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!

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.

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: 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!

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?

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.

A: I have read this many times before and there have been people who have [...]]]> Dear Dr. Gourmet,

Q: Is it true that olive oil loses its health benefits when it is used to saute? I read somewhere that it does.

A: I have read this many times before and there have been people who have written to me about the topic. They have, in fact, been quite adamant that heating olive oil is very bad and unhealthy. The claims range from the heat producing everything from carcinogens contained in the smoke created by heating, to conversion to trans-fats.

Fortunately, the science doesn’t support these claims. A group whose report was published in the Journal of Agricultural Food Chemistry heated olive oil to 350°F for 36 hours. Heating Olive Oil

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. Substitutes for Fish or Shellfish

Q: I am one of those people who cannot use Splenda, or a lot of the ones that replace sugar. I get rashes, my hair falls out, huge tummy issues!

I need to know how to use your diets to help lose weight and not use Splenda and eat better.

A: There are some Dr. Gourmet recipes that use Splenda, but you do have options. The recipes have been tested with three sweeteners: granulated sugar, stevia and Splenda. All three will work and there are instructions on many of the recipes regarding this. Substitutes for Splenda

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.

There are a lot of vitamins sold today. They [...]]]> [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 are a lot of vitamins sold today. They come in all forms – pills, capsules, packets of pills and supplement drinks. We now have more and more good research that says they are pretty much worthless. We know that vitamins are good for you, but the research is now clear that getting your vitamins from food and not supplements is better for you. Vitamins and Supplements

Featured Recipes

Fusilli with Morels and Roasted Garlic | Low Sodium Version

When I told a friend that I had some fresh morels, they asked how I was going to prepare them. “As simply as possible” was my reply. There’s so much great flavor in these guys that you don’t need much. Garlic, shallots, butter… that’s all you need.

Polenta and Eggs

If I had a nickel for every time in the last year I have said, “eggs are OK; quit worrying about them,” I would be pretty rich by now. They’re OK and this is a great way to have them. It’s sort of like toad in the hole with great flavorful carbs and rich yummy eggs.

Exercise Ideas:
Play Video Games!
Exercise with Jacques Courseault, M.D.

Video games aren’t just for kids! According to a recent report, 53 percent of American adults play video games, and one in five adults (21%) play every day or almost every day. While sedentary behavior is linked to chronic diseases and obesity, new, active video games systems may help you meet your weekly exercise recommendations. Play Video Games!

Frankly: noni has a horrible flavour, but mangosteens are delicious, and I [...]]]> Q: Since you’ve already addressed the overinflated claims (and prices) of noni and acai, I’m wondering about your opinion of mangosteen products (e.g. Xango).

Frankly: noni has a horrible flavour, but mangosteens are delicious, and I get them fresh where I live (Honduras). The same people who touted noni juice are now on the mangosteen bandwagon, though, but it all just seems like more “snake oil” and “patent medicine” to me.

A: I will admit to not having eaten mangosteen, but I have heard that it is pretty tasty. You are right about the “snake oil” claims for these juices. They may be high in antioxidants, but so are most fruits. We do know that juices are not the best way for getting your antioxidants: better to eat the fruit itself. Mangosteen / Xango

A: There’s no research that I have found about any interaction between [...]]]> Q: I’m looking into taking acai berry as a supplement. Will it have any negative reaction with the Tegretol I am taking for epilepsy?

A: There’s no research that I have found about any interaction between acai berry and tegretol. There is, however, great research that says….

A: There’s no evidence at all that resveratrol is beneficial. None, nada, zip. There is [...]]]> Q: I have been hearing a lot about the positive affects of Resveratrol. Could I take that supplement along with Coumadin (warfarin)?

A: There’s no evidence at all that resveratrol is beneficial. None, nada, zip. There is some research that indicates foods containing resveratrol may offer benefit but that’s not conclusive. Coumadin and Resveratrol

A: I believe that such products are a scam. Pure [...]]]> Q: Can Juvenon and other natural cellular health supplements really slow the aging process? As this is a new phenomenon, are there any possible long-term negative effects you could foresee?

A: I believe that such products are a scam. Pure and simple, supplements like these are designed only to take your money. There is no substantial proof that such supplements will benefit you. This particular group offers a page of scientific articles to help you feel good that they are telling you the truth. After all, if there’s science to back up the use of expensive supplements, you’ll want to purchase their product. Right? Don’t you believe it! Juvenon

Q: Can I take the PGX or PolyGlycopleX, a water soluble plant fibre, along with my Coumadin (warfarin)?

Q: I’ve been checking the internet [...]]]> Two related questions came in from two different readers:

Q: Can I take the PGX or PolyGlycopleX, a water soluble plant fibre, along with my Coumadin (warfarin)?

Q: I’ve been checking the internet for some low-fat crock pot recipes, and one website kept mentioning Miracle Noodles. Have you ever heard of them? They seem harmless enough, so I thought I might try some, but I wanted to check with you first.

A: This is not the first time that I have been asked about these products. In addition to many brand names, such as PGX and PolyGlycoplex, you’ll also find a related product that folks eat, Glucomannan. This is a calorie free starch that’s generally used as a thickener, as well as in a host of nutritional supplements, but is also made into calorie free noodles such as the Miracle Noodles. PGX, PolyGlycopleX, Glucomannan, etc.

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 is some [...]]]>

Dear Dr. Gourmet,

Q: Do you have any advice for a supplement for lowering cholesterol without liver damage? I heard that CoQ10 with red yeast rice does damage to the liver. Is there an effective, safer supplement?

A: There is some evidence that red rice yeast does lower cholesterol. It is not clear if this effect helps prevent heart attack as do eating a healthy diet and some pharmaceutical medications on the market. It appears to be fairly safe. Here’s a great review: CoQ10 with Red Yeast Rice

Q: Can you tell me how much Vitamin K is in Spring Mix salad mix? Yes, I am on Coumadin.

A: Since spring mix has no real meaning it would be one to be careful with. There could be any of a number of lettuces or cabbages in it that are very high in Vitamin K.

Q: I have a question about Sai-fun noodles used in Asian cooking. My husband calls them “slimy noodles,” but I think they are also called cellophane noodles. Since they are made of mung beans, do they count as a carb or a vegetable?

A: Saifun noodles are often called cellophane noodles. They are produced from flour made from mung beans. As such they are considered a carbohydrate. According to the USDA database…. Saifun Noodles

Q: Does it make any difference what kind of pot you cook hard boiled eggs in – aluminum, stainless steel, etc.?

A: The type of pot should not make much difference. The main concern would be if you used a heavier pot that might hold heat better. The water would remain at a higher temperature and possibly be a little overcooked. Making Hard Boiled Eggs

Q: How long does it take for the odor of baking soda mixed into chili last? Will it ruin the taste of the chili?

A: I have not tried this technique in chili but will try this soon. The experiment with using baking soda in the tomato sauce took about eleven tries before I felt that it was just right. Using a pH meter and finding the least amount that would make an acid neutral sauce and not ruin the taste took time. Making GERD-Friendly Chili

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.

Many doctors say that women [...]]]>

Breast Cancer and Calcium Supplements

You may have heard that certain vitamin supplements can help you reduce your risk of breast cancer. One in particular that you’ve probably heard about is calcium supplements with vitamin D.

Many doctors say that women would do well to take a calcium supplement containing vitamin d in order to help prevent bone loss. The science for the current recommendations of 1200 milligrams per day may not be great, but there is some. The proof for calcium and breast cancer, however, doesn’t appear to be nearly as good. Breast Cancer and Calcium Supplements

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)

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: At this time there [...]]]>

Dear Dr. Gourmet,

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 website to help you.

Q: I’ve signed up for The Quality Calorie Diet. I selected 1800 calories per day (not “Let Dr. Gourmet decide”) and it keeps returning to 2300 calories for me. Is there a problem with the program?

A: If you’re exercising regularly and have listed your exercises in your profile, the system will add the calories you burn while exercising to the level of calories you have chosen. So if you’re averaging burning 500 calories per day exercising, choosing 1800 (base) calories per day will yield a 2300 calorie-per-day diet. To be allotted only 1800 calories per day in your diet, you have two choices….

Q: I take 5mg of Coumadin daily. I have a supplement that contains the acai berry. The ingredients are: psyllium seed, fennel seed, buckthorn bark, goldenseal whole herb, cascara sagrada bark, rhubarb root, licorice root, ginger root and acai fruit. From my understanding goldenseal can decrease the effects of Coumadin and ginger can increase it. I was interested in taking this product but I am worried about the overall effects. Any advice?

A: Acai berry as a supplement is just plain silly, whether you are taking Coumadin (warfarin) or not. Being on warfarin, you should be very concerned about taking any sort of supplement. There’s no telling what might might or might not be in what you are taking and what effect it might have on your INR levels.

Q: I have just seen your website for the first time and I certainly find it interesting. I am sure that I will be trying some of your recipes. I couldn’t help but notice an advertisement for Campbell’s Soups, most of which contain MSG. As a person who is severely allergic to MSG, what is your take on advertising such products?

A: This is always a difficult question. We do fund our web site through advertising and we work hard to monitor what ads are displayed. For example, we do not allow ads for pharmaceutical products, supplements or fast food products, and if they do creep in we remove them as soon as they are identified. Campbell’s does have some soups that are advertised on the site through an advertising network that we use. In one recipe on the web site I even use one of their products in a Tuna Noodle Casserole. This is from their Healthy Requests line and does not contain any MSG by their report.

Some of their soups do contain MSG and this can be a problem – not just from the standpoint of the amount of added sodium, but also because of issues like yours. While I am not allergic, I do have what I feel are some mild reactions to too much MSG (I don’t eat at very many Asian restaurants as a result). Allergies are a serious issue for some, but our allowing Campbell’s to advertise is the same as allowing Planter’s nuts to advertise….

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 have found that [...]]]>

Dear Dr. Gourmet,

Q: What research have you done concerning high fructose corn syrup? Some health experts are telling us to stop drinking sodas because of either the high sugar content or the high fructose corn syrup.

I have found that when I eat high fructose corn syrup I can’t sleep. It’s like I’ve had too much caffeine. But how do I avoid it, especially when eating out?

We went to Applebee’s and I asked about HFCS; it was in everything I wanted to order. I couldn’t even order plain cooked vegetables because the seasoning had HFCS in it. Another high class expensive restaurant in downtown Seattle, though, refuses to serve anything with HFCS in it. The manager said, “I think it will be the death of the human race.”

A: You are right that there is a lot of controversy about high fructose corn syrup (HFCS) these days. I have done a lot of reading and looked at the research that we have now and I find that it is inconclusive. We simply don’t know for sure if eating HFCS is any more harmful than sucrose (table sugar). Some research says yes and some says no. Some indicates that it has contributed to the problems of obesity and others not.

People have reported reactions such as you have had to many “artificial” foods such as aspartame, Splenda and MSG. Whether this is widespread with HFCS….

Q: My eatTHISdiet has chosen the 1500 calorie diet for me, but I am a new mother (5 month old) and want to be sure that 1500 calories will be enough to support healthy breastfeeding.

A: This is a fantastic question and you are correct that moms who are breastfeeding do need extra calories. Depending on your size, the estimate runs from about 300 – 500 extra calories per day over what your body would normally use.

For most women this will be in the 1,800 to 2,000 calorie range. There is some evidence that eating less than 1,500 calories could put your breastfeeding at risk. More on Breastfeeding.

Q: I subscribe to and enjoy your newsletter. I use your advice basically to help my 82 year old mother who is on Coumadin. I am wondering whether you are aware of any multivitamins that have no or low concentration of Vitamin K. My mother wants to take a multivitamin but all of the ones she has found to date contain pretty hefty amounts of vitamin K.

A: There are multivitamins available without Vitamin K. I do not endorse any specific ones, so I do not list them on the website.

Simply ask your local pharmacist to order a multivitamin without Vitamin K if he or she doesn’t have any in stock.

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: As [...]]]>

Dear Dr. Gourmet,

Q: I was reading your article about BMI and WHR today. I didn’t understand what one had to do with the other. What is a good Waist to Hip Ratio and what is a bad one?

A: As a physician I look to have an idea of how my patient’s health might be overall. I am looking for certain risk factors for disease and the research has come to show that being overweight or obese can be an issue. In looking at my patient’s weight I want to have a guide of what a healthy weight is but we now also know that the distribution of the weight on the body is an important factor.

Body Mass Index (BMI) is an indirect measure of weight as it relates to height. It’s not a perfect measurement but for most folks it can give us an indication of whether they are overweight or obese. Because it is an inexpensive measurement, BMI is widely used in research to substitute for much more sophisticated measures of body composition, including such things as body fat percentage. Because the measures only take into account height and weight, the measure can be inaccurate for those who are very muscular (they may weight a lot, but the weight is in healthy muscle not fat). This is where Waist to Hip Ratio (WHR) comes in.

Q: I am a Coumadin user. Recently one of my physicians suggested that I take a dietary supplement: “Dr. Sears ZONE – Metabolic Digestive Support” on the condition that I could find out if the ingredients in the supplement would interact with Coumadin. Usually, I go to the pharmacist for such information. This time, I was told that the ingredients in the supplement are not in their system and they cannot help me, except to verify that the Green Tea Extract would change my Protime.

I am seeking your help. The following are the active ingredients in the supplement: “Green Tea Extract – 250mg; Bromelain (600 GDU) 600mg; Querceint – 50 mg; M.E. Complex 3000mg. In a proprietary blend of papain, lipase, pancreatin, ajowan extract, fennel extract, lactase, multi enzyme complex. Other ingredients: Gelatin, microcrystalline cellulose, magnesium stearate and silica.”

A: I would be very careful about consuming any product that contains Green Tea Extract. While it appears that green tea itself can be healthy, this may not be the case with the extract.

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.

That said, cholesterol content of foods is important to consider, but a more important factor in eating a healthy diet to lower cholesterol is the amount of fat and types of fats in the foods you choose.

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: Our spaghetti sauce recipes are [...]]]>

Dear Dr. Gourmet,

Q: I was looking for a recipe for spaghetti sauce. I would like to use it for canning. Do you have a good and healthy way to make home made spaghetti sauce?

A: Our spaghetti sauce recipes are not suitable for traditional canning.

For years it has been felt that canning tomato sauce is safe, but the issue is first and foremost which particular recipe that you use. Traditional canning of acidic foods, such as fruits and tomatoes (not in sauce), in a water bath is felt to be safe because of their higher acidity. The U.S.D.A., however, cautions that because many of the tomatoes on the market today are sweeter (lower acid) they may not be safe.

The issue with spaghetti sauce is that it includes foods that are lower acid, such as onions, garlic or peppers. Using the traditional canning process…

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.

That said, I have had patient after patient who has made substantial changes in their diet who have had complete resolution of their GERD symptoms even with reintroduction of their trigger foods. The best strategy….

Q: Tonight on the news there was a segment about PGX or Polyglycoplex. It is a fiber supplement that supposedly reduces cholesterol and can help you lose .5 to 2 pounds a week. I was wondering if you have heard of this and what your opinion is on it.

A: I reviewed the article that you mention in your email and it’s just plain speculation. One of the problems these days is that such supplements are very poorly regulated by the Food and Drug Administration. There is, in fact, almost no regulation and any supplement that you take should be suspect. We have good science now that is showing that even Vitamin supplements are not helpful.

We do know that a high fiber diet helps folks lose weight. We also know that it helps with controlling cholesterol. This is, however, high fiber foods and the research on fiber 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.

A: Tapioca is a starch that is made from the cassava root. The root is native to South America but has been cultivated around the world for some [...]]]>

Dear Dr. Gourmet,

Q: Just what is tapioca, anyway?

A: Tapioca is a starch that is made from the cassava root. The root is native to South America but has been cultivated around the world for some time now. The root is processed into many different forms: powder, flakes and a coarse flour. The most common form found in Western culture is pearl tapioca….

Q: There has been a lot of discussion about the flavors you can add to your water for variation. For example: the generic brand of Crystal Light, actually marketed by Wal-Mart: Sugar Free Pink Lemonade individual packets. 5 calories, 0 fat, 0 sodium, potassium 50 mgs, and 0 carbs, 0 sugars, 0 proteins.

It only has taste value… nothing nutritional. It does contain aspartame. It is okay to drink this a few times a day with my daily 64 or more ounces of water?

A: This is certainly controversial. On the one hand these are chemicals that create the artificial flavors and colors in water. It appears that they are safe for you. The second issue is aspartame which many folks feel is very harmful. The present evidence, however, doesn’t seem to support this.

The main issue is whether using artificial flavors and sweeteners is better than or as good for you as water. My answer is….

Q: I have recently begun taking wheatgrass (1-2 oz daily) and sweetpea green (1-2oz daily) juice(s) along with carrot/celery juice (1-2 carrots + 1-2 stalks of celery). My wife takes 2-3mg of Coumadin daily. Can she join me in benefits of these juices, perhaps in small degrees?

A: Wheatgrass is an interesting item. Folks really believe that it has properties that are far beyond what the claims could possibly provide. There’s no science to back up such claims unfortunately. I have repeatedly tried to find the nutritional content and what information is available is deemed unreliable by most sources (mostly because it is not considered a food source).

It doesn’t appear to be harmful – but then again there’s no research to show that it might be good for you, either.

Sweet pea green juice has even less information.

As such it’s hard to give you a good solid evidenced based recommendation….

A: There’s [...]]]>

Dear Dr. Gourmet,

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….

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