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Dr. Gourmet
08 October 2007 @ 10:03 am

A few weeks ago I laid responsibility for obesity in America at the feet of the fast food companies. A bit over the top, maybe, but not too far fetched. My comments did elicit some responses as you might expect.

One writer very graciously noted, "They certainly are partly responsible; particularly in lower-income communities. But the problem of obesity is far greater than the fast-food companies… The problem is multi-faceted and includes the problem created by many in the restaurant industry of serving portions that are far greater than any one of us should eat."

While there is no definitive research that says "fast food makes you fat," there's enough evidence that says it is a major contributor. Certainly the issue of portion size is a big contributor to obesity (pun intended). In one of my favorite studies, a group of researchers at the University of Wisconsin estimated just how much supersizing costs you in the long run.

Their study took into account the difference in price between a regular and a supersized meal. At the same time they estimated the weight gain over time from the added calories in the larger portions. Their bottom line? The larger meal cost an additional 17% at the cash register and provided an additional 73% more calories than a regular meal. The hidden costs in the health problems from weight gain added somewhere between 123% and 191% to the overall cost of the meal.

Such research and conclusions are supported by USDA estimates that puts added health care costs from obesity at $71 billion per year. If you haven't seen the film "Supersize Me," you should. In it, Morgan Spurlock eats only McDonalds for a month and supersizes the meals whenever offered the option at the cash register. The results are devastating to his health and are documented in the film.

So can it be done? Can you eat fast food and do OK? Only if you're really, really careful. There are a number of people now who have eaten only at McDonalds but made more intelligent choices than in Mr. Spurlock's experiment and actually lost weight. After all, he did supersize most meals and often ate as many as 5,000 calories per day.

I went into McDonalds today to see what was available. This is a dismal place and looked and smelled dirty. The décor is tired and the odor greasy. The general fare was on offer and hamburgers were much cheaper than the healthier options. Salads were $5.00 and there's not much more that could be considered healthy.

The only inexpensive healthy option is a Chipotle BBQ Snack Wrap with Grilled Chicken. It's a reasonable choice at only 260 calories and 8 grams of fat. Why then do they call it a "snack?" Their regular hamburger is 250 calories and 9 grams of fat, but isn't labeled as a snack. This is the sort of attitude that doesn't lead to healthy eating - it leads to overeating.

In short, is the fast food industry responsible for obesity? In my opinion, yes. Just because other industries and companies also play a role doesn't excuse that guilt. If Ronald and Wendy rob your house together, Ron bears full responsibility along with Wendy.

But certainly more important is that the food is just plain awful. Life's just too important to eat terrible food, especially food that's going to make you fat and unhealthy.

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 
 
Dr. Gourmet
03 October 2007 @ 10:02 am

When scientific studies are reported on in the media they can appear far more conclusive than they really are. For example, many clinical studies in humans have shown a link between high sodium (salt) intake and high blood pressure. Based on that evidence, the American Heart Association has recommended a maximum daily intake of less than 2300 milligrams of sodium. Yet there are still those scientists who argue, based on other studies, that improving overall dietary quality, including high intake of fruits and vegetables and adequate intake of minerals like potassium and calcium, is just as important as salt intake to reducing high blood pressure in humans.

These conflicting interpretations of scientific studies in humans are perfectly reasonable when you realize that the effects of changes in the human diet are affected by multiple variables, including age, gender, body weight, smoking status, and more. It's simply not feasible to control all other variables so that the effects of salt intake can be assessed as accurately as possible.

That said, it is possible to control all other dietary variables - if you don't use humans.

An international group of scientists studied the effects of varying levels of salt intake in chimpanzees, our closest genetic neighbors (Circulation. 2007;116:1563-1568). Unlike studies of humans, the scientists were able to control the monkeys' dietary intake with great accuracy, as their diet consisted solely of vegetables and fruits supplemented with dietary "biscuits." These biscuits provided the chimps with potassium, calcium, and salt in specific amounts, so the biscuits could be manipulated to provide varying levels of sodium in the monkeys' diet. Obviously humans would find it difficult to tolerate such a restricted diet - nor could they participate in such a study for the term of this study, which was over two years in length.

The results are striking: Increases in sodium intake were clearly linked to increases in blood pressure. Similarly, decreases in blood pressure were seen along with dietary decreases in salt intake. The amount of salt in the monkeys' diet, unlike other, previous studies, was similar to the amount of salt in that of humans and represented the high sodium intake of a typical Western diet (as much as 6-8 grams of sodium per day) versus that of current recommendations (about 2 grams per day).

What this means for you

It's hard to draw conclusions from animal studies that clearly apply to humans, so you won't see me talking about them all that much. However, this one is pretty compelling, as it removes a lot of the complicating variables and controls the participants' salt intake very accurately and for an extended period of time. No study is absolutely conclusive, but this one adds a hefty weight to the sodium-intake side of the blood pressure debate.

 
 
Dr. Gourmet
01 October 2007 @ 10:05 am

I love pasta. In spite of what Dr. Atkins would have you believe, pasta is really good for you -- especially whole wheat pasta. The issue is not carbohydrates, but the portion size of pasta, and by keeping in mind that a serving is 2 ounces of uncooked pasta you’ll do fine.

Ruote Pasta
Ruote

One of my favorite things is how pasta is named. There’s a lot of reasons for the different shapes, and the most important is how a particular sauce will cling to whatever pasta you’re eating. The best part is that the names almost always have a meaning in Italian. Most commonly it’s what the pasta actually looks like.

Fettuccine means “little ribbons” and fettuccine is a little wider than linguine which means “little tongues.” Spaghetti which is thinner and round is named for “string.”

Farfalle
Farfalle

Penne is one of my favorites and these little tubes resemble a feather or quill and the Italian word for the writing instrument. You’ll find both penne lisce (smooth) and the more common penne rigate (lined). Ziti are long macaroni tubes (originally ziti was 18 inches long). The word comes from zito which is Italian for bridegroom so I’ll leave the derivation of calling an 18 inch tube after a bridegroom to your imagination.

Rigatoni are also tubes but with ridges. The word comes from the verb rigare meaning to draw a line (like the ridges).

In addition to the tongues there’s a lot of other human parts. Orecchiette are little ears, cappelletti look like little hats and capellini is known as angel hair pasta.

Here’s some others but there’s dozens and dozens more shapes. If you have a favorite that’s not included, do send them in and we’ll add them to the list.

Pasta Name Meaning
Orzo Barley
Fusilli Corkscrew
Farfalle Butterfly
Vermicelli Little worms
Ruote Wheels
Radatori Radiators
Lumache Snails
Gigli Lily
Gemelli Twins
Riso Rice
Campanelle Bells
Ditalini Little thimbles
Rocchetti Spool
Riccioli Curl
Rotini Spiral

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 

 
 
Dr. Gourmet
26 September 2007 @ 10:00 am

A study published in the American Journal of Preventive Medicine (2007;33 (4S): 209- S225) looks at the prevalence of sugared soft drinks in middle schools and high schools and reports on the just how much revenue soft drink sales generate for those schools. With adolescent overweight a current (and future) concern, you have to wonder if the revenues generated by soft drink sales are worth the long-term health costs.

The study focused on 345 middle schools and high schools in the 2004 and 2005 school years. As part of two ongoing surveys, data was gathered from school administrators as well as cafeteria workers and was collected anonymously to encourage honesty.

The study found that "the vast majority" of students have sugared soft drinks available to them through vending machines through most of the day as well as through the school-supplied cafeteria. Diet soft drinks were less available to students, while the most healthful option, bottled water, was available throughout the day through vending machines to less than 20% of middle school students and less than half of high school students.

Lunch time was the worst time for choosing healthy drinks, with nearly 50% of middle schoolers able to purchase sugared soft drinks at lunch, and nearly 60% of high schoolers. Diet soft drinks, interestingly, were the least available at lunch, while no information was available regarding whether students could purchase bottled water at lunch.

Given the market penetration of these products, you'd think that the schools would be generating a significant amount of income from their pouring rights contracts. Not so. On the average, high schools only generated about $6,000.00 per year. Total! Middle schools averaged only $500 per year.

What this means for you

One of the simple ways to eat healthy and have your kids eat healthy is to not drink soda. Soft drink companies bear some responsibility for the epidemic of obesity in both children and adults.

Given the significant impact that sugared soda has on weight, it seems clear that the benefits of removing sugared soft drinks from schools outweigh the financial advantages to the school district. Teach your children by example to reach for water before soda, and tell your school board to take the sale of sodas and sugared drinks out of the schools and make water easily available to your kids throughout the day.

 
 
Dr. Gourmet
24 September 2007 @ 10:16 am

A lot of my recipes use wine or other alcoholic beverages as important ingredients. Many people don’t wish to use any alcohol, however, and fortunately there are many alternatives now.

With the cooking process, most of the alcohol evaporates, but never completely. Quite simply, it depends on how long you cook a particular recipe. Keep in mind that there's less than a half-teaspoon of alcohol in a tablespoon of wine. Alcohol evaporates faster than the water in the wine, but there will still be a little alcohol left after cooking.

The amount that remains depends on what is being cooked, as noted in the table below. A stew, such as beef bourguignon, that cooks for a few hours will have time for more of the alcohol to burn off. On the other hand, a dish that is rapidly cooked, such as chicken piccata, may have as much as 50% of the alcohol remaining. So you could be getting as much as 1/4 teaspoon of alcohol in a serving of chicken piccata made with white wine. The same serving of the beef bourguignon will have about the same 1/4 teaspoon of alcohol, even though the recipe begins with 2 cups of wine.

Scientists at the USDA measured the alcohol content of foods prepared by different methods. This table shows the results of those experiments.

Preparation Method

% of Alcohol Retained

Alcohol added to boiling liquid & removed from heat

85%

Flamed (as with a flambé)

75%

No heat and stored overnight

70%

Baked for 25 minutes with the alcohol not stirred into mixture

45%

Baked or simmered with the alcohol stirred into mixture depends on the amount of time:

15 minutes

40%

30 minutes

35%

1 hour

25%

1 1/2 hours

20%

2 hours

10%

2 1/2 hours

5%

There are some very good non-alcoholic wines on the market -- some made by the better California vineyards. A long time friend and reader of this newsletter sends his comments on different choices and these are included as a separate article in this week’s newsletter. He was one of my first students in cooking class (I hope that’s not why he has chosen to use a pen name for his review).

To replace rum or bourbon, you can use extracts that have similar flavors. Extracts are concentrated liquids that flavor recipes but have little flavor of their own. They are made in a number of ways. Some flavors require distillation as with bourbon or vanilla extract and these are usually suspended in a small amount of alcohol. As a rule of thumb I factor about 1/2 teaspoon of extract in 2 tablespoons of water per serving in a dish such as the Pork Chops with Bourbon Pecan Sauce.

For a lot of people even the 25% contained in an extract is more than they wish to use but in that 1/2 tsp. there’s only 1/8 tsp. of alcohol. In a dish such as this, about 40% will burn off, leaving just over 1/16 of a teaspoon.

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 
 
 
Dr. Gourmet
19 September 2007 @ 01:52 pm

Food additives have long been suspected to be associated with increased hyperactivity in children. Previous studies have focused on children who had been formally diagnosed with ADHD, but not on those children in the general population. In a study recently published in The Lancet, researchers examined the effects of common food additives on children's behavior in both 3-year-olds and 8 or 9-year-olds (doi:10.1016/S0140-6736(07)61306-3).

Over 260 children (137 3-year-olds and 130 8/9-year-olds) completed the seven week study. Every day for a week at a time the children were given a pre-measured juice-flavored drink containing a group of food colorings and sodium benzoate (a preservative). One of three drink mixes were used: one placebo mix, with no food colorings or preservatives; one drink mix with a specific amount of sodium benzoate and food colorings; and a third drink mix with a greater amount of food colorings and the same amount of sodium benzoate as the other test mix. The amounts of both additives were 25% greater in the drinks given to the 8/9-year-olds to account for their larger food intake. For the duration of the study, the children's parents were asked to refrain from feeding their children any other foods that contained the preservative and food colorings used in the study.

The scientists then measured the levels of hyperactive behavior in the children using the combined assessments of trained observers, parental observation, and teacher observation.

All of the children showed increased levels of hyperactive behavior during the weeks they received the drinks containing food colorings and sodium benzoate. However, the younger children showed more hyperactive behavior while receiving the drink containing greater levels of food colorings, while the older children did not. Further, the individual children showed a wide range of effects from the drinks - some only slightly more hyperactive, some much more hyperactive.

The researchers note that it is impossible to assess exactly which compound was causing the hyperactive behavior and call for further study to establish whether the age-related differences in the effects of food coloring on the children's behavior could be replicated.

What this means for you

This study lends strong support to the notion that hyperactivity in children is related to the consumption of artificial food additives. Certainly highly-processed foods aren't that great for you OR your children - stick to fresh foods and you and your children will be healthier. Here are some ideas for snacks for your kids - and yourself.

 
 
Dr. Gourmet
10 September 2007 @ 11:17 am
Going out to eat is so easy these days, and it's so much a part of our lives that most of us don't think much about it. This is, however, key to both weight loss and to eating healthy. Because you're not in control of how the food is made and what goes in it it's hard to know exactly what you're eating. For a lot of folks this is where so many extra calories come from.

I have ten pretty simple rules that can help you make it easier to eat well, eat healthy and enjoy life.

No. 1 - Go out to eat, but when you go out, enjoy it.
Don't just eat out because there's no time to cook. Eating great food takes a bit of advance planning and being “trapped” into not cooking for yourself is the easiest way to end up eating food that's not so great tasting and not great for you.

When you do go, pick a restaurant before you go that you know will have great food.

No 2. - Stop going out so much.
Eating out is so easy now. Lots of patients tell me that they eat out more often than they have dinner at home. The key to being healthy is to begin making your own food and cooking from fresh ingredients.

This takes a little planning but there's so many great resources available. While there's plenty of recipes on the Dr. Gourmet web site there are also hundreds of thousands of great healthy meals to be found on the Internet and most of them take less than 30 minutes to cook.

That's less time than it takes to drive to most restaurants or even order in a calorie-dense but nutritionally empty pizza that tastes like the cardboard box it was delivered in.

No. 3 - Don't eat fast food.
Just don't. Just stop going to McDonald's, Burger King, Wendy's and any place like them. If the restaurant you go to doesn't make food fresh, don't go there.

I believe that in spite of what McDonald's would have you think, they and the fast food chains like them are responsible for the obesity epidemic. There's not much of anything on their menus that's very good for you. Most everything that is available is pre-made in a factory somewhere and not a lot different than what you find in a frozen TV dinner.

The research is clear that it's just as cheap now to make your own food. Not only is the meal less expensive, there's great evidence that you'll pay less in doctor's bills later.

No. 4 - If you do have to eat fast food, check out the lists on the Dr. Gourmet web site first.
There's a lot of info that will help you make better choice. These files can be downloaded as PDF documents so you can print them out and take them with you to the restaurant.

No. 5 - Don't go out to eat without a plan.
This is not much different from how to eat better in general. One of the easiest places to get tripped up is not thinking about where or what we're going to eat. If you have a plan, then it's more likely that you won't be needing to go out anyway.

The other five rules deal with decisions you make once you are in the restaurant. More on this in next week's Dr. Tim Says… column.

Eat well, eat healthy and enjoy life.

Dr. Gourmet

 
 
Dr. Gourmet
05 September 2007 @ 03:51 pm

Just last month I reported on a study that concluded that children will eat more when presented with a larger amount of food (News Bite, 8/1/07). Another study seemed to show that using a larger bowl (or plate, presumably) would result in serving and eating more than if a regular-sized bowl is used (10/6/06). These studies seem to shore up the widely-held belief that using smaller plates will help you eat less. Scientists at Pennsylvania State University, however, designed a three-part study to evaluate this belief directly (Appetite 2007, doi:10.1016/j.appet.2007.04.005).

These three studies utilized three plates of identical appearance, but of different sizes: 17, 22, or 26 centimeters in diameter.

Part One: Participants ate lunch in the laboratory once a week for three weeks. On each occasion they were presented with an identical amount of food on a serving dish and were directed to serve themselves from the serving dish onto their plate prior to eating the meal. The same serving dish was used for each meal, but a different size plate (small, medium, or large) was used each time. The amount of food consumed by each participant was measured each time and analyzed, comparing amount eaten to the size of the plate.

Part Two: Participants ate lunch in the laboratory once a week for two weeks. Each time the same amount of food was served, but the difference this time was on the size of plate the meal was presented on (medium or large, in this case). Again the amount of food the participants ate was measured, then the researchers compared how much was eaten by each subject on which size plate.

Part Three: In this last arm of the study, once a week for three weeks the participants were given the smallest plate and given access to their own private buffet consisting of five popular foods containing the same number of calories by weight. Participant were directed to serve themselves from the buffet several feet away, then return to their place setting to sit down to eat. Once again the amount of food consumed was measured along with the number of trips made to the buffet.

The results? All three of the studies showed that the size of the plate (or needing to walk across the room) made no significant difference to the amount of food the subjects ate.

What this means for you

This study shows that you can't fool yourself into eating less by using smaller plates, and it does conflict with some other research on this subject. This is, however, one of the best designed studies I have seen on this topic and supports the idea that portion control is still an important tool for managing your weight. Here are some portion size guidelines to help you know what is a standard portion size.

 
 
Dr. Gourmet
29 August 2007 @ 03:54 pm
Remember back in Algebra class, when you learned that if A = B and B = C, then A = C? Well, medicine doesn't always work like math, with simple, straightforward lines of reasoning. Here's a good example:

Gout is a chronic inflammatory disease characterized by high levels of uric acid in the blood (hyperuricemia). Studies have shown that many inflammatory disorders are associated with premature death from various causes. Other studies, however, have NOT seen any link between hyperuricemia and heart disease. So is gout linked to heart disease and premature death, or not? Researchers at Harvard University, together with colleagues from the University of British Columbia in Vancouver, devised a prospective study (one following subjects over time) to see if they could clarify the relationship, if any, between heart disease and gout. Their findings were published in the most recent issue of Circulation (2007;116:894-900).

The researchers made use of data from the Health Professionals Follow-up Study. This large-scale study followed over 51,000 male health professionals beginning in 1986. The subjects' demographics, health status for various diseases and conditions, and personal habits were evaluated by written questionnaire every two years. Using that information, plus supplemental questionnaires specifically concerning gout, the researchers were able to correlate the respondents who reported having a diagnosis of gout with their incidence of heart disease.

They found that compared to those men who did not have gout at the start of the study, those who did have gout were more likely to die of heart disease than those without. Their risk, in fact, increased by 55%. Further, the longer a subject had gout, the more likely they were to die of heart disease: up to 78% more likely for those with gout for over 11 years.
What this means for you

If you are diagnosed with gout, you'll want to confer with your doctor about your risk of heart disease and do all you can to avoid it. In the mean time, as I've reported in another News Bite (May 30, 2007), be sure to drink coffee!
 
 
Dr. Gourmet
27 August 2007 @ 11:23 am

Next week is Labor Day. I love summer but it’s about over and time to celebrate. Holidays are certainly a good time to splurge a bit and maybe eat too much. Not a big deal -- that's one of the most important parts of eating healthy. It's really important to give yourself permission to cut loose now and then.

That said, you can still eat food that's great for you even if you're eating a bit too much. I’ve put together some ideas for you.

The Chicken and Rice Salad is perfect to take to a pot luck. It’s easy to make ahead and people love it. If it’s your barbecue the Southwest Venison Burgers are great. You can easily substitute extra lean ground beef for the venison and the burgers are fantastic. Pair that with today’s Potato Salad recipe sent in by Barbara Gendelman and you’re good to go.

Another great choice for the grill is the Polynesian Chicken. You can use the marinade with shrimp for some variety and either one of these paired with lemon rice makes a great end to the summer.

For dessert, check out these reviews of frozen yogurts (especially last week’s comments on the Stonyfield Farms Mint Chocolate Chip). Another great choice is making the super easy Strawberry Shortcake.

Here are some other ideas for your Labor Day:

Grilled Sage Lamb Kabobs or
Barbecue Chicken with Roasted Corn on the Cob
Cornbread Muffins
Cole Slaw
Potato Vinaigrette Salad

Eat well, eat healthy, enjoy life!

Dr. Gourmet