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Dr. Gourmet
22 August 2007 @ 03:59 pm
According to the National Psoriasis Foundation, 75% of people with psoriasis feel that their condition has a "moderate to large" negative impact on their quality of life – enough that their daily activities are affected.

For years there has been anecdotal evidence from physicians who see a link between overweight and psoriasis, and indeed, several studies have shown a connection. But until recently (Arch Intern Med 2007;167(15):1670-5) there haven't been any long-term prospective (following subjects over time) studies to assess this connection.

This research made use of data collected as part of the Nurses' Health Study II, a long-term, large scale study of over 116,000 nurses who were between 25 and 42 years of age in 1989, the study's inception. After the initial questionnaire, which included data about height, weight, smoking and alcohol status, eating habits, and medical conditions (including psoriasis), similar questionnaires were administered every two years.

The researchers at Harvard Medical School, Brigham and Women's Hospital, and the University of British Columbia, Vancouver compared those women who reported a diagnosis of psoriasis with those who did not have that condition. They found a remarkable rising risk of developing psoriasis correlating with a higher Body Mass Index: those women who were simply in the overweight category (between 25 and 29.9) increased their risk of psoriasis by 40%! Obese women (with a BMI over 30) saw their risk increase by nearly 50%, while very obese women (BMI over 35) were at an incredibly increased risk of 169% (that's not a typo).

Dr. Setty's team also correlated weight change since the age of 18 with the risk of psoriasis, and found that those women who were obese (BMI of 30 or greater) at the age of 18 were 73% more likely to develop psoriasis.
What this means for you

Psoriasis is a chronic inflammatory disease, and obesity has been shown to cause a chronic, low-grade, inflammatory state in the body. Although there have been case reports of complete remission of psoriasis symptoms in those who lose significant amounts of weight, why work for remission when maintaining a normal weight will help you avoid psoriasis completely?
 
 
Dr. Gourmet
20 August 2007 @ 11:19 am

Last week I wrote about breakfast and how important it is to make this part of your day. At the same time I wanted to offer some practical advice about what made up a good breakfast (both quick and easy as well as elaborate). There was a lot of response to that column and it got me thinking about how lunch is important, too.

While it's not the "most important meal of the day," lunch is the one where a lot of folks get into trouble. There have been hundreds of my patients who by simply eating a good breakfast and planning for lunch have made significant changes in their health and had significant weight loss.

One of my favorites was a discussion that I had with a patient about peanut butter. She loved peanut butter sandwiches but wouldn't prepare them and take them to work because the peanut butter was "so high in fat and calories." Instead she was eating out at different fast food joints. She thought that she was eating healthier, but the Smokehouse Turkey sandwich at Panera Bread that she was regularly eating had 700 calories, 22 grams of fat and over 2,300 mg of sodium! (Here's a list of healthier choices at Panera.)

That "unhealthy" PB&J? All of 438 calories, with only 18 grams of fat. Even using peanut butter made with salt it comes in at only 433 mg of sodium. While there's a lot of fat, it's mostly good monounsaturated fat (9 grams of mono for the PB&J vs. 9 grams of saturated fat in the Panera sandwich). Now, keep in mind that she loved peanut butter and jelly sandwiches. Worth it at a savings of 250 calories per day (which is about what you need for a weight loss of a pound or so every couple of weeks).

There's some guidelines about portion sizes and making good lunch choices on the Lunch Guidelines page for eatTHISdiet.

By taking a few extra minutes to package up last night's leftovers, make a sandwich or a salad you'll feel better, eat better, lose weight and be healthier. Best of all, you'll save money. The average lunch ticket at a fast food restaurant is around $6.00, while it'll cost you about $2.00 to take your lunch (sandwich or salad or leftovers and a piece of fruit).

Hmm. . . $20.00 per week, $80.00 per month, $960.00 per year. . . That's a trip to the Caribbean.

Eat well, eat healthy, go to the Islands for a vacation!

Dr. Gourmet

 
 
Dr. Gourmet
15 August 2007 @ 04:13 pm
A recent long-term (10 years) study of over 28,000 women in the United States found an inverse association between the amount of whole grains consumed in a typical day and the subjects' risk of high blood pressure (Am J Clin Nutr 2007; 86:472-9).

The women in the study were all health professionals of at least 45 years of age and were free of heart disease, cancer, or high blood pressure at the start of the study. Their dietary habits were assessed by a detailed questionnaire, and their health status was monitored through regular follow-up contact. The researchers' analysis took into account Body Mass Index, smoking status, alcohol use, and exercise level, among other variables.

Whole grains were defined in this study as including dark bread, whole-grain breakfast cereal, popcorn, cooked oatmeal, brown rice, and other grains. Those women who ate between two and four servings of whole grains per day, on average, saw their risk of high blood pressure drop by almost 10% compared to those women who averaged less than one serving of whole grains per day. Those women whose average intake topped 5 servings per day enjoyed a reduction in risk of almost 25%.

What's particularly interesting about this study is that the whole grain foods that were eaten most frequently were dark bread, popcorn, and whole-grain cold breakfast cereal (there's that "old fashioned" breakfast again!).
What this means for you

It's easy to get more whole grains in your diet, simply by making better choices in what you eat already. Have a whole-grain cereal for breakfast, or have oatmeal. Choose wheat bread for your sandwiches at lunch. And at dinner, choose brown or wild rice for your side dish. (Or have a whole-wheat pizza crust.)
 
 
Dr. Gourmet
13 August 2007 @ 11:20 am

There’s a lot of information on the Dr. Gourmet web site and sometimes I have trouble keeping track of it myself. I had a question from a visitor to the site the other day about breakfast. He had read the Dr. Tim Says... article I wrote back in April about the importance of breakfast in maintaining a healthy weight. After reading the column he was still wondering what he could eat for breakfast. Specifically he wanted to know about "old fashioned breakfasts."

He wrote:

"old fashioned breakfasts" such as cereal, hot or cold; toast and its trimmings; milk, non fat: fruit juice. A combination of such items has been my staple for years. Are you suggesting that I stop using them, or should I be creating a new group for my breakfast? They are fast, convenient, nutritious.

This types of breakfast that he describes are exactly correct. What we think of as "an old fashioned" breakfast as part of a Western diet is actually pretty healthy if you make the right choices. The key is to include some carbohydrates (the higher in fiber the better) along with a serving of protein. So a slice of whole grain toast and a scrambled egg is a fantastic way start to the day. Most folks prefer fruit juice at breakfast but having fruit is a better choice because fresh fruit has so much more to offer (more vitamins, more fiber, more satisfaction).

There’s pretty good research that eating a balance of foods like this at breakfast will sustain you throughout the morning and keep you from feeling hungry around "coffee break" time. For instance, having some "complex" carbs like whole grain cereal along with milk is similar to the toast and eggs. A good quality whole grain cereal is filling, the fiber is good for you and the protein in the milk helps sustain you through the morning until lunch (Interestingly, the coffee break is a modern invention that is claimed by the company that is now Barcalounger. This evolution of taking a break was in response to social changes in the workplace at the turn of the last century and workers wanting a mid-morning and mid-afternoon break— not for dietary reasons.)

There’s information on the website about all of the items that make up a great breakfast as part of the eatTHISdiet plans.

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 
 
Dr. Gourmet
08 August 2007 @ 04:14 pm
A recent study in Japan investigated our ability to estimate amounts of food based on appearance (Appetite 2007;49:183-190). Noting that two types of food, soft food or hard food, might be estimated differently, the scientists selected raw carrots as their sample hard food and surimi gel (ground fish) as a sample of softer food. (Both were familiar foods to the test subjects.)

For the study, the team cut the two sample foods into various shapes, including a single block, multiple fine strips, and a number of small blocks. The procedure of the study was fairly simple: A computer screen was used to present a sample size of the given food on the left of the screen (for example, a single block of carrot labeled as 5 grams in weight). On the right side of the screen was a sample of the same food in a different form: perhaps fine strips instead of a single block. Both sides of the screen also showed a plastic spoon as a size reference item. The subjects were given a target weight for the item on the right (say, 12 grams) and were instructed to use the arrows on the keyboard to display pictures of larger or smaller quantities until they felt that the picture they selected matched the target size. The two types of food were not compared to each other, but each test subject performed over 200 comparisons for various reference sizes, food types, and target weights.

The scientists found that the subjects consistently overestimated the weight of finely cut foods, regardless of which type of food (carrots or surimi gel) they were estimating. All of the subjects had normal vision and had some cooking experience, although none was a professional cook or chef.
What this means for you

Chances are you can't eyeball your food and accurately estimate how much you're eating. One of the most important pieces of equipment you can have in your kitchen is a good scale. Weigh and measure everything you cook. Eventually you'll learn how to look at different foods and judge their weight accurately, but until then... use a scale.
 
 
 
Dr. Gourmet
06 August 2007 @ 11:25 am

These lovely fruits are in the same family as tomatoes and are often called Mexican Green Tomatoes or Tomatoes Verde. Sometimes they are called Husk-tomatoes. Native to Central America, like tomatoes, they were taken back to Europe and the widest cultivation there has been in Spain. They are widely available in markets and most large chain grocery stores.

While tomatillos look like small green tomatoes covered with a papery husk, that is where the resemblance ends. The skin of the tomatillo is tougher and the meat of the fruit is coarse to mealy (of course a lot of the tomatoes on the market now are coarse and mealy but in a bad way).

Ripe tomatillos are firmer than tomatoes and if they get soft, they are too far gone. Purchase tomatillos when the husks are still light green and moist. As they age the husk will brown and dry. They will keep pretty well for about a week or so in the refrigerator. If I am going to use them pretty quickly, I won't put them in the fridge but in a basket on the counter.

The flavor is acidic and has a wonderful tartness that adds character to salsas, guacamole, moles and sauces. There are so many recipes that you can use these for and here's a few examples:

Cumin Pork Chops
Pork Tomatillo Salsa
Taco Salad
Tomatillo Salsa
Roast Chicken with Tomatillo Sauce

4 ounces tomatillos = 36 calories, 1g fat, 0g sat fat, 0g mono fat, 1g protein, 6g carbohydrates, 1mg sodium, 0mg cholesterol, 11 mcg Vitamin K

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 
 
Dr. Gourmet
01 August 2007 @ 04:17 pm
We know that in adults, a larger portion size will mean consuming more calories at that meal. We also know that foods that have more calories per serving (are "energy dense") will often do the same.

But is this true for children? In theory, children might eat only the number of calories they actually need, as opposed to being affected by visual cues like the amount of food on their plate.

A team of scientists recently developed a study to test this theory (Am J Clin Nutr 2007; 86:174-9). They recruited 53 children of preschool age (5-6 years) and their mothers to participate in a feeding study. The children were initially presented with a standardized meal, the main dish of which being macaroni and cheese. Enough of the main course dish was given to the children that they did not eat all of it, but rather stopped eating when they felt full. The amount, by weight and number of calories, eaten by each child was calculated and recorded as the reference, or standard, meal.

On a second occasion the same meal was served, but the main course (again, macaroni and cheese) was manipulated to contain almost twice as many calories for the same amount of food. Each child stopped eating when he or she felt full, and again the amount of food eaten, by both number of calories and by weight, was recorded.

The third session involved the same macaroni and cheese dish as the first session (not manipulated to have more calories), but this time the children were presented with twice as much on their plate. Again the amount of food and the number of calories eaten was recorded.

The scientists compared the three sessions and found that the children ate one-third more of the main course dish in the third, large-portion session, than in the first, reference session. On the other hand, the children ate about the same weight amount of the more calorie-dense meal than the reference meal.

What this means for you

It's clear that larger portions mean eating more, not just for children, but also for adults. The really interesting finding, though, is that the children ate the same weight of the lower-calorie food as they did of the higher-calorie food. This ties in with what I wrote about last year (Nutrition Bite 06/21/06): that you can decrease the number of calories you eat – and not feel hungry! - by switching to lower fat and lower calorie versions of the foods you love.

(PS: Here's my Creamy Mac and Cheese recipe. Kids love it!)
 
 
Dr. Gourmet
30 July 2007 @ 11:21 am

We eat too much salt. Simple but true. As a culture today, the developed world consumes a tremendous amount of sodium. It’s not just in the U.S., but the United Kingdom has had a campaign for about three years to convince people to reduce the amount of salt they consume. Most Asian diets are high in sodium as well, with almost every sauce, from soy sauce to fish sauce to hoisin, having added salt.

As a population it’s a major issue for policy makers to get folks to cut back from over 6000 milligrams (mg) (that’s 6 grams) of sodium per day (about 2 1/2 teaspoons of salt) to the more reasonable 2400 mg. Tough to do, because there’s so much salt in the processed foods that Americans eat. A report this week by the Council on Science and Public Health estimates that such a lowering of salt intake might save 150,000 lives each year.

That’s a lot of your friends, family and co-workers.

Step number one to making this difference in your life is to take the processed food out of your life. If you want Mac and Cheese, make Mac and Cheese. Cooking your own fresh food from scratch takes a little more time, but it tastes so much better and it’s so much better for you. If you’re used to frozen or packaged meals, snagging fast food for dinner, or eating on the run, start slowly by making just two meals per week at home. Beyond the meals on this website, there are so many recipes out there that anyone can cook easily.

Step number two is that when you do eat packaged or processed foods, pay attention to the salt. The sodium content is the one item on the Nutrition Facts label that isn’t confusing. There’s no high fat, low-carb, low-fat, Mediterranean, Atkins, South Beach or other “diet” to worry about. Simply eat less sodium and you’ll likely prolong your life. Your goal should be less than 3000 mg per day.

Step three: I know people who crave sodium but there’s been terrific research that shows that your salt taste buds do learn to want less. In effect, the more you saturate them the more you can’t taste how salty something is. For some this will mean working a bit harder. (Interestingly, if you’re making fresh food, adding salt at the table and not while cooking makes food taste saltier and research shows that you’ll use less.)

Lastly, keep in mind that that the 2,400 mg per day recommendation is about 1 teaspoon salt. Measure your salt when you do cook. It’s easy and a simple step to being healthier.

Here’s a listing of lower-sodium recipes on the Dr. Gourmet web site.

Eat well, eat healthy, enjoy life!

Dr. Gourmet

 
 
Dr. Gourmet
18 July 2007 @ 04:18 pm
Grapefruit is known to interact with more than 60% of all medications taken by mouth, including hormones such as progesterone and estrogen. We also know that higher levels of female hormones are associated with an increased risk of breast cancer. A study just released in the British Journal of Cancer (10 July 2007; doi:10.1038/sj.bjc.6603880) investigates this link.

This large-scale, multi-aim study initially included over 200,000 men and women in Los Angeles, California and Hawaii. All were between 45 and 75 years of age at the initial phase of the study, between 1993 and 1996. After excluding men, women who were not postmenopausal, and women already diagnosed with any type of cancer, over 46,000 women remained.

Among other dietary and lifestyle information, the women were asked how often they ate "grapefruit or pomelo" during the past year, and how much they usually ate when they did. The eight possible answers ranged from "never or hardly ever," to "once a week" or as much as "2 or more times per day." In addition, the women were asked about their hormone therapy use, if any.

At the end of 2002, almost ten years later, the number of diagnosed breast cancer cases were correlated with the relative levels of grapefruit a woman ate and the woman's use of hormone therapy. After allowing for such variables as Body Mass Index, exercise level, and dietary items other than grapefruit, the scientists were sobered to find that eating 1/4 or more of a grapefruit each day, the highest level of consumption in the study, was strongly associated with a 30% increase in a woman's risk of breast cancer. This held true regardless of a woman's Body Mass Index and hormone therapy use, both of which are known to increase a woman's risk of breast cancer.

What this means for you

The scientists note that this is the first specific food that has been shown to increase the risk of breast cancer in postmenopausal women. While there's no need to ban grapefruit from every woman's life, I will be telling those of my patients who are already at an increased risk of breast cancer to consider not eating as much of both grapefruit and grapefruit juice.
 
 
Dr. Gourmet
16 July 2007 @ 11:26 am

I love avocados. I have loved them since I was a kid when my mom would serve them garnished simply with her fantastic French Dressing. There was a time, though, when avocados had gotten a very bad rap. That was in the day when we had less information about fat in the diet and it was felt that ALL fat was bad (not so).

OK, we know better now. The best part of knowing better about avocados is that you can eat them without feeling like you’re committing some low-fat, healthy diet sin. Just the opposite. They’re really good for you.

Avocados grow in tropic and subtropic climates. They are actually a fruit and not a vegetable and are one of my favorite healthy foods. For a long time the only avocados available in the grocery were from Florida and California. Even though Florida was the first state in the U.S. to cultivate them, about 80% of domestic avocados in the grocery today are from California and the most common you will see is the Haas avocado. (There is now a huge import market from Central and South America.)

The Haas avocado is the one with the pebbly skin and is a little smaller in size. The other common variety is the slightly larger, more teardrop shaped,= Fuerte. Look for evenly colored green or dark green skin with no cuts or blemishes.

Because of today’s produce market, avocados are available pretty much year ‘round. Like most fruits they are very fragile and are now picked very much unripe. The best way to ripen them is as you would with peaches, by placing them in a paper bag for about two days. You can find ripened ones in the market because they ripen fairly quickly but it’s a bit of a treasure hunt. A ripe avocado will give slightly to very gentle pressure. Don’t refrigerate them unless they have been cut. I prefer to eat them fairly quickly after they ripen, but they will keep up to about a week in the fridge.

Avocados are essentially a fat. While a cup of slices is only about 120 calories, it’s mostly fat. But... they are really low in saturated fat and have tons of good monounsaturated fat (read that GOOD fat). They also have a lot of fiber, as well as being high in Vitamin C.

1/2 cup sliced avocado = 117 calories, 10 g fat, 1.5 g sat fat, 7 g mono fat, 1.5 g protein, 6 g carbohydrates, 5 mg sodium, 0 mg cholesterol, Vitamin K 15 mcg

For more about Florida Avocados visit:
http://www.fl-ag.com/tropical/avocado.htm

For more about California Avocados visit:
http://www.avocado.org/

I always loved growing avocados and here’s a good site for just that:
http://faq.gardenweb.com/faq/lists/seed/2002114535011263.html

Eat well, eat healthy, enjoy life!

Dr. Gourmet