What Kind of Omega-3 Oils Should I Take?

My doctor told me to take fish oil pills for a touch of high cholesterol. I was just wondering what is better: Fish oil pills or omega three or salmon pills.  Also, what is the best oil to cook with.... I think it is olive oil but not sure.  Thank You. Anne H.

Dear Anne,

You are absolutely right about olive oil being good for cooking. As one of the monounsaturated oils (along with canola and peanut oil) this type helps lower your total cholesterol without affecting the "good" (HDL) level, as polyunsaturated oils, such as sunflower and safflower have been found to do.

Regarding the Omega-3 fatty acids: They are found in fish oils, including salmon, so you are on track with your information. Most capsules provide 1000 mg and your doctor likely suggested one per day. Higher doses should not be taken without your physician's advice as there can be harmful side effects for some people at this level. My own physician suggested capsules of flaxseed oil, which is a source of omega-3 fatty acids, instead of fish oil merely because there is no danger of a fishy aftertaste later in the day. I think that is good advice!

Are My Vitamins Good Ones?

I was wondering if you might know anything about spring valley vitamins and how effective they are? I buy them at walmart, so I'm wondering about the quality of them. I've been taking a vitamin B complex and seem to have much more energy, even with less sleep. but i still want to make sure I'm buying good vitamins that will really benefit my body. thank you, Amanda H.

Dear Amanda,

While the number of supplements available are too numerous to keep up with brand specifics, I do know that the FDA regulates supplements to be sure they contain what they say they do and that there are no false claims made about what they can do. So I would feel comfortable saying that vitamins sold at Walmart are as good as those sold in health food stores which may be more expensive.


What B vitamin pills do is supplement your diet. Few people have B vitamin deficiencies since they are plentiful in carbohydrates (breads, cereals, rice, etc) and many are fortified. Some reasons that a person may have a deficiency would be from excessive alcohol intake or eating mostly non-enriched sources of refined starches (for example, large amounts of sugary soft drinks and candy).

The feeling that you have more energy is more likely coming from your mind than your body. While B vitamins help your body use the energy (calories) you get from eating carbohydrate foods, they don't actually give you the feeling of having more energy as in being energetic or more awake.

The best supplements provide about 100% of the daily value and not a lot more. If your supplements provide 500 or 600% of the RDA for these vitamins watch for bright yellow urine--this is just your body's way of flushing out all the extra that is not being used!

Should I Take an Iron Supplement?

I've heard that Iron is good for improving memory and mental sharpness. Is that true? Is iron available as a suppliment, and if so are there any dangers involved with taking it? I would assume it would be much safer without the red meat tied in with it?  --Nick T.

Dear Nick,

I have not heard that iron has any effect on memory or mental function.

Iron is available as a supplement. Men need about 10 mg per day, and it is rare to see iron deficiencies in men. Be sure to check the label of a supplement you choose to be sure it isn't more than 100% of the RDA. The tolerable upper limit for males is 45 mg.

Taking more than you need does have potential side effects. Iron can build up in the body and deposit in the organs, causing organ failure. There are no symptoms to warn of this condition until damage has occurred. Therefore, I would recommend speaking with your physician before taking an iron supplement.

If you would rather avoid the cholesterol and saturated fats in red meat, other good sources of iron are turkey, dried beans, and fortified breakfast cereals.

Help the Hungry This Holiday

If you have young children and you could use some nutrition tips, here's a great resource. Click here to buy "Expert Nutriton Tips for Your Toddler". It's 52 pages of questions answered by pediatricians and dietitians. For only $9.95 you not only get the book, but ALL of your money goes to fighting hunger in America. Donations go to "Share Our Strength" to help end hunger in America.
Get your copy today and feel good about contributing to those less fortunate.

Have a healthy and happy holiday season.

How Can I Increase My Metabolism?

I would like to increase my metabolism as much as possible. I am 29 years old and can remember having a very good metabolism as recently as age 24 where I didn't really need to exercise and wouldn't really gain anything. I am 5' 11" and 205lbs, and at least Wii Fit is telling me I'm in the middle of the overweight category. Are there charts that tell people by how much their metabolism tends to slow down by age, as well as when a person moves away from an ideal BMI? I'd really like a guide to have a clear idea of the norms. Particularly how much metabolism I have to gain by getting myself back down to say 160lbs. -- Mike J.

Dear Mike,

My favorite site for computing your BMI is by the NHLBI . 

Just enter your height and weight. They also explain the body mass index.
As for your goal weight, that is very reasonable for your height.


Changing your metabolism has so many variables there are not really instructions on how to do it... everyone is different. What were you doing differently in your daily life when you were 24? Even without feeling like you were exercising it's likely you were more active. Maybe you walked more in your job or played on a sports team. Maybe as you've gotten older you've been able to afford to eat out more and that generally comes with more calories.

If metabolism slows with age it's probably due to a decrease in muscle mass and there's evidence that does not have to occur if you always work on keeping your muscles in shape. Usually that starts after age 35 for women, and older for men so that's probably not what's at work with you.

My best advice is to start keeping a food and exercise diary. There are many sites that help you do this online if you have regular access to a computer, such as http://www.thedailyplate.com/, http://www.fitday.com/ or http://www.sparkpeople.com/ . You may realize after keeping track that you are eating more than you thought or moving much less.

Remember to take your time losing those 45 pounds. More than 2 pounds each week means you may be cutting calories too much. You're much more likely to keep the weight off by changing your habits to include about 500 fewer calories per day and upping your activity by another 250 calories. All these reputable diet sites listed above can translate that into daily foods and activities!

Can Fat People Starve?

I am just wondering, can fat people starve themselves? I would think if both fat and calories are both energy that can be burned, that a fat person can't starve until they become thin? --James. T.

Dear James,
You are correct in assuming that a person with ample fat stores would not starve to death from lack of energy stores. However, if an overweight person ceased to eat (or ate extremely poorly) they could still die from malnutrition. Having inadequate vitamin and mineral intakes could lead to deficiency diseases after several months and most of these are ultimately fatal. Protein is also vital and there are no body stores.  After a time without protein the body becomes more susceptible to infections and poor recovery. The heart and kidneys, among other organs, would be reduced in size and strength to the point they could not sustain their function adequately to support life.

Is Orange Juice Fattening?

I was wondering if 100% fresh squeezed orange juice is going to slow my weight loss on my diet?  Chris. R.

Dear Chris,

There is no one food that's going to blow a diet. It totally depends on the sum of the foods you eat, and the portions are also quite important.
Orange juice has about 11 calories per ounce, so a 6-ounce glass in the morning will be a valuable contribution for your daily intake of vitamin C, folic acid, and other nutrients. I would definitely put orange juice just about last on my list for giving up on a diet. However, do keep in mind that drinking four 12-ounce glasses a day is another story!

Foods that will really hamper your weight loss efforts are those high in sugar and fat: donuts, pies, ice cream, soda, fried foods--these I would give up for a diet because you aren't missing out on anything that's very good for you by avoiding these, but you are giving up a tremendous number of calories.

Good luck!  And for more information on a healthy and well-balanced diet during weight loss I always like the food guide pyramid site http://www.mypyramid.gov/ for their wealth of information.

Are Some Types of Beans Better Than Others?

My family eats a lot of legumes, mostly chickpeas and black beans because I have lots of recipes for those. I am wondering if there is enough nutritional difference between varieties of beans that I should be branching out and serving more different kinds - maybe lima beans, kidney beans etc? Or are they basically all the same nutritionally anyway? Thanks so much! - Jennifer C.

Dear Jennifer,

It appears at first glance that all beans are equally good sources of iron, fiber, and minerals so you might not need variety. But the same seems true of many fruits and vegetables until the discovery of some new phytonutrient that seems to come along every few months. All of a sudden one day blueberries are super, or tomatoes have something no other food has so much of, or red raspberries are a must for this new fantastic component that is healthy for our cells!

Apparently the lesson is that variety is always important, even within the same type of food.
I would suggest using any type of bean you can find to mix and match in recipes: try black-eyed peas, great northern beans, pinto beans and navy beans for starters. You might find some new favorites, and you'll never be left out of the loop when some amazing nutrients are discovered in high concentration in one kind of bean!

What if I Can't Drink Eight Glasses of Water?

I have a question about drinking water.  It seems like the healthy people I see are carrying around water bottles, or drinking lots of water with lemon.  I tried to drink 8 glasses a day a few years back, but it makes me feel bloated and of course I have to run to the rest room every hour!  I want to lose weight and be healthy, but I am mostly a coffee drinker and I'm afraid drinking more water will just make me uncomfortable.  Tim Y.

Dear Tim,

If you drink mostly coffee and hardly any water, there's a good chance you are walking around in a consistent state of dehydration.  Coffee (with caffeine) tends to increase urination and you aren't replacing the water lost from your body.  You may feel a bit sluggish or get slight headaches as an indication you need to drink more fluid.  By the time your mouth is dry from thirst, you've really gone over the edge into dehydration, so don't use "I'm not thirsty" as a judge of when it's time for you to drink.

People who drink lots of water may be a more appropriate weight because they may tend to eat and drink fewer calories than other people do.  Often we look for something to eat between meals when what we actually need is something to drink.  Our brain can send confusing signals which cause us to look for food.
Water is also a calorie-free source of hydration, whereas drinking soda, sweetened tea, lemonade, etc can really pile on the calories.

My advice to you would be trying to drink three or four glasses of water a day.  You don't need to get in eight glasses a day to be in better shape than you are now!  If you can sip at a bottle of water in between each meal you'll be getting a lot more in without feeling like you have to chug it all at once (making you feel bloated) or having you running to the restroom so often.  Remember that most water bottles contain 16 ounces which is two glasses.  If you can try drinking two bottles a day, I'll bet you notice that you start feeling a little bit better and eating a little bit less.

Does Sugar Cause Weight Gain?

I was wondering if sugar causes weight gain, or if it is the calories in the sugar that add up over time?  Janet R.

Dear Janet,
I love the way you phrased that, and you are correct! It is the calories that add up.


For example, if someone drinks several sugary juices or sodas each day, they will end up with a few hundred extra calories they aren't using and their body will store this as energy (fat) for later use.

The other issue is, many foods that contain sugar (like donuts, cake, and candy bars) have fat in them as well---putting on more calories and more weight.

There is nothing wrong with sugar, itself, in moderation---enjoy a teaspoon in your coffee or on your morning cereal without worry!

How Can I Stretch My Food Budget?

I'm a college guy on a very tight budget.  I have my own apartment so I can store and cook food, but my family is helping me to pay many of my bills.  I would like to figure out how to cook with the least money possible--any suggestions?  Sam D.

Hi Sam,
Here is a great resource that was printed to help people live on a food stamp budget: That means something around $30 a week for a guy like you!  There are tips for shopping and cooking, meal plans, menus, and recipes in this book, "The Thrifty Meal Plan".  I hope you like it!  http://www.cnpp.usda.gov/Publications/FoodPlans/Miscpubs/FoodPlansRecipeBook.pdf

Can You Live Off the Water Found In Food Without Drinking?

I have been debating an issue with my coworker. We all know that water is essential to good health. Does water in food count the same as drinking water? Example: is drinking 8 glasses of water in a day the same to the human body as getting the same 8 glasses of water in mashed potatoes? My coworker believes that the 8 glasses of water in the mashed potatoes would not satisfy the body's liquid requirement the same as drinking water would. Could the human body survive if it never had water in liquid form but instead had all of its liquid from food?   Lonnie N.

Dear Lonnie,
Yes, technically if you could get all the water you needed from food, the body would use it the same--H20 is H20!  But it would be quite difficult. The average person who eats 2000 calories per day requires 1 gram (cc) of water per calorie to metabolize the food eaten. 2000 cc's of water is about 8 glasses, and this is where the recommendation comes from.

Let's take a large banana that weighs 200 grams (a bit over 6 ounces) and is 75% water (one of the highest water-content foods)  It contains 150 grams of water--just about 5 ounces. You need most of this to metabolize the calories contained in the banana (maybe 120 calories) so you wouldn't have much left over (1 ounce) for other foods that are low moisture--cheese and crackers and meats and oils.

Indeed if it were possible to eat fruits and vegetables all day long, and nothing else, one may get a good percentage of the water needed. Certainly there are people who never drink water and instead slurp down beverages that make them require more water: sugary sodas, caffeinated coffee, and alcoholic beverages. They manage to live, but they would do much better getting enough water for the many functions it serves in the body: transport, weight elimination, blood volume, and temperature control just to name a few.

What is the Oily Residue in My Cooking Pans?

If you cook with margarine in a pan, can there be margarine residues on the pan after washing? When I wipe the pan with some paper towels, there seem to be a slight staining.  -- Ben H.

Hi Ben,

Yes, there certainly can be some residue, especially if the pan is just rinsed and wiped. Oils need lots of soap to break up the molecules and allow them to rinse away.

The residue may be greater when using spray margarines and squeeze margarines, as well as some of the low-fat varieties of "buttery spread" because they have other products in them that contribute an oily feel, but are not the same as real oil in structure.  They mimic the taste well, but the consistency is a bit different and they may be reflected in what remains after cooking.  Some of the spray butters and light butters do tell you not to use for cooking, and I've been told they virtually melt into something resembling plastic when heated.

Also, when using a "non-stick" pan it is advised that you not coat the pan, especially not with a cooking spray.  The directions do say that leaves a residue.

Eating Healthy versus Eating Disorder

Confidential to K.M
I hesitate to provide you with all the ways you can reduce your calorie intake, count your calories, monitor your weight, burn the most calories, etc. because I am concerned you may be flirting with disordered eating.

While I do not suspect you have a full blown eating disorder such as anorexia nervosa or bulimia, certain parts of your letter indicate you may benefit from counseling at this time instead of more information on dieting.  Being afraid to gain weight, focusing the majority of your morning planning what you'll be eating the rest of the day, and other thoughts concentrated on calorie-burning are a way of controlling things in your life when there are so many other issues over which we have little control.  Perhaps a trusted therapist will be able to help you deal with so many of the other aspects and one day your weight will not be something on which you focus 24/7.  Other options are eating disorder therapy specialists, outpatient eating disorder units, and local support groups.  Most hospitals can direct you to assistance in your area; I hope you'll take advantage of it and get your old happy self back!

Where Does My Fat Go When I Lose Weight?

When you lose fat weight, where does it go?  How does it physically leave the body?  --Carrie S.

Dear Carrie,

I just love that question!  I'm sure it's something we've all wondered at one time or another.

Well, it's a matter of biochemistry. Each fat molecule is made up of atoms of Carbon, Hydrogen, and Oxygen. When your body needs energy (like when you are exercising, or if you haven't eaten enough to support your weight) the fat molecules break down to yield energy in the form of calories. The molecules go through a series of reactions which generate energy that has been stored up until now in neat packages of fat, in special cells for this storage purpose. When you burn a lot of energy (like when running) your body temperature actually goes up and you begin to sweat.

The final breakdown products (and these same atoms are present in protein and carbohydrate as well--which go through a variation of the biochemical reactions to yield calories) are Hydrogen Oxygen, and Carbon. The Hydrogen and Oxygen leave your body as water through the kidneys, the intestine, your breath, and a small amount through your skin (as in sweat). The Carbon atoms combine with the oxygen you breathed in, and are excreted as carbon dioxide.
 
Ha! Remember in 6th grade when you learned "you breathe in oxygen and you breath out carbon dioxide"? Now you know where the carbon comes from!

Am I Eating Enough Calories?

I am 145lbs and would like to be 125lbs. I am confused about how many calories I should eat. If I burn 1600 calories doing nothing and I work out burning anywhere from 350-800 calories depending on the excercise how many calories should I eat to lose 2lbs a week? I eat about 1600 calories a day and when I incorporate work outs, I am wondering if I am eating enough. I am thinking I need to increase my daily calories.  Sarah M.

Dear Sarah,

The number of calories each person burns varies quite a bit with age, height, activity level, and body type.
At your weight (I am estimating age and height) you may burn about 1600 calories doing no exercise during the day, but if  you want to lose 2 pounds per week you would have to eat 1000 calories PER DAY less than you burn.  This would have you eating 600 calories per day, and it's neither healthy nor reasonable. 

You are doing what's wise by incorporating calorie-burning workouts into your day to promote faster weight loss.  With a slight decrease in calorie intake along with a daily workout to boost calories burned, you'll be able to lose weight, but probably closer to one pound per week than two.
Let's say you burn an average of 2100 calories per day including your work out: Then 1600 calories per day will allow one pound per week weight loss.  Unless you are very large, it's too difficult to lose two pounds of body fat per week.  (For example, a 250 pound man who is 6 feet tall might burn 2900 calories a day and he could  fairly reasonably reduce his intake to 1900 calories per day to lose two pounds per week).

I hate to be the one to tell you, but you are eating enough, and eating more will not allow for any more weight loss than a pound every few weeks. Be sure you are eating nutrient-dense and filling foods so you aren't going around hungry!

Is Fruit Sugar Better for You Than Refined Sugar?

Is the natural sugar found in fruits better for you than refined cane sugar?  Mike J.

Dear Mike,

Your body actually processes all sugars to the same end product--glucose.  Whether you consume milk sugar (lactose), fruit sugar (fructose), cane sugar (sucrose), or even starches, the final breakdown product is glucose, the simple sugar that is the preferred source of energy for most of the body's cells.

I think processing has a negative connotation in some regard because of the over-processing of some products (like wheat) that results in the omission of nutrients.  The refining of cane sugar is necessary because we cannot cook or bake with chunks of raw cane!  So the process is merely necessary to get the consistency of a product we can use.

Fruit itself is probably healthier than products you consume that contain cane sugar because of the vitamins, antioxidants, and fiber contained in addition to the fruit sugar.

What's The Best Diet Plan?

My doctor advised me to lose 25 or 30 pounds to help reduce the pain from my sciatica.  I have tried Atkins diet before but was unsuccessful.  What do you think the best diet plan is?   Donna L.

Dear Donna,

If you're looking for a weight loss plan I'd have to say weight watchers is the way to go.
You might also see if you would like planning your own diet using the food guide pyramid at http://www.mypyramid.gov/. This site shows you how many servings from each group you need, based on your height, weight, activity level, and weight loss goals. Then you make your own meal plan to support that.

If you feel you would benefit from ongoing support, consider working with a diet coach.
A coach will work with you weekly on an individual basis to help keep you motivated, update your weight loss plans, and remain accountable.
Weight watchers offers weekly support on a group basis, both in person and online.  It's up to the individual what works best for you.  Some people prefer groups and some like to stay at home!

The very best plan would be altering the eating habits that have lead to your weight gain, instead of going on a set "diet" or meal plan. Slowly work to reduce portion sizes, become more active (like taking a flight of stairs instead of the elevator), choose lower fat foods, drink more water, and eat more fresh fruit and vegetables--especially instead of sweets and snacks.

The weight won't come off at a rate of five pounds a week, but once you reach your goal you'll have healthy new habits and the weight will stay off  for good!

Is My Peanut Butter Too High in Saturated Fat?

I just read the label on my peanut butter jar and found it has 1.5 grams of saturated fat in a 2 Tablespoon serving.  Is that really bad?     Gary L.

Dear Gary,

No, I don't think it's really bad.  I actually think it could be a better substitute for what a person may be eating it in place of: substituting this for bacon and eggs on your toast at breakfast, making a sandwich with it for lunch instead of a few ounces of high-fat cheese spread, or having some for a snack instead of a candy bar--it is a better option than many other choices, and there are many foods that would be considered "worse" on a good-to-bad food scale.

But mostly I think there are no "bad" foods--only bad diets.  You need to consider how much peanut butter you consume as a serving, and how often you eat it.  Whether or not you are otherwise healthy or perhaps have a high cholesterol level and need to be limiting your saturated fats. 

There are levels of eating "better" foods and limiting foods that have more fat and calories than nutrition.  There is the issue of including balance in your diet and limiting portion sizes to what is reasonable. There isn't really any one food that stands alone as "bad".

Oh, and of the three varieties of peanut butter that are in my pantry right now, they have between 2 and 3 grams of saturated fat per 2 Tablespoon serving--so your peanut butter actually appears among the better, saturated-fat-wise!

What Do You Think of My Vitamin D Supplementation?

I have been doing some reading on Vitamin D supplementation, and recently started taking 1000IU of Vit D. I also get 800IU in my calcium pill and 500IU in my daily Centrum multivitamin. I also take 1000mg of fish oil daily. I am 58 year old male in good general health. What is your opinion about Vit D supplements and the general regimen I have described?    Dave N.

Dear Dave,

I would be interested to know the source of your reading and what it was you read that made you decide to supplement at a level above the daily value. The daily value for vitamin D is 400 IU. You are more than meeting that in your multivitamin, and then getting some more in your calcium pill. I couldn't say how much additional is in the fish oil you are taking, but remember that you are also getting some in your diet (especially from dairy products), and likely receiving some of what you need through daily sun exposure.  Topping it off with another 1000 IU supplement leads you to exceed the tolerable upper limit that is currently set for this vitamin.

Since vitamin D is a fat soluble vitamin, excess amounts are stored in your body. The tolerable upper intake level is currently set at 2,000 IU, (although later studies do suggest the upper limit could be set higher). Some effects of taking too much vitamin D include calcium deposits in soft tissues (which can damage organs) and kidney stones, as well as other symptoms like generalized weakness, constipation, poor appetite, and also an increase in serum calcium levels which could lead to serious heart rhythm abnormalities.

I suggest you see your physician to discuss an optimal level for you . Exceeding your needs of this vitamin could very well result in doing more harm than good.

Is There Trans Fat in My Peanut Butter?

My peanut butter label says "zero trans fat" on the front, but when I read the ingredients there are "hydrogenated oils" contained.  These seeming conflictions are confusing to me... what can I believe?
Larry F.

Dear Larry,
Technically, if a food has only 0.5 gm trans fat in a serving they can state"zero trans fat" on the label.  There is currently no recommendation for a safe level of trans fats and consumers are advised to avoid any amount whenever possible.  I would take a close look at the listed serving size on your peanut butter label: there's a chance some manufacturers may start listing smaller serving sizes in an attempt to be able to claim "zero trans fats" for their products.

Why Do People With Strokes Sometimes Need Their Liquids Thickened?

My Aunt had a stroke and now we have to add something called "Thick-it" to all her liquids.  How does this help her swallow?  Janet W.

Dear Janet,

Sometimes after a person has a stroke, or if they have any condition that affects their gag reflex (ALS, Parkinsons Disease, advanced stages of Alzheimers), liquids will not be swallowed properly, but instead will accidentally go down the windpipe (trachea) instead of the food pipe (esophagus).  We can experience something like this if we are talking while we eat, or accidentally take a breath while we drink: We cough and cough and say, "something went down the wrong way".  But in stroke patients where the swallow reflex is affected, the person may not even sense that something did go down into the lungs, and may not have a coughing reflex to attempt to get the fluids out.  Eventually, this can lead to a build up of fluid in the lungs and lead to pneumonia, advance to a serious infection, and even result in death.

Thick-It is a powdered thickener that, when added in varying amounts, can make liquids the consistency of honey, nectar, or pudding.  The prescription from the doctor will usually specify to what thickness liquids should be made.

Thickening all liquids (even water) will make it easier for the nervous system to sense what is in the back of the throat (fluids are not as easy to sense), close the epiglottis (the flap that covers the trachea when swallowing) and send the liquids down the safe, intended route to the stomach.

The swallowing process is not done consciously, so if the swallowing function is not working properly , a person may present to the hospital with frequent episodes of pneumonia without knowing the cause. In order to diagnose the condition a speech therapist will do a swallow assessment with the patient, and if any signs of aspiration (food or fluids going down the trachea) are suspected, the next step would be a modified barium swallow (x-ray test) to see exactly what is going on in the throat during swallowing.

Is Weight Watchers A Good Diet Plan?

I am 30 pounds overweight and thinking of joining Weight Watcher's. What is your professional opinion of this diet program and why?  Linda N.

Dear Linda,

I have a very high opinion of the Weight Watcher's program.  It's a realistic way of weight loss because they teach you how to eat in real life--you can cook your own meals, purchase ready to eat meals from the grocery store, or eat out wherever you like.  They teach you to be aware of what you eat and what your portions are.

Many people also appreciate the accountability that is built in by showing up every week and weighing in.  During your meeting you get information and support, as well as rewards for weight loss, which can be very motivating.

This diet, more than any other, is one you can stay on for life. And that's important. Because when you go off a diet, you gain back the weight.

If you are finally read to change your lifestyle, your eating habits, and your activity level, instead of trying another diet for a few weeks to get the weight off for now, this is one of the best ways to go!

You can also choose to join either online or in person, whichever suites you best.

Second to having your own personal diet coach, I think it's one of the best plans out there!

Is Deer Meat High in Cholesterol?

Dear Laurie,
My family received a large amount of deer meat as a gift from a friend who is a hunter.  I would like to eat it, but my concern is that I was able to reduce my cholesterol from 250 to 210 over the past few years by reducing my intake of beef and other meats.  If I enjoy venison this winter, will my cholesterol level go back up again? I really want to avoid taking medication for it.   Drew R.

Dear Drew,

Congratulations on reducing  your blood cholesterol level so well by changing your diet!  My suspicion is that you did more than just eliminate beef on a regular basis: You may also have cut back on other fatty foods, reduced portion sizes, increased fiber intake, and started exercising more.  You probably lost weight as well.  It's usually a combination of dietary changes that leads to such a significant change in cholesterol level.  It's also significant, as you probably know, what the level of your LDL and HDL cholesterol is, too.

If you would not consider eating beef again, you might not want to consider eating venison either: While lower in fat than beef, it is also higher in cholesterol by about 25%.  The lower fat content may make it a safer option than beef, but if your tendency is toward higher serum cholesterol you'll want to proceed with caution.
Be sure the portions are small (3-4 ounces) and that you eat leaner cuts of the meat.  If it were me, I'd try having it once a week and have my blood cholesterol level checked in about six weeks.  By then you should be able to see a difference if one will occur.  If your cholesterol goes up, you'll have to back off on the deer meat, and if not you can continue to enjoy small amounts throughout the winter.

In time, you may become more comfortable enjoying certain foods on occasion, which you have been used to avoiding over the past few years.  It's the combination of all the lifestyle changes I'm sure you have made that reduced your cholesterol level and as long as you keep up most of them on a regular basis you should continue to keep your cholesterol under good control.

Are Meat Substitutes Healthy?

I was wondering about the meatless patties that substitute for burgers and chicken.  Are they healthy enough to eat every day?   --Peter T.

Dear Peter,

There are many varieties of meatless burgers: some are combinations of vegetables, some are made from soy products and my favorite, Quorn is made from textured mushroom protein. There is not a reason I can think of that they wouldn't be good to eat as often as any other food.

Just remember to include variety in your diet.  It's not a good idea to eat any one food to the exclusion of others.  If you like meatless meals, consider other options such as pasta dishes, vegetable stir fry, casseroles, or bean-and-rice dishes to provide a good source of protein and other nutrients as well.

How Much Is Too Much Fruit?

Dear Laurie,
I just found out that I love kiwis and have been enjoying them along with lots of other fresh fruits this month.  It got me to wondering, can a person eat too much fruit?  I mean, I know that fruit is good for you, but what if you are eating a lot?  Is there some maximum number of servings above which it's not good for you anymore?    Francine K.

Dear Francine,
This is quite a thoughtful question and you bring up a good point: At some level, even things that are "good for you" can take a turn and become more harmful than helpful for a number of reasons.  As far as fruit goes there are a few ways that eating many servings per day could start to be less "good for you":

1) Eating so much fruit that you experience discomfort from the fiber intake:  If you aren't used to a high fiber intake you could begin to experience intestinal bloating and/or diarrhea.  At this point it would be a good idea to back off to fewer servings per day.

2) Eating so much fruit that you don't have room for other nutritious foods:  The reason it's important to include balance and variety in your diet is to get in good sources of all the vitamins and minerals.  Fruits contain some, like vitamin A and C and potassium, but are poor sources of thiamin, riboflavin, calcium, protein, and vitamin B12.  You must leave room in your diet to include grains, dairy, protein, and some healthy fats to keep your diet balanced and include all of these nutrients.

3) Eating so many fruits your calorie intake becomes too high:  You can eat so many fruits, or juices, that you gain weight from an excessive calorie intake.  Fruit, while fat-free and low-calorie, is not calorie free!  A typical fruit serving has 60-80 calories, so if you start having 10 each day, you can see how this could quickly add up!  Limit fruits to three or four servings daily (and leave juice out of your diet) if you are trying to limit your calorie intake, and focus on taking in more vegetables, which are generally lower in calories.

4) Fruit isn't a good choice for some people on medical therapeutic diets: If a person has diabetes or renal disease, their fruit intake has to be limited to control the intake of sugar and potassium, respectively.  For a normal healthy diet fruit contributes necessary nutrients, but in some conditions these same nutrients must be restricted.  If you are on a special diet for a medical condition, be sure your doctor or dietitian has explained to you what really is good for you and what should be limited in your diet.

Fruits are healthy snacks and additions to any meal for all the nutrients they contain.  But you certainly can overdo it!  Even though the recommendations are for 9-12 servings of fruits and vegetables per day, there are people who eat more than this, and for the above reasons, it can become a case of doing more harm than good.  It goes back to the rule we dietitians use all of the time in deciding how much is a good amount: Everything in moderation!

What Are Hidden Fats?

I've been reading that when watching one's calories it is important to also watch for "hidden fats".  What exactly are these?    Linda H.

Dear Linda,

Hidden fats are those that are not at first apparent in a food.  You know you are adding fat to your food when you put butter on your bread, or dressing on your salad.  But when are there fats present that you may not be aware of?

Unless you are a cook or a baker, you may not know that fats are used in preparing many foods.  Butter can be used to cook fish, for example.  You may order what you believe to be a low-fat menu item that actually has more calories provided by the butter the fish is cooked in, than calories from the fish itself!  When ordering in a restaurant, ask how a meal is prepared.

Baked products, like pies, muffins, and croissants, use lots of shortening to result in a moist or flaky texture.   Some people mistakenly believe if they don't put butter on their muffin or croissant that they're having a low-fat breakfast or snack.  In fact, the fat contained in one of these treats can contribute over half the calories.

There are also fats naturally occuring in many animal products: milk, cheese, or yogurt that does not specifically state "low-fat" or "fat-free" can also have as many as half the calories contributed by fat.  This means a 'fat free' version would cut your calorie intake in half!
Meats and chicken also have fat in them.  Leaner cuts can save calories, but the fat does serve a purpose in keeping the meat moist and tasty.  You need to find a happy medium between enjoying your food--fat included--and limiting the amount of fat you take in throughout the day.

There are many sites available on the internet where you can look up fat content of foods to find out where the hidden fats lie.  Ingredient labels are also helpful when purchasing packaged foods and they will always tell you exactly how many grams of fat are included on the "nutrition facts panel".

Being well-informed will be your best weapon against excessive fat intake.

How Can I Help My Adult Daughter Lose Weight?

Dear Laurie,
I am writing because I'm concerned about my daughter.  She's 35 years old and a single mother.  She doesn't take the time to cook healthy but is always taking her 11 year-old daughter out for fast food or ordering pizza, and keeping junk food in the house.  They are both overweight and now she has been diagnosed with diabetes.  I'm worried the same is in store with my granddaughter.  What is a relatively simple diet they can go on that isn't too restrictive so they can stay on it long enough to have results?    Jane W.

Dear Jane,

Unfortunately, all the love and concern you have for your daughter is not going to help her lose weight.  The person with the problem is the one who has to decide when they are ready to make a change.  Just like any other condition, each individual decides when their priority is to get healthy.  Your daughter has another incentive--having a healthy daughter herself.

I know how frustrating it is to sit by and watch someone contribute to their own health risks--we all know people who smoke, drink too much, eat too much or exercise too little and we wish we could help... but all we can offer is our support, and to let them know we are here for them in whatever capacity they need when they are ready to change.

You might ask your daughter if there is one change she is willing to make that is simple and easy (such as substituting water in place of soda this week and see how she and her daughter feel about that).  Let her know you are concerned and that when she is ready, you will help her find a plan that is easy and tasty! 

Perhaps they can plan a visit to a registered dietitian where your daughter and granddaughter can go  together.  What they really need is not a diet, but a lifestyle change, and that is scary to think about all at once.  A dietitian is trained to help people make these changes in a way that is safe, reliable, and most likely to last a lifetime, as opposed to the diet-of-the-week which is more likely to result in gaining the weight back in a short period of time.

How Much Junk Food Can I Have In a Day?

What is a good level of calories to eat of junk food in a day?   Sam M.

Dear Sam,

While many Americans consume nearly 30% of their calories from junk foods, in reality we only have about 10% to spare on foods that provide energy without nutrition.

This means an average person who eats a 2100 calorie diet takes in 700 calories from fried foods, candy bars, danishes and pastries, cakes, cookies and candies, ice cream, soda and similar foods.  It's very easy to see the number climb quickly because these foods are very calorically dense.

Ideally, after you consume the nutrient-dense foods (fruits, vegetables, grains and starches, dairy products, and good sources of protein) you will have 150-250 calories leftover to indulge in a sweet treat.  A small square of chocolate or a half-cup of light ice cream; a small piece of cake or 2 plain cookies will give you the sweet taste you seek without overdoing the fat, sugar, and calories.

What's The Cheapest Fruit To Buy?

Dear Laurie,  I am on a limited budget and can only afford one type of fruit--what would the best choice be? --Carolyn L.

Dear Carolyn,

You don't have to limit yourself to one type of fruit, even if you can only afford limited amounts each day!  Mix them up every day of the week to give yourself the most variety.  That's important to get in the variety of vitamins, minerals, fibers, and phytochemicals that fruits provide.

If I had to pick a few nutrient-packed choices I'd go with oranges and kiwis for their concentrated vitamin sources.  But all fruits have something good to offer!

Remember that frozen and canned fruits, while lower in fiber, still have a lot of nutrient density to offer in a naturally low-calorie package!  Look for canned varieties that have the least sugar added.  There's no need for sweetener in a food that already contains nature's fruit sugar. And, while fruit juice can contain the good vitamins that fruits provide, they are nowhere near as filling as eating the fruit itself.

I Want To Gain Weight, But Not Gain Fat

I read your post on gaining weight with the Carnation Instant Breakfast Drink.  I am also a teenage girl, trying to gain some weight healthily but do not want to get fat. What should I eat to gain weight healthily instead of drink nutritional supplements?  Laura B.

Dear Laura,

In order to gain weight, it's simply a matter of taking in more calories than you burn each day.  The supplement I suggested is well-balanced and helpful for those who simply cannot ingest a larger amount of food.  It's actually not that easy to eat a lot of calories when you are eating nutrient-dense foods such as fruits, vegetables, low-fat dairy products, and whole grains!

You are wise to inquire about how we can gain weight without having it come from high-calorie foods that provide little nutrition; like creams, gravies, chips, cakes and other foods low in nutrient density.

I always recommend turning to the food guide pyramid (http://www.mypyramid.gov/) for a balanced diet, that is nutrient dense, and provides a variety of foods while incorporating moderation.  You can enter your specific details and there will be a diet plan designed just for you!  You can choose the foods you enjoy from each group and know you are following a healthy diet plan that will eventually lead to a healthy weight--whether you are looking to gain or to lose.

How Many Calories Do You Burn Running One Mile?

I am curious to know how many calories are burned running a mile?  Laura K.

Dear Laura,

There are a few factors to mention when answering this question.  It's not the same for everyone:

First, the more someone weighs (especially if it's more muscle tissue than fat comprising their weight) the more they burn with any kind of movement compared to someone who is smaller.  For instance, a 200 pound man who runs a mile will burn more calories than a 110 pound woman.  That's why when you're on the gym equipment they have you enter your weight, so the machine can more accurately compute the calories you are burning.

Seemingly, it would also depend on how fast you are running the mile.  It would make sense that someone running a 8 minute mile would burn more than someone jogging a 12 minute mile.  Not so!  Remember that after the 8 minute mile, the faster person stops--the slower person continues to exercise 50% longer.

Realistically I use an average of 100 calories burned per mile, whether a person is running, jogging, or walking.  A very slow person just starting out may take 25 minutes to walk a mile.  They are burning the same 100 calories--it's just taking longer.

If you like to use a pedometer, the average steps per mile is 2000.  This means you can also calculate 100 calories burned per 2000 steps if you don't have the access to measuring the actual length of your walk.

Happy trails :)

Should Fruit Be Eaten on an Empty Stomach or With Meals?

Hi, I'm trying to find out the best time to eat fruit. I have heard many suggestions, but I need to hear it from a registered dietitian. Is it better to consume it on an empty stomach, with meals, or does it really matter at all? Thanks, Marie A.

Dear Marie,

I am so glad you have turned to an RD for the answer to this!  Today is not the first time I've had this question posed either (see entry of 8/31).
The truth is, the human body is capable of digesting any food you eat at any time of day and in combination with any other food, despite certain diet books that claim the contrary.

So go ahead and enjoy fruit whenever you like: if there were any rules they would look like this:

- You can eat it in your house, you can eat it with a mouse
- Enjoy some fruit while on a boat, you can have it with your goat
- You can digest it in a box, or munch on some while with a fox
- On a train, in a plane,  stomach full or empty--it's all the same
- Night or morning does not matter, ignore the diet fad book chatter!
(credit, of course, must go to Dr. Suess for the play on words from the book Green Eggs and Ham)

How Can I Find the Glycemic Index of a Food I Eat?

Can you please tell what the glycemic index would be of Thomas English Muffins - Light Multigrain. Each muffin has 100 calories, 22 grams of carbs and 8 grams of fiber. My sister is borderline diabetic and I am trying to help her find the glycemic level of this muffin.  Thank You, Linda F.


Dear Linda,

It's great to see someone take control of their diet and monitor it closely in attempts to control their blood sugar, even before they are labeled with diabetes.
In first trying to come with a simple numerical answer for you, I found this informationon a website called NutritionData.com: 
 "GI testing is relatively expensive and very time-consuming. Human test subjects are required, and only a limited number of laboratories currently perform these tests. Consequently, GI data is only available for a very small percentage of the foods that we consume. . . .
 
To make matters worse, food manufacturers are creating new food products at a much faster rate than GI testing can be performed. Each year, tens of thousands of new packaged-food items are added to grocery shelves, but only a few hundred foods are tested for GI. Because of this, it's doubtful that we'll ever reach a point in time where GI is known for all foods. . . ."

So the short answer is, there may not be a known Glycemic Index number for the product about which you inquire.  That said, the fact that these muffins are multigrain is probably going to mean a lower glycemic index than a refined grain product. 

Even so, the number itself is something to be taken with a grain of salt.  Glycemic index is tested when the food is eaten alone in a measured amount (not necessarily a serving size) and based on the amount it raises blood glucose levels as compared to a reference food with the same number of grams of carbohydrate.  It is tested on a small number of healthy individuals, and you cannot necessarily extrapolate that information to yourself or another person with altered blood glucose metabolism.  Furthermore, the glycemic index will change if you eat the muffin with anything else--say an egg, or a buttery spread on top of the muffin--or drink juice or milk or any other calorie-containing beverage along with the muffin.

The best way to know how this muffin will affect your sister's blood sugar levels are for her to test her sugar 2 hours after eating the muffin and several times throughout the day to see if it has an effect on her readings in comparison to a day when she has another type of bread at the same meal.

How Does Pasteurization Affect the Health Benefits of Juice?

I've heard much about the benefits of black currant juice. The juices I find in grocery and health food stores are all pasteurized. What effect does pasteurization have on the health benefits of this or any other juice? Mark N.

Dear Mark,

There's a lot in the news these days about juices providing health benefits. Fruits contain many different substances that we are finding can help protect our cells.

I wouldn't put all my eggs in one basket, so to speak, when choosing a juice for health benefits--they all seem to bring some great properties to the table.

Also, eating the fruit itself, is usually better for several reasons: you're usually getting a more pure form (zero processing), fewer calories, and less concentrated sugar, as well as more fiber when you eat the fruit instead of the juice.

And, as I found out researching your question this morning, it turns out that pasteurization does have an effect on some of the components in juices.

Pasteurizing the fruit is for safety reasons, to keep bacteria from growing. So this has to be considered a health benefit too!
However, I did find some studies that seem to answer your question. One, Biodiversity of Total Phenolics, Antioxidant Capacity, and Juice Quality in Apple Cider Taxa that was submitted to the Journal of Horticulture, Environment and Biotechnology examined the effect pasteurization has on phenols and antioxidants. They found no effect on the phenol content of apple juice after pasteurization, but in fact there was a "significant effect" on the antioxidant activity.

Another study found a significant reduction in carotenoids (namely violaxanthin and lutein) after the pasteurization of Valencia orange juice (Effect of thermal pasteurization and concentration on carotenoid composition of Brazilian Valencia orange juice from Food Chemistry in 2004).

So, it turns out that pasteurization does have an effect on some of the components that are healthy in juices: however, it does outweigh the risk of getting sick from bacteria that can grow in juices that aren't pasteurized.

The bottom line is that it's probably best to eat the fruit when you can, and drink a safer (pasteurized) juice that gives you a bit fewer of the antioxidants and vitamins when the fresh fruit is not available.

Is This The Best Supplement For Me to Gain Weight?

I am a 15-year-old teenager who is currently underweight and is taking a packet of nutritional oral supplement everyday. The supplement that I am taking contains high protein and calories, no fat and a lot of nutrients. However, both my parents and I have noticed that the supplement contains 30grams of sugar in each single packet, which is a very high amount of sugar a day for a teenager like me, excluding the other amount of sugar I consume in my daily food. Should I continue to take the supplement for its benefits or should I switch to other supplements instead because of the high amount of sugar it contains, to prevent diabetes or other health problems in the future? Candice N.

Dear Candice,

It would be so helpful for me to know the name or specifics of your supplement. Also, I wonder why it is you are underweight? Any health problems now? Or just very active without a big appetite?

Actually, 30 grams of sugar is not a tremendous amount. That's what can be found in a can of soda, so it's not unreasonable to see it in a serving of a supplement, especially if that is the only ingredient that is giving you calories... without it you wouldn't possibly be able to gain weight!

There is also no danger of getting diabetes from eating sugar itself--once a person has diabetes sugars can contribute to high blood glucose levels, and certainly excessive amount of sugar can cause weight gain--but you aren't overweight! It's a great habit to have healthy eating habits right now to continue into your later years, but if weight gain is your priority now you're going to have to be eating some sugars and fats to get in the calories!

I'm not certain what the other health benefits are in the supplement you're taking, but I do have another suggestion.

If weight gain is your goal, having a supplement with no fat in it may be counterproductive. Fat has twice the calories of sugar and it would be easier to gain weight eating less food if fat was one of the ingredients in your supplement. The one I recommend most often for young people is Carnation Instant Breakfast Drink. They have actually recently changed their name to "Carnation Instant Breakfast Essentials".

When the powder is mixed with one cup of whole milk it provides 220-250 calories and 13 grams of protein. You can also buy it ready-to-drink in cans. The carb content is 20 grams per serving.

It also provides 25% of many essential vitamins and minerals in each serving. If you're trying to gain weight you may try taking two to three servings each day.

Help! I've Reached a Plateau on the Atkins Diet

I have been doing atkins diet for the past year. For the first 6 months I lost 50 pounds, and for the past 6 months no more weight has come off, in fact I have put on about 16 pounds. I am currently 160. I have tried everything from exercise to adding carbs but nothing works. I'm guessing my metobolism has dropped so low that my brain thinks I'm in starvation mode. I am now consuming about 50 carbs a day and calorie intake about 2000. I'm worried by increasing carbs too much I will put it back on. im thinking of switching to a low calorie diet but worried that won't work due to low metobolism ie weight gain. I exercise 60 mins a day with combination of 20 mins bike and 30 mins moderate walking and jogging. Please give me some advise as to what to to. Elena S.

Dear Elena,

Wow! First of all, congratulations on sticking with it for six months to lose all that weight.

I suspect the problem may be that you are eating too many calories at this time.
I don't believe your metabolism drops on the Atkins diet: it usually drops from following a very low calorie diet for an extended period of time, and depending on how you follow Atkins, it's not usually low calorie. The fact is, at about 6 months is the time many people reach a point of taste fatigue on the Atkins Diet--they just literally can't put up with eating meat/vegetables/cheese and that's all anymore! Little by little, other foods work their way in to the diet. As soon as you add in the carbs, the principle of the diet won't work anymore (you now are feeding your body some quick energy and it doesn't have to constantly burn fat for it).

If you're now eating 2000 calories a day, that is a maintenance diet for your weight. You didn't mention your height or your goal weight, but I'm assuming you want to lose another 20 pounds or so, especially if you put 15 back on recently. It may be somewhat reassuring to know that, if you had added carbs back in, this results in normalizing your body's way of obtaining energy, which includes not flushing out a great deal of fluid to rid of the ketone bodies built up on a carb-free diet. In other words, several of the pounds the scale reflects now are just water in your body, going back to where it belongs... you probably did not gain 15 pounds of body fat!

Try going on a lower calorie diet (www.mypyramid.gov is a good site to build a balanced diet and find out how many calories you can eat and still lose weight) and eat as many grams of carbs as you like :)
Sometimes, switching to another diet will get you over that hump and back to losing weight.

Don't expect it to come off as quickly, though. If you lose a pound a week, that is fantastic progress, so don't be discouraged by doing it slow and steady.

By the way, great move with the hour a day of exercise! If you can make that a habit you'll be set for life at the weight you want once you get there :)

Can Someone With Low Cholesterol Eat a "Cholesterol-Lowering" Spread?

I am wondering if it's safe for someone without high cholesterol to eat a product like "Smart Balance" that says it's helpful for those with high cholesterol ... also, could it be harmful for a toddler to eat it? --Alice O.

Dear Alice,

The human body makes all the cholesterol it needs (it actually does have some useful functions!) and you never have to eat any.
Some of the products that claim they are good for lowering cholesterol are really just suggesting they don't contribute to higher cholesterol. The same would be true for having fresh fruit--as an example--it won't raise your cholesterol!

On the other hand, there are some products out now that DO contain ingredients to LOWER your cholesterol. Benecol, and "Take Control" are spreads that have soybean or other plant components designed to bind to cholesterol and drag it out of the body (like a medication called questran, and the over-the-counter metamucil also do). These would not be harmful to kids any more than feeding them extra soluble fibers (like beans or oats), but they are quite expensive and I doubt most people would let any other family member use theirs instead of a less-expensive spread that's good enough for everyone!

So smart balance would be fine for a small child, just as any other spread, and even butter! Just remember the old adage, "everything in moderation".

What Are Some Good Protein Foods for Vegetarians?

I need help planning healthy vegetarian meals. I don't eat cheese because it gives me migraines, and beans give me lots of gas, even if I use beano. I don't really know what to do with tofu? -- Mary S.

Dear Mary,
For vegetarians to get good sources of protein, the meal should include a combination of foods that will provide all 9 essential amino acids. The easy rule for this is to mix two of the following three food groups: vegetables, grains, and dried beans/nuts.

Now, you've already said you can't do the beans, so finding ways to combine vegetables and starches would be your best option. For example, tomato sauce and pasta, rice with stir-fry vegetables, corn tortilla filled with salsa and guacamole, or rice and peas are ways to combine these: and a peanut butter sandwich is another combination that works! Other less-frequently used grains include cous cous, and quinoa (the latter of which is an excellent source of protein).

Consider making an omelet for dinner sometime, with veggies inside (although the egg white is already a complete protein source).

Try soy cheeses if the dairy might be what triggers your migraines.

And, finally, there are loads of great veggie-burgers out there already made with soy or other good protein sources, so you don't have to process and cook tofu meals: You've probably seen the veggie patties, burgers, sausages, etc. which are made to give vegetarians similar options as meat eaters without using any animal products. My favorite brand is Quorn: they have 'chicken' nuggets and cutlets, 'beef' patties, 'turkey' roasts and more! The vegetable protein is made from mushrooms and these are the best fake meats I've ever tasted (and I'm not a vegetarian!)

How Do I Count Sodium Intake to Meet the Daily Value?

I read the daily value for sodium is 2400 milligrams, but how do I count this up when all foods (like fruits and vegetables) don't have labels on them--let alone eating out in restaurants. Also, is this a minimum or a maximum or an average? James P.

Dear James,

The daily value for sodium is actually more of a maximum suggestion. This is different from most of the nutrient recommendations because the average American is known for eating too much--more than 4000 milligrams per day, and sometimes as much as 7,000 or 8,000 milligrams per day! We only need about 500 milligrams per day for proper body functioning, but public health advocates do want to be certain that people don't start buying everything "low sodium" in an effort to eat minimally, lest they end up falling short of their needs. The daily value is a great number to shoot for without going crazy trying to find low sodium versions of everything, and being able to enjoy a hot dog once in a while.

Rather than counting everything you eat (which is exhausting by the middle of the day, let alone trying to continue monitoring your intake over a long period of time) I suggest reading labels on canned, frozen, and other processed foods and avoiding anything with over about 500 milligrams per serving. Be sure to read what the label calls a serving size: if you eat a can of soup that has 400 milligrams per serving, you can be pretty sure they call a serving "1/2 can", meaning you will be consuming 800 milligrams!

Canned soups are usually very high sodium (with some good lower sodium alternatives right on the next shelf), as well as smoked meats and lunch meats (like ham and hot dogs), and the typical TV dinner (there are some great lower sodium brands available). Fast food meals are also often approaching 1000 milligrams in a sandwich: all fast food establishments will provide you with their complete nutritional information, so check out the sodium content of the foods you usually choose. Some of the websites even have a 'meal builder' so you can add fries and desserts to your burger and see what the grand total is!

Many other foods--canned vegetables, breads, cereals, and dairy products--may have 150-250 milligrams per serving. If you have a few servings of these per day they can add up, but won't exceed thousands of milligrams a day. Also balancing out your diet are very low sodium foods, like fruits, juice, fresh vegetables, rice, and chicken. I wouldn't bother to count these to add up a daily total more than once or twice, just to give yourself a good idea of how you generally eat.

By limiting each meal to less than 700 milligrams, you'll total a daily sodium intake below 2100 milligrams (saving any highly salty snacks) without having to count every bite you take.

Supplements To Improve My Health

It's really hard to eat right these days so I bought some one a day vita craves and some ensure(Immun Balance, complete balanced nutrition). I was wondering if those two products could help me nutrition wise when taken with my regular meals? Or is it not a big influence in my nutrition? My major in college is Health and wellness. I love the body and doing physical activity. I think eating healthy is such a big part though. That is why I try to eat good. Thank you for your time. --Joe G.

Dear Joe,

That's great that you are trying to eat right, especially considering your major! You might want to focus on how you can eat better so you'll be able to share this experience with your clients in the future. Interesting that you point out how difficult it is -- if you can figure out what your difficulties are in eating healthy and how to overcome them, you will be a huge help to those with whom you work in the future.

Meanwhile, the vita craves look like a good choice, since a serving (2 gummies) provides just about 100% of most of the daily values for many vitamins and minerals--you don't want to aim for more than 100% of what you need... that would be like pouring extra oil into your car and hoping it will run better!

Also, consider that your intake of calcium is not met through a supplement, nor is fiber, nor protein, and probably lots of other micronutrients we may not even fully understand yet. So, eating well is of utmost importance and these vitamin supplements can act as a safety net when our diets aren't so great.

The ensure is really more aimed at elderly people who cannot eat enough food. Some people just are too sick to eat or need many more calories than they can manage to swallow, so they are supported by 3, 4 or even 8 cans of these drinks per day with minimal intake of regular food.

A supplement I think may be better suited for you is Carnation Instant Breakfast Drink. Especially if you aren't overweight, this drink provides 250 calories (if you mix it in whole milk), vitamins and minerals; you get protein and calcium from the milk; and it's much less expensive and more tasty than many of the pharmaceutical canned drinks.

Do I Drink Too Much Iced Tea?

Hello, I found your blog through Google and was wondering if you can tell me if it's bad for my health if all liquid which I consume through the day consists entirely of iced tea. Greg S.

Dear Greg,

That depends on a lot of other things. Chances are you can maintain your hydration adequately with just drinking tea (instead of water), which I believe is what you wanted to find out.

But you may be consuming a high amount of something that is not healthy for you in large amounts, depending on how much tea you are drinking and if you have any present health conditions: too much caffeine (which can affect your blood pressure, and urinary frequency), too much oxalate (potentially harmful if you're at risk for developing kidney stones); too much sugar and calories if it's sweetened or too much artificial sweetener if it's diet!

Everything in moderation is a good rule to follow .... consider replacing one or two glasses of your tea with another beverage once in a while, like juice or milk, which provide valuable nutrients ... or just plain water!

Drinking Water During Workout Makes Me Nauseous

I know how important it is to keep hydrated before, during, and after exercising. I do my best to drink plenty of water, but whenever I drink water during a workout it makes me nauseous. If I don't drink anything while I work out I get thirsty, and I know it's not doing me any good. But if I DO drink anything (water, Poweraid, Gatorade, etc.) I really feel like I'm gunna puke seconds later. I have no clue why this happens, do you have ANY ideas? Rita N.

Rita,

I can make a few assumptions here: One is that you are drinking large gulps of water during your workout instead of sips. This can cause nausea: The blood flow in your body during exercise is dedicated to helping you have an efficient workout--the muscles that you are working, the lungs breathing in plenty of oxygen, and your heart beating faster--as a result, blood is diverted away from the GI tract.
Many people feel nauseated, and even throw up, when working out very hard. Your GI tract is disturbed by the presence of having something to attend to when it's not ready to handle it.

If you are drinking a few ounces at a time, I would suggest taking minimal sips just to quench the dryness in your mouth...just a tablespoon or so between sets. If you do this 15 times during your workout (every 4 or 5 minutes in an hour) it will add up to about 8 ounces. This may be enough to keep you hydrated during your workout.

Then drink plenty of water afterwards when it doesn't upset your stomach.

There is also the fact that warmer water is more quickly absorbed than colder water, so if the water you are drinking is very cold you might try bringing a bottle of room temperature water--it will quench your thirst and hydrate you just as well.

I'd love to hear back from you regarding how these steps work!

Should Fruit Be Eaten on an Empty Stomach?

Is there any proof to back this statement: "Fruits should be eaten on an empty stomach"?
Kathy C.

Dear Kathy,

There is no reason fruits, or any other food, should be eaten on an empty stomach.
The digestive system is set up to take any food in any combination at any time of the day or night.

There is simply no scientific evidence to suggest otherwise!

What Is Trans Fat?

I know we aren't supposed to eat trans fats because they aren't good for us, and many companies now advertise their foods do not contain any. But what are they exactly?? Marissa N.

Dear Marissa,

Trans fats are those that have been chemically modified in order to become more solid.
This mimics the structure of oils that are naturally solid at room temperature, such as lard.

Simply put, fatty acids contain long strands of carbon chains. Each carbon atom is linked to another on each side, and then there are two more free bonds: these are either available to double-bond to the carbon atom on each side, or to be saturated with Hydrogen atoms on both the top and the bottom. When an oil has more hydrogen atoms saturating it, it becomes more solid.

Several decades ago when we knew foods like butter and animal fat contributed to high cholesterol, it was mistakenly assumed this was because of the cholesterol present.
So food scientists got the bright idea of making corn oil margarine: we would take a 'healthy' oil (because it was so liquid) and saturate it with hydrogen atoms. Then we could have a butter substitute that was not going to contribute to heart disease!

Several years later, however, research showed that the saturation of the fats was what contributed to elevating serum cholesterol levels, even moreso than eating foods with cholesterol.
An example of a high-cholesterol/low-saturated-fat food is shrimp. It is not unhealthy to eat a food such as this when on a cholesterol-lowering diet.

Margarine, on the other hand, was found to contribute to elevating cholesterol even though it was made with a cholesterol-free product: the process of saturating it turned it into an unhealthy fat.

Some time ago most food products stopped using lard in their ingredients, and a few years later they stopped using "tropical oils" (coconut and palm oil) which--while they do not contain cholesterol--contain a high percentage of saturated fats. The time has now come to find other ways of making the texture and taste suitable without using trans fats in order to keep our diets heart healthy.

How Do I Know if I Have Anemia?

I have a question as to whether or not I could have anemia. Last month I tried to donate blood (I had donated a few times before) but they wouldn't let me because my iron level was at 11.6. When playing basketball with friends in June they noticed that my skin became somewhat jaundicey and I became faint easily (I am athletic and have played rigorous sports all my life). This year I am living with roommates and we have been arguing about temperatures in the house because everyone wakes up sweating while I wake up shivering. I also get dizzy often when I stand up. I believe that I have a healthy diet, stay very active and am in good physical shape. Could I be anemic? --James S.

Dear James,

Well, you certainly could be anemic, so you should see a doctor ASAP!

It may have been your hemoglobin level that was 11.6, which is what they usually check before blood donation. This level is a reflection of the oxygen-carrying capacity in your red blood cells, and yours was a bit below normal.

There are several types of anemia, by the way--it can be caused by an iron deficiency, a vitamin deficiency (E, B12, or folate are a few), or some other issue in your body that is preventing you from forming and maintaining healthy red blood cells.

If your skin appears jaundiced (with a yellow tinge) or the whites of your eyes appear yellow, this is indicative of a problem with your liver, and another reason to see your physician immediately for diagnosis and treatment.

Is There Vitamin E in Peanut Butter?

Hi,
I just bought a jar of natural peanut butter and there was no vitamin E reported on the label--just peanuts and salt. Doesn't peanut butter have vitamin E in it? Jane E.

Hi Julie,
The average serving of peanut butter contains about 3 milligrams of vitamin E. It comes from the peanut oil in the peanuts, so you won't see it as an added ingredient.

According to food label laws, vitamin A and vitamin C are the only vitamins required to show content in the form of daily value. The nutrients chosen to be present on the label were those for which Americans had a higher likelihood of deficiency. Since we rarely see vitamin E deficient people, it is not deemed to be a health issue. Food labels are meant to inform as well as educate, and they provide information on nutrients that health care scientists believe people should be getting more of (iron, calcium, vitamin C) or less of (sodium, fat) than they usually do.

Can I Have Bread on a Gluten Free Diet?

I just came from a visit to my doctor for long-time abdominal bloating and frequent loose stools. He thinks I may have an allergy to gluten. I know gluten is in wheat, and my problem is I love to have toast for breakfast. I went on the wheat-free diet once before and it did help a lot, but I don't want to live without my toast... Is there any kind of bread I can have? Melissa R.

Dear Melissa,

It certainly sounds like you may have a gluten allergy (a severe reaction to the protein present in wheat and some other grains), especially because when you stopped eating it, your symptoms improved.

There are many people with a diagnosable gluten allergy, known as celiac sprue. Reliable information can be found on the website of the Celiac Sprue Association here: http://www.csaceliacs.org/gluten_grains.php. Since a great number of people suffer from this condition, as well as others who find they simply feel better in some way when they avoid gluten, there are thousands of gluten free products on the market today, including breads! The most popular is potato bread which can be found in virtually any grocery store.
Look for gluten free breads, crackers, pastas, cookies, and other products in the "health food" aisle of your favorite grocery store and you'll be pleasantly surprised at the variety.

Be sure to note, as the Celiac Sprue site informs you, there are grains other than "wheat" that should be avoided, including other forms of wheat (such as cous cous, for instance) that we don't often recognize as a wheat product. In this way you can be sure that you are really avoiding all sources of gluten while you test this diet.

By the way, some people have strong reactions to even a tiny amount of gluten while others can tolerate some in small amounts. After a month on a gluten free diet you may want to experiment, adding back a little of some gluten-containing products to see what works for you. As you might imagine, dining out can be extremely difficult when you don't know what's in the foods you're ordering (for instance, people don't generally think about the fact that flour is used in making beef gravy). Knowing that you might tolerate a small amount of gluten--if that is the case for you--will give you the freedom to enjoy dining away from home without fearing the return of your abdominal symptoms.

The multitude of products on the market today thankfully make it much easier to follow this diet restriction than it ever was in the past.

Which is the Better Supplement: Beta Carotene or Vitamin A?

Is there any difference to the body whether you use vitamin A in the form of retinyl palmitate or in the form of beta carotene? I know the retinyl palmitate can be toxic, but is it better to use? Kathy C.

Dear Kathy,

In nature, beta carotene is the plant form, also called "pre-vitamin A" and your body converts this to the forms of vitamin A needed in the body for your vision, healthy skin, immune system, and other functions.
Receiving too much beta carotene (whether from carrots or pills) can cause a build-up of the pigment and may turn the skin orange. This symptom is not harmful in itself, and will reverse when the excessive intake is stopped.

Pre-formed vitamin A (retinol, retinal, retinyl) is found in animal sources, such as egg yolk, whole milk, butter, meat, and especially concentrated in fish liver and fish liver oils.
Too much vitamin A can be toxic and even fatal, because it is a fat-soluble substance. This means the body cannot easily rid of the excess, and it can cause physical damage, even lead to death. This has occurred rarely from dietary sources (in cases of arctic explorers eating polar bear liver--an extremely highly concentrated source of vitamin A) and more commonly in people supplementing with too much cod liver oil or other concentrated sources of the vitamin over a period of time.

Neither source is preferred by the body; we are able to get what we need from either animal or plant sources. Using the beta carotene form, however, is safer in cases where one may be exceeding their needs.

Weight Gain During Freshman Year In College

Dear Laurie,
I am a 19 year old male and I've gained weight with no explanation over the past year. I used to eat 3 meals a day at home, but in college I live in the dorms and I started skipping breakfast, partly due to sleep habits. My lunch and dinner are usually fast foods, but I try to choose the healthiest items they offer. Other than that I drink only about one soda a day and maybe a couple of light snack foods. So I'm not eating that much, but I've gained about 20 pounds since last year. It's affecting the way I look, especially my stomach, and I would like to go back to the way I was a year ago, and definitely not to gain any more! Can you help??!! --- Adam T.

Dear Adam,

I believe I can explain your weight gain in several ways: you may be able to change one or two habits and stop the gain this coming year, and maybe even lose!

Although it may seem that you should not be gaining weight because you cut an entire meal out of your daily regimen (breakfast), this action can actually contribute to weight gain.
When you refuel your body at breakfast time, it reacts by reving up and burning calories for daily metabolic processes. If your body believes there is no fuel available (as happens when a person is starving due to decreased availability of food) it makes an effort to conserve energy and you actually burn fewer calories during the day.

Secondly, though you are trying to make the best choice at a fast food restaurant, that's not always easy to do for more reasons that one: It might be tempting to add fries and a shake once you see them, or see others ordering them, even though you were determined not to before you went in. And even if you skip what you know is high in calories, it's hard to know what is in the foods unless you've looked up the actual nutritional content on the restaurant's menu information. Even I was surprised to see the high calorie content of things like "market fresh" sandwiches (over 800 calories) and healthy baked potato dishes (over 500 calories) and fish sandwiches (over 700 calories). There are often sauces, spreads, and other hidden sources of fat in these dishes that can mean ingesting hundreds of calories over what they seem to provide.

Thirdly, snacking during the day is something we often do more often than we think we do. We don't remember grabbing that candy bar from the vending machine on the way to class, accepting a cookie from a friend, downing a soda on the way to the gym, and so forth. So we can ingest another few hundred calories without realizing it.
Make a conscious effort to keep track of your snacking, even carrying a small pad of paper with you and jotting down what you eat to monitor what you're actually eating.

I suspect once you become more attentive to your diet, including having breakfast, eating only foods which you know the calorie content for, and being aware of the extra snacks and sodas you actually consume during the day, these will add up to a high enough number of calories saved every day to get quite a few pounds off your sophomore year in college!

How Much Fish Oil Should I Eat?

What is the recommended amounts of fish oil to consume in supplemental form? Barb H.

Dear Barb,

Depending on the purpose for supplementing fish oil, the amounts differ.

If someone is aiming for a healthy diet, the American Heart Association recommendations are to consume fatty fish twice weekly, along with other foods high in EPA and DHA (forms of omega 3 fatty acids) such as walnuts, canola oil, and flaxseed. The range contained in fish runs from less than one gram to just about two grams per 3 ounce serving, depending on the type of fish.

A person who has been diagnosed with coronary heart disease is still encouraged to follow the above dietary guidelines, but 1 gram supplement may be advised by the individual's physician.

Patients with elevated triglyceride levels may be recommended by their physician to take up to 2-4 grams in the form of supplements of the EPA and DHA.

Taking these supplements should be done only under a physician's care: levels over 3 grams per day can cause bleeds and stroke in certain people, and these are certainly life-threatening conditions.

Weight Gain After Gall Bladder Removal

Ever since my gall bladder was removed several years ago I have been gaining weight. Will taking bile salts or digestive enzymes help? Or is there a specific diet for post-gall bladder removal to keep me from gaining weight? Stephanie V.

Dear Stephanie,
I have heard of this phenomenon before, but there is no medical explanation.
A couple of reasons it is possible are (1) before you had your gall bladder out there was pain and discomfort associated with eating many foods so you ate a lot less then, or (2) many of us tend to gain weight over a period of years and some women pinpoint the time back to when their gall bladder was removed--realistically, though, it's just that weight gain occurs over time.

The function of the gall bladder is to store bile and then release a larger amount when a fatty meal is eaten. The purpose of bile is to help break up the fat as it enters your small intestine so the digestive enzymes have access to more of the fat molecules. Picture shaking up a bottle of oil and vinegar dressing: you see it change from a layer of fat, to tiny balls of fat dispersed through the liquid.

Now that you do not have a gall bladder, bile continues to be manufactured in the liver and released slowly and constantly into the small intestine. So you still have all the bile you need. (Sometimes bile salts and/or a low fat diet are prescribed for the first few weeks after the gall bladder is removed, until your system adjusts). The digestive enzymes come from your pancreas and are not affected by your gall bladder.

The best action you can take now is to examine your diet to find where you can cut excess fat and calories. It might be reducing portion sizes, finding lower calorie foods, or eating smaller meals. Increasing activity level can help burn calories too. No matter what the root cause, losing weight is almost always accomplished by taking in fewer calories and burning more through being active.

What Oil Is Best For Frying Foods?

Does Palm oil contribute to bad cholesterol when used in cooking or frying? What's the best cooking oil to use if I have high cholesterol? Carol D.

Dear Carol,

Yes, palm oil is highly saturated and this type of fat has been linked to raising cholesterol levels in some people. The better fats to use are polyunsaturated or monounsaturated (the latter helps 'good' cholesterol stay the same while lowering the 'bad'; polyunsaturated fats can lower total cholesterol).
Corn, safflower, and sunflower oils are polyunsaturated and olive and peanut oils are monounsaturated.

Of course, more is not better when it comes to using oils; these oils are preferable to using the saturated fats (palm and coconut oils, as well as animal fats--lard--and butter) but still should be limited when watching one's cholesterol level and to limit fat intake in general.

If you do fry foods, be sure to blot them thoroughly before eating to remove as much excess grease as possible. If you just need a small amount of oil to cook something like an egg, cooking spray is a good alternative because it coats the pan using a much smaller amount of oil.

What Foods Should I Eat to Reduce the Acid In My Body?

I'm concerned about eating too many acid foods because of some things I've heard about acid being bad in your body. Are there alkaline foods to eat to balance this out, or is taking bicarbonate a better idea? Mark S.

Dear Mark,

I'm not sure to what your sources are referring when they say that acid can be bad: some rumours from supplement companies try to scare you into using their product by saying your blood might be too acid, causing health problems; sometimes people refer to a high level of stomach acid when people experience heartburn. So let me start at the beginning and take each of these scenarios one at a time.

Certainly, there are foods that are more acidic (with a low pH) on the pH scale, and foods that are more alkaline (or more basic, with a higher pH). (There are actually extremely few foods that have a pH of more than 7.0). But once they get into your system all of that can change. When the food in a meal starts working its way through your digestive tract, the stomach acid makes the entire stomach environment acidic regardless of what you ate. This aids the process of digestion, so it's usually a good thing.
Some things people eat may cause them to either produce more stomach acid, or--more likely--cause more reflux. Reflux is when some of the stomach contents are pushed back up into the esophagus, causing what we know as heartburn.

People often complain that they get heartburn from eating tomatoes and citrus fruits. However, these foods have a pH close to 4.0. Stomach acid is lower than 2.0 which is literally one hundred times stronger than a pH of 4.0. The stomach acid is what burns coming back up. A person's diet might be cause the sphincter at the end of the esophagus to not close all the way, and allow some acid to come back up (reflux).
Just to give an example of how acid foods don't always mean more heartburn, coca-cola has a pH of about 3.0 (ten times more acidic than both the citrus fruits and the tomato sauce), and I've never heard anyone complain that drinking coke gives them heartburn.

Some factors that can help heartburn are (1) not eating until the point where you are stuffed, but learning to stop sooner, (2) not lying down immediately after eating, and (3) not wearing tight clothing that puts pressure on your stomach (which is higher up than your abdomen, practically between your ribs).

Now, as for your blood pH, this is very carefully controlled in your body to maintain a level between 7.35 and 7.45 (a bit alkaline, but very close to the neutral pH of 7.0). Your body has several systems to keep this level in place for hundreds of reactions that are continually taking place in your blood and your body in order to maintain life! If the pH goes out of whack, you can die.

No one is walking around with an acidic blood pH because of their diet, and getting symptoms like 'fatigue' or 'aches and pains' (as many 'health' sites selling 'nutrients' claim).
When the pH of the blood changes (which can happen under extreme conditions, such as intense physical activity, lung disease, or kidney disease), the body corrects it by altering the amount of carbon dioxide that is retained or excreted. The lungs and kidneys function in a carefully choreographed balance to maintain your blood pH where it needs to be.

Stress and bad diets, while they may very well affect how good your stomach feels, cannot affect blood acid level; and acid-neutralizing pills, while they may lean toward neutralizing some of the environment of your digestive system, do not affect your blood pH.