Why Do I Feel Full After Eating a Small Amount?

I have a problem with getting too full very quickly even from eating a small amount of food. I don't have any digestive problems other than occasional constipation. But sometimes I skip a meal because I'm just not hungry, and when I feel hungry later I get full right away. I have been under a good deal of stress and wonder if this can be related?  Sonia C.

Dear Sonia,
Stress can certainly affect our appetites a great deal! Some people eat when they are stressed and others find they can barely eat all day. Still others lose their appetite when they are especially happy or excited.
If you notice you can eat fine when you're relaxed, but have a greatly diminished appetite when you're stressed, then it's likely due to stress. In this case, many people find it much easier to drink than to eat. Beverages like SlimFast and Carnation Instant Breakfast Drink are designed to be a meal replacement, providing a good deal of protein, vitamins, and minerals.

If you go several days without an appetite, or find you are losing weight because of it, do visit a physician just to rule out the possibility of a physical issue. There are many things that can cause these feelings called "early satiety" and they will often have a quick fix such as a simple antacid or a laxative. But only a qualified physician can diagnose your situation after a careful history and physical. It will probably put your mind at ease to visit your doctor just to be on the safe side.

Is Coca-cola Really Fattening?

Hi,
I am 15 years old and would like to lose a few pounds, but I drink  lot of coke. I figured out I can lose weight on 1200 calories, and I know going lower than that is not healthy. But if 300-400 of the calories are from coke, will that keep me from losing weight?
Jenny R.

Dear Jenny,

Three hundred to 400 calories of Coke is not more fattening than 300-400 calories of anything else. If you can lose weight on 1200 calories it doesn't really matter what composes those calories--it could be all fruits or it could be all ice cream and you would still lose the same amount of weight!

What does matter is the nutrition you're getting. The diet you have proposed has you getting 25-30 percent of your daily calories from COKE! The reason 1200 calories is a recommended minimum healthy diet is because it takes that many calories on a balanced diet to meet your needs for protein, essential fats, vitamins, and minerals. You won't be meeting your needs when only 800-900 calories is coming from food even if all those foods are highly nutritious.

I would suggest you try different ways to cut down your coke consumption, at least by half. Try using the smaller cans, substituting one can a day with another beverage, or mix half a coke with diet coke to cut the calorie and sugar intake. Not only will you be able to lose weight, but you'll probably reduce the number of cavities you get as well!

How Can I Gain Weight Without Drinking Supplements?

Hello,

I'm a 16 year old guy who is currently underweight. I am 5'2" tall and weigh 86 pounds. I am not an active person and do not excercise much. I've tried taking supplements before to gain weight but I dislike drinking them. As I would choose to eat healthily to gain muscle mass instead of drinking supplements, how much calorie must I take a day and what should I eat to gain weight healthily?
I usually have oatmeal and bread for breakfast, and  noodles or rice with meat and vegetables for lunch and dinner.
I look forward to your reply, thanks a lot!
-Sammi

Dear Sammi,
The number of calories you need depend on all sorts of things: I suspect you are still growing at your age and your body is using an increased number of calories to fuel that growth.

You have just a few options in order to ingest more calories: One is to add snacks to your diet, another is to eat larger portions of the foods you are currently eating, and a third is to add fat to your meals. A fourth healthy option is trying some high-calorie shakes or bars which can help you get in hundreds of calories quickly and eaisly. I wonder what kind of supplements you've had in the past, and whether you don't like the taste of them, or don't like the full feeling you may get after drinking them.

I would suggest starting with snacks. Many students do not have the opportunity to take a mid-morning snack, so let's start with afternoon and evening. Aim for 300 calories at each snack time to gain one pound per week. You can try an energy bar (like Clif bars), or some peanut butter on crackers or toast. Nuts are high in calories (almost 200 calories in just 1/4 cup) as well as dried fruit. Some of the tastier high-calorie drinks would be a milkshake or a Carnation Instant Breakfast (powder you add to your own milk that raises the calorie count to at least 250 if you use whole milk).

Next, try adding some fat to your meals: a spread on your toast (peanut butter, nutella, cream cheese) can add a hundred calories; butter on your noodles or rice adds about 100 calories per tablespoon; and you can have your vegetables stir-fried instead of steamed to add some more fat calories. If you're eating very little fat now, your total intake of fat should still be in line with the guidelines as long as you just add a little to each meal.

Another option is trying to eat a larger portion of the foods with calories, like oatmeal, toast, noodles, rice, and meats. Finally, fruit juice has a lot of calories, which people don't realize. Just 8 ounces usually provides a good amount of vitamins, but also 80 calories. If you can drink some more juice this might be an easy way for you to add another 100 or so calories each day.

For every 500 additional calories you can eat each day, you'll gain about a pound at the end of that week.
Good luck!

How Can I Break the Habit of Having Dessert after Dinner?

I have a question about the urge to continue eating after dinner. I enjoy a delicious, filling dinner but instead of feeling satisfied, I immediately feel the urge to eat more or devour a dessert. Is there a scientific reason for this? Or is it just the habit of eating dessert after dinner? Is there anything I can do to stop it? I'm thinking that chewing gum after my meal would help. Thank you for any information!  --Gina R.

Dear Gina,

Yes, this craving is likely a result of your body knowing you are in the habit of having dessert.
The craving is driven by hormones in your body signaling you "It's time to eat something sweet!" This urge can come from whatever is familiar that preceeds the dessert--even a feeling of fullness!

Take heart, it just takes a few weeks for your body to realize this is not a habit anymore and it should not expect dessert at this time. Meanwhile, distract yourself or find a miniature substitute. I usually grab a handful of cereal which satisfies the carb craving, leaves a sweet taste with me, and has less than 25 calories! If chewing gum helps you that is a great solution.

Does Vitamin B12 have to be injected, or are the pills good enough?

I am a nurse who was trained that vitamin B-12 (cyanocobalamin) had to be given parenterally or sublingually. However, I have seen bottles in stores of the tablet form of B-12. I wonder if they are even absorbed by the GI tract. Has there been new science showing it can now be absorbed in the GI tract? Thanks in advance, Dorothy.

Dear Dorothy,

Great question, and I'm happy to answer because vitamin B12 is hands down my favorite vitamin! It has such unique characteristics, including the way it is absorbed in the body.

First B12 must bind to intrinsic factor in the stomach, where the environment is acidic. If someone is missing intrinsic factor (if they had their stomach removed due to multiple polyps, severe bleeding ulcers, or cancer) they would not be able to absorb the vitamin orally. Likewise if the acidic environment were changed (and this happens when people age, as well as in people who take antacids regularly) the B vitamin would not be absorbed if taken orally.

Next this compound of intrinsic factor bound to B12 (which used to be called the "extrinsic factor") travels to the terminal ileum (the last part of the small intestine) which is where absorption takes place. If you have a patient who has ileal disease (like Crohn's disease) or had this part of their intestine removed, they would need shots of B12 because an oral source of B12 would not be absorbed into their system.

Vitamin B12 pills are helpful to those who have no problems in their digestive system affecting normal absorption of the vitamin. Since B12 is only found in animal products, it is recommended that vegans take a supplement. They can swallow a pill and absorb it just as most people can absorb the vitamin from foods.

If, however, someone is suffering from a B12 deficiency due to an alteration in the physiology of their stomach or small intestine, they do need to take the injectable form since an oral supplement will not be effectively absorbed.
I hope this clears it up for you!

I Have Trouble Digesting High Glycemic Index Foods

Dear Laurie,
I think I have carbohydrate intolerance. I have always eaten lots of breads and cereals, but always had bad gas and bloating, along with other symptoms.

Last week I cut out all carbs and I feel SO much better and even lost a pound!

Now I have discovered low glycemic carbs like yams and converted rice.
Can I eat these types of carbs, or in my case are ALL carbs bad-even the low glycemic ones?

Dear Bea,

Glycemic Index is a measure of how much blood sugar levels raise after eating a specific amount of carbohydrate food. There is no relationship between glycemic index and digestion.

What you may have is an intolerance to gluten, the protein found in wheat and some other grains. People who are allergic to gluten have symptoms as you have described: gas, bloating, abdominal discomfort, and diarrhea. The reason rice and potatoes do not cause distress is because they do not contain gluten.

I would suggest you see a gastroenterologist, or at least your family physician, for a thorough check-up. They can rule out any other conditions and provide you with a gluten free diet to try and see how you feel on it.
Find more information from this gastroenterology website on gluten free diets.

How Much Sugar Should You Have in a Day?

Are the sugars in ice cream, candy and soda the same as the white sugar that you put in your coffee or tea? (for consideration of overall daily sugar intake?) Also refined sugar, brown sugar? Should we count sugar in rice, bread, potatoes? I just don't want to go above the daily sugar intake recommendations.  Rochelle J.

Dear Rochelle,

Recent studies point to added sugars contributing to chronic diseases, now including heart disease. Eating too much sugar can cause weight gain, a rise in bad cholesterol level, a decrease in good cholesterol levels, and elevation of triglyceride level.

Sugars found in fruit or milk are not counted as "added" sugars. Nor are the carbohydrates from rice or wheat (although eating these without a limit can raise calorie intake and contribute to weight gain!). The added sugars provide calories with no nutrition. When you get sugar calories from fruit or milk you are getting nutrients along with them.

Sugar like white sugar in coffee, processed sugar in your cereal, brown sugar in baked goods, high fructose corn syrup in soda, candy, etc should be limited to 25 gm (100 calories) per day for women and twice that for men. (Men at a healthy weight generally can afford a higher calorie intake due to their larger size).