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?

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 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

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 [...]]]> 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!

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

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: 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.

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: 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!

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

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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?

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: 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!

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

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: 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

Q: My husband has type 2 diabetes as well as congestive heart failure. He is 67.5 years old, is 5′7″ and weighs 313 lbs. Is there a place where I can get recipes that deal with all three issues?

A: It is well established that a Mediterranean style diet can help control diabetes. Likewise, this can help lower cholesterol, raise HDL (good) cholesterol, lower LDL (bad) cholesterol and lower blood pressure. For our patients with congestive heart failure (CHF) we generally want them to be on a low sodium diet as well, which limits the patient to 1,500 milligrams per day of sodium. Diabetes and CHF

A: Both of these fishes would [...]]]> Q: My husband is on Coumadin (warfarin), is diabetic, has hypertension, gout and arthritis. His favorite food is sashimi (tuna and salmon); is it okay for him to eat it?

A: Both of these fishes would be fine for him to eat. Here are some links to other questions about sushi: Sushi, Cholesterol, Sodium and More

There are a number of reasons why you should make a healthy breakfast part of your life. When you consider that you had dinner at [...]]]> It looks like your mother was right (she knew it all along). Breakfast may just be the most important meal of the day.

There are a number of reasons why you should make a healthy breakfast part of your life. When you consider that you had dinner at 6:00 or 7:00 the night before and you might get up for breakfast at 6:00 A.M. you have already gone about 12 hours without eating. By not having breakfast and waiting until your “coffee break” or lunch adds even more time. By the time you get around to eating it could be that your body has been starving for as long as 18 hours.

It’s well established that such long periods of starvation will lower your metabolism. The body essentially slows itself to hold onto stored calories and this can have an effect how easy it is for you to lose weight. At the same time, the research shows those who are overweight consume a larger portion of their daily calories before noon instead later in the day have an easier time losing weight.

The type of breakfast makes a difference in how easy it is to lose weight. In one research study participants who ate cereals, quickbreads (like banana bread or zucchini bread) or muffins had a lower Body Mass Index (BMI) when compared to those having meat and eggs. (The meat and egg eaters tended to eat more calories, which makes sense.) Having whole grain and cooked cereals fared better for folks than ready to eat cereals or muffins. (JACN 2003, 22: 296-302)

Studies have also shown that those who skip breakfast have a higher BMI. Likewise, there’s good research showing that breakfast eaters with a lower Body Mass Index are more likely to eat their meals more regularly throughout the day. (AJCN l992;55:645-5l) Similarly those eating early in the day are less likely to snack during the day. When those who do have breakfast have snacks they tend to snack more sensibly.

Eating breakfast regularly even helps with improving cholesterol profiles. In one study women who didn’t eat breakfast have higher total cholesterol and LDL (bad) cholesterol. Those women also had developed problems in how their insulin responds to eating. Such changes in insulin response are now clearly linked to heart disease and diabetes. (AJCN 2005;81:388-96)

Researchers looking at data from the large long-term Physician’s Health Study found that those eating breakfast cereal had lower rates of heart failure. Those who had two servings of high-fiber cereal per week had a reduced risk of heart failure of almost 20%. (Arch Int Med 2007;167:2080-2085)

Studies go on and on to reinforce the importance of breakfast as being the most important meal of the day. Start with a high fiber cereal, whole grain toast, muffins or quickbreads and you’ll be satisfied and less likely to eat more during the day.

So your mom was right (and probably about more than just breakfast). Eat breakfast and get your day started right!

What’s a healthy breakfast? Here are some guidelines.

A: The Dr. Gourmet recipes, books and [...]]]> Q: I am taking Coumadin and also have type 2 diabetes. Is your book, The Quality Calorie Diet for Coumadin Users, compatible with a healthy diabetic diet?

A: The Dr. Gourmet recipes, books and The Real World Diet planner are all based on a Mediterranean style diet. We know now that this is the most effective diet for diabetics, especially Type II diabetics. Here’s the link to information about diabetes on the Dr. Gourmet web site: Diabetes

It’s been a great year for nutrition research and some of the best has been for diabetics. There was breakthrough research showing that the Mediterranean style diet is the best diet for those with diabetes: The Mediterranean Diet IS a Diabetic Diet!

Here are a few other studies that I found especially interesting:

Alcohol and Type 2 Diabetes
You’re almost certainly aware by now that being overweight is just one of the risk factors for type 2 (non-insulin-dependent) diabetes. But you may not know that uncontrolled diabetes can lead to vision loss, kidney failure, amputations, heart problems, and sexual dysfunction – among other long-term effects.

A Little More Fiber Can Help You Reduce Your Risk of Diabetes
More and more children and adolescents are considered overweight or even obese, leading to a related rise in the cases of insulin resistance, pre-diabetes, and type 2 diabetes among children. This is usually attributed to the amount of sugar in their diets combined with the poor quality carbohydrates they eat.

A Look at Vinegar and Diabetes
There may be something to vinegar and diabetes after all: two studies from Arizona State University’s Department of Nutrition, led by Carol S. Johnston, PhD., suggest that taking apple cider vinegar orally may help improve insulin sensitivity and glucose levels.

Here’s hoping you have a happy and healthy New Year.

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

A: There has been good research on this spice and [...]]]> Q: I have read that cinnamon helps control blood sugar levels. Is this true, and how much cinnamon would one have to eat daily?

A: There has been good research on this spice and how it might help control blood sugars. These have been well controlled, blinded studies. Unfortunately, the research has had small study groups — generally less than 60 participants. Some studies have shown benefit of a reduction in the Hemoglobin A1c (a 90 day average of blood sugars) by almost 1%. Cinnamon and Diabetes

http://opa.yale.edu/news/article.aspx?id=7013

If you want more great info and a look at the Nutrition Facts of cereals click this link:

http://cerealfacts.org/

This is a great organization that [...]]]> OK, sarcasm aside, there’s a great report by the Yale University Rudd Center for Food Policy and Obesity that shows how marketing has an profound effect on our children’s nutrition.  Here’s the link:

http://opa.yale.edu/news/article.aspx?id=7013

If you want more great info and a look at the Nutrition Facts of cereals click this link:

http://cerealfacts.org/

This is a great organization that looks at exactly what the impact of cereal marketing has on consumption.

Q: I am lactose intolerant and prediabetic. I have recently started using a dairy substitute product called “Almond Breeze”. My husband and I really like it (he is diabetic). We use the vanilla [...]]]>

Q: I am lactose intolerant and prediabetic. I have recently started using a dairy substitute product called “Almond Breeze”. My husband and I really like it (he is diabetic). We use the vanilla flavored unsweetened kind. It only has 45 calories and has 30% calcium, same as milk. Is this product safe for us to use? Can this product be used the same as milk in recipes?

A: This is a great choice for you. Almond Breeze is the brand name for a milk-like product made from almonds. It is produced by the Blue Diamond almond growers cooperative. There’s not much in it other than water and almonds. The tapioca starch you see on the ingredient listing is to help with thickening. While there is some added calcium listed on the package, almonds contain a lot of calcium. Almond Breeze Dairy Substitute

It’s clear that those in Mediterranean cultures consume less meat and eat leaner meats than those in Western [...]]]> [This article is part of an ongoing series on The How and Why of Eating Healthy. Read the whole series to date.]

It’s clear that those in Mediterranean cultures consume less meat and eat leaner meats than those in Western cultures. Diet studies reveal that they consume an average of 4 ounces or less of meat each day, so a lot of prospective research has been undertaken to focus on the effect of consuming less meat.

In one study, a group consuming less lean beef or pork as part of a lower fat diet showed improvements in cholesterol profiles similar to those who ate fish and chicken instead. This appears to be result of the negative effect that foods higher in saturated fat have on cholesterol profiles. The Mediterranean Diet: Meat

In 2004 Dr. Johnston submitted a brief report to the journal Diabetes Care. She and her [...]]]> There may be something to vinegar and diabetes after all: two studies from Arizona State University’s Department of Nutrition, led by Carol S. Johnston, PhD., suggest that taking apple cider vinegar orally may help improve insulin sensitivity and glucose levels.

In 2004 Dr. Johnston submitted a brief report to the journal Diabetes Care. She and her team recruited 8 non-diabetics, 11 people who were insulin resistant (pre-diabetic) and 10 people with diagnosed type 2 diabetes. The participants drank either a diluted and sweetened vinegar solution or a placebo, then ate a standard meal. Their blood was collected before the meal and then 30 and 60 minutes later and tested for glucose and insulin analysis. A Look at Vinegar and Diabetes

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!

We know that a Mediterranean style diet that’s [...]]]> The traditional American Diabetic Association diet that we teach patients is done.  Dead.  I’ve thought this for some time but not had proof.  The mounting evidence is clear that a change is needed now.  I predict that it will take a long time before this becomes the standard.

We know that a Mediterranean style diet that’s high in fiber, fruits, veggies, legumes and monounsaturated fat is what works:

http://care.diabetesjournals.org/content/32/12/2168.abstract

http://www.annals.org/content/151/5/306.abstract

http://www.executivehm.com/news/cost-of-obesity-in-the-united-states/

Under most circumstances, [...]]]> What causes heart disease? Among others, the major culprits are lack of exercise, smoking, obesity and poor diet. These can also cause high blood pressure and diabetes, both of which are also risk factors for heart disease.

Under most circumstances, research done on lifestyle changes to prevent heart disease focuses on whether risk factors like high blood pressure and diabetes numbers are improved – not whether a person’s risk of heart disease itself is improved. In an effort to measure whether that risk is improved or not through lifestyle modification, researchers at Johns Hopkins made use of data collected through a large-scale research study called PREMIER. Reducing Your Risk of Heart Disease

You can always check to see if your question, [...]]]> 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 checking our main Ask Dr. Gourmet page.

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 website 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)?

Weight Loss / The Quality Calorie Diet

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 Quality Calorie Diet (formerly My eatTHISdiet) or the Dr. Gourmet website?

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

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?

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’s no selection for a diabetic diet [...]]]>

Dear Dr. Gourmet,

Q: I want to add diabetic to my The Quality Calorie Diet profile of Coumadin and low sodium. It is not a choice on signin. How can I do that?

A: There’s no selection for a diabetic diet because the foundation of Dr. Gourmet recipes and the Quality Calorie Diet is the Mediterranean style diet. Both the American Diabetic Association diet and the American Heart Association diet are based on this style diet. We work hard to keep recipes high in fiber, low in saturated fat and lower in sodium. Diabetes and The Quality Calorie Diet

Q: I was on your site looking at your GERD book, and I noticed a few of the recipes have lemon juice, onion or garlic. It was my understanding that all of those were really big stomach upsetters, what is the truth? Everything I read says to avoid citric acid, but that is in almost everything – they use it as preservative among many other uses. It’s usually at the end of the list of ingredients, but still there nonetheless. Should that be something to look out for? Any advice on this would help; I’ve gone to the doctors more times than I can count and they really are not knowledgeable in this area.

A: GERD triggers are generally specific to each individual and one person might be able to tolerate chocolate where another can’t. The same holds true for such things as lemon juice, onions and garlic.

Start slow. Use recipes with one ingredient that might bother you at a time to see what triggers your reflux. Sometimes that might even be a recipe with a lot of garlic where only a single clove does not provoke symptoms. GERD Triggers in Cooking

Q: A reader from your website asked about Resveratrol. I purchased Resveratrol plus, but noticed that a lot of the ingredients listed Grape Seed Extract. My question is: Would there be any difference in taking just one supplement of Grape Seed Extract that is much cheaper than Resveratrol? Or is the most effect obtained in the Resveratrol?

A: There’s absolutely no evidence that taking such supplements are helpful in any way. The more concerning issue is that we don’t have any evidence about whether such pills might be harmful. We have only early evidence about this molecule in the lab at this time and there is no practical application yet. Resveratrol

Update:

Here’s another comment from one of our readers, Mr. Spitzer, on flaxseed:

“In your column about flax seed, you said that it must be crushed to be digestible. I buy Hodgson Mill flax that is already crushed or milled. After I open the box I store it in the refrigerator. This is more convenient than grinding the whole seed yourself. But, is it as nutritious? Chia seed does not require refrigeration and I eat some whole or crush in a blender.”

To answer your question, Ron, this is a fantastic idea. Chia seed is a great choice and just as nutritious. Refrigeration for both items is a good idea because it does prolong shelf life.

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: Dry roasted peanuts are just that. They are roasted in ovens without any added fat or oil.

Q: Does cooking affect lactose? For [...]]]>

Dear Dr. Gourmet,

Q: Are dry roasted peanuts actually fried?

A: Dry roasted peanuts are just that. They are roasted in ovens without any added fat or oil.

Q: Does cooking affect lactose? For example, will baked goods made with milk be OK for someone with lactose intolerance?

A: Lactose is a sugar that is made up of two different sugar molecules. The disaccharide (di for two and saccharide for sugar) is made up of the two sugar molecules galactose and glucose. The bond that holds these two sugars together is broken by an enzyme called lactase. The reason that many folks are lactose intolerant is because their bodies don’t make the enzyme lactase. Lactose and Cooking

Q: Are there any particular diet plans or guidelines in your diets that would acommodate a medicine-controlled Type 2 female diabetic

A: Diet is one of the cornerstones of treating diabetes. For diabetics that don’t make any insulin (juvenile or Type I diabetics) eating similar meals at similar times of day is important because they are working to time insulin release to their eating habits.

For Type II diabetics diet is key because very often it is being overweight that causes the diabetes so timing of meals is not as crucial (it is still important). It is the number of calories and working on slow steady weight loss that is of tremendous benefit. Many times getting back to a normal weight will control the diabetes without needing medicine. Guidelines for a Diabetic Diet

Update:

Here’s a timely suggestion from one of our readers. Thanks to the Weber family for this great idea:

“I just finished one of your articles concerning the use of flax seeds. The concern of digestion of the seed was asked. To make it simple we use a coffee grinder daily to grind the seeds. This is then added to a juice and taken daily. A great natural.”

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: We doctors have an expression about the effect of medications on the [...]]]>

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 the dose. Lactose in Cheeses

Q: I purchased several small bottles of balsamic vinegar for party favors for friends. Once home, I noticed that the warning on the side says that this product contains lead! Why would balsamic vinegar contain lead? Or is the glass bottle it’s in? I’m concerned about ingesting this type of chemical. Are all balsamic vinegars made that way?

A: I checked with an importer and it appears that there are trace amounts of lead in some vinegars. The key word is trace amounts. The controversy grows out of a group known as the Environmental Law Foundation who sued a number of manufacturers and sellers of balsamic vinegars because their products contained lead. In California, under a law passed in 1986, no food products may be sold that contain certain toxins without a warning. Balsamic Vinegar and Lead

Q: Why isn’t Diabetes Type 2 included as an optional condition (like Coumadin use or low-sodium) in The Quality Calorie Diet?

A: All of the meal plans are written to conform to the guidelines of the American Heart Association and the American Diabetes Association. The Quality Calorie Diet and Diabetes

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. Aluminum and Alzheimer’s

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: One of the most common areas where we have folks restrict potassium is when they [...]]]>

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)

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