Opening another bottle of wine is tempting during these times of hibernation, reclusion and unanticipated fear.  We have been made to believe that it’s now or never to flex our baking skills, binge watch the television series we missed last year and consume a bag of chips to go with it.  After all, people are getting sick, job loss is overwhelming, our children are home-schooled by overburdened parents, the government is in disarray and the road ahead is uncertain.

As cloudy as the future looks, one thing is certain: heart disease, diabetes, high cholesterol and other chronic illnesses will persist even after we find a vaccine for this virus.  These diseases, along with cancer, worsen with erratic sleep habits, sedentary behavior, stress, and consumption of rich foods including meat and sugar.  As we flatten one disease curve, let’s not create a steep slope in others.

We owe it to our families and ourselves to stay fitter than ever.  Furthermore, all data seems to show that virus-infected patients with chronic health conditions fare much worse than healthier patients.  I challenge you to believe there is no better time than now to focus on your own health, especially while health care workers are putting everything on the line to keep the sickest among us alive.  The good news is that you don’t need fancy gyms, private trainers, complex grocery lists or a wealth of resources to do it.

Here are several tips that can help start the journey:

• Is there a health food you have sworn off due to taste?  Or one that you’ve been too afraid to try?  Now is a great time to search the Internet for a recipe that will make brussels sprouts palatable (try roasting them) or cooked white beans delicious (try mixing them with lemon juice and dill and serving over a bed of greens).  Although not a sardine-lover, several weeks ago I purchased a few tins of these bony fish for my pantry.  Those pantry days came quickly and I discovered that rinsed sardines paired with roasted tomatoes and balsamic vinegar were not only delicious but a very effective way to consume calcium, vitamin D, omega 3s and protein when fresh fish was not lying around.

• Consider planting some seeds that will mature into vegetables and herbs that you can eat all summer long.  Gardening is a healthful activity in itself, but when you couple it with the joy of growing a fresh eggplant or having enough basil to make homemade pesto, it will inspire you to continue cooking at home long after Covid passes.  You need nothing more than a windowsill to grow a bounty of mint, chives or other herbs that you can use in a dozen different ways.

• Alcohol is not your best friend despite memes, social media posts, or acquaintances telling you otherwise.  The American Heart Association maintains a guideline of less than 1 drink per day for women and less than 2 drinks per day for men.  Try to stay well within this limit, as anything more will only worsen anxiety, wreak havoc on sleep and contribute to cancer and heart disease in the long run.  Save the bottle of wine for a celebration with friends once the pandemic has passed.  If your emotions need an escape now, find an online therapist, a friend to talk to or a journal in which to write your thoughts.  (The latter is a powerfully cathartic and inexpensive tool to get you through stressful times.)  Exercise daily, place positive quotes around the house, listen to music, read inspiring books and try to emerge from this pandemic as better version of yourself.

• Make a list of healthy foods you actually enjoy eating.  Try to pick as many vegetables, nuts, fruits, and legumes (beans, lentils) as possible and then do an Internet search for quick recipes using those ingredients.  Get in the habit now of making dishes that will double as a healthy lunch so that you can skip afternoon take-out at the office or treats supplied by co-workers.

• Missing the gym and don’t feel comfortable exercising outside?  Best kept secret: you need nothing more than a few square feet to get an excellent workout that will leave you feeling satisfied and keep the mood in check.  Try jumping jacks, knee lifts, and lateral shuffles for cardio; push-ups, sit-ups and squats for resistance training.  If that’s not your style, there are countless free aerobic and strength training videos online for any age group.  Continue using them into the future to tide you over on days when you can’t get to the gym or when you want a change from your regular routine.  Turn on music or your favorite TV show for motivation and start low and slow.  Build up each day until eventually you are exercising 3-5 days per week for at least 30-45 minutes.  Spend a little time on the other days meditating, stretching or doing balance exercises.

In the end, you have made the painful but responsible commitment to halt your life as you know it by social distancing and staying put.  When life gives us lemons, we must try to make some lemonade.  If you’re one of the lucky ones who remain Covid-free, continue to set your life on the healthiest course possible instead of falling prey to the diseases that existed before this pandemic.

It’s no secret that sugar is bad for you. In fact, it’s plain awful when it comes to diabetes, your waistline, cavities, acne, cholesterol, and inflammatory disease, to name a few conditions. So sugar is no good, but like alcohol, nicotine and drugs of abuse, is it also addicting? If sugar is addicting, what is the best way to quit?

The research on the addictive properties of sugar is a relatively new but burgeoning area of study. The medical definition of an addiction is compulsively seeking a substance despite its harmful consequences. Neuroimaging studies demonstrate that sugar releases opioids and dopamine in the central nervous system, thus acting upon the reward pathways in the brain much like drugs of abuse. Animal studies have shown that sugar induces binging, craving, tolerance and withdrawal, all properties attributed to an addiction. In one study, the withdrawal of sucrose in animals triggered symptoms of anxiety and depression. Reinstating the sucrose in these animals eradicated the anxiety and depression.

If sugar is in fact an addiction, and if withdrawal from a high sugar diet can induce cravings, anxiety and depression, how does one safely quit – and quit for a lifetime?  Here are a few thoughts to make the process of weaning off sugar a little easier:

1. Make a commitment to quitting sugary foods by reminding yourself that sugar is nothing more than a temporary pleasure with serious long term health consequences.

2. Understand that not all sugars are created equal. An orange is very different from a glass of orange juice which is very different from an orange cream popsicle. Go for eating the fruit in its natural form, which is full of fiber and has a much lower glycemic index that the other options, while still satisfying the sweet tooth.

3. Take a page out of the medical psychiatry manual for quitting caffeine. Cut down on sugar by no more than 25% per week. In other words, if you’re eating a bowl of ice cream after dinner 7 nights a week, eat only ¾ of a bowl of ice cream each night for a week, then ½ a bowl of ice cream for a week then ¼ bowl of ice cream for a week, then cut it out completely. This will help curtail the withdrawal symptoms, cravings and emotional side effects.

4. Avoid any and all artificial sweeteners. These are chemical-based compounds that have been linked to weight gain and diabetes. It may be safer to have a little of the real stuff than a little bit (or certainly a lot) of the artificial junk.

5. Stay hydrated. Not only does water quench our thirst and stop us from reaching for juice or sodas (which are an absolute sugar nightmare), but there is data that hydration, adequate sleep and exercise curtail our cravings for sugar.

6. Avoid Alcohol and Marijuana (as well as other illicit drugs). Both induce cravings for sugary foods and typically in an unregulated fashion.

7. When you do partake in a sweet treat for a birthday or holiday, cherish each bite much like cherishing a spa day or fancy night out. While these are not daily routines for most people, we all do deserve to splurge now and again.

Digital media organization, Clean Plates, recently asked me for advice on choosing healthier food and drinks at Starbucks.  I love the practical article that journalist Beth Lipton put together.  Check it out here: https://www.cleanplates.com/eat/tips-eat/4-expert-tips-order-better-starbucks/

I was recently asked by a patient for a good alternative to bread.  While I mentioned the many gluten-free options that are available to replace traditional white or wheat bread, I explained that though these substitutes are gluten-free, they are often still high in carbohydrates and/or calories.  This prompted me to research healthy options for bread.

Cue in cauliflower.  Could there be a more versatile vegetable?  Cauliflower is a fantastic substitute for the potatoes in “mashed potatoes” and left in larger pieces, I throw it into Macaroni & Cheese to reduce the pasta-concentration and increase veggie intake.  But this may be one of the sneakiest uses for the cauliflower yet – pizza dough!  The idea of enjoying a guilt-free pizza is the kind of thing that gives me goose bumps.

The thought of cooked cauliflower may not appeal to everyone, but cauliflower pizza dough is a surprisingly delicious base for your favorite tomato sauce, cheese and toppings.  You could instead add garlic, butter and cheese to the cooked dough and make cheesy garlic bread.  Spread the dough out very thin and instead make a cauliflower cracker.  The options are endless.  My little kids could not even tell the difference!

Cauliflower Pizza Dough

Ingredients

1 large head of cauliflower (approximately 2lbs)

1 egg

1 tspn salt

½ tspn dried oregano

½ tspn dried or fresh chopped basil

¼ cup goat cheese

¼ cup fresh grated mozzarella cheese

Directions

1. Pre-heat oven to 400 degrees F
2. Place pot of water on stove to boil
3. Grate cauliflower with box grater using medium-sized holes OR cut into florets and pulse in food processor until cauliflower is rice-like consistency
4. Place the grated cauliflower in the pot of boiling water and cook for 5 minutes
5. Drain cooked cauliflower in strainer and let cool for 10 minutes
6. Place cooked cauliflower in cheese cloth or clean dish towel
7. Ring out cauliflower until excess water completely removed – this step is important to achieve a crispy crust!
8. Place dried cauliflower in mixing bowl
9. Add egg, salt, herbs and cheeses and mix well
10. Spread mixture on parchment lined pizza pan or cookie sheet and create circular or rectangular crust. Crust should be ¼ to 1/3 inch thick.  Pinch edges of dough to create a raised edge for the pizza crust.
11. Place in oven and cook for 30 minutes
12. Flip over pizza dough and cook for another 10-15 minutes
13. Spread cooked dough with tomato sauce, freshly grated mozzarella cheese, and toppings
14. Place in oven and cook for 5-10 minutes until cheese is bubbly and golden
15. Cut pizza into slices and serve immediately.  Enjoy!

This dairy-free turmeric milk, also known as golden milk, is good for sleep, body aches, and overall inflammation.  Try this recipe in the cold days ahead, especially if you’re feeling under the weather…

Ingredient List:

1 teaspoon turmeric

1 teaspoon coconut oil

1/2 cup coconut milk

1/2 inch ginger peeled and chopped

2 teaspoon honey

1 teaspoon ground cinnamon

2 peppercorns

Serves 1

Directions:

In a small pot place 1/4 cup of water over medium heat.  Add the turmeric and the coconut oil and blend with a whisk.  Bring to simmer.  Add the coconut milk and the remaining ingredients and bring to simmer.  Strain mixture using a fine mesh strain.  The ground cinnamon will pass through.  Enjoy warm.

Recipe by Sonya V. Chawla, M.D.

Like everyone, I make To-Do Lists; on paper, on my phone, on my computer.  But the mental to-do list I start with every day is 1. exercise and 2. eat vegetables.  Accomplishing both between sunrise to sunset is often more challenging than checking off my paper, phone and computer to-do list combined.  I’ll address the exercise challenge another day.  Today, I’ll tackle the “eat your veggies” action item.

So how many vegetables should we eat each day?  General guidelines recommend 4-5 servings of vegetables per day, with the definition of a serving being 1 cup of leafy greens, ½ cup of cooked or raw vegetables or ¾ cup of pure vegetable juice.  Aim for variety with the veggies.  The juice loses the fiber, so vegetables in their natural state is best.

With that in mind, there are two places in town that I always know will satisfy my taste buds and make the task of eating vegetables a breeze.  When I can, I try to stop by these places to pick up lunch.  And by the time I’m done eating, not only has this item on my mental to-do list been checked, I find that I am energized and not craving carbs or large portions for dinner either.

With three locations in DC and one in Maryland, the image the name BeefSteak conjures does not reflect the food they serve.  Rather, “beefsteak” is referring to the tomato variety and the subheader, “Vegetables, Unleashed” is a much more accurate description of what you’ll be eating.  Something about the sauces and the parboil on the veggies and all the different (healthy) toppings at BeefSteak, make the combination of kale, potatoes, edamame, carrots or whatever vegetables you’re in the mood for, taste rich and appetizing.  I try to amplify the protein content by adding cheese, beans or chicken sausage.  The best part is that I’ve kept the calorie count low, the fiber count high, and my belly is totally satisfied.  Thank you, Jose Andres, for this daring lunch option.

Sweet Green has long been a go-to stop for me.  Unlike some of the other salad places in town, the ingredients change with the season, are locally sourced, and they have fresh, delicious soups and warm grain bowls if salad is not your pleasure.  With many locations in Maryland, Virginia and DC, it’s a fairly quick and always delicious way to meet your daily veggie intake.

Of course, ordering a salad at any restaurant or fast food is always an option, but there are several limitations.  A Cobb salad with iceberg lettuce and all the fixings may not meet the daily recommendation of veggies.  Avoid salads filled with fried chicken, bacon, croutons and excessive dressing.  I like the idea of mixing dark leafy greens and packing in more vegetables than lettuce.  Crunch is always a plus, but veer toward sunflower or chia seeds rather than fried onions or crispy noodles.

But just to be clear, eating all the veggies for the day during lunch does not give license for splurging daily on dinner.  It simply takes care of the mental to-do list of good daily nutrition.  Nothing is stopping you from more veggies for dinner!