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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Mark Your Calendars!

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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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.

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.

A: It is a myth [...]]]> Q: I have a terrible sweet tooth and my blood sugar is normal. I’m otherwise healthy and have no blood pressure problems. Can too many sweets cause me to become diabetic? Should I be concerned?

A: It is a myth that eating too much sugar causes diabetes.

There are a lot of factors that go into whether one will develop diabetes. Type I, or juvenile diabetes, occurs when the cells in the pancreas stop producing insulin. Type II diabetes generally happens as folks age, primarily in those that are overweight. It can arise in those of normal weight, but either way the reason seems to be that the body doesn’t use insulin properly. Diabetes and Sweets

Q: I have just been put on Coumadin after having aortic valve replacement. I cannot find out if raspberries have a large amount of Vitamin K in them. Can you answer for me? Thank you.

A: A cup of raspberries contains about 10 micrograms (mcg) of Vitamin K. That would be considered a low amount and safe for Coumadin® (warfarin). In fact, pretty much all fruits are going to be safe for you. You can check that using the lists on this page: Coumadin (Warfarin) Diet Information

Q: My blood sugar has been creeping upwards and I’ve been cautioned against eating white sugar, white breads, and white rice. Is honey OK, and what fruits are permissible?

A: It’s great that you are working at making changes. For those with higher blood sugars avoiding processed foods and foods with a lot of sugar is key. The examples you give of table sugar, white bread and white rice are a good start. Working at getting more fiber in your diet by having whole wheat bread, brown rice, whole wheat pasta, beans and veggies will help control your weight and your blood sugar.

While honey is somewhat sweeter than sugar, both are still sweeteners. Better Choices to Control Blood Sugars

There’s good research about snacking and it seems most of [...]]]> Dr. Tim Says….

[This article is part of The Real World Diet Coaching Program, an ongoing series on The How and Why of Eating Healthy. Read the whole series to date.]

There’s good research about snacking and it seems most of us are one of two types. We are either sweet snackers or salty snackers. Knowing which you are can help you manage your weight by making sure you have snacks on hand that will be satisfying. This doesn’t mean that you need to schedule every one of your snacks, but having the right snack available helps you keep from eating things that you might want to avoid. Snacking is Essential

Featured Recipe

Chicken Cacciatore | Coumadin Safe Version

There are so many variations on this recipe it’s amazing. I started working on it about 6 months ago and found recipes with all different ingredients. Some had onions, peppers, mushrooms, different pastas, boneless chicken, bone in, skin on and skin off. The result for me was to make it as simple as possible for you to make and to eat. Peppers, onions but no mushrooms. Dried herbs and great parmesan and it all comes together to be warm and comforting.

This recipe is low in sodium (salt). It is gluten-free provided you use gluten-free pasta. Those who are lactose intolerant but can tolerate cheese may enjoy it. Those with GERD / Acid Reflux should avoid it.

A Healthy Pregnancy
with Faith Bontrager, RN, BSN

Most doctors and mothers would agree that breastmilk is the best diet for a newborn. But what if you aren’t going to be with your baby 24 hours a day? Many women choose to express (pump) milk for their babies.

After the breastmilk is expressed, how long does it last? Most formulas need to be freshly prepared for a feeding and then discarded if the baby does not finish the bottle at that feeding (read label directions for specific brands). Breastmilk, on the other hand, stays fresh a long time. But how long? Keeping and Storing Breastmilk

Cranberry Vinaigrette Green Goddess Dressing Honey Mustard [...]]]>

It seems amazing that Christmas is almost here, but there are only 8 shopping days left. Time to plan those holiday meals and Dr. Gourmet is here to help with some of our favorite holiday recipes.

Salad Dressings

Cranberry Vinaigrette
Green Goddess Dressing
Honey Mustard Dressing

Soups

Pumpkin Clove Soup with Spiced Sour Cream and Toasted Pumpkin Seeds
Butternut Squash Soup

Main Course

Maple Sage Turkey Breast
Roast Turkey Breast
Stuffed Turkey Breast
Shiitaki and Cranberry Stuffed Pork Loin

Sides

Candied Carrots
Green Beans Almondine
Roasted Brussels Sprouts
Cornbread Dressing
Mashed Yams
Holiday Gravy

Desserts

Chocolate Cheesecake
Holiday Panna Cotta with Chocolate Cranberry Sauce
Pumpkin Creme Brulee
Pumpkin Tarts

And to Make Use of Those Leftovers….

Turkey Waldorf Salad
Roasted Turkey, Wild Rice and Cranberry Salad
Turkey White Bean Soup

From all of us here at Dr. Gourmet, we wish you the happiest of holidays and a fine, healthy New Year.

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

http://www.medicalnewstoday.com/articles/172098.php

Look, I like chocolate and it’s not really bad [...]]]> I love stories like these.  They are all over the web.  They are research studies that are funded by a particular company to make the public think that their product is somehow healthier (in this case flavanoids = good and chocolate = flavanoids therefore chocolate = good).

http://www.medicalnewstoday.com/articles/172098.php

Look, I like chocolate and it’s not really bad for you unless you eat a lot of it (which most Americans do at about 12 pounds a year).  It’s statements like this that make folks think eating chocolate is good for you:

“Being able to fully measure and communicate the levels of flavanol antioxidants in products is increasingly important for studying the potential health benefits of cocoa and chocolate and providing information to consumers,” said Debra Miller, Ph.D., Director of Nutrition at The Hershey Company.

It’s OK to study this but until you really prove something there’s no reason to do a press release (unless, of course, you are the publicist who’s job it is to send out press releases).

Dr. Miller, when you can show through research that risk of eating 12 pounds of chocolate a year is outweighed by the benefits of the flavanoids in that 12 pounds of chocolate that’s something to report on.

Oh yeah, am I the only one who thinks that the title Director of Nutrition at The Hershey Company is the best oxymoron?

Dr. Gourmet

Eat well, eat healthy, enjoy life!

When I was a kid there was a family down the street that always gave apples. Interestingly, it was a popular stop. The mother [...]]]>

Dr. Tim Says….

Are there healthy alternatives to all that candy on Halloween?

When I was a kid there was a family down the street that always gave apples. Interestingly, it was a popular stop. The mother who came out had a terrific act, having dressed up in a dramatic witch costume and handing out the “magical” apples. Sometimes getting us to eat better is just in how the message is delivered!

About five years ago I lived next door to a woman who gave money. She saved up her spare change through the year and doled out about 30 – 35 cents to each kid (about the cost of candy). The kids were always delighted at this – even more so than getting candy. I do this now and love the squeals of “Mooomm, I got money!” almost every time.

Along healthy lines, trail mix is a great way to go. Choose those with a mixture of nuts, seeds and dried fruits and avoid the mixes that contain candies like M&Ms. Halloween Candy

Featured Recipe

Chicken Marsala

This is such an old fashioned recipe. It was a menu favorite in Italian restaurants when I was growing up and I almost think of it as comfort food. It makes a quick and easy dish for small dinner parties but it’s simple for weeknight meals as well.

You might not think it worth going out and purchasing a bottle of Marsala for. The wine doesn’t have to be terribly expensive and it will keep fairly well. Then as long as you have chicken breasts you have an easy and elegant meal.

This recipe is safe for Coumadin® (warfarin) users and is low in sodium, lactose-free and safe for those with GERD / Acid Reflux. Those who are gluten-sensitive should avoid it.

Chocolate is Good For You!

Aside from being delicious, chocolate is generally thought of as being bad for you. While it does contain fat, its fats are the less harmful ones, stearic and oleic fats, and they don’t cause a rise in blood cholesterol levels. Because it is made from a plant, it contains some beneficial substances associated with other foods of plant origin. There are small amounts of copper, zinc, iron and magnesium, along with polyphenols (chemicals that have been implicated in research studies as providing potential health benefits).

Both cocoa powder and chocolate are derived from a bean that’s high in flavonoids (known antioxidants). As with other antioxidants, flavonoids have been associated with a reduction in cardiovascular disease risk.

It seems that unsweetened powdered cocoa contains the highest quantity of these antioxidants, followed by dark chocolate and then milk chocolate. The more diluted the finished cocoa, the less flavonoids in each serving. According to one research study, a 40 gram serving (about the size of a standard chocolate candy bar) of milk chocolate contains about 400 milligrams of antioxidants. This is equal to a typical serving of red wine, which has also been recommended for its flavonoid content.

Eat well, eat healthy, enjoy life!

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