Hazelnut-Chocolate Spread Recipe, Spotlight on Hazelnut, Stress and Stroke Risk, plus Small Amounts of Physical Activity, Big Reductions in Dementia Risk

I love being able to share healthier ways of making favorite dishes, and the following recipe is a fun one! Hazelnut-chocolate spread is delicious slathered on a piece of toast or pound cake, used for ganache, cake frosting, or pudding…or when you just want a spoonful of comfort food. We all know how important mental health is, and a new study that found a link between stress and stroke in women is another reason to rein in this emotion. The other research I’m sharing is on avoiding dementia: how even small amounts of exercise—also a great stress reducer—can help.

Hazelnut-Chocolate Spread

• Hazelnut-Chocolate Spread

  It’s one of the world’s favorite spreads, yet most packaged hazelnut-chocolate blends are mostly palm oil (high in saturated fat) and sugar with minimal hazelnuts and chocolate. My recipe emphasizes the two flavors you’re craving and has a minimal amount of sugar. It also keeps in the fridge for weeks, though the spread will likely be gobbled up long before that.

  Ingredients

  • 8 ounces shelled and roasted hazelnuts
  • 1 ounce dark chocolate, melted
  • 2 tablespoons extra virgin olive oil 
  • 1/4 cup cocoa powder
  • 1/3 cup sugar or equivalent
  • 1 teaspoon pure vanilla
  • Pinch of fine sea salt

  Directions

  Place the roasted hazelnuts in a high-powered blender or food processor and process until the nuts turn into a paste. Be patient—depending on your machine it could take 5 to 8 minutes. Add the melted chocolate, olive oil, cocoa, sugar, vanilla, and salt, and process until fairly smooth. Transfer to a lidded glass jar and refrigerate.

  Yields about 1-1/2 cups

Healthy Ingredient Spotlight

Why Homemade Hazelnut Spread is Healthier 

Most packaged hazelnut-chocolate spreads are mostly palm oil, one of the most highly saturated fats among plant-based oils. On average, hazelnuts account for under 15% of the ingredients. Rather than using pure vanilla, they often contain vanillin, an artificial version. With homemade, you get more nutrients from the nuts, olive oil, and cocoa.

Quick Kitchen Nugget

Roasting Hazelnuts

Readers of our newsletter and Fresh-Pressed Olive Oil Club members alike know that one of my mantras is always roast your nuts! Roasting intensifies flavor, so it’s worth the few minutes it adds to prep time. Simply preheat your oven to 400°F, spread out the nuts on a rimmed baking sheet, and pop them in the oven for about 5 minutes or until you can smell their delicious aroma. If the nuts weren’t skinned, turn them onto a clean kitchen towel after roasting and rub vigorously to remove as much of the papery skin as you can. 

For Your Best Health

Stress and Stroke Risk

According to a study published online in Neurology, the medical journal of the American Academy of Neurology, some people living with chronic stress have a higher-than-average risk of stroke. The study looked at younger adults and found an association between stress and stroke among women but not among men. This study does not prove that stress causes stroke, only that there’s an association.

“Younger people often experience stress due to the demands and pressures associated with work, including long hours and job insecurity, as well as financial burdens,” said Nicolas Martinez-Majander, MD, PhD, of the Helsinki University Hospital in Finland. “Previous research has shown that chronic stress can negatively affect physical and mental health. Our study found it may increase the risk of stroke in younger women.”

For the study, researchers looked at 426 people ages 18 to 49 who had an ischemic stroke with no known cause. They were matched for age and sex with 426 people who did not have a stroke. An ischemic stroke is when blood flow is blocked to part of the brain. It can lead to weakness, trouble speaking, vision problems, and even death.

Participants completed a questionnaire about stress levels over a one-month period. Those who had a stroke were asked to record the stress levels they experienced in the month prior to the stroke through questions like “In the last month, how often have you felt that you were unable to control the important things in your life?” Scores for each question ranged from 0 to 4, with 4 meaning very often. A total score of 0 to 13 represented low stress; 14 to 26, moderate stress; and 27 to 40, high stress. Those who had a stroke had an average score of 13, compared to 10 for those who didn’t have a stroke.

People who had a stroke were more likely to have at least moderate stress levels. Of those who had a stroke, 46% had moderate or high stress levels, compared to 33% of those who did not have a stroke.

After adjusting for factors that could affect the risk of having a stroke, including education level, alcohol use, and blood pressure, researchers found that for female participants, moderate stress was associated with a 78% increased risk of having a stroke and high stress was associated with a 6% increased risk. Researchers did not find a link between stress and stroke in male participants.

“More research is needed to understand why women who feel stressed, but not men, may have a higher risk of stroke,” said Dr. Martinez-Majander. “In addition, we need to further explore why the risk of stroke in women was higher for moderate stress than high stress. Knowing more about how stress plays a role could help us create better ways to prevent these strokes.”

A limitation of the study was that people experiencing higher levels of stress may have been less likely to enroll in the study, which could have affected the results.

Fitness Flash

Small Amounts of Physical Activity, Big Reductions in Dementia Risk

A little movement could help prevent dementia, even for frail older adults, suggests a study led by researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore, published in the Journal of the American Medical Directors Association. They found that engaging in as little as 35 minutes of moderate to vigorous physical activity per week, compared to zero minutes per week, was associated with a 41% lower risk of developing dementia over an average four-year follow-up period. Even for frail older adults—those at elevated risk of adverse health outcomes—greater activity was associated with lower dementia risks.

Dementia, usually from Alzheimer’s disease, is one of the most common conditions of old age. It is estimated to affect about seven million people in the US, including about a third of those who are 85 years of age or older. Although the risk of dementia rises with age, studies in recent years have suggested that dementia is somewhat preventable, within a normal lifespan, with lifestyle changes that include better control of cholesterol, blood pressure, and blood sugar, and being more active.

The minimum amount of activity needed to reduce dementia risk meaningfully isn’t yet clear. For many older individuals, especially frail ones, the high amounts of exercise recommended in official guidelines are unattainable and may discourage any exercise at all. Both the US Department of Health and Human Services and the UK National Health System recommend that adults get at least 150 minutes of moderate-intensity exercise per week, an average of 20 minutes per day.

For their analysis, the researchers analyzed a dataset of 89,667 adults, mostly in their 50s and older, who used wrist-worn accelerometers to track their physical activity for a week during the period from February 2013 to December 2015. Follow-up of their health status extended for an average of 4.4 years, during which 735 of the participants were diagnosed with dementia. (The data was generated as part of the UK Biobank project, a long-running, ongoing study of approximately 500,000 individuals.)

The analysis compared individuals whose trackers showed some weekly moderate to vigorous physical activity to those whose trackers showed none and accounted for age and other medical conditions. The associations between higher activity and lower dementia risk were striking. 

Dementia risk was 60% lower in participants in the 35 to 69.9 minutes of physical activity/week category, 63% lower in the 70 to 139.9 minutes/week category, and 69% lower in the 140 and over minutes/week category. Participants in the lowest activity category, ranging from one to 34.9 minutes per week, had an apparent risk reduction of about 41%. The study also found that even frail or nearly frail older adults might be able to reduce their dementia risk through low-dose exercise.

“Our findings suggest that increasing physical activity, even as little as five minutes per day, can reduce dementia risk in older adults,” said study lead author Amal Wanigatunga, PhD, MPH, assistant professor in the school’s department of epidemiology and a core faculty member at the Johns Hopkins Center on Aging and Health. “This adds to a growing body of evidence that some exercise is better than nothing, especially with regard to an aging-related disorder that affects the brain that currently has no cure.”

Dr. Wanigatunga noted that the study was not a clinical trial that established causation indicating that exercise reduces dementia risk, but its findings are consistent with that hypothesis. To check the possibility that their findings reflected undiagnosed dementia leading to lower physical activity, the researchers repeated their analysis but excluded dementia diagnoses in the first two years of follow-up. The association between more activity and lower dementia risk remained robust.

Dr. Wanigatunga and his colleagues recommend future clinical trial-type studies to investigate low-dose exercise as an important initial step toward increasing physical activity as a dementia-preventing strategy. Funding for the study was provided by the National Institute on Aging.

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Skillet Torta Recipe, Spotlight on Fresh and Dried Chiles, How to Choose Better Tortillas, The Brain and Processed Foods plus Does Cold-Water Immersion Impact Good Health?

When you have the fresh spiciness of extra virgin olive oil to lavish on food, the dishes themselves don’t need to be complicated to taste delicious. This one-skillet torta meal is a case in point—prep time is minimal and it bakes in short order. You’ll also read about a provocative study that shows how the brain is involved in obesity and type 2 diabetes and another study that looked at the potential benefits of cold-water plunges. 

Skillet Torta

• Skillet Torta

  This is a fun breakfast or lunch dish that can be made fresh…or it’s a great way to add zest to leftover vegetables. It has the cheesy goodness of a quiche but without a heavy crust. I’m giving it a Spanish flair with Manchego, a sheep’s milk cheese, but you can use whatever cheese you like, even a mix of cheeses if you have a little bit of this and a little bit of that in the fridge.

  Ingredients

  • 5 large eggs  
  • 1 cup shredded Manchego cheese 
  • 2 tablespoons chopped fresh cilantro
  • 1/2 teaspoon fine sea salt 
  • 3/4 teaspoon freshly ground black pepper 
  • 4 tablespoons extra virgin olive oil, divided use, plus more for drizzling
  • 4 ounces red onion, finely diced
  • 1 red bell pepper, finely diced
  • 1 jalapeño pepper, seeded and finely diced, or 1 dried chipotle, soaked and diced
  • One 12-inch round corn, whole wheat, or grain-free tortilla 
  • Optional toppings: sour cream, chopped cilantro, salsa, avocado slices

  Directions

  Step 1

  Preheat your oven to 375°F. Whisk the eggs, cheese, cilantro, salt, pepper, and 1 tablespoon olive oil in a bowl; set aside.

  Step 2

  Heat a 10-inch cast-iron skillet over medium heat. When hot, add the remaining 3 tablespoons olive oil, the red onion, bell pepper, and jalapeño, and sauté until tender. Transfer the vegetables to a separate bowl.

  Step 3

  Use tongs to place the tortilla in the skillet and press the edges against the sides of the pan. Add back the vegetables and then pour in the egg mixture. Bake until firm, about 20 minutes. 

  Step 4

  Keeping an oven mitt on the handle of the hot skillet, run a spatula around the edge of the torta and then cut it into quarters. Plate each serving and top with your choice of optional garnishes and a drizzle of olive oil.

  Yields 4 servings

Healthy Ingredient Spotlight

Chiles: Fresh and Dried

Go to any garden nursery in the spring and you’ll see a huge selection of chile peppers for planting—a few varieties are a great addition to the vegetable garden. But which to choose? The amount of heat a chile adds to a dish varies widely, from about 1,000 Scoville units to well over a million (with few people finding those varieties pleasant to eat). An unusual fact is that many fresh chiles get renamed when they’re dried. Chipotle, for instance, is a dried jalapeño and ranges from 2,500 to 8,000 Scoville units. A poblano is a dried ancho chile, rather mild at 1,000-1,500 Scoville units, and a mirasol becomes a guajillo, in the 2,500-5,000 range. These are all relatively mild dried chiles that are great to have in your pantry. When you need to turn up the heat, chile de árbol has between 15,000 and 30,000 Scoville units. Online spice stores and Latin food markets usually have a good selection to choose from. 

If you want to sprinkle on dried chiles the way you would red pepper flakes, toast one or two in a hot, dry pan for about 30 seconds to bring out their flavor, then chop in a spice grinder with or without the seeds, depending on how much heat you want. To use dried chiles for part of a salsa or other sauce, rehydrate them with a 20-minute soak in warm water before removing the stems and seeds and then chopping. 

Quick Kitchen Nugget

Choosing Better Tortillas

Prepackaged white flour tortillas are not among the healthiest of foods, but there are now many alternatives available, not only whole wheat options but also wraps made from corn or other whole grains with beneficial fiber included. Be sure to read labels to find brands with a low sodium level and a minimum of added ingredients. 

For Your Best Health

The Brain and Processed Foods

A recent study, done at the Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen and the German Center for Diabetes Research (DZD) in Neuherberg, offered intriguing new insights into the possible origins of type 2 diabetes and obesity as well as detail into the brain’s function as a critical control center and the complex roles of the hormone insulin. 

Most of us think of insulin’s job as regulating blood sugar levels and energy metabolism, but there’s much more to it. When a person is in a healthy state (and at a healthy weight), insulin has an appetite-suppressing effect in the brain. But in people with obesity in particular, insulin no longer regulates eating behavior properly, resulting in insulin resistance. Brain insulin responsiveness is linked to long-term weight gain and unhealthy body fat distribution. The new research shows how little it takes to start this chain reaction. 

The researchers divided 29 male volunteers of average weight into two groups. For five days in a row, the first group had to supplement their regular diet with 1,500 calories of highly processed high-calorie snacks. The second group—the control group—did not eat the extra calories.  

Both groups underwent two separate examinations following an initial evaluation, one immediately after the five-day period and the other seven days after the first group had resumed their regular diet. The researchers used magnetic resonance imaging to look at the liver’s fat content and the brain’s insulin sensitivity. The fat content of the liver of the first group increased significantly after five days of increased calorie intake, and a significantly lower insulin sensitivity in the brain compared to the control group persisted one week after the participants’ return to their normal diet. This effect had previously only been observed in obese people.

“Our findings demonstrate for the first time that even a brief consumption of highly processed, unhealthy foods (such as chocolate bars and potato chips) causes a significant alteration in the brain of healthy individuals, which may be the initial cause of obesity and type 2 diabetes,” said study leader Stephanie Kullmann, PhD, professor and deputy head of the division of metabolic neuroimaging at the University Hospital of Tübingen.

Professor Andreas Birkenfeld, MD, director of the IDM, a DZD board member, and the study’s final author, concluded, “We assume that the brain’s insulin response adapts to short-term changes in diet before any weight gain occurs and thus promotes the development of obesity and other secondary diseases.” More research on how the brain contributes to these illnesses is needed in light of these findings, he added.

Fitness Flash

The Big Chill: Does Cold-Water Immersion Impact Good Health?

From frigid showers to icy polar plunges, cold-water immersion is increasingly popular among athletes and wellness warriors. It involves immersing the body partially or fully in cold water, in temperatures typically ranging from 10° to 15°C, or 50°F to 59°F. Is it just good fun or is it also good for you? 

In the most comprehensive review and analysis of its kind, University of South Australia (UniSA) researchers have taken a deep dive into its effects on health and well-being. They analyzed data from 11 studies with 3,177 participants with exposure at or above chest level and for a minimum time of 30 seconds, including cold showers, ice baths, and cold plunges. They found that cold-water immersion may lower stress, improve sleep quality, and boost quality of life…but there are limits.

“Cold-water immersion has been extensively researched and used in sporting contexts to help athletes recover, but despite its growing popularity among health and well-being circles, little is known about its effects on the general population,” UniSA researcher Tara Cain said. “In this study, we noted a range of time-dependent results. Firstly, we found that cold-water immersion could reduce stress levels, but for only about 12 hours post exposure. We also noted that participants who took 20-, 60-, or 90-second cold showers reported slightly higher quality of life scores, but again, after three months these effects had faded.

“[Other] benefits may be gained from cold showers as well, with one study reporting that participants who took regular cold showers experienced a 29% reduction in sickness absence. We also found some links to cold-water immersion and better sleep outcomes, but the data was restricted to males, so its broader application is limited. And while there have been many claims that cold-water immersion experiences can boost your immunity and mood, we found very little evidence to support these claims.”

Co-researcher Ben Singh, PhD, said the study also showed that cold-water immersion caused a temporary increase in inflammation. “At first glance this seems contradictory, as we know that ice baths are regularly used by elite athletes to reduce inflammation and muscle soreness after exercise,” Dr. Singh said. “The immediate spike in inflammation is the body’s reaction to the cold as a stressor. It helps the body adapt and recover and is similar to how exercise causes muscle damage before making muscles stronger, which is why athletes use it despite the short-term increase. Knowing this, people with preexisting health conditions should take extra care if participating in cold-water immersion experiences, as the initial inflammation could have detrimental health impacts.”

The researchers pointed out that while the findings highlight the potential benefits of cold-water immersion, they also underscore the highly time-dependent and contextual nature of its effects.

“Whether you are an elite athlete or everyday wellness seeker, it’s important to understand the effects of what you put your body through,” Cain said. “Right now, there isn’t enough high-quality research to say exactly who benefits most or what the ideal approach is to cold-water immersion. More long-term studies, among more diverse populations, are needed to understand its lasting effects and practical applications.”

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