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.
Thursday, August 20, 2009
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.
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!
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.
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.
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.
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.
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.
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