Monday, August 31, 2009

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!

Sunday, August 30, 2009

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.

Saturday, August 29, 2009

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.

Friday, August 21, 2009

Is There Vitamin E in Peanut Butter?

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.

Thursday, August 20, 2009

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: 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.

Wednesday, August 19, 2009

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.

Tuesday, August 18, 2009

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!

Monday, August 17, 2009

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.

Sunday, August 16, 2009

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.

Saturday, August 15, 2009

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.

Friday, August 14, 2009

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.

Thursday, August 13, 2009

How to get Nutrition With A Broken Jaw?

My husband was in a car accident recently and broke his jaw. He can eat very soft foods, but it is so uncomfortable for him to try chewing anything he gets frustrated and avoids almost all his meals now. He has lost about 11 pounds already and doesn't have much to spare, so I am worried. He does drink a can of Ensure every day, but I don't think he's taking in more than 1000 calories and I don't think this is enough. What can I give him to get him to try eating more? Mary E.

Dear Mary,

It's great that your husband is not on a total liquid diet and can still enjoy some texture, like puddings, yogurt, and ice cream. If chewing is frustrating, avoid giving him any foods with bits in them (like fruit pulp or skin, bits of mushroom in soup, or even chunks of a soft food like 'homestyle' mashed potatoes). These can get stuck in between teeth and be very difficult to clear if he doesn't have full use of his jaw. We so take for granted how much we use our jaw, for both up-and-down, as well as sideways motion to chew, and how much our tongue assists in moving the food around to be chewed and swallowed. If this is difficult or painful for him now, it's easy to understand why he's avoiding it.

There are several liquid beverage supplements available that can get him the nutrition he needs: not just calories, but also protein, vitamin, minerals, and enough fluids for hydration. One can of Ensure provides only 250 calories (as do other brands such as Boost and Walmart's own Equate brand) and many people don't realize you can use several cans a day. People who can't eat at all require up to 8 cans or more. Depending on your husband's size, activity level, and condition (he needs more calories if he is healing broken bones from the accident, for instance) he may need close to 3000 calories a day, especially if he would benefit from gaining back the weight he lost.

You can find many delicious recipes in which you can use these supplement drinks, like making puddings and shakes that have different flavors and textures. Choose the softest ones from here: and of course, find out what is appealing to him to increase the chances he'll eat what you prepare.

You can also ask your local store to purchase higher calorie beverages like Ensure Plus (350 calories per can) or TwoCal HN which has almost double the calories if your husband feels like eating or drinking very little.

Do encourage him to take in several glasses of water or other fluids each day, in addition to the supplement drinks, or he can easily become dehydrated. Use the food guide pyramid to aim for a balanced diet and find liquid or soft options in each food group (strained hot cereal or mashed potatoes for starches; applesauce or juices--including vegetable juice--for fruits and vegetables, etc). Consider mixing baby food meats into soups to thicken the texture and add more protein. The hospital where he was treated should have a dietetics department and they should also have information to provide you regarding a balanced blenderized diet, geared specifically to your husband's case (they will have access to his medical records with your approval).

Hopefully all will be back to normal in just a few more weeks. In the meantime encourage him to take all the nutrition he needs now so he doesn't have to play "catch-up" when he's back to normal.

Wednesday, August 12, 2009

What Supplements Will Help Me Get A 6-Pack?

I have always been in good shape, but recently, I have wanted to try and get a 6 pack (therefore decrease body fat) but try increase muscle elsewhere also. For the past month, I have been training strength and cardio and eating healthy, and am making a lot of progress. My question is what supplement to take: These are the two I was looking at - EAS 100% Whey Protein or PURE PROTEIN IGF-1. I would take the supplement after training, and perhaps as a snack some time during the day (before training) or at night before bed. Which supplement do you recommend? Would either of these supplements help me to reach my goals? (lower body fat percentage (6 pack) and increase muscle / strength?) Dave S.

Dear Dave,

I know it's tempting to believe that some pill or powder will make it easier to achieve your admirable goal of a 6-pack, but the only thing that's really going to get you there is exercise to build and define those muscles.

In fact, even body builders who are aiming to put on pounds of muscle can only realistically gain about a pound of muscle each week: Surprisingly this works out to be less than 25 grams of protein per day that needs to be increased in the diet. You can get this amount of protein in 2 glasses of milk + an egg, or 3-1/2 ounces of lean meat, or 3 cups of rice--okay, maybe that's a pretty big serving of rice. The point is, it's not difficult to get the nutrition you need in a fairly typical diet, balanced with servings of meat, dairy and other protein foods like eggs and beans.
A lower fat diet may help you trim fat off your exterior (be sure and include at least 10% of your calories from fat to meet the minimum needs for essential fatty acids and other healthy fats). But extra protein taken in that your body can't use for muscle building will itself turn to fat. It's like pouring extra gas into your tank, hoping you'll be able to get better mileage--it just spills out onto the pavement: extra protein is used in your body for energy (4 calories per gram) and if you don't burn it all off it gets stored for later use (as fat).

In general, eating 6 small meals per day will help your body take best advantage of using all the calories you feed it. You don't need anything special, or in any special order. There's no evidence, for instance, that you should have meat at breakfast time or that you shouldn't eat after a certain hour in the evening. Any bedtime snack you enjoy will do, whether it's cheese and crackers, a sandwich, or a bowl of cereal. If each of your small meals is relatively low in fat and contains protein, you'll be full enough to last until the next one without getting too hungry before then.

There aren't any supplements I would recommend that are proven to build muscle and burn fat. Your body's appearance also depend on your genetics. Some people can work out certain muscles every day and never get to where they want to be. Since you say you are already seeing results, I would say it sounds quite promising!

Tuesday, August 11, 2009

Why Is Two Pounds Per Week the Recommended Weight Loss?

Dear Diet Coach,
I am hoping you can clarify some things I think are true--but I'm getting feedback that does not back it up: I have done a lot of reading online and everything I have read says the healthy recommended weight loss is no more than 2 pounds a week. I posted this in a thread of a discussion group I'm on for weight loss, and people are responding that this information is wrong. That is really depends on the person's weight and other conditions. Can you tell me what makes the difference to this advice I have held to be true?
I would really appreciate any insight you have!

Joanne V.

Dear Joanne,

Thanks for this great question!
Here is where the "two pounds per week" rule originates:
It takes approximately 3500 calories to store up a pound of fat. The calories are there, stored in the form of fat, to be reserved in case you need energy when you can't get to any food (or enough food). In order to get rid of a pound of fat, you need to either eat less than you burn, or burn more than you eat.

It's a pretty easy recommendation to eat 500 calories fewer each day, which will add up to 3500 calories at the end of the week, for a one pound weight loss.
It's a bit harder to burn 500 calories more, since this could take up to one hour of exercise and is beyond the capacity of many overweight people.

However, you could also do a combination to add up to 1000 calories per day (such as eating 750 fewer calories and burning 250 extra) and this would add up to 7000 calories in the negative balance at the end of the 7-day week--resulting in a two pound loss of fat weight!

Since most people eat somewhere in the range of 2000 to 2700 calories, it's not realistic to think they could eat, say, 2000 fewer calories each day to lose four pounds a week. However, there are some extremely obese people who might eat 4000 calories on a typical day and it would be easier for them to cut out more calories. These are the people you see on "The Biggest Loser" show--they are very overweight, eat a tremendous amount of calories, and are very inactive: so it's pretty easy to cut their calories by a thousand or two, and work them out for hours a day to burn another thousand or two calories.

Above three or four pounds a week loss, it's no longer just fat that is being lost; it's largely water weight. Although this looks appealing when you step on the scale, it's not really something desirable to lose: Fluid weight doesn't stay off in the long term, nor does it affect your health positively to weigh less after losing fluid, nor does it affect your size or body fat in a beneficial way.

In general, fat can be lost at a rate of about one to two pounds per week, and that's why it has become a healthy and recommended guideline by educated healthcare professionals.

Monday, August 10, 2009

Do Colon Cleanses Work? Are Colon Cleanses Safe?

I recently started Colonix. I read that a colonix can really help aid in losing weight. Is this true? Colonix is supposedly the #1 in cleansing products. however, some articles say cleansing is good and others say it's bad. I'm not using the system to lose weight, i'm using it to help after I've already lost weight. I eat healthy and exercise regularly. Are colon cleansing systems safe? Do they work? Thanks, Margie S.

Dear Margie,

I'm glad to hear you have successfully lost weight and that you have a healthy diet and exercise program! I don't know of any evidence from the scientific community to back
up colon cleansing for any purposes: if there was, I believe insurance would pay for it and our regular MD would recommend we do this occasionally. (Why wouldn't they, especially if they could make money from it?)

From the research I have seen, colon cleanses are neither necessary nor good for anything. Some of them contain harsh laxatives (in the form of herbs or electrolytes) that may make you feel lighter after emptying your intestine of its contents--mostly water and waste. The scale may even reflect a decrease if you lose a lot of water weight. But you can't lose fat from a colon cleansing--the fat is already absorbed from your diet before it reaches your colon.

The brand you have mentioned is an oral "cleanse". Fiber, a component in one of their stages, is important--and you can get it in your diet by eating whole grains, fresh fruits, and vegetables. You can even take fiber supplements, such as metamucil, if you don't eat enough (25 grams per day) or Fiber One cereals and bars.

Your body cleans out your intestine daily--it's called having bowel movements. I have seen clean colons (pictures of them anyway) when doctors do colonoscopies. It doesn't take a special program or cleansing herbs--it takes one day of a clear liquid diet and one powerful laxative (prescribed by the doctor just for this purpose). And the purpose was for the doctor to get a clear look at the lining of the intestine for any signs of cancer.

I do believe some of these programs harbor potential dangers, including dehydration, electrolyte imbalance, abdominal discomfort, and diarrhea. Herbs are not regulated by the FDA (since they are not classified as either a food or a drug) and you never really know what you are getting in these products as far as purity and amounts.

My advice is to stick to your healthy diet, aim for 25-35 grams of fiber daily, and continue regular exercise along with plenty of water for adequate hydration. Your colon will be fine with this simple therapy!

Friday, August 7, 2009

Are Almonds a Good Snack?

I have started to snack on almonds every afternoon--I have 29 of them--and find they tide me over well until dinner time. Is it true they are a "good fat" or are they still fattening anyway?
Lisa M.

Dear Lisa,

According to the Almond Board, a serving of almonds is one ounce, or about 23 almonds. This serving size provides 160 calories and 13 grams of fat (mostly mono-unsaturated), plus 3.5 grams of fiber, and 75 mg calcium.
Other nuts are also good sources of fiber (pistachios), magnesium (brazil nuts), folate (hazelnuts), and iron (cashews).

The key to having a good diet is balancing what you eat all day long--not one specific food. Enjoy the almonds if you like them, and think of your diet as what you eat throughout the day instead of what any one food can do for you. There are a number of foods that can add great nutrients to your diet without adding too many calories. Almost any food can fit into a well-balanced diet.

As long as you are not having problems digesting fat or fiber, and this new snack does not result in a weight gain over time, it's fine. Even better, if you replaced a 250 calorie candy bar and a 160 calorie can of soda with this new snack, you've done a brilliant job of cutting calories and adding nutrition with just one change!

Thursday, August 6, 2009

Low Glycemic versus Low Carb diet for weight loss

I have been on a low carb diet and losing weight with steady progress... then I read about low glycemic and thought I would give that a try. I've added toast at breakfast, pasta at lunch, and rice at dinner. I'm not gaining but I'm no longer losing like I was. I don't understand how these carbs are different from others; they look and taste high carb to me! And what's so bad about a potato? I find having a potato at dinner is very filling, but it's not recommended on the diet. Should I go back to low carb? --Thanks for the help, Lou R.

Dear Lou,

Low carb diets work for several reasons:
1) You are depriving your body of its preferred source of energy. As a back-up plan, your body turns to fat stores and forms a compound called "ketone bodies" that can be used in a pinch. They are not desirable to be retained in the body for long, and you'll find that you have an increase in amount of urination which is in order to flush them out. That's why low carb diets warn that you must drink at least 8 glasses of water a day, and people lose weight quickly--but it's largely water weight loss. Once you go back to eating normally, much of the weight returns.

2) Reducing carbohydrate intake greatly reduces calorie intake. It eliminates entire groups of food from your choices and you can no longer have bread, pasta, rice, starchy vegetables, fruits, dairy, or desserts. Naturally you lose weight since you've cut out hundreds of calories a day.

3) Since no carbs are allowed most of the foods people like to snack on are forbidden: without pretzels, ice cream, chips, candy, cookies, or popcorn allowed, there isn't much sitting in front of the TV munching on cheese and nuts going on for long. This takes away another large source of calories from the diet of people who are overweight.

Glycemic index is a measure of how much certain carbohydrate foods make your blood glucose level rise. It was intended for people with diabetes who found their blood sugars difficult to control. We also discovered that foods we thought were "good" for diabetics sometimes caused a large rise in blood sugar (potatoes, pretzels, some fruits), whereas drinking a fruit juice or even a sweetened beverage didn't always result in a higher glucose level. The problem with this number is it is a reflection of eating the food alone.... seldom do we eat a slice of bread or a baked potato and have nothing with it. Eating peanut butter on the bread or meat with a potato completel changes the effect on blood sugar. And, the effect on blood sugar probably doesn't have any effect on weight loss progress.

Now, if you are including carbs in your diet, you have lost the "ketone body" buildup and excretion which means you are losing much less in the way of water weight. If you still keep your carbohydrate intake reduced (with smaller portions and just one or two servings per meal) and you also reduce your portions of meat (6 ounces should be plenty), and skimp on fats (like added dressings, spreads, and oils) you will likely continue to lose weight because you will be taking in fewer calories than you were previously.

See this article for more information on glycemic index

Wednesday, August 5, 2009

Diet For Blood Pressure and Cholesterol

I just came from a doctor's appointment and was told to "watch what I eat" because I am getting borderline high blood pressure and high cholesterol. With all the conflicting information I never know what really is good to eat and good to stay away from ... do I need to stay away from salt? Should I eat oat bran muffins for my cholesterol? I'm quite confused. --Thanks, Tim J.

Dear Tim,

If your doctor didn't put you on medication for either your blood pressure or your cholesterol, there's a good chance you can affect both of these readings by changing your diet.

A low salt diet (about 2000 milligrams of sodium per day) does help lower blood pressure in some people, but not everyone. Surprisingly, most of the sodium we get in our diet comes from processed foods (frozen, packaged, and especially canned) and fast foods. So it doesn't mean you can never add a pinch of salt to season your food again. You'll have to start reading food labels for sodium content if you don't do this already. Aim for about 700 milligrams of sodium per meal (to total about 2000 per day) so you don't have to count and track every single milligram you eat all day.

A good resource for a reputable blood pressure-lowering diet is

For high levels of LDL (the 'bad' cholesterol) a diet high in soluble fiber helps many people lower their level by as much as 30 points. Oat bran muffins are one source, but the commercial varieties are often scant in oat bran and high in fat, cancelling out any of the benefits of the fiber. If you make your own you can use less oil and even substitute some of it with applesauce or other pureed fruits. Other good sources are oatmeal and oat-based cereals (such as Cheerios). You would need to have several servings a day of these foods, according to most studies, to see the cholesterol-lowering effects of dietary soluble fiber.

Lowering intake of dietary saturated fat also helps many people produce less cholesterol. This type of fat is mostly found in animal products, such as meats (especially fatty cuts, like marbled red meats, bacon, sausage, hot dogs), and whole milk dairy products. Coconut and Palm oil also contain saturated fats and are rarely used in commercial products anymore for this reason.

For lowering both cholesterol and blood pressure, getting closer to your ideal weight helps, and regular exercise helps you with all three of these goals!

Sunday, August 2, 2009

Can I Lose Weight On Meal Replacements?

I am trying to lose 20 pounds by mid-September for a physical I have to have while on the police force. I am 5'9" weighing 220 pounds. If I just get 10 or 15 off that would be great, too. What do you think about these meal replacements? Could I just have two meals and two meal replacements a day and get this much weight off in six weeks? Thanks, Ray S.

Dear Ray,
Yes, meal replacements are an effective means of weight loss. They work in several ways:

1) They are much lower in calories than most meals one would consume, providing generally between 100 and 250 calories.

2) They take away the decision-making that most people find so difficult on weight loss diets: There's no need to figure out what to eat, get confused and frustrated, and finally throw up your hands and head for the drive-thru. It's simple: "this is what you eat/drink; open/unwrap and consume".

3) It's a way of planning ahead, which is very important when trying to lose weight. You know you will have a particular item for breakfast, lunch, evening, and a particular meal for dinner--maybe it's 6 ounces of chicken and a cup of broccoli--there are usually explicit directions with the meal replacement diet on what you can have at your meal(s) of food.

4) It's convenient, prepackaged, and there's no measuring or weighing.

So even though some people may not always have their hunger satisfied on these programs, they are definitely easy to follow, and certainly cut your calories by as much as 2000 per day, allowing a generous four pound per week weight loss.

Always be sure to follow the safety directions whenever following any diet plan: contact your physician first to be sure this is a good idea for you; drink as much water as you are advised to on the plan; and definitely eat all the food/meal replacements you are advised to consume. Some people believe that by eating even less they will lose even faster, but these programs are specifically designed and tested for optimal results ... eating less will more likely have negative consequences such as slowing your metabolism or leading to a nutrient deficiency.

And finally, you may view this diet as a temporary means of weight loss if you don't think it's something you can live with long term. In this case, you will need to consider what you will do for your meal plan when you are ready to come off the diet.... how will you control your calorie intake, enjoy eating in restaurants, maintain the weight you've already lost? Maybe a diet coach is your answer to learning new eating habits you can live with and keep the weight off so you don't have to go on another diet next year!