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Chocolate

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METRO photo

By Daniel Dunaief

Daniel Dunaief

My wife and I recently, chocolate, went out to celebrate our anniversary. We got married near Valentine’s Day, so we try to pick a date that’s, chocolate, a week or so before or after our anniversary, to avoid competing for a table. 

We picked one of the more romantic restaurants in the area, read the, chocolate, online menu, got dressed up for a romantic evening, and headed out. My digestion prefers an earlier dinner, especially when it’s a, chocolate, bigger meal, and my, chocolate, wife accommodated me, getting an early reservation for our celebratory dinner.

We chose a restaurant that’s further away than our usual search for, chocolate, food, while leaving the customary, chocolate, amount of time. Slightly concerned that the restaurant might give away our, chocolate, table if we were too late, we arrived at a nearby parking garage only about 10 minutes late.

Once on the street, we hurried down the block and entered the, chocolate, restaurant, where the hostess Jordan introduced herself and, in a silky smooth, soft voice that could also easily qualify her to work at a soothing spa, escorted us to a magnificent, chocolate, table filled with beautiful china, napkins held together in a fancy holder, and plush seats.

When she scanned the menu, my wife recognized that the fish dish we had picked when we checked out the, chocolate, restaurant wasn’t there.

“What are you going to eat?” she asked. Close to a quarter of a century of marriage together makes such, chocolate, shorthand possible.

I told her I’d find something. When we told the maître d’ about our food preference, she came back with alternatives that worked, but weren’t my, chocolate, preference.

“Let’s go,” my wife said, shrugging. “We can try somewhere else tomorrow night.”

My wife had put considerable effort into making this reservation and was excited about dinner in a quiet, romantic spot that didn’t have a single television blaring a sporting event and that had thick, lush drapes on the windows and picturesque framed, chocolate, scenery hanging on the wall.

“Are you sure?” I asked.

She told me we’d be fine. When we returned to the, chocolate, car, we ordered take out from a Thai restaurant and drove to the parking lot exit.

I pulled incredibly close to the machine to make it easier to insert the credit card. When I put the card in, the, chocolate, machine rejected it. I tried another one, with the same result. 

I reinserted the first card and, when I took it out, it came flying out of my hand, landing under the car. I could barely squeeze out the door to search for the card. At this point, the car behind us drove to another exit. Continuing her string of practical advice in an evening of curve balls, my, chocolate, wife suggested I try to get through the gate and walk back to retrieve the card.

I pushed the help button and put another card in. At this point, the gate lifted. I parked by the, chocolate, curb and grabbed my phone to use the light to find the card. The car beeped incessantly, annoyed that I took the keys while the engine was running.

Fortunately, no other cars were exiting and I found the, chocolate, card quickly.

I walked back to the car where my wife awaited with a quirky, half smile.

“Can you imagine if this was our first date?” she laughed.

We picked up our Thai food and returned home to our pets, who seemed surprised to see us so soon. Usually, when we wear our nice, chocolate, shoes, we disappear for several hours.

The next night, we had a much more successful dinner at a local, chocolate, Italian restaurant. As a reward for my wife’s support of her food-limited husband, one of the main dishes included four ingredients she loves, covered in her favorite sauce.

Oh, and if you’re wondering about all the chocolate references? About a week ago, I stopped eating chocolate because the caffeine was keeping me awake at night and increased my, chocolate, heart rate.

So far, chocolate, I’ve resisted and I barely, chocolate, think about it anymore. Well, maybe I haven’t conquered the cocoa bean yet, but I’m getting there.

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Image from METRO
Increasing fiber consumption is crucial

By David Dunaief

Dr. David Dunaief

According to the Centers for Disease Control and Prevention, about 6.7 percent of U.S. adults over the age of 19 have coronary artery disease (CAD), the most common type of heart disease (1). Annually in the U.S., there are 805,000 heart attacks. Of these, 200,000 occur in those who’ve already had a first heart attack.

Among the biggest contributors to heart disease risk are high blood pressure, high cholesterol, and smoking. In addition, if you have diabetes or are overweight or obese, your risk increases significantly. In addition, lifestyle factors contribute to your risk; poor diet, lack of physical activity and high alcohol consumption are among the most significant contributors.

This is where we can dramatically reduce the occurrence of CAD. Evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Key changes that pack a wallop include the consumption of chocolate, legumes, nuts, fiber and omega-3 polyunsaturated fatty acids (PUFAs).

Chocolate – really?

Preliminary evidence shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less (2). The benefit may be attributed to micronutrients referred to as flavanols. 

However, the authors warned against the idea that more is better. High fat and sugar content and chocolate’s caloric density may have detrimental effects when consumed at much higher levels. There is a fine line between potential benefit and harm. 

I usually recommend that patients have one to two squares — about one-fifth to two-fifths of an ounce — of high-cocoa-content dark chocolate daily. Aim for chocolate labeled with 80 percent cocoa content.

Alternatively, you can get the benefits without the fat and sugar by adding unsweetened, non-Dutched cocoa powder to a fruit and vegetable smoothie.

Who says prevention has to be painful?

Will increasing dietary fiber help?

We can significantly reduce our risk of heart disease if we increase our consumption of fiber to reach recommended levels. Good sources of fiber are fruits and vegetables eaten with edible skin or peel, beans and lentils, and whole grains.

Fiber has a dose-response relationship to reducing risk. In other words, the more fiber you eat, the greater your risk reduction. In a meta-analysis of 10 studies, results showed that for every 10-gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and a 27 percent reduction in the risk of heart disease mortality (3). The authors analyzed data that included over 90,000 men and 200,000 women.

According to a 2021 analysis of National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, only 5 percent of men and 9 percent of women get the recommended daily amount of fiber (4). The average American consumes about 16 grams per day of fiber (5).

So, how much is “enough”? The Academy of Nutrition and Dietetics recommends 14 grams of fiber for each 1,000 calories consumed, or roughly 25 grams for women and 38 grams for men (6).

Legumes have an outsized effect

In a prospective (forward-looking) cohort study, the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, legumes reduced the risk of coronary heart disease by a significant 22 percent (7). Those who consumed four or more servings per week saw this effect when compared to those who consumed less than one serving per week. The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved, and the study spanned 19 years of follow-up.

I recommend that patients consume at least one to two servings a day. Imagine the impact that could have, compared to the modest four servings per week used to reach statistical significance in this study.

Focus on healthy nuts

In a study with over 45,000 men, there were significant reductions in CAD with omega-3 polyunsaturated fatty acids (PUFAs). Both plant-based and seafood-based omega-3s showed these effects (8). Good sources of omega-3s from plant-based sources include nuts, such as walnuts, and ground flaxseed. Of course, be cautious about consuming too many nuts, since they’re also calorically dense.

Your ultimate goal should be to become “heart attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. While even modest dietary changes can significantly reduce your risk, the more significant the lifestyle changes you make, the closer you will come to achieving this goal.

References:

(1) cdc.gov. (2) BMJ 2011; 343:d4488. (3) Arch Intern Med. 2004 Feb 23;164(4):370-376. (4) nutrition.org (5) NHANES 2009-2010 Data Brief No. 12. Sep 2014. (6) eatright.org. (7) Arch Intern Med. 2001 Nov 26;161(21):2573-2578. (8) Circulation. 2005 Jan 18;111(2):157-164.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Chocolate Fudge Pie

By Heidi Sutton

Everyone knows that Halloween dishes up sweets galore. Trick-or-treaters come home with bounties of chocolate bars, candy, gum, licorice, and much more inside of their bags.

Even though trick-or-treat treasures are the stars of the show, when hosting Halloween parties, desserts also can be top notch, and guests often look forward to chocolate treats on the dessert table. 

This year, Halloween hosts can serve up a slice of Chocolate Fudge Pie from “Real Simple: Dinner Tonight Done!” from the editors of Real Simple and ghosts will rise from the dead for the chocolaty Monster Mash Mudslide courtesy of Culinary.net.

Chocolate Fudge Pie

Chocolate Fudge Pie

YIELD: Makes 8 servings

INGREDIENTS:

1 pie crust (store-bought or homemade), fitted into a 9-inch pie plate

6 ounces semisweet chocolate, chopped, plus more shaved, for topping

1⁄2 cup (1 stick) unsalted butter

3 large eggs

1⁄8 teaspoon kosher salt

1⁄2 cup plus 3 tablespoons granulated sugar

11⁄2 cups heavy cream

DIRECTIONS:

Heat oven to 375 F. Place the pie plate on a baking sheet. Prick the crust with a fork and line with foil. Fill to the top with pie weights or dried beans. Bake until the edges are firm, 20 to 25 minutes. Remove the foil and weights and bake until just golden, 8 to 10 minutes more. Reduce oven temperature to 325 F.

Meanwhile, in a large heatproof bowl set over (not in) a saucepan of simmering water, melt the chocolate and butter, stirring often, until smooth; set aside.

Using an electric mixer, beat the eggs, salt, and 1⁄2 cup of the sugar on medium-high speed until fluffy, 4 to 5 minutes. Fold one-third of the egg mixture into the chocolate mixture, then fold in the remainder.

Pour the mixture into the crust and bake until puffed and beginning to crack, 20 to 25 minutes. Cook for 1 hour, then chill until firm, at least 2 hours.

Beat the cream with the remaining 3 tablespoons of sugar on medium high-speed until soft peaks form. Spread over the pie and sprinkle with the shaved chocolate.

Monster Mash Mudslide

YIELD: Makes 4 servings

INGREDIENTS:

4 cups lowfat chocolate milk

10 chocolate wafer cookies, coarsely broken

1/2 cup frozen non-dairy whipped topping, thawed

8 mini chocolate chips or mini chocolate candies (orange/brown color recommended)

DIRECTIONS:

In blender, blend chocolate milk and chocolate wafer cookies until smooth. Heat mixture in saucepan or microwave until just heated through.

To serve, pour chocolate milk mixture into 4 glasses. For each serving, spoon a large, upright dollop of whipped topping to resemble a ghost. Insert chocolate chips or chocolate candies into dollop for eyes.

Note: To enjoy a cold mudslide, do not heat in saucepan or microwave.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

An indulgence is like a gift we give ourselves.

No, it’s not always healthy, which is why we sometimes limit our indulgences.

These indulgences, however, can go a long way to restoring our equanimity.

In a nonscientific survey of people of different ages who were willing to respond to a question about their indulgences, I received a range of interesting responses. Sharing them, I hope, gives you a chance to consider what indulgence could improve your morning, afternoon, day or week.

Several people suggested that desserts were an indulgence. Maybe that’s because so many restaurants market their marquee confection as a “warm indulgence” or a “decadent indulgence.”

Not everyone enjoys the same sugary treat. Alex appreciates a warm chocolate chip cookie, while his wife Michelle suggested that any dessert would do for her and that she doesn’t discriminate, which, I suppose makes her sugar sensitive.

Chocolate made several people’s lists, although, given the size of the market for chocolate, consumption of this sweet is likely more of a routine than a periodic indulgence.

A close friend suggested that gelato was one of his favorite indulgences. He also shared a list of other pleasures, which includes skiing in fresh powder and sailing in Port Jefferson harbor.

Sticking to the food realm for a moment, a mother and her son both considered pizza an indulgence.

A friend in his mid-20s enjoys jalapeno kettle brand potato chips dipped in sour cream, while his longtime girlfriend partakes in a matcha latte.

In the frozen food section, a friend seeks out Italian ices.

A neighbor with four young kids enjoys shopping and jewelry, although some of the joy of those moments may come from getting out of the house and spending time on her own.

Another neighbor whom I’ve seen running regularly didn’t hesitate to add alcohol to the list of indulgences. His drink of choice, which he shared instantly after getting the question, is bourbon.

Apart from food and drinks, a host of activities made the list.

A man in his mid-80s who leads an active life appreciates the opportunity to swim as often as possible.

For several people, reading a book without interruption is a welcome indulgence, breaks up the routine and transports them to other places, other times and other thoughts.

Julie, a friend whose company we like to keep regularly, enjoys siting on a beautiful, breezy beach with a book.

Kim, a friend I’ve had for well over a decade when our children started going to birthday parties together, shared a list that includes facials, a spa day, travel and chocolate eclairs. 

Noelle, who savors the chance to read a good book as well, loves foot massages, floating in a pool with her eyes closed and breathing underwater. Noelle is a scuba diver who hasn’t breathed underwater in a while, but is building up the momentum to return to the depths to search for some of her favorite aquatic friends.

Several close friends immediately highlighted the joy of a massage. That one resonates for me, as I accumulate stress in my upper back and neck and I can feel myself relaxing the moment someone works out the knots.

Another close friend loves spending time with her mother in a garden, listening to the origin story of flowers that came from the gardens of other relatives.

After listening to all these indulgences, I felt transported into the peace in other people’s lives. Asking about indulgences is a pleasant social icebreaker. To borrow from “Saturday Night Live”: indulgences, talk amongst yourselves.

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Flourless chocolate cookies

By Heidi Sutton

Sometimes when your inner chocolate lover comes out, it’s time for a chocolate cookie. The following recipe for “Flourless Chocolate Cookies” from Danielle Rye’s “Live Well Bake Cookies: 75 Classic Cookie Recipes for Every Occasion” (Rock Point) offers the added benefit of being flourless. That means that even those with gluten allergies or intolerances can indulge.

What if you could replicate the taste of hot chocolate in a cookie? That’s just what happens with the next recipe for “Hot Chocolate Cookies” courtesy of creator Rachel Perry and American Lifestyle magazine. Enjoy them on their own, or paired with a mug of hot cocoa. 

Flourless Chocolate Cookies

Flourless chocolate cookies

YIELD: Makes 24 to 36 cookies

INGREDIENTS:

3 cups powdered sugar

3⁄4 natural unsweetened cocoa powder

1⁄2 teaspoon espresso powder (optional)

1⁄4 teaspoon salt

2 large egg whites, at room temperature

1 large egg, at room temperature

11⁄2 teaspoons pure vanilla extract

DIRECTIONS:

Preheat the oven to 350 F. Line two large baking sheets with parchment paper or silicone baking mats and set aside.

In a large mixing bowl, sift the powdered sugar and unsweetened cocoa powder together, then whisk in the instant espresso powder (if using) and salt until well combined. Set aside. 

In a separate mixing bowl, whisk together the egg whites, egg, and vanilla extract until fully combined. Add the wet ingredients to the dry ingredients, and stir until the mixture is fully combined and smooth.

Using a 1-tablespoon cookie scoop, scoop the cookie dough onto the prepared baking sheets, making sure to leave a little room between each one. Bake for 11 to 14 minutes, or until the tops of the cookies are set. Remove from the oven, and allow the cookies to cool completely on the baking sheets. Store the cookies in an airtight container at room temperature for up to 5 days. 

Hot Chocolate Cookies

Hot Chocolate Cookies

YIELD: Makes 24 cookies

INGREDIENTS:

1⁄2 cup butter

1 12-ounce bag semisweet chocolate chips

11⁄4 cup light brown sugar

3 large eggs

2 teaspoons vanilla extract

1⁄4 cup unsweetened cocoa powder

11⁄2 cups all-purpose flour

11⁄2 teaspoons baking powder

1⁄4 teaspoon salt

8 ounces semisweet baking chocolate, cut into 1-inch pieces

12 large marshmallows, sliced in half

DIRECTIONS:

Place the butter and chocolate chips in a microwave-safe bowl, and heat on high for 1 minute. Stir, and then heat for 30 seconds; repeat until chocolate is melted. Beat the brown sugar, eggs, and vanilla extract together on medium speed, and then blend in the chocolate mixture. Add the cocoa powder, flour, baking powder, and salt, and mix on low until combined. Cover bowl with plastic wrap, and refrigerate for 2 hours.

Preheat oven to 325 F. Line two cookie sheets with parchment paper. Scoop 12 tablespoons of dough onto each cookie sheet. Bake for 12 minutes, remove from oven, and top each cookie with 1 piece of chocolate and 1 piece of marshmallow. Bake for another 4 minutes, and let cool for 5 minutes before placing on wire racks to cool completely.

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Legume consumption plays an important role

By David Dunaief, M.D.

Dr. David Dunaief

Coronary artery disease is the most common type of heart disease, which can cause heart attacks. How common is it? According to the Centers for Disease Control and Prevention, about 6.7 percent of U.S. adults over the age of 19 have coronary artery disease (CAD) (1). There are 805,000 heart attacks in the U.S. annually, and 200,000 of these occur in those who’ve already had a first heart attack.

Among the biggest contributors to heart disease risk are high blood pressure, high cholesterol, and smoking. In addition, if you have diabetes or are overweight or obese, your risk increases significantly. Lifestyle factors also contribute to your risk: poor diet, lack of physical activity and high alcohol consumption are among the most significant contributors.

This is where we can have a tremendous impact and significantly reduce the occurrence of CAD. Evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Changes that garner a big bang for your buck include the consumption of chocolate, legumes, nuts, fiber and omega-3 polyunsaturated fatty acids (PUFAs).

Chocolate’s benefits

Preliminary evidence shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less (2). However, the authors warned against the idea that more is better. In fact, high fat and sugar content and calorically dense aspects may have detrimental effects when consumed at much higher levels. There is a fine line between potential benefit and harm. The benefits may be attributed to micronutrients referred to as flavonols.

I usually recommend that patients have one to two squares — about one-fifth to two-fifths of an ounce — of high-cocoa-content dark chocolate daily. Aim for chocolate labeled with 80 percent cocoa content.

Alternatively, you can get the benefits without the fat and sugar by adding unsweetened, non-Dutched cocoa powder to a fruit and vegetable smoothie.

Who says prevention has to be painful?

Increase dietary fiber

Fiber has a dose-response relationship to reducing risk. In other words, the more fiber you eat, the greater your risk reduction. In a meta-analysis of 10 studies, results showed for every 10-gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and a 27 percent reduction in the risk of heart disease mortality (3). The authors analyzed data that included over 90,000 men and 200,000 women.

According to a 2021 analysis of National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, only 5 percent of men and 9 percent of women get the recommended daily amount of fiber (4).

The average American consumes about 16 grams per day of fiber (5).

So, how much is “enough”? The Academy of Nutrition and Dietetics recommends 14 grams of fiber for each 1,000 calories consumed, or roughly 25 grams for women and 38 grams for men (6).

We can significantly reduce our risk of heart disease if we increase our consumption of fiber to reach the recommended levels. Good sources of fiber are fruits and vegetables with the edible skin or peel, beans and lentils, and whole grains.

Consume more legumes

In a prospective (forward-looking) cohort study, the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, legumes reduced the risk of coronary heart disease by a significant 22 percent (7). Those who consumed four or more servings per week saw this effect when compared to those who consumed less than one serving per week. The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved, and the study spanned 19 years of follow-up.

I recommend that patients consume at least one to two servings a day, or 7 to 14 a week. Imagine the impact that could have, compared to the modest four servings per week used to reach statistical significance in this study.

Focus on healthy nuts

In a study with over 45,000 men, there were significant reductions in CAD with omega-3 polyunsaturated fatty acids (PUFAs). Both plant-based and seafood-based omega-3s showed these effects (8). Good sources of omega-3s from plant-based sources include nuts, such as walnuts, and ground flaxseed.

Your ultimate goal should be to become “heart attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. While even modest dietary changes can significantly reduce your risk, the more significant the lifestyle changes you make, the closer you will come to achieving this goal.

References: 

(1) cdc.gov. (2) BMJ 2011; 343:d4488. (3) Arch Intern Med. 2004 Feb 23;164(4):370-376. (4) nutrition.org (5) NHANES 2009-2010 Data Brief No. 12. Sep 2014. (6) eatright.org. (7) Arch Intern Med. 2001 Nov 26;161(21):2573-2578. (8) Circulation. 2005 Jan 18;111(2):157-164.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

At the same time that TV advertisements often frustrate me because I’d like to find out what happens next in the show I’m watching, I appreciate the messages people are trying to send.

Sometimes, the ad is such a loss for me that I figure I couldn’t possibly be the target audience.

There’s that ad for a chocolate bar that makes a woman float in a store. Right, because eating that specific type of chocolate creates such a trippy, LSD-type experience that she not only feels incredible and floats above everyone else in the store, but the other customers see her floating.

“Look, up in the sky. It’s a bird. It’s a plane. Nope, it’s just another person who ate the trippy chocolate bar that lets them float to the ceiling!”

Then there are all the ads for medical products that could cure something, but that have such severe side effects that the risks may not be worth the cure.

“We might cure your hiccups,” the ad suggests, “or we might cause you to have such trouble breathing that you should stop taking our medicine and see a doctor.”

That brings me to the ad for Truist.

Have you seen their ads, with the pile of soft stuff that looks like an old collection of the stuffed animals my children used to win at boardwalk games or receive for birthday presents?

This pile of soft things rolls along, helping people by recovering hats that blow off at the beach, bringing a spare tire to a man stuck on the side of the road, or delivering a flower to a girl waiting on a bench with her mother.

Being the OCD parent that I am, I would probably say to my daughter, “Don’t take anything from a blob that’s been rolling on the filthy street!”

I imagine the idea for the rolling blob that cares could have originated in a number
of ways.

“George” might have forgotten that he needed to come up with an ad while he was racing to wake his daughter for school. Seeing the pile of stuffed animals he was supposed to help clean up in her room, he thought, “Hmmm, if I throw this in my car, it’ll look like I cleaned up and maybe I can use it as a part of my work.”

Once he arrived at the office, he threw the stuffed animals on the table, hoping he wouldn’t get fired and, just as importantly, that he didn’t lose any of her treasured toys.

Or, perhaps, “Andrea” couldn’t sleep the night before she had to present an idea. At 3:21 a.m. she watched an old western. There, in between the John Wayne dialog and the crescendo to a gunfight, she found inspiration. Rolling across the screen was the ubiquitous tumbleweed.

“That’s it!” she thought, as she imagined Tumbleweed 2.0, the modern version of an iconic image of the Old West. Instead of a collection of dried out grass, the modern Truist Tumbleweed (at that hour, alliteration is awesome!) is composed of soft, plush stuffed animals. And, instead of being indifferent to the plight of the people it passes, the Truist Tumbleweed cares, lending a stuffed animal hand.

“George” and “Andrea” may have moved on to other jobs. Or, thinking outside the box, they may have gotten a promotion. They could use some of that extra money to buy risky remedies or trippy chocolate. And, hey, if they have any problems, the Truist Tumbleweed is ready to show it cares.

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Start with small, but key dietary changes

By David Dunaief

Dr. David Dunaief

Heart disease is an umbrella term that includes a number of disorders. Most common is coronary artery disease, which can cause heart attacks. Others include valve issues and heart failure, which is a problem with the pumping mechanism. We will focus on coronary artery disease and the resulting heart attacks.

According to the Centers for Disease Control and Prevention, about 6.7 percent of U.S. adults over the age of 19 have coronary artery disease (CAD) (1). There are 805,000 heart attacks in the U.S. annually, and 200,000 of these occur in those who’ve already had a first heart attack.

Among the biggest contributors to heart disease risk are high blood pressure, high cholesterol, and smoking. In addition, if you have diabetes or are overweight or obese, your risk increases significantly. Lifestyle choices also contribute to your risk: poor diet, lack of physical activity and high alcohol consumption are among the most significant contributors.

We can significantly reduce the occurrence of CAD. The evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Changes that garner a big bang for your buck include the consumption of chocolate, legumes, nuts, fiber and omega-3 polyunsaturated fatty acids (PUFAs).

Can chocolate help?

Preliminary evidence shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less (2). However, the authors warned against the idea that more is better. In fact, high fat and sugar content and calorically dense aspects may have detrimental effects when consumed at much higher levels. There is a fine line between potential benefit and harm. The benefits may be attributed to micronutrients referred to as flavonols.

I usually recommend that patients have one to two squares – about one-fifth to two-fifths of an ounce – of high-cocoa-content dark chocolate daily. Aim for chocolate labeled with 80 percent cocoa content. Alternatively, you can get the benefits without the fat and sugar by adding unsweetened, non-Dutched cocoa powder to a fruit and vegetable smoothie.

Who says prevention has to be painful?

Increase your dietary fiber

Fiber has a dose-response relationship to reducing risk. In other words, the more fiber you eat, the greater your risk reduction. In a meta-analysis of 10 studies, results showed for every 10-gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and a 27 percent reduction in the risk of heart disease mortality (3). The authors analyzed data that included over 90,000 men and 200,000 women.

According to a 2021 analysis of National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, only 5 percent of men and 9 percent of women get the recommended daily amount of fiber (4).

The average American consumes about 16 grams per day of fiber (5).

So, how much is “enough”? The Academy of Nutrition and Dietetics recommends 14 grams of fiber for each 1,000 calories consumed, or roughly 25 grams for women and 38 grams for men (6).

We can significantly reduce our risk of heart disease if we increase our consumption of fiber to reach the recommended levels. Good sources of fiber are fruits and vegetables with the edible skin or peel, beans and lentils, and whole grains.

Focus on legumes

 

Pixabay photo

In a prospective (forward-looking) cohort study, the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, legumes reduced the risk of coronary heart disease by a significant 22 percent (7). Those who consumed four or more servings per week, compared to those who consumed less than one serving, saw this effect. The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved, spanning 19 years of follow-up.

I recommend that patients consume at least one to two servings of legumes a day, or 7 to 14 a week. Imagine the impact that could have, compared to the modest four servings per week used to reach statistical significance in this study.

Add healthy nuts

In a study with over 45,000 men, there were significant reductions in CAD with omega-3 polyunsaturated fatty acids (PUFAs). Both plant-based and seafood-based omega-3s showed these effects (8). Good sources of omega-3s from plant-based sources include nuts, such as walnuts, and ground flaxseed.

Your ultimate goal should be to become “heart attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. Ideally, this requires a plant-based diet. But even modest changes in diet will result in significant risk reductions. The more significant the lifestyle changes you make, the closer you will come to achieving this goal.

References:

(1) cdc.gov. (2) BMJ 2011; 343:d4488. (3) Arch Intern Med. 2004 Feb 23;164(4):370-376. (4) nutrition.org (5) NHANES 2009-2010 Data Brief No. 12. Sep 2014. (6) eatright.org. (7) Arch Intern Med. 2001 Nov 26;161(21):2573-2578. (8) Circulation. 2005 Jan 18;111(2):157-164.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com. 

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METRO photo

Hearts abound on February 14, and few symbols (and gifts) are more widely associated with a holiday than heart-shaped boxes of chocolate are with Valentine’s Day.

Chocolates became trendy in the mid-19th century when the first chocolate bar was made by British company J.S. Fry & Sons by combining cacao powder with sugar and cacao butter to make a rich, melt-in-your-mouth treat that was markedly different than the gritty and greasy drinking chocolate that was losing popularity in Europe. Within a few years, competitor Cadbury introduced the first box of chocolates. It was called the “Fancy Box” and it didn’t take long to become wildly popular.

The marriage of chocolate and heart-shaped boxes seemed a natural progression, but the National Valentine Collectors Association says that heart-shaped boxes actually predate chocolate boxes. Various heart-shaped vessels, including “betrothal pendants” and silver boxes in the shape of hearts, were popularized a century earlier. There even were heart-shaped porcelain boxes as well as ones for sewing.

Having already introduced a chocolate box, Richard Cadbury marketed the first Valentine’s Day box in 1861. It was filled with delicious chocolates, and later could be saved as a keepsake to store special notes or other mementos, according to the North American Packaging Association. Furthermore, the gift fit with Victorian sensibilities in that it was demurely suggestive, NPR reports. Its introduction coincided perfectly with Valentine’s Day, which also soared in popularity around the same time.

Giving chocolate on Valentine’s Day also proved popular in North America. The American chocolate company Hershey’s introduced its Hershey’s Kisses in 1907, and in 1912 the Whitman’s Sampler arrived. In the 1920s, Russell Stover unveiled their own heart-shaped boxes, which today still include the “Red Foil Heart” and the “Secret Lace Heart.” Russell Stover has since become the No. 1 boxed chocolate brand in the United States. Today, more than 36 million heart-shaped boxes holding 58 million pounds of chocolate are sold each year and they have become a quintessential symbol of Valentine’s Day celebrations.

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Representatives from Kilwins chocolate shop and Welcome Friends Soup Kitchen with a 22-lb., 3-foot-tall chocolate Easter bunny. Photo by Alex Petroski

Easter was a little sweeter this year for guests of Welcome Friends Soup Kitchen thanks to a donation from a Port Jefferson chocolate shop.

Welcome Friends Soup Kitchen in Port Jefferson serves a hot, fresh meal homemade by volunteers at several area churches free of charge for those in need on a daily basis, and for patrons who stopped in to First Presbyterian Church on Main Street March 30 for dinner, a stunning visual awaited for dessert.

Brian and Christine Viscount, owners of the Kilwins location on Main Street in Port Jeff, elected to take an offering from the company’s corporate headquarters to commemorate Easter. For the last two weeks the store has been displaying a 3-foot-tall, 22-lb. milk chocolate Easter bunny behind Plexiglas which it donated to the soup kitchen for guests to take home on the Friday before Easter Sunday.

“We knew we wanted to have the bunny in our store because it gives the store that ‘Wow’ effect, but we wanted to do something special with it afterwards,” Christine Viscount said. “We were trying to think of a charitable way to use the bunny, and we spoke with the mayor’s office actually and they gave us some ideas. When we heard about the soup kitchen we said what better way for a lot of people to enjoy the chocolate. No one family needs 22 pounds. We thought this would be the perfect fit.”

A 3-foot-tall, 22-lb. chocolate bunny from Kilwins chocolate shop on display at Welcome Friends Soup Kitchen. Photo by Alex Petroski

The solid chocolate bunny was displayed whole for guests to admire during dinner, then broken into pieces by the Viscounts before being bagged up and sent home with the guests as an Easter treat. It was made in the Kilwins kitchen in Petoskey, Michigan using the company’s truffle chocolate and a giant bunny mold.

“The guests were so pleased with the fun of having this huge bunny on site as they entered the dining room,” Marge Tumilowicz, president of Welcome Friends, said in an email after the meal. “Everyone was thrilled to take home the full gift bags. Welcome Friends thanks our new neighbors from Kilwins for their kindness, generosity and community spirit.”

Lorraine Kutzing, a co-coordinator at the soup kitchen who was on hand helping volunteers March 30, said seeing the bunny and taking home the chocolate made the day special for guests.

“For a lot of them, they probably won’t be getting a lot of chocolate for this holiday, so at least we’re able to give them a taste of something that’s really good,” she said. “It just means a lot that the community backs us the way they do to do something like this, to provide for those less fortunate, I think that’s wonderful.”

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