Five Ways to Make Healthier Hot Chocolate

Updated on Nov 12, 2025 | Diet and Nutrition, Recipes, Your Health

Hot chocolate isn’t just a sweet treat—it can also offer some surprising nutritional benefits. Rich in antioxidants and compounds that may support heart health, mood, and even brain function, hot chocolate made with cacao (especially high-percent cacao) can be a great way to enjoy the holidays while providing an alternative to other highly processed treats.

Taylor Stein, RD

In this Q&A, Taylor Stein, RD, Graduate Assistant in the Department of Environmental Medicine and Registered Dietitian at the Mount Sinai Physiolab, explains some of the health benefits of cacao and how you can make hot chocolate a more nutritious option.

What are the nutritional benefits of chocolate?

What we typically think of as chocolate—like in a chocolate bar or drink—has different nutritional benefits from cacao, the plant that cocoa and chocolate products are made from. It largely comes down to processing and the amount of cacao in different products.

Cacao and cacao-containing foods are rich in antioxidants—chemicals that protect cells from free radicals—and similar compounds that have various health benefits. One worth mentioning is theobromine, which studies suggest may support memory and cognitive function.

There are also numerous studies looking at cacao flavanols in relation to cardiovascular health, mood regulation, glucose metabolism, and lipid metabolism.

How can I make hot chocolate healthier?

There are many ways to make hot chocolate a bit more nutritious, especially for people managing things like saturated fat intake, blood sugar, or other health concerns. Of course, people can still enjoy it however they like—but if you want a healthier version, here are five easy tips:

  1. Make it from scratch, so you can control the ingredients.
  2. Use dark chocolate that’s at least 70 percent cacao. It’s still slightly sweet but provides more antioxidants and potential health benefits.
  3. Choose a low sugar or sugar-free sweetener or adjust sweetness with your preferred type or amount of sweetener. You can also mix real sugar with a low-calorie sweetener to reduce total added sugar while maintaining taste.
  4. Consider protein options. Using soy milk, “high-protein” dairy milk, or even adding a chocolate protein powder can boost protein content—especially helpful for older adults or anyone with higher protein needs.
  5. Add fiber with ingredients such as unsweetened cacao powder, psyllium husk, ground chia seeds, or blended oats. These can also thicken your drink, making it seem richer. You can also blend in dates to add both fiber and natural sweetness.

What can I use for flavor that also has health benefits?

  • Honey and maple syrup are both natural sweeteners with small amounts of antioxidants and other compounds that add a touch of nutrition along with sweetness.
  • Spices and herbs are another great way to add flavor and possible benefits. Cinnamon is a popular choice and may have minor blood sugar benefits. Mint adds freshness and can aid digestion.
  • Nut butters—like almond, peanut, or sunflower seed butter—contribute flavor, healthy fats, and some fiber.
  • For something unique, culinary lavender can add a floral note and may support relaxation through its scent. Interestingly, one study on mood and chocolate found that simply smelling hot chocolate improved participants’ mood, suggesting that sensory enjoyment itself has benefits.
Read more about Your Health

Hand, Foot, and Mouth Disease in Kids: Tips for Prevention

Updated on Nov 5, 2025 | Your Health

Many parents may be unfamiliar with hand, foot, and mouth disease, but it’s actually very common among young children. The good news is that it’s typically mild, and it can be easy to treat and prevent. However, hand, foot, and mouth disease may cause parents and caregivers to worry and perhaps even cringe a bit. But why exactly?

It’s a highly contagious viral disease that predominantly affects children age five and under, but it can also affect older children and adults. The most common symptom is a rash in the mouth, and on the hands and feet. Other common symptoms include fever, painful sores and ulcers, muscle aches, dehydration due to painful swallowing, general fussiness from discomfort, and in some cases diarrhea and gastrointestinal problems. It’s known to spread rapidly, especially in daycare centers and schools, and it causes great pain and discomfort for kids.

In this Q&A, Tessa Scripps, MD, a pediatrician and Assistant Professor, Icahn School of Medicine at Mount Sinai, explains what causes hand, foot, and mouth disease, how long it’s contagious, and tips for prevention.

Tessa Scripps, MD

What causes hand, foot, and mouth disease?

It’s caused by a group of viruses referred to as enteroviruses. The most common cause is the Coxsackie A6 virus, but other strains of Coxsackie virus, as well as other enteroviruses, can cause the illness. When there is an outbreak of hand, foot, and mouth disease, there may be more than one type of virus circulating. Since there are different strains of the virus, a child can get the virus more than once. Adults may not be immune to the virus, so as a result, children can transmit it to their parents and caregivers.

How does it spread?

The virus is spread easily through:

  • Person-to-person contact with droplets when an infected person talks, coughs, or sneezes. These droplets can land on objects or be rubbed into eyes, nose or mouth. These droplets do not stay in the air (like COVID-19) and do not travel more than three feet.
  • Touching skin lesions (kissing, hugging) or coming into contact with objects and surfaces that have been contaminated.
  • Coming in contact with an infected person’s poop, such as changing diapers, and then touching the eyes, nose, or mouth.
  • Touching objects and surfaces that have the virus on them, like doorknobs or toys, and then touching your eyes, nose, or mouth.

What are the signs and symptoms of hand, foot, and mouth disease?

The signs and symptoms include:

  • Fevers
  • Rashes appear like red pimples that can transform into blisters mainly on the palms/between fingers/feet and around the mouth. Other common places are knees and elbows and diaper area. Children who have eczema are more susceptible and can have a more widespread and aggressive rash. Rashes normally scab over and heal without scarring, although some discoloration where the spots where can last for some time.
  • Mouth sores, similar to cold sores that you can see, can develop inside the mouth and tongue but mainly at the back of the throat. This can worsen appetite due to discomfort, so dehydration is a concern in a child who cannot tolerate fluids orally.
  • Diarrhea can occur before, during, or after the skin rash appears.
  • Nail shedding and loss of nails can occur weeks to a few months after onset. While alarming, this is not painful or dangerous, and the nails regrow on their own.

How do you treat hand, foot, and mouth disease?

There is no specific treatment for the virus. It needs to run its course, and this normally takes 7 to 10 days. Here are some suggestions about how to treat the symptoms in kids:

  • For fevers and discomfort, over-the-counter medicines like acetaminophen and ibuprofen can be used. (Note: Aspirin should not be used in children.)
  • It’s important to drink plenty of fluids to prevent dehydration. Cold foods like ice cream, smoothies, and popsicles also help by numbing the area in the mouth. Soft foods like yogurt, pudding, and mashed potatoes can help, and these all can be a nice treat for kids who have trouble swallowing. Avoid hot drinks, sodas, and acidic juices or foods because they can make the pain worse.
  • Get plenty of rest.
  • If mouth sores are particularly bothersome, ask your doctor for treatments that may ease discomfort like lidocaine gel or magic mouthwash (usually not used in kids younger than 6 years of age).
  • For skin rashes, a physician may recommend moisturizers. Symptoms do get better within 7 to 10 days for most people. Children with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry to keep it clean. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection, and cover it with a small bandage.
  • Try to stay as comfortable as possible, and prevent transmission by washing hands and using good hand hygiene.

 How do you prevent hand, foot and mouth disease?

There are some steps you can take to prevent this condition. These include:

  • Wash hands with soap and water often.Hand washing is especially important after using the toilet, after changing diapers or potty training, before and after eating, and before preparing food.
  • Keep hands away from the eyes, nose, and mouth.
  • Avoid close contact with anyone who has it.
  • Disinfect surfaces if an infected person came in contact with them.

When can my child return to school or daycare?

A child can return to school if:

  • There is no fever for 24 hours
  • There are no new skin lesions or open blisters (most lesions should be scabbing over).
  • They appear well enough and active.

When should I call my doctor?

You should call the doctor if:

  • Your child is not able to drink normally and you’re worried they might be getting dehydrated (very sluggish, urine less than three times a day, sunken eyes).
  • The fever lasts longer than three to four days.
  • Symptoms do not improve after 10 days.
  • Your child has a weakened immune system (body’s ability to fight germs and sickness).
Learn more about Pediatrics at Mount Sinai

What Are the Best Winter Boots? A Foot Doctor Explains

Updated on Nov 4, 2025 | Orthopedics, Your Health

From steep curbs and icy sidewalks to deep, slushy puddles, New York City winters can be treacherous for ankles and feet. While boots can be fashionable, they should also provide good protection and support.

Meghan Kelly, MD, PhD

In this Q&A, Meghan Kelly, MD, PhD, a foot and ankle surgeon at the Mount Sinai Health System, shares expert tips on how to shop for winter boots that will protect your feet while getting you where you need to go.

What should I look for in a safe and supportive winter boot?
The most important feature is tread. Good traction is essential for stability on icy or slushy sidewalks. Look for thick soles with deep grooves—similar to the treads on a car tire—to reduce your risk of slipping. It’s the depth of the grooves that provides grip. Deep, wide tread patterns are key for stability on ice and snow.

Ankle stability is also important. In the Northeast, where snow and ice are common, we see an increase in falls leading to ankle fractures or sprains. These injuries are usually caused by slipping rather than the boots themselves.

How can I tell if a boot provides enough ankle support?
Boots that rise above the ankle and lace up high—like hiking boots—tend to offer the best ankle stability, which helps prevent sprains when walking on uneven or slippery ground. Reinforced material around the ankle joint is especially helpful if you’re prone to sprains or have weaker ankles.

🥾Expert Tips for Buying Supportive and Comfortable Winter Boots

  • Pick boots with thick, deep treads for grip on ice and snow, and styles that rise above the ankle with laces or reinforcement for added stability.
  • Look for waterproof materials with insulation, and use orthotic insoles if your boots lack arch support to help prevent pain and fatigue.
  • Try boots on with your winter socks—ideally wool or merino—and size up about a half size if needed for comfort, warmth, and circulation.

What materials work best for winter weather?
Waterproof materials are key, but insulation and comfort matter, too. Look for rubber or waterproof synthetics around the sole and lower half of the boot, paired with a softer, insulated upper material. This combination keeps moisture out and warmth in, and will protect your feet from slush and puddles.

How can I find waterproof boots with good arch support?
That’s a common issue. Many waterproof boots sacrifice internal support for warmth and durability. In that case, orthotic insoles can help. Without proper arch support, people may develop tendonitis, plantar fasciitis, or Achilles tendon pain—especially those with flat feet or low arches.

What should I look for when shopping for orthotic insoles?
For most people, over-the-counter orthotics work well, make walking more comfortable, and reduce foot fatigue. Most insoles in footwear can be removed and replaced, even if it takes a little effort. Being able to switch them out is helpful if you use orthotics in multiple pairs of shoes.

People with flatter feet should choose insoles labeled “arch support,” while those with high arches may need lateral (outer-edge) support instead.

There are also newer 3D-printed orthotics that analyze your foot pressure and create a custom fit. These are available in some shoe stores and  are generally more expensive than other store-bought inserts. But they are less costly than prescription orthotics, which can take weeks to make.

How should winter boots fit?
Fit is extremely important. Many people need to size up about a half size to accommodate thicker socks. Always try boots on with the socks you plan to wear—wool or merino wool are best for warmth and moisture control.

A boot that is too tight can restrict circulation and increase the risk of blisters or even wounds, particularly in people with diabetes or neuropathy. Aim for a snug but not constricting fit, with enough room to wiggle your toes.

What should I look for when shopping for socks?
Choose warm, moisture-wicking materials to keep feet dry and prevent skin problems. Cold, damp conditions can worsen circulation issues and cause pain, especially for people with diabetes or Raynaud’s disease.

Schedule an appointment with a Mount Sinai podiatrist

What to Expect at Your Child’s Telemedicine Well Visit

Updated on Nov 5, 2025 | Your Health

Telemedicine appointments with a pediatrician are one option available to parents who do not want to delay seeking care from their doctor. Tessa Scripps, MD, a pediatrician and Assistant Professor at the Icahn School of Medicine at Mount Sinai, explains what to expect from a telemedicine appointment and some of the benefits.

How is a telemedicine well visit similar to an in-office well visit?
Similar to an in-office visit, during the telemedicine visit, which consists of a face-to-face video conference with your child’s pediatrician, you will have the opportunity to discuss nutrition, development, sleep, parenting, updates on any chronic conditions, and any concerns you have.

How does a telemedicine well visit differ from an in-office visit?
Your child’s pediatrician will not be able to perform a complete exam, however there are many parts of the exam which can be observed on the video conference such as examining your child’s skin or looking for any signs your child may have difficulty breathing. Some of the screening exams which are performed in the office, such as hearing, vision, and blood pressure screens, cannot be done, however your child’s pediatrician will discuss with you the best time to have these checked. If your child is due for immunizations and/or lab work, the doctor will discuss with you the best time to bring your child in for these.

What are some benefits of telemedicine well visits?
During a time that you may not be able to bring your child to the office, telemedicine well visits give you the opportunity to connect with your child’s pediatrician, ask questions, and address concerns you may have. The doctor has the unique opportunity to observe the child in their natural environment, whether it be their permanent or temporary home. Children are often more comfortable in these familiar places and therefore are more playful and vocal. Your pediatrician will be able to do a developmental assessment based on these observations and can guide you about future milestones to look out for. Telemedicine visits let you and your child’s doctor stay up to date with your child’s medical care and allow your family to remain safe at home.

Tessa Scripps, MD

How can you and your child prepare for telemedicine well visits?
Prior to the visit, if you have a scale, you can try to measure your child’s weight without clothes and a diaper on. If you have a measuring tape, you can attempt to measure your child’s height by having them lie down, make a mark or place an object at the top of their head and bottom of their feet and measure the distance in between. Let your child’s doctor know about these measurements during the visit. They will be able to plot them, and you can review your child’s growth curve together.

During the visit, you should have your child available. It is okay if they crawl or walk off to play. Your child’s doctor is happy to observe them play as part of the visit. If possible, have your child wear clothes that can be easily raised up or pulled down in case there is anything you would like the doctor to examine as part of the telemedicine visit.

In which cases may your child’s pediatrician consider treating your child with antibiotics?
Antibiotics are medications which treat bacterial infections. Common bacterial infections that often require antibiotic treatment in children include ear infections, sore throat caused by streptococcal bacteria, certain skin infections, pneumonias, and urinary tract infections.

Why are doctors careful about prescribing antibiotics?
If antibiotics are overused, bacteria can become resistant to them and the medication loses its effectiveness in treating the bacteria. In addition, like all medications, antibiotics can be associated with side effects. Pediatricians have to carefully consider these variables when making the best decision for treatment for your child.

Is an in-office exam necessary to get a prescription for the antibiotics?
Pediatricians use the physical exam as an important diagnostic tool to make decisions about whether or not antibiotics are needed. Some parts of the exam/visit cannot be performed virtually. These include an internal ear exam, listening to the lungs, and swabbing the throat to test for infection. There are some parts of the exam that can be observed virtually including the skin exam and signs of difficulty breathing. If it is not possible for your child to come into the office, your pediatrician may recommend a telemedicine visit so they can observe your child. Based on the history and this observed exam, your child’s pediatrician may determine that a bacterial infection is likely and may consider prescribing antibiotics without seeing the child in the office.

Get more answers from Mount Sinai to your health questions
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My Story: Why I Decided to Disclose My Multiple Sclerosis

Updated on Oct 29, 2025 | Featured, Your Health

Author Kenneth Bandler, a multiple sclerosis patient and advocate, is a member of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis Advisory Board

“What are you doing here?” Andrea and I asked each other when we met in the waiting area at Mount Sinai’s Corinne Goldsmith Dickinson Center for Multiple Sclerosis. She was a volunteer at the American Jewish Committee (AJC), where I was director of media relations.

My heart sank at this surprise encounter in June 2004. I had managed to keep my multiple sclerosis (MS) a secret for years. Quickly adjusting, I said to her that a few days earlier I had told AJC’s CEO about my MS. Luckily, Andrea and I had not crossed paths at the Center earlier. It might have swayed me to disclose sooner than I desired.

Concealing MS is not stress-free. I first came to the Center in May 2003, shortly after the second MRI in my life revealed new brain lesions, showing the disease had progressed since my first MRI and diagnosis in 1990. I needed to see an MS neurologist.

I chose the Center for several reasons. It was convenient to my residence and workplace. I was able to get an appointment with Fred Lublin, MD, the Center’s director. And I noticed a social worker was on the Center staff. I thought she might come in handy as I embarked on a new chapter in my MS journey.

After an MS diagnosis, finding trusted individuals to speak with for help in navigating this unpredictable disease is critical in averting loneliness. For many, one’s immediate family—spouse, parents, siblings—are the first line of assistance. Others find comfort in MS support groups.

A workplace is a very different situation. For comradery some people share information about family, vacations, and other interests, but certainly they are not obliged to divulge a health condition.

With my relapsing-remitting MS, maintaining the secret was not difficult, as in this most common form of the disease, there are periods of remission and symptoms disappear. I looked fine to my colleagues, and I did not allow MS to interfere with my work production.

I was very fortunate that the Center’s comprehensive care includes a social worker whose unparalleled guidance was crucial in giving me the self-confidence to tell my secret.

But the reality was that only I knew how I felt and that I needed to manage exacerbations. I thought about telling my boss so that he would be aware of my MS in case a debilitating attack struck me at the office or while travelling for work. However, I knew you cannot take it back if sharing did not go well. I feared the unknown of what the reaction would be. Why take that risk when my job was going well?

Enter the social worker. Through confidential one-on-one conversations, a social worker familiar with MS helps you navigate life challenges related to the disease. The social worker and I established a very good rapport. Our conversations encouraged my thinking about the pros and cons of disclosing. Their questions about the demands of my media relations work for a global advocacy organization, and my relationship with the CEO, helped me focus on how I saw MS affecting my job.

Our discussions helped me recognize what I already knew deep inside—that it would be best for me to tell my boss, and it would be safe to take that risk by disclosing on my terms. Deciding to divulge was huge, but how and when to do it still were big hurdles. Several times over a period of months I told my social worker that I was ready, but at the last moment, as I sat with my boss, I hesitated. The timing and setting did not feel right.

Another stress factor weighing on my mind was an oped article I had written about my MS. Center staff encouraged me to publish it, but how could I without telling my employer I have MS?

One Friday evening, in late May 2004, I walked into the CEO’s office and told him I have MS. He was stunned to learn about my disease, and that I had kept it a secret. I gave him my article to read over the weekend, and Monday morning he encouraged me to publish it with my AJC title. It appeared in the International Herald Tribune under the headline “The loneliness of coping with MS.”

The psychological burden of constantly thinking about whether or not to disclose had been lifted. Relieved of the stress of concealing my MS I continued to pursue an enjoyable, successful career heading AJC media relations for more than 25 years.

I was very fortunate that the Center’s comprehensive care includes a social worker whose unparalleled guidance was crucial in giving me the self-confidence to tell my secret.

By Kenneth Bandler, a multiple sclerosis patient, advocate, and member of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis Advisory Board

 

Listen to Kenneth Bandler talk about his story on the Can Do MS Podcast
Learn more about the Corinne Goldsmith Dickinson Center for Multiple Sclerosis
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Creatine Can Help You Build Muscle—Here’s How

Updated on Oct 24, 2025 | Diet and Nutrition, Fitness, Your Health

Creatine is a natural compound found in meat and popular supplements that can help you build muscle, improve strength, and boost workout performance. Whether you’re a fitness enthusiast or just starting strength training, creatine can support your goals—but it works best when combined with proper exercise and nutrition.

“Creatine is not a magic pill—it only works when combined with consistent strength training, adequate protein, and healthy lifestyle habits,” says Taylor Stein, Associate Researcher and Registered Dietician with the Mount Sinai Physiolab, which provides personalized health and wellness recommendations based on unique assessments that capture your personal metabolic and physiological data.

Taylor Stein, RD

In this Q&A, Ms. Stein explains the basics on using creatine supplements to help build strength—while stressing that you should check with your doctor on what is right for you.

What are the benefits of creatine?

Creatine has been studied for a range of possible effects. Research suggests it may

  • Enhance exercise performance and recovery
  • Support cognitive function, especially in older adults
  • Show potential in healing traumatic brain injuries
  • Improve blood sugar management and overall metabolic health

The extent of these benefits can vary. Speak with your doctor to see if creatine supplements are right for you.

What about risks?

If you take creatine appropriately, there are few known risks. However, you should be aware of the potential that it could result in:

  • Falsely elevated creatinine levels, which may raise concerns about kidney function. (It’s important to tell your doctor if you are using creatine or any other supplement.)
  • Possible gastrointestinal side effects—such as nausea, bloating, or stomach discomfort—especially when starting. This is usually temporary and can be improved by adjusting the dosage.

What are the best sources of creatine, and how much do I need?
Creatine is naturally found in protein-rich foods, primarily fish, beef, and pork. A four-ounce (113g) serving of prepared beef or fish provides roughly 0.5 grams of creatine, while chicken, turkey, and other poultry contain smaller amounts.

The recommended daily dose is about five grams. To reach that amount through food alone, you’d need around 40 ounces of cooked protein daily—an unrealistic amount for most people. That’s why supplementation often makes more sense.

If I supplement, is there an ideal way to take it?
Creatine is best absorbed as creatine monohydrate (the form with the most research support) and does not require other foods for effective absorption. It usually comes in powder form, though gummies are available. Some people find the powder gritty, so I recommend mixing it into a warm beverage to dissolve it better. It’s water-soluble and doesn’t need to be combined with other foods.

Are protein and strength training necessary when taking creatine, and why?
Yes. Creatine helps ATP (adenosine triphosphate), which provides the energy for many processes within living cells, which in turn powers your muscles for contractions, allowing for improved strength and workout performance. Taking creatine can amplify the effects of physical activity, but on its own won’t do much if you are not exerting yourself in some way. Without strength training and adequate protein, creatine supplementation won’t lead to significant results.

How much protein and strength training should I do weekly?
The general recommendation is at least two strength-training sessions per week, targeting all major muscle groups (including your quads, glutes, hamstrings, and upper back).

Most people need at least 90 grams of protein a day for muscle growth, but needs vary widely depending on your body weight, goals, and whether you follow a vegetarian or vegan diet, which can include less protein per serving compared to a diet that contains meat.

How much creatine supplements should I take per day for muscle growth?
Most creatine products—powders or gummies—come in five-gram doses, which is the typical daily recommendation. Sometimes a short-term “loading period” is suggested: 20 grams per day, divided into four doses, for about five days, to reduce potential stomach upset. After that, continue with a maintenance dose of five grams daily. The reason for the loading period is that muscles can store creatine.

Does creatine work differently for women and men?
Yes, there are some differences. Some research suggests women may have lower creatine storage capacity, so the loading phase may be especially beneficial for them. For women in menopause, declines in estrogen reduce the body’s ability to build muscle. Research shows supplementation can improve exercise performance, muscle growth, recovery, and even support bone health during menopause.

There’s also some evidence supporting benefits for bone mineral density and cognitive function in older women.

Schedule an appointment with the Mount Sinai Physiolab for personalized health and awareness recommendations. Note: The Physiolab does not take insurance at this time.

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