That’s about 150 calories and 4 grams of fiber.

Q: I just had a hiatal hernia repair and am supposed to be on a liquid/pureed diet for at least a month. Nothing tastes good and short of getting retail baby food, do you have any recipes that are tasty and easily pureed? I am lactose intolerant with GERD and Barrett’s esophogus, healing well, but definitely need some protein as I have lost 11 pounds in only 7 days. Thanks so much!

A: There a number of options for you. Smoothies can be a good choice for breakfast. Here’s some recipes and these have been designed to be GERD friendly: Recipes for a Liquid Diet

Q: My wife and I like Thai curry – but coconut milk is so high fat… and high in 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

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Dear Dr. Gourmet,

Q: I really enjoy trying some of your recipes; I am a cancer survivor and am always looking for healthier food ideas. Your recipe for Salmon in Parchment with Mangoes – is it possible to use foil for the pockets instead of parchment?

A: Certainly you can use foil instead of the parchment. There may be a subtle difference in the meal in that the parchment breathes a little more so I generally add a little less liquid. My rule of thumb is to add 25% less liquid when I use foil. Foil vs. Parchment

Q: I heard on the news that eating fish (because of the mercury in it) is now proven to be a link to Alzheimer’s disease. They didn’t specify how much or how many times [the people affected] eat it per week. I am thinking they would mean what the average person might eat: 2-3 times a week. The other days we usually eat other meats. Have you any opinions on this factor.

A: I have always taken the issue of mercury in fish very seriously.

It is quite clear that excess intake of mercury in humans leads to many health conditions. This includes both short term health effects such as fatigue, irritability and short term memory loss. Long term effects have been well established and include the short term effect as well as muscle and nerve problems, mood and behavioral disorders, kidney, heart, liver and digestive problems. Fish, Mercury and Alzheimer’s Disease

Q: I have read your advice to eat oatmeal for reduction of cholesterol. Is there a real difference between rolled oats and steel cut oats? Some of the health food companies suggest only steel cut.

A: What we call oatmeal is processed from one of the cereal grasses – oats. As with most cereals a fair amount of processing takes place before we pluck the familiar round cardboard carton from the store shelves to cook up a bowl of steaming oatmeal. Rolled Oats vs. Steel Cut Oats

Dr. Harlan’s newest diet book, Just Tell Me What to Eat!: The Delicious 8-Week Weight-Loss Plan for the Real World, is being published in April, 2011, and you can be part of it!

Have you used The Dr. Gourmet Diet and lost weight, improved your cholesterol scores, or even avoided going on diabetes medication? Maybe you just feel better or discovered that there are some vegetables you do like? If you’ve had success with The Dr. Gourmet Diet, tell us about it and your comments may be used in the book!

Send your stories tosuccess@drgourmet.com and if you are quoted in the book, you’ll receive a free copy of the book, signed by Dr. Harlan. We’d love to hear from you!

Dear Dr. Gourmet,

Q: How do you feel about Morning Star Products – the vegetarian burgers, sausages etc.. They seem to be made from soybeans, possess high quantities of fiber and protein, low fat, high in B vitamins, but not overwhelming in sodium.

A: I am always challenged by these sorts of products. For those who are vegetarian but want foods that resemble meat they can be a good alternative. They are, however, highly processed and it’s hard to know what effect that might have on the otherwise healthy ingredients that they are made with. Morning Star Products

Q: I started having some general stomach issues (overall blah, nausea) about six weeks ago – it would come and go. Two and 1/2 weeks ago, I woke up in the middle of the night with intense burning right around my belly button which continued off and on the next day and night. Went to the doctor and they started me on Nexium (twice a day). I had an upper GI that showed severe GERD.

There have been other tests done and we’re waiting for results, but in the mean time I’m eating a very bland diet and drinking Maalox before meals. I don’t have the “traditional” sypmtoms of GERD where it burns in my esophagus; to me it’s all around my stomach when I eat. I’ve looked online for dietary guidelines for GERD and it sounds like I can’t have much of anything. Do you have suggestions for foods that I can eat and ways to make it taste good without aggravating my symptoms?

A: Gastroesophageal Reflux Disease can be challenging. Symptoms can be isolated to the stomach as they are with you, but folks will also have traditional heartburn and often no symptoms at all. Silent reflux is common and I see this in patients with unexplained cough and sometimes symptoms that have been diagnosed as nasal allergies.

Diet can be part of the treatment. The best evidence we have is pretty mixed with some folks responding to limits on certain foods with other people not have problems with the same ingredients. Eating with GERD

Q: I have recently developed a balance problem, actually more disorientation than balance. Scans have been done (didn’t show anything), medication given to no avail, and no improvement. Do you think it is possible that diet or medication build-up of some kind could be causing the problem? I have been taking medication for my high triglycerides.

A: There are a number of causes of balance issues. The most common is Benign Positional Vertigo (BPV). There can be clear signs of this on physical exam that can help confirm this, but often BPV is a diagnosis of exclusion, with negative brain scans and lab tests.Balance Problems

A: Wow! It’s always great when folks are [...]]]> Dear Dr. Gourmet,

Q: In the review of instant rice, it said Uncle Ben’s was the least favorite. [In the Quickie Arroz con Pollo recipe] it is the best. What’s up?

A: Wow! It’s always great when folks are paying attention.

You’re correct. In our review of instant brown rices we put Uncle Ben’s at the bottom of the list of the four that were tested.

The interesting thing is that the features that made it our least favorite as a side dish make it best for this sort of casserole. Why Uncle Ben’s?

Q: I would like your advice. I am going to buy my wife new cookware and wanted to know what kind to buy. She does not like Teflon coated pans and is not a gourmet cook, but we just had our kitchen renovated and she needs new cookware.

A: This is a great question. It is one that any chef could talk about for hours and hours and if you put more than one in a room they might argue for days. The discussion would become increasingly complex with each additional chef added to the room.

If I were going to refit a kitchen I would choose a variety of pots and pans. (For those of you out there who would like to comment on my choices please don’t hesitate, it’s a great discussion.) Cookware

Q: I just had an oopher / hysterectomy done Oct 1st and was diagnosed with breast cancer in February. I had a lumpectomy and sentinel node removed, clear margins and then 6 wks radiation, completed June 6th 2010.

I read one of your articles and had another question along the same lines. My oncologist wants to put me on Femara in 3 weeks. Do you know how the edamame soybeans will react with the medication for estrogen? Can it still possibly benefit me, or do you know if it will produce more estrogen.

A: Thus far the research has not supported that there is any problem with consuming soy products and any increase in the risk of cancers.Femara and Soy

Dear Dr. Gourmet,

Q: My daughter is allergic to all forms of sesame and peanuts. What can I use in stir fries to substitute for sesame oil yet maintain a nice Asian flavour?

A: This is a bit of a challenge and I don’t feel you will get all the flavor that comes with sesame oil with any alternative oil. Your best bet would be to use an oil with less flavor such as canola or grapeseed oil and find the Asian flavor in other ways. Sesame and Peanut Substitutes

Q: My guy has been sober for sixteen years and prefers that there is no alcohol in the foods that I make. I do use extracts but never heavily. I have avoided the wine / champagne vinegars, but I wonder about balsamic vinegar and the alcohol content. I would love to know what to use to make up for the lack of wine vinegar. Some recipes I feel I can interchange, but I really wonder about something like gazpacho, where the flavor is really needed.

A: There are traces of alcohol in vinegar but a very small amount. Wine vinegars such as red or white wine and balsamic vinegar do start with a dilute wine which is then fermented. Instead of the bacteria fermenting sugars as happens when the wine is made bacteria from the acetobacter family use the alcohol in the fermentation process. Most of the alcohol is used up and much like the extracts you are using there may be traces of ethanol remaining. It’s not likely to be very much – on the order of 2% or so. Vinegar

Q: I was thrilled to stumble across your website recently. I’ve been cooking my way through the Week 1 Sample menu found here: eatTHISdiet Week 1

…with one problem. It’s 90+ degrees in New York City this week. I live in a tiny apartment. Nearly all of these recipes involve running the oven at 400 degrees to roast some thing or another.

It would be great if your menu planning tools took the season into account. Besides not wanting to turn up the oven quite so high in summer, I’m also very interested in eating vegetables when they are in season.

A: Thanks for your email and I love your idea. You can create two week menu plans with our meal planner, The Real World Diet. Login to The Real World Diet.

After creating a profile for yourself, the planner will create two-week menu plans complete with shopping lists for each week. After creating your menu there is the option to change the recipe choices and you’ll be able to tailor the plans to fit your taste and the season.

Q: I was wondering if parboiled white rice was as good for diabetics as brown rice. I read that the process of making parboiled rice puts back nutrients taken out and that the result was that parboiled rice is as good as brown rice. Also does parboiled rice have the same fiber content as brown rice?

A: Truthfully, there’s not much I dislike more than parboiled rice. First and foremost, rice is so easy to cook that there’s no reason to use pre-cooked versions like Minute Rice. Secondly, the rice is “enriched” but what is put back in is not the best part of the rice — the outer layer. It is that bran layer that is removed when making white rice in much the same way that bran is removed from wheat berries to make white flour. Parboiled Rice vs. Brown Rice

Dear Dr. Gourmet,

Q: Is there a substitute for red wine? Perhaps grape juice made from grapes rather than concentrate? I do not drink alcohol at all and would not do so even for the benefits of red wine.

A: There is good evidence that drinking grape juice has many of the same benefits as drinking red wine. The antioxidant polyphenols in red grape juice have been shown to have positive effects on cholesterol in the same way as red wine. Is Grape Juice a Substitute for Red Wine?

Q: When I look at some of your recipes I see some of them are way over 250mg cholesterol, for instance your Eggs Benedict with 283mg. I understand eggs are considered a high source so that doesn’t surprise me with the figure. But…..

I have a cholesterol problem and am trying to lower it without medication. I came across your recipes by doing a search. What is considered HIGH cholesterol content in food when looking at a Nutrition Fact section? Just curious as my doctor really wants me on medication. But every time I take it I feel like crap AND it is so expensive compared to just looking after your dietary intake.

A: This can be a confusing issue because your cholesterol is high and the first thought is to eat less cholesterol. Researchers used to think that eating about 300 mg of cholesterol per day was the key to lowering cholesterol. While it is important to be careful, we understand a lot more about this now.

Even though you eat things with cholesterol in them, it’s important to know that your body makes its own cholesterol — about 300 mg per day. Some people make more but most folks with cholesterol problems have difficulty with how the cholesterol is handled in the body. Eating for High Cholesterol

Q: Are there any foods or food groups that contribute to migraine headaches? Are there any foods or food groups that assuage migraine headaches?

A: There are no foods that have been definitively shown to help relieve migraines. We do have some evidence that foods that are high in tyramine can provoke migraine. Here’s a list of some foods that are high in tyramine. In general if it says aged, dried, fermented, salted, smoked or pickled, you should suspect that this is high in tyramine.

But recently, due to various usual work frustrations, holidays, etc. my weight has [...]]]> Q: From Aug to March of last year I lost 65 pounds on the Medifast diet which is typically less than 1000 calories per day.

But recently, due to various usual work frustrations, holidays, etc. my weight has crept back up about 5-8 pounds. I want to shed this weight plus a little extra to make sure I’m well into my healthy BMI range. I suspect that my metabolism is pretty low from following that diet for so long, and it seems like the only way to lose this excess is to go back on Medifast, due to my body being used to so few calories.

I’ve done this (Medifast) without much success so far for the past month or two. But I’m tired of it! The profile I created on The Real World Diet shows I should consume 1500 calories per day, but it seems like if I consume 1500 calories per day, I’ll either not lose any weight or maybe even start gaining! I feel like I’ve shot myself in the foot. Am I stuck with restricting my calorie intake to less than 1000/day?

A: While I am not a fan of diets like Medifast, it does work for some folks. There are the issues with such diets of slowed metabolism when being on so few calories. Another concern of mine is that the programs seldom spend enough time teaching folks how to transition back to healthy eating. Consequently, there is often a creeping weight gain once you end the diet.

You may do very well on The Real World Diet. The planner chooses a calorie target based on your height and weight. The computer is not, however, a doctor or dietician sitting in a room with you discussing all of the factors that go into the amount of calories you eat vs. exercise, your likes and dislikes, your precise Body Mass Index, Waist to Hip Ratio, etc.. It may be that you will do better at 1,200 or 1,000 calories for a short period of time while you lose the 5 – 8 lbs. and get to your target and that the 1,500 calories is a good target for you to maintain your weight. This is why there is the option of selecting the number of calories yourself. Check with your doctor….

Q: My daughter lives in Italy, in the Puglia region (southeastern coastline). They can not get goat cheese. What could she use to substitute for goat cheese in recipes?

A: There would be a number of great choices for your daughter. The key is for her to look for a soft, creamy cheese that is made with a reduced fat milk. Because goat and sheep milk is naturally low in fat, they work well….

Q: I recently learned that I am pregnant. I would like to know where I can find a reliable list of the vitamins and minerals I should be getting, and the foods I should be eating. I would rather get these vitamins from foods rather than supplements; is this possible? Which option do you think is better? Is there a “pregnancy diet” I can follow that will ensure I am getting the proper nutrition for me and my baby without gaining unnecessary weight for the next nine months?

A: Congratulations on your pregnancy.

It’s a wonderful coincidence that you have written because we are just now preparing a section of the Dr. Gourmet website dedicated to eating healthy during pregnancy. We have asked a nurse I know who specializes in caring for pregnant women to write articles on healthy diets in pregnancy. Here’s an excerpt from one of her recent articles….

A: There’s two ways to look [...]]]> Q: I appreciate your writing about salt and sea salt. How can Campbell’s Soups claim that they have used sea salt and have, therefore, less salt? That has really been bothering me.

A: There’s two ways to look at the issue of sea salt. First, some science for review.

Ordinary salt is sodium chloride and is made of one molecule sodium and one molecule chloride. The crystals of the sodium chloride that form can be of any size. Think of a grain of salt from the familiar round blue box of Morton salt in your cupboard vs. a large salt lick placed out in the field for horses. Sea salt is usually a coarser salt….

Q: Many of your recipes indicate, “Those who are lactose intolerant should avoid it.” I am lactose intolerant, however, I don’t avoid dairy but rather take a lactase enzyme supplement when consuming dairy. Often that mean taking the enzyme once or twice a day. Is it safe to use the enzyme so often? It works well for me.

A: We are very strict about labeling the recipes on the Dr. Gourmet web site regarding health issues. With lactose that means that if the recipe contains any lactose it is marked with the statement “Those who are lactose intolerant should avoid it.”

Interestingly, lactose intolerance is an issue of how much lactose is in a particular dish. Lactose is the main sugar found in milk and is made up of two sugar molecules bound together. The body can’t absorb lactose and it must be broken down….

Q: What effect does taking saw palmetto have on Coumadin levels?

A: It’s important to check with your doctor about taking any supplements if you are on any prescription medication including Coumadin® (warfarin) but also others such as blood pressure medications and medications for cholesterol or diabetes.

The research on taking supplements is disappointing and few have shown any benefit.  This includes saw palmetto, which in a large trial….

A: My opinion is that this is a scam. There’s no reason to take multivitamins except in some very specific cases and there’s no [...]]]> Q: Is the product Vitamin Water Zero a hoax or does it have some redeeming value?

A: My opinion is that this is a scam. There’s no reason to take multivitamins except in some very specific cases and there’s no health benefit proven from drinking vitamins.

Here’s the statement released in mid-June 2010 as part of the new dietary guidelines for Americans: Vitamins

Q: Is there more vitamin K in raw blueberries or in cooked blueberries, such as in pie filling?

A: One cup of raw blueberries is a little higher in Vitamin K than other fruits at 29 micrograms (mcg). According to the USDA, a cup of canned blueberries in heavy syrup has only 16 mcg of Vitamin K. This is likely because some of that cup contains syrup and sugar (the blueberries in syrup come in at 225 calories and the cup of raw fruit is only 84 calories). Raw vs. Cooked Blueberries

Q: In our household we have members with high blood pressure, high cholesterol, type 2 diabetes, reflux, and Coumadin use. Your Real World Diet program sounded like a custom combination could be made to cover all of us. However, the diabetic, high cholesterol, and high blood pressure diets are not choices. . . . What would you suggest we do? Your website could be a lifesaver for all of us.

A: We now know that the most effective diet for all three of the issues you mention is a Mediterranean style diet. There is tremendous research to show that eating this way can effectively treat diabetes, high cholesterol and high blood pressure. All of the recipes on the Dr. Gourmet web site are based on Mediterranean diet principles and translate them to more familiar American recipes for you. You can read about this by using The Real World Diet Coaching program, a collection of brief essays on how to eat healthy.

You are correct that a lot of folks who have these sorts of problems also have other challenges like acid reflux or are taking Coumadin (warfarin). This is why we have tagged every recipe to let you know how a dish might affect other conditions. We have set up The Real World Diet planner to create two week meal plans for all the members of your household. Diets for Multiple Conditions

Q: Thank you for your informative article about multivitamin use and breast cancer.I just started taking multivitamins a week ago because I am vegan, live in the Pacific Northwest, and am trying to conceive so I need B12, vitamin D, and folic acid. Would you say that I could interpret this new study to say that I should toss the multivitamins and just take individual supplements for those ingredients I listed above? I would really appreciate your input in this matter as I have PCOS and Endometriosis and therefore have an abundance of estrogen which would seem to place me in higher risk according to this study.

On a side note, are you familiar with the work of Dr. Neal Barnard and his studies on vegan diets and reducing or eliminating diabetes? I read his book and am curious to hear from a nutritionally informed physician (sadly, there are few to call upon) on his validity within the medical community.

A: In a case such as yours it would be good to consult with your Obstetrician about which are the best vitamins to take. You are correct that making sure to get enough folate and Vitamin B12 is both important for women of childbearing age but especially so for you, since you are a vegan. This is the sort of case that the new guidelines speak to. Vegans, Vitamins and Pregnancy

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

A: Right now there is no Dr. Gourmet book for those folks who have GERD [...]]]> Q: Can you please tell me what recipe book or cookbook you would recommend as the “best of” for people with GERD / Acid Reflux?

A: Right now there is no Dr. Gourmet book for those folks who have GERD or Acid Reflux, but we’ll be publishing one very soon. In the mean time you can find a lot of free information on GERD / Acid Reflux here at DrGourmet.com.

A: While cranberry juice is safe with Coumadin (warfarin), [...]]]> Q: There is information about cranberry juice interacting with Coumadin (warfarin), however, I would like to request information about the interaction of grapefruit with Coumadin (warfarin) and if it is contraindicated.

A: While cranberry juice is safe with Coumadin (warfarin), grapefruit and grapefruit juice is most definitely contraindicated (to be avoided) – not only with Coumadin but with many other medications. Cranberries, Grapefruit and Coumadin (warfarin)